Advocating for an API-led Approach to Healthcare Data Sharing

How have you and your clients reacted to the federal interoperability and patient access final rules? What has some of the initial feedback been? MuleSoft and Salesforce broadly have been advocating for an API-led approach to healthcare data sharing for some time. There is an enhanced level of security and the speed of sharing capabilities available with this approach, and even before the new rules came out, we’ve seen healthcare providers and payers accomplish some pretty ambitious use cases to provide real-time digital services to patients and physicians alike. When the final rules did come

out, we knew adhering to these new API rules would require a significant amount of work for many healthcare providers and payers who were still heavily reli- ant in point-to-point, HL7 V2-heavy approaches to clinical data shar- ing. With our Accelerator for Healthcare, we’ve templatized a number of the new FHIR-based requirements outlined in the final rules to help reduce this burden and safely provide our customers with the tools needed to support healthcare interoperability.

On the vendor front, what are the biggest challenges when it comes to complying? How about for providers? While many challenges exist, API secu- rity and full-scale visibility are probably two of the more important elements of adhering to the new rules that are unfor- tunately going overlooked. There are many shortcuts to exposing these new FHIR-based APIs, but the patient data being exposed needs to be secured, and needs to have the right monitoring capa- bilities in place to prevent unauthorized entities from gaining access to patient

records. Having robust security and monitoring safeguards must be consid- ered paramount before embarking on the actual API design elements.

How would you characterize the industry’s interoperability maturity today? On a 1 to 10 scale, where do the majority of organizations lie? It’s tough to say across the board. Most healthcare organizations have dabbled in FHIR for some time, but they might only have a few applications that are live. Some of the more advanced

healthcare entities have been lever- aging FHIR APIs and SMART on FHIR capabilities for years, and may be well ahead of the interop- erability curve. But I’d say most are still relatively early on their interoperability journeys. On the bright side, these new

rules provide IT teams with a fresh opportunity to review their inte- gration and patient data strategy holistically to determine how best to setup a future-proof architecture to best support current and matur- ing interoperability needs.

From a broader healthcare interoperability perspective, what are the core barriers to achieving industry-wide success, and what are some possible solutions? Patience, sharing best practices and understanding that there is no one- size-fits-all approach to success. Each healthcare organization has their own IT systems, many are heavily custom- ized, and even with the growing stan- dardization of FHIR R4 itself, it’s still a maturing standard. Having a healthcare IT ecosystem that can share best practices and support common patterns of secure patient data sharing will go a long way in accelerating interoperability broadly.

How has the pandemic accelerated the need for greater data access and data sharing, in your view? Organizations that have embraced API-led methodology early have been able to respond to the pandemic chal- lenges more quickly. Providing real-time patient results, automation services to reduce manual tasks, helping to redirect resources to sites in need, all the way to contact tracing efforts. IT delivery time- lines that would normally take months are being done in weeks and days, and it’s making a significant difference in the responsiveness of healthcare entities sup- porting patients in need.

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