Readying for Interoperability Step 4

Readying for Interoperability Step 4

Develop Your Long-Term Integration Roadmap

In our fourth and final step of our blog series, “4 Steps to Evaluating Your Interoperability Readiness”, we will explore what it takes to create a dynamic technology roadmap. At this point in our process, we’ve taken a pragmatic and fluid approach to preparing your organization for interoperability.

There’s little question that developing a long-term integration roadmap is a process that requires juggling many moving parts. But it’s a process with a high-payoff for healthcare organizations. West Health Institute estimates that the benefit of interoperability and integration could be as much as $30 billion in healthcare savings.

With that in mind, let’s review a few guiding principles that will help you build your long-term integration roadmap.

Use Gained Insights to Your Advantage

If you’ve already optimized API integrations within your system, you’ve likely acquired some insight into early successes and setbacks associated with integration. As you build your roadmap, these insights can serve as an initial guide to planning for the long-term success of interoperability. Analyze harvested data to create short-term and long-term goals for your technology roadmap.

As we mentioned in our original post, you’ll want to ensure that your system integrations are all performing correctly. This proactive measure includes failure-testing and reporting, and on-going code updates to correct any issues.

If you don’t have an existing outline to build your technology roadmap from, consider the one offered in this blog post by Perficient a great starting point.

Remain Flexible and Forward-Thinking

“Plan for roadblocks and detours by identifying all actionable alternatives and giving due consideration to each,” advises the authors of  ‘5 Steps for Health System Integration’. Interoperability will be best-achieved if you consider it as a dynamic process, one that requires flexibility and foresight.

While you may not anticipate every “detour,” you can indeed plan alternate routes. Organizations should update their roadmap regularly, taking into consideration the quickly changing healthcare landscape and updating their plan accordingly. Compliance issues and technology standards are ever-evolving.

Pursue an Integration Platform Partnership

Your organization may very well have the capability of developing an integration platform in-house, but with so many demands on IT departments (such as data security and data management), you may find it worth your time to seek out an iPaaS provider. You’ll want to be sure that the integration platform you invest in offers API technology that meets FHIR guidelines.

You’ll also realize greater value from an integration platform provider that continues to manage the platform after integration and who will contribute to your fluid interoperability roadmap. This creates a more collaborative and well-rounded approach to system interoperability, opening up your organization to outside innovation-driven insights.

If you do decide to write proprietary API code in-house, we suggest working in updated formats only. Spending time to write code for older, message-based formats is just a band-aid. As standards develop and technology improves, you’ll want your system to remain responsive to updated standards.

Know Your Key Objectives

It’s helpful to understand what you’re striving for when building a technology roadmap for IT integration. Key objectives can be summarized into three points. These are:

  • Aiming for synergy as quickly as possible (to realize greater cost savings, swiftness is key)
  • Plan ahead to eliminate errors so that your launch day does not interrupt business flow
  • Adequately prepare and train key stakeholders so that the impact on workflow and experience is minimal

With these guiding principles, your system can create a strategic integration roadmap that will guide you through industry changes and into interoperational harmony. And, if you need help with platform integration, don’t forget to reach out to Interoptex.

Seth Hobgood is CTO at Interoptex.

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Got Patient Dupes?

Got Patient Dupes?

When name and birthdate aren’t enough, it’s eMPI to the rescue.

When your hospital or healthcare facility has multiple records for a singular patient, you have what we like to refer to as “patient dupes.” This costly mishap is a result of necessary systems in place to create and maintain EHRs. According to this article, the cost to fix a single mistaken duplicate record can be nearly $1,000. Factor in the costs of denied claims and unnecessary patient care, and your total losses for duplicate patient records just keep mounting.

Why so many duplicate records?

It’s estimated that nearly 92% of duplicate records occur at patient registration. Changes – such as an address, surname, or insurance carrier – can cause a registrar difficulty when locating an existing record. Unable to locate an existing patient record within a hospital information system (HIS), a staff member creates a new record for a patient who is already in the system. In 2016, it was estimated that up to 12% of all patient records are duplicates.

