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Caristix is pleased to make the online HL7® Definition reference available to all users. It’s an easy-to-use complete reference. Just chose the HL7® standard you need to use (the default is v2.51) from the drop down menu. Next, choose the trigger event, segment, data type or table, or enter a search string to get the needed definition.

You can find it here: http://hl7-definition.caristix.com:9010/Default.aspx

While you are on our website, check out our Workgroup demo. Workgroup is our team focused solution for the development [...]

Caristix is sponsoring a series of blogs posts on John Lynn’s Hospital EMR and EHR blog. You can read the latest post, What’s the Glue Holding EHR Migration and Conversion Projects Together? here: http://www.hospitalemrandehr.com/2015/08/13/whats-the-glue-holding-ehr-migration-and-conversion-projects-together-optimize-healthcare-integration-series/

We’re focusing on the particular issues of QA. What are the tools you need to support the work of your QA teams?

DIAGRAM EDITOR

There is a new module, called Diagram Editor. This module replaces the current Interface View and includes many requested features such as:

Create and share multiple diagrams
Add metadata for dataflow endpoints
Reconnect a dataflow to a new system
Insert a new system in an existing dataflow
Set a display name for systems
View your systems and dataflow as a grid
Enhanced dataflow discovery (Connectors)

MESSAGING HL7-V3

Introducing new modules for CDA/CCD/XML messaging.

De-identification
Edit and Validate
Search and Filter

FRAMEWORK

Added “CCD – Continuity of Care” Conformance Profile
Export any grid’s content as [...]

Now available: Migration Guide: From Oracle eGate to InterSystems Ensemble®

Many hospital and health systems are being faced with major decisions and challenges concerning interface engine conversion and migration due to DataGate/eGate and eBiz hitting the end-of-life mark. Interface engines are responsible for the critical flow and orchestration of financial, administrative, and clinical data. Disrupting that data flow takes a high level of project organization. Even if an organization is not being forced to replace their interface engine due [...]

What is an HL7 specification?

HL7 specification standards

 No matter how many interfaces you are integrating, a critical step is the definition of your HL7 interface specifications.

A formal definition from HL7 International in the v2.5 standard definition states:

“An HL7 message profile (or HL7 specification) is an unambiguous specification of one or more standard HL7 messages that have been analyzed for a particular use case. It prescribes a set of precise constraints upon one or more standard HL7 messages.”

In other words, HL7 [...]

In a previous post, we talked about reducing migration project risks and some of the drivers in interface engine selection. In particular, with DataGate/eGate and eBiz at the end-of-life mark, many hospitals and health systems are faced with major conversion and migration decisions. The interface engines now in place are responsible for the critical flow and orchestration of financial, administrative, and clinical data. Disrupting current critical data flow to take on a migration project is challenging.  And the [...]

If you’re in the hospital or health system world, you’ve probably noticed: the topic of interface engine migration is big right now. And no wonder. Because of the Meaningful Use carrot and stick, we now have a baseline foundation of EHRs to work with. That foundation paves the way for more sophisticated capabilities than ever before, including the promise of analytics, population health management, and the ability to access new sources of clinical and operational data to improve both care [...]

If you’re selecting a new interface engine, you know you’re in for some pain as the team migrates interfaces from the legacy engine to the new one. But with the right planning and the right interface migration tools, you can minimize disruption and ensure a smooth transition during interface migration projects.

Reducing migration cycle time

That being said, what if we told you that you can cut 90% of the time it takes to code the schema you’re migrating? Or [...]

Have a wonderful holiday season and wishing you the best for 2014!

New interface selection: a big decision

Is your team selecting a new interface engine? If so, you’re in good company. With DataGate/eGate and eBiz at the end-of-life mark, many hospitals and health systems are faced with major conversion and migration decisions. The engines they have in place now are responsible for the flow and orchestration of financial, administrative, and clinical data. They can’t afford to disrupt their current capabilities. And the smartest organizations are working to expand their interoperability.

This leaves hospitals [...]

Last week, we talked about how you can do more with less by applying a lifecycle approach  to your interface and interoperability work. By managing the lifecycle (instead of developing via trial and error), you’re able to forecast timelines, resources, and costs with more accuracy – and better outcomes and margins.

Start by getting a firm grasp on the key interface lifecycle concepts behind interface lifecycle management. This post will give you a solid foundation.

HL7 requirements

You need requirements thinking to build [...]

Caristix White Paper: HL7 Integration: From Trial and Error to Predictable Project Outcomes and Margins

If you’re responsible for interfacing within a hospital system, a consulting organization, or an HIE, you know one thing: you need to do more with less. With EHR implementations slowing down, the big HIT implementation budgets are drying up. But so much of the promise and value of those systems is tied to interoperability and data exchange, and you’re still accountable for delivering those capabilities. [...]

