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Expert Commentary: Interoperability The EMR installation disconnect

When it comes to connectivity issues, you can’t be too prepared. By George Gides

ith the impending implementation of the federal meaningful-use (MU) standards, healthcare organizations are rushing to fully implement EMR systems. This in- cludes managing the requirements for interoperability. As a consultant who has specialized in making disparate systems “talk” to each other for the past 20-plus years, I’m seeing an interesting trend during EMR implementa- tions: There is a complete lack of planning when it comes to connectivity, yet MU connectivity requirements are one of the major reasons EMRs are being implemented in the fi rst place – to connect all systems for universal patient record access.


In one recent (and increasingly common) example, the EMR vendor’s resource was not experienced with large integrated healthcare networks. The person knew the vendor software very well, but was not familiar with the client organization’s other systems, business or culture. During the testing phase of the EMR implementation, it was “discovered” that multiple medical record numbers were being created for each patient. The problem could have been solved up front by answering simple questions, such as: What is the main patient identifi er (if one exists)? How is it assigned? Does it change? What does the in- terface code need to do to account for this information? Since the interface connectiv- ity plan did not account for this sort of “global” research and analysis and since the

George Gides is a senior consultant at Hayes Management Consulting. For more information on Hayes Management Consulting solutions:

resource was inexperienced, interface installation fell sor- rowfully behind.

EMRs must be connected completely across the entire healthcare enterprise. Why, then, is interoperability plan- ning left on the sidelines or given to an inexperienced vendor or internal resources? There are three reasons: 1) There is a mistaken perception that the connectivity solutions that come with the EMR will easily connect to other systems

36 February 2011

in the enterprise; 2) Healthcare organizations assume that the vendor will provide the expertise and services; and 3) If there are no connectivity experts on the day-to-day implementation team, connectivity project planning gets overlooked or short-shifted due to mere ignorance of the steps that need to be taken.

When an organization implementing an EMR does not have a good connectivity plan in place and a good connectiv- ity project manager, you can bet that there will be delays in the implementation of the EMR itself.

When an organization implementing an EMR does not have a good connectivity plan in place and a good connectivity project manager, you can bet that there will be delays in the implementation of the EMR itself.

Ok, let’s assume you’re on board with the need to have a connectivity plan in place and the right resources to execute it. How do you know the plan is a good one? Here are some pillars of a good connectivity project plan: • A clear statement of what the overall goal is and why it is important to achieve it;

• A clear textual and graphical explanation of the overall connectivity plan;

• A clear defi nition of the detailed installation steps, when they will be done and by whom;

• A clear statement of the intermediate steps and ex- pectations of the results; and

• A clear contingency process to follow when dates are missed. Clearly, clarity is crucial. The timing and the process of creating a connectivity plan is as important as the plan itself. Here are some suggestions: • The client-side connectivity team should be estab-


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