# Performance of API Design for Interoperability of Medical Information Systems
## 5 Conclusions  
At a global level, there is a significant need for medical interoperability. However, one of the major challenges is the heterogeneity of the systems that store patient information in medical centers or hospitals. Memory management becomes a key challenge in the operation of the proposed API, as it needs to seamlessly execute on any device, ranging from healthcare units like mobile phones to servers in cloud computing. In this proposal, an object-oriented approach was chosen, and design patterns were integrated to enhance the performance of the software architecture of the medical interoperability API. The implementation of design patterns, such as abstract factory and wrapper, in the proposed API architecture provided the capability to clone itself, generating instances at runtime and distributing each of these instances to medical centers where patient information is required. Once contact is established with the medical centers, the API retrieves patient information by encapsulating details such as controlled personal data, like patient identification data, a list of previous illnesses or conditions, records of performed medical procedures, and reports from imaging studies (X-rays, MRIs, etc.). The information obtained through the instances at each medical center returns to the requesting medical center and consolidates the information for the requisition. During the architectural design evaluation, this study reported a 94.5 percent performance, which was indirectly demonstrated through the assessment of operation sequences, suggesting a good level based on complexity and coupling. Based on the results obtained, we can conclude that this approach optimizes memory and time resources, improving the efficiency for object construction during execution in heterogeneous environments. This approach increases the efficiency of memory usage and response time in the exchange of electronic records, which impacts the improvement of efficiency in hospital care responses. Therefore, we concluded that HL7 is a suitable standard for managing interoperability. However, it needs to be complemented to enhance and facilitate the management of the semantic representation of electronic health records (EHRs).  
In future work, the validation of the proposed design in real-world contexts is imperative to ensure its practical utility. The proposed architecture will be implemented in the Java language, and other protocols will be included in its format, such as OpenEHR, which is widely used in the development of medical interoperability APIs. This pivotal aspect involves equipping the architecture with mechanisms to adapt to diverse existing medical interoperability standards. The builder design pattern emerged as a promising solution to address this requirement.  
Conceptualization, L.D.N. and J.E.M.H. Methodology, L.D.N. and I.A.J. Design, L.D.N., J.E.M.H. and A.B.M. Validation, A.B.M. All authors have read and agreed to the published version of the manuscript.  
This research received no external funding.  
Not applicable.  
The data presented in this study are available on request from the corresponding author due to privacy.  
The authors declare no conflicts of interest.