Build your own EHR Integrations using Open Source

Summary

The webinar discusses integrating healthcare apps with electronic health records using open APIs. It provides an overview of common EHR interfaces like FHIR and HL7, explaining the differences and use cases. Through live demos, it showcases authenticating and accessing patient data from Epic EHR sandbox. It also demonstrates processing HL7 messages. The presenters then showcase an app integrating patient records from Epic EHR and MedPlum EMR into a unified view. They share lessons from real-world implementations, documentation and code to simplify integration. The goal is enabling developers to easily and securely build apps leveraging EHR data to solve healthcare problems.

Takeaways

• 😀 Interoperability between healthcare systems enables better patient care by providing complete health records from different providers
• 👩‍⚕️ Over 70% of providers have to access multiple systems daily, wasting time and leading to repeat tests or missing information
• 🔌 The 21st Century Cures Act mandated FHIR APIs to enable interoperability between EHRs in the US
• 🌐 FHIR provides open APIs for patient, provider and system access over HTTPS
• 💉 HL7 v2 is still used for real-time, event-driven workflows like admissions and lab results
• 🤖 Bots can handle different interfaces like FHIR and HL7 to integrate data
• 👍 Reference apps and documentation simplify creating integrations
• 🔐 Patient access has fewer restrictions than provider access per healthcare regulations
• 🔎 Hospital systems add restrictions beyond the base API capabilities during implementation
• 🌟 Building incrementally fosters provider trust and expands future access

Q & A

What is the goal of integrating healthcare systems?

The goal is to connect different healthcare IT systems like EHRs to enable easy access and sharing of patient data among providers to improve efficiency and quality of care.

What is FHIR and how does it help with integration?

FHIR (Fast Healthcare Interoperability Resources) is a standard for exchanging healthcare data electronically. It provides RESTful APIs that allow easier integration between healthcare applications and systems.

How can developers get access to EHR sandboxes?

Many certified EMRs like Epic and Cerner provide developer sandboxes that allow testing connections to their systems without accessing real patient data.

What authentication protocols are used to connect to EHRs?

Connections typically use OAuth2 authentication via SMART on FHIR libraries to securely access EHR APIs.

What is the medplum agent and how does it connect on-premise systems?

The medplum agent is software that enables hl7 and other on-premise interfaces to connect to cloud platforms. It uses websockets to securely relay the messages.

What protocols are still commonly used besides FHIR APIs?

Many systems still use older protocols like HL7 v2, X12, and proprietary interfaces for things like admissions/discharges, lab orders, scheduling etc.

How are patient credentials handled for API access?

Patients have direct access using their existing EHR portal credentials. New patient-centric identity providers like Apple Health are also emerging.

What governance is required for provider API access?

Provider apps usually need some form of contract and restrictions to prevent excessive data access beyond agreed scope.

How do sandboxes differ from production environments?

Sandboxes allow free testing but may have usage limits or sample data. Production systems have real patient data and enforce stringent access policies.

What reconciliation is needed when consolidating records?

As different systems encode data differently, some normalization/reconciliation of codes, terminologies etc. is required when combining records.