Chapter 3: Leveraging APIs to Drive Interoperable Systems

Open APIs, orchestration services, and standards-based exchanges are the key to a unified platform for patient care.

As we continue on the path toward interoperability, we see three main areas of continued focus and investment: open APIs, orchestration services, and standards adoption.

Open APIs

At Salesforce, we launched our first API nearly 20 years ago and haven’t looked back since. We support API-enabled fields that can be used for synchronous or asynchronous flows and promote the foundational use of standards-based APIs like REST, SOAP, Bulk, OData, and streaming. As more organizations seek true interoperability, the need has grown for enterprise-scale API management capabilities in order to properly secure their endpoints.

Orchestration Services

We recognize the need to move away from point-to-point integrations toward enterprise reusability through modern orchestration that connects data, devices, and applications quickly through APIs. We also recognize the reality that integration can be messy and our AnyPoint Platform thrives on orchestrating data in a heterogeneous environment — from real-time APIs to processing batch files or event-driven messages. What we have learned, though, is that when unified data is used for purpose-built applications that are owned and managed by the business, you can stream more value and keep control closer to the end user.

Standards Adoption

For us to achieve our vision and to become the leading patient experience platform for synchronized care in all segments, we have invested in developing what healthcare providers need in order to convert legacy healthcare standards such as HL7 v2, C-CDA, and X12 into FHIR, including our MuleSoft FHIR RAML auto-generator. When organizations adopt standards these standards, only then can they deliver on the promise of connected, personalized, and holistic care.

As such, we will continue our adoption of FHIR R4 and United States Core Data for Interoperability (USCDI) to inform and guide our data models and define our FHIR APIs. We are also continuing to evaluate SMART on FHIR apps as another pathway to the EHR — and to better support life sciences companies.

Brands Making Strides in Interoperability

The COVID-19 pandemic disrupted some healthcare providers more than others. One thing became clear: anyone who had a connected, digital experience in place was better able to weather the pandemic. Patients needed questions answered. They clamored for virtual visits and Salesforce customers were able to stand up solutions in days. Employees needed to be able to work from home — and get a 360-degree view of patients. Salesforce users could do this, thanks to data integrations already available that provided the right information at the right time. Here are two stories of how Salesforce put users on the path to interoperability and helped patients achieve better outcomes.

MIMIT Health

MIMIT Health, a Chicago-based independent physician group specializing in minimally invasive and targeted treatments, is a leader in digital innovation. A Health Cloud customer, MIMIT integrates with a number of systems to continue adding value to the patient experience, while also advancing the overall interoperability solution. Before implementing Health Cloud, the company began with Service Cloud, where it realized the tremendous value of having EHR data integrated for increased patient engagement, scheduling, and care plans. MIMIT now integrates its EHR, Medstreaming LLC, with Salesforce using HL7:

  • ADT messaging for patient registry
  • SIU messaging for appointments
  • CCDA for clinical documentation around encounters

When we first started with our EHR, the data wasn’t all visible to the whole team. By integrating with Salesforce, we were able to see a holistic view of the patient, giving us a 360-degree angle. It’s all on one page, which makes it very easy and accessible to the whole team.”

Manish Goomar Director of Digital Systems/Solution MIMIT Health

Nebraska Medicine

Nebraska Medicine operates two hospitals and 39 specialty and primary care clinics throughout the state of Nebraska, with partial ownership in two rural hospitals outside their central hospital location, and a specialty hospital as well.

With these various locations with differing needs, this leading healthcare organization looked to Salesforce and MuleSoft for their interoperability work, both for their clinical and non-clinical systems. Currently, they use two core systems to manage patient care – Salesforce Health Cloud and EPIC, they took these systems, and working across Salesforce added MuleSoft to create a new API-led integration approach which enabled patient data to flow between both systems in real-time and keep their records accurate and up-to-date for patient data that was at staff fingertips when they needed it. More than 110 staff and contact center agents now use Health Cloud to update and create patient records, creating a 360-degree view of the patient across all systems and enhancing the quality of care.

With this, they utilized bi-directional sync between Epic and Health Cloud for real-time data feeds across: patient demographics, appointments, vaccinations, medications, guarantor and insurance information, admissions/discharge/transfer messages, and more.

Using Salesforce, teamed with the MuleSoft Accelerator for Healthcare, Nebraska Medicine has achieved a 150% increase in API consumption.

In this same regard, they have seen increased productivity and savings across their call center operations. In their first year working with Salesforce and MuleSoft for integration across Epic, Nebraska Med saw enhanced agent productivity that resulted in over $104K in realized savings, plus over $376K in realized savings from one call resolutions.

Now, they are taking this work across internal and external business solutions as they move forward with Salesforce.

The Future of Healthcare Is Interoperability

Interoperability is key to the healthcare community, and API-led connectivity and application network approaches are the paving stones to get there. As healthcare becomes more consumer-driven, the demand for connected experiences increases, creating more use cases for sophisticated, context-driven integration — true interoperability. MuleSoft and Health Cloud were designed to extend the value of your source systems, not only unlocking EHR clinical data across applications, but furthering collaboration to extend patient care for improved health outcomes. As we develop our capabilities with these goals in mind, we will continue to turn to the latest health data standards to further align with the industry and ensure a fully connected healthcare ecosystem. And, as always, we will continue to invest in our platform to make it even more open, trusted, and collaborative.

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