You already know that HL7 messages are a rich source of actionable insight about your clinical and financial operations.

To get to that insight, start by inspecting, analyzing and querying your messages. You can do this manually via text editors and their basic search features. Or you can check out Caristix software.

Here are some HL7 message inspection and analysis tutorials to get you started using Caristix Pinpoint software. And get your data working for you.

Download Pinpoint

To use these tutorials, [...]

HL7 message samples should be system-specific   

When you build interfaces, you need HL7 message samples and test messages for your validation workflow. It’s tempting to simply hit Google for generic samples, or check on Stack Overflow or another tech discussion forum. But there are problems with that approach.

For one thing, you’ll end up with messages that don’t fit your systems – your ADT, your LIS, the applications personalized for your environment. What’s more, if you use just a handful of messages, [...]

Interoperability barriers and HIE business models

In a previous post, we talked about the interoperability barriers facing HIEs (healthcare information exchanges). What are they? Primarily 1) cost and 2) complexity. That is, the cost of interface development, and the technical difficulty involved. These are especially in context of the business model switch, as HIEs move from startup grant-based funding to self-generated revenue based on membership fees and services.

The problem is, self-generated revenue is tricky to achieve at best. In some cases, [...]

The purpose of HL7 interface validation

In the interface lifecycle, validation is critical. HL7 interface validation is about checking the interface you’ve developed: making sure it works and that it meets the requirements you captured before interface development.

The most important requirements are around clinical workflow. In essence, validation is about testing against your workflows. You should test performance, message volume, and edge use cases, all before the applications and interface go live.

Need more detail on what you should test? Get an [...]

Caristix release 3.2 is a broad release of additional features through the range of Caristix products from Workgroup through the individual HL7 modules, Cloak, Conformance, Pinpoint and Test.  We’ve put some additional focus on Test as we continue to add features that accelerate test creation and test execution to help you get your interfaces into production faster.

Workgroup
New HL7 Messaging Feature

Support file drag-and-drop in the Message Gap to quickly compare message files

New DeId Features

Preformat the source value of a generator or [...]

Cost and technical barriers?

As soon as you hear the word “interoperability” in healthcare, “cost” and “complexity” are right around the corner. If you’re a technical leader at an HIE, this won’t come as a shock. In a recent survey, 59% of HIEs see the cost of interface development as a barrier. And another 38% view technical difficulty in interfacing as their biggest hurdle.

So what’s the solution? 

For starters, there is no easy technical fix. Direct messaging can tackle some use cases. [...]

Interface Conversion Projects: 10 or More Steps

If you’ve ever worked on converting from a legacy interface engine to a new one, you know one thing: this is one complex project. With a lot of moving parts. You’re easily facing 10 or more different workflow steps — per interface.  The workflow can start with simply backing up the legacy production interface and can end with testing and deploying the new interface. But between Step 1 and 10, there is a lot [...]

When you first start researching the interfacing capabilities of each engine vendor, you might be overwhelmed. If you’re in a startup, small company, or a hospital with fewer than 100 beds, get ready for sticker shock. Interfacing and integration don’t come cheap.

And if you’re in a bigger organization and you need a new engine, get ready for complexity and value propositions that may be overkill.

 This post will help you match your needs to the capabilities in the market. [...]

De-identification is a technique to mask or remove protected health information (PHI) from sensitive patient data. If you need to use production HL7 data, you’ll need to find a way to protect PHI. De-identification is a good choice when you need to:

Troubleshoot an interface
Populate a test system
Gather data for analytics

Why de-identify?

There are a number of reasons you should consider de-identification.

1. Leverage the richness of production data

When you test a system or an interface, you’ll cover the most realistic test scenarios [...]

It’s been 2 years this fall that we started publishing the HL7 Survival Guide chapter by chapter. It’s proven to be our most popular download and has been called “truly awesome reading for a true practitioner”.

The HL7 Survival Guide helps you get in control of the entire interface lifecycle. Move beyond the basics with a go-to guide full of real-world practice advice on effective interfacing. The HL7 Survival Guide helps you cut non-value-added tasks and focus on the essential.

Take this [...]

Requirements Thinking

What are HL7 requirements? First, in the world of software engineering, requirements refer to documented needs that an application or system must perform. Requirements are critical for both designing the software and verifying that it works. In the world of HL7 interfacing, requirements thinking is the right way to build an interface. The problem is, traditional HL7 requirements-gathering leaves serious gaps.

Traditional HL7 Requirements Approach

Key technique: manual analysis and pipe counting in message samples
Small data samples
Incomplete and/or outdated documentation

The result is [...]

