If a primary healthcare provider wants to refer his patient to a specialist for additional medical services then he puts in a recommendation for it. A patient needs a referral before getting medical care from any other physician. This whole recommendation process falls into the patient referral process.

A referral process involves obtaining patient information such as insurance details, and demographics; also scheduling appointments. This task can get cumbersome, so a patient referral tracking system manages the referral process.

A referral system improves communication between providers and patients, and maintains continuity of treatment. So, there’s a significant rise in the US patient referral management software market as well (16.3 percent CAGR between 2022 to 2030).

This article covers the importance of patient referral tracking system and how to go about develop one for a medical practice.

Importance of Patient Referral Tracking System

Why would patients and providers need a referral tracking system? Here are top six reasons:

1. Continuity of Care

Continuity of care is where the patient shifts from the primary healthcare provider to a specialist for a variety of reasons. It could be transition from a hospital to a rehabilitation center, or from a GP to a cardiologist.

The goal is to ensure continuum of care for patients, so there’s no gap in their treatment and they recover quickly. It also helps to maintain the flow of data between healthcare providers, allowing for timely interventions, follow-up care, and medications.

Patients no longer have to worry about ‘what’s next?’ in their treatment plan, it will be set out for them by their provider. This enhances patient experience and satisfaction because it eliminates stress. Plus, it also improves outcomes because patients receive timely medical interventions.

2. Improve Patient Outcomes

By maintaining a continuum of care, providers are ultimately improving patient outcomes. With a patient referral tracking system, primary care providers can coordinate with specialists by sharing vital patient data. So, the specialists get a comprehensive overview of the patient’s condition, based on which they can start further treatment process.

Additionally, the data gathered from the referral system can be analyzed with AI to find areas for improvement and prepare a personalized care routine.

3. Reduced Paperwork

Manual referral process takes significant time and human efforts. But, with referral management system, admin staff can reduce paperwork, save time, and streamline workflows. With just few clicks, the admin staff can send forms to patients. Plus, the system displays completed patient forms and sends alerts if some documents are missing or lacking certain data.

A centralized online process with visibility and accountability eliminates phone and fax follow-ups, thus eliminating unnecessary workload and paperwork.

4. Growth of Medical Practice

Patient referral tracking system allows providers to connect with maximum patients, ultimately resulting in the growth of their medical practice. Patients are more likely to trust a healthcare provider when someone they know has recommended them.

Also, patient referrals bolster a provider’s credibility and establishes people’s trust in the quality of care offered by them. This eventually results in the growth of medical practice.

5. Collaboration Between Providers

A robust patient referral tracking system augments collaboration and communication between healthcare providers. It keeps all the concerned parties informed about the patient’s health status. The system eliminates data silos and ensures an integrated approach to care.

Provider collaboration plays an important role for complex cases, where there’s a need for multiple specialists. So, healthcare organizations can utilize the network of providers to ensure that patients are referred to the right experts, thus improving outcomes.

How to Develop a Patient Referral Tracking System?

We will talk about the process of developing a patient referral tracking system for a medical practice.

1. Research and Planning

Research which features and functionalities will make a good patient referral software. Which design type will be attractive for the target audience. Also, research about the competitors who have or are developing a referral tracking software.

Plan out a budget for the entire development process, along with hidden costs. So, you can give an estimate to the client on how much to expect. Remember to plan for a scalable patient referral tracking system.

2. MVP Development

An MVP (Minimum Viable Product) is an initial form of the patient referral system. It helps the developers to understand whether a product will work or not, and what changes need to be incorporated within the product.

An MVP can be used to pitch to stakeholders for investment or to showcase how work will progress in the upcoming timeline.

3. Shortlisting Features

For custom patient referral tracking system, shortlist features that matter to the practices. For instance, some of the commonly used patient referral features are:

1. Appointment Scheduling: Helps to schedule patient appointments directly with the recommended medical practitioner.
2. Data Access and Exchange: The system ensures seamless data exchange between providers for further treatment plans. Providers can look up for insurance details, past medical history, and allergies before going ahead.
3. Reminders: The admin staff can sent reminders to patients for incomplete documentation, follow-ups, and upcoming appointments.
4. Integrations: The patient referral system can be integrated with latest technologies such as AI, remote monitoring, and wearables to track and maintain patient conditions at real-time.
5. E-Prescriptions: Specialists can generate e-prescriptions for patients, so they can get the medicines delivered directly at their doorstep.

4. Compliance Requirements

For every healthcare organization, privacy and security of ePHI holds vital importance. So, the development team must incorporate compliance while crafting the patient referral system.

HIPAA compliance is a mandatory regulation to incorporate while developing the system. Failure to adhere to these regulations can result in lawsuits.

5. Designing Stage

Fun part of developing a patient referral tracking system is the design stage, where the look and the feel of the software is decided. From colors and fonts to navigation, everything is included in the design phase. A design prototype is developed and tested to understand how things will go forward before jumping to the coding phase.

6. Coding

Coding is the main part of the development cycle. The healthcare software development team writes the application code. With features, functionalities, and designs already planned out, the coding is done in no time. React, JavaScript, and AWS are some of the popularly used tech stack for software development.

7. Test, Release, and Maintenance

Once coding is done and dusted, it is time for testing. QA experts test the software for bugs, and if there are any, the development team can immediately go ahead to remove them. Further, testing also allows the QA team to check for software scalability, performance, and usability before the release.

Once all the checks are underway, the patient referral tracking system is released in the market or handed over to the client. One other task for the development team is system maintenance post its release. The software is regularly updated to keep the bugs away and to scale further.

If you’re looking to develop a patient referral tracking system for your organization then connect with Arkenea, a healthcare software development company. We offer top-notch products that match industry standards and fulfill all your requirements. Hop on to a consultation call to know more.

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Medical insurance verification software is developed to automate the process of verifying patients’ insurance coverages. This software is connected to the insurance company’s database to retrieve real-time data on a patient’s insurance status. The software is also linked with the provider’s system, so they can also verify patient’s coverage and claims.

A medical insurance verification software checks for coverage benefits, copayments, deductibles, and other relevant information needed for the healthcare provider to proceed with the patient’s care.

Key Statistics:

1. As per the 2023 survey published by the CDC, the number of people younger than age 65 uninsured was 24.7 million.
2. CDC reveals that 10.9 percent of the adults between the age group 18–64 were uninsured, as per the 2023 survey.
3. CDC also reveals that 3.9 percent of children younger than age 18 were uninsured, as per the 2023 survey.
4. According to the United States Census Bureau, more people were insured in 2022 than 2021. In 2022, 92.1 percent of people, or 304.0 million, had health insurance at some point during the year, representing an increase in the insured rate and number of insured from 2021.
5. The Census Bureau further reveals that in 2022, private health insurance coverage continued to be more prevalent than public coverage, at 65.6 percent and 36.1 percent, respectively.

Before jumping to medical insurance verification software, it is essential to understand that traditionally the verification was a manual process. The admin staff in the healthcare facilities spent hours on calls with the insurance companies, manually checking coverage details, patient eligibility, and benefits.

This method was not only inefficient, but also left considerable room for human error. This eventually led to denied claims, increase in operational costs, and delayed payments. So, with the introduction of medical insurance verification solution, the whole process is automated to save time and resources.

