This guide is for healthcare integration analysts and their managers. If you’re building your interfaces in house, you’ll be dealing with clinical system vendors. If you’re outsourcing interface development, you’ll be working with consultants In this chapter, learn what issues to avoid and what deliverables to demand.

1. HL7 SURVIVAL
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CHAPTER 5
A publication of
A supplement to the HL7 Survival Guide, available at
http://caristix.com/blog/category/hl7-survival-guide/

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CHAPTER 5: Vendors, Consultants, and Interface Specialists

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After assessing clinical interoperability issues (Ch. 4), start
building your interfaces.
4
Read on to see
issues to avoid when dealing with
clinical system vendors and consultants

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• Discuss interoperability and HL7 during the initial negotiation
• Approach your manager before negotiations and get
involved.
• Highlight the issues that come up with interoperability and
HL7 are not addressed during negotiations
• Your goal is to avoid project complications
• Set yourself and your manager up for a smooth, successful
project
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1. Negotiating an Interface

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• The vendor keeps control of the project and interface
• You pay for additional needs.
• Knowledge walks out the door with the consultants.
• To avoid this, ask for documentation including the interface
specification in the contract.
• Documentation should detail, at a minimum:
• Which systems are linked/interfaced
• Which messages are exchanged
• Which message formats are used
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2. Black Box Syndrome

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3. Vendor Lock-in
• Some interface vendors or consultants introduce their
own intellectual property into the interface.
• In such cases, your organization has license to use the
interface, but not full ownership of the interface.
• You’ll need to pay the vendor for any required changes or
updates you’d like to see.

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• In the past, the clinical technology vendor would drive the spec
and customers had to conform to the requirements.
• Now: the hospital drives the spec and vendors must conform.
• Though more expensive initially, the process is smoother for the
hospital, especially as hospitals are increasingly part of HIEs and
merge to form large hospital groups or IDNs.
• You need the right infrastructure (i.e., the right HL7 software and
integration engine, configured to meet your organization’s needs)
and culture to support this approach, whether you handle
interface implementation in house or outsource it.
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4. Who Drives the Interface Specification

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• A good integration engine is a great building block.
• You also need supporting technology and a culture that help
you – and anyone else who gets involved at any time –
manage and update the engine and interfaces over time.
• Look for software and technology that simplify the process of
generating, updating, and managing specifications,
requirements, test scenarios and other documentation
associated with your engine and data exchange work.
• Develop a repository that provides a central location for
anyone with permission to access the documentation.
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5. Supporting Technology

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• Culture and approach can make or break a consulting
engagement or in-house project.
• Make sure you drive the show with consultants
• Set clear expectations
• Control deliverables
– Clear definitions and due dates
• Use documentation to ensure clarity and accountability
• Ensure structured test methodology is used
• Clearly define your acceptance criteria
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6. Culture

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• HL7 conformance profiles (also known as profiles or interface
specifications). HL7 profiles should at a minimum provide a list of
messages, segments (including z-segments), fields, data types,
and typical code sets or data.
• Gap analysis between systems to connect. Gap analysis sets
the scope of the interfacing project. Read more about gap
analysis in this Caristix white paper.
• Test scenarios. Vendors typically provide you with a boilerplate
validation guide to ensure the interface works as expected.
ensure that your organization’s clinical workflows are covered.
Make sure the guide covers real-life and specific scenarios you
encounter in your environment.
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Demand These Deliverables

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• Test system. Understand how they’re going to document
test results and don’t sign off on acceptance criteria unless
your clinical workflows are covered.
• Message samples and test messages. Critical for testing
prior to go-live as well as post-go-live for troubleshooting.
• Process and workflow maps. This rounds out your view of
your interfacing ecosystem. Complement the message
structure and content details from HL7 profiles with good
process and workflow maps for future interfacing asset
management.
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Demand These Deliverables (cont.)

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• Chapter 6 in the HL7 Survival Guide
• Interfacing Artifacts: HL7 Conformance Profiles or
Interface Specifications
– Once you have a vendor or consultant strategy in place,
and you’ve identified the artifacts you need, you’ll need to
start developing the interfaces. The next chapters walk
you through that process. Learn more in Chapter 6.
– Blog link: http://caristix.com/blog/2012/11/hl7-survival-
guide-chapter-6/
– Slide deck on Slideshare: coming soon.
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UP NEXT: CHAPTER 6

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