Tip 25 in the Interoperability Tip Series

This is our last tip in the Interoperability Tip Series. Read the entire series here.

The fact is that the value of your interface-related artifacts increases over time. While they’re useful for development and go-live, they are essential down the road, in a year or two or more. Follow the 4 best practices for extracting maximum value from your artifacts and get the most from them.

1. Work with real-world messages.

When you’re developing deliverables such [...]

Why consider reverse-engineering? Lack of accurate specs

If you’ve worked on an interfacing team or for HIE, one of the issues you’ll hear about is a lack of accurate interface specifications. For instance, the vendor spec might be missing. Or the source or destination spec on hand might no longer match the production version.

So what do you do?

Lack of specs: what’s the impact on your ability to deliver?

Well, you might be facing weeks of digging and research. You’re missing a lot [...]

Tip 24 in the Interoperability Tip Series

Read Part 1 here

In our previous tip we asked: why document HL7 profiles and specs. In beginning to answer that question, we explained that profile documentation is critical for troubleshooting and maintenance.

Another benefit to documenting profiles is that it streamlines processes when you are performing a system upgrade. Let’s say you’re changing or upgrading your pharmacy system – that change affects the interface of any other system that communicates with the pharmacy system. Imagine [...]

Tip 23 in the Interoperability Tip Series

The last few tips have been about what to document and how to document. This one and the next explain why documenting your HL7 profiles and specs is so important.

When you document your HL7 profiles and specs, you can much more easily troubleshoot issues and tweak configuration once your interface is live. Plus, if you created electronic – i.e., machine readable – versions of your profiles, you can use them in your monitoring. For [...]

In the design of Meaningful use, C-CDA – especially CCD – was supposed to solve the pressing issues in healthcare concerning interoperability and data exchange problems. But it’s just not turning out that way.

Emerging Major Data Exchange Problems

One recent study found 11 interoperability barriers relative to C-CDA. This is of concern and it’s a concern that integration analysts and developers will have to address in their work.  How does an organization deal with the mismatch of specific patient information? What [...]

Tip 22 in the Interoperability Tip Series

In the previous tip, we talked about documenting your interfaces and workflows – especially important for HIE organizations. This tip is all about our recommendations for what to look for when you’re planning out how to organize your assets – documentation, requirements, test scenarios, and the rest.

4 Capabilities to Seek Out

Visualize all of your interoperability assets, from multiple interface engines to the interfaces themselves.
Cover the entire interface lifecycle.
Access a library of interfacing assets and [...]

First, what’s the problem?

One of the problems we hear about from HL7 team leads and their management is that interfaces take a long time to configure. The reasons why boil down to missing information. Here’s what they typically hear back from the team members:

“The fields need fine-tuning.”

“We don’t know up-front which message types will need the most work.”

“That field mapping was a bear because we couldn’t get a complete code set from the source and destination systems.”

“These code sets have [...]

Tip 21 in the Interoperability Tip Series

This tip is especially relevant for Healthcare Information Exchanges (HIEs), regardless of whether your exchange is internal to an IDN or if it connects multiple regional stakeholders from community hospitals to physician practices.

Some interface engines let you view workflow within the engine. But what happens with external systems, such as an HIE transmitting to an internal engine, or multiple systems from different providers connecting across a region? Keeping track of workflow is a [...]

Healthcare Information Exchange Types

There are three basic types of healthcare information exchanges (HIEs): some cover a geographic region (for instance, NCHIE in North Carolina), others a community; and yet others that cover a single hospital system (which in turn may be spread out geographically – for instance, Catholic Health Initiatives).

HIE Business Models: Grants vs. Revenue Generation

While some regional and community HIEs got their start via government grants, many of those grants are coming to their end. Even though they might [...]

Tip 20 in the Interoperability Tip Series

In our previous tip, we explained why you need to map processes and workflows. Many developers list their interfaces and workflows in a spreadsheet. You’ll find examples of what to track in the HL7 Interface Asset Template here.

While a spreadsheet provides a good start, you need to go beyond to capture the details and interconnections to capture a complete picture of your interfacing workflows. After all, in most hospital and HIE environments, you’ll be [...]

Tip 19 in the Interoperability Tip Series

Throughout the Interoperability Tip Series, we’ve stressed the need to complement the message structure and and content details from HL7 profiles with good process and workflow maps for future interfacing asset management. Earlier in the Interoperability Tip Series, Tip 4 emphasized the importance of mapping out the message process and workflow from the very beginning to kick off the planning of an interoperability project.

If you’ve documented your systems and taken the time to map [...]

Tip 18 in the Interoperability Series

What’s The Big Deal?

