If you're building a healthcare application that needs patient data, you'll eventually evaluate health data API providers. The build-vs-buy decision is real, and for most teams, partnering makes sense.

But not all API providers are equal. Here are five questions to ask before you choose.

1. What's your actual EHR coverage?

This seems obvious, but dig deeper than marketing claims.

Some providers advertise broad coverage but rely on aggregated networks that introduce latency and data gaps. Others focus on specific EHR segments.

Ask specifically:

• Which EHR systems do you have direct integrations with?

• What percentage of US patient records can you access?

• How do you handle health systems that aren't in your network?

At Consolidate Health, we have direct integrations with Epic, Cerner, athena, eClinicalWorks, NextGen, Flatiron, and Modernizing Medicine. These systems cover the majority of US patient records.

Direct integration matters because it means real-time data access without intermediary delays.

2. Is data access patient-directed or provider-directed?

This distinction has major implications for your product design and compliance posture.

Provider-directed access requires relationships with healthcare organizations. You're accessing data because providers authorized exchange, typically through Health Information Exchanges or network participation.

Patient-directed access means patients authorize your application directly. The 21st Century Cures Act requires providers to honor these authorizations through standardized APIs.

The difference matters for:

• Compliance: Patient authorization creates a direct consent relationship

• Data freshness: Patient-directed APIs connect to live EHR systems

• Coverage: You're not limited to providers who've joined a specific network

We built Consolidate Health around patient-directed access. Patients control their data; we enable that access.

3. How granular is consent management?

When patients share data, can they control what they share?

Basic implementations offer binary consent: share everything or share nothing. More sophisticated platforms support:

• Category-level consent (medications but not behavioral health)

• Time-limited access (30 days, not indefinitely)

• Purpose-specific authorization

Granular consent isn't just a privacy feature—it affects patient willingness to share. When patients trust they control their data, they share more.

Ask your potential provider: how do you handle consent? What controls do patients have?

4. What data format do you return?

Raw FHIR data requires parsing and normalization before it's useful to your application. Different EHRs use different extensions, coding systems, and field mappings.

Some API providers return raw FHIR and leave normalization to you. Others provide cleaned, normalized data structures that are immediately usable.

Ask:

• Do you normalize data across EHR sources?

• How do you handle missing or inconsistent fields?

• What format is your API response (raw FHIR, custom schema, both)?

The time you save on data normalization is time you can spend on product features.

5. How long until we're in production?

Time-to-value matters, especially for early-stage companies.

Building EHR integrations in-house typically takes 3-6 months per system. Using an API provider should be dramatically faster—but actual timelines vary.

Ask about:

• Sandbox availability (can you start testing immediately?)

• Integration complexity (how much code do you need to write?)

• Production deployment process (what approvals are required?)

We've designed Consolidate Health for fast integration. Developers can access our sandbox immediately and build working integrations in days, not months.

The Evaluation Framework

When you're comparing options, weight these factors by what matters for your business:

Coverage: Will this provider give you access to the patient populations you need?

Consent model: Does the approach align with your compliance requirements and patient experience goals?

Data quality: How much work will you need to do to use the data you receive?

Time-to-value: How quickly can you ship your actual product?

Cost structure: How does pricing work, and does it scale with your business?

There's no universal "best" provider. The right choice depends on your specific requirements.

But the questions above will help you evaluate options clearly—and avoid surprises after you've committed.