Achieving full interoperability in healthcare is a difficult task. But that doesn’t mean it’s impossible. If you have tried to build an HL7 EMR interface to connect your healthcare information systems, you know that it’s not a stroll in the park. That’s why we want to help you discover why you may be experiencing an interoperability freeze or black hole.

Here are 5 reasons why your HL7 EHR interface is not working and recommendations to fix the situation.

1. No Data Standards

According to a 2019 report by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), one of the greatest interoperability challenges is the absence of data standards.

Before you implement an HL7 interface project, you must define your data standards. Start by asking your vendor about the standards and HL7 version used for data exchange.

While some vendors may claim that they only deviated slightly from a particular HL7 standard, a deeper investigation may reveal multiple deviations. Examples of these deviations include custom messages, custom data types, and special code sets.

Obtaining a detailed list of customizations made to the HL7 standard by a vendor will enable you to understand the work volume required for successful integration with other systems.

2. Choosing the Wrong Type of Interface

Basically, you have two options for developing an interoperability interface: a point-to-point interface or an interface engine. Both have their pros and cons.

Point-to-point interfaces allow you to quickly set up a new interface when you have to link a few systems. It is simple to implement and is cost-effective for connecting less than five healthcare systems.

However, such interfaces are difficult to scale. The systems are closely knit together, and a single change can have an adverse effect on other systems. When you have a large healthcare facility with 10 or more systems to connect, you need an interface engine to build reliable HL7 interfaces.

3. No Formalized Workflows

Interface engines are effective tools for developing interfaces at scale. But they don’t solve interoperability problems associated with workflow processes.

To illustrate the importance of workflows, let’s look at a possible scenario. A doctor orders pain medication for a patient. The pharmacy information system does not recognize the terms or message sent with the order.

Unfortunately, the order gets dropped, and the patient has to remain in pain until the situation can rectify. This situation could have been avoided if a bi-directional interface was designed to provide immediate feedback to the doctor after the pharmacy dropped the order. Such situations also occur when ordering lab and radiology tests.

4. Lack of Data Transparency

A poorly documented interface will spell doom for any interoperability project. The more detailed the documentation is, the less likely you will have any issues with messages and data values down the road.

If you don’t have a full list of exceptions and gaps for data elements, you will have a long testing process. Your systems and workflow will be disrupted many times as you wait for clinical testers to help you test the interface for bugs.

Without a well-documented list of customizations and exceptions, your in-house IT team will spend a long time sending troubleshooting tickets. At the same time, physicians keep calling their helpdesk for solutions.

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