If you’re just getting your feet wet with clinical and medical applications, you might think: “What’s the big deal? I’ll just hit Google for some sample HL7 messages and get started that way.” 

Don’t do that! If you do, you’ll get some basic structures right – like pipes and carets. But you won’t have any information about the interface you’re trying to build: the message types it uses, the segments and fields, positions, [...]

Brian Ahier is right

Before you read any further, please go right now and check out what health data exchange expert Brian Ahier has to say about C-CDA on the HIStalk blog.  He is right on the money about the need to clear up the problems with CDA/C-CDA documents. Once you’ve read his article, come back here and you’ll get exactly why  we’re building our new CDA functionality around gap analysis.

A bit of context. A few weeks back we talked about [...]

Tip 17 in the Interoperability Tip Series

HL7 Data for Testing

In last week’s tip on HL7 test reporting, we suggested that you use production data for your testing. That said, you obviously can’t use real production data. You need to find a way to remove protected health information (PHI).

That’s where a technique known as de-identification can help. You keep the clinical workflow in the messages, but you remove patient identifiers and replace them with fake values. You can also replace [...]

Over the past few weeks, we’ve reviewed multiple HL7 testing topics. So you know how critical it is to test interfaces during interface configuration, the validation phase, and during maintenance.   This HL7 interface testing checklist will help you design a testing process that covers your most important needs. And if you already have a testing process in place, it will help you identify any areas of concern.

1. We’re running tests to make sure we’re not injecting errors during interface development, [...]

Tip 16 in the Interoperability Tip Series

The past few tips have covered HL7 testing and test automation. This one covers what you should do with HL7 test reporting.

Creating Test Reports    

As part of the testing process, you’ll want to run reports. The reports should document the following: 

The number of times the test was run, as well as test duration – if you’re sending messages, this helps you understand performance.
Test results, including positive validations and failures.
The messages that were used; note [...]

This release is focused on test automation within the Caristix platform. We’ve developed significant new features to accelerate test creation and test execution. This will help you get your interfaces into production faster.

Tutorials

These new features add a lot of power to the Caristix platform. To get started on using them, check out our new test automation tutorial series.

Workgroup
New Test Automation Features
More granular control on test execution

Add timing intervals (before and after execution) at the Task level (just like Actions and [...]

Tip 15 in the Interoperability Tip Series

Once you’ve developed a test plan and test scenarios, you need to configure your interface in a test environment.

Healthcare Data test vs. production

What do we mean by test environment? Essentially, another instance of your interface engine, along with simulations of the clinical systems you’ll be interfacing.

It’s important that you do your testing in a test environment, not in a production environment. It’s easy to think it can’t hurt to test in a live [...]

We get this question a lot. Over the past few years, we’ve come up with a few answers. Let’s bring this full circle into 3 simple bullet points:

A profile captures an interface specification. So profile = spec.
Some people use the terms profile, spec, and specification interchangeably.
Why build a profile? So that you save time building an interface and getting it into production.

Why build an HL7 profile?

The profile or spec also gives you interface documentation you can share with your team [...]

Tip 14 in the Interoperability Tip Series

In last week’s tip, we talked about capturing workflows.

Here’s why. Before you can conduct any  interface testing, you must understand what to expect of your workflows. This should include common workflows – such as a patient being transferred – involving the use of the products that will be interfaced.

For example, in many hospitals, emergency department and in-patient ADTs are two separate systems. A new patient that comes through the emergency department would be registered [...]

Testing and validation are important tasks, as we explained in the Interoperability Tip Series and the HL7 Survival Guide.

Shouldn’t interfacing be easy by now?

Testing is what takes the longest when you’re building an interface. So when you hear about interface engines that allow you to get an interface into production in a couple of hours, that’s absolutely true. Coding is quick with modern interface engines. But bear in mind that coding time seldom includes testing. We’ve worked with organizations that [...]

Tip 13 in the Interoperability Tip Series

Last week in Tip 12, we covered when, why, and what to test when you’re working with interfaces. This week, we’re looking at the different interface test types a team needs to perform.

Make sure that your tests cover your interoperability requirements. These will vary depending on the systems you’re working with. Be sure to also cover the following:

1. Workflow

Confirm the interface engine handles your standard workflows as expected.  Just as a reminder, workflows are [...]

Tip 12 in the Interoperability Tip Series

In tips from the past few weeks, we covered two requirements-related artifacts analysts must create: 1) profiles or specs and 2) gap analyses, which include mapping tables.

In this tip, we look at testing an interface. And see how it doesn’t have to be an exercise in frustration.

When to Test: 3 Phases

You need to perform healthcare interface testing at 3 different phases in the HL7 interface lifecycle: during configuration and development; during the formal validation [...]