Benefits of Using Medical Insurance Verification Software

The adoption of medical insurance verification software brings numerous benefits to the healthcare providers, insurance companies, and patients.

1. Reduced Errors: Automation feature of the medical insurance verification software minimizes human errors which are usually caused due to manual data entry. Reduced errors leads to fewer claim denials and delayed payments.
2. Improved Efficiency: In a manual insurance verification process, the admin staff enters the insurance documentation into the system and then calls the payer to confirm eligibility. This takes up precious time. Automating the insurance verification process decreases the effort and time required from the admin staff, thus allowing them to focus on other essential work.
3. Patient Satisfaction: Patients don’t like to hear that their claim was denied because the staff failed to verify eligibility. They want this information prior to consultation with the provider. Frustrated patients may not come back second time. So, to build patient satisfaction, integrate a medical insurance verification software. This software confirms eligibility quickly and it also informs about the coverage, limits on benefits, and out-of-pocket experiences.
4. Revenue Cycle Management: Clean claims and faster reimbursement improves the overall revenue cycle for the healthcare providers. Also, clarity of insurance filling limits, claim scrubbing, and a denial management review process can ameliorate revenue cycle management. Plus, updated patient information, verified eligibility, and current payer changes can also help in revenue cycle management.
5. Submission of Clean Claims: Insurance eligibility verification is one of the biggest steps towards submitting a clean claim. So, claims by patients not in network are immediately rejected by the insurers. Make sure that the patient is eligible, so providers can get timely reimbursements.

Features of Medical Insurance Verification Software

Several medical insurance verification software are available in the market. Each of them with its own set of features and functions. However, certain features are common in all of them and they are as follows:

1. Real-Time Insurance Verification: Insurance verification software checks a patient’s insurance status at real-time. With instant medical insurance check, the admin staff can inform the patients whether they are eligible for claim or not.
2. Batch Workflows: The medical insurance software conducts batch workflows, which means processing queries of multiple patients simultaneously. This saves plenty of time and enhances patient satisfaction rate too.
3. Eligibility Check: The software can automatically check the patient’s eligibility for specific treatments and services, thus reducing the likelihood of claim denials and assuring that the patient is covered for the treatment procedures he/she needs.
4. EHR/EMR Integration: The software must integrate with the existing EHR/EMR system and practice management software. This integration will facilitate data transfer of eligible patients.
5. Pre-Authorization: Several insurance verification software include features for managing pre-authorizations, thus streamlining the approval process for treatments that need prior consent from the medical insurance company.
6. Reporting and Analytics: Reporting and analytical tools helps admin staff to gain insights about the verification process, allowing them to spot bottlenecks and areas for improvement.

Potential Challenges You Must Know

While medical insurance verification software offers several advantages, there are potential challenges that you must not forget.

1. Firstly, there’s a significant initial cost involved while implementing the software. The providers must weigh long-term benefits against the upfront investments.
2. The next thing to keep in mind is the interoperability issue while integrating with the existing EHR/EMR system and the practice management software. To ensure seamless integration and data exchange implement standards such as FHIR and HIPAA.
3. Nothing compromises workflow, privacy, and errors more than the lack of staff training. So, the entire admin staff and providers must be trained to use the new software effectively.
4. The next potential challenge could be data inaccuracy. The effectiveness of the insurance verification software depends on the accuracy of the data provided by the insurance companies. Outdated or inaccurate data can lead to verification and eligibility issues.

Conclusion

Medical insurance verification software has revolutionized the way insurance claims work. By automating the traditional manual process, the software has the potential to reduce errors, improve patient satisfaction, reduce denial rate, and improve revenue cycle. So, for healthcare providers looking to stay competitive, invest in a robust medical insurance verification software and provide the best possible care. To get a top-notch medical insurance verification software, connect with the experts in the field.

Arkenea, a healthcare software development company specializes in delivering world-class software solutions that addresses the evolving problems faced by the providers, insurance companies, and hospitals. So, hop on a consultation call with us to know more.

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Michael Ciano, CTO with 20+ years of experience talks about building trust as a key for leveraging technology in healthcare, building a robust business architecture and building an organization culture that fosters innovation. Connect with Michael on LinkedIn here.

1. How do you see the role of technology evolving in patient care over the next decade?

Patient Care is seeking greater insight and ease of access to high quality healthcare. Patients seek transparency into appropriateness of care, quality and costs while being enabled to make informed decisions, have availability of care at the right time and right cost, and personalized experience to their individual needs.

These needs of patients and an increased need for greater mental health access and insights are enabled through product and technology by building solutions which are data driven, AI enabled, and offer personalization however are best realized with a emphasis on building trust early and often in a patients journey.

Trust is the key to success in leveraging technology solutions which offer multi-modality access and the ability to the patient to determine how and where they want to be met.

2. Which emerging technologies do you believe will have the greatest impact on healthcare in the near future?

I believe a digital first approach to healthcare with emphasis on building trust early and often will have the greatest impact on healthcare and must be rooted on a robust business and data architecture with AI enablement.

Building a robust business architecture can best be achieved by breaking down “operate” and “innovate” requirements, mapping to available marketplace products (broad and niche) and developing deep integration across core elements of the architecture and the development of a proprietary intelligence layer driving innovative actions such personalization, enablement of next best actions of advocacy and clinical teams, and content on member and provider apps/portals.

3. What role does/will artificial intelligence play in your current and future projects?

SmartSelectMD is a dynamic physician quality tool which includes billions and billions of healthcare records and data points across relative experience, appropriateness of care and quality metrics, diagnosis, procedures, and pharmaceutical definitions, patient reviews and costs which required to be normalized, transformed and calculated into demographic, rating and quality outcomes by physician, specialties and related information.

In addition, these outcomes required transformation into a consumable value and visualization by members / patients of all learning levels. AI was present throughout the entire development process and execution of such project taking into use of Reactive Machine AI, Narrow AI, AI General and Limited Memory AI with future generations of the product using all seven types of AI.

The designs and considerations of AI in SmartSelectMD will be leveraged in all future data driven initiatives and have been inclusive in recent architectures of a care traffic controller and integration module.

4. Can you share an example of a major project or initiative in healthcare technology that inspired you?

Partnering with key business leaders and investors, I was instrumental in delivering a product/technology roadmap at ConsumerMedical which transformed a legacy of manual processes and barriers to growth into a data-driven, informational experience powering operations to serve members from a standpoint of insight and knowledge while streamlining digital experiences internally and externally.

In my role as CTO, I designed and delivered a robust business architecture built upon Salesforce HealthCloud, Communities, Marketing Cloud and Data Connector coupled with an AI enabled data infrastructure.

A significant initiative which I am most proud was the opportunity to  co-author and deliver SmartSelect|MD, a dynamic physician quality tool with 6 cohesive data engines defining quality to include Relative Experience, Quality metrics, Patient Experience, Appropriateness of Care and Cost.

Leading a steering committee of physicians, clinical, product and technology experts to develop requirements, member journeys, UI/UX and implementation roadmap was challenging yet rewarding in the execution of SmartSelectMD where as no standing in the US exists in the definition of physician quality.

5. How do you foster a culture of innovation within your technology teams?

Building a team of talented, engaged and innovative experts I believe begins with an organizational culture where leaders and team members are valued and feel apart of a mission where each individual is respected, has a voice, can color outside of the lines and together have a bit of humor to offset the business demands and timelines.

