Streamlining Healthcare Business Interactions

Transcription

1 WHITE PAPER Streamlining Healthcare Business Interactions Sponsored by: Axway Lynne Dunbrack December 2014 IDC HEALTH INSIGHTS OPINION Today's changing healthcare IT (HIT) environments are generating a greater demand for data and process integration. Traditional connectivity between internal systems provided by early-generation "interface engines" has evolved to include external data sources that encompass XML and other Web-based messaging standards. This shift has led to the introduction of a new generation of "integration platforms" to meet these evolving requirements. Key findings include the following: Interface volumes are increasing significantly especially connectivity with external stakeholders such as community-based physician practices. Aging legacy interface engines cannot keep pace with this growing demand and the complexity of heterogeneous IT environments created through mergers and acquisitions. A connected healthcare environment enables and improves clinician access to health information across the continuum of care, which in turn reduces provision of redundant or inappropriate care, improves patient care and safety, and reduces the cost of care. Additionally, complying with the meaningful use provisions under the HITECH Act requires the ability to actively and securely exchange health information. Rapid development environments, ease of use, product reliability, and vendor stability are key attributes for evaluating new interface platform options. Using Axway technology, customers were able to streamline interface development through the use of a self-service managed file transfer (MFT) portal and reduce the level of effort and resources by almost half. An online repository of interfaces and an automated process reduced errors and the chance of redundant interface development, thus saving both time and money for the profiled Axway customer. IN THIS WHITE PAPER This White Paper is presented by IDC Health Insights and sponsored by Axway. The objectives were to gain insights into: The business value that can be gained from reducing the time to connect new partners and systems and reducing the time to identify and resolve transmission issues How healthcare organizations can protect themselves from a HIPAA data breach How a prominent healthcare organization is leveraging Axway technology to successfully address its data integration challenges December 2014, IDC Health Insights #HI252427

2 SITUATION OVERVIEW The U.S. healthcare system is in the midst of a momentous transformation as it shifts toward new care delivery and reimbursement models in order to meet health reform objectives of controlling healthcare costs while improving the quality of care, patient outcomes, and the patient experience. Thus the business of healthcare is becoming increasingly data driven in the post-reform era that emphasizes value-based reimbursements. It will be critical for payer and provider organizations to have a clear picture of their financial, operational, and clinical performance if they are to survive under this new paradigm of increased emphasis on accountability. Healthcare organizations that are more adept at deriving value from data and can use data effectively to differentiate their services, costs, and quality will be more successful. Business and IT Challenges Facing Healthcare IT Today The unprecedented disruption being felt by the healthcare industry is creating numerous business and IT challenges: Heterogeneous IT platforms. Despite the trend toward acquiring application portfolios from a single supplier, or from a limited number of suppliers, few hospitals are able to meet all of their application portfolio requirements using a single source. Heterogeneous IT portfolios are, and will remain, the norm. Mergers, acquisitions, affiliations, and other governance changes to provider organizations will only accelerate this trend. Strong information management capabilities will be critical to the continued deployment of analytics solutions by payers and providers. Fragmented healthcare data. Healthcare data is by its very nature complex originating from multiple, disparate sources in numerous structured and unstructured formats. Fragmented data archiving and storage strategies, including the cloud, only serve to compound the situation and make it difficult for provider organizations to access reliable and accurate enterprise-level data. Payer and provider IT organizations will need to aggregate, cleanse, and normalize data from disparate sources to create a unified, holistic view of the enterprise's administrative, financial, and clinical performance. This unique level of visibility into the organization's performance will enable healthcare organizations to make the fundamental changes necessary to achieve the objectives of health reform. Stage 2 meaningful use requires health information exchange. ARRA and its meaningful use requirements require healthcare organizations to share health information to enable population health management, care collaboration and coordination, and care transitions. Specifically, stage 2 requires the following: A clinical summary of care must be sent to the patient after an office visit. Patients must have online access to their electronic health information and be able to download and transmit that data should they choose to. A summary-of-care record must be sent when a patient is transitioned to another care setting or referred to another provider IDC Health Insights #HI