9 Diagnostic Questions: Interfacing Management Maturity Model

Last week, we introduced a maturity model for interfacing management. We explained how organizations progress through 3 distinct stages: Manual, Message, and  System.

This week, we’ll cover key diagnostic questions. These 9 questions will help you determine which stage you’re in and whether you should consider moving to the next stage.

1. How many sample messages are you using when scoping?

This gives you an idea of which stage you’re at. A handful of messages and you’re [...]

Tip 11 in the Interoperability Tip Series

Last week, you learned about doing a gap analysis – mapping differences  between the systems you’re interfacing. Today, we’ll cover why you need this artifact.

1. Interface Requirements

No interface matters unless those coding the engine can accurately scope the interfaces they need to build. You need a way to communicate who does what on an interface. Is the vendor changing a field? Is the interface engine handling the field transformation? It’s critical that you pin [...]

It’s clear that the needs around interfacing and integration are exploding. To match that need, Caristix is introducing an interfacing management maturity model. If you’re reading this, you know that there is a lot of implementation expertise available from analysts, developers, and consultants. But at the organization level, capabilities vary. Many organizations are seeking benchmarks to see where and how they can grow and adapt to meet their needs. That’s where our model can help.

This interfacing management maturity model is [...]

Tip 10 in the Interoperability Tip Series

In the previous tip, we covered specifications. Another key requirements or scoping document you’ll need is a gap analysis. In this tip, we discuss how to develop an interface gap analysis document.

Many analysts develop their own gap analysis templates in Microsoft Word or Excel. To fill in templates, they look at messages, run queries when they can, and manually document their findings. This can be a fairly onerous process if they’re basing the analysis [...]

Tip 9 in the Interoperability Tip Series

In Tip 8, we explained what an HL7 interface specification should include. In this tip, learn how to develop an HL7 interface specification, which you’ll need for each interface you develop.

(A quick note about terms. There is no standard term for a spec. Some people call them a profile, conformance profile, schema. We use the term profile or HL7 profile in our software. We use the terms specification, conformance profile, and profile interchangeably in [...]

In our discussions with vendors and providers on these new standards, we’ve seen a wide range of learning curves. Some people are just getting started, while others are knee-deep in live exchange. What are the tools and resources that are out there? This blog post gives you a handy list  of resources for CDA, CCD and consolidated CDA documents to get started.

Start with HL7 International

HL7 International is the standards developing organization for healthcare data exchange and integration. They provide the [...]

Tip 8 in the Interoperability Tip Series

Critical Elements in an HL7 Interface Specification

These are critical elements a developer needs to create a interface that works (almost) out of the box with minimal testing. The more accurate the HL7 interface specification, the faster it’ll be implemented – and the less costly the work will be.

1. Interface nameHow do you refer to your interface in your integration environment? Some organizations manage thousands of interfaces. If you’ve got 10 or 20 interfaces, no [...]

Bridging the Gaps

In a previous post on CCD, C-CDA, and CDA, we compared HL7 v2 messaging to CCD development. This week’s article is about the biggest roadblock with CCD document specification: gap analysis.

What is Gap Analysis?

Simply put, gap analysis is about understanding the differences in the data between two systems. The output of a gap analysis process is a list of all the differences between two systems charted in a requirements document. With HL7 v2 messaging, many organizations create their [...]

Tip 7 in the Interoperability Tip Series

Communicating These Needs to Leadership

These are the most important assets you’ll need when you’re working on creating new interfaces or converting existing ones from one system to another. You’ll need to create them manually, or automate this work via interface lifecycle software.

Why These Assets?

Besides making sure that you have complete requirements so that you can accurately scope a project, you need to make sure you have all the parts and piece lined up and [...]

Confused? Start with What You Know

Over the past few months, we’ve heard a lot from our hospital-based customers about CCD and C-CDA readiness. There’s more urgency with Meaningful Use Stage 2 deadlines, even with the extension.

But the funny thing is: hardly anyone ever says, darn, but this is confusing.

Sometimes people express their frustration. “What the heck are those regulators doing? Why are they pushing more stuff at us, when we’re barely able to keep up as it is?”

Others bury their [...]

Tip 6 in the Interoperability Tip Series

This tip is for hospital or provider analysts and team leads.

You’ve got a firm grasp of the technical ins and outs of system and application interfacing. Because you’ve got the background, you know that contractual and cultural issues can affect your team’s ability to deliver on time and on budget. 

Make sure these issues are on the table with your leadership, ideally during negotiation before a deal is signed. Your leadership will thank you for [...]

