Healthcare APIs in 2024: Top 7 Use Cases & Case Studies

Healthcare APIs in 2024: Top 7 Use Cases & Case Studies

APIs (application programming interfaces) are rapidly transforming healthcare by enabling secure data connectivity between disjointed systems and parties. As a data analyst and AI consultant with over 5 years of experience, I am excited to explore some of the top ways leading healthcare organizations are leveraging APIs in 2024 through real-world examples and case studies.

Whether you are a healthcare CIO, product manager at a health tech startup, or simply interested in how APIs are impacting medicine, this article will provide valuable insights. I have synthesized research from across the industry as well as lessons learned working closely with healthcare executives and innovators on their API initiatives.

My goal is to not only overview the top use cases for healthcare APIs today, but also equip you with knowledge to evaluate if and how they could drive value in your own organization or initiatives. Let‘s get started!

What are Healthcare APIs and Why Do They Matter?

First, what exactly are APIs and why should healthcare organizations care about them?

APIs act as an interface that enables software applications to communicate with each other. They allow discrete systems to exchange data in a structured way according to specified protocols and rules.

Healthcare organizations typically have dozens of disconnected IT systems built up over many years. Core systems like electronic medical records (EMRs) often don‘t easily integrate with newer technologies.

APIs solve this by providing a standardized way for these disparate systems to share data and work together seamlessly. Adopting APIs to connect systems unlocks tremendous benefits:

• Improved data exchange – APIs allow patient health data to flow securely between different provider EMRs, wearables, remote monitoring devices, patient portals, and more.
• Increased innovation – Public APIs enable third-party developers to build new applications leveraging provider systems and data as digital building blocks.
• Enhanced patient engagement – Patient apps connected via APIs give personalized experiences, tools, and information to drive better health outcomes.
• Boosted interoperability – Standardized APIs like FHIR make integrating with other health IT systems faster and more seamless.
• Better analytics – Unified data access via APIs powers better analysis of clinical and business performance.

Now let‘s explore some of the most impactful healthcare API use cases and examples of them in action today.

1. Patient Health Information APIs

Empowering patients with direct access to their health records is a growing API use case. Patient health information APIs allow people to aggregate their medical history from across providers into unified views.

For instance, HumanAPI provides a health data network that connects electronic health records (EHRs), fitness trackers, and other personal health accounts. Users can then securely share their holistic timeline with any verified party, enabling personalized medicine.

HumanAPI offers SDKs and APIs that partners integrate to build consumer-centered applications leveraging personal health data. One partner using their API is HiMama, which provides management software for early learning centers and preschools.

By connecting with HumanAPI, HiMama gives parents the option to automatically import details like immunizations and pediatrician visits into their child‘s profile from the HumanAPI-powered health timeline. This gives teachers and administrators a more holistic view of the child‘s medical history for better care.

Broadening patient access and control over health records empowers people to make smarter choices related to their care. It also reduces duplicative tests and clerical work for providers. More healthcare organizations are expected to embrace patient data APIs to enable personalized medicine and research apps.

Industry Data:

• 76% of healthcare organizations currently operate at least one public API according to a 2022 industry survey, with patient data APIs being the most common.
• Respondents predicted the number of public APIs their organizations offer will grow 169% on average over the next two years.

2. Remote Patient Monitoring APIs

Remote patient monitoring (RPM) leverages connected devices and telehealth platforms to track a patient‘s vitals and health status outside clinics. This allows providers to detect emerging issues early and intervene quickly before conditions worsen.

But launching enterprise-wide RPM requires securely connecting data from remote monitoring devices to existing clinical systems like EMRs. RPM APIs make this possible.

For example, healthcare IoT company PhysIQ has an API that aggregates and analyzes data streams from wearable medical devices using AI algorithms. If any concerning or clinically significant changes are detected in a patient‘s biometric data, it immediately alerts care managers to intervene.

By providing RPM via an API-based platform, PhysIQ allows healthcare systems to scale their remote monitoring programs without major IT investments. The API seamlessly integrates RPM data with existing tools and workflows.

