Lecture 13 System Integration and Interoperability (Chapter 13)

1. Lecture 13 System Integration and Interoperability (Chapter 13)

2. Learning Outcomes System integration and interoperability for healthcare delivery. Interface in system integration Types of system interoperability Benefits of integration and interoperability Integration issues IS 531 : Lecture 13

3. Why System Integration Health and financial data are collected at multiple points within the healthcare delivery system. Redundant efforts are expensive, frustrating, waste time, and result in different “versions” with none being complete or error free. IS 531 : Lecture 13

4. Benefits of Integration Allow instant access to application and data Improve data integrity with single entry of data Decrease data entry cost Facilitate the formulation of accurate and complete patient record Facilitate information tracking for accurate cost determinations IS 531 : Lecture 13

5. System Integration Different information systems should be able to exchange data in a fashion that is seamless to the end user This exchange occurs across an “interface” IS 531 : Lecture 13

6. Types of Interface • Software that tells different systems “how” to exchange data • Point-to-point: Directly connects 2 systems • Requires custom programming • Expensive • Interface engine: Allows data exchange between sending and receiving systems IS 531 : Lecture 13

7. Interface Engine Allows data exchange between sending and receiving systems Uses translation tables to move data from each system to the clinical data repository, a database where collective data from all information systems are stored and managed IS 531 : Lecture 13

8. Interface Engine … • Benefits of Interface Engine • Timeliness and availability • Decrease integration cost, time, effort as alternative to point-to-point type • Improve data quality with data mapping • Preserve institutional investment in existing systems • Simplify data processing • Improve management of care, financial tracking for care rendered, and efficacy of treatment IS 531 : Lecture 13

9. Clinical Data Repository Provides data definition consistency through mapping May also be referred to as the clinical data warehouse (CDW) Mapping—terms defined in one system are associated with comparable terms in another system IS 531 : Lecture 13

10. Real-Time vs. Batch Processing Real-time processing occurs immediately or almost immediately; used when speed is important. Batch processing usually occurs once daily at the end of the day (traditionally when there are fewer demands on the processor). IS 531 : Lecture 13

11. Interoperability • Ability of two entities to exchange and predictably use data or information while retaining the original meaning of data • Used interchangeably with term “interface” • but interface engine routes information from system to system without enabling understanding/use IS 531 : Lecture 13

12. Types of Interoperability • Syntactic (functional)—ability to exchange the structure of the data, but not the meaning • Semantic—guarantees meaning of the exchanged data on both ends of the transaction • Critical for clinical data IS 531 : Lecture 13

13. Interoperability Efforts • OpenEHR to provide “archetypes” high-quality, reusable clinical models of content and process • “Header”, “definition”, “ontology” • Service-oriented architecture (SOA) to create key functions as modules • Reusable, self-contained “object” • Vendor and technology neutral • Readily available in “registry of service” IS 531 : Lecture 13

14. Benefits of Interoperability Improved access to information Improved physician workflow, productivity, and patient care Improved safety Fully standardized healthcare information exchange Estimated savings = 5% annual U.S. healthcare expenditures IS 531 : Lecture 13

15. Integration Issues • Massive undertaking • Vendors failure to deliver on promises • Lack of agreement on standards • Politics and power • Lack of agreement on data dictionary, data mapping, and clinical data repository • Fear of change • Competition among providers IS 531 : Lecture 13

16. Drivers / Success Factors Consumer demands for improved care Demands from managed care The move toward the EHR Improved trending Easier data collection for accreditation purposes, research IS 531 : Lecture 13

17. Integration Requirements Data Dictionary —defines terminology to ensure consistent understanding and use Master Patient index (MPI)—database that lists all identifiers assigned to a client in all the information systems within an enterprise Clinical Data Repository IS 531 : Lecture 13

18. Uniform Language Provides uniform definition of terms Facilitates communication and ability to exchange data with a shared meaning Facilitates ability to replicate research Systematized Nomenclature of Medical-Clinical Terms (SNOMED-CT) recognized by American Nurses Association (ANA) IS 531 : Lecture 13

19. Role of the Nurse • Must be involved in: • Identifying and defining data elements that an interface can supply • Determining measures to ensure the quality of data exchanged among individual systems • Formation and maintenance of the electronic health record IS 531 : Lecture 13