Interoperability Accelerates the Healthcare and Life Sciences Industries
Integrating data from the wide variety of systems used by healthcare and life sciences organizations today requires balancing data needs with a diverse range of internal and external imperatives. While IT departments are constantly under pressure to integrate systems as quickly and as cost effectively as possible, there are several trends to consider.
- Compliance & Standards
- Value-Based Healthcare
- Modernizing & Digitizing IT
- M&A - Life Sciences
- M&A - Healthcare
Regulatory Compliance and Industry Standards Challenges
Healthcare and life sciences organizations must navigate a complex regulatory landscape where regulations are updated and changed frequently. These frequent changes make it a challenge for technology to keep up with reporting requirements for aggregating data into a “single version of the truth.”
Today, it’s not enough to have electronic medical records (EMRs). There are a variety of key healthcare interoperability requirements, from provider, payer, life sciences and processor management to following the highest security standards while ensuring compliance. Providers must keep in mind that:
- U.S. law now requires that for Medicare and Medicaid, healthcare organizations must meet the Meaningful Use Stage 1 criteria where EMRs must be used in a meaningful way—which then requires enabling more applications to process these records.
- HIPAA-covered entities need to use ICD-10 codes to receive payment for healthcare services rendered, or risk providing care and not being paid. Even life sciences organizations need to pay attention to ICD-10, for drug indication and label language. Given the complexity of ICD-10 codes compared with ICD-9, current data mapping is now obsolete, requiring new application integration and mapping scenarios.
- One of the most significant challenges healthcare organizations must address is compliance with Health Level-7 (HL7), the standard for information exchange between medical applications (as well as payers and processors).
- 21 CFR Part 11 sets the standards for which the Food and Drug Administration (FDA) accepts data from life sciences firms, including all electronic records and signatures, whether for research and development, manufacturing, laboratory operations or clinical trials.
- United Kingdom NHS Interoperability Toolkit (ITK) compliance: UK healthcare organizations increasingly expect healthcare applications and platforms to comply with NHS standards. Dell Boomi is demonstrating this compliance – view our first .
Remaining competitive requires an integration solution that’s flexible and responsive enough to handle the frequent updates to regulatory compliance requirements and industry standards.
A New Business Model: The Value-Based Era in Healthcare
With a new emphasis on population health management, the “value-based era” in healthcare focuses on managing the reduction or eradication of specific diseases within specific communities. This method of healthcare delivery is resulting in a shift to value-based payment and reimbursement models (instead of fee-for-service) for providers and hospitals that are evolving into accountable care organizations (ACOs), a new healthcare payment model where providers are paid for a population’s overall health—whether they see a doctor or not.
These new business models are being initiated both by the government and by payers. At the government level, the arrival of the Affordable Care Act (ACA) has refocused healthcare programs on reducing cost, improving care quality and improving access goals. From the payer's perspective, health insurance companies are forcing new models of cost management such as value-based reimbursement.
As practitioners strive to become ACOs that contribute to population health management, they’re accountable for:
- providing effective treatment
- delivering quality, measurable patient care
- reducing healthcare costs while improving operational efficiency
Producing the new metrics to support payment amounts requires far more data, improved interoperability among systems, and fast, low-cost integration of those systems.
To make population health management a reality, healthcare providers and hospitals need data. And it must be collected, captured, integrated, and measured—whether it’s patient data, clinical data, patient admission data, demographic data, community data, and more—each coming from a different data source, with different data structures and formats, measured against a range of predefined metrics.
The need for application integration, data integration, and system interoperability has never been greater.
Modernizing and Digitizing Healthcare IT
The first step involves modernizing IT systems while ensuring compliance with data protection laws—because standards and metrics drive the delivery of care in these models. Evaluating those metrics involves accessing far more data than ever, and highlights the need for improved interconnection among systems such as electronic medical records (EMR), Health Information Exchanges (HIE) and Patient Administration Systems (PASs).
At the provider level, medical practice and business operations must be organized into a seamless machine to run physicians’ offices and to generate safe, measurable and economically viable outcomes for patients while driving efficiency for the practice. These would involve managing:
- financial systems
- billing systems
- ordering systems
- supply chain systems
- ordering systems
- procurement systems
Any move to digitize medical records and modernize existing IT systems will involve working with legacy or clinical systems from a variety of vendors, connecting data from several branches of hospitals or healthcare networks.
While your organization may have interface engines that were originally created to help connect legacy interfaces, these engines may now be too expensive and inflexible to maintain, configure and adapt.
In some cases, they’ve may even be a hindrance to today’s interoperability needs—a problem that’s exacerbated when extended to cloud integration and mobile deployment. These proprietary interfaces are also hard to maintain, and as vendors sunset legacy products, continuous support isn’t guaranteed.
Mergers and Acquisitions Highlight Challenges for Life Sciences
With mergers and acquisitions (M&A) among pharmaceutical companies and biotech firms, realizing the value from the M&A activity means addressing interoperability challenges. Time to market is a key driver for pharmaceutical companies—and the same applies to data integration.
