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5 pts.
 Interfacing best-of-breed PM/EHR solutions via HL7 transactions
PCP Associates, a small PCP practice (two physicians), already has a practice management (PM) system installed.  There is no acceptable EHR solution that uses the same database and computer system that the PM uses.  PCP Associates belongs to a local independent practice association (IPA) which is offering a program to encourage small PCP practices to adopt an EHR.  However, the program requires all the participants to adopt the same PM/EHR solution.  Adopting this solution will force the replacement of the existing PM system.  The proposed solution consists of two different best-of-breed products interfaced via modified HL7 transactions.  What’s your advice?[o:p][/o:p]

ASKED: August 4, 2010  5:35 PM
UPDATED: August 11, 2010  8:49 pm

Answer Wiki:
Most mid size and large organizations are using HL7 for integration. From sending simple Patient demographics over the network or receiving the charge from the EMR and creating the encounter automatically at the PM level there is rarely a problem. It is unfortunate that many vendors tend to discourage HL7 simply to get you to purchase their entire system, but the reality is that HL7 interfaces are used extensively. With the interface engine there are about two things that may pop up once a year: 1*Interface engine stops working due to an exception somewhere (to avoid this, ensure that your HL7 engine vendor sets up notifications in case the engine fails) 2*During an upgrade of either systems the vendor or IT department forgets to test the changes to ensure that data is still successfully being processed. So, really I would most definitely reassure you that it is completely safe and acceptable to have an interface or use HL7 transactions.
Last Wiki Answer Submitted:  August 9, 2010  2:50 am  by  RedaChouffani   1,785 pts.
All Answer Wiki Contributors:  RedaChouffani   1,785 pts.
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My advice for PCP Associates is yank out the existing PM solution and replace it with the PM/EHR solution that the local IPA is offering. Do this even if it means retiring the brother-in-law (or wife!) that has been keeping the books up to now.

As noted in the above answer, HL7 interfaces work pretty well. A completely integrated solution would be even better, but under the circumstances, go with the best-of-breed solution that the local IPA is offering.

The strength is in the fact that it is a solution that will be shared across the local community. The IPA will be able to muster the IT support in the event something goes wrong. This IT support is something no individual small practice is likely to be able to afford, but they can pay for it via their IPA membership fee. The benefits of a single solution shared in common across a community of users are substantial. The fact that the IPA is targeting the best-of-breed solution to small practices implies that the package has been selected with particular attention to the needs of small practices. In other words, it is not a big, complex solution appropriate for a large practice or a hospital. Presumably the IPA has already led the way by negotiating standard agreements with the two best-of-breed vendors and by arranging implementation and training services appropriate to specific local needs. In addition, the community of users is in position to leverage their individual experiences thanks to the common solution.

If the IPA is really on the ball, it will batch several practices together to make the transition to the new PM/EHR solution concurrently. By doing five to ten small practices at a time, the resources needed to do the job will be used more efficiently.

 385 pts.

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