Enabling Patient Access to Health Records and Enhancing Patient Experience and Engagement Drive Early Adoption of Patient-Facing APIs

Approaches and Barriers to Implementation Vary, UCSF Study Also Finds

Ten health systems known for early adoption of health technology recently shared their priorities, experiences, and barriers in implementing patient-facing application programming interfaces (APIs) that facilitate patient access to their health data. A research team at the University of California, San Francisco found common motivation and enthusiasm across health systems for using APIs to share health data with patients and their health apps, but uncovered differences in strategy, approach and barriers to adoption. These early insights will be imminently published in the Journal of Medical Internet Research and are available in pre-print here.

Eight of the ten health systems involved in the study currently have patient-facing APIs in operation and two are actively planning for implementation. Of those with active APIs in place, five organizations have a specific, defined strategy supporting both implementation and governance for patient-facing APIs. The other three have a general strategy in place.Factors shaping strategy include federal policy requiring that patients can access and use their health data through patient facing APIs, the ability for patients to download their health record data to Health Records on Apple iPhones, and the belief within the surveyed health systems that they have an ethical obligation to provide patients better access to their information.

A majority of the organizations cited that their patient-facing API efforts are driven by the desire to enable patients to create a longitudinal health record integrating information from multiple providers as well as payers. Four of the ten also expressed the importance of meeting patient expectations and enhancing patients’ digital experience and engagement with the health system with features like telehealth and the self-scheduling of appointments.

Privacy and security concerns were the most frequently mentioned barrier to implementation. This was couple with a belief that while patients have a right to their data, more work needs to be done to both screen apps and educate patients on how to evaluate app security for themselves. Insufficient app functionality, the unwillingness of vendors to shared data outside or their system, and the lack of API and semantic standards were also cited as problems.

The results of the study underscore the call for national regulation for the interoperability of health information by the Office of the National Coordinator (ONC) for Health Information Technology at the U.S. Department of Health and Human Services (HHS). The ONC and the Centers for Medicare and Medicaid Services (CMS) have stipulated that Medicare and Medicaid providers must give patients and their apps electronic access to their health data through patient-facing APIs since January 1, 2019; however, guidelines for interoperability are still forthcoming.