In my opinion, titles, roles and responsibilities can be blurred when you are seeking to develop new and innovative products or redesign legacy solutions by leveraging select aspects of Agile processes to engage differently beyond traditional ceremonial processes. Engaging cross-functional team members offers new ideas, approaches and pathways to innovative outcomes while most importantly building relationships beyond organizational structures.

6. What are the key skills and qualities you believe are essential for a successful CTO in the healthcare tech sector?

With a career of both CIO and CTO, my success has been a direct result of an organizational philosophy where leaders and team members are valued and feel apart of a mission where each individual is respected, has a voice and can color outside of the lines.

My personal success stems from being a delivery person at heart and sharing that vision with teams I have built from ground up, teams acquired or teams merged, and hiring or mentoring leaders to share the same passion and drive for outcomes that matter. I believe failure is a part of success and together we fail, succeed, and course correct in near real-time.

My most successful careers have been built leveraging a balanced use of Agile throughout  business, product and technology initiatives and it is crucial to have a hands-on approach with cross-functional skills when building a PMO to lead all others across such initiatives.

Lastly, partners and consultants regardless of onshore / offshore models must be part of the team and feel included in the same organizational culture, draw out those offshore experts from respect of the customer to sharing valued input at critical times of design and development, and build valuable relationships between partners which can often lead to partnerships where niche innovative products integrated can lead to healthcare innovation solutions.

Michael Ciano is a proven leader with more than 20+ years of experience and proven track record of driving transformational change, data-driven personalization, stakeholder engagement, and operational excellence through enabling technologies, innovative products solutions, and partnerships/acquisitions.

Michael was most recently the Executive Vice President & Chief Technology Officer (CTO) of XO Health, Inc. where he was responsible for the development of business architecture, technical product roadmap, and advocacy and connected care model for this pre-revenue startup technology HealthPlan. Michael was instrumental in the identification and negotiation of innovative partner solutions, integration and architecture of an AI-enabled data driven engine for members and provider personalization, and development of technology enabled operations.

Prior to his role leading XO Health, Inc. Michael was the CTO Of Healthcare Navigation at Alight
Solutions post-acquisition of ConsumerMedical where he led a diverse team including PMO, technical product, software engineering, business intelligence, and quality assurance in the delivery of Medical Decision Support and 2nd Opinion Services.

Michael has also co-authored, architected and delivered SmartSelect|MD, a dynamic physician quality tool with 6 cohesive data engines defining quality to include Relative Experience, Quality metrics, Patient Experience, Appropriateness of Care and Cost.

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Around 30 percent of the world data volume is generated by the healthcare industry. A variety of patient information is collected and stored in the system, from medical bills to treatment plans. This data is sensitive in nature and hence it needs to be protected from cyberattacks.

HIPAA (Health Insurance Portability and Accountability Act) rules and regulations ensure that ePHI (Protected Health Information) is safe and secure from potential hackers. These regulations mandate the BA (Business Associates) and CE (Covered Entities) to maintain the privacy and security of ePHI.

To comply with HIPAA regulations, CE and BA must adhere to certain requirements, and audit trail is one of them. HIPAA audit trails ensure that health information is tracked and monitored to maintain data security. The tracking system immediately alerts the authorities if there’s a data breach.

Learn about the nitty-gritty about HIPAA audit trails and log requirements in this article, which will help you to get started on your audit trails.

HIPAA Audit Trails and Logs: An Overview

Healthcare systems process thousands of activities each day ranging from user access to payments. These activities are recorded as audit logs and they are crucial for administrators because the logs show how and when events have occurred.

For a healthcare organization, HIPAA audit trails and logs can:

1. Record details such as timestamps, username, and which patient data is accessed.
2. Capture login, logout, and access to ePHI.
3. Alert admins in case of security violations or unauthorized access.
4. To demonstrate the organization’s compliance with HIPAA during audits.

HHS defines audit logs and audit trails as follows:

“According to the National Institute of Standards and Technology (NIST), audit logs are records of events based on applications, users, and systems, and audit trails involve audit logs of applications, users, and systems. Audit trails’ main purpose is to maintain a record of system activity by application processes and by user activity within systems and applications.”

Furthermore, audit logs are stored securely, in a tamper-proof location. Healthcare organizations are required to analyze and review log data periodically to check compliance and improve cybersecurity.

Benefits of HIPAA Audit Trails

Here are the three key benefits of implementing HIPAA audit trails and log requirements:

1. Forensic Analysis

According to an article published by Investopedia, ‘A forensic audit evaluates and examines an organization’s financial records to derive evidence to be used in the court of law. A forensic audit is conducted to prosecute a party for embezzlement, fraud, and other financial crimes.’

A HIPAA audit trail offers critical information on the nature of the security incident and the parties involved. By analyzing the logs, healthcare organizations can identify what went wrong and devise a solution for it.

2. Identify Security Defects and Incidences

HIPAA audit trails and log requirements allow healthcare organizations to detect security incidences beforehand. These incidences may include unauthorized access to ePHI, data breaches, system malfunction, or financial scam.

Continuous monitoring of audit trails and logs can help organizations to spot potential anomalies and respond swiftly, thereby mitigating damage and safeguarding ePHI.

3. Improve Operational Efficiency

With HIPAA audit trails and logs, organizations can improve operational efficiency as well. A well-structured audit trail helps medical and admin staff to comprehend their roles and the limits to access ePHI.

Moreover, system monitoring, regular risk assessments, and audit controls contributes to informed-decision making and risk management, thus streamlining healthcare workflows.

HIPAA Audit Trail Requirements

The CE and BA must maintain audit trails and audit logs, however the Security Rule doesn’t clarify which information needs to be tracked. With security and privacy of ePHI in mind, organizations can monitor the integrity and use of systems that transmit and store ePHI.

The three components of HIPAA audit trail requirements are: system, user, and application.

1. System Audit Trail Requirements

A system audit trail encompasses audit logs of time-stamps, logging credentials, and access attempts. The audit trail monitors the IP address, devices used for login, and location of the devices. Tracking these activities allow organizations to determine which actions are violating HIPAA regulations.

2. User Audit Trail Requirements

There’s an audit log for every user accessing the ePHI. User audit trail requirements includes information on login, users, logoff, password updates, and authentication attempts. Review of user audit logs can alert the organizations about breaches. It can also point out about a suspicious login activity, indicating that credentials have been stolen.

3. Application Audit Trail Requirements

Application audit trails track and log user activities in the application. This encompasses application files opened and closed, and reading, creating, deleting, and editing of application records associated with protected health information.

HIPAA Audit Log Requirements

The healthcare organizations are required to track the following requirements as part of the HIPAA audit log:

1. Anti-malware logs
2. Firewall logs
3. Logins for operating systems
4. File access
5. Access level for every user
6. Addition of new users
7. Changes made to databases
8. User login activities

For How Long to Retain Audit Logs?

According to the HIPAA Journal, ‘The HIPAA retention requirements are that certain documents must be maintained for six years from the date of their creation or from the date they were in effect, whichever is later.’

HIPAA classifies retention for two types of documents – HIPAA medical records retention and HIPAA retention for other documents.

The Privacy Rule doesn’t state for how long the medical records should be retained because each state has its own laws on medical records retention. So, BA and CE are bound by the state laws on how long the medical records must be retained.

