Top 4 Ways Health Systems Benefit from An API Approach to Clinical Surveillance

Speed is one of the most essential attributes of an effective approach to clinical surveillance. The faster patient data can be pulled from the EMR and sorted by clinical surveillance technology, the more quickly physicians and pharmacists can receive targeted alerts that lead to more optimal patient care decisions.

These alerts might be related to the identification of potential medication errors, the inappropriate use of antibiotics, or a possible outbreak of an infection such as C. diff.

To read about how health systems are using clinical surveillance to enhance patient care, read  “Clinical Surveillance: The Next Step in Value-Based Care.”

At the recent HIMSS Conference in Orlando, Adam Klass, chief technology officer at VigiLanz, and Dave Levin, MD, chief medical officer, Sansoro Health, spoke about how application programming interfaces (APIs) can be a gamechanger in clinical surveillance because they help data flow between EMRs and clinical surveillance solutions more quickly.

To view their full presentation, click here.

“We’re dealing with really important clinical problems here, and the sooner we can get these solutions in place and begin to impact the outcomes, the better for everyone,” said Levin.

APIs vs. HL7

For many years, most healthcare systems have transferred data from EMRs to outside solutions, such as clinical surveillance technology, via HL7 interfaces. But there are some drawbacks to this approach.

According to Klass:

  • The HL7 standard is interpreted in many different ways, which can raise confusion.
  • Hospital IT departments must spend time validating transferred data to ensure it is exchanging properly.
  • The approach requires building interfaces and maintaining them, which can be costly and time-consuming.

API data acquisition and transfer, on the other hand, provides a “more unified” data model, Klass said.  Information is pulled from the EMR in near real time, in a standard format, and it’s always sent to partners the same way, regardless of the EMR from which it originates.

“The value as you build out a full API footprint is getting that full clinical model from Day 1, so you’re not having to circle back to healthcare organizations to gather more data over time,” Klass said. “The hospital IT team involvement becomes significantly less as you use these APIs. The cost is also significantly less because you remove the maintenance and support that goes into supporting interfaces.”

Growing movement

More and more hospitals are recognizing the benefits of the API approach to data transfer. In fact, 30 health systems are already using APIs to exchange EMR data with VigiLanz’s platform, and many more are starting to implement the technology, said Klass.

He cited the following four benefits:

  • Less hospital IT department time spent on clinical surveillance.
  • Reduced hospital costs associated with clinical surveillance (hospitals no longer need to build interfaces, oversee numerous file transfers, or bring in consultants to assist with the work).
  • Faster implementations.
  • Broader accessibility for providers to clinical surveillance tools immediately after implementation.

Levin agrees. “An API approach to integration greatly reduces the amount of time that’s required to deploy the [clinical surveillance] solution and that translates into a cost savings,” he said. “But more importantly, it translates into a better user experience, a richer data set that takes a product that’s already really good and makes it even better.”

Interoperability in Real Life: Practical Ways to Leverage APIs & Transform Healthcare

Interoperability between EMRs and other applications is a key challenge in healthcare today. Application Programming Interfaces (APIs) have transformed interoperability in other industries and now healthcare, too, is increasingly relying on them to solve important clinical and business problems. VigiLanz recently co-hosted a panel discussion on the topic, with one of its partners, Sansoro Health, which featured leaders from a diverse group of healthcare organizations, who shared how they use proven API solutions to successfully address complex, real-world clinical, operational and workflow challenges.

Although the three panelists were at different stages of their journey in leveraging APIs to provide better healthcare solutions, more rapidly and at lower cost, all recognize that legacy technology does not meet their needs for integration with EMRs and data liquidity.

The Longest-Established API User

As moderator of the panel discussion, David Levin, MD, Chief Medical Officer of Sansoro Health and former CMIO of Cleveland Clinic Health System, explained it’s vital to have bi-directional data flow back into EMRs to save clinicians from double documenting. It’s an issue that Peter Chang, MD, Chief Medical Information Officer, Tampa General Hospital, faced, until he implemented Sansoro Health’s Emissary® API solution to deliver efficient, real-time read-and-write EMR interaction across complete patient demographics and clinical data. The longest established API user of the group, Dr. Chang spoke about how his hospital leverages APIs to focus solely on their application and not get disrupted on the integration. Tampa General Hospital can now integrate in a matter of days across EMRs, sourcing all the data its clinicians need.

The Middle Stage of the Middleware Journey

Adam Klass, Chief Technology Officer of VigiLanz, at the middle stage of the middleware journey, spoke on how APIs reduce barriers to EMR integration and can be rapidly deployed to provide robust, real-time interoperability between complex applications. To help healthcare providers deliver real-time results and  improve interoperability, he described how medical facilities today require a services-oriented architecture and API. The API must enable efficient aggregation, interaction and exchange of disparate data throughout the health care enterprise and across any of its software technologies, including EMRs and third-party vendors.

