Example 14: System Integration Problems

Issues Encountered

After implementing an EHR, a small hospital discovered that test results from an outside lab were not being loaded properly into the EHR. Lab results were being attached to the wrong patient records. Additional interface problems between the EHR and the coding and billing systems also began to emerge, which prevented claims from being processed in a timely manner.

Finding a Solution

Local IT staff developed an algorithm, which mostly succeeded in resolving the mismatched lab results. However, monitoring and updating the efficacy of their homegrown solution is a major burden on local IT staff. The problems with the EHR/billing system interface arose immediately after implementation of the EHR system, and the problems typically reemerge after an update to the billing system. Again, local IT staff members have developed solutions to the problems; however, the interface needs to be reprogrammed and tested for each billing system update.

Lessons Learned

  • Missing or scrambled lab, pharmacy, or financial data in the EHR are signs of poor system integration.
  • Integrating your EHR with your other clinical and financial systems can be a challenging, expensive, and labor-intensive process.
  • Updates to your EHR and other systems are frequent sources of unintended consequences.
  • Choosing systems that have worked well together in other practices or facilities and thorough testing of system interfaces will help you avoid system integration problems.

Source: This material was derived from responses to a membership survey about unintended consequences that the American Health Informatics Management Association (AHIMA) conducted in 2009. For further information, contact Spencer Jones at the RAND Corporation at sjones1@rand.org.

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