Interconnected Health 2012 HL7 Integration: From Trial and Error to Predictable Project Outcomes April 2012
HL7 Interface Lifecycle Management at Interconnected Health 2012
May 26, 2015
http://caristix.com
HL7 Integration: From Trial and Error to Predictable Project Outcomes
By nature, an HL7interfacing project consists of many unknown unknowns. And far too many teams rely on trial and error and drawn-out iterative processes to get projects completed. Unfortunately, those in charge often lack the transparency into accurate information about project status. With complex projects, the result all too often is an inability to predictably hit a target go-live date, impacting planning and the ability of leadership to extract the maximum value from project resources.
This presentation introduces a new concept, Interface Lifecycle Management, which covers 7 key stages that every healthcare organization goes through when implementing interfaces. These steps are: scoping, configuration, validation, go-live, monitoring, maintenance and support, and finally, an upgrade decision when sending systems change. Using examples drawn from providers and HIT vendors, the presenter will cover best practices and automation strategies that leadership can implement during each step regardless of interface engine or integration technology in use.
HL7 Integration: From Trial and Error to Predictable Project Outcomes
By nature, an HL7interfacing project consists of many unknown unknowns. And far too many teams rely on trial and error and drawn-out iterative processes to get projects completed. Unfortunately, those in charge often lack the transparency into accurate information about project status. With complex projects, the result all too often is an inability to predictably hit a target go-live date, impacting planning and the ability of leadership to extract the maximum value from project resources.
This presentation introduces a new concept, Interface Lifecycle Management, which covers 7 key stages that every healthcare organization goes through when implementing interfaces. These steps are: scoping, configuration, validation, go-live, monitoring, maintenance and support, and finally, an upgrade decision when sending systems change. Using examples drawn from providers and HIT vendors, the presenter will cover best practices and automation strategies that leadership can implement during each step regardless of interface engine or integration technology in use.
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Interconnected Health 2012
HL7 Integration: From Trial and Error to Predictable Project Outcomes
April 2012
Agenda
• HL7 is flexible• Current approach: trial & error• Proposed new approach: Interface Lifecycle
Management
© Caristix 2012. All rights reserved.2
HL7 Specification
Product A
Deployed interface
Product BDeployed interface
HL7 v2.2HL7 v2.3.1HL7 v2.4HL7 v2.5.1HL7 v2.6HL7 v2.7
GAPS:WORK REQUIRED
HL7 is Flexible – No Plug & Play
3 © Caristix 2012. All rights reserved.
Gaps: A Few Examples
• Z-segments• User-defined Data Sets
© Caristix 2012. All rights reserved.4
Z-segments
© Caristix 2012. All rights reserved.5
MSH|^~\&|SPC|R|ENG|R|200609280101|43|ADT^A08|44859646|D|2.6|44859646||AL||EVN|A08|200609280101||PID||03777168|0001754426^^^R|9960^R17400|REGISTRATION^AMY^^||19601020|F||3|123 BOOGEY AVE^^NICECITY^MN^44444^US^C^25|25|(999)555-9999|(999)555-9999|ENGLISH^E^|M|BAP^^|0627330001^^^R|569-33-8744|NK1|1|REGISTRATION^PAT|B^^|123 BOOGEY AVE^^NICECITY^MN^44444^US|(999)555-6879NK1|2|N^A|T^^|^^^^^|PV1||O|MRIR^^^R^^^|3|||16515^SMITH^JANE^S^^^DO|^REGISTRATION^MIKE^J^^^||IMG||||1||EMP|16515^SMITH^JANE^S^^^DO|OPR^^R|0627330001^^^R|S|||||||||||||||||||R|||||200609280001|||0.00||PV2|||||N|||200609280800||||OPR RAT|||||||||*|||||""|||||||20060928||||||^MRIBRAIN W/O CONTRASTAL1|||^|||DG1|0|I9||HEADACHE||A||||||||DG1|99|I9||HEADACHE||WORKING||||||||GT1|1|9960|REGISTRATION^AMY^^||123 BOOGEY AVE^^NICECITY^MN^44444^US^C^25|(999)555-9999||19601020|F||A|569-33-8744|||1|ZZHEALTH^111|1087 DENNISON AVE^^NICECITY^MN^43201^US^^25|(999)555-9999||1IN1|1|100|800|SELF PAY|^^^^^^C^||||||ZZHEALTH^111^||||C^^|REGISTRATION^AMY^||19601020||||||||||||||||||||||||1|F|1087 DENNISON AVE^^NICECITY^MN^43201^US|IN2||569-33-8744||||||||||||||||||||||||||||ACC|200609241500|3|CLEVELAND AVE/FRANKLINUB1|1|||||||||45^15||||||05^20060924~^~^~^~^|||||||ZCA|||^^^ZCD||N|||^NEW LIFE^||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||^SURGERY CASE NUMBER~^EMSTAT NUMBERZCE|15^SECRETARY^|""|111^ZZHEALTH^|1087 DENNISON AVE^^NICECITY^MN^43201^US^^25||||1||ZCI|1|SELF PAY, NO INSURANCE||S|N|569-33-8744|N||P||||""||||""|||||||||||||||||1ZCV|||||FALL||PDR|0ZCM|N|||||||||*|||||||||||||^REGISTRATION^MIKE^J
