How closed APIs are holding British healthtech back

On one level, the British healthtech industry has shown clear signs of progress. Britain’s healthtech sector is the third largest in the world and is growing rapidly – with a ninefold growth in innovation from 2016 to 2021, reaching a value of $3.8 billion.

The pressures of an ageing population, coupled with the need for innovation to deal with a chronic NHS backlog, will only act to further spur innovation.

However, the sector is currently being constrained in its growth by one major obstacle: closed APIs. While the NHS is working to open APIs across its systems, this has not yet been fully reciprocated by the healthtech sector.

The result is a harmful imbalance, whereby healthtech providers are using NHS open APIs while denying access to their own systems – fragmenting the British digital healthcare ecosystem and leading, ultimately, to worse patient outcomes.

What’s more, closed APIs harm the healthtech sector itself. The inability of developers to access the interfaces of other healthtechs reduces interoperability, siloing them and limiting the ability of each business to be useful.

Therefore, the Government, healthtechs, and healthcare organisations should work towards the universal opening up of APIs, to the benefit of the sector and the patients it serves.

Outlining the problem

An open API allows other developers to access the interface and back-end data of an application. This helps to connect one application more easily with another, increasing interoperability between them.

However, when it comes to British healthtech APIs this is seldom the case. Right now, these must either be paid for, or are closed altogether. This is causing a whole host of problems – a lack of collaboration and interoperability among UK healthcare and healthtech providers.

In turn, this prevents platforms from sharing vital medical information, such as medical records, prescriptions, payments, and patient contact details. Considering these platforms are used by primary care services across the UK, including the NHS, the effect this can have on patient outcomes is highly concerning.

Where communication exists between primary and secondary care providers, it is often manual and inefficient – taking the form of scanned documents or even paper records. Closed healthtech APIs do nothing to enhance such communication, and by fragmenting the healthtech ecosystem, closed APIs can prevent doctors and medical professionals from accessing important information about patients.

The lack of a coherent medical story for each patient makes for worse patient outcomes, leading to medical errors such as a patient receiving the same erroneous prescription from multiple providers. When one considers that the healthtech providers are themselves using open NHS APIs, the need to correct this imbalance in access becomes more urgent.

This lack of interoperability also means that no one healthtech can specialise in a particular function.

If information cannot be easily transferred between systems, then every system will have to in-source all key functions – such as prescriptions, medical histories, and communications. This, in turn, leads to a lack of standardisation between healthtech systems, making interoperability and the outsourcing of functions even more difficult.

The overall result is a sector with several general ‘one-size-fits-all’ applications. Instead of specialising, healthtechs are in competition with each other to provide the same offering. This is an inefficient approach, leading to high development costs, the shutting out of new participants in the sector, and the stifling of innovation.

Closed APIs also stymie adoption. If a healthtech cannot easily communicate with the existing IT system of, say, a hospital, then there is a far smaller chance of uptake. Many healthcare providers and firms are unwilling or simply unable to undertake the IT system overhaul that is required to adopt a closed API healthtech. This, of course, limits the commercial viability of the sector.

Building a healthtech ecosystem

If we want healthtech innovation, then providers should be encouraged to open up their APIs to other developers. An analogy can be found in the Open Banking regulations of 2017, which opened up the APIs of fintechs, allowing for a seamless flow of information and payments.

These regulations helped introduce fintech into all walks of life, and spawned fintech unicorns – such as Monzo and Revolut – that have now become household names. Similar regulations or initiatives should be considered for the healthtech sector.

The use of open APIs in healthtech would allow medical information to be shared, creating a network of complementary healthtech tools – speeding up innovation and adoption. Different tools could specialise in different functions, leading to greater efficiency for developers and users.

Open APIs would also open the market to nimble new entrants, who would now not have to pay a high fixed cost for interfaces. In addition, interoperability would lead to the development of common healthtech standards and languages, allowing for easier communication between platforms.

The overall impact of open APIs would be a revitalised healthtech ecosystem. Instead of a few large and general applications, we would see an interconnected space that can give patients, GPs, and other health professionals a complete picture of medical histories.

What’s more, the large volumes of data gleaned from a more integrated healthtech ecosystem will help inform policymakers, leading to more effective public health strategies.  It is clear, then, that this simple rebalancing of API access would pay major dividends: for the sector, for the NHS, and for the patients themselves.

Devaraj Soundararajan is CTO of pharmacy tech platform Charac