What is a Headless EHR?

Advances in digital health are transforming how care is delivered. New care models that aim to engage patients and extend care beyond brick-and-mortar settings are emerging. Electronic Health Records (EHRs) are an essential software solution that enables healthcare providers to streamline workflows and interact with other health technology and software through application programming interfaces (APIs). APIs are elements of software coding that serve as messengers or translators to help software programs communicate with each other. Recently, “headless” EHRs have emerged, designed to meet federal requirements around access, use, and sharing of patient electronic health information. Headless EHRs are built around APIs that make EHRs flexible and customizable to several digital health solutions.

Healthcare startups and legacy providers can custom-tailor care to support specific patients and their overall populations much more comprehensively. Some amazing companies are releasing a seemingly unlimited number of models to deliver every type of care.

Let’s back up. Let’s start with: What is an EHR?

An EHR is an electronic patient record — a digital version of a patient’s paper chart, if you will. EHRs are real-time, patient-centered digital records that make information available securely and instantly to authorized users. EHRs include critical administrative and clinical data relevant to a person’s care. This data might include patient demographics, provider progress notes, diagnoses, medications, vital signs, immunizations, laboratory data, radiology reports, and past medical history. The EHR centralizes patient information access and can help automate provider and care team workflows. EHRs can also support care-related activities by interfacing with other tools, such as evidence-based decision support, outcomes reporting, patient engagement, and quality management.

There are many certified EHR solutions out there — and according to clinicians and care teams who are daily users, along with program builders, not all EHRs are created equal. How can a healthcare organization find the right EHR for its providers and care teams? EHRs designed specifically for clinical users and care teams and that are not tied to structured charting templates are ideal. User-friendly approaches enable improved and streamlined processes and support overall goals to improve patient and population health.

In October 2022, the Information Blocking Rule’s expanded scope became effective, prohibiting providers from blocking or interfering with the access or exchange of any electronic health information in a designated record set. Authorized through the Cures Act Final Rule in 2020, this significantly expands the information that must be made available to patients and other stakeholders without delay. How does this affect EHRs and providers? Now:

1. EHRs must respond to third-party requests to exchange or access EHI within 10 days and may not block access for arbitrary reasons;
2. EHRs may not impose unreasonable fees or pricing that interferes with EHI access and exchange; and
3. Providers using EHRs must respond to patient requests for data transmitted through third-party applications.

The expanded rule intends to give patients greater control over their health data and enable enhanced data-sharing between providers, health organizations, and patients. This rule weakens EHR vendors’ ability to control data, lock in their users, and tie sharing data to their own financial gain. Now, EHR vendors must update their tools to allow their customers — providers and healthcare organizations — to respond to requests to access and exchange patient data.

So, what’s a headless EHR?

Simply put, a headless EHR is built with an API-First approach. Meaning, having a built-in API for every action one would want to take in the EHR. So if you wanted to build something or access any data, you could. It’s an open canvas — giving you all functions available in the EHR UI to be available externally via API.

Headless EHRs have followed the path of the headless CMS (Content Management System). A headless CMS is an evolution of a traditional CMS. Traditional CMSs were created to store and display content elements (such as video, images, or text) on websites. Traditionally, all elements were grouped in one bucket, making it impossible to reuse content because it was intermixed with code.

As the need for more flexible solutions has emerged and the technology has evolved, CMS models have evolved as well. A headless CMS is a back end content management system where the repository for content is separate from the presentation layer. This allows the management of content in one place, along with the ability to deploy content across any front end a user may choose. This is key to deploying omnichannel strategies and lets users integrate content into any system, tool, software, or website by connecting to the CMS APIs.

A headless EHR is a riff on the concept of a headless CMS. In the case of the headless EHR, the EHR is the body — similar to the repository for content for a CMS. The front end user interface is the head — like the presentation layer of the CMS. This makes the front end user interface more easily customizable and enables information from the EHR to be funneled in through APIs.

Digital health organizations want the flexibility to build their own customized programs. A headless EHR allows them to use that framework and foundation with their own display, user interface, and expanded functionality. Simple and inexpensive HIPAA-compliant cloud software with built-in integrations for tasks like claims, e-prescribing, and reference labs allow them to customize and design a front end aligned with their unique vision.

A truly headless EHR takes an API-first approach

As an obvious statement, the digital health market is a broad sector. Most digital health companies fall within one of three categories:

1. Patient apps: consumer-facing apps on mobile phones, the internet, or other platforms.
2. Provider organizations: digital health companies that employ providers and care for patients through telehealth offer a new twist on traditional provider organizations.
3. Provider software: these companies sell software and IT solutions to traditional provider organizations. This category in the digital health market supports legacy brick-and-mortar provider organizations and integrates new advances like electronic health records (EHRs), telemedicine, machine learning, artificial intelligence, and remote monitoring devices.

Software solutions, specifically EHRs, enable providers to streamline workflows and interact with other health technology and software through APIs. Within EHRs, APIs make it easier for patients and providers to access and share health data more securely and efficiently. As EHR technology evolves, APIs allow provider organizations to integrate advances in health technology into workflows, patient data management, and patient engagement.

A headless EHR approach builds an API for every action a user might want to take in the EHR without investing in the front end. APIs allow for the information to be sent anywhere and displayed in whatever format is required. Prioritizing APIs and designing EHRs around API flexibility would allow digital health organizations to build their approaches on that foundation.

Developing EHRs with an API-first approach creates more value for a product in the long run. Headless EHRs are nimbler as compared to the earliest versions of EHRs. An API-first approach allows the ability to meet increasing regulatory compliance requirements while delivering a flexible and customizable user experience.

Headless EHRs allow for a platform approach that can continuously evolve, integrate with other technologies, and facilitate interactions between users and other third parties. This capability is a fundamental shift from the earliest versions of EHRs — still many in the market today — that attempt to control and restrict access to patient data beyond their own software. Success stories from adjacent sectors demonstrate the value of a platform approach.

A headless approach

As telehealth and digital health have advanced, provider organizations have more opportunities than ever to integrate new technologies into their care models and workflows. Federal regulations are focused on ensuring patients and providers have more access to data to support better health outcomes. New focuses on headless EHRs open the door to more customizable, flexible care management solutions.

Headless EHRs are designed to meet federal requirements and are built around APIs that make EHRs flexible and customizable to a number of digital health solutions. This technology makes it easier for provider organizations to evolve their practices, supporting in-person care with technology that helps improve patient outcomes and experience.

An API-first design allows specialized models of care and user interfaces to be developed without a drain on resources.

A little bit about why Welkin is API-First:
At Welkin Health, we knew how important it was to take on an API-First approach to give back the power to our customers. Our providers can access any data they want, along with building anything they want into their instance. Welkin allows providers to build a perfect environment suited to their workflows, care teams, and patients. Although we aren’t a certified EHR, we’re a Care Management platform that does take on the bulk of the functionality of an EHR.

Request a demo to find out a little bit more about why this is so important for our customers