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Multiple integration projects: One open API

New care models require health IT infrastructure that can interact with multiple solutions, devices and applications in a more streamlined, scalable and efficient way. In the complex IT environments of large health systems, the resources organizations spend integrating disparate systems can stifle innovation. But Application Programming Interfaces (APIs) can help them create a successful health IT ecosystem.

NewYork-Presbyterian (NYP), a nonprofit university hospital based in New York City, started using open APIs to achieve interoperability in 2014. According to NYP Director of Information Systems Ravi Koganti, “Based on the continuing success of early projects, APIs have become a go-to technology for new projects because they are easy to use, well-documented and capable of growing quickly.”

Clinicians drive the priorities for integration projects between electronic health records (EHRs), third-party software and devices at NYP. Here are three examples of how NYP solved challenges using API options:

1) Link inpatient documentation with outpatient billing

In 2014, doctors practicing in the hospital were documenting in the inpatient EHR. But after leaving the hospital facility, they had to go back to their offices and document again to bill. This situation required double data entry, wasting valuable time and creating the opportunity for error.

API solution: To link inpatient documentation with outpatient billing, the team used in-house staff with expertise using open APIs to build a custom application. It streamlined the billing process and linked notes to bills, eliminating the need for double entry.

 2) Populate vitals information into flowsheets more efficiently

HL7 interfaces between vitals devices and EHRs were slow and required extra steps. Nurses were sometimes entering the results in the EHR directly and circumventing the interface, writing down notes to keep track of data or standing in front of the EHR waiting for vitals information to appear.

API solution: An API solution now immediately sends results from the vitals device to the EHR and eliminates additional steps to associate the data with the patient’s medical record. Increased accuracy of data and reduced omissions of data freed clinicians to spend more quality time with patients and, also, improved clinician satisfaction. NYP did not have to wait for a major release of either the device vendor’s software or the EHR software in order to use the solution; instead, NYP could build, test and use new API calls according to its own timeline for rolling out the new solution.

3)  Uploading images in the burn unit

Users in NYP’s burn unit were concerned about the time spent uploading pictures for a patient, which help clinicians track progress. Clinicians wanted the pictures to automatically upload into the EHR.

API solution: NYP turned to a small start-up company, Yosko, that was a partner in Allscripts Developer Program. It added features to its existing application and was agile enough to work quickly to deliver results. The solution is now live and existing users identify that they are saving 5-10 minutes per patient to save the pictures. The initial rollout to 30 users has rapidly expanded to hundreds of users that can take advantage of this application.

“In all these situations, we evaluated existing options, including EHR functionality, HL7 and other applications on the market,” Koganti said. “But we did not find a solution until we explored APIs and created custom applications and API calls to meet our clinicians’ needs.”

This approach enables NYP to address the inefficiencies and frustrations that clinicians brought to the attention of the IT team, and positions the organization to be able to respond effectively to future challenges. Congratulations to Ravi and his team at NYP on finding innovative ways to solve for better clinical processes and outcomes.

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