Need is accomplished by assessment of current functionality and business needs and identifying gaps and improvement opportunities.

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3 Need is accomplished by assessment of current functionality and business needs and identifying gaps and improvement opportunities. Solutions evolve from defining needs and opportunities, vendor review, design, and development. Implementation moves the process from testing to production, involves training, and support participation. Measurement evaluates full scale operation and yields direction for modification (Dimick, 2009). 3

4 The McKinsey Global Institute found that 91 billion of health cares spending in the United States was spent due to inefficient and redundant health administration practices (Bentley, 2008). 4

5 Interoperability is a collaborative effort among every department and group within a health care system. Data exchange should follow a schema and standards that permit sharing among the public, clinicians, supporting departments, and vendors that create and support software and medical devices (HIMSS, 2013). 5

6 Many are affected by the gaps identified. Patients, clinicians, admitting, laboratory services, and pharmaceutical services experiences duplicate data entry, delayed access to patient data, and complicated down times when one point in the system goes down or need updating are all typical problems straining efficiency of the health care data flow. 6

7 Many are affected by the gaps identified. Patients, clinicians, admitting, laboratory services, and pharmaceutical services experiences duplicate data entry, delayed access to patient data, and complicated down times when one point in the system goes down or need updating are all typical problems straining efficiency of the health care data flow. 7

8 Uniform coding of data is accomplished by HL7 as it was developed as a standard language for the sharing and integration of health data (Intersystems, 2013). It is reliable and reduces issues with interoperability among applications and facilities nationally and internationally. 8

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10 Strategic planning should involve all stakeholders to ensure a thorough and successful process of defining, planning, implementation, communication, and controlling. - Identifying a design that accomplishes the most bank for the buck, the RFP process, and setting expectations for training. This involves thorough assessment of business needs and developing functional requirement for vendors. 10

11 The solution will reduce the required number of export and import endpoints, allow for the reuse of data between applications, provide and easier method to interface a new or replaced application, provide the ability to monitor the entire system at one time, and provide the ability to proactively notify interested parties using visual alerts and s when problems arise (Corepoint Health, 2010). 11

12 The phased project will replace the current home grown design (Someshwar, 2013) with a central data processing model, allowing improved data flow, centralized maintenance, and scalability (Corepoint Health, 2010). 12

13 Current hardware and software should be analyzes to prepare requirements for proposed solution. The request for proposal (RFP) process involves preparing a legal document presenting the need in detail for vendors to develop a solution. Costs are estimated for solution implementation, training, maintenance, future expansion, etc. 13

14 Information exchange in health care information technology adoption faces technical barriers, economic barriers, and commercial barriers (HealthIT.gov, n.d.). Interoperability and lack of local/national infrastructure are expensive barriers to overcome. 14

15 Implementation takes the product into use and should involve prior testing. Awareness to all involved should take place prior to training and throughout the process. 15

16 Support is important to have in place from all key stakeholders including IT, upper management, and key departments. Change can be difficult and always involves user acceptance and often resistance. Success can be correlated to managing culture change. 16

17 IT resources should be in place not only for support but also ensuring continual security measures avoiding any breaches in privacy. Disaster planning should be accounted for a new implementation. 17

18 Measuring against defined goals and objectives is the last part of the process. It gives opportunity to control the project, training efforts, and perform root/cause in efforts to modify necessary items of implementation. This is a revolving process until all functionality and goals have been met. 18

19 Management should support the push for standards. The Office of the National Coordinator for Health Information Technology (ONC) Comments on Patient Safety and Electronic Health Record Systems recommend the continual improvement of Information Technology (IT) to increase patient safety with emphasis on learning, improving, and leading (HealthIT.gov, 2013). We should seek to get federal and state legislation involved to help create mandates and standards that encourage interoperability. Without standards, many vendors do not fully understand or acknowledge the need to create software that allows interoperability. Healthcare providers may understand the need for interoperability but may cut corners to cut cost if standards are not set to promote interoperability. 19

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