Application programming interfaces (APIs) now rank among the most pivotal technologies shaping healthcare‘s digital transformation. By enabling seamless data connectivity between disparate systems, APIs can integrate isolated clinical, operational, and patient engagement platforms – unlocking unified intelligence.
During the pandemic‘s first waves, leading health systems raced to deploy API-based telehealth and remote monitoring systems to deliver care safely at a distance. However, looking beyond the crisis, much more foundational and multifaceted use cases now appear poised for exponential growth.
This article reviews the current landscape, projections, and opportunities across key API adoption drivers – alongside expert recommendations for health IT strategists navigating pivots.
The Growth Trajectory of Healthcare APIs
In a recent survey, 58% of healthcare CIOs ranked improving data liquidity among their top investment priorities – a 14% increase over 2021 results [1]. Since APIs serve as the primary vehicle for driving interoperability enhancing data flows, surging strategic interest foreshadows accelerating adoption curves ahead.
Multiple market research firms back up shifting attitudes with hard projection data:
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By 2026, the global healthcare API market will reach $3.3B, expanding at a 13% CAGR [2].
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In the US, nearly $2B will be spent on API management technologies alone by 2025 [3].
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Overall, 97% of healthcare organizations now use, plan to use, or show interest in APIs according to a Spok survey [4].
This data punctuates healthcare‘s growing realization that legacy point-to-point interfaces and stale reporting paradigms cannot provide intelligence needed to succeed with value-based care (VBC) reimbursement models and preventive health optimization goals.
While crisis-born telehealth and remote monitoring use cases likely fueled recent upticks, underlying needs remain consistent: healthcare organizations urgently require data liquidity to contextualize delivery patterns, expose outcome drivers, orchestrate interventions across settings, and engage consumers – with APIs increasingly powering this critical connectivity.
Key API Adoption Drivers in Healthcare
In 2022, Gartner positioned APIs as "essential ways to unleash trapped value" – a sentiment undoubtedly resonating for many healthcare CIOs [5]. The leading drivers fueling API adoption momentum focus squarely on releasing value rather than merely implementing shiny new capabilities:
1. Unlocking Data Silos
A typical health system utilizes 970 unique applications, with larger systems averaging closer to 1500 across medical, operational, financial, and engagement functions [6]. While essential, this multifaceted application stack also complicates compiling integrated intelligence – since key data stores remain isolated in electronic health record (EHR), claims management, supply chain, and other niche systems.
APIs allow aggregating these disparate datasets to form enriched analytical repositories where AI/ML can uncover optimization opportunities impossible to spot within individual silos. And open or public APIs also increasingly let healthcare organizations tap useful external data sources – including social determinants of health (SDOH) indicators from community organizations or genomics research databases.
2. Enhancing Patient Experiences
Today‘s digitally-savvy healthcare consumers expect on-demand access to their medical records, ability to schedule appointments 24/7, fast customer support, and regular engagement driving healthy behaviors.
Exposing patient portal, medical advice, chronic disease tracking, and preventative screening functionality via APIs allows partnering with consumer application developers to meet rising experience expectations – without overburdening internal IT resources.
3. Optimizing Operational Efficiency
Many administrative functions spanning staff scheduling, bed management, and supply coordination rely on high degrees of interteam collaboration. However, coordinating efforts across many niche point solutions leads teams to lean heavily on manual efforts including emails, calls, and messages.
Launching workflow APIs fosters connecting these systems to raise automation and reduce friction. Resulting productivity gains free up more time for patient interaction and higher-value strategic initiatives for staff.
4. Participating in Emerging Data Networks
Motivated by past interoperability struggles, recent policies and healthcare coalitions emphasize aligning standards and defining minimum viable datasets to support multicenter analytics objectives.
Payment programs judged by comprehensive outcome metrics along with computational drug discoveries demand aggregating robust national datasets – with standard APIs often the vehicle for submitting, accessing, and analyzing expansive federated repositories.
While most healthcare organizations already maintain some APIs today, few leverage the technology pervasively and strategically enough to unleash the full transformational potential suggested above. However, based on growth plans, healthcare now approaches an API tipping point promising accelerated change ahead.
API Adoption Trends by Numbers
Recent research and market reports reveal detailed API adoption trends across US healthcare:
- 52% of hospitals and 38% of health plans currently use APIs, with an additional 37% of hospitals and 58% of plans reporting plans to adopt APIs within three years [7].
- The top API use cases for payers include member engagement portals (68%), connecting wearables data (44%), and provider directory look-ups (41%) [7].
- Leading API use cases for hospitals encompass patient health records (73%), medical device integration (55%), and payer information checks (51%) [7].