User-defined Data Sets
© Caristix 2012. All rights reserved.6
User-defined Data Sets
© Caristix 2012. All rights reserved.7
User Defined Data Sets
© Caristix 2012. All rights reserved.8
MSH|^~\&|SPC|R|ENG|R|200609280101|43|ADT^A08|44859646|D|2.6|44859646||AL||EVN|A08|200609280101||PID||03777168|0001754426^^^R|9960^R17400|REGISTRATION^AMY^^||19601020|F||3|123 BOOGEY AVE^^NICECITY^MN^44444^US^C^25|25|(999)555-9999|(999)555-9999|ENGLISH^E^|M|BAP^^|0627330001^^^R|569-33-8744|NK1|1|REGISTRATION^PAT|B^^|123 BOOGEY AVE^^NICECITY^MN^44444^US|(999)555-6879NK1|2|N^A|T^^|^^^^^|PV1||O|MRIR^^^R^^^|3|||16515^SMITH^JANE^S^^^DO|^REGISTRATION^MIKE^J^^^||IMG||||1||EMP|16515^SMITH^JANE^S^^^DO|OPR^^R|0627330001^^^R|S|||||||||||||||||||R|||||200609280001|||0.00||PV2|||||N|||200609280800||||OPR RAT|||||||||*|||||""|||||||20060928||||||^MRIBRAIN W/O CONTRASTAL1|||^|||DG1|0|I9||HEADACHE||A||||||||DG1|99|I9||HEADACHE||WORKING||||||||GT1|1|9960|REGISTRATION^AMY^^||123 BOOGEY AVE^^NICECITY^MN^44444^US^C^25|(999)555-9999||19601020|F||A|569-33-8744|||1|ZZHEALTH^111|1087 DENNISON AVE^^NICECITY^MN^43201^US^^25|(999)555-9999||1IN1|1|100|800|SELF PAY|^^^^^^C^||||||ZZHEALTH^111^||||C^^|REGISTRATION^AMY^||19601020||||||||||||||||||||||||1|F|1087 DENNISON AVE^^NICECITY^MN^43201^US|IN2||569-33-8744||||||||||||||||||||||||||||ACC|200609241500|3|CLEVELAND AVE/FRANKLINUB1|1|||||||||45^15||||||05^20060924~^~^~^~^|||||||ZCA|||^^^ZCD||N|||^NEW LIFE^||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||^SURGERY CASE NUMBER~^EMSTAT NUMBERZCE|15^SECRETARY^|""|111^ZZHEALTH^|1087 DENNISON AVE^^NICECITY^MN^43201^US^^25||||1||ZCI|1|SELF PAY, NO INSURANCE||S|N|569-33-8744|N||P||||""||||""|||||||||||||||||1ZCV|||||FALL||PDR|0ZCM|N|||||||||*|||||||||||||^REGISTRATION^MIKE^J
HL7 v2.6 suggests “2106-3”
A Few Numbers
• 60% of hospitals deal with 100+ systems.• 64% of hospitals increasing HL7 integration
over 12 months.
• In HL7 v2.6:– 370 trigger events– >500 data elements per message– >500 suggested code sets
© Caristix 2012. All rights reserved.9
Sources: HIMSS 2008 survey, Core Health Technologies 2011 survey. HL7 International.
Current Approach
Requirements based on:• Manual analysis (pipe counting)• Small data samples• Incomplete and/or outdated
documentation:– Interface specifications– Ecosystem data flow
© Caristix 2012. All rights reserved.10
Current Approach: Results
• Low-fidelity, low-trust requirements:– “What is connected here?”– “Which data structures?”– “What is optional in which scenario?”– “Which data sets? From when?”– Are the semantics consistent?”
© Caristix 2012. All rights reserved.
11
Current Approach: Results
“Let’s start with a best-guess interface and fix issues when they pop up.”
The Trial & Error loop starts...
© Caristix 2012. All rights reserved.
12
Trial & Error Outcomes
• Cannot predict effort, timeline and costs• Cannot evaluate risk• Continue iterating after go-live• Hard to capture and reuse issue discovery
– With Colleagues– With Providers/Client teams
© Caristix 2012. All rights reserved.13
Proposed New Approach
© Caristix 2012. All rights reserved.14
Interface Lifecycle Management
Interface Lifecycle Management
© Caristix 2012. All rights reserved.15
• Understand gaps early• Work with real-life messages• Predictable• Focus on automation
Scoping
• Automate as much as possible• Analyze real life data• Compare sending vs. receiving systems• Gaps found = Tasks
© Caristix 2012. All rights reserved.16
Configuration
• Configure your integration engine– Filtering– Transformation– Mapping
• Consider automation based on gaps
© Caristix 2012. All rights reserved.17
Validation
• Build reusable and repeatable test scenarios based on gaps
• Automate test scenarios• Run tests in test environment• Include real life data (de-identify if needed)• Refine test scenarios
© Caristix 2012. All rights reserved.18
Monitoring
• Keep tracking any gaps that may appear• Refine scoping results, configuration and test
scenarios
© Caristix 2012. All rights reserved.19
Evidence-based Decision-making
30-60% Time Savings
© Caristix 2012. All rights reserved.20
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Known vs. Unknown Gaps through Interfacing Project
Current Approach Proposal
Contact Information
Jean-Luc MorinVP R&D, Caristix
April 2012
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