The Health API Guy Table of Contents

A guide to the articles on this site by different themes, material, and tracks

This is an evergreen post intended to help direct people to the right content - I’ll keep it and the associated spreadsheet updated with new entries as they are produced.

Not always into AI generated art, but I’m picking up what they’re putting down here.

We’ve now crossed 40 articles on this site, with articles ranging in length from 2000 words to nearly 8000 words. That’s a lot of content, making it hard for some newer readers to discern what’s valuable and interesting for them to focus.

Inspired by the excellent

Net Interest

Substack by Marc Rubenstein, I shamelessly borrowed his archive format, which should act as a better overview of what’s available and pertinent to anyone interested. You can find that here.

This gives a list of articles on Health API Guy that I’ve written with:

• Some metadata like the subtitle and the date

• A brief summary

• Some categorization to allow for people to pick out article styles or topics they like more easily.

A second tab has links to other content, such as videos, webinars, podcasts, or articles I coauthored or helped with. I haven’t added the same granular categorization as the articles page, but it does have:

• Metadata about content format and date

• A summary of what is covered in the article/content/podcast

I will be adding a third tab for links to some longer-form social media posts on LinkedIn or X. Some more recent updates I’ve put out, especially related to the PointClickCare case, have not made their way to Substack or other form factors, so aggregating the best content there might be useful to those looking to go deeper. I’ll update this post to reflect that when I do.

Aside from being a personal blast in the past and self-reflection into the evolution of my own thoughts, my goal is to compile and curate different tracks or themes to help people learn about concepts they are interested in that cross multiple pieces of content, which you can find below. Let me know feedback or thoughts!

EHR Integration

• How to win friends and integrate systems: A guide to integrating with EHRs, breaking down some of the key factors you’ll need to consider and listing some of the popular tools/services to help in that process.

• Super Integration Fighter III: A framework classifying healthcare integration into three categories (RPA, direct to database and sanctioned interfaces) with distinct pros and cons

• FHIR 101: A rundown of what FHIR is, what it is used for, and where it’s going.

• The Scheduling Conundrum: Some detail on a common healthcare integration workflow, open scheduling, and why it’s challenging

• A Brief & Opinionated History of Healthcare Standards: A chronicle of the progression and development of various healthcare standards through the decades, leading to the incredible variety and complexity we see today

• The wild and magical world of claims: A deep dive into the data access patterns for claims datasets (both identified and deidentified)

Health Information Exchange

• A Tale of Rails and Ramps: A theme you’ll hear from me consistently is that interoperability is a superset of different infrastructure-to-be-built that are at vastly different maturity levels and are useless unless discussed at a more granular level. This article is one of the first to explain that conceptually, break it down into different workflows, and explain where we stand with each.

• CWC Stories: Interoperability with Brendan Keeler: This webinar with Andrew Hines of Canvas Medical continues the themes of “A Tale of Rails and Ramps” with fewer memes and more in-depth-discussion.

• Epic v. Particle: Provides high-level explanations of the core health information networks (the type of health information exchange focused on clinical data retrieval), the core concepts of purpose of use and reciprocity, and dives into the Epic v. Particle dispute of the spring

• Epic v. Particle 2: The Problem of Secondary Use: Explains secondary use of data, highlighting the challenges and ambiguities that arise when data collected for one purpose (like treatment) is used for other purposes within healthcare organizations.

• The Evolution of Health Information Networks: The Road to TEFCA: Traces the evolution of health information networks, focusing on how TEFCA aims to address issues with the current "On Behalf Of" exception and secondary data use to create a more robust and transparent national health data exchange system.

• TEFCA Individual Access Services Open Forum: A explanation of the historic and progression of patient access, what TEFCA’s Individual Access Services provides, and how Epic’s implementation of IAS works

• TEFCA Delegates Open Forum: A discussion on the TEFCA Delegate role, parallels to similar concepts in Commonwell (Adjacent Products) and Carequality (On Behalf Of), and how Delegates address some of the problems of those designations

• TEFCA Operations Open Forum: A discussion on why payers want access to clinical data, existing pathways to access, and what will be possibly via TEFCA Operations.

Patient Access

• Indiana Jones and the Personal Health Record: The most common startup idea is a tar pit: the Personal Health Record. This article goes through its history, the associated access patterns, and why PHRs miss the mark (do not solve the most important provider-patient workflows).

• TEFCA Individual Access Services Open Forum: A deeper dive into the progression of patients’ access to clinical data, one of the core provider-patient interoperability workflows, including the new TEFCA IAS option and Epic’s implementation.

• The State of Payer Patient Access APIs: An objective analysis of the Patient Access APIs offered by payers as a result of CMS-9115, scoring their implementations on discrete criteria and explaining the most common barriers.

• Why Identity in Healthcare Sucks: Patient access to health data is predicated on proving their identity. This explains how identity is handled by health systems, including an analysis of all identity mechanisms used across the Epic community at the time of writing.

Health Technology Regulation

• The Gang Explains Information Blocking: HIPAA: Starts at the beginning with the OG regulation, HIPAA, and explains its influence on health technology and data sharing

• The Gang Explains Information Blocking: Meaningful Use Era: Goes through the effects of the HITECH act on integration, interoperability, and patient access.

• The Gang Explains Information Blocking: Part III: Explains the Cures Act (the law) and information blocking, one of the key principles legislated in that Act.

• The Gang Explains Cures: Fills in the other half of the Cures Act and gets into the impacts of TEFCA and updated certification criteria in the ONC Cures Final Rule.

• The EHR Labyrinth: Drills into all the details of what the ONC (now ASTP) certification program is, what constitutes a certified EHR, the various programs that incentivize EHRs, and who needs to use a certified EHR.

• Pondering the Health Policy Orb: An early 2022 look-ahead at planned ONC (FHIR APIs, EHI Export, USCDI updates) and CMS rules (the CMS Interoperability and Patient Access Final Rule and the CMS Interoperability and Prior Authorization Proposed Rule)

• Regulation, the law, and other boring things made slightly more fun: A 2023 prospective look at all regulation that may influence or affect digital health companies, co-authored with Marissa Moore of OMERS Ventures.

• HTD Hot Takes: HTI-2 Edition: An analysis of the HTI-2 proposed rule, the ASTP/ONC’s newest regulation of certified health technology.

• Interop Summer High: An August 2024review of a wild summer of interoperability changes and drama and look-ahead at what remains for the year.

• Mr. Health API Guy Goes to Washington: A comment on the CMS Prior Authorization RFI, co-authored with Aneesh Chopra of CareJourney (now Arcadia)

• Sliding into the CMS' DMs (again): A comment on the CMS Prior Authorization Proposed Rule (CMS-0057) by Flexpa