Walid Tohme Jad Bitar. Healthy Links Bringing Interoperability to Healthcare Delivery

Transcription

1 Perspective Ramez Shehadi Walid Tohme Jad Bitar Healthy Links Bringing Interoperability to Healthcare Delivery

2 Contact Information Beirut Ramez Shehadi Partner Walid Tohme Principal Jad Bitar Senior Associate Conrad Leister also contributed to this Perspective.

3 EXECUTIVE SUMMARY Healthcare organizations are striving to ensure continuity of care for their patients by moving from a paper-based environment to a digital setting in which information is collected, stored, and shared through IT applications such as electronic medical records (EMR) and hospital information systems (HIS). These applications offer significant benefits to the functional areas where they are implemented, such as finance or human resources, but they also add to the organization s overall data management challenges because they lack an integrated solution to storing and sharing critical patient data. To maximize the benefits of these investments, a solution that ensures different systems and applications are interoperable is imperative. An enterprise integration solution (EIS) addresses this challenge by ensuring data can be seamlessly exchanged across different systems and applications, making it available to the right individual in the right place and at the right time. Because an EIS cannot be implemented without considerable investment, healthcare organizations need to comprehensively document their needs before thoroughly vetting EIS vendors and available solutions to make the most of their investments and help assure that the system can grow along with the organization s future needs. 1

4 KEY HIGHLIGHTS Healthcare organizations current technology solutions typically operate in silos and as such cannot be integrated with other solutions, creating critical communication gaps in the sharing of patient data. An EIS enforces standardization across functions and facilities, resulting in the real-time sharing of information and lower operating costs. Healthcare organizations need to seek EIS vendors that can provide flexibility, adherence to industry standards, and long-term customer support. THE INTEGRATION CHALLENGE The healthcare industry is undergoing a major transformation. For too long, healthcare organizations have relied on paper-based medical records and manual processes that make it difficult to gather, retrieve, and share information. In recent years, however, industry leaders have begun to invest in new health IT applications, sophisticated medical devices that can capture and share digital results, and administrative systems such as ERP. In fact, IT spending by healthcare organizations nearly doubled from 1.66 percent of revenues in 1997 to 3.02 percent in 2007 (see Exhibit 1). Exhibit 1 Healthcare IT Investments Soar Source: Gartner Consulting Worldwide IT Benchmark Service; analysis 2

5 Although healthcare organizations have ramped up their spending on IT equipment and applications, they have not paid as much attention to the integration of these technology solutions. The lack of an enterprise system to connect these new applications and devices has resulted in key data not being accessible to all key actors in a hospital (such as physicians and nurses) or available to the right individual at the right time and place (such as in the emergency room, at the bedside, or in the operating room). Of course, making information flow seamlessly between different departments and teams is easier said than done. In most cases, the technology solutions that providers have adopted within their organizations operate on different platforms and can t communicate seamlessly with other systems. This gap stems from a piecemeal approach to technology adoption and deployment. Typically, providers have adopted technology as each new challenge in a specific department or function has emerged, such as automating processes within the human resources department or deploying a payroll system. These IT fixes are performed in isolation from other functions that could be affected by these new systems, causing information to be fragmented within the organization. To tackle this challenge, healthcare organizations have traditionally deployed point-to- point integration solutions between two systems, which are quickly and simply implemented but don t provide for a holistic solution for multiple information systems when integration needs go beyond just a few applications. As a result, hospitals are finding themselves in a difficult situation as clinical, administrative, and other information systems are becoming more and more ubiquitous across the healthcare landscape and older legacy systems are still being employed. Having adopted a number of point-to- point solutions for cost savings and expediency, hospitals end up with complicated, costly, and inflexible systems. In most cases, the technology solutions that providers have adopted within their organizations operate on different platforms and can t communicate seamlessly with other systems. 3