3 Increasing points of integration. The volume and the degree of complexity of healthcare data and applications are growing in a geometric fashion. Consequently, interface volumes are increasing significantly especially for connecting to external stakeholders such as community-based physician practices. Deployment of clinical technology such as EHRs and CPOEs, as well as the investment by payers in new and emerging technology to support provider and consumer engagement, is creating a technology infrastructure that is increasingly inefficient, inflexible, and cost prohibitive, with many assets underutilized or overutilized. Constrained IT staff and budgets. The demands on availability, uptime, security, mobility, and performance for point-of-care computing are increasing, while the budgets to implement, secure, and manage the data required to run these applications are declining. A challenging economic environment and competing IT initiatives continue to constrain healthcare IT budgets. The cost pressures on the industry do not allow for the addition of staff to manage the infrastructure. HITECH and the HIPAA Omnibus Rule are intensifying the risk of HIPAA violations. The risk of privacy breaches is rising as more consumer information is made available in electronic formats and is thus accessible both inside and outside the organization via health information exchange and a range of devices (including mobile devices). Under ARRA, privacy breach notification, minimum use, and disclosure reporting requirements become more stringent, and the total annual penalties for violations can increase to $1.5 million. CHALLENGES AND OPPORTUNITIES This is a period of great change in the structure of the healthcare industry, as new business models, regulatory changes, and cost and quality improvement initiatives are fundamentally restructuring traditional business and clinical processes and organizational models. These changes are accelerating IT adoption throughout the industry while adding complexity to the IT environment, requiring healthcare organizations to: Improve business and clinical workflows. Timely and accurate information sharing is a vital component of these changes. As a result of ARRA and the drive toward the meaningful use of EHRs, provider organizations are beginning to have unprecedented access to electronic health information, which will enable them to use data for improved decision making and operational and clinical transformation. A connected healthcare environment enables access to health information across the continuum of care. Improved access to health information by clinicians reduces the provision of redundant or inappropriate care, improves patient care and safety, and reduces the cost of care. Streamline the process of integrating data and exchanging health information. Streamlining and automating interface development will drive operational efficiencies. Data integration will help make transitions between workflows seamless to the end user and will reduce the number of applications that must be accessed to look for information or complete a task. Selecting technology that improves staff productivity and also reduces technical complexity is critical if healthcare organizations hope to take advantage of these IT-enabled efficiencies IDC Health Insights #HI

4 Secure protected health information. Data files are routinely extracted from healthcare organizations' servers for further analysis by staff on laptops. While the data may be encrypted when behind the corporate firewall on company servers, security measures become questionable when data files are moved to employee laptops, especially if employees take their laptop home or on a business trip. Furthermore, mobile devices are proliferating in healthcare. Their portability presents a security risk because they are easy to misplace or conceal if stolen. As such, data should be encrypted not only while in transit but also while at rest on all devices to prevent a security breach if a mobile device goes missing. Implement audit and security features. Audit and security features are important to ensure HIPAA and other regulatory compliance requirements. Robust event logs, journaling capabilities, and automated recovery and restore capabilities provide rapid recovery efforts in the event of a transaction corruption or system failure. Standardize data connections. Constrained interface development teams cannot keep up with the sheer volume of interface activity to connect both internal and external systems. Tools that facilitate development across all types of interfaces will maximize a developer's ability to reuse components (objects) previously developed for other interfaces and thus create additional interfaces in hours, not days. AXWAY'S DATA EXCHANGE AND INTEGRATION SOLUTIONS Axway is a market leader in governing the flow of data, helping nearly 400 healthcare providers and more than 240 payers securely manage a wide range of business interactions. These business interactions can involve data flows (including s, messages, files, services, and events) across systems, with external trading partners, between individuals, within communities, and to and from cloud-based services. While healthcare organizations have endeavored to simplify their business infrastructures and application portfolios, growth through mergers and acquisitions and expanding IT portfolios to support accountable care and population health management initiatives have made connecting the medical ecosystem even more complicated. The Axway approach, which is branded as Axway 5 Suite, holistically addresses the complete enterprise community. Axway 5 Suite addresses the needs of healthcare organizations that have unwieldy IT portfolios of thousands of business and clinical applications. It enhances transparency and visibility allowing healthcare staff to better manage throughput and exceptions. As a result, healthcare organizations and their trading partners know that their data either in batch files or real time has been accepted and processed on time. Axway 5 Suite supports real-time event monitoring, reporting, and alerts across multiple channels and orchestration of business processes with configurable rules. In addition, the suite bridges mobile, social, cloud, and on-premise data in a secure and HIPAA-compliant manner. Client data can be onboarded using drag-and-drop interfaces operated by business analysts within the department or business unit of a healthcare organization IDC Health Insights #HI

