Have we got a solution for you

Our middleware roundtable participants describe their latest solutions to bridge the interoperability gap

By: HMT Mag   
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istock-622505468-health-applicationsLooking for an answer to your interoperability woes? You’ve come to the right place. Our HMT middleware roundtable executives describe their latest offerings for applications that make the enterprise more streamlined and information more usable.

Optimize asset utilization on the fly

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Steve Elder

Steve Elder, Senior Marketing Manager, STANLEY Healthcare

Interoperability with other HIS is one of the key features of STANLEY Healthcare’s RTLS solutions that customers leverage to extract more value from location data. In fact, we support a wide range of integrations: EMR, ADT systems, computerized maintenance management systems (CMMS), nurse call systems, and more. In all these cases, customers want to add location data to the information handled by these systems to streamline workflows and patient flows. For example, EMR integration allows for the bidirectional flow of data, with patient location information appearing in the EMR—which many hospitals now use as their central information clearinghouse—and information flowing to STANLEY Healthcare’s patient flow solution to automatically populate patient data fields. Similarly, location data on assets like IV pumps can be displayed in CMMS systems, and such information as firmware version and maintenance information can be displayed in our solution.

Latest offerings: We’ve seen particular customer preference for our solutions, even over other HIS that we integrate with, in the area of analytics. To take the example of asset management, our MobileView Analytics business intelligence platform gives Material Services a complete picture of the location, status, and usage of assets, including performance against par-level targets. Visual information updated dynamically makes it much easier to get out in front of bottlenecks in equipment before they impact care, and over time it enables fine-tuning of par levels so that bottlenecks don’t happen in the first place. The end result is optimum utilization, where there are just enough pumps to meet demand but never a shortage.

 

Way beyond the standard simple interface engine

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Todd Winey

Todd Winey, Senior Advisor, Strategic Markets, InterSystems

HIT is actually not a single market. InterSystems interoperability solutions cover the entire spectrum of HIT, including clinical, lab, HIM, imaging, revenue cycle, life sciences, m-health, and supply chain.

Each of these disciplines has unique interoperability needs based on the standards they rely on as well as the maturity of interoperability within the segment. Our solutions provide needed connectivity across the HIT spectrum as well as unique capabilities to drive analytics and workflow, as a true middleware platform must do. We also provide a development platform to which our software partners add their domain expertise to build a wide range of targeted solutions.

For example, within the clinical lab space, there are two main types of middleware: point-of-care testing (PoCT) and central lab. In the case of PoCT middleware, the purpose is to connect and manage various devices and provide a common connection point to the EMR. Central lab middleware has evolved from simple lab instrument connectivity to the EMR to become a platform that manages much of the operational and production data of a modern lab. An example of a partner using our interoperability solutions to develop true central lab middleware is Data Innovations, the most widely deployed lab middleware in the world.

This similar pattern of unique middleware solutions occurs in other segments as well. In the imaging area, interoperability can expand and take the shape of a vendor-neutral archive (VNA) or image exchange and go beyond basic messaging needs to registry capabilities using the XDS standards. We support those interoperability needs as well.

Latest offerings: Most solutions that are referenced as interoperability solutions are simple interface engines, performing only the transactional capability of moving messages, typically with a focus on HL7. InterSystems HealthShare is a family of solutions that goes far beyond just moving messages to store, analyze, and react to the data that flows through them. These are solutions built with an understanding of healthcare, including health information exchange, patient engagement, and more.

There is a lot buzz around the FHIR standard in the interoperability middleware world, and it holds great promise to allow improved access. But FHIR is just one tool in the interoperability toolbox. Other formats like CCDA are and will remain the standards of choice for things like transitions of care.

The core strength of our solutions is our ability, proven at industry connectathons and at customer sites, to work equally well with CCDA, HL7, or FHIR and easily move across the data standards to support deeper capabilities. Despite the promise and potential for FHIR to streamline data sharing, healthcare organizations will be dealing with multiple standards for decades to come, and we make that easy.

 

Leverage the full value of code sets

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Steve Ross, M.D.