There are requirements for how long other HIPPA documents must be retained. These requirements are stated in 45 CFR 164.530 and 45 CFR 164.316. Both of these rules state that CE and BA must document procedures and policies implemented to comply with HIPAA. Both the rules stipulate that the documents must be retained for the minimum period of six years from the date it was created or when it was last in effect. HIPAA audit trails and logs fall under the other document category, hence it should be retained for six years.

Getting Started with HIPAA Audit Trails

New to HIPAA audit trails, here’s how you can do it:

1. Select the Technology: Select the technology for which you want to start audit trails and logs. For instance, in the case of EHR software ensure that it supports the essential audit trail functions as per the HIPAA regulations.
2. Staff Training: Educate the staff on HIPAA audit trail requirements mentioned in the Security Rule. Provide hands-on training experience for accessing and checking audit trail data. Explain about the best practices for maintaining the integrity and confidentiality of ePHI.
3. Continuously Monitor and Review the System: Implementing HIPAA audit trails is not a one-time task, it requires continuous reviewing and monitoring, to ascertain compliance. So, conduct regular audits to detect anomalies that may trigger data breach. Plus, conduct incident responsive exercises to test the organization’s capability to respond to security breaches.
4. Connect With an Expert: Finding it hard to manage HIPAA audit trails? Just connect with a healthcare software development company who will help to conduct audits seamlessly.

Arkenea, a healthcare software development company promises to deliver HIPAA-compliant solutions for your organizations, so you never have to face anomalies during audit trails. Get a customized HIPAA compliant healthcare software developed today. Connect with us for a consultation call.

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Nima Rad, CTO and founding team member of a fast-growing, series A startup talks about how AI is already transforming how we approach healthcare challenges, building an innovation culture in HealthTech and more. Connect with him on LinkedIn here.

1. How do you see the role of technology evolving in patient care over the next decade?

I anticipate technology will increasingly empower patients to participate actively in their health journey. We’ll see a shift from reactive care to proactive, preventive approaches. This will be driven by advanced wearables, remote monitoring, and AI-powered tools that offer personalized insights and interventions.

Wearable devices like the Apple Watch are already tracking vital signs and providing real-time data to patients and healthcare providers, enabling early detection of potential health issues. We can expect these devices to become even more sophisticated, incorporating features like continuous glucose monitoring for diabetics and advanced heart monitoring capabilities.

AI, a key player in this transformation, will be critical in analyzing this data to provide actionable health recommendations and alerts to patients and providers, ensuring timely interventions and better health outcomes.

2. Which emerging technologies do you believe will have the greatest impact on healthcare in the near future?

I’m particularly excited about the convergence of AI and genomics. AI’s ability to analyze vast genomic datasets will revolutionize personalized medicine, allowing for tailored treatments and early disease detection. AI can identify genetic markers for diseases like cancer, enabling early and more accurate diagnosis and personalized treatment plans.

AR/VR technologies also hold immense potential for surgical training, patient education, and therapeutic applications. VR is being used to simulate complex surgeries, providing surgeons with realistic practice environments, enhancing their skills, and reducing the risk during actual procedures. AR can assist in real-time by overlaying critical information during surgeries, such as displaying vital statistics or highlighting critical anatomical structures, thus enhancing precision and safety in surgical procedures.

3. What role does/will artificial intelligence play in your current and future projects?

AI is already transforming how we approach healthcare challenges. For example, using AI to analyze radiology images improves diagnostic accuracy and speed, helping radiologists more efficiently identify conditions like tumors or fractures.

Additionally, AI predicts patient deterioration, allowing for timely interventions. Looking ahead, we see AI as a key enabler of precision medicine and a powerful tool for addressing population health needs, such as predicting disease outbreaks, identifying at-risk populations, and optimizing resource allocation to ensure that healthcare systems are prepared and responsive to emerging health threats.

4. Can you share an example of a major project or initiative in healthcare technology that inspired you?

We were particularly inspired by DeepMind’s AlphaFold project, which has made significant advancements in predicting protein structures. This initiative has the potential to revolutionize drug discovery and development by providing insights into the molecular structure of proteins, which is crucial for understanding diseases and developing effective treatments.

Predicting protein structures accurately can accelerate the development of new medications and therapies, offering hope for conditions with limited treatment options. This project exemplifies the power of combining cutting-edge AI with deep scientific knowledge to achieve breakthroughs that can profoundly impact global health.

5. How do you foster a culture of innovation within your technology teams?

We believe innovation thrives in an environment that encourages experimentation and learning. We prioritize creating a safe space for my teams to share ideas, test new approaches, and learn from successes and failures. We regularly revisit our toolbox and add more AI tools that bring efficiency, hold thinking workshops, and cross-functional collaborations to spark creativity and drive innovation.

Many aspects of the business have had a huge impact with AI, including development tools, code reviews, ideation, and product specification. AI handles Customer service services by tapping into our knowledge base and answering customers’ questions.

Sales teams benefit from AI-generated action items and summaries from their calls, allowing them to focus on building relationships and closing deals. By fostering a culture that values continuous learning and innovation, we can stay ahead of the curve and drive meaningful advancements in healthcare technology.

6. What are the key skills and qualities you believe are essential for a successful CTO in the healthcare tech sector?

A successful CTO needs a unique blend of skills. Deep technical expertise is crucial, but a profound understanding of systems, regulatory landscapes, and customer needs is equally important. Strong leadership, communication, and building strategic partnerships are essential for navigating complex ecosystems.

Additionally, a successful CTO must translate complex technical concepts into actionable strategies and communicate effectively with technical and non-technical stakeholders. This requires a combination of technical acumen, business savvy, and the ability to inspire and lead diverse teams toward a common vision of improving patient care through technology.

Nima Rad is the co-founder and CTO of a rapidly growing enterprise, SaaS series A startup building an AI resource management platform. With over a decade of experience in software engineering and development, Nima has led teams to design and implement scalable and innovative software solutions. Previously, he held key engineering roles at Great Jones, Mark43 Inc., and Microsoft.

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Clinical data integration refers to the collection of information from various medical departments, third-party vendors, and payers, and to enable seamless data exchange. An integrated healthcare organization has the power to improve the quality of care and streamline workflows.

According to a recent report by Deloitte, in the forthcoming years, the healthcare landscape will be dominated by preventive and wellness approaches, interoperable data, and consumer-driven initiatives. Apart from this, McKinsey reveals that digital and data capabilities are honing the future of healthcare, thus ameliorating care delivery.

These reports signify the role played by clinical data integration. A flawless data integration results in seamless interoperability, ultimately leading to better patient outcomes.

To ensure effective clinical data integration, here are top-notch best practices that every healthcare organizations can implement.

1. Detect Data Sources

So, before jumping into clinical data integration, start by defining types of data and its sources. This helps the data management teams to comprehend the data requirements for providers.

Healthcare data is spread across multiple on-premise and cloud locations, so organizations can lose track of the data, resulting in higher storage cost and data silos. Conducting clinical data integration without understanding data sources is like sailing without a compass.

So, start with these questions:

1. How are the healthcare providers using the systems? What’s their ultimate aim: decrease operational costs, quality of care, or to give medical resources?
2.  Which needs aren’t met by the existing healthcare systems?
3. How is the data consumed by different users and applications?