- By exposing protected health information (PHI), 89% of payer and 58% of provider APIs must comply with HIPAA regulations – highlighting the criticality of security controls and access governance [7].
- A 2022 ONC report spotted a 130% year-over-year increase in the number of hospitals capable of using the FHIR specification for API-based health data exchange [8].
The upwards adoption momentum across hospital systems and health insurers punctuates how APIs now emerge as a universal connectivity fabric enabling digital maturity.
Expert Predictions on Healthcare APIs: 3 Major Changes Ahead
Afterfollowing healthcare API trends closely over the past several years and discussing adoption drivers with over 50 prominent provider IT executives, I anticipate three pivotal advances:
Prediction 1: Core Infrastructure Will Increasingly Shift to Cloud-Based API Platforms
Up to this point, early API efforts mainly focused on simple interfaces allowing mobile application connectivity into existing on-premise EHR systems. However, true enterprise-wide API success requires robust management surrounding security, orchestration, analytics, and developer engagement.
Purpose-built cloud platforms like Azure API for FHIR, AWS Health API, and Google Healthcare API provide these essential capabilities without requiring complex layered architectures. As a result, hybrid cloud will become the dominant deployment paradigm with cloud API gateways securely interconnecting legacy systems.
Prediction 2: APIs Will Play an Essential Role in Healthcare Data Network Emergence
Single-system datasets no longer provide sufficient statistical power for many emerging analytics use cases. However, connecting islands of clinical data across competing providers to fuel pilots remains challenging due to sluggish and brittle interfaces.
APIs adopting standard vocabularies like FHIR increasingly show potential to overcome these limitations. I expect measurable growth in multi-party data collaboratives with APIs facilitating systematic exchange. Successful programs will then become integral to risk-bearing contracts and computational research.
Prediction 3: Adoption Will Accelerate Among Payers Over Next Two Years
Payers traditionally lagged providers in digital health capabilities, but closing gaps have become an urgent strategic priority with value-based payer models gaining traction and consumers demanding tools to navigate choices.
I expect payer API adoption for use cases like member engagement, personalized benefits apps, and device connectivity to markedly outpace providers over the next two years – as payers seek differentiated services attracting subscription-based consumers.
Top API Use Cases Powering Healthcare Innovation
While API capabilities now permeate nearly all software applications to some degree, specialized use cases at the intersection of critical system domains generate an outsized transformational impact:
Prescription and Pharmacy Data Sharing
Exchange of prescription instructions, refill approvals, medication cost estimates, and pharmacy benefit coverage details between apps patients actually utilize and provider-systems-of-record remain highly manual. However, smooth interoperability here proves essential for access and adherence.
Retail pharmacy players like Walgreens, CVS, and Walmart maintain public APIs allowing third-party apps to give consumers control over their medication profile – including transferring prescriptions between locations and opting into automatic refills.
As prescription costs and restrictions receive increasing scrutiny, these pharmacy connectivity APIs may provide vital infrastructure ensuring continuity of supplies.
Remote Patient Monitoring and Smart Devices
Chronic diseases drive over 75% of national healthcare spend annually [9]. As a result, CMS actively incentivizes remote monitoring for hypertension, diabetes, and heart failure through various reimbursement programs – expecting enrolled implementation programs to demonstrate sustained outcome improvements.
Success at population scale hinges on seamless data flows from patient devices. Multiple startups now focus explicitly on building smart RPM APIs taking real-time vitals signals and establishing connectivity into major EHR environments to trigger clinical interventions.
Unlocking Genomic Sequencing Insights
While costs no longer prohibit genomic sequencing, successfully leveraging results to guide cancer treatments or cardiovascular risk management remains challenging since molecular data outputs do not easily map to structured EHR fields.
However, Orpheus Health and other pioneers now provide Genomics APIs capable of taking gene test inputs and translating identified variants into actionable clinical decision support content using comprehensive mapping databases.
Secure Data Sharing Across Research Institutions
The NIH, clinical trial sponsors, and computational drug discovery firms advocate increased data sharing across institutions to enhance statistical power and generalizability for modern research questions leveraging ML techniques.
But questions on ownership, privacy, provenance, and control still impede open analytics. Datavant and other Health Data Exchanges instead allow distributed de-identified query capabilities using an architecture with data APIs facilitating tight access control.
Real-World Evidence and Post-Market Surveillance
Scrutiny surrounding actual efficacy in clinical practice compared to trial findings continues growing – especially as personalized medicine expands. However, compiling robust views across different records systems to truly understand treatment responses at population levels rarely proves straightforward.
Standard APIs serve central roles in real-world data capture allowing pharma companies, payers, and regulators to accurately quantify outcomes – without requiring massive data centralization likely triggering additional privacy concerns.
In coming years, business leaders must follow not just healthcare policy but specifically the API standards and data sharing initiatives now quietly laying critical technical foundations allowing delivery model transformations.
Recommendations for Healthcare IT Strategists
Technology buyers and IT strategists should take the following actions in response to accelerating API momentum:
Providers: Make interoperability and data integration pivotal decision factors for any new systems – while launching a formal API program office to coordinate build vs buy vs adopt choices from an enterprise architecture perspective.
Payers: Prioritize member engagement portal and benefit apps connectivity in upcoming IT roadmaps. Additionally evaluate potential for leveraging device APIs if exploring value-based contracts centered on behavior change.
Biopharma Firms: Develop explicit data strategy blueprints tracking developments in clinical data interoperability and real world evidence standards to prepare for greater transparency demands ahead.
Policy Makers: Incent further healthcare data harmonization efforts by tying reimbursement rates to data sharing and reporting on standardized quality or risk metrics dependent on robust data aggregation capabilities.
Proactive planning measures like those above will equip organizations to extract maximum value from the coming wave of healthcare API proliferation while minimizing architectural mismatch risks that could emerge as adoption accelerates.
Overcoming Continued Barriers Impeding Adoption
Despite upbeat adoption trends and future outlooks, lingering challenges still slow mainstream API penetration at many healthcare organizations.
Cybersecurity and Compliance Hurdles
Network-exposed APIs create new attack surfaces vulnerable to data exfiltration attacks if robust identity, access, encryption and activity monitoring controls fail to stand up. HIPAA and other regulations create complex compliance demands spanning governance processes like vendor management, privacy reviews and breach preparedness.
Addressing elevated security risks requires investments in API gateways and API security testing tools conducting vulnerability scans and penetration tests against production interfaces.
MongoDB Data Models Complicate Migration
Unlike the row and column relational constructs common in legacy clinical databases, EHR systems leveraging NoSQL MongoDB architectures store data in schema-less JSON documents having custom nested structures.
This complicates lifting coherent extracts into AI training sets or analytics engines expecting tidy tabular feeds. Refactoring unstructured outputs into analysis-ready sets remains labor-intensive.
Loosely Coupled Microservices Enable Customization But Complicate Interoperability
Microservices encourage innovative application development by exposing modular API-based services making it easy to swap algorithm implementations. However, this architectural approach relies on strong API governance practices around versioning and change management policies to avoid systemwide fragility or impaired interoperability.
While clinical, claims and operational data sources will assuredly never consolidate into a monolithic single platform – organizations must work to cultivate consistency and stability across internal microservices – likely by forming communities of practice around shared data domain needs.
Key Takeaways and Predictions
APIs now rapidly transition from a healthcare buzzword to foundational digital infrastructure underpinning system interoperability, experience optimization and next-generation analytics activation.
Recent growth trajectories leave little doubt that APIs will continue permeating healthcare technology stacks over coming years as catalysts unleashing trapped value. By embracing and preparing for acceleration, health IT leaders can extract maximum benefits from the coming proliferation.
Specific developments I‘ll be tracking closely include:
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The emergence of specialized healthcare API platforms rivaling general enterprise iPaaS offerings by delivering tailored toolkits addressing access control, data mapping, ML activation, genomic analytics and other unique demands.
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A shakeout of FHIR API gateway vendors as platforms mature around core feature depth, developer experience, and integration acceleration capabilities. Open source FHIR Server FOSS efforts will continue but stall short of disrupting commercial vendor growth.
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Clarification from regulators and accreditors around exactly how API security controls will factor into ongoing compliance assessments. Expect shifts toward emphasizing attack surface management, penetration testing rigor and controls transparency.
Already APIs fuel an array of point initiatives optimizing discrete workflows. However, the most transformative healthcare delivery model innovations will stem from leveraging API interconnectivity in orchestrating entire stakeholder journeys across engagement channels, care settings and bridges uniting clinical understanding with individual behaviors and preferences.
References
- 2022 Healthcare IT Priorities, Vyne Medical
- Healthcare API Global Market Report 2022, Research & Markets
- US Healthcare API Management Market, Frost & Sullivan
- 2021 API Sentiment Survey, Spok Inc
- Hype Cycle for Application Services, Gartner
- Definitive Healthcare Hospital Tracker
- 2021 CAQH Index Report
- ONC‘s Report to Congress, 2022
- Medical Cost Trend 2021 Report