Steve Ross, M.D., Manager of Clinical Informatics, Wolters Kluwer Health, Health Language

Wolters Kluwer’s Health Language solutions address the challenges of terminology management and data normalization across health IT systems. The breadth and depth of the Health Language offering sets it apart in the industry. As the only comprehensive Enterprise Terminology Management solution on the market, our complete suite of content and tools is managed in a central terminology server. This framework, based on the Health Language “Language Engine,” enables users to use all kinds of standard and home-grown terminologies without having to worry about the details of various content models. In fact, our content database contains more than 200 clinical terminologies and 790 value sets for satisfying multiple use cases, applications, and user groups. Terminologies are always in flux, and it is burdensome for healthcare systems to keep them up to date and in sync. The Health Language team of clinical and technical experts relieves this burden by curating terminology content and delivering updates to clients in a standardized format that is easy for them to consume.

The Health Language suite also supplements standard terminology content with applications, services, and its own proprietary content to assist healthcare operations. Proprietary content includes “provider-friendly terminology” that helps EHRs optimize the provider experience while enhancing the precision of documentation and coding. Applications include tools to assist with mapping and management of value sets. For clients that don’t want to use these tools themselves, Wolters Kluwer’s expert team can provide services to organizations of all sizes to help them achieve the value of true semantic interoperability.

Latest offerings: Our experience in the field and deep understanding of hospital and health system workflows helped our team identify the need to introduce our Code Group Manager tool and optimize our LEAP Map Manager solution. We recognized that healthcare organizations are increasingly identifying the need to leverage value sets, or code groups. While there are industry-level offerings available on the national stage, we’ve found that hospitals and health systems often require customized definitions for their analytics and interoperability initiatives. LEAP Code Group Manager helps safeguard and promote the integrity of code groups, which are often hard-coded in business rules and maintained in numerous spreadsheets. The tool essentially enables organizations to establish a single standard for concept definitions across a healthcare organization.

LEAP Map Manager addresses the complexities of data normalization and analysis and provides the industry’s most sophisticated algorithms as well as more than 1 million clinically curated synonyms and an up-to-date content library of more than 180 standard and proprietary terminologies. The tool was recently expanded to offer enhanced collaboration and workflow management tools that streamline workflow for IT, data warehouse, and quality improvement departments. These improvements include real-time mapping tools and allow users to collaboratively draft and review maps and publish final versions to the central Language Engine server where they can be accessed runtime via a REST API.

These Health Language solutions are also offered in a variety of locally hosted and cloud-based solutions to meet the needs of diverse clients.

 

An alternative to ripping and replacing IT systems

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Thanh Tran

Thanh Tran, CEO, Zoeticx

The Zoeticx healthcare middleware solution addresses patient medical information flow so that developers can focus on healthcare innovative solutions for providers. Zoeticx’s Patient-Clarity platform is the main engine to inspire the next generation of healthcare innovative applications.

The company has developed care applications, aimed at operational care environments, that address specific needs for both inpatient/ICU and outpatient/ambulatory needs and the capability to present patient-centric views across the care spectrum.

The Zoeticx Care application suite enables healthcare providers to address the challenge in system integration and interoperability among diverse EHR systems. The suite of applications is designed as a series of customized, low-cost, universal solutions aiming at supporting additional care providers’ needs.

Latest offerings: Healthcare middleware solutions such as the Patient-Clarity platform are unique in the market. Middleware simplifies the legal and administrative concerns brought into healthcare systems by HIEs, reduces healthcare IT costs by addressing EHR interoperability, and eliminates additional HIE database layers.

The value of the Patient-Clarity platform is its capability to create EHR interoperability for operational care environments by allowing the integration of healthcare systems while also offering an alternative to ripping and replacing IT systems. In addition, it fosters the evolution of healthcare applications with its data switch, enabling applications to access patient medical records from EHR systems, a challenge no other vendor is addressing.

Providers require specific functionalities, ranging from how patient medical information is presented to improving patient outcomes by ensuring the right information gets to the right providers at the right time. The ability to access data at critical operational junctures varies in different care environments, such as ICUs and cardiology, while overall collaboration among diverse healthcare organizations also adds to the challenge.

