HIE.Next: Building an API-centric Infrastructure for Health Information Exchange

The Health Information Exchange (HIE) landscape is perhaps more diverse today than it’s ever been.  Since the winddown of federal HITECH funds several years ago, HIEs have had to become more creative, nimble, and responsive to the unique needs of their service area in order to thrive. 

So how do HIEs, health systems, and other like-minded organizations go about freeing the valuable data they hold?   Regardless of an HIE’s business model or service offering, the answer may be APIs. 

CRISP Case Study

Leap Orbit recently led its client CRISP, a regional HIE supporting Maryland, West Virginia, and the District of Columbia, through a multi-year transition to an API-based infrastructure.   This work was envisioned as part of Maryland’s plan to modernize it’s unique “all-payer model,” for which it receives broad waivers from national CMS rules.

With the underpinnings of the technology updated with an API Gateway, CRISP is now empowered to begin serving up data for a host of new innovative use cases.  The initial three they’ve started with are as follows:    

1)     In-Context Alerts:  Delivery of data such as PDMP, care alerts, overdose alerts, provider and care management attribution, recent encounters, public health alerts, and news directly into a             provider’s EHR workflow.  

2)     CCDA Federator:  Compiles CCDAs from a range of sources, including local data contributors and national networks, such as Carequality.

3)     Discrete Data APIs:  Enables customers to query the HIE for discrete types of data such as medications and attribution.

As of June 2018, the In-Context Alerts service has been the most widely deployed of the three services thus far.   As a result of this effort, critical information from the CRISP HIE is now being directly embedded into the EHRs of thirty-seven out of the forty-seven hospitals across the state of Maryland, with the last ten still under development.  

Fig. 1:  The above graph illustrates the dramatic increase in monthly query volume since CRISP deployed its In-Context alert service
Since the initial In-Context implementations began in mid-2016, CRISP has seen average monthly query volume rise from 150 thousand queries in the web-based clinical portal to 1.7M queries of the same information being delivered in-context via APIs.   This represents an over 1000% increase in HIE data utilization in just over a year’s time.

The evolution to API-based interoperability has so far been a win for all of CRISP’s stakeholders.    Physicians are receiving vital information to help better inform decision-making at the point of care.   Patients are receiving better care with the hope of it ultimately improving their overall health status.    The State is realizing Medicare cost-savings with targeted information fostering more efficient coordination of resources.   

Lastly, CRISP is now experiencing an exponential increase in utilization volume.   With CRISP data embedded in the workflow, physicians are increasingly realizing the value and becoming reliant on this data on a daily basis.    With the backing of such powerful forces as health systems and the physician community, as well as the State, embarking on this API strategy has helped the HIE strengthen its position in the market and become a vital force in Maryland’s healthcare ecosystem.  

To access the full white paper click here.  

To learn more about how Leap Orbit can help guide your organization’s API strategy contact Ashley Wells at awells@leaporbit.com