Chapter 2: Pros and Cons of Interfacing Capabilities Also available at: http://caristix.com/blog/2012/11/hl7-survival-guide-chapter-2/ This guide is for healthcare integration analysts and their managers. HL7 interfacing and interoperability – you can’t live without it but that doesn’t mean you have to suffer as you work to connect the systems that make your environment hum along. This guide will help you get a firm grasp on all the challenges, standards, and choices you need to make along the way, whether you’re developing interfaces on your own or working with a third party.

1. HL7 SURVIVAL
GUIDE
CHAPTER 2
A supplement to the HL7 Survival Guide, available at
http://caristix.com/blog/category/hl7-survival-guide/
A publication of

2. HL7 SURVIVAL GUIDE CHAPTER 2 2
ABOUT CARISTIX
Caristix software brings your whole interfacing
process together in a single, powerful platform.
CUT TIME-TO- NO MORE TRIAL
GO-LIVE AND ERROR
Up to 50%. Scope it right. Manage
requirements.
VENDOR- CLEAR YOUR
AGNOSTIC INTERFACING
Work with any BACKLOG
interface engine. Simplify dramatically.
Align teams.
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http://promo.caristix.com/demo/
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3. CHAPTER 2: PROS AND CONS OF INTERFACING CAPABILITIES
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4. HL7 SURVIVAL GUIDE CHAPTER 2 4
• Point to point interfaces?
• Interface engine?
• Integration engine?
How do you make a good choice among these
interfacing approaches?
• You need to look at their advantages and trade-offs
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5. HL7 SURVIVAL GUIDE CHAPTER 2 5
POINT-TO-POINT INTERFACES: ADVANTAGES
• Up and running quickly
• Fewer systems? Point-to-point makes sense
• Cost-effective for fewer than five healthcare
information/clinical systems
– Minimal infrastructure investment, reduced complexity
• No interfaces? Start from scratch more easily
• No need for technical resources; vendors can set
up interfaces
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6. HL7 SURVIVAL GUIDE CHAPTER 2 6
POINT-TO-POINT INTERFACES: TRADE-OFFS
• Harder to grow.
– Systems are tightly coupled. Change one, impact all.
• Less scalable.
– There will be N(N-1) interfaces in ecosystem
– E.g., 5 systems – 5(5-1) = 20 interfaces
• Inflexible: systems must understand other systems’
expected data structure and semantics
• Limited monitoring capabilities
• Costs can grow rapidly if you rely on vendor to
change or add new interfaces
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7. HL7 SURVIVAL GUIDE CHAPTER 2 7
INTERFACING CAPABILITIES: ADVANTAGES
• Mediates transport protocols between systems
• Scales elegantly to reduce number of interfaces required (N
+ 1)
• Centralizes and facilitates monitoring of message flows and
interfaces
• Systems are loosely coupled
– Add new interfaces and modify existing ones without impacting other
systems
• Interface adapts to different HL7 message and data formats
• Reduces interface costs by using single application
capabilities across all applications
• Reduces dependency on multiple vendors for changes to
message format
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8. HL7 SURVIVAL GUIDE CHAPTER 2 8
INTERFACING CAPABILITIES: TRADE-OFFS
• Steep learning curve – need to be well-versed in a
specific engine vendor’s technology to develop
interfaces
• Vendor lock-in can mean additional costs for
integration engine infrastructure, as well as costly
interface engine technology conversion that
involves large projects impacting several systems
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9. HL7 SURVIVAL GUIDE CHAPTER 2 9
INTEGRATION CAPABILITIES: ADVANTAGES
• Includes workflow management features
– Interfaces can respond as clinical workflows evolve
– More flexible migration path for systems and ecosystems
• Provides a single point for system integration to
ensure consistent management
• Technology is built to scale
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10. HL7 SURVIVAL GUIDE CHAPTER 2 10
INTEGRATION CAPABILITIES: TRADE-OFFS
• More complex and expensive than smaller-scale
interface engine due to shortage of skilled analysts
and need for extensive training
• Expensive software licenses
• Need to create a dedicated team (if you don’t
already have one)
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11. HL7 SURVIVAL GUIDE CHAPTER 2 11
VENDORS OF INTEGRATION ENGINES AND TECHNOLOGIES
• Vendors address different needs
– Some serve small hospitals
– Some scale to support multiple locations and
stakeholders
– Some are vendor-specific: for example, Summit and Iatric
are fairly Meditech focused.
• Evaluate based on Advantages and Trade-offs
listed earlier
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12. HL7 SURVIVAL GUIDE CHAPTER 2 12
VENDOR LIST
(partial list – we welcome your suggestions!)
• Cerner Open Engine
• Corepoint Health
• Iatric EasyConnect
• InterSystems Ensemble
• Interfaceware Iguana
• iWay
• Lawson Cloverleaf
• McKesson Pathways
• Microsoft BizTalk
• Mirth Connect
• Oracle Fusion
• Oracle JCAPS/ICAN/e*Gate/DataGate
• Orion Health Rhapsody
• Siemens OpenLink
• Summit
• Sybase e-Biz Impact
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13. HL7 SURVIVAL GUIDE CHAPTER 2 13
ENGINE VENDOR PERFORMANCE RANKINGS AND MARKET SHARE
• For vendor performance rankings, see the KLAS
Research website:
– http://www.klasresearch.com/search/?q=Interface+Engines
• For a current view of the HL7 interface market within
healthcare, see the 2012 HL7 Interface Technology
Survey Results published by Core Health Technologies.
– http://corehealthtechnologies.com/2012-hl7-interface-
technology-survey/
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14. HL7 SURVIVAL GUIDE CHAPTER 2 14
UP NEXT: CHAPTER 3
• Chapter 3 in the HL7 Survival Guide
• The Heart of the Matter: Data Formats, Workflows,
and Meaning
– Your main challenges are not with the plumbing
(transporting or routing data). The real issue is with the
data and workflows. Learn more in Chapter 3.
– Blog link: http://caristix.com/blog/2012/11/hl7-survival-
guide-chapter-3/
– Slide deck on Slideshare: coming soon.
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15. HL7 SURVIVAL GUIDE CHAPTER 2 15
QUESTIONS? FEEDBACK?
Is a recommendation unclear?
Disagree with something we said?
Let us know! We thrive on feedback.
Contact Us
support@caristix.com
1-877-872-0027
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