Are EMRs stronger together? The need for EMR-to-EMR interfacing is on the rise as more urgent cares partner, affiliate, or are purchased by hospital systems. An EMR-to-EMR interface lets urgent care clinics share patient encounters with referral health systems in a CCDA (Consolidated Clinical Document Architecture) document using HL7 (Health Language Seven) standards in XML files.
For the Love of Interfaces
Interfaces aren’t new for urgent cares. Clinics have already embraced interfacing to connect their EMRs to outside software, such as with billing software, labs, health registries, and radiology systems. Efficient transmission and data exchange improves staff workflow and patient history accuracy. Reducing data entry and speeding up importing of lab results equals improved patient care and accurate provider treatments.
Urgent care interfaces vary in functionality and can be either one-direction or bi-directional; examples include web check-in to PM, PM to EMR, EMR to labs, or EMR to pharmacy. Even with all this digital communication, the urgent care and healthcare industries are still working on building a state of EMR interoperability. Historically, HL7 has done the heavy lifting with digital transmissions from server to server.
Wondering what steps are involved in setting up an EMR-to-EMR interface with your urgent care to a health system? If continuity of care and patient referrals are your goal, here are the basic steps to know before getting started.
1. Talk About Your Urgent Care’s Interface Needs First
Before you start discussing interfaces, first talk about what your true needs are as an urgent care. Do you truly need to share data with an interface? What type of functionality is required to reach the goals you desire? If you have multiple clinics, do all locations need to transfer data to the health system? Goals for data exchange should drive all your software functionality decisions
2. Begin a Project Timeline with Your IT Team and Software Vendor Interface Analysts
IT and interface analysts (for your EMR software vendor and the health system’s software vendor) need to be in close contact regarding an interface project from the beginning. Interface analysts are versed in questions to ask, and can guide both healthcare entities through the project. They know what EMR-to-EMR interfaces have been done before, and understand basic needs, as they work on these daily.
3. Consider the Receiving EMR and Its Requirements
Each EMR software speaks its own lingo, and has its own unique features and software architecture. Due to the software variations, interfaces will differ in what they request for the data exchange, and often how or when data is called from servers. Interface analysts will help trade vendor specifications to ensure the correct data criteria is being exchanged between EMR systems.
4. Have a Plan for Matching Patient IDs and Demographics
Each EMR identifies patients differently. Thus, matching patients from system to system needs to be determined when the interface is being built. ADT (patient demographic data of admission, discharge, and transfer) needs to be transferred accurately, or a weighted system to match files needs to go into a queue for manual matching. CCDA files can be built to match patient identifiers and demographics. A small amount of manual tweaking of encounter notes is often still required to match patient demographics from EMR to EMR due to unique software architectures.
5. Ensure You Have a Secure VPN Tunnel (if using an Interface Engine)
HIPAA and PHI regulations apply to electronic data exchanges as well as paper. To protect patients, individually identifiable data cannot be compromised. Having a secure VPN tunnel if using an interface engine is a requirement. An interface engine helps share data by routing messaging, translating data into the same language, and filtering data by blocks. A Secure Socket Layer (SSL) and FTP security are essential, depending on the data storage area.
As web-based API querying becomes more commonplace with FHIR (Fast Healthcare Interoperability Resources) instead of HL7, a secure web service will be needed instead of a VPN tunnel. FHIR promises more possibilities for health information exchanges with REST architecture. Other FHIR upsides include more file types to transfer (JSON, XML, text, and more), specific data querying instead of “push” and “pull” data exchanges, and patient data caching (instead of server storage) for improved patient security.
6. Test Your Interface and Data Exchange Quality Before Launching
With your interface built (which could take anywhere from days to months, depending on the complexity and decision-makers involved), test data transfers closely. Ensure exchanges are meeting the correct criteria before automating the process for server calling. Many interfaces offer real-time data transfers (up to several seconds) based on workflow triggers in the software, while other interfaces can be set to transfer data during certain times of day.
An Interface is a Marriage of Data
To join your EMR with any other software is to create a digital partnership, a marriage of data exchange. Do you want to partner with another healthcare entity? Is it the best option to ensure your best-of-breed software EMR keeps your workflow smooth while still referring patients to a partner hospital system? Which EMR will be the “source of truth” and override the other? Your urgent care’s goals will answer these questions and determine if an EMR-to-EMR interface is in your best interest.
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