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POSTS BY TAG | HL7

Healthcare Interface Integration, a three-way tango


IT TAKES TWO TO TANGO BUT THREE TO INTERFACE


While dance shoes are not required, implementing a health care interface, especially one that can smoothly share data between two systems, can be as intricate as a three-way tango. The partners you choose to dance with can make all the difference. Who will lead? What special talents does each dancer have?  How do we put together a winning routine?

Small & Mid-Sized Practice Management System Vendors More Responsive

Here at pMD, we have worked with every imaginable type of system vendor from small mom-and-pop shops to huge national organizations. There is no hard and fast rule, but in many cases, the benefit of working with small and mid-sized organizations is that more often than not, they’re more responsive and eager to satisfy the customer.

While it seems like everyone may get overloaded, in my experience, working with a smaller vendor actually often means you have access to the people who can make decisions and get them implemented.  Want to add a more complicated dance move to your routine?  With a small-to-midsize dance partner, often you can just easily ask for help with that and it gets done. 

Delays Common When Working Alone with Large Vendors

With a larger one, a request for a new feature may get taken by your account manager, then relayed to a technical analyst who in turn has to get approval from a committee. Then, if it gets approved, you may find out that the dance partner does not even know how to carry out that complicated dance move. Too many dancers on the dance floor can lead to a spotty routine!

pMD has a long-established, reliable interface with a very large and major vendor, making it easy to implement for new practices joining pMD. Groups that are new to pMD and that request this interface can often get it implemented in a matter of days. Which is great, right?

Recently, a few practices with this interface asked about leveraging a new feature in their practice management system. The other vendor was unwilling to enhance the existing interface and insisted on making it a brand new project. On our end, we were able to make the requested enhancements in just a few days but somehow ended up spending months trying to get a new connection up and running in order for us to send that additional data over to the vendor's system correctly. While this isn’t always the case for all large vendors we work with, this tango, unfortunately, fell short. 

Working With Responsive Vendors Results in Faster Implementation

In working with many small and mid-sized vendors, we’ve found that the person we are dealing with is the actual interface designer and developer. Projects like these can often go very smoothly due to that close proximity. In a recent project with a mid-sized systems vendor, the interface engineer was reliably on every status call, creative about addressing special requests from the practice, and prompt in following up. The customer was able to go live in about a month with a customized interface that addressed their needs. Here, the tango routine wowed. 

Charge Capture Interface Implementation a More Challenging Project

If you’re unfamiliar with interfaces, just know that different types of interface projects have different degrees of difficulty. For example, there is very little variation in setting up patient demographics interfaces from one vendor to the next.  However, when it comes to charge interfaces, or sending charges from one system to another, they prove to be a little more challenging, take more time, and require more testing. In other words, the dance routine takes more practice and finesse. 

Interface Implementation with Vendors & Customer Working Together

While we at pMD and your practice management system vendor or hospital IT department are the dancers that have to agree on the moves, the dance routine cannot go anywhere without that third partner, the customer. The customer helps keep the tempo and encourages us vendors onto our feet, pushing us to dance through the routine without stopping. Keep us on-beat and you’ll find the dance slowly unfolding as a thing of beauty - an interface that will wow the crowd.

To find out more about pMD's suite of products, which includes our MIPS registrycharge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.





The vision and realization of interoperability in health care IT has been evolving and manifesting - slowly - over many years. Significant progress has been made in technology, health care policy, and the mindsets of the people and parties involved. In 2019, we are witnessing an invigoration around the topic, and here at pMD, we are excited to be a part of it.

New Rules Surrounding Interoperability in Health Care IT

In February of this year, the U.S. Department of Health and Human Services (HHS) proposed new rules surrounding interoperability, which aim to improve electronic access to health information. The rules will require the industry to implement standardized application programming interfaces (APIs) that enable electronic health records (EHRs) and other health care technologies to integrate and transfer electronic health information (EHI) between them by 2020. The rules also require that patient electronic access to this EHI be made available at no cost. These rules are not only directed at providers, but also payers, who must make their data available to patients and Health Information Exchanges.

This is great news! But before we drink the newest flavor of interoperability Kool-Aid, let us be aware that the call for patients’ access to their medical record has been sounding for many years. Back in the early 1970s, the legendary Dr. Larry Weed - the “father” of the EMR - said prophetically, “The patient must have a copy of his own record. He must be involved with organizing and recording the variables so that the course of his own data on disease and treatment will slowly reveal to him what the best care for him should be.” — Dr. Lawrence Weed, “Your Health Care and How to Manage It.” Dr. Weed was a tremendous force in evolving health care technology to where it is today. However, his work took decades to get to a point that, unfortunately, feels like a starting line today.

Speaking of decades, it has been 10 years since President Obama introduced the Health Information Trust Alliance (HITRUST) Act of 2009, which, along with “meaningful use” incentives of Obama Care, propelled the industry toward the use of EHRs by laying the framework for widespread, secure use of modern interoperability standards such as HL7, FHIR, and Continua. This often overlooked aspect of the HITRUST Act has been a tremendous catalyst to leverage technology for better patient outcomes.

Barriers to Progress in Interoperability & Data Openness

Although ideas of interoperability and openness have circulated for many years, progress in these areas has been relatively slow and not without obstacles. In his keynote lecture at the 2016 Connected Health Symposium, Dr. Harlan Krumholz, MD, SM (Professor of Medicine and Director for Outcomes Research and Evaluation at Yale), describes one such barrier: the perceived conflict between individual business interests and the interests of the industry at large. In short, some data holders (i.e. hospital systems, payers, pharmaceuticals, software vendors) feel that it is to their competitive advantage to restrict access to the data in their possession and, in doing so, have presented major challenges to using all available resources to provide the best possible patient care.

Modern Technologies Attract Major Tech Players Supporting Data Openness

Luckily, corporate bureaucracy has not completely impeded the advancement of technologies that will enable new ways to deliver health care. The evolution of HL7 FHIR and other internet standards are laying the foundation for fast, secure open APIs and web services, key components to creating a patient-centric system in which providers can focus on what they do best - guide patients to better health outcomes. These modern technologies have drawn the attention of many big time technology players to health care (i.e. Apple, Microsoft, Salesforce, Amazon, Google), further supporting the drive for data openness.

Innovation & Cooperation in a New Era of Health Care Technology - It's Exciting!

This renewed spirit of cooperation is certainly needed as we continue to push for a health care world that is both patient-centric and provider-friendly. It is sweet music to our ears at pMD, where we have many years of experience integrating with different health systems and software vendors across the country. We’ve encountered our fair share of roadblocks along the way, but those obstacles pale in comparison to the many successes we've had in supporting doctors to improve patient care while streamlining business operations.

2019 may indeed be a milestone year due to a perfect storm of policy change, technology maturation, and the expectations of both patients and providers in regards to technology. The demand and opportunity for change at this scale is much bigger than any one company, and I'm personally very excited about what we (as a collective industry) can do for both providers and patients as we all continue to innovate and cooperate in this new era of health care technology.

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.