A new report from Chilmark suggests that while enthusiasm for APIs and datasharing is widespread throughout healthcare organizations, there is still uncertainty about who will make the first move and how APIs will get off the ground. The research firm spoke to 24 individuals from 15 organizations representing hospitals, payers, and large and small health IT vendors.
"Small healthcare organizations are waiting for large healthcare organizations to establish that API programs offer a path to applications that better support their goals," Chilmark analyst Brian Murphy writes in the report. "There is also a broad recognition that even large healthcare organizations may not have the resources or the time to invest in building the infrastructure that can unlock the value of open APIs. They need HIT vendors, and particularly the largest EHR vendors, to blaze the trail. The largest HIT vendors can do the industry a service if they can make APIs a bit more plug-and-play and a bit less massive IT project for healthcare organizations."
While most stakeholders agreed that leadership would come from large vendors, Murphy says a "vocal minority" wants to see innovation come from outside the system, from nontraditional healthcare players like Apple, IBM-Watson, or Google.
"In part this belief is based on widespread dissatisfaction with the current state of HIT applications and the track record of innovation from large healthcare organizations and HIT vendors," he writes. "In general, respondents in close contact with or part of the clinician user community were more inclined to express 'blow up the system' sentiments. Some also point out that technology that originates in 'Innovation Centers' at large health systems and academic medical centers is not actually used by those same large players."
The disagreements in the Chilmark report don't end with who will lead on APIs, but with the simple question of what different stakeholders want APIs to achieve; what problems they want to solve. Some believe that they have to be aimed at solving the problems of providers while others believe they will be most valuable as patient-facing tools. Even within the realm of provider-facing tools, some see the largest benefit in the direct improvement of care (giving doctors access to information they wouldn't otherwise have) while others think streamlining workflows and removing inefficiencies is the biggest promise.
Funding is also a big question. Generally, Chilmark interviewees didn't think patients or consumers were much inclined to pay for apps or for data access, but weren't sure who would -- maybe healthcare organizations, if they could demonstrate the value upfront. One vendor who works for a data integrator put it colorfully, telling Chilmark "[Hospitals are] just not at that stage that [device-generated] data is something that they’re willing to pay for. You know, it’s like charging for the fuel that’s going to power the jetpack I will have one day. Until I have my jetpack I don’t want to pay.”
The diversity of opinions on so many topics means that in many ways the Chilmark report raises more questions than it answers. But the report ends with a call to action, encouraging healthcare stakeholders to get the ball rolling in any way they can.
"Every healthcare stakeholder wants a diverse and vibrant application marketplace for clinicians, patients, and others," Murphy writes. "Most believe that open APIs are the linchpin to making it happen. But most recognize that API programs will have to deliver benefits to provider and patient. These benefits – whether financial or health status – will have to be so clear that it becomes irresponsible not to take advantage of APIs."