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3 steps to a successful HL7 implementation

INSIGHT ARTICLE  | 

Whether a health care organization is implementing new or upgrading existing software, Health Level Seven International (HL7) interfaces will typically be a consideration. Due to application interoperability, HL7 interfaces are necessary to support data integration needs. Properly implemented HL7 interfaces can reduce duplicative data entry and enhance end user workflow.

As with any new technology effort, how HL7 interfaces are implemented may dictate the success of a project. Fortunately, proper project coordination can limit the risk of failed HL7 work efforts and produce successful project outcomes. Robust project coordination can help your organization avoid a number of poor HL7 outcomes, including incorrect tracking of patients throughout their stays, results not presenting for the correct patient and results presenting on an incorrect patient record.

ADT and other interfaces

HL7 interfaces are solutions that allow patient data to be communicated between multiple health care software solutions. For example, HL7 admission, discharge, transfer (ADT) messages carry patient demographic information along with important trigger events. These trigger events include ADT, registration and merge messages, to mention a few. Taking the time to properly identify ADT content relative to your project is key. The ADT feed is typically the backbone of the HL7 data being transmitted to a system. If the ADT content is inaccurate, the subsequent data from resulting systems will not match up with the patient and visit. Some applications can require a relatively common set of ADT transactions that include admissions, discharges and patient updates. Other ADT implementations have greater needs where merges are needed when patient, visit and encounter identifiers change.

While ADT may be the most frequently discussed HL7 interface, there are other common HL7 interfaces used within health care organizations. These other interfaces are deployed to share physician, clinical and financial data relative to patients and visits. Examples of these other interfaces are:

  • DFT – Detailed financial transaction
  • ORU – Observation results
  • ORM – Orders
  • MDM – Medical document management
  • MFN – Master files notification
  • SIU – Scheduling
  • BAR – Billing account record

Three key steps

Plan the interface

  • Scope—When implementing HL7 interfaces, the first step should be working on the scope of the HL7 work effort. Taking the time to identify the required interfaces is key, as well as identifying interfaces that are not part of the current project scope. Taking the time to correctly identify these needs will assist project staff in creating the project budget, help save money and prevent headaches down the road. 
  • Staffing—In addition to the scope of the project, identifying staff that can work on the project is also important. Internal staff capabilities and working with consultants both need to be considered.
  • Content—A key step in the interface planning phase is taking the time to review the content (segments and fields) of the identified HL7 interfaces. HL7 provides the standard structure for messages but field content can change locations relative to each implementation. Each interface should be reviewed to avoid data irregularities.
  • Workflow—An item that needs as much, if not more, attention is the review of ADT workflows relative to the sending and receiving systems. Not taking time to consider complicated ADT workflows such as patient merges, account merges and cross facility transfers, to mention a few, can lead to improper execution of an interface feed.

Build the interface

  • Execution—This is the project execution phase and where much of the hands-on work starts. In order to execute this stage properly, many steps are involved. The first step is for the interface engineers to complete any application side work efforts and to also define ports and content on those ports.
  • Interface build—Taking time to understand the specifications and properly build the interfaces is an important step. Setting up the interface to properly handle content and field locations for medical record numbers, accounts and visits is part of this step.
  • Testing—Connectivity testing should wrap up the build stage and start transition to the validation stage.  Connectivity testing is the process of having a source system and a destination system connect at a port level and successfully pass data. Sending HL7 data across those ports validates there are no network barriers to receiving the HL7 content.

Test and validate

  • The testing phase is another important phase of the implementation. Taking time and properly reviewing the design, utilization and content of these interfaces is one of the most important steps of a successful project.
  • Unit and integrated testing are areas where application subject matter experts truly need to be involved. The reason subject matter experts are needed is that while interface analysts are typically great at working with the technical items relevant to an interface, they may not be data content experts.
    • Unit testing walks through validating specific feeds and reviewing data for accuracy. This testing should identify any issues the interface engineer did not find during the initial gap analysis.
    • Integrated testing involves reviewing data as it flows through upstream and downstream systems via the HL7 interface solutions. Project sponsors and their supporting staff for the project are typically very familiar with the data and need to be involved in validation steps.

Conclusion

HL7 interface development may seem like a complex project technically, but managing it doesn’t need to be difficult. Successful HL7 interface implementation takes teamwork and should combine the skill sets of the interface team and the data subject matter experts that have the background to assist with testing. Considering the use of consultants can add interface expertise along with helping decrease an organizations backlog of interface work. Coupling a strong interface team along with coordinated testing can provide successful outcomes for an implementation.

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