5 Axway 5 Suite is available as hosted or on-premise software and provides a single solution to support all of the internal and external integration and communication protocols for the vast majority of companies that run multiple IT applications or those working with third-party outsourcing partners. This single solution can be the backbone for connectivity with suppliers, customers, and business partners. Axway offers a full portfolio of security and data privacy options for file transfer, including strong authentication, digital signing for nonrepudiation, controlled list of IP addresses, DMZ secure relay, and role-based user access. In addition to these explicit security features, with real-time analytics and notifications, anomalous entries can be identified upon receipt. The healthcare organization can work with its trading partners to determine if these atypical transmissions are due to changed business practices or if they originated erroneously or even fraudulently. As healthcare fraud continues to grow, healthcare organizations need to have extra security layers to improve detection. One Healthcare Provider's Experience One of the largest healthcare systems in the United States, with more than $14 billion in assets and 8,000 beds across 18 states, turned to Axway to help it address the business challenge of managing the interactions between thousands of applications and interfaces enterprisewide. Managing file transfers between applications and trading partners is made even more complex by the growing regulatory requirements of HIPAA, HITECH's meaningful use requirements, and the Patient Protection and Affordable Care Act. These regulations established more stringent privacy and security provisions while requiring the ability to exchange health information to improve business and clinical performance. The healthcare organization wanted a future-proof solution that would improve data security, improve file transfer visibility, and prevent data loss. For many years, the standard integration protocol for batch file transfers was FTP. The healthcare organization wanted to create a managed file transfer solution that would enable it to meet the following objectives: Extend its existing enterprise application integration (EAI) platform Consolidate all file transfers through one, standardized file transfer solution to reduce the potential for data loss Centralize knowledge, auditability, and security/privacy controls Obtain better file transfer visibility to business departments and IT supporting critical applications Drive adoption across the enterprise for internal and external use cases Create a scalable solution for building and managing thousands of file transmission scripts that support hundreds of critical applications and business functions Achieve continuous quality and efficiency gains in onboarding new partners and enabling IT teams to build their own flows Establish and manage enterprise MFT standards 2014 IDC Health Insights #HI

6 The healthcare organization recognized that MFT would need to be self-service if the solution was to be scalable with interfaces that could be deployed faster, easier, and cheaper. A self-service approach would provide autonomy for application development teams and enable faster response to initiatives involving the rollout of a new EHR enterprisewide and ICD-10 readiness. New integration strategies would also better position the healthcare organization for future merger and acquisition opportunities. The first set of goals for the self-service MFT project involved reducing the build time and resources needed for developing interfaces by more than 50%. The healthcare organization wanted to make MFT development easier through self-service to promote migration from the legacy FTP interfaces. The ultimate goal is to significantly increase automation of interface configurations. The process for building out interfaces before the self-service MFT portal was deployed involved many people, principally the EAI team. The highly manual process was prone to interruption, and it often took up to three weeks to develop an interface. Applying best practices was difficult at best. In contrast, the self-service approach enabled the application teams and key business users to work with the EAI teams to develop their own interfaces. Centralizing data management was critical to ensuring security while promoting efficiency by providing end users the tools to develop interfaces for the products and applications they managed. Through the self-service MFT portal, IT staff can easily track the secure flow of data from a single pane of glass. The automated processes reduced errors caused by manual processes and accelerated the turnaround time for interface work. Duplicate efforts were also reduced because of the visibility into the interface development process provided by the portal and a single electronic data repository of MFT interfaces. In addition, the healthcare organization could enforce best practices and policy compliance with privacy, security, HIPAA, and change management requirements. ESSENTIAL GUIDANCE Integration platforms are a vital component of a healthcare organization's IT environment. They are essential to the efficiency, timeliness, and accuracy of critical interdepartmental and, increasingly, external communication processes. The role of this technology continues to grow in importance as healthcare organizations shift their IT investment focus from administrative and financial applications to clinical applications and from an episodic, encounter-specific view to a more recurrent, longitudinal view of patient data. Healthcare organizations should seek products that provide not only necessary functionality but also ease of use, flexibility, reliability, low total cost of ownership (TCO), and high return on investment. In addition, they should look for vendors that provide expert professional services as well as deep healthcare experience IDC Health Insights #HI

7 About IDC International Data Corporation (IDC) is the premier global provider of market intelligence, advisory services, and events for the information technology, telecommunications and consumer technology markets. IDC helps IT professionals, business executives, and the investment community make factbased decisions on technology purchases and business strategy. More than 1,100 IDC analysts provide global, regional, and local expertise on technology and industry opportunities and trends in over 110 countries worldwide. For 50 years, IDC has provided strategic insights to help our clients achieve their key business objectives. IDC is a subsidiary of IDG, the world's leading technology media, research, and events company. Global Headquarters 5 Speen Street Framingham, MA USA idc-insights-community.com Copyright Notice Copyright 2014 IDC Health Insights. Reproduction without written permission is completely forbidden. External Publication of IDC Health Insights Information and Data: Any IDC Health Insights information that is to be used in advertising, press releases, or promotional materials requires prior written approval from the appropriate IDC Health Insights Vice President. A draft of the proposed document should accompany any such request. IDC Health Insights reserves the right to deny approval of external usage for any reason.