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Enabling the future of healthcare through Integration and InteroperabilityVeera S RaghavanExecutive Director – Healthcare & Life SciencesMay 2016

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• Integration and interoperability – global view• Components• India focus• Sample scenarios• Way forward

Agenda

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Hospital

Primary

Specialists

Home Health

Urgent Care

Skilled Nursing

Lab / Research

State HIE

Radiology

Public Health

Integration & Interoperability

Integration is about connecting two or more systems so that they can share data

Interoperability means that two (or more) systems work together unchanged even though they weren't necessarily designed to work together.

HIE Networ

k

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Integration & Interoperability components (U.S. Market sample)

Multiple EHRs or HIEs

Lab

• Sunquest Mysis Lab• CoPath• HCLL Mediware• Cerner Gen Lab

Rad• McKesson Rad Manager• Muse• DR Pacs• Cerner Radnet• Impac - RadOnc

ERP Systems

• Lawson• Oracle• PeopleSoft• SAP

• IBM initiate• Infor• Epic

EMPI

• Cloverleaf• Ensemble • CorePoint• Rhapsody• Mirth

Middleware

Third Party

• 3M Coding• AlertMD • Wellcentive• Dragon• PowerScribe

• Quest• Labcorp• Immunization

Registry• Syndromic Registry

Interface Data

HIEFuture of Healthcare Integration is moving to FHIR and Smart on FHIR

A look forward…

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Integrated healthcare system – An overview

EMR

Emergency

Pharmacy

Radiology

Laboratory

Ambulatory Care

Acute Care

Critical Care Hospital

Information System(HIS)

Telecomm

PACS / Imaging

Patient Portal

Medical Device

AnalyticsAdministra

tive & Financial

Reporting

Case Manage

ment

HIM

Transcription

Scheduling

Billing

Integration

Referral (CRM)Sales Inventory

HRFinance & Accounts

ERP

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One size does not fit allPrimary/Metros

Secondary/Tier1 Tertiary/Tier2-3

Hospital Chains

Standalone Hospital

Established/Mature Health

systems

Upcoming/Fast growing Health

systems

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IT spend break down – Mid Range hospitalsImplementation (across industries)

System Integration spend (SI)• 3-5 times of software spend, per year (Dedicated instance)• 2-3 times of software spend, per year (SaaS)

Ongoing Maintenance(India)Ongoing Maintenance (US) application

services17%

Sw license5%

Infrastructure & services

47%

Internal IT staff31%

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System Integration

• Hardware • Tools/software products • ISV/HIT vendor(s) • System Integration ?

System integration is defined as the process of bringing together the component subsystems into one system and ensuring that the subsystems function together as a system

????

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Issues with data!

Post DQ solution

Post DQ solution

Exam

ple

1Non standard address data

Non standard address data

Exam

ple

2• Do you see issue like this today?• Will the current Software/HIS fix this?

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Issues with data!

Item Code Item Description Cost

3338ANTERIOR PAK 0.9 W/0 PROBE/IL-8065751155 2600

AQua fold AQUA FOLD LENS 8.0D 2500

Item Master from HIS – Centre A

Central dB - SAP

Item CodeItem

Description Cost

3338

ANTERIOR PAK 0.9 W/0 PROBE/IL-8065751155 2600

Con

Anterior Pak 0.9w/o Probe/il - 8065751155 2600

AQua foldAQUA FOLD LENS 8.0D 2500

AQUA FOLD AQUA FOLD LENS 8D 5000

Item Code Item Description Cost

ConAnterior Pak 0.9w/o Probe/il - 8065751155 2600

AQUA FOLD AQUA FOLD LENS 8D 5000

Item Master from HIS – Centre A

Service Code Service Description Cost

AFB Suscep AFB Susceptibility C/S . 980ANTI – CCP ANTI – CCP Antibody. 3489

Service Code Service Description Cost

3456 AFB Susceptibility C/S. 980

CCP ANTI – CCP Antibody. 3489

Service Master from HIS – Centre A Service Master from HIS – Centre BService Code

Service Description Cost

AFB Suscep

AFB Susceptibility C/S . 980

3456

AFB Susceptibility C/S. 980

ANTI – CCPANTI – CCP Antibody. 3489

CCPANTI – CCP Antibody. 3489

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Data issues – sample role of an SI

Get consensus on nomenclature

for Services & Items

Add workflows for central IT to approve

creation/editing of master records by

Centers

Optional ETL add-on

Automate cleansing of

legacy master records

• Screen new records in real-time

• Fuzzy look-up based match algorithms

• Enhance & auto-correct master records

Centralize Service & Item masters.

Educate end users & manage process

change

MDM Solution

Option 1Manually cleanse legacy data + Enhance HIS workflow + Manage

Change

Option 2Implement Data Quality from

Informatica/equivalent MDM tools

Cost effective

Minimal training effort× MDM scope limited to Medics

× Limited scalability

× Effort intensive

Auto-cleansing of legacy data

× More expensive

Real-time screening & fuzzy match for new data Scalable

× Greater implementation and training effort

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In summaryIf IT is a key enabler, what do you want it to look like?

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Way Forward - for the fast growing health system chains in India

• First step – Define IT strategy• Aligned with business strategy /  RoI?• Do it right first time. Budget for SI work• Is your ISV the SI?• Management buy-in / change management• Implement IT road map in stages• IT maturity audit and course correction

You can't cross the sea merely by standing and staring at the water - Rabindranath Tagore

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Thank you!

Veera_s_raghavan@dell.com

Twitter - @VeeraRAtDel