The Status Quo

This is the world interface analysts, developers, and quality testers work in:

2 weeks to get a list of code values for a single field
1 week to get a list of custom field formats like lab order codes
20 hours to code a schema in an engine from a spec in Excel
9 days on gap analysis
30 days to test a 10-minute code change
8 versions of a spec before it’s baked enough for development

Productivity with Caristix

With our software, especially with the [...]

Tip 5 in the Interoperability Tip Series

9 Critical Questions You Need to Ask Your Clinical System and Interface Vendors

Like our last two tips, this week’s tip is geared to hospital teams asking their vendors the right questions. Vendors who are on the ball will have the answers at their fingertips.

Why Should Health System Leadership Care About This?

These lay the foundation for interoperability. They are the basic format and content scoping questions that kick off each and every interfacing project. Your [...]

We’re excited! This is a major release for the entire Caristix platform with significant new features.

Workgroup
New Features

Message Comparison: compare messages one-on-one. Do a deeper form of gap analysis on content in addition to format.
Re-engineered Gap Analysis

Pre-set Gap Analysis Filters to speed up gap analysis work. Set a filter based on message flow or directly compare product versions.
Filters help you identify the gaps that matter the most, with far fewer clicks.
Reduced noise on Usage attribute. Default to “Optional” whenever needed, for [...]

A 16-minute Introduction to Caristix Workgroup: Part Six

We’re wrapping up our Introduction to Workgroup with Part 6 (1:30 minutes) We designed this demo webinar to give you a bird’s-eye view of Workgroup software. And we’ve covered a lot in a short 16 minutes, demonstrating just how comprehensive Workgroup truly is.

In the wrap-up, you’ll learn:

the key business reason why analysts and developers need more than ad-hoc tools to deliver interoperability
what enables better customer collaboration
why Workgroup

We’re open to any and all feedback [...]

Tip 4 in the Interoperability Tip Series

5 Questions for HIT Vendors and Internal Interfacing Teams

Like last week’s healthcare data interoperability tip, this week’s tip is geared to hospital teams asking their vendors the right questions.

Why Should Health System Leadership Care About This?

These are the basic mapping and workflow questions that kick off the planning for an interoperability project. Your teams will work with your vendors to answer these questions for every system they work with, and for most of the [...]

A 16-minute Introduction to Caristix Workgroup: Part Five

When you work with patient data, you need to be vigilant about protecting privacy. Caristix Workgroup software covers the critical concern of removing PHI from HL7 data. The de-identification capabilities in Workgroup let you remove protected health information from production data and replace patient names, identifiers, and related data with either blanks or dummy data. This means the message flow looks and acts like realistic data with all customizations, Z-segments, and non-standard field [...]

Tip 3 in the Interoperability Tip Series

Work in a health system or for a provider organization? This tip on healthcare data is especially important for you.

If you work for a vendor, read this tip to understand what’s on the minds of your customers.

Why This Tip Matters to Leadership

Health system CIOs, this is the work your interfacing and interoperability team performs everyday. Their jobs revolve around answering these questions. The questions you need to ask your team lead are:

In getting the [...]

A 16-minute Introduction to Caristix Workgroup: Part Four

Ready for the next piece of our 16-minute webinar on Caristix Workgroup? Learn what Workgroup can do for you and your team to prevent costly project reworks and delays. Save time and dollars by removing the major bottleneck that testing often becomes.

In Part 4 (2 minutes), you’ll learn:

 All about using your workflow to drive validation
How to generate hundreds of test messages automatically
How one-step setup can save hours of testing time

Missed the first three [...]

Tip 2 in the Interoperability Tip Series

Data and Information Challenges

Learn how this tip boils down to speed and dollars.

In Tip 1 of our Interoperability Tip Series, we talked about the HL7 interface standards and their 3 challenges.

Dig deeper, and you find that underlying challenge with interoperability in healthcare information systems is at – you guessed it — the information level.

To tackle the challenge of interoperability within healthcare information systems, analysts need to ask: What information is needed by whom, when, [...]

A 16-minute Introduction to Caristix Workgroup: Part Three

Not much time? That’s why we’re offering our 16-minute webinar on Caristix Workgroup Software in small easy-to-consume pieces for quick viewing.

In Part 3 (3 minutes), we introduce you to:

The documentation strengths of Caristix Workgroup software
Automatic Gap Analysis, for easy mapping table creation

In case you missed the first two parts:

In Part 1  (4-minutes), we introduced you to Workgroup , what exactly it is and why and who we designed it for.

In Part 2 (4-minutes), [...]

Introducing the Interoperability Tips Series from Caristix

If you’ve seen our HL7 Survival Guide, you know it’s chockablock full of valuable information for interoperability and HL7 projects. (If you haven’t seen the HL7 Survival Guide, get a copy here). We’re starting a series of brief snippets and actionable tips based on learnings from the Guide.

