Patients Need Further Knowledge on APIs, Mobile Apps

By Christopher Jason

November 30, 2020 - Stakeholders reported consumers have limited knowledge of available application programming interfaces (APIs) and mobile phone applications that enable patients to coordinate their care through a third-party app, according to a new Office of the National Coordinator for Health IT (ONC) report. ONC facilitated a discussion with health IT stakeholders about their respective costumers’ experiences and the future of patient-facing APIs and applications.

Although EHR adoption is becoming more widespread throughout the healthcare industry, interoperability and patient data sharing are still struggles for providers.

As a result, the ONC final rule takes a hard stance on information blocking. It also calls on medical providers and device developers to promote patient data access using third-party apps and APIs.

ONC proposed to adopt the HL7 Fast Healthcare Interoperability Resources (FHIR) standard as a foundational standard and requested comment on four options to determine the best version of FHIR to adopt.

Ultimately, ONC adopted FHIR Release 4.

“The advantage in the API enabled app world is the patients have their data, then they decide if they want it to be used for research or other purposes they may want, as opposed to finding an efficient way for patients to consent for data to be used by researchers,” explained ONC.

To boost patient care while also improving scientific discovery through EHRs, standardized methods to increase exchange through separate health IT systems and mobile apps are a must.

Along with reducing the amount of time that consumers spend obtaining their respective data, stakeholders defined four key characteristics that app developers should focus on:

• Interoperable
• Detailed
• Accurate
• Timely

Stakeholders said developers need to combine data from consumers, EHRs, and claims to standardize this data to make it interoperable.

“In the future, participants can be the conduit [for all data sources] and there will be one comprehensive record,” said an anonymous participant.

Next, developers should provide detailed information to keep the individual interested in the application. This detailed information will educate and provide context to the user.

“The information in your patient portal is like a ‘connect-the-dots,’ where you don’t know what it is,” said a stakeholder. “Notes fill in the context and promote trust and deepen relationships with providers.”

The data needs to be accurate to maintain and further trust between the consumer, the provider, and the developer. Keeping the data free from errors and potential omissions is crucial for developers.

“In a lab, the microphone is 90% predictive of Parkinson’s, but in the real world, your dog is barking,” explained an anonymous respondent. “For a thermometer reading of 101 degrees, it’s not the value but the trend that can matter.”

Lastly, the data needs to be as up-to-date as possible to maintain that it’s actionable and meaningful to the user. Real-time data provides more value than a regular healthcare visit.

“I looked at Apple Health, and I can see my weight and blood pressure, but I have more access to blood pressure from my home health devices, as compared to the readings from my twice-a-year doctor’s appointments,” an anonymous stakeholder said.

To increase API or application awareness to individuals, stakeholders recommended targeted marketing approaches and communication or outreach from trusted health organizations. Respondents worried a healthy individual might not be motivated or interested in using a real-time data application.

Stakeholders also said individuals might have concerns about reusing and selling data and developers need to communicate privacy and security to their users.

“There is no monolithic patient,” ONC wrote. “Everyone has their own privacy and security preferences, and they can change every time the perceived risks and experience[s] are different. Patients need to be able to change their mind[s] when their situation changes, and the risks of the downstream use of that data outweigh the benefit of immediate access.”

Overall, individuals lack awareness of APIs and applications, and stakeholders emphasized transparency and marketing from developers.

“Tools from reputable research and advocacy organizations were perceived as more trustworthy than those from less well-known apps developers with unproven sustainability models and little evidence of providing value back to the consumers and communities supplying their personal data,” wrote ONC.