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APIs: The Popular Elixir to EHR Data Migration Challenges

APIs: The Popular Elixir to EHR Data Migration Challenges
22 August 2022

The integration of Electronic Health Record (EHR) systems and digital health along with the ability for EHR data migration has had an undeniably beneficial effect on the lives of providers and their patients.   

Yet, many of the organizations providing EHR software are currently reckoning with the possibility of becoming obsolete and being left behind by the healthcare community. Why?  

The answer is the same as it is in any other industry that is evolving at a rapid pace; they are unable to adapt to the challenges of times.   

The reason we emphasized many, when talking about EHR software providers struggling, is because it is important to note that this is not a problem that is hampering all of us in the EHR software space.  

In fact, there are quite a few EHR software providers who have taken the necessary steps to evolve; and innovated new EHR systems that are future proof and intuitive; through the introduction of cloud-based applications that seamlessly integrate within the healthcare ecosystem and allow for easy healthcare data migration.  

What is the key element of these systems? Their interoperability in the digital health sphere, made possible through the extensive use of Application Programming Interfaces (APIs).    

While API might be a familiar moniker for many, their use in EHR systems is not always well understood. So, let us simplify it.   

An API is a software connection that allows applications to talk and interact with each other.  

The EHRs designed by those who have adapted to keep up with the industry needs, use APIs to do everything from connecting to laboratories, eRX services, deposit data, pull reports, and more. This is in stark contrast to the traditional closed loop systems, who wildly use their programs outside of their intended scope to accomplish the same effect.

This means that these legacy systems then require additional, disparate systems, which results in fragmented or incomplete patient medical information.    

What is the most common outcome of bad data and incomplete records? Bad patient outcomes.    

These legacy systems can and usually do become a nightmare for a healthcare organization’s technical team, especially when dealing with the migration or transmission of EHR data; whether it is EHR migration from one system to another, or patient data migration and EHR data transfer while integrating a new solution. This often becomes a time-consuming and costly process.   

Let’s examine the challenges in older systems that APIs have overcome:  

  • Migrating data from legacy systems 
  • Synchronizing data with analytics solutions 
  • Integrating with other complimentary applications 

 Before APIs 

Previously, in instances of health data migration between two systems, often, both systems would not give direct access to their databases.  Vendors claimed that the database structure is intellectual property that cannot be shared. 

The workaround “solution” they practiced was your data would be made available to you in a file type of their choosing, often at an unreasonably prohibitive cost, even if it is not in a format that can be consumed and read by another system.    

The other traditional healthcare data migration methodology was marginally better, requiring one or both tech teams to understand the EHRs’ data tables, often proprietary, to map where data existed to where it would then be landed — in such a way that the receiving system could appropriately read that information.   

This process was time intensive and difficult.   

It required understanding the structure of the databases, finding the right data tables, creating two scripts to move those data tables; one for exporting and one for importing; without corrupting or losing any data, and verifying the quality of the ported data.    

When working with gigabytes or terabytes of information, there is no guarantee as to the accuracy or quality of the data.    

For the challenge of migrating data from legacy systems, and syncing data with analytics solutions, the methods above are not adequate, as both goals require transferring substantial amounts of data exactly.    

Furthermore, while trying to integrate with other supporting applications, older systems will often not allow direct ‘conversations’ between products. This meant that providers would have to design or buy complex middleware for each use case or need.   

This medical data migration methodology was a mess and was only adopted because it financially benefitted the system developers and consultants.     

Life After APIs 

What exactly does an API do? We explained above in simplified technical terms. But let us make it even simpler.  

Much like serving staff in a restaurant, who takes your order, submits the order to the kitchen, picks up the food and then delivers it to you, API migration seamlessly ensures a smooth data exchange without you needing to do the work every step of the way.   

Just place the order and receive the results.    

Although data migration APIs have been around for a long time, cloud-based applications are the ones who have normalized it and made it astandard EHR offering.  Some legacy systems are attempting to modernize, to provide their clients healthcare data migration service, and have started to build APIs; but they are the exception, and APIs are not considered a priority, nor thought of as integral to the older technology.     

APIs are used for exchanging transactional entries, either singly or in bulk.  For instance, systems will have an API that can remotely create a new patient in the EHR.  When said patient is created in one system, such as your population management software, an API can export that new patient entry, automatically, to an EHR or a health exchange.   

The receiving system will have a corresponding API that receives the data package and appropriately places the data in the system where it can be read.  Usually, a key will determine the linkage between these two APIs.

The APIs can also be used to update existing data automatically if a change is made in one system and needs to be updated in the other. To a user, this is beneficial, as the two-systems function coordinated.     

The current crop of cloud based EHRs come equipped with transactional APIs, but many of those do not have APIs that facilitate the mass migration of data.    

At blueEHR, we place emphasis on making sure that our system reduces any inconveniences that might arise for our clients; which is why our system has APIs that enable mass data migration between systems.    

This allows our valued clients to eliminate the need to analyze, map, develop, and quality control data as it moves from one system to another.

If both the sending and receiving EHRs have this mass migration API, then the job of migrating from a legacy system can be accomplished efficiently and with few errors – good data in, good data out.     

The Value of a Future Proof EHR 

APIs are a way of future proofing any technology, which helps systems to meet most future requirements and/or regulations in the healthcare space.    

Or if you are a cautious person, you can also look at it as a step towards preventing future problems.  

A notable example of why systems should be future proofed is the fallout from the 21st Century Cures Act1. The rules on interoperability stirred tensions among many EHR vendors not using APIs, resulting in application-specific development taking weeks, if not months, to roll out.

This then delayed the implementation of the new regulations and disrupted the existing workflows of practices and providers. These delays, and unexpected system changes, can cause provider burnout, which is one of the largest issues caused by legacy EHRs; as cited by practices across the globe.   

The 21st Century Cures Act is also where systems like blueEHR standout, thanks to proactive planning on needed future technologies. blueEHR’s APIs are designed to easily adapt to changes and regulations in the healthcare space, or for specific needs of individual clients. APIs can easily address the challenges discussed above in the legacy systems.     

  • EHR data migration using APIs enables the organized transfer of data based on data types used in all connected systems – even if the data is from multiple sources.   
  • Any latest updates to the original database can be integrated with the already migrated data on every ‘PULL’ request. 
  • The IT staff does not need prior experience in migrating data as these APIs are easy to manage. 

With the ability to bulk data transfer, using blueEHR’s advanced APIs and proactive future proofing of the system, our clients can achieve true system interoperability. This has also enabled practices to seamlessly move or integrate with any other system without facing any barriers from healthcare technology.