System integration is a main goal for many healthcare organizations today. A number of pressures, chiefly the meaningful use program, are putting a premium on speedy set up, making it difficult for providers to consider a best-of-breed approach.
We still have several outstanding applications that are best-of-breeds and the leverage is on us to try to integrate all that information into one.
clinical systems administrator, Skagit Valley
There are many advantages that can come from using the same vendor for all IT systems. Some executives say it is less expensive to take this approach, but the main benefit is that integration is typically easier. Health IT systems from different vendors are notoriously difficult to stitch together. With hospitals currently focusing on speed, going with one vendor is often the simplest solution.
This was the problem that Mount Vernon, Wash.-based Skagit Valley Hospital wrestled with when IT staff started planning to transition to a new enterprise content management system. The hospital already used one vendor for most of its IT systems, so sticking with them seemed like an obvious choice. But after looking at available options, the hospital found there is much more to consider.
Alan Duke, clinical systems administrator at Skagit Valley Hospital, said the facility is mainly a Meditech shop. The main EHR system is Meditech, which was introducing a new enterprise content management (ECM) system around the time the hospital was planning to transition away from its legacy system.
"We have been one of those places that has been reactive in the IS [information systems] department to the different demands and requirements of all the different departments," Duke said. "We still have several outstanding applications that are best-of-breeds and the leverage is on us to try to integrate all that information into one. We had been converting many of our applications to Meditech."
But he said the hospital's chief financial officer asked his department to do due diligence on the different options available before making the switch. What they found was there is more to integration than using one vendor.
Duke ended up choosing an ECM system called OnBase from Hyland Software Inc. Duke said the Meditech ECM had some attractive features, but it was mostly focused on clinical processes. The OnBase system incorporated business data, as well as clinical.
More uses of
ECM systems image management
Standalone software, EHR module are both ECM options
ECM security tips
There was one other coincidental advantage that ended up being important. Duke said the OnBase system runs on Centra servers, which the hospital already used for its picture archiving and communication system storage. This enabled the hospital to purchase a new node rather than an entirely new storage system.
The process wasn't without drama. Duke said two weeks before the planned transition to OnBase, the hospital's existing content management system failed as a result of a disabled server. The new system was already installed at the time, as Duke planned to overlap the transition. The failure of the old server meant that everything would have to transition to the new system ahead of schedule with less testing.
Additionally, Duke said preconfiguring workstations to run the new ECM and deploying all the necessary files and software to 2,000 users was a bit of a challenge.
But these initial challenges have been overcome. The experience of Skagit Valley Hospital shows that a best-of-breed approach to enterprise content management systems implementation can work. It also shows there is more to integration than using a single vendor. Duke said it is important to understand how different applications interact with each other. Some naturally integrate well, while others present greater challenges. A single-vendor solution doesn't necessarily solve every issue.
"Having Meditech as our gold standard throughout our organization would make [integration] easier for us," he said. "I understand the efforts of everyone to try to get it all under one roof, so finding something that wasn't Meditech, yet gave us more efficiencies, was surprising."
This was first published in July 2013