Electronic Health Reporter

Guest post by Chris McNabb, general manager, Dell Boomi.

Many healthcare IT organizations find themselves caught between a regulatory rock and a technological hard place. The breadth and increasing complexity of today’s healthcare regulatory compliance is putting tremendous pressure on them to rapidly and efficiently establish interoperability between the variety of systems, applications, data sources and devices that populate the diverse healthcare ecosystem of providers, payers, government agencies, labs and more. However, most of these IT departments don’t have adequate budgets, resources and bandwidth to make major investments in new technology while also maintaining expensive legacy systems and trying to manually consolidate their highly fragmented data silos. Instead, they remain mired in outdated application integration strategies based on traditional middleware solutions that require long and costly development cycles, making it impossible to satisfy the new and ever-changing regulations anytime soon.

There is a better way. Integration Platform as a Service (iPaaS) enables the rapid and economic integration of applications in cloud-to-cloud, cloud-to-on-premises, and on-premises-to-on-premises integration scenarios. Because iPaaS is offered as a service, similar to the way Software as a Service (SaaS) is delivered, the barrier to entry is dramatically lower and the shift from CAPEX to OPEX delivers predictable costs. And because the integration will work with existing applications, IT will be able to focus immediately on meeting the challenges of the most significant new regulations, such as meaningful use, accountable care and the ICD coding standard. Let’s examine these regulations for their application integration challenge and see how iPaaS can help.

Meaningful Use

Even as healthcare organizations work to digitize their medical and clinical records, the requirement for meaningful use of certified electronic health record technology (CEHRT) means that the use of patient records needs to directly benefit patients through greater portability across health and insurance systems. This in turn requires IT to establish new, complex processes for recording patient information as structured data and exchanging summary care records. Several system providers and consulting firms offer solutions designed to overcome the portability challenge, but their proprietary interfaces can be a significant downside. As a result, the healthcare industry has been slow to attain compliance with the “meaningful use” requirement for EHR technology.

Accountable Care

Accountable care organizations (ACOs), which are designed to dramatically improve patient services, come with a new payment model. Instead of direct payments for services rendered, ACOs get paid based on the overall health of a population within the boundary of a defined community. Actually receiving payment, however, requires the ACO to produce a new set of metrics that must be collected from multiple systems, including EHRs, the Physician Quality Reporting System (PQRS), a variety of legacy on-premises applications, and the many new cloud applications that health organizations are adopting. The data must then be rapidly integrated for analytics and measurement. If this integration can’t be done rapidly, securely, and at a relatively low cost, the ACO model simply won’t work.

ICD-10 Coding Standard

Slated to go live in October of 2015, ICD-10, the latest revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), will enable much more granular patient and disease information to be captured, potentially leading to improvements in diagnoses and outcomes. It will also support more accurate population studies, leading to sounder conclusions. The recording requirements of ICD-10, however, are very stringent, and doctors fear that coding errors by their healthcare teams could lead to a loss of revenue.

Because of this, healthcare organizations must make it easier for the forms to be filled in. For example, if healthcare professionals can dictate the information into tablets while at a patient’s bedside or in an exam room, they can significantly reduce the potential for errors compared to entering the information hours later at a desk. However, faster and more efficient workflows based on mobile technology will require new business processes and a more versatile application integration solution.

Application Integration: Traditional Middleware vs. iPaaS

Application integration challenges are not new. IT has been successfully integrating disparate applications for decades using “middleware.” Middleware is the software layer that enables solutions such as customer relationship management (CRM), enterprise resource planning (ERP), and supply chain management (SCM) to interact and share data from across the enterprise. But there are two significant problems with healthcare IT organizations using middleware to meet today’s new regulatory challenges. First, middleware development projects are expensive and can take months or even years—time that healthcare organizations simply don’t have. Second, middleware was never designed for the types of cloud-to-cloud and cloud-to-on-premises integrations that are required in today’s healthcare organizations.

iPaaS takes a completely different approach. Instead of an on-premises integration solution requiring extensive coding and testing, iPaaS providers enable IT to easily build, deploy and manage application integrations, whether cloud to cloud, cloud to on-premises, on-premises to on-premises, or even EDI (electronic data interchange, for integration between different organizations). Because no software or hardware installations are required, development can begin almost immediately, and most iPaaS providers offer an easy-to-use drag-and-drop interface for mapping integrations that eliminates hardcoding while still supporting critical features such as security assurance and compliance capabilities. A recent Gartner report, Selecting the Most Suitable Platform for Cloud Service Integration, recommends using iPaaS “when time to integration is critical, the amount of projects is high and the SaaS applications involved include numerous offerings also from second-tier providers.” All of which is true for many healthcare IT organizations.

Key Considerations When Looking for an iPaaS Provider

When considering an iPaaS provider, look for these top-level capabilities:

• Full support for any combination of integration: cloud to cloud, cloud to on-premises, on-premises to on-premises, and EDI.
• A true multi-tenant solution that enables crowd-sourced features, such as suggesting integration mappings, suggesting resolutions for common errors, and predictive assistance, which helps customers maximize their ROI from the investment in the service.
• Full data security and compliance.
• Easy connection to almost any application, and straightforward access to any file store.
• A simple drag-and-drop interface that eliminates hardcoding and the need for rigorous bug testing.
• A distributed deployment model that eliminates the need for a transaction hub, which is a performance choke-point and a single point of failure.

Meeting evolving regulatory demands requires moving rapidly to enable efficient and flexible application integration across a variety of systems and data sources, both on-premises and in the cloud. The fastest, most cost-effective and most secure way to accomplish this is with an easy-to-deploy, easy-to-use iPaaS.