As telehealth models mature, simple API-based RPM connectivity will be crucial for providers to manage higher-risk chronically ill populations more effectively across care settings.

Industry Data:

• By 2025, the remote patient monitoring market is forecast to reach $117 billion according to Fortune Business Insights. RPM APIs will play a central role in scalable adoption.
• Connectivity and compatibility with EMR systems was cited as the biggest technological challenge in RPM adoption in one survey of healthcare leaders.

3. Prescription Management APIs

Prescription management involves intricately orchestrating workflows and data across prescribers, pharmacies, insurers, and more. APIs help streamline medication ordering and fulfillment to boost efficiency and safety.

For instance, Eligible‘s prescription pricing API allows pharmacies to check a patient‘s cost for a medication in real-time based on their benefits. This provides accurate pricing to patients upfront and lets pharmacists suggest lower cost options on the spot.

Integrating Eligible‘s API into pharmacy POS systems reduces prescription abandonment by resolving sticker shock confusion. The API covers copays, formulary status, generics, and more for each insurer.

Leading pharmacy chains like Walmart, CVS, Walgreens use Eligible‘s pricing API today to boost transparency and improve patient medication adherence. Maintaining huge formulary databases internally creates overhead. Adopting a purpose-built API solves this efficiently while retaining control over the patient experience.

Industry Data:

• Every year, 125,000 deaths in the United States are linked to medication non-adherence according to Pharmacy Times. Prescription APIs can help.
• 20% of new prescriptions are never filled by patients largely due to benefit coverage confusion or unexpected costs at the pharmacy counter.

4. Insurance Eligibility APIs

Checking patient insurance coverage eligibility is a major administrative pain point for provider practices. Constant staff follow up with payers is time-consuming and bogs down coordinating care.

Eligibility verification APIs solve this by enabling real-time queries from existing practice management systems. For example, athenahealth‘s eligibility API lets staff check coverage details directly in their workflow.

This eliminates most calls, faxes, or web portals to retrieve coverage details. Having eligibility insights immediately also reduces claim denials by clarifying patient responsibility before visits.

According to athenahealth data, a typical practice processes around 4,000 eligibility requests per provider per year. Automating this workflow delivers huge time savings equivalent to 2.5 full-time employees.

Payers like Aetna, Cigna, UnitedHealthcare, and Humana are rapidly adopting eligibility APIs as well given the massive impact on call volumes. Streamlining this process is a win-win scenario.

Industry Data:

• Verifying insurance coverage is the biggest administrative burden in healthcare, taking up 14% of staff time according to a Medical Economics analysis.
• 36% of initial claims are denied and resubmitted primarily due to eligibility issues and benefit discrepancies.

5. Patient Engagement APIs

Keeping patients engaged between visits is critical for medication adherence, preventing hospital readmissions, and driving preventative screening compliance. However, manually coordinating outreach across channels like text and email is time-consuming.

Patient engagement APIs solve this by automating patient messaging at scale. For instance, Luma Health offers an API that triggers appointment reminders, care gap notifications, and other messages to patients automatically based on defined criteria.

Luma‘s API integrates directly with the healthcare organization‘s EMR system to monitor care needs and gaps. For example, Providence Health uses Luma‘s API to identify patients overdue for cancer screenings based on clinical guidelines. Automated multi-channel outreach increased screening compliance among those patients by 5x.

Omnichannel patient communication APIs enable more targeted, personalized engagement initiatives that were previously impossible due to manual coordination barriers.

Industry Data:

• 33% of patients no-show to primary care appointments per Medical Economics, contributing to billions in lost revenue.
• Utilizing text-based outreach increases appointment show rates by up to 33%. But 90% of practices still use manual processes.

6. Telehealth APIs

Virtual care models are surging in demand after COVID-19 reduced in-person visits. But healthcare organizations must race to connect their clinicians with patients via user-friendly telehealth platforms.