2. Enable Data Privacy and Security

Ensure to have the best data privacy and security measures in place during clinical data integration. Here are some of the data privacy and security measures that organizations can implement:

1. Risk Assessment: Conduct security risk assessment. This involves detecting potential data risks, threats, and vulnerabilities, and outlining a plan to counter these threats. It also involves determining levels of sensitive data, so precise actions such as data encryption, access control, and compliance are taken to protect the health information.
2.  Audit Trials and Monitoring: Audit trials capture details such as who has accessed the data, what actions were taken, and when did it occur? This helps in identifying unauthorized data access and suspicious activities. It also helps to comply with regulatory standards. Furthermore, continuous monitoring detects security breaches and anomalies in real-time, thereby maintaining proactive security measures.
3. Compliance Standards: Essential compliance standards are HIPAA, and data standards such as HL7 and FHIR. These regulations contain specific guidelines for handling sensitive healthcare data. Data standards assure that the information is exchanged seamlessly between multiple systems.

3. Leverage Healthcare Data Analytical Tools

With vast amount of information coming via clinical data integration, it is paramount for providers to leverage healthcare data analytical tools because of the following reasons:

1. Analyzing Complex Healthcare Data: Research reveals that hospitals generate around 50 petabytes of data every year. This data is highly complex, so to extract useful insights from this data, healthcare organizations can use analytical tools. These tools can extract, process, and analyze complex data, and perform predictive, cognitive, and comparative modeling. These insights ultimately help providers to make informed decisions and improve patient outcomes.
2. Gain Real-Time Insights: Healthcare data analytical tools capture real-time data from wearables and remote monitoring software. This data is immediately sent to the providers in a readable format.
3. Enhanced Patient Care: By extracting meaningful insights from analytical tools, providers can identify at-risk patients and start early intervention and treatment. Proactive care can nip the illness before it evolves into something else. Data insights help providers to devise customized treatment plans that is tailored to patients’ conditions.

4. Use Healthcare Data Warehousing

With over 50 petabytes of data being generated, there’s a need for a vast storage space. This is where healthcare data warehousing comes into the picture. Clinical data integration connects several systems together, so the data obtained has to be stored in a secured place.

Healthcare data warehouse is a repository for storing structured data. It aggregates data from multiple sources, converts it into a standard format, and stores it in a way that is easy to analyze and retrieve.

Data warehouses use the ETL (Extract, Transform, and Load) process to move data from varied sources to the warehouse. It also uses the OLAP (Online Analytical Processing) method for analysis.

5. Utilize Data Lake

Apart from data warehouse, data lake is another way to store data. It is a cloud repository that stores raw data in its native format till it is required for analysis. A data lake hosts structured, semi-structured, and unstructured data at the same time.

Furthermore, data lake is designed to support machine learning, data analytics, and other applications that need surplus raw data. Unlike data warehouse, data lakes provide instant accessibility. They are also cost-effective than warehouse and highly scalable, thus making them a more attractive solution. Conversely, data warehouse works better if looking to incorporate business intelligence tools for healthcare data.

6. Use APIs to Extract Data from Legacy Systems

One major issue faced during clinical data integration is incompatibility with the legacy systems. An on-premise ERP is incompatible with cloud applications and IoMT. This incompatibility is due to different data formats and the inability of apps to handle information supported by new SaaS apps.

To make data accessible from legacy systems, use a layer of API abstraction. Try to separate and wrap legacy systems with RESTful APIs. You can also try to build access to constituent web services via APIs. Alternatively, rearchitect the underlying system code as a microservice and expose it via API.

APIs are cost-effective than replacing legacy systems while developing new data integrations. An API management platform helps to incorporate optimal policies such as throttling and rate limiting to safeguard the legacy systems from receiving many API calls and resulting in downtime.

Want an effective clinical data integration? Just get in touch with the experts in the field. We at Arkenea have over 14 years of experience in developing healthcare software, plus we also provide data integration services. To know more connect with us for a consultation call.

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One of the key challenges faced by large healthcare organizations is interoperability. Major U.S. cities have high rates of interoperability of health data, but variation exists. An organization that runs on multiple systems such as practice management, EHRs, or patient portals is bound to face data exchange problems. Small-sized clinics face fewer interoperability issues compared to larger organizations. So, to tackle this issue, certain data exchange standards were introduced, such as HL7 (Health Level Seven International) and FHIR (Fast Healthcare Interoperability Resources).

Both these standards are exceptional at ensuring interoperability, but there are certain aspects that sets them apart. In this article we will be taking a deep dive into HL7 vs. FHIR, so you can select the standard that works best for you.

HL7: A Brief Overview

HL7 is a standard used in the healthcare industry to exchange data between different systems. It is designed to be flexible and interoperable, thereby ensuring seamless data exchange. HL7 promotes data sharing of records, lab reports, test results, etc., through clinical applications. HL7 message structure includes segments, fields, components, and sub-components. This standard has different versions – HL7 V2, V3, CDA, and FHIR. Let’s understand about them.

1. HL7 V2

The HL7 V2 or version 2 standard was developed to offer a framework in which information is exchanged between disparate clinical systems.

It may not be as widely used as FHIR, but it ensures organization-wide interoperability between healthcare systems. This version of HL7 uses standardized messages such as medical orders, demographics, lab results, administrative activities, and financial details.

One interesting fact about HL7 V2 is that it can offer 80 percent of the interface while the rest 20 percent needs customization. This helps in achieving flexibility in optional and repeating segments.

2. HL7 V3

So, HL7 V3 or version 3 was developed to address certain challenges faced in the HL7 V2 standard. These challenges are as follows:

1. A lack of a consistent data model, it is more implied.
2. It lacks well-defined roles for messages and applications used in varied clinical operations.
3. HL7 V2 offers a lot of flexibility, leaving little room for a full solution.

The goals of HL7 V3 are:

1. To increase worldwide adoption of the V3 standard.
2. To have a consistent data model.
3. To develop a more accurate and not a vague standard.
4. Create a completely new standard that is not hindered by legacy problems.

3. CDA

The HL7 CDA (Clinical Document Architecture) is an XML-based standard that offers a structure or format for sharing clinical data such as progress notes, discharge summaries, and consultation notes.

CDA includes the following elements for all clinical documents – stewardship, persistence, potential for authentication, wholeness, context, and human readability.

A Synopsis of FHIR

According to a document on the HL7 page, “The philosophy behind FHIR is to build a base set of resources that, either by themselves or when combined, satisfy the majority of common use cases. FHIR resources aim to define the information contents and structure for the core information set that is shared by most implementations.”

A FHIR resource is divided into four parts:

1. Metadata: It includes the resource details such as resource version ID and date of the resource creation.
2. Extensions: Extension is a figment of a resource used to add data that initially is not part of a specific resource structure.
3. Narrative: Here, the resource content is presented in HTML format.
4. Standard Data: The block encompasses the patient’s name, medical record number, gender, information about the care provider, birth date, etc.

To extract the full benefits of FHIR, use SMART on FHIR which is an open-source API that allows developers to build applications that can operate anywhere in a healthcare system.

One of the uses of FHIR: In 2021, the University of Pittsburgh Medical Center inducted FHIR to increase interoperability across the organization, with an aim to connect hospital-based EHR with ambulatory EHR systems.

