How to do it: Information technology

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1Interface flexibility is important when attempting to share information with other providers and stakeholders. Flexibility allows you to specify exactly what types of information will be exchanged and the messages' format, and it should allow for the implementation of custom interfaces as needed to support the widest possible range of compatibility, says Thomas Weitzel, technical support manager, Keane Care.

“Ensure your vendor is working toward LTPAC EHR technology to be sure your system will be fully interoperable,” Weitzel advises.

2 He joins a host of others in recommending evaluating the local exchanges, such as regional health information exchanges (RHIOs) and health information exchanges (HIEs).

“Interoperability, while still in its infancy, is critical to any EHR system and will become even more important as LTC providers participate in organizations such as ACOs, HIEs and RHIOs,” adds Doc DeVore of AOD Software.

3 Standardized messaging protocols such as Health Level 7 (HL7) and Continuity of Care Documentation (CCD) are necessary to help distinct systems speak the same language.

“Ask a vendor to share with you their implementation guide for HL7 and check it against the latest HL7 standard,” recommends Doron Gutkind of LINTECH. “Can the vender  support all census transactions or just an admission?”

6N's Trace Jersen agrees: “Make sure your vendor can implement the necessary technology to keep you current. Systems that are utilizing old technology are risky.”

4 Transfer of information must be sophisticated enough, notes Robert C. Davis, CEO of Optimus EMR.

“One-direction messages or faxes of an order is not interoperability and should not be represented as such,” Davis notes.

5 The consumer needs to know exactly what the vendor is actually doing, says Carrie O'Connell, vice president of clinical development for Health Care Software (HCS).

“When data exchange is discussed, don't be scared to ask exactly what data elements are being exchanged, what systems and how often. Determine the flow of data,” she advises.

6 Providers must investigate whether partners are ready to electronically exchange data.

“Keep a healthcare interoperability glossary on hand and be ready for CCD, CCR, PHR, CDA, RHIO, ONC-ATCB, NIST, NCPDP, LONIC, HITSP, HIE, XML,” O'Connell adds.

7 “It is not just the clinical record — the financial record also must be interoperable,” says John Sheridan, president of Health Data Solutions. Most providers are far from this second requirement.”

And SigmaCare CEO Steve Pacicco emphasizes looking “for integrations beyond billing.”

“Choose a vendor that has a large integration allocation in its roadmap, including RHIOs, HIEs, lab and radiology integrations,” he says.

8 “Finding the appropriate technical resource from a vendor standpoint to discuss these standards and their use in the vendor's system is important,” notes Dan Cobb, HealthMEDX's CTO. “Find the appropriate vendor technical resource and ensure that they follow adopted industry standards.”

9 Limiting the scope of some projects can help with interoperability, explains David Pollack, President and CEO of ADL Data Systems. Verify that both vendor sources and database elements are sufficient to capture full details of messages, he adds.

“Make sure a vendor has major experience implementing HL7 or HIE interfaces,” he says. Beyond looking for clarity, make sure software and its integration is tested in a “real-world environment” before deployment, stresses OnShift CEO Mark Woodka.