Rather than taking months to build customized video visit capabilities, telehealth platform APIs allow rapid integration into an organization‘s workflow. Providers can be up and running with enterprise-grade telehealth in weeks, not months.

For instance, Cerner offers a white-labeled Virtual Care API that allows health systems to launch multi-specialty telehealth under their own brand, integrated with their EMR system. Key capabilities include:

• Automated patient appointment booking
• Customizable intake forms
• Clinical video visits via web and mobile apps
• Virtual waiting rooms and queues
• EMR documentation and coding

Taking advantage of proven telehealth APIs accelerates time-to-market while also reducing technology risks. As virtual care becomes a pillar of healthcare delivery, slick integrations enabled by APIs give organizations a competitive edge.

Industry Data:

• The global telehealth market is projected to grow by over 30% annually according to Fortune Business Insights.
• But only 11% of healthcare organizations have extensive telehealth capabilities today according to Definitive Healthcare‘s Telemedicine Outlook Report.

7. Healthcare Data APIs

Beyond powering applications, many healthcare enterprises are productizing data access via APIs to fuel innovation and complement internal analytics.

For example, Optum offers a suite of real-time healthcare data APIs that enable customers to leverage its vast data resources securely for analytics use cases. APIs provide access to:

• Claims data spanning over 230 million patients
• Lab results from 2.1 billion tests annually
• Pharmacy claims from 67 million members
• Provider demographic data across 1.2 million clinicians

UnitedHealth Group subsidiaries like Optum aggregate some of the richest healthcare datasets nationally. Its data APIs allow customers to focus on analytics rather than managing infrastructure.

Exposing high-value enterprise data resources via self-service APIs generates new revenue streams. It also cultivates richer insights by combining internal and external data perspectives.

Industry Data:

• 1 in 3 healthcare organizations currently monetize their data assets through internal analytics contracts or external sales according to Definitive Healthcare.
• 63% of healthcare organizations said improving data analytics and reporting capabilities is a top priority over the next 1-3 years.

Overcoming Healthcare API Adoption Challenges

While APIs unlock major opportunities in healthcare, there are also organizational and technical obstacles to be aware of:

Legacy System Constraints – Many core healthcare IT systems were not designed for open API connectivity. Retrofitting APIs requires more planning and effort.

Data Security Concerns – Exposing systems via APIs increases the attack surface. Rigorous API security best practices including authentication, encryption, and scanning are essential.

Compliance Requirements – Patient health data handling via APIs must adhere to regulations like HIPAA. Failing compliance invites steep penalties.

IT Skills Shortages – Most healthcare tech teams lack API and modern integration expertise today. Training or external help closes these knowledge gaps.

Cultural Resistance – Change management is key when implementing transformative technologies like APIs that alter workflows.

Standards Gaps – While rapidly maturing, healthcare API interoperability standards like FHIR still have gaps. Expect hiccups integrating disparate systems.

Thankfully, early API adopters in healthcare are proving these hurdles are surmountable with the right strategy and expertise. Organizations moving quickly today to embrace APIs will have a definitive competitive advantage.

The Future of Healthcare APIs

The use cases for impactful healthcare APIs we explored are just the tip of the iceberg. Looking ahead, I expect API adoption to accelerate across the healthcare ecosystem.

Virtually every aspect of healthcare, from billing to supply chain to genomics, can be improved by strategic API usage to seamlessly bridge data and capabilities across disjointed systems.

Leading healthcare enterprises are increasingly realizing they must transform from isolated monoliths into open, API-connected platforms. APIs enable entirely new business models, patient experiences, and growth opportunities.

Of course, healthcare organizations can‘t blindly chase API trends. Success requires carefully evaluating API opportunities against organizational priorities and challenges. With a strategic approach, companies can harness APIs as a core enabler of their digital transformation.

I hope overviewing today‘s top healthcare API use cases and real-world examples provides insights you can apply to your own technology roadmap and initiatives. Please don‘t hesitate to reach out if you would like to discuss further!