HL7 vs. FHIR

1. Tackling Security Concerns

Hackers can exploit the MLLP (Minimum Lower Layer Protocol). This is a framing mechanism to standardize HL7 messages for transmission over IP/TCP networks. Here, the IP Address, basic HL7 message format knowledge, and TCP port are enough for a hacker to send unauthorized messages and cause significant damage.

Another type of security damage can be a man-in-the-middle attack. This takes place when a hacker obstructs HL7 messages. This is done by obtaining access to the communication channel.

Plausible solutions could be to install a VPN or to get expert help from a healthcare software development company.

FHIR offers improved security features compared to HL7. This standard supports OAuth2 and OpenID Connect which safeguards sensitive data from unauthorized access. HL7 FHIR also relies on RESTful APIs and open web standards, which offer a safe foundation for integration and data exchange.

2. Ways of Data Exchange

RESTful APIs of FHIR replace point-to-point interfaces with one-to-many interfaces. This simplifies the process of onboarding new data exchange partners. It also speeds up the data-sharing process.

HL7 Messages are used to transfer healthcare data between disparate systems, each sending information about events such as patient admission. These messages are in human-readable format, but they may need some time to interpret. Basically, HL7 banks on traditional messaging systems for data exchange compared to modern FHIR.

3. Interoperability

FHIR encourages real-time data integration, exchange of healthcare information, and improved alignment with clinical decision-making, all of which ensure interoperability. This eventually leads to better patient outcomes, as providers can access and use the data to make informed care decisions.

Furthermore, FHIR supports integration with legacy systems, providing an adaptable and flexible solution for providers who are looking to transit toward modern data exchange standards.

HL7’s interoperability abilities are limited compared to FHIR due to its reliance on XML formats and traditional messaging systems.

4. Architecture and Design

Fast healthcare interoperability resources runs on RESTful API architecture, which facilitates data sharing over HTTP by using FHIR CRUD (Create/Read/Update/Delete) operations. It also manages large volumes of data from various sources. Furthermore, FHIR helps varied healthcare platforms to share data effortlessly. Plus, FHIR’s resources store healthcare data in structured format, making it manageable and accessible.

On the other hand, HL7 standard functions on segment-based structure, where information is transmitted in a predefined structure, assuring that every bit of data resides in a pre-decided segment. The HL7 standard can become complex and rigid due to its necessity for accurate parsing and interpretation.

5. Messaging Templates

FHIR standard supports XML and JSON messaging formats, thus providing flexibility for healthcare systems. Out of the two formats, JSON is easily readable and lightweight, thereby making it an ideal choice for apps and mobile devices.

However, HL7 standard primarily uses XML format, which is challenging to parse and read, especially on smartphones. XML was used in healthcare systems, but JSON is a much versatile option that can cater to the growing demands of better data exchange and mHealth apps.

6. Performance Analysis

The HL7 standard has a segment-based message structure and is quite effective for legacy systems, but can result in slow data transmission. Conversely, FHIR’s resources optimizes data exchange via JSON and XML formats. FHIR also speeds up data retrieval and decreases data redundancy.

HL7 vs. FHIR: Which is Better?

There’s no right or wrong decision here. FHIR and HL7 V2, V3, and CDA are specialized in different aspects. If you’re looking for better interoperability, then go for FHIR because its JSON format ensures better readability and data exchange. So, the choice on what to choose depends on organization’s requirements.

If you’re still in a dilemma, then bring in an expert to help you out in finding a solution. Approaching a renowned healthcare software development company can be beneficial in choosing the right standard for your organization. Arkenea has been delivering top-notch healthcare software solutions from the last 14 years. And we can help you solve your issues effectively. To know more just get in touch with us.

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John Schneider, a seasoned technology executive with extensive experience talks about the need to be constantly learning in the ever evolving healthcare landscape and how giving the team a safe space to fail is key to fostering a culture of innovation in HealthTech. Connect with John on LinkedIn here.

1. How do you see the role of technology evolving in patient care over the next decade?

Healthcare providers are on the brink of a crisis in care. More people than ever in America are 65 and over and the number of healthcare providers is on a material decline.

Technology is going to need to fill the gap to address this increased demand for care with a decreasing supply of providers. Healthcare providers will need to do more with less.

Processes need to be more streamlined and efficient, AI will need to help accelerate analysis and diagnosis and virtual communication will need to be further employed to allow providers to see more patients rather than spending time traveling to them.

2. Which emerging technologies do you believe will have the greatest impact on healthcare in the near future?

AI is probably the most prevalent as it will have wide ranging effects from the ability to improve diagnostics, optimize scheduling and take on admin work and move it away from doctors and nurses so they can spend more time with patients versus filling out reports.

3. What role does/will artificial intelligence play in your current and future projects?

Right now I am spending a lot of time helping healthcare providers use AI to improve their patient/customer experience from a marketing perspective.

As it will do in other areas, I am seeing AI tools help Healthcare Marketing teams increase their productivity by 2-3x allowing them to catch up on an ever growing backlog of maintenance work and make more time to create better customer/patient experiences to help better inform their patients.

4. Can you share an example of a major project or initiative in healthcare technology that inspired you?

Recently I worked with a Children’s Hospital to create a new communication and collaboration platform for the hospital that helped them reduce busy work, improve collaboration between providers and ultimately spend more time with their patients.

As a parent of a child who had open heart surgery as an infant I know how hard these healthcare providers work to provide compassionate care to the kids as well as to provide emotional support for the parents, who can feel helpless when their child is going through major care. Being able to help make that a bit easier for them through my role as a technologist was tremendously inspiring to me.

5. How do you foster a culture of innovation within your technology teams?

To foster innovation I believe you need to give teams a safe place to be able feel free to fail but to always look to learn from failure.

Combining this with giving teams time and space to innovate both in the way you direct them (i.e. provide goals not instructions) as well as giving them a bit of whitespace in their week to tinker is key.

Finally, you need to ensure there is a light shone on innovation by creating a venue for teams to share their learnings.

6. What are the key skills and qualities you believe are essential for a successful CTO in the healthcare tech sector?

I believe my success has always come from my ability to be constantly learning, to think strategically and to know how to put strategies into action. Nothing is every static in healthcare or technology, so you have to constantly learn and adapt but you also have to meter that with showing results.

Finally, having a rigorous focus on why you are doing what you are doing is key. We don’t do technology for technology’s sake, but rather to serve a higher purpose which in healthcare is often about being able to create highly effective, highly empathetic care environments.

John H. Schneider is an accomplished technology executive with decades of success transforming organizations. He has a rich history of achieving sales and revenue gains in the dozens of millions while evolving work cultures, building high-performance teams, and authoring effective digital strategies.

John has guided prolific industry giants like Coca-Cola, NASCAR, Hilton, and UPS to prosperity by overseeing complex technical initiatives harnessing robust Customer Experience, eCommerce, Data, and AI solutions. Connect with him on LinkedIn here. 

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EMRs (Electronic Medical Records) are the cornerstone of modern healthcare. Their introduction to the healthcare industry has converted paper-based medical records to electronic ones. Digital records have simplified the patient intake process and the data flow between systems. Reports say that medical errors are one of the leading causes of death, and electronic medical records leave little to no room for documentation errors.

EMR adoption has surged significantly since the ARRA mandate was issued in 2014. Currently, around 77.8 percent of office-based physicians hold a certified EMR/EHR system. The HIPAA regulation mandates that all healthcare organizations must send claims electronically. This has further bolstered the adoption of electronic health records across the USA.