When the goal is beating your competitors to establish market dominance while a drug is still protected by patent or exclusive marketing rights, speed is critical—despite the challenges of operating under intense regulatory scrutiny and addressing enormous data requirements. Even when submitting clinical trial data for the FDA’s rigorous, data-intensive drug approval process, data is the driver.
Starting with the clinical trial—an intensely collaborative process where facilitating that collaboration requires a significant amount of data sharing—clinical trial data is aggregated from different databases, as it travels back and forth between the sponsoring company and its contract research organizations (CROs). In addition, it’s moving between suppliers, physicians, researchers, partners and customers. So ensuring data integrity requires collecting and aggregating data from multiple systems.
The more efficiently data can be gathered and approved, the faster a pharmaceutical company can bring a drug to market and start generating a return on its investment.
Healthcare Organizations Face Challenges of M&A, Too
In a healthcare organization, the business drivers and potential roadblocks that will have an impact on making an M&A a successful business transaction may include speed of value realization, the potential for expensive disruptions, efficient use of resources, quality improvement, and population health management.
In a heavily regulated industry like healthcare, where the compliance landscape is ever-changing, healthcare providers and networks undergoing M&A activity likely focus on providing value-based care, as well as quality. Since many healthcare organizations are embracing the new accountable care payment/revenue models, the move to a value-based reimbursement model is taking center stage, as the previous fee-for-service model fades away.
During an M&A situation, legacy systems and even legacy interface engines necessitate a migration plan, but healthcare organizations face a wide range of challenges here, too:
- Proprietary interfaces are hard to maintain.
- Vendors are sunsetting legacy products so continuous support is dwindling.
- Industry standards—such as HL7, HIPAA 5010 and ICD-10—are changing and evolving.
Legacy systems can be very expensive to operate, and with a diminishing skillset on the market, even harder to configure and change to adapt to new requirements. Those headaches continue when you extend to cloud integration and mobile deployment because the rigid architecture isn't flexible, and there are complex licensing agreements, renewal processes, and renegotiations that take place.
Dell Boomi: The Ultimate Interoperability Solution
For healthcare and life sciences organizations, Dell Boomi helps speed time to value when it comes to compliance—over time—because as regulations change, we make sure that your integrations can keep up. As a flexible, cloud-based solution, Dell Boomi AtomSphere® integration platform as a service (iPaaS) integrates your applications whether on premises, or in the cloud.
And our Master Data Management (MDM) solution provides your organization a “single version of truth” to eliminate the data silos on the ground and in the cloud—the silos that many healthcare organizations still struggle with today.
Dell Boomi was selected as a leader in Gartner’s Magic Quadrant for Enterprise Integration Platform as a Service, Worldwide* for its integration platform as a service offering, AtomSphere. Featuring our patented Atom technology with its drag-and-drop functionality and automatic mapping, AtomSphere offers you faster time to value, ease of use and simplicity. Healthcare and life sciences organizations will find it easier to share your data, because of AtomSphere’s:
- Flexible, adaptive architecture featuring our patented Atom® technology, that either adapts to what you have or replaces it, as required—with no coding, no hardware—for secure integration and monitoring.
- Emphasis on configuration, instead of coding, providing greater speed and eliminating complexity and improving ease of use.
- Centralized development, distributed deployment to relieve operational stress on any one system or node.
- Predictable pricing that provides an economically viable solution as a cloud-based solution that provides a low barrier to entry.
- Proactive issue resolution from our Predictive Assistance technology, which integrates our patented near-real-time customer usage metrics with our customer relationship management (CRM) system, so our Client Services team can proactively help you resolve problems.
The result? Dell Boomi’s cloud-based solutions offer the productivity and business benefits to deliver the value to help you achieve your imperatives.
Now, with thousands of clients already using our solutions, Dell Boomi AtomSphere offers the collective knowledge of our community through our innovative crowdsourcing capabilities:
- Boomi Assure lets you submit sample data and integration processes for executing regression tests against upcoming releases.
- Boomi Suggest leverages the collective intelligence of Dell Boomi’s growing community to dramatically shorten development time by automating data mapping.
- Boomi Resolve leverages crowdsourcing to enable resolution of common errors in minutes.
*Gartner, “Magic Quadrant for Enterprise Integration Platform as a Service, Worldwide” March 23, 2105. Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner's research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.
Benefits for Healthcare and Life Sciences
Whether you’re providing quality patient care or bringing new products to market, Dell Boomi’s solutions and services provide a variety of benefits to help you:
- Reduce your time to value through integrations you can customize, configure and deploy easily—over weeks, not months.
- Cut costs through a predictable subscription pricing model.
- Increase your operational efficiency, so you can stay current with regulatory changes by allowing users outside of IT—such as business analysts—to handle integrations.
- Address provider, payer and processor management, and offer compliant message exchanges and healthcare partner enablement through our HL7 connectors.
Dell Boomi can help your organization increase its agility, improve patient care, accelerate revenue, eliminate complexity, and increase cost savings.
Contact Dell Boomi today to discover how we can help you.