Medical APIs to create a custom EHR

[ReynaldoBrowning]

Yalantis’ experience integrating a third-party EHR 

We had to enable the Healthfully app to exchange personally identifiable information, PHI, and information on doctor appointments with a third-party EHR system used by a partner organization. To do this, we needed to ensure smooth data transfer within HIPAA-compliant environments.

The EHR system used by our client’s partner organization is on-premises/cloud-based software that provides different communication interfaces for third-party integration partners depending on the contract agreement. For Healthfully, two interfaces were available: an HTTP RPC-based API interface and an HL7 layer, each serving specific purposes. 

Here are the main EHR integration challenges we faced and the solutions we used to properly integrate with the EHR: 

Securing network communication between Healthfully and the EHR system. We established a secure VPN tunnel, connecting a hardware-driven IPSec VPN gateway on the client side with a virtual software-based VPN gateway on the Healthfully side using a software appliance (Openswan/Libreswan).

Implementing the HL7 messages processing layer. We integrated with the HL7 messages interface by implementing proxy software within the Healthfully infrastructure. This software converts XML-based data into the HL7 format accepted by the EHR system and vice versa. 

Implementing an RPC API processing layer. We implemented several abstraction layers on the Healthfully side. To do that, we separated the business-level architecture from specific communication data specifications used by the EHR system. This API strategy has had significant results:

1. Developers can focus on the app logic rather than on dealing with the third-party data format and data flow specifics.
2. Healthfully can easily onboard new partners with their own EHR systems. This allows Healthfully to focus on developing new communication adapters for every specific EHR system while retaining common business logic across organizations.

We used the same modular approach to successfully implement all third-party integrations within the Healthfully app, including payments and a telemedicine solution.

APIs have helped developers with sending, retrieving, and processing data. But as you can see from our EHR integration API experience, APIs alone can’t solve all the technological issues and lack of data standards in the industry. But it seems like a light has appeared at the end of the tunnel.

What the future holds for healthcare interoperability: How APIs keep disrupting the industry  

This spring was marked by an optimistic outlook for the healthcare industry and software developers when the US Department of Health and Human Services released its final rules regarding interoperability, data sharing, and patient access. 

Implementation of a Patient Access API

Starting in 2021, Medicare Advantage, Medicaid, the Children’s Health Insurance Program, and plans participating in the federal exchanges will have to support a standardized API (HL7 FHIR version 4.0.1). This API will help patients access claims and their clinical data via any third-party app they choose. This API might also be used to integrate a health plan’s data into a patient’s EHR. 

Adoption of a Provider Directory API by CMS-regulated payers

The adoption in 2021 of a Provider Directory API among CMS-regulated payers also promises to benefit developers and the healthcare industry as a whole. This API is tailored at helping third-party app developers provide patients with a variety of healthcare providers to choose from. The Provider Directory API will enable healthcare providers to find other providers for coordinating patients’ treatment. 

This unified standard will significantly simplify developers’ work as they’ll no longer have to adjust their software solutions for different CMS-regulated payers.

These US government initiatives are likely to enable app developers to provide healthcare consumers with the same top-notch experience they already have managing their finances, travel, and shopping. The most exciting part of the history of APIs and medical innovation is yet to come, but mature modern medicine software providers are already experienced and brave enough to solve any integration challenge.

Read the full blog post here.

Edited March 5, 2021 by ReynaldoBrowning

[Deemer Walton]

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