As the Affordable Care Act puts increasing pressure on healthcare delivery organizations to provide more efficient, value-based care, electronic health records (EHRs) are failing to live up to the needs of providers, a new report has found. Moving to Open Platforms: EHR Vendor Strategies and Assessment, the latest report from Chilmark Research, argues that the future of the EHR market lies with open application programming interfaces (APIs) to enable ongoing development efforts.

The report explores the interoperability capabilities of various EHR vendors, which it describes as limited, as well as the companies’ in-house API programs. Current EHRs “perpetuate and extend data silos,” preventing the ready exchange of information, the report says. Instead, “current technology interfaces that provide data after the fact, non-disclosure agreements, data access fees, and the lack of reasonable software tools for developers are all obstacles to the development of extensions by independent software vendors or healthcare organization developers.”

In response to these constraints, EHR vendors are currently implementing HL7 Fast Healthcare Interoperability Resources (FHIR), a new technology that its proponents say will provide real-time access to data across applications and organizations and may help enable the rise of platform-as-a-service (Paas) based ecosystems.

“Open APIs will ultimately form the basis for the interoperable health records that patients and providers are demanding. The work being done by the major vendors to support FHIR is only the beginning,” says Brian Murphy, the report’s lead author and a Chilmark Research analyst. “In the next year, we expect healthcare technology contributors—IT vendors, payers, health information organizations (HIOs), and others—to move beyond endorsement to actual implementations. FHIR APIs will eventually replace much of the data exchange technology painstakingly assembled over the last 30 years with modern ideas of open, distributed computing. Programmers will access data where it lives rather than where it has been staged, leading to rapid improvements in IT functionality, usability, and genuine choice in applications to use.”

According to the report, leading IT vendors must API-enable their EHRs if they intend to meet their customers’ needs. EHR vendors are particularly well-positioned to devise creative solutions to their interoperability challenges, it says, because these companies manage clinical data, are at the center of physician workflow, and can command the attention and resources of C-suite executives.

The report is available for purchase on the Chilmark Research website.