While your hospital information system catches some duplicates, even the “best” systems only have a matching rate of 75%. That’s because only basic matching systems are used by most HIS. This leaves a rather large – and costly – gap.

Duplicate patient records undermine good data.

Another area of concern is the unfortunate effects of duplicate records on quality data. In past posts, we’ve shared how vital good data is to an organization and to the healthcare industry as a whole.

Some of the benefits, as outlined here, include:

  • Linking data to provide “patient-centric” care across the continuum
  • Meeting the goals of Population Health, which rely on matching individual healthcare records
  • Providing metrics that are useful for researchers and system analysts
  • Finance departments rely on good data for programs like value-based purchasing, revenue cycle management, and risk-share reimbursement modeling.

“Patient matching is almost universally needed to enable the interoperability of health data for all kinds of purposes. Patient matching also requires careful consideration with respect to its effect on patient safety and administrative costs,” writes Steven Posnack, who leads the ONC Health IT Certification Program.

Dump the Dupes.

One solution that’s seeing a lot of results in our industry is an Enterprise Master Patient Index (eMPI). More sophisticated than the matching systems used by most HIS, an eMPI utilizes a match engine that’s either deterministic or probabilistic.

Looking beyond basic data like date of birth, address, and surnames, an eMPI applies advanced query logic to patient data that allow the index to match medical records across disparate systems. This filters out false positives to achieve a greater degree of patient matching accuracy.

As with any industry’s database management plan, healthcare organizations should put protocols in place to proactively prevent bad data from resurfacing once it has been systematically eliminated. Training staff, standardizing data collection policies, and staying up to date on eMPI technologies are the best ways an organization can dump the patient dupes.

Seth Hobgood is CTO at Interoptex.

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What’s New in Healthcare and Technology?

What’s New in Healthcare and Technology?

Webinar: Technology that Empowers

Healthcare industry leaders have been pursuing advanced technology initiatives for over a decade now, and the results are mixed, at best:

  • In a recent survey, only 9% of providers “reported they’ve fully implemented products that meet the requirements of the 2015 edition of Certified EHR Technology (CEHRT), though 41 percent said they’re in the process of doing so.”
  • The same survey also found 68% of “providers believe current interoperability solutions fail to help meet the goals of value-based care.”
  • A new KLAS report revealed “only 14 percent of participating organizations reported deep interoperability when sharing data with disparate EHR systems.”

There’s no question to providers the revenue and patient care advantages that can be realized via strategic alignment between healthcare and technology. The question seems to be, “How?”

Listen as Seth Hobgood, Chief Technology Officer at Interoptex, and Joan Butters, CEO at XSOLIS, engage in a far-ranging conversation on how leading healthcare providers are embracing the potential of advanced technologies – real-time cognitive computing, predictive analytics, interoperability – to transform efficiency and empower employees. All while circumventing the challenges that typically arise when adopting a new approach.

Joan and Seth will share their insights and experience, provide a few tips and best practices, and help us understand how technology leads to innovation and better outcomes, both now and down the road.

In this interactive panel discussion, we will address:

  • How technology can improve bottom line revenue for providers
  • Why ease of implementation remains a key factor when selecting vendors
  • What healthcare IT leaders are doing to position their organizations for future growth

We hope you find this webinar to be educational whether you are considering emerging technologies to supplement your organization or just interested in learning about this potential.

Mike Leff is VP of Business Development at Interoptex.

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Why Interoperability (Still) Matters

Why Interoperability (Still) Matters

A follow-up to the 2015 AHA report

Interoperability is the final destination on a long road of confusion that has plagued the healthcare industry. Today, interoperability doesn’t only matter – it’s vital to the call for healthcare providers and payers to offer value-based care and to meet federal regulations.

In 2015, the American Hospital Association (AHA) published a report titled “Why Interoperability Matters.” This report serves as a valuable resource towards understanding the key barriers to interoperability, which is especially important since this article, published earlier this month, cites statistics showing shockingly slow growth of EHR availability to patients.

