of the key Federal mandates in the healthcare space is meaningful use that focuses on interoperability and data exchange between Electronic Health Record systems(EHRs) and Picture Archiving and Communication Systems(PACS) in the radiology, cardiology and endoscopy departments. However, integration challenges remain.
Larger healthcare organizations have moved towards integrated systems that permit sharing of images while simultaneously complying with the requirements of Health Insurance Portability and Accountability Act (HIPAA). Organizations have adopted EMR to solve enterprise image distribution issues to overcome limitations in areas that PACS do not serve well.
Some of the steps that leading companies have taken to ensure interoperability include:
- Interconnecting PACS archive and EHR systems: This starts with determining who will access which images and what use they would be put to and subsequently identifying the list of tools and deployment steps to be used for implementation
- Ensuring compliance to HIPAA regulations: When PACS images are deployed to EHR services, user identity is authenticated to ensure regulatory compliance.
- Implementing an integrated system: Implement customized solutions (EHR, PACS and patient portal) that allow physicians to personalize the system to suit their requirements to enhance their productivity and efficiency besides permitting integration with additional applications.
- Data integration: Most radiology facilities are already standards-compliant and hence offer a base for integrating data from radiology information systems (RIS) and communication systems (PACS) into other programs. Radiology offers the scope for quick wins in initiatives associated with enterprise integration of systems.
However, a large number of healthcare organizations have encountered several challenges in ensuring interoperability. They include:
Integration issues between medical devices and EMR: Lack of industry-wide standards for integrating medical devices and EMR hampers the integration efforts. The lack of integration results in manual data capture in the EMR system and can result in possible errors that the EMR systems were meant to eliminate in the first place. To overcome this problem, the healthcare facility that invests in EMR systems needs to work with the software vendors and suppliers of medical devices to obtain suitable connectivity interfaces.
Integration of various legacy systems within the enterprise: Organizations are unable to overcome the technical challenges in integrating the various systems that host the information pertaining to patient data (personal information, clinical data and billing information to name a few). Only a few organizations have been to overcome the internal interoperability challenges and healthcare information integration still remains a goal. An effective integration approach needs to factor in the realities of multi-vendor and multi system environment when the architecture design is conceptualized.
Leveraging existing investments in technology: Any integration effort needs to factor in the existing investments in IT infrastructure and avoid expensive outlays caused by upgrades or data migration initiatives. There should be minimum disruption to existing configuration of workflows within the systems. Any integration approach that fails to consider the cost of existing investments is unlikely to gain acceptance.
Patient experience: Integration efforts also get abandoned if there is possible disruption to existing patient experience.
Efforts to ensure interoperability require proper planning and knowledge of common issues that may be encountered. The integration will face resistance if it fails to leverage investments in existing legacy systems, imposes change to existing care workflows and ignores the patient experience. The approach must leverage standards-based interfacing. Moving to a more integrated environment has the potential to improve the quality and cost-effectiveness of care delivery and optimized healthcare experience for the patients.