EMRs and Systems Integration

The healthcare industry is commonly known to be far behind other industries in terms of technology adoption. So I find it quite interesting that despite this lag, I think that healthcare will lead the way into the future with respect to systems integration.

I have been working with healthcare entities on implementing practice management software (PM) and electronic medical records (EMR) for the past 6 years. At present, I work as a Systems Application Analyst (whatever that means) at Piedmont Medical Care Corporation. Basically, the IS department supports the network of physicians - primary care, specialty, surgical and hospitals, etc. - that are employed by Piedmont Healthcare. In studying the literature on the success (or, more often, failure) of EMR implementations, what Piedmont has been able to accomplish is quite impressive with nearly all primary care physicians using EMR for their everyday charting.

Beyond simply entering chart notes into a computer, going digital comes with the hope of:

1. Providing a single point of access for reviewing past medical records
2. Communicating test results to patients, hospitals (when needed) and other healthcare professionals
3. Interfacing with lab and diagnostic systems so that orders are sent electronically and results received digitally as well
4. Integration of drug databases that allow for drug-drug, drug-allergy and drug-condition checking to improve patient safety
5. Incorporation of ICD-9 (and soon, ICD-10) codes
6. Offering web portals for patients to access anytime / anywhere to view their medical history including labs, diagnostic reports and have secure communications with their providers
7. Digital faxing to reduce the cost of traditional paper faxing
8. Access to drug formularies at the point of care delivery to help ensure that medications prescribed are on the insurance formulary
9. The ability to easily exchange information between 1 system and another.

Piedmont has most of the above fully implemented and is working on even more functionality greater than this.

My future blogs will cover this topic in more detail.

Early Integrations between ERP and Best of Breed Systems

I've spent the last 10 years supporting Software Systems used by large companies. I started working with ERP (Enterprise Resource Planning) systems that run all aspects of the company - Sales, Procurement, to Finance. ERP systems do a good job - but they don't provide businesses with a competitive advantage. The company I worked for installed an ERP system but quickly realized specialized systems were needed in addition to the ERP system. Best of Breed systems were designed to specialize in a specific area i.e. Warehouse Management Systems (WMS) were designed to provide exceptional distribution processes.

My first experience integrating a "bolt on" WMS wasn't very impressive. We linked the two systems through flat files. While this improved the performance within the warehouse walls, it left a lot of room for improvement. The Sales department did not have visibility into the order once it was transmitted to the warehouse. Even worst, the order could not be changed once it was downloaded into the warehouse. Customer's weren't satisfied with sales reps suggesting that they accept the order as is and simply return items that they didn't want. The order hadn't even shipped yet but they couldn't change it!

Clearly flat file integration was not the ideal solution.

In future blogs, I will explain the learning curve experienced as we gradually improved our integration between the host ERP system and several bolt on best of breed systems.

KA