Klass, one of the company’s original founders in 2001, outlined the company’s mission of providing real-time clinical decision support to its customers by helping with all manners of manual data collection processes, using data and real-time rules engines. From pharmacy surveillance and predictive models to antimicrobial stewardship and other clinical use cases, the company relies on receiving EMR data in a timely manner. VigiLanz has always sought to answer the question of how to extract data from an EMR. It wasn’t rocket science, in Klass’ words, and yet it was challenging to collect the same data from every hospital in every EMR, in a way that enabled customers to have an intimate understanding of provider behavior through benchmarking. A creative solution was needed.

It’s one reason VigiLanz partnered with Sansoro Health to develop its VigiLanz Connect solution, which plugs into an organization’s EMR in less than one week for hospital IT-lite integration. Traditional integration methods are often customized for each installation, require regular maintenance and cannot be reused. Using a standard set of population-based APIs that facilitate seamless, real-time, bi-directional data flow, VigiLanz Connect normalizes data faster—and empowers clinicians to make an impact sooner. It plugs in once to deliver standardized, interchangeable APIs for seamless integration across all data sources. VigiLanz Connect has now been successfully deployed at several hospitals.

Exploring the Advantages to APIs

Matthew Cunningham, Executive Vice President of eviCore, described how his company is comprised of more than one thousand doctors and nurses in its ranks, so it needs a robust, flexible platform to identify and distribute the precise data and analytics to make informed, individual-based decisions across the 100 million lives it manages. With an understanding for the types of clinical and business problems that can be addressed with API technology, eviCore has begun to explore the advantages of commercially available APIs, like Sansoro Health’s Emissary platform.

Plug-and-play EMR integration is a reality today. Within days, hospital organizations are up and running with a standard set of APIs that work the same across EMRs. By leveraging middleware, organizations only code their application once for seamless integration across all data sources. This eliminates the need to build traditional custom interfaces for each EMR, saving significant time, resources and reducing costs – for clinicians, the hospital IT department and third-party solutions.

Tri-City Medical Center and VigiLanz: Achieving a Middleware First Through VigiLanz Connect

Customer Profile

Located in Oceanside, California, Tri-City Medical Center has served its community for over 50 years and is a 388-bed full service, acute-care hospital, with a primary care clinic and over 700 physicians practicing in 60 specialties. Its Gold Seal of Approval® from the Joint Commission recognizes its commitment to safe and effective patient care for the residents of the community it serves. It operates the only Level III Neonatal Intensive Care Unit (NICU) in North County, as well as an Orthopedic & Spine Institute, a Cardiovascular Health Institute and a Neuroscience Institute along with the Tri-City Wellness Center in Carlsbad, California, recognized as one of the best wellness centers in San Diego County. It also specializes in women’s health, robotic surgery, cancer and emergency care.


In the age of value-based care, it’s all about performance. Hospitals continually face increased financial pressure to reduce length of stay, hospital-acquired infection rates and hospital readmissions. The organization must improve healthcare analytics and core measures, avoid penalties and secure reimbursement, so it can continue to grow and thrive. This shift means hospitals must now consider cost avoidance instead of expecting direct reimbursement for patient care.

The challenge becomes how to support and enable next-generation healthcare providers to deliver real-time results from disparate platforms and technology. Sixty-two percent of hospital CIOs identify interoperability as a top priority, and 80 percent of accountable care organizations also cite data integration as a top challenge for their IT departments.

To help more healthcare providers deliver real-time results and to improve interoperability, medical facilities like Tri-City Medical Center require a services-oriented architecture and open application programming interface (API). The API must enable efficient aggregation, interaction and exchange of disparate data throughout the healthcare enterprise and across any of its software technologies, including EMRs and third-party single-point-solution vendors.


APIs fit the bill by allowing access to all of the data a digital health application and a health system would need in real time. Clinicians and administrators can now rapidly integrate new clinical and business information for better decision-making and, most importantly, for improved patient care with new interoperability services.

Tri-City Medical Center is the first VigiLanz customer site to utilize the company’s middleware API solution, VigiLanz Connect, to convert health data from its EMR into uniform, actionable intelligence in the VigiLanz Platform. Through VigiLanz Connect, the hospital turns its closed EMR systems into open platforms through robust services that do not rely on HL7 interfaces. VigiLanz handles connectivity and normalizes data structures across major EMR platforms, including Tri-City Medical Center’s Cerner platform, to quickly unlock the data. Benefits include shorter integration time (from months to days), elegant workflows, decreased maintenance costs and minimized risk.

“An API is definitely the way to go. Not only are APIs easy to use, but they are a no-brainer when it comes to rapid and successful implementation. Using VigiLanz’s middleware API helped us maximize the platform in a different, modern way. It is a simpler effort than using a solution like HL7, and it’s also stable and steady so it’s easy to maintain, despite the significant amount of data being pulled.” – Mark Albright, Vice President of Technology, Tri-City Medical Center

A middleware architecture has been shown to be the best technological solution for addressing the problem of EMR interoperability. The middleware platform facilitates the transparent, yet secure, access of patient health data directly from the various databases where it is stored. A hospital like Tri-City Medical Center no longer has to do all of the development itself. Instead, it can rely on off-the-shelf applications to solve problems. Middleware brings an application-agnostic approach to connecting EMRs to one another while allowing for specific development to enhance the significant investment by hospitals, health systems and physicians.