Use these tips to get your interoperability projects up and running, educate leadership on interoperability, and sell your vision.

Here’s the first tip.

Reading time: about 2 minutes

Tip 1: [...]

A 16-minute Introduction to Caristix Workgroup: Part Two

We know you’re busy. That’s why we’re offering our 16-minute webinar on Caristix Workgroup Software in bite-sized pieces for quick consumption.

In Part 1 (4-minutes), we introduced you to Workgroup, what exactly it is and why and who we designed it for.

In Part 2 (4-minutes) of the Introduction to Workgroup Webinar, we take a deeper dive into Workgroup functionality. You’ll see:

 Scoping – why it’s the most important phase
 How to reduce the time needed for [...]

A 16- minute Introduction to Caristix Workgroup Software

We’ve just developed a quick on-demand webinar that gives you the opportunity to take a bird’s-eye view of Caristix Workgroup software. See just what Workgroup can do for you and your specific teams and their projects.

No time for a full 60-minute webinar? Is 30 minutes too much? We get how busy interfacing team members are. That’s why made this a 16-minute Webinar.

In 16 minutes, you’ll learn what Workgroup is and what it can [...]

Announcing Caristix Converters

We gave you a sneek peak at our new Caristix technology, converters, in a previous blog post, Cutting Interface Costs, Continued. In this blog post, we discussed a big area where interface costs are extremely high: migrating from a legacy interface engine to a newer engine technology.

We had several customers tell us that out connectors were saving them a lot of programming time. But was there a way to use the connectors to migrate their interfaces? Now, there [...]

Are you just getting started with Caristix software? Or do you need a refresh on functionality you haven’t used in a while?

We’re launching a video tutorial series for Caristix users. The series prepares you to use Workgroup to cover the entire interface lifecycle: scoping, configuration, testing, go-live, maintenance, and upgrades. The series will walk you step-by-step  through loading HL7 data to output a spec and interface requirements, setting up validation testing, de-identifying messages, and much more. This week we’re kicking [...]

A sneak peek at new Caristix technology

A few weeks ago, we published an article on the cost of interfaces. We’ve also ranted a little, and you — readers here, on LinkedIn, and elsewhere — responded with a great discussion. A big area where interfaces cost way too much: migrating from a legacy interface engine to newer engine technology.

Imagine what you could do if you could remove the manual work.

Well, we’re putting our money where our mouth is. We’re developing a [...]

Workgroup
Bug fixes

Several corrections to the HL7 v2.7 reference profile

Enhancements

Sort, Create New Folder, and Refresh Library are available through a right-click contextual menu from the blank area in Document Library.
In the Gap Analysis Workbench, the tree view behavior is now simpler. There are two basic states (unselected and selected with child nodes) and one advanced state (selected without child nodes). To select a node without its children, use SHIFT+click or the right-click menu.
In the Profile Editor, Data Distribution now lets you [...]

Here’s Our Quick Take on What’s Coming Up in 2014

 Meaningful Use Stage 2 and ICD-10 implementation are going to be big headaches for providers and resource drains for vendors. No big surprise here but it needed to be said.
Big data and clinical analytics are going to get more serious and less hype-y. In their recent survey of 555 healthcare professionals, IBM reported that two thirds of the organizations in both developed and emerging markets consider analytics a priority and have an analytics [...]

Have a wonderful holiday season and wishing you the best for 2014!

Read More

The premise of Marshall Goldsmith’s leadership book, What Got You Here Won’t Get You There, is simple: the habits and work methods that get you in the game won’t get you to up your game.

The same shift is happening in healthcare integration.

Where We Came From

5 years ago, a vendor analyst could fire up an HL7 message viewer tool or even Notepad++  and start reading through sample messages one by one to pick out unexpected PID.2  values over the course of [...]

Information for Cloak and Workgroup Users

With our recent v2.8 update, we made the default de-identification rules more robust. You’ll need to add fewer rules manually. But this means your default de-id rules are going to look different than previous versions. Here are some answers to some of the questions you might have.

What’s the change?

Unlike older versions, there is no single default de-id rule file. Default de-id rules are now HL7-version-based and will adjust to whatever HL7 v2.x version you pick [...]

Here’s how it starts:

Are HL7 interfaces becoming more important or less important with the push for interoperability and the popularity of integrated hospital systems?

HL7 interfaces are becoming more important than ever. Interoperability matters because information has to flow in order to improve patient outcomes, reduce error, reduce costs, and remove duplicate testing. Despite the popularity of integrated systems, much of the data in hospitals, physician practices, and other organizations is still siloed.

ICD-10 computer-assisted coding systems need interfaces. HIEs rely on [...]

Does innovation start with standards?

