Imagine you have a filing cabinet in your company’s basement. It contains all the paperwork over the years, all neatly sorted and organized, of course. The more your company grows, the more paperwork you need to file away, but you can’t keep increasing the size of your basement. While your competition is digital, you will still have the pen-and-paper approach. This isn’t feasible for your sustenance, so the best choice is to migrate your paperwork data to a digital format, gradually, that can be easily accessible without spending hours to find what you need.

According to a recent survey by TCS in collaboration with AWS, 2/3rd of those who participated were still using legacy systems and are looking to upgrade, citing security and increased efficiency as the driving factors. The healthcare sector, in particular, is characterized by its nature of sensitivity and complex process. It poses a set of unique challenges when made to migrate to a new system. Doing so in an inferior fashion can result in all sorts of perils. Consultants and experts have narrowed down a set of practices, which are listed below, to integrate legacy systems successfully without interrupting active service to their customer base.

Prioritizing Interoperability

The ability of different systems to communicate seamlessly and share data is critical for ensuring coordinated patient care and efficient healthcare operations. Interoperability is the backbone of successful system integration of healthcare systems. Adoption of HL7 (Health Level Seven International) or FHIR (Fast Healthcare Interoperability Resources) has shown to facilitate smooth communications between disparate systems.

"Interoperability challenges in multi-cloud networking arise from differences in systems and services. Businesses should prioritize standardization and use robust API management,"Dhananjay Ganjoo, Managing Director, India and South Asian Association for Regional Cooperation (SAARC), F5.

Cleveland Clinic implemented HL7 standards to boost interoperability among its numerous healthcare systems. By adopting this protocol, they improved data sharing between EHRs (Electronic Health Records) and auxiliary systems, thus ensuring a more integrated and collaborative approach to patient care.

Middleware Integration

A suitable bridge is needed to interface the system and applications. This is where middleware integration came into the picture. Introducing middleware solutions has allowed developers to overcome interoperability challenges and facilitated the seamless exchange of data between legacy systems and newer applications. It has provided a standardized communication layer, enabling data to flow in a secure and efficient manner across healthcare ecosystems.

Kaiser Permanente, a leading integrated healthcare system, utilized middleware solutions to bridge communication gaps between its legacy systems and newer applications. This middleware facilitated seamless data exchange and streamlined processes, enhancing overall operational efficiency and improving patient care.

API Integration

APIs (Application programming interface) is critical for the functioning of legacy system integration. Developing well defined APIs has allowed the healthcare related applications to interact seamlessly by promoting data exchange and functionality integration. They have also been cleverly implemented to unite legacy systems with EHRs, billing systems and miscellaneous critical healthcare applications.

Epic Systems is a major service provider catering to this need, they have provided numerous hospitals and other healthcare organizations to connect their legacy systems with their platform, ensuring a cohesive and interoperable healthcare IT ecosystem. SMART (Substitutable Medical Applications, Reusable Technologies) on FHIR is an initiative that combines FHIR standards with APIs to create an open and standards-based platform. It allows developers to build healthcare applications that can be easily integrated into existing systems.

Phase Implementation

Legacy system integration is one of the costliest investments any company can make, and it is a complex process where the risks are numerous. Trivial errors have resulted in entire user bases locked off the website when integration was done overnight. Experts have recommended gradual implementation; the phased approach allows organizations to mitigate the above risks and opens room for the identification of issues in the early stages of the project. The common approach followed is integrating the non-critical systems and, later on, integrating the critical components.

Partners Healthcare, now part of Mass General Brigham, adopted a phased approach when integrating legacy systems. They started with less critical systems, allowing for a smoother transition and minimizing disruptions to essential healthcare services during the integration process.

Change Management

When all is said and done, the success of integration relies upon how well the company accepts and understands the new system. Common industry practice is to offer the client organization training and change management programs, which will help them utilize the latest systems efficiently in a shorter duration. This involves all high-end healthcare professionals in the process, addressing concerns, if any, and building a positive outlook towards the change.

"Communication should be clear and concise, and should be delivered in a way that every employee can understand. It is also crucial to listen to employees' concerns and address them promptly to ensure a smoother transition,"Rico Wang, Chairman Singapore Chamber of E-Commerce.

Cedars-Sinai prioritized user training and change management during its EHR integration. By involving healthcare professionals in the process, conducting comprehensive training programs, and addressing concerns proactively, the organization ensured a positive reception to the changes introduced by the integration.

Legacy system integration in healthcare demands a strategic and delicate approach to navigate the intricacies successfully. By putting interoperability at the forefront and leveraging middleware solutions and API Integration while ensuring security and following a phased implementation tactic, healthcare organizations can modernize their systems without compromising critical patient data, all while carrying it out efficiently. It falls on the onus of the service provider to help the client institution understand the new system by providing change management services. As the tech world progresses at a lightning pace, adopting the finest practices in legacy system integration becomes imperative for organizations to stay ahead in healthcare innovation.