Article

Healthcare IT integration best practices

Integration within the healthcare IT environment has been called “many orders of magnitude more complex” than other commonly recognized integrated vertical environments such as Finance and Banking. Understanding and working within this complexity requires specialized IT and trouble-shooting skills, comprehensive understanding of enterprise data flows, and clear and thorough documentation.

Sectra utilizes the following best practices for the successful deployment of customer integration projects:

  • Documentation: Create clear, comprehensive, and highly detailed documentation of the enterprise workflow
  • Standards: Choose standards-based integration over proprietary integration when possible
  • Test environment: Scrupulously maintain a complete integrated test environment using live data
  • Test plans: Generate test plans for all integrated systems based on the workflow documentation
  • Vendor management: Coordinate changes with vendors from all affected systems in advance
  • Version control: Implement a version control system to manage changes

Documentation

Some of the most basic Best Practices in Healthcare IT Integration revolve around comprehension and detailed documentation. The way in which data are generated and moved throughout the enterprise—from textual data entered on patient arrival to images generated at various modalities—needs to be understood and documented in both a visual and textual format. This highly detailed documentation should be maintained so that even minor changes, such as an increased patch level, result in corresponding changes to the documentation.

Standards-based integration

Using standards-based integration offers the benefit of a large breadth of experience and exposure over proprietary integration. It reduces the cost of implementation and management, along with making future changes easier and integration with other facilities more likely.

Test environment

Maintaining a test system that replicates the live environment and using live data through the interfaces is a must. Often test systems sit disconnected, and unmaintained, which reduce their usefulness. Only a test environment that replicates live will be useful to test integrated systems. Always use your integrated test system to trial changes to software, interfaces and workflow.

Test plans

The overall workflow documentation is used to generate detailed test plans for use prior to updating any of the integrated systems. All of the affected system’s workflow should have corresponding test plans, as well as a clear recovery or rollback plan for changes that go awry. These changed should be trialed in the integrated test environment, and only moved into live once the test plans and recovery plans have been tested.

Vendor management

Advance coordination between vendors and the customer prior to the move of changes into the live environment is a key component for ensuring continued efficient patient care. Incorporating vendors from every affected component in the integrated system should be a chief concern of the customer in order to reduce any potential for downtime or instability. Overlooking vendor involvement can often lead to delays in the correct transfer of data between systems.

Version control

Use a version control system to manage changes to configuration files, workflow documentation and test plans. Keep backup copies indefinitely of detailed logs, and configuration files along with clear documentation of what was changed.

Following these integration best practices across your healthcare enterprise will certainly help avoid costly inefficiencies and delays.

XDS cross-enterprise document sharing—taking integration to the next level

Due to the increasing need and challenges of sharing data between healthcare professionals across different organizations and regions, an IHE profile has been established called XDS, for cross-enterprise document sharing. XDS allows for sharing of both structured and unstructured data across healthcare information systems to help improve the quality of healthcare and increase the level of service to the patient.

XDS for imaging (XDS-I) makes it possible to share radiology reports and images. Image data are not duplicated. Instead, XDS-I documents include references to the image storage locations. Given the compliance of most RIS and PACS with HL7 and DICOM, realizing an XDS-I network has become a straightforward task. Yet, it still requires implementation of rules and guidelines through an XDS Affinity Domain Policy. This needs to be thoroughly defined and adhered to for a successful implementation.

Adoption of the XDS profile is progressing very quickly. The Sectra RIS and PACS product portfolios are designed to be IHE compliant and have made considerable progress with the implementation of the XDS profile. Sectra has demonstrated compliancy with the XDS-I integration profile at Connectathon meetings arranged by IHE.

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