According to the AHA’s report, 75% of hospitals “employ at least a basic EHR.” However, only 23% of the hospitals surveyed report being able to perform all four of the basic interoperability functions, which are to find, use, send, and receive data from electronic health records. And while nearly 78% of those hospitals can send data to other providers, only 40% of them can actually use the information.

Interoperability Progress Remains Slow

Earlier this month, published a study titled “Progress in Interoperability: Measuring US’ Hospitals Engagement in Sharing Patient Data.” This study reflects upon the most recent data available to researchers on interoperability. Hospitals that are able to effectively perform all four interoperability functions only rose to 29.7%.

According to the research article’s abstract, “Our results reveal that hospitals’ progress toward interoperability is slow and that progress is focused on moving information between hospitals, not on ensuring usability of information in clinical decisions.

It seems the slow growth being measured by researchers could indicate that the healthcare industry is still grappling with barriers to interoperability. A report by the Government Accountability Office identifying key challenges to the issue was referenced and summarized in the AHA’s 2015 study, which stated that “costs and other factors, such as loose standards, are major barriers to improved interoperability.”

New Standards Paving the Way

Exciting developments in interfaces, identified by the AHA as one of the primary areas beneficial to improving interoperability, have occurred over the last two years. Industry influencers seek to leverage existing technology and use it to reduce costs and increase data integration.

For example, many authorities, including the Federal government, are supporting the use of API technology. Boasting low-costs and open-source formatting, APIs level out the playing field and promote widespread conversion to a standard.

The report by AHA notes several individuals who feel that solving the solution to interoperability comes down to establishing good data practices through a set of standards. As we’ve discussed previously on the blog, in the last year FHIR standards have been adopted by some major players in the market with the hopes that quick adoption will promote standardization, seen as an instrumental next step.

Interoperability or Bust

In 2017, we no longer question why interoperability matters. Our industry has come to understand that care coordination, patient access, and data sharing are cornerstone concerns. Federal mandates are pushing for innovation by requiring interoperable functions and open-sourced formatting for EHR data.

The initial question posed by the AHA is simply now a statement: Interoperability Matters. It matters, and will continue to be important in the years to come. As key lawmakers, leaders, executives, and patients continue to drive the need for improved interoperability, many in our industry continue to seek an innovative solution that will make data more integrative and usable.

Seth Hobgood is CTO at Interoptex.

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Readying for Interoperability Step 3

Readying for Interoperability Step 3

Measure Performance and Value

In previous posts, we shared steps aimed at readying your organization for interoperability. We’ve gone into greater detail on step one here and step two here. Now we are ready to dig further into step three to measure the performance and value of API integrations. Once you’ve optimized APIs in your current system to improve interoperability, it is important to manage this dynamic format. But how do we know if an API is running successfully?

Let’s review some key indicators of successful API performance:

  • Successful API performance can be measured by data quality. Good data is a strong signal that your API integrations are performing correctly.
  • In-place testing protocols for API systems are necessary for success. The fluid nature of an open format system calls for a measured quality assurance program – one that includes security checks.
  • Evaluate your financial metrics. Research indicates that APIs are a successful component in lowering healthcare industry costs. You should see financial results as you push towards total interoperability.

The healthcare industry is poised for innovation. The opportunity and gains that APIs represent to patient-centered and value-driven care cannot be overlooked. But in the gap of innovation and implementation, many of our clients are facing multiple EHR interfaces. With the aforementioned key performance indicators in mind, I’d like to share some best practices with you as they related to managing API integration into existing systems.

How Good is Your Data?

A great way to measure the performance of your APIs is to look for improvements in your collective data. The ONC’s Meaningful Use mandate requires API integration that gives patients access to their health data. Proactive organizations should go a step further, and look at ways they can grow the accessibility of EHRs because this is the future of healthcare. Look to your data to see if you’re obtaining gains in frequency, reliability, and content.

Additionally, being mindful of data accuracy, training staff on data protocols, and promoting awareness of these standards within your institution are all best practices for creating good data.

