Healthy Links - Bringing Interoperability to Healthcare Delivery

Healthcare IT spending has doubled to 3% of revenues, but healthcare organizations still lack the IT integration required for reaping the benefits technology can yield.

Healthcare organizations are striving to ensure continuity of care for their patients by moving from paper-based environments to digital settings, where information is collected, stored, and shared through IT applications such as electronic medical records (EMR). To maximize their benefits, a solution that ensures different systems and applications are interoperable is imperative, finds a new study by Booz & Company. An enterprise integration solution (EIS) addresses this challenge by ensuring data is seamlessly exchanged across different systems and applications, making it available as required.

The Integration Challenge

“Industry leaders have begun to invest in new, sophisticated health IT applications that can capture and share digital data,” commented Ramez Shehadi, a partner at Booz & Company. In fact, IT spending by healthcare organizations nearly doubled from 1.66 percent of revenues in 1997 to 3.02 percent in 2007. Healthcare organizations however have not paid as much attention to the integration of these technology solutions. The lack of an enterprise system to connect these new applications and devices has resulted in key data not being accessible to all key players or available where and when required.

“Providers have adopted technology as each new challenge in a specific department emerged. These fixes are performed in isolation, causing information to be fragmented within the organization; meaning existing solutions can’t communicate seamlessly with other systems,” stated Walid Tohme, a principal at Booz & Company.

To tackle this challenge, healthcare organizations have traditionally deployed point-to-point integration solutions between systems, which don’t provide a the scalability and effectiveness desired. As a result, hospitals are finding themselves with complex IT environments as new clinical, administrative, and other information systems are being implemented on top of older legacy systems are still being employed. Having adopted a number of point-to-point solutions for cost savings and expediency, hospitals end up with complicated, costly, and inflexible systems.

The Case for an Enterprise Integration Solution

Given increasing demands to treat patients across the entire continuum of care, healthcare organizations need a technology platform that can support disparate systems interoperate and help extract their maximum benefit. “A well-designed EIS serves this purpose, by reducing point-to-point connections and enforcing standardization across functions and facilities on multiple levels,” commented Jad Bitar, a senior associate at Booz & Company. It also helps streamline and better coordinate different organizational elements such as processes and services—the result being lower operating costs and increased organizational flexibility.

Dozens of IT vendors have entered the EIS market, but no clear criteria exist to evaluate off-the-shelf solutions or ascertain how they handle specific problems. In most healthcare organizations, an EIS is required that can systematically replace point to-point connections. Five criteria are critical to guide healthcare organizations through the evaluation process and to help them maximize existing IT investments and avoid unforeseen consequences.

Vendors’ cross-testing capabilities: “Organizations need to conduct a traditional vendor analysis that examines their financial stability, market size, and how the product can solve their specific issues,” Shehadi commented. Organizations must understand the vendor’s capability to test and validate the system once it is up and running, as this typically takes two and a half times as long as research and development. As such, the EIS vendor’s capacity to ensure the solution can interface with multiple applications with different standards after it has been configured—is critical.

Vendors’ adherence to industry standards: It is imperative that the chosen EIS supports key industry standards to allow for the interconnection of software assets, services, and components. Organizations should give preference to approaches that make use of open codes and standards so that they can add functionality to their systems on an ongoing basis and aren’t too reliant on the original vendor for updates.

COTS product functionalities: A well-designed EIS typically requires a product that offers a multitude of functionalities, including the support of various industry standards and integration styles, state-of-the-art security, an easy-to-use but robust management dashboard, and auditing capabilities. “These should be available ‘commercial, off-the-shelf’ (COTS), to avoid the unnecessary use of resources to develop them and allow for standardized rather than customized version upgrades,” said Tohme.

Modular product packaging: The ability to incrementally deploy an EIS is vital. It allows health organizations to build up their integration infrastructure in smaller steps, and enable faster payback periods while minimizing deployment risks. “Organizations need to properly understand their integration needs up front before selecting a solution that is too bulky or not scalable, where some modules may be underutilized and the whole system may need to be replaced if it can’t support future needs,” Bitar noted.

Long-term, comprehensive support: The EIS vendor should provide long-term support for multiple hardware and software platforms, operating systems, and enterprise applications, such as enterprise resource planning (ERP). Time-consuming informational lapses can arise when healthcare organizations are left to deal with third-party system integrators.


Delivering effective healthcare services is a challenge for many reasons; and although health information technology has been widely adopted, these often disparate investments have added significantly to the complexity of hospital data management. As healthcare organizations migrate to digital information systems, demand is increasing for an EIS that can bridge the gap between legacy systems, emerging devices and other technologies that enable real-time sharing of critical patient data. Selecting the right vendor is critical to ensuring that the full benefits of IT investments are being realized.