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Increasing Collaboration in Today’s Value-Based World

Patient viewing her healthcare information online

Massive changes in healthcare delivery, regulation and payment models are creating a shift in how healthcare organizations (HCOs) use technology. Historically, little incentive existed to encourage collaboration or data sharing due to a more traditional fee-for-service model, which resulted in silos of data and HCOs suffering from a lack of interoperability.

New value-based payment models incentivize payers and providers to work together to improve patient outcomes, provide the highest quality care, lower costs and better engage patients. They must manage patients across the care continuum, keeping them as healthy as possible, to achieve the best outcomes at the lowest costs.

But this newfound need to collaborate to achieve such goals has put pressure on healthcare’s communication technologies. Since communication among patients, payers and providers served the transactional nature of the fee-for-service payment model, messaging of data was often – and in some organizations still is – complicated and inflexible.

But things are evolving.

The key for this collaborative success is having a solid application programming interface (API) strategy. Just as value-based payment models are new to healthcare, so are APIs. Many new population health and care management applications are emerging, but are somewhat limited due to their access to pertinent healthcare data; they must use the existing Health Level 7 (HL7) messages, as software vendors are just now introducing APIs. Traditional applications need to be modernized due to the inherent value of the data that is stored in them. APIs allow HCOs integrate these applications to ensure data is made readily available while participating in a new economy of collaboration with stringent security controls.

What Is an API?

Over the years, standards and rules have been created to help manage and decipher the data being exchanged among patients, providers and payers, including in meaningful use regulations. And the technology itself has risen to help better facilitate collaboration with a new level of application that can integrate across silos in healthcare.

This resource –APIs – is a broad, longitudinal solution that operates on top of healthcare’s transactional systems.

APIs act as a bridge between applications that may not be programmed to communicate with each other by facilitating the flow of data between applications. Used in conjunction with modern development platforms, they allow organizations to easily deploy and scale.

The technology makes collaborative communication simpler and faster. As such, APIs can pull and push information and provide querying capabilities. Additionally, they can be used to securely connect critical information from disparate systems and devices as well as between patients, providers, payers and various applications in real time.

How Do APIs Help HCOs?

Some of the opportunities APIs make possible include:

  • Integrating internal or external data sources
  • Avoiding a rip and replace and maintaining existing systems across enterprises
  • Enhancing resource management and improving patient throughput
  • Merging population health and care management activities and processes seamlessly
  • Facilitating patient engagement through functions that support interactions as well as view, download and transmit activities
  • Simplifying clinical disruption through broadened application function to support such things as workflows
  • Standardizing attached devices to facilitate better use and decision making whether the attached device is at the bedside or at home

A solid API strategy depends on having an open technology platform for multifaceted integration that provides security, flexibility, re-usability, scalability and the governance to manage all the APIs. The types of systems that need to be integrated and exposed through APIs are changing and endpoints are growing dramatically due to the progression of smart devices and wearables. Therefore, it is important to leverage an API platform that is thriving in terms of community participation. Fully supported open source platforms provide the best infrastructure to leverage an API platform that has a strong ecosystem.

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