With interfacing and interoperability, there’s an unspoken assumption that innovation starts with standards. It seems like we wait for standards organizations, industry associations, and government edict to point the way. Someday, somehow, They will give us The Rules to make interoperability happen.

Instead of waiting, what if we, as vendors and providers, stepped in?

This is an amazing competitive opportunity for vendors and consultant that step in now. Today, the hourly rate business model is the bread and [...]

This dot release contains several new features and enhancement requests.

Caristix Users

To access v2.8, simply go to the Help menu, and click Check for Updates. Follow the on-screen instructions to update your software.

Workgroup

Drag & Drop files directly to the Document Library. A usability enhancement that allows you add Caristix files (profiles, gap analyses, test scenarios, etc.) and documents in Excel, Word, PDF, etc to the library for easier sharing and updating.
Filter differences in Gap Analysis (filter on grid). Set up filters [...]

“Interfacing costs? They’re too high.”

We hear that a lot. The cost is frustrating, especially to physicians who need to implement EMRs for Meaningful Use. First there are the license fees. Then you find out you need an interface. Or two. Or six. That number can expand with the interoperability requirements in Meaningful Use Stage 2.

Software Packages vs. Software Programs

Here’s why I think interfacing costs are frustrating. After 30 years of PC use and now BYOD smartphones and tablets, we’re used [...]

Meaningful Use, the changeover to ICD-10, the 2013 HIPAA Final Omnibus Rule, among other drivers, makes it clear that integration is an essential, critical process. How do hospital CIOs and healthcare information exchange (HIE) leaders find cost-effective ways to develop the HL7 interfacing that underlies such critical integration projects?

No matter what the bells and whistles of an integration engine or integration technology, if you cannot accurately scope the interfaces that need to be built, you’ll find yourself behind the eight [...]

What is Your Biggest Interfacing Challenge?

To gain insight into the issues our users are facing, there is one key question we ask when a reader downloads a Caristix software trial, white paper, or article: what is your biggest interfacing challenge?

Here are 99 of them.

1. Working as a third party to large health systems and independent physician practices.2. Communication.3. Health information management.4. Custom work.5. Ask on Entry (AOE) prompt question validation at the ordering facility.6. Compatibility between several different platforms; convince [...]

How to Handle Break-Fix Issues

During the validation phase of the interface lifecycle, you’re running tests. Here’s more on testing: test scenarios and test systems as well as message samples and test messages.  One other thing you may be doing is break-fix work. With break-fix work, you’re looking to solve very specific issues. And you need to get the answers quickly, share the information right away, or fix the interface yourself.

There are many ways to go about doing this. Some people go [...]

Developing the Interface

Image courtesy of sippakorn / FreeDigitalPhotos.net

Now that you’ve scoped your interface/integration needs (covered in Part 1), the next step is to develop the interface based on that knowledge. Your interface spec should capture the following:

 Interface name
 Source or destination system name and version
 Message types used in the interface
 Message definitions including segments, fields, data types
 Segment and field attributes
 Z-segments
 Data types
 HL7 tables
 Specialized interoperability challenges

When you combine these elements with your clinical or workflow constraints, they become your specification (or profile). You’ll [...]

3 Considerations for Integrating Your Application in a Healthcare Provider Setting

Image courtesy of sippakorn / FreeDigitalPhotos.net

As the technical lead in a healthcare startup, you’ve been focused on building an application – for example, a clinical analytics application for cardiac care – that meets the needs of your market: healthcare organizations and their users. You’ve already determined product functionality. Now you need to figure out how to integrate this application with key systems in your customer’s care setting — a [...]

Our readers have been asking, and now it’s here: the complete HL7 Survival Guide, now available as a single PDF download.

Download your copy now.

The HL7 Survival Guide helps you get in control of the entire interface lifecycle. Move beyond the basics with a go-to guide full of real-world practice advice on effective interfacing. The HL7 Survival Guide helps you cut non-value-added tasks and focus on the essential.

Inside the HL7 Survival Guide:

Introduction
Ch.1. How to Integrate and Exchange Healthcare Date
Ch. 2. Pros [...]

Resources

For vendor performance rankings, see the KLAS Research website.

For a current view of the HL7 interface market within healthcare, see the 2012 HL7 Interface Technology Survey Results published by Core Health Technologies.

For more on de-identification, check out these blog posts: De-Identifying Patient Data Part 1, De-Identifying Patient Data Part 2.

Frozen Interface Syndrome: Wes Rishel of Gartner weighs in on this interoperability issue

How to automate your tests.

How to figure out if you suffer from Interface Black Box Syndrome.

Messaging Workbench available via [...]

Anonymization

This is a type of de-identification where all sensitive data is removed.  More details and a definition of anonymization