6 THE CASE FOR AN ENTERPRISE INTEGRATION SOLUTION Given increasing demands to treat patients across the entire continuum of care, healthcare organizations need a single technology solution that can bridge these disparate systems and help extract their maximum benefit. A well-designed enterprise integration solution (EIS) serves this purpose (see Exhibit 2). An EIS greatly reduces point-to-point connections and enforces standardization across functions and facilities on multiple levels business, organizational, and technological. It also supports the ability to streamline and better coordinate different organizational elements such as processes and services, with the overall effect being to lower operating costs and improve the organization s flexibility to respond to market changes. The benefits provided by an EIS have not gone unnoticed by the IT industry. Dozens of IT vendors have entered the EIS market, but no clear criteria exist to evaluate the growing array of off-the-shelf products or ascertain how each of the available solutions handles specific problems. For example, healthcare organizations may decide to implement an EIS using a big bang approach, in which they replace all integration interfaces in a single step. Such an approach may be advantageous for a greenfield project because it allows rapid deployment with minimal investments. However, this option isn t realistic for an established hospital with multiple legacy systems as there are potentially hundreds of interfaces operating in a typical enterprise applications portfolio. The hospital runs a real risk of losing critical data if one of these connections is wrongly substituted. Instead, it needs an EIS that can systematically replace pointto-point connections. Five criteria are critical to guide healthcare organizations through the evaluation process and to help them both maximize their existing IT investments and avoid unforeseen consequences. Vendors Cross-testing Capabilities: Organizations need to conduct a traditional vendor analysis that examines the financial stability of each potential firm, its market size, Dozens of IT vendors have entered the EIS market, but no clear criteria exist to evaluate the growing array of offthe-shelf products. 4

7 Exhibit 2 EIS: Bridging Technology Gaps * RIS/PACS: Radiology Information Systems/Picture Archiving Communication Systems Source: analysis 5

8 and how the specific product can solve the issues they are trying to solve. But this alone is not sufficient, given the complexity of the task at hand. Organizations also need to understand the vendor s capability to test and validate the system once it is up and running. Testing and validation of an EIS typically take two and a half times as long as research and development. As such, the EIS vendor s capacity to maintain extensive cross-testing that is, to ensure the solution can interface with multiple applications with different standards after it has been configured is critical. Vendors Adherence to Industry Standards: It is imperative that the chosen EIS support key industry standards to allow for the interconnection of software assets, services, and components. These include general IT standards such as networking and communications standards, messaging, and security, as well as industry-specific standards (such as HL7, SNOMED, and DICOM). Organizations should give preference to approaches that make use of open codes and standards so that they can add functionality to their systems on an ongoing basis and aren t too reliant on the original vendor to handle these updates. COTS Product Functionalities: A well-designed EIS typically requires a product that offers a multitude of functionalities, including the support of various industry standards and 6

9 integration styles, state-of-the-art security, an easy-to-use but robust management dashboard, and auditing capabilities. These functionalities should be available commercial, off-the-shelf (COTS). This will not only avoid the unnecessary use of resources to develop them but also allow for standardized rather than customized version upgrades. Modular Product Packaging: The ability to incrementally deploy an EIS is vital. Doing so allows health organizations to build up their integration infrastructure in smaller steps, which enables faster payback periods and minimizes deployment risks. By contrast, if an organization has to purchase an entire EIS up front, some modules of the system may be unused or underutilized; the whole system may need to be replaced if the existing system can t support future needs. Long-term, Comprehensive Support: The EIS vendor should provide longterm support for multiple hardware and software platforms, operating systems, and enterprise applications, such as ERP. Time-consuming informational lapses can arise when healthcare organizations are left to deal with third-party system integrators rather than the original vendor. The ability to incrementally deploy an EIS is vital. Doing so allows health organizations to build up their integration infrastructure in smaller steps, which enables faster payback periods and minimizes deployment risks. 7

10 CONCLUSION Delivering effective healthcare services is a major challenge for many reasons; one of the foremost reasons is the difficulty of managing the ever-increasing volumes of patient data being generated. Although the adoption of health information technology has increased significantly over the last few years, these often disparate investments have added significantly to the complexity of hospital data management. As healthcare organizations migrate to digital information systems from manual and redundant paper-based approaches, demand is increasing for an EIS that can bridge the gap between legacy systems and emerging devices and other technologies that enable real-time sharing of critical patient data. A growing array of EIS options offers hospitals shortterm relief, but choosing the wrong vendor or product can lead to costly headaches down the road if the system can t accommodate the organization s evolving needs. Selecting the right vendor one that will grow along with the organization as it strives to provide a continuum of care is critical to ensuring that the full benefits of IT investments are being realized. 8

11 About the Authors Ramez Shehadi is a partner with in Beirut. He leads the information technology practice in the Middle East. He specializes in e-government, e-business, and IT-enabled transformation, helping corporations and government organizations maximize leverage of IT, achieve operational efficiencies, and improve governance of IT services. Jad Bitar is a senior associate with in Beirut. He specializes in healthcare and information technology, with a focus on strategy, organization, operations, and technology management. Walid Tohme is a principal with in Beirut. With a focus on healthcare and IT, he specializes in the management and strategic use of IT to enable transformation via new IT strategies, organizational restructuring, outsourcing solutions, and operational improvements. 9

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