Currently, the vast majority of EHR systems are proprietary, and vendors do not make their application programming interfaces (API) available. As a result, interactions are limited to each healthcare provider’s system making integration of outside data or tools effectively impossible.* (See attached article from Keith Marsolo in the Journal of the American Medical Informatics Association.)
As such, many EHRs are slow to innovate and cannot respond to the changing needs own the patients and providers they serve. While private companies have not needed to make their proprietary systems more accessible, the federal government has been (and continues to) subsidize the purchase of these systems, and should have substantial interest in favoring products that are open to human-centered innovation. Published APIs would enable innovations in the usability of EHRs by enabling outside entrepreneurs and developers to design customized user interfaces and tools for their populations' specific needs.
Policymakers have readily available channels to prompt vendors to begin publishing their APIs. The most compelling would be to include a published API layer in the federal criteria for EHR certification (http://www.healthit.gov/providers-professionals/certification-process-ehr-tec...). This approach would give vendors a choice and those that are not willing to publish their API could still sell their products in the marketplace. However, vendors that chose to do so would receive substantial benefits, including certification (assuming that they meet other criteria) and the ability of the purchasers of their products to receive federal subsidies through Meaningful Use.
(Adapted from 2013 Report to the White House Office of Science and Technology Policy)
Link leads to: http://jamia.bmj.com/content/early/2012/09/21/amiajnl-2012-001194.full
Link leads to: http://www.ghdonline.org/uploads/Mamlin_Biondich_Concept_Dictionary_Design_Goals_AMRS_ezODuak.pdf