“Have it your way.” This famous slogan has become part of the hamburger competitive advertising folklore as McDonalds and Burger King fought for market share. As you may remember, the positioning was McDonalds only prepared hamburgers one way, and Burger King would add or take off items to fit your tastes.
Approaching integration with Electronic Health Records () is much the same way. There are, however, two central questions:
How your organization answers these questions will drive your EHR approach. How your healthcare organization delivers connectivity to EHRs will be quickly recognized in the marketplace. Ultimately, it will likely affect the number of referrals received from various physicians and the strength of a long term relationship.
This paper will outline the EHR integration approach options and the resulting attributes for your organization.
EHR adoption has accelerated quickly with the passage of the Health Information Technology for Economic and Clinical Health () and the adoption of Meaningful Use standards. According to a 2010 Centers for Disease Control (CDC) survey, 50% of physicians are now using some kind of electronic system (in some scope or manner), with 25% using a “basic system” and 10% now using a “fully functional” system.
EHRs are being used by various healthcare providers to collect and store patient information and their medical history. Although EHRs hold a great deal of value to all involved in the healthcare community, there are several challenges to overcome in order to achieve the ultimate goal of efficient delivery of quality patient care.
One of the primary challenges that influence the effectiveness of an EHR implementation is exchanging patient information between various and numerous healthcare applications. To add to the complexity, there are several standards available to use including:
Add to this the different EHR vendor data specifications, and it can become a real predicament to navigate the connectivity maze.
EHR integration standards—quick definition
With these definitions as background, let’s discuss the differences in each of the approach options.
This is the EHR connectivity quadrant that no one wants to be in. In this scenario, the connection type and format has to be on your inflexible specifications, and it is probably a point-to-point interface which takes time to develop.
Characteristics of being in this quadrant include:
The end result: Uncompetitive in being able to deliver timely connectivity to a physician’s EHR system and unsatisfied healthcare providers because interfaces are not proactively monitored.
Low connection flexibility plays out the same as above, but now the responsiveness is timelier. EHR interfaces are turned around more quickly and are more closely watched.
What is happening in this scenario, however, is that the interface staffing levels are high. Essentially, it is throwing people at the interfacing problem. More people to develop, test, and deploy interfaces, and more people to closely watch interface connections and their results. Characteristics of being in this quadrant include:
In this quadrant, the scenario begins to change. With high connection flexibility, the likelihood that an interface engine is located in one or more of the facilities is very high.
An interface engine delivers the capability to transform the patient’s clinical data to meet the different EHR specifications. If one EHR has the patient name “Evans, Jill A.” and your application needs it “Jill Evans,” the interface engine introduces the ability to adapt and change the data format before the information is sent forward.
However, in this situation, the responsiveness is low. The interface engine is present, offering greater interface adaptability, but the monitoring capabilities or the tools to build the interfaces may be complex or limited. In this case, half the battle is won; nevertheless, the strength of referring physician relationships is built on quick response times and building confidence in the patient messages being sent and received.
Characteristics of being in this quadrant are:
Here is the place to be! Any EHR interface can be built, tested, and deployed in days—the data specifications in the receiving application and the sending application can be easily mapped and data transformed to meet the requirements.
EHR interfaces are monitored proactively and alerts are set to be sent if any indicator parameters are surpassed.
Characteristics of being in this quadrant are:
Taking the same two-by-two illustration a step further, the attributes can be outlined as shown in the graphic below.
Essentially, the attributes can be summarized by:
The approach that your organization takes to implement interfaces to a referring physician’s EHR or will translate into how your organization is viewed by that physician. Establishing close, long term relationships can sometimes be challenging. The interface approach that you take may be a determining factor in how long-term that physician relationship is.
“Have it your way” is a reasonable, doable approach when it comes to EHR interfaces. Processes and supporting technology exists to implement that strategy effectively. Building a community of physicians, each with their own unique EHR system, can be a reality for your healthcare institution.
The long term operational impact of high connection flexibility, high connection responsiveness approach is very positive, delivering the right financial results, quality of care results, and physician relationship results. Moreover, it is the right way to deliver the spirit and intent of Meaningful Use.