Integrating with the HIE
The benefits of Health Information Exchanges (HIEs) are quite profound. Recently we were able to assist one of our clients in exchanging data from the Electronic Healthcare Record (EHR) with their state’s HIE network – specifically registrations, radiology results and documents. The biggest challenges we faced in integrating the EHR and the HIE included the following:
- Patient identifiers – these can be different between driving system (Radiology Information System (RIS), Laboratory Information System (LIS), and EHR. Consistency with the Master Patient Index (MPI) across all interfaces is the desired outcome.
- Filtering – mental health document types, “celebrity patients,” preliminary documents, unverified results – the list goes on and on. Knowing the gamut of different options of configurability is helpful in deciding which filtering should take place.
These interfaces were built in the ConnectR interface engine utilizing the existing Application Programming Interface (API) to the Allscripts Enterprise EHR (AE-EHR) – inbound and outbound stored procedures. It should be noted that the ConnectR interface engine is used as the standard interface engine by Allscripts to facilitate the communication between healthcare systems, however there are alternatives.
This approach is not entirely desirable in that it requires customization of the interfaces to the particular vendor/client based upon their underlying data exchange implementation architecture. In an ideal sense, the data exchange would facilitate a “seamless” plug-in to existing AE-EHR users and HIEs. This is certainly what the industry is driving towards.
As Dr. Halamka alluded to in his blog posting yesterday, the ideal scenario is one in which CDA/CCD documents are used to exchange data between the EHR and the HIE as they offer a complete set of the patient record. HITSP (Health Information Technology Standards Panel) standards describe these transactions as there are thirteen original Interoperability Specifications (IS) into an EHR-centric view to facilitate alignment with Health Information Technology provisions of the American Recovery and Reinvestment Act of 2009 (ARRA). For more information regarding Health Information Exchanges (HIEs) and “real-world” implementations and their utilization of HITSP products see the following HIMSS webinar. In the interim, for those Allscripts clients looking to get ahead of the game with meaningful use, we are left to develop interfaces within the framework of the existing API to/from the AE-EHR.
In closing, be very aware of the possibilities as the HIE landscape is changing. For example, Navinet now offers subsidization of HIE implementation costs. However, the challenge remains in determining the best business model to fund the exchange going forward.
For additional information regarding Galen Healthcare Solutions’ data exchange / interface services please contact justin.campbell@galenhealthcare.com or visit www.galenhealthcare.com/interface-service