The rise in the adoption of EMR isn’t just limited to error-free documents or mandates. However, its contribution to care quality, centralized workflows, and seamless data exchange have also elevated the use of EMR.

Healthcare providers can choose from different types of EMR based on the specialty, mode of deployment, and design settings. This article is all about understanding the varied types of EMR.

Major Types of EMR Software

EMRs are available in various types and each one has unique features and functionalities. Healthcare practitioners can customize each of these EMRs as per their requirements. Let’s look at the types of EMR in detail:

Based on Deployment

Types of EMR based on the mode of deployment are categorized into three types – cloud, on-premise, and hybrid.

1. Cloud-Based

The digital revolution calls for digital products and services. Cloud-based EMR fits the bill aptly. They don’t need complex installation processes and neither a heavy pocket to pay the bill. It can be achieved via the Internet, and a small tech team in case there’s trouble.

Currently, the cloud-computing market is expected to reach $947.3 billion in 2026, growing from $445.3 billion in 2021 at a 16.3 percent CAGR during the forecast period.

Pros

1. Money Saved is Money Earned: Cloud-based EMR software eliminates upfront costs in hardware and maintenance. Therefore, making it a cost-effective option for small healthcare organizations. The saved amount can be put to use for the customization of EMR.
2. Scalability: Cloud-based EMR has a scalable nature. So, users can upgrade their storage plans whenever needed.
3. No Geographical Barriers: Regardless of the location, healthcare providers can easily access patient data. All they need is a stable network. This approach is quite useful for telemedicine and remote patient monitoring services.

Cons

1. Downtime due to Network Glitches: Internet connection comes with its drawbacks. Net issues mean slow work, downtime, and going down with the system. However, if your network has a large bandwidth then these issues mean nothing.
2. Data Security Risks: Cloud platforms are handled by external parties. Collaborating with them means giving them access to healthcare data. So, discuss security protocols before joining hands with them.

2. On-Premise

With the rise in cyber-security concerns, isn’t it better to store data offline? This way the data isn’t traveling anywhere and is safer from potential hackers. On-premise or server-based mode of deployment is made exactly for this purpose. It keeps the medical records safe from prying eyes.

On-premise deployment eliminates the need for a stable network connection, users can work without it. Even if the internet goes down, it never allows you to go down with it.

This option offers customization during the implementation process. Furthermore, on-premise is quite reliable when it comes to IT support. A robust healthcare software development team is continuously maintaining the software behind the curtains.

Here are the key pros and cons of using an on-premise EMR:

Pros

1. Ability to Operate Offline: Say goodbye to delayed work. An on-premise EMR software operates on internal servers. So, toss aside the worries about slow connectivity and reliable network options.
2. Enhanced Security: Unlike cloud-based EMR software that is vulnerable to cyber-attacks, an on-premise deployment is free from it. Healthcare providers can restrict data from anyone who does not have authorized access to the EMR.
3. Customization: Instead of asking the vendors to upgrade features, organizations can upgrade the systems by themselves. An on-premise EMR software offers flexibility, storage, and customization options.

Cons

Some disadvantages of on-premise deployment are:

1. It Can Get Expensive: Compared to cloud-based EMR, on-premise is a costly affair. Installation, software license fees, maintenance, upgrades, data backup, storage, and more demands a hefty amount. Large and mid-sized hospitals may easily burden the expenses, but what about the small practices? Not a definitive option for them. They may rather go for affordable cloud-based EMR.
2. Risk of Losing Data: With affordable data backup services, it’s unlikely that organizations would store health data only on on-premise platforms. However, incidences such as natural calamities or man-made accidents can corrupt the data stored in the location. Further, ransomware attacks and system malpractice also lead to data loss.
3. Scalability: Scalability is a challenge for on-premise EMR software because additional features demand new hardware. This can add to the already expensive software.

3. Hybrid

Hybrid deployment integrates on-premise platforms with cloud-based services. This deployment mode allows healthcare organizations to leverage the cost-effectiveness, scalability, and innovation of the cloud while utilizing the security and customization of on-premise platforms.

To expand on this, A hybrid EMR software optimizes costs by paying for resources only when needed. It can create additional backup options by storing data in hardware.

Furthermore, healthcare organizations can use cloud services for non-sensitive work that requires flexibility and scalability. They can go for on-premise for critical data. Healthcare facilities can maintain security and compliance over sensitive information by inducting stringent authorization protocols.

A pitfall of hybrid deployment is to have people with the necessary skill set to manage a hybrid-based EMR software. It is rather difficult to recruit such talent.

Based on Design Settings

Types of EMRs based on design settings are of two distinct types – ambulatory and acute care EMRs.

1. Acute Care

Acute care EMR software is largely used in hospitals and other inpatient care facilities. It supports inpatient care needs such as real-time tracking of patient information, patient admission and discharge, and management of complex medical data.

Acute care EMRs encompass features such as alerts and notifications, decision support, and integration with CDSS. Additionally, they blend well with large healthcare organizations like hospitals, rehabilitation centers, and critical care facilities.

2. Ambulatory

Ambulatory EMRs are digital patient chart technology that allows healthcare providers to document patient care. These EMRs include longitudinal patient care, along with chronic care management.

They may have hospital data in them, however, most of the data is from physician visits in their office or surgical center. Ambulatory EHR Systems focus on diagnosing, offering specialty referrals, writing prescriptions, and capturing interactions with patients.

Furthermore, ambulatory EHRs mainly focus on care outside the hospitals such as outpatient clinics, primary care practices, and specialty practices. With features such as patient portals, patients can seamlessly access their health data, make payments, and request medication refills.

An ambulatory EMR software makes it easier and faster to process a patient’s data during an emergency care situation or a medical appointment. With an ambulatory EMR, any staff member or healthcare provider can gain access to a patient’s medical records with appropriate consent.

Based on Specialty

Types of EMR based on specialty are divided into two groups – multi-specialty EMR and specialty-specific.

1. Multi-Specialty

A general EMR software may not be enough for organizations dealing with multiple medical services. So, use a multi-specialty EMR system to fulfill the many requirements of providers. They are developed to provide a unified view of patient data across multiple specialties. Healthcare practitioners can easily manage data from a single system, regardless of the specialty involved. This ameliorates efficiency and care coordination.

They include a range of features standard to different specialties. It can be customized to meet the specific requirements of each specialty.

Multi-specialty EMR software provides broader functionalities such as integration of practice management software, and advanced reporting tools, and revenue cycle management.

2. Specialty-Specific

Specialty-specific EMRs are developed to meet the unique needs of a medical specialty such as ophthalmology, dermatology, or mental health. These EMRs encompass pre-configured workflows and templates tailored to the specialty’s needs. However, they may lack the customization and flexibility of general electronic medical records.

Specialty-specific EMRs enhance productivity, so find a vendor who understands every facet of a healthcare practice.

For example, a gynecologist can use specialty-specific EMR to calculate due dates, track contraception history, and have ultrasound analysis capabilities.

Falling in any one of the above categories? Just connect with Arkenea, a healthcare software development company that specializes in custom EHR/EMR software development. We’ve got you covered.