Error Test Your APIs.

Let’s be honest, it’s exciting to see the potential of APIs unlocked for the healthcare industry. But we also need to assess best practices for API testing, especially as big data makes organizations vulnerable to hacking.

Assertible provides a primer resource on this subject, sourcing information from Google’s Testing Blog. Both Assertible and Google call into attention the usefulness of unit tests in regards to APIs as just one of many ways to scan your system. Testing will also indicate if API formats are more or less finicky than message-based formats.

Regular scanning of systems also allows organizations to stay at the forefront of data security. There’s no doubt that a proactive approach via procedural testing is best practice when it comes to interoperability.

Harness Aggregated Financial Data to Measure Costs Benefits.

One of the exciting benefits of API integration is the reduced time investment and costs for healthcare systems. CFOs can evaluate financial metrics that have been aggregated by a platform like Interoptex to measure if financial value is being actualized. Concerns over costs are both a driver of innovation and a roadblock for healthcare organizations, making it imperative to measure the success of your interoperability efforts.

It’s an exciting time to be on the forefront of healthcare innovation. Harness the benefits of API technology through a measured, value-driven approach. Look for our final post in this series, which will expand on step four titled “Develop Your Long-Term Integration Roadmap”.


Seth Hobgood is CTO at Interoptex.

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Readying for Interoperability Step 2

Readying for Interoperability Step 2

Evaluate Highest Potential Value

A lot has changed since the fantastic article by David M. Cutler, “Where Are the Health Care Entrepreneurs? The Failure of Organizational Innovation in Health Care,” published in April 2010. There, Cutler maintains that volume-based insurance payments and the lack of access to data created technology stagnation in the healthcare industry. A move to quantify quality of care and payment on that value by government and commercial payers is in the process of becoming a reality throughout the market. However, we still have a long way to go to realize the benefit of access to data through Electronic Health Records (EHR). 

For those following my blog, you know that I laid out four steps to take advantage of the new interoperability standards that are being implemented in our industry – more specifically, FHIR. (Read Blog Here, Read Step One Here). In this post I’m going to explore Step Two: Evaluate Highest Potential Value. My second step recommends that your team identify potential productivity gains and value adds that can be realized by converting from an existing data share model to FHIR.

Identify Potential Productivity Gains and Value Adds

The call for a common platform is being enthusiastically answered by some major players in the healthcare industry, who are actively working to bring FHIR to market sooner rather than later. Hoping to spark innovation and rapid adoption, it’s clear that benefits are big for those that are implementing FHIR-based API.

You can identify your own productivity gains and value adds by determining which of your file-based formats are lacking in either content, frequency, or reliability. Go ahead and supplement those areas with API interfaces and move away from legacy formats. Leveraging a common platform to translate your messages in FHIR API calls will provide a dramatic lift in efficiency over multiple proprietary APIs.

Finding Innovation in Healthcare

Another true value of FHIR is that it relies on open-source API, which will move the healthcare industry away from the restrictions of vendor lock-in. A 2015 article published by Clinical Informatics News highlights the healthcare ecosystem for the military as a case study into this issue.

According to the article, Frank Kendall, Under Secretary of Defense for Acquisitions, Technology, and Logistics, said, “[Something] we have to consider in a best-value equation is the degree to which we’re locked into a specific vendor because of proprietary content and his products… We do not want to be locked into a specific vendor.” Without the worry of vendor lock-in, innovation can flourish in the healthcare industry.

Most organizations today spend upward of $5,000 to $10,000 per HL7 interface. FHIR has an ambitious goal for integration capabilities to be built into the EHR itself, along with other aspects of authentication and security to eliminate the need for expensive integration projects and licenses.  

Most of us are waiting eagerly for our vendor partners to engage with FHIR messaging. Ensuring we know what we want, what we need, and which applications would benefit the most from adoption of FHIR puts you in the driver’s seat for an exciting new time in healthcare technology.


Seth Hobgood is CTO at Interoptex.

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