 

Workflows become seamless and without boundaries

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Jon Zimmerman

Jon Zimmerman, VP GM, GE Healthcare

The niches that GE Healthcare currently occupies are as follows: hospital, medical and monitoring devices, medical images, revenue cycle, payer clearinghouse, practices, medical and monitoring devices, clinical orders/results (EMR), revenue cycle, payers, clinical data clearinghouse (nascent but starting), gaps in care, encounter summaries, and hierarchical condition categories (HCCs).

Latest offerings: We have two major additions to our capabilities. One is for seamlessly connecting the workflow of physicians in clinics to the workflow of physicians in hospitals. GE has worked with a few hospitals and clinics to develop and deliver two-way hospital-to-ambulatory workflow integration using standards plus Epic CareEverywhere. To each party, the data appears as though it has come from their native systems within their workflows.

The second solution is seamlessly connecting the workflow of care managers in the payers to the clinicians in practices. GE has been working with payers and providers to electronically integrate workflows to process gaps in care and deliver encounter summary data, including hierarchical condition categories (HCC). Today, these interactions impact quality of care, operational efficiency, and financial performance for both payers and providers. This kind of workflow integration leveraging interoperability is showing great interest from payers and providers.

 

A whole new world for registries

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Richard Garcia

Richard Garcia, Vice President of Marketing, NextGate

NextGate provides a suite of software technology that facilitates interoperability by ensuring the data refer to the same patient and provider. NextGate’s products—Enterprise Master Patient Index (EMPI), Provider & Organization Registry, XDS Registry and Repository, and Event Relation Registry—are centralized indexes that correlate related records coming from different applications and provide a universal identifier for confident data exchange. The centralized indexes create a “golden record” of consolidated information and associate (link) all local identifiers to the master universal identifier, providing a convenient cross-reference mechanism. Accurate patient and provider identification is required for portals, EMR, MU, ACO, and HIE projects. NextGate delivers cross-platform identity resolution for intelligent data integration and exchange. Built on MatchMetrix technology rated #1 by KLAS and currently managing 200 million lives, the NextGate Registries for Healthcare provide a platform for accurate, efficient, meaningful data exchange.

Latest Offerings: MatchMetrix is an interoperability platform that contains multiple registries that serve as a foundation for accurate interoperability and an integration engine to connect using standard APIs. The registries include EMPI for patient data management, the Provider & Organization Registry for provider data management, and the Event and Relation Registry to link disparate data into a cohesive whole. We’ve added facial recognition as another element to improve the speed and accuracy of identification for both patient and provider, and support for FHIR integration. Additional advantages include duplicate record reduction rate, process automation for patient registration, and other points of record entry.

 

Population health gets turbocharged

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Kristin Russel

Kristin Russel, Vice President of Product Strategy, Transcend Insights

Transcend Insights provides an EHR-agnostic platform for community-wide interoperability across health systems and hospitals, as well as analytic tools that integrate clinical, claims, and wellness data, to offer health system executives and care teams a single, comprehensive view of their patient populations. Through our unified solution suite of population health management offerings, we help health system executives quickly evaluate quality and utilization metrics down to the individual clinician level. In addition, we offer care teams actionable, clinically validated health insights at the point of care to enable the freedom to make confident decisions.

Transcend Insights’ enterprise-grade interoperability solutions, supported by the HealthLogix Health Information Exchange (HIE), connect health systems nationwide to our enterprise partners, allowing the bidirectional exchange of patient medical records for healthcare-based analytics. Through the sharing of information to improve quality and measure effectiveness, we help strengthen value-based relationships.

Latest offerings: Our unified solution suite, announced at the HIMSS’16 conference and built on the HealthLogix platform, supports an ecosystem of population health solutions including: HealthLogix Populations, a performance measurement application that provides actionable, configurable visualizations and dashboards to help health system executives and care teams quickly evaluate quality and utilization metrics, and compare performance across an entire care community; HealthLogix Care, a tablet- and web-based application that provides physicians and care teams with a single, comprehensive view of a patient’s clinical, claims, and wellness data at the point of care; myHealthLogix, a patient engagement solution that connects care teams with their patients to enable a more coordinated approach to care; and going forward, HealthLogix Market, a future offering that will establish an open, scalable marketplace for third-party healthcare applications developed on the HealthLogix platform.

In contrast to population health management tools that emerged from accounting or revenue cycle solutions and struggle in a clinical setting, Transcend Insights’ focus on building clinician- and person-centric solutions has led to a platform that helps to power a better care experience, supports the freedom to make confident decisions, and enables care teams—not tools.

 

A data-access dream come true for physicians

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Dustin Lake

Dustin Lake, RVP, Sales, Aventura

Delivering relevant patient information, in real time at the point of care and in a secure manner, is one of the largest and most complex HIT problems today. Aventura’s Sympatica software platform sits at the junction of delivering flexible security, automating mindless logins, and unifying the presentation of clinical information across disparate applications.

Latest offerings: The Interoperability Module is the latest addition to Aventura’s Sympatica platform. Building upon our Security and Personalization modules, the Interoperability module becomes the heads-up display that ties the patient context and the relevant information sources together for the clinician.

As a clinician you can now walk into a patient’s room, tap your ID card at a computer, and within a matter of seconds the clinical desktop will appear with each relevant application running and logged in. The Patient Picker will present a screen with the name of each patient in the current location. With one click on the patient’s name, the EMR and each Tile Application in the Interoperability Dashboard updates its context to the patient in care.

In a workflow with our Interoperability module, the EMR continues to consume a majority of the screen real estate; however, the dashboard appears as a sidebar that presents secondary and tertiary applications in a uniform tile format in harmony alongside the EMR.

The Interoperability module leverages a RESTful API, which removes much of the confusion and integration permutations required with the myriad of protocols and proprietary application programming interfaces (APIs) that exist today. Aventura’s Patient Picker takes care of the custom integration with the EMR and then supplies the context to the RESTful API for the Dashboard’s Tile Applications. The Interoperability Dashboard, complimented by its API and SDK, acts as a platform to unify the contextual intelligence of the user and presentation of clinical applications. The result is a unified workflow that presents the right information when and where the clinician needs it, with less clicks, less logins, and less time waiting on technology.

 

Get smart providing value-based care

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John Kelly
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Vik Sachdev

John Kelly, Principal Business Advisor, and Vik Sachdev, Vice President, Smart Trading and Community Product Lines, Edifecs

At Edifecs, our mission is to build innovative healthcare solutions that harness data into meaningful transactions, reducing operating risks and scaling value-based initiatives, to meet the specific needs of our clients. Historically, we did that by reducing the administrative and financial costs associated with healthcare delivery—thus making more dollars available for medical care without increasing premium cost for consumers and employers. Our Smart Trading platform has evolved from just being able to reduce the friction costs associated with HIPAA transactions to incorporate business application functionality to correlate clinical and administrative data to support population health and value-based care initiatives.

We help our customers exchange structured and unstructured data in an easy and scalable manner, sharing a whole spectrum of health information among and between providers, healthcare delivery systems, government organizations (e.g., Medicare/Medicaid), and other payers and pay-viders. Essentially, to the extent possible, we leverage already established healthcare standards and optimize the use of those standards—like HIPAA, HL7, NCPDP, FHIR (as well as other medical and non-medical code sets). These standards allow us to establish a common language our customers can use to exchange member benefits, provider network data, and other financial and clinical data with those who are delivering medical care—at the time it is needed.

Latest offerings: The latest Edifecs solution is a continuation of our Smart Trading platform designed to provide our customers with a single solution to connect, consume, and process clinical data to use for their value-based care (VBC) initiatives. Since successful transition to VBC will require combining administrative, financial, and clinical data, Edifecs’ philosophy is that you need a single common channel vs. yet another new silo of data processing for clinical data. We’ve also extended our current solution with a new offering for population health, Population Dimensions and Population Payment Management, to provide for a normalized and integrated patient record. Importantly, this is not a “medical record.” It is a longitudinal log of all the highly granular event data that is produced in a continuous steam as every patient/customer moves across all the stakeholder operations associated with care delivery, health support, and wellness management. The product not only ingests and stores, it correlates and applies logic. It is an extension of the type of real and near-real time infrastructure that supports all other major industries that, in the past 30 years, went through the radical transformation that just now is happening in healthcare.

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