Joining An HIE Without Hitting The Wall
By Wren Keber
Many healthcare organizations are faced with the challenge of multiple information technology systems, including disparate electronic health records, practice management applications, clinical and financial decision support applications, document repositories or registries, and more. In lieu of standardizing all the applications onto complimentary platforms, many organizations choose to implement enterprise software to exchange data between different systems, part of a health information exchange. It is a growing niche within the larger health information technology industry segment.
For organizations that have decided to implement an HIE, there are roles and responsibilities for many staff groups both in and out of the IT department. Executive leadership has the ultimate responsibility to ensure the success of the implementation and reduce complications which may be paramount given the investment of human and financial resources involved. Here are four high-priority recommendations to avoid common pitfalls during this major endeavor:
Take Inventory. An important task that's often skipped at the beginning of an HIE implementation is to take inventory of all the data systems in the organization. Ensure that the chief information officer or HIT staff creates an authoritative and comprehensive list of what systems exist throughout the organization. In addition to documenting major known systems, it is good practice for the CIO or IT staff to interview key stakeholders who will use the HIE. Stakeholders will have knowledge of any "workaround" systems, data repositories, or system peculiarities adapted for their own specialized reasons. For example, if a practice management platform does not support a custom billing code, office staff may have created an alternative database to track it, and thus ultimately that financial data might not be available through the HIE. These interviews are also prime territory to build consensus.
Learn the Lingo. While technical terms may be frustrating and difficult to grasp, learning the differences between major classes of applications can improve communication with IT staff, vendors, and other healthcare leaders. For example, there is a difference between a clinical data warehouse and a health information exchange. The two concepts, however, are interrelated, as an HIE can be a major supplier of data to a clinical data warehouse. Both types of software might even be marketed, sold, and implemented together, thus confusingly appearing as one solution.
Integrate Organizational Silos. While building consensus and buy-in is important, do not let the desire for decision-by-committee supersede the need to integrate all organizational initiatives that need to leverage the HIE. It is common advice to find champions for IT projects – when strong supporters are identified and promoted, they work to help shepherd along initiatives. Cross-pollinate initiatives with champions that sit on multiple committees, so that one group can communicate their needs and priorities with others. For major initiatives, convene a steering committee overseeing multiple initiatives that will use the HIE.
Think Big, Start Small. There are grand possibilities to conceptualize when IT systems work together through an HIE. The big picture outcome for an HIE implementation is to enable a vibrant network of users circled around high-quality and accessible clinical data, no matter where it is stored. Healthcare organizations can realize efficiencies, report on quality indicators, and improve accessibility and accountability of clinical data. Thinking outside the physical walls of a hospital or practice, there are positive implications in the community with affiliates, owned practices, emergency service providers, and more. The possibilities can be daunting, so grounding the vision with a dose of reality keeps project scopes in-check, resulting in small wins that build consensus and lead to a larger, more sustainable success.
Wren Keber is a manager with The Camden Group, an El Segundo-based healthcare consulting firm.