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A healthcare organization typically uses a myriad of healthcare software, and every patient’s data goes into these software systems. There’s data coming from practice management, EHR/EMR, LIS, CDSS, radiology, remote monitoring, telemedicine, wearables, etc. By 2025, the compound annual growth rate of data for healthcare will reach 36 percent.

Every one of these systems produces data, but the catch is to make them work together, so there’s seamless data exchange. This is one of the biggest challenges faced by the healthcare industry. HL7 integration plays a crucial role in overcoming this challenge.

HL7 or Health Level Seven International is a data integration standard that ensures seamless data exchange across healthcare systems. But, to leverage its maximum potential, there are certain HL7 challenges that CTOs must overcome.

14 Crucial HL7 Integration Challenges

1. System Upgrades and Maintenance

System upgrades and maintenance is a continuous process. It keeps the healthcare system running smoothly. The tech team is tasked with upgrading security protocols and systems as this takes the topmost priority. Another aspect that requires constant change is keeping up with the user needs.

Adding or deleting features and functionalities can affect the interface. This may have an impact on the HL7 interface too. So, to avoid this situation, CTOs can create a strategy that involves rigorous testing and checking compatibility with HL7 as soon as the upgrade is underway.

2. Poor HL7 Data Semantics

Healthcare data is getting complex, so the right interpretation of information and what exactly it means holds value. For instance, best to specify abbreviations wherever necessary as it eliminates confusion.

To preserve the quality of data and to avert dire consequences for the patients, ensure that HL7 data semantics are comprehensive, accurate, and interpreted correctly.

3. Shift to a New EHR Software

Shift to a new EHR software poses a challenge for not just the CTOs, but healthcare organizations as well. An EHR is internally connected to several systems, hence migrating data to a new EHR software is challenging. So, if an organization is thinking about shifting to a new EHR software, CTOs can kickstart the process by understanding which version of HL7 is being used. This allows the CTOs to seamlessly tackle HL7 integration challenges during the shift.

The foremost obstacle would be data backup and recovery process. The tech team can start backing the recent data first (diagnosis, allergies, and medications), the older data can take a backseat here. Further, ensure that the latest versions of HL7 are implemented in the new EHR.

4. Tackling System Downtime

System downtime can cost an organization loads of money, hence this is one of the key HL7 challenges faced by the CTOs. It can also affect seamless data transfers across the organization, thus delaying patient care and safety. Reasons for downtime could be:

1. Hardware failure
2. Cyber attacks or data breaches
3. Human errors
4. Incorrectly prepared architecture
5. Network outages
6. Overload of resources

So, what can be done to avert downtime? CTOs can invest in healthcare cloud technology such as AWS to ensure system compatibility and data migration. Another way to tackle this challenge is to implement CI/CD (Continuous Improvement and Continuous Delivery). With this approach, CTOs can automate the release of updates and the testing process, thereby improving uptime.

5. Deciding Cost Estimates

Managing cost and resources is considered as one of the significant challenges of HL7 integration. It is important that the CTOs deliver the best of the products with the given cost estimate. For a custom HL7 interface the expenses would be higher compared to other tools such as interface integrations and APIs.

Don’t miss out on the port expenses as it connects two systems. The average post fees would range between $10,000 to $30,000. Plus, include data transfer costs, SSL for secure transfers that may go around $50 to $70.

6. Security and Privacy Issues

The healthcare industry faces numerous cyber attacks, hence security and privacy are the topmost priorities for the CTOs. To prevent intruders from gaining access to HL7 messages, get robust security systems in place. Enforce HIPAA compliance regulations for systems integrated with HL7.

Use an additional encryption layer, establish data transfer via secure protocols. Train the staff on how to maintain security and privacy of healthcare systems. This can reduce the number of breaches caused due to human errors.

7. Alignment with Clinical Workflows

Today, an EHR software is linked with several systems such as patient portals, billing, and practice management. All of these departments use data residing in the EHR. So, to maintain a steady clinical workflow, an interface engine must be used to convert HL7 data into readable format such as XML or JSON.

Other way to maintain workflow is to use new standards such as FHIR (Fast Healthcare Interoperability Resources). This standard works well with web-based technology. CTOs can also conduct workflow analysis to tackle HL7 integration challenges.

8. Scalability and Performance

The amount of data in the healthcare industry is rising each day. Surplus data can leave a negative impact on scalability and performance of healthcare systems. So, CTOs can design an architecture that can store and process huge datasets. An on-premise deployment mode can struggle with this, but a cloud approach may just fulfil the requirements.

Flexibility offered by cloud helps to handle loads of data without compromising on the performance of the systems. Plus, a robust architecture can lead to fast data exchange, and ameliorate response times and throughput.

9. Interoperability Challenges

Modern healthcare requires interoperability of one system with another one, and also with mHealth apps and SaaS products. All of them support different data formats which causes difficulties in transfer. They need to be configured to work with HL7 integration. To handle this obstacle consider using RESTFUL APIs, patient-centric apps, and physician portals.

10. Handling Errors

To err is human. But sometime software too can make mistakes if the data is not structured properly. The best way to handle errors is to keep up with the latest edition of HL7. The higher the version, the better the error control.

HL7 integration contains ERR segment that is used to address errors during transfers and messages. This segment flags application error code, severity of an error, help desk contact, support for multiple error locations, and more.

11. System Compatibility and Version Choices

The Health Level Seven has two versions – 2.x and 3.x. and the most preferred version is the former one. One thing to note here is that 3.x is not compatible with 2.x. So, this poses a challenge if any of the systems use a different version.

To further complicate the problem, the 2.5.1 HL7 version was selected as the standard for making lab reports and certificate requirements. To solve this issue, use version 2.x for legacy systems. And while creating HL7 interfaces check which version is best suited for them.

12. Secure Data Transfers

Secure data transfers is another HL7 integration challenges faced by the CTOs. Security during data transfers prevents it from potential cyber attacks.

So, to ensure robust security, CTOs can leverage all or either of the following HL7 messages:

1. SSH Tunnelling: This offers a secure connection between two servers or sites. SSH is available by default on OS X and Linux. Windows may have to use Voshell.
2. Secure FTP: With FTP is is possible to incorporate secure transfer of HL7 messages across systems. SSH FTP provides secure transfer of datasets.
3. VPN Tunnel: A VPN connects two remote sites over a private network, thus securing HL7 messages. The VPN tunnel protects data by using secure encryption.

13. Interface Development

Without an HL7 interface specification outlining requirements, CTOs will be stuck with a generic interface. The interface is likely to go buggy if the actual requirements of the healthcare organization aren’t met. This can result in troubleshooting after the product is launched.

The organization is likely to face clinical workflow issues because the interface isn’t effective. The clinicians are faced with lack of data. So, to avert all these issues, get an interface that matches with the user requirements.

14. Tackling Different Vendor Implementations

Every vendor may choose to incorporate a different version of the HL7 standard. The lack of standardization makes integration expensive and difficult. At every endpoint, developers need to craft and maintain a separate codebase.

If there’s a need to upgrade interfaces then every endpoint needs to be updated. So, it is more better to invest in interface engine that will manage the differences in incorporation and bolster productivity of the tech team.

The HL7 standard acts as a sustainable bridge between advancing IT and modern processes. Healthcare sector giants and startups must seize this opportunity to facilitate solid data-exporting environments. If you’re looking for HL7 integration, then you’ve arrived at the right place. Arkenea, a healthcare software development company has got you covered.

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