Hospital adoption of API-enabled patient data access

Abstract

Despite a decade of progress in digitization of the U.S. health care system via electronic health record (EHR) adoption,(1) patient access to their own health data remains a challenge (2). Recent policy efforts have prioritized patient access to EHR data via application programming interfaces (APIs).(3, 4) APIs use standards to connect third-party software, including mobile applications like Apple HealthKit (5), to EHRs for easy transmission of data.(6) APIs can enable patients to download their data from the EHR and choose which applications can access that data. APIs may also facilitate bi-directional exchange of data between health care organizations, allow patients to contribute data into their provider’s EHR system, and allow patients to aggregate their data from multiple EHR systems into a single record.(7) Given the low level of interoperable data sharing(8) and ongoing concerns over “information blocking” (4, 9) in hospitals, enabling access to data via APIs may facilitate a “leap forward” in electronic patient data exchange. Establishing an infrastructure where developers can leverage accessible EHR data to bring innovative new products to patients is an important step in moving towards a patient-centered and connected health care system. Since APIs are a new technology in health care, little is known about hospital adoption of API-enabled patient data access. We sought to determine the extent of patient API access in US hospitals, and whether hospitals varied in their API access adoption by organizational characteristics and EHR vendor. Our results provide an important baseline for both policymakers crafting regulations for patient access to health data as well as application developers looking to create new technologies leveraging EHR data.