If the proposed Stage 3 Meaningful Use rule is finalized in its current form, application programming interfaces (APIs) could supplant portals as the preferred method adopted by providers to enable patients to “view, download and transmit” their health information.

“APIs may be enabled by a provider to provide the patient with access to their health information through a third-party application with more flexibility than often found in many current patient portals,” states the proposed rule. “From the provider perspective, using this option would mean the provider would not be required to separately purchase or implement a patient portal, nor would they need to implement or purchase a separate mechanism to provide the secure download and transmit functions for their patients because the API would provide the patient the ability to download or transmit their health information to a third party.”

Under the proposed Stage 3 rule, if providers elect to implement an API they would only need to fully enable the API functionality, provide patients with detailed instructions on how to authenticate, and provide supplemental information on available applications which leverage the API. And, there are potentially significant advantages for patients as well.

“From the patient perspective, an API enabled by a provider will empower the patient to receive information from their provider in the manner that is most valuable to that particular patient,” states the proposed rule. “Patients would be able to collect their health information from multiple providers and potentially incorporate all of their health information into a single portal, application, program, or other software. We also believe that provider-enabled APIs allow patients to control the manner in which they receive their health information while still ensuring the interoperability of data across platforms.”

At the same time the Centers for Medicare and Medicaid Services released its proposed Stage 3 rule last month, the Office of the National Coordinator for Health IT proposed its 2015 Edition HIT certification criteria establishing the capabilities and related standards and implementation specifications for certified electronic health record technology (CEHRT). ONC’s proposed certification rule would establish API criteria to enable patients—through a third-party application—to pull certain components of their unique health data directly from the provider’s CEHRT, and potentially could—on demand—pull such information from multiple providers caring for a patient.

Also See: ONC Expanding HIT Certification Beyond Meaningful Use

“The point of doing the APIs is to spur innovation and make the data more accessible so that folks can innovate around providing patients with the ability to view, download and transmit data,” Jodi Daniel, director of ONC’s Office of Policy, told Health Data Management at HIMSS15 last week. “Presumably, APIs could also make it easier for providers if there are good tools that are developed.”

The proposed Stage 3 rule encourages health IT developers to leverage existing API platforms and applications to allow providers no-cost, or low-cost solutions to implement and enable an API as part of their CEHRT systems. Specifically, a proposed Stage 3 objective is to have eligible professionals and hospitals provide access for patients to view online, download, and transmit their health information, or retrieve their health information through an API, within 24 hours of its availability.

“When you see that kind of innovation that’s focused more on what an individual is looking for, I think you’ll also see more folks using that data and demanding the data because it will be in a tool that’s actually helpful,” argues Daniel.

Erica Galvez, ONC’s interoperability and exchange portfolio manager, is similarly critical of patient portals. “People may not be using portals, not because they don’t want portals or they don’t want their data but because a lot of them aren’t useful—at least at this point in time,” added Galvez.

“The requirement is view, download and transmit. The requirement is not a portal, but that is how it’s currently being implemented [in Stage 2] because the vendors are basically saying ‘I can solve this problem for you. Here it is—it’s a portal,’” said Daniel. However, APIs have the potential to “provide the data and present the information in a way that is helpful, useful, accessible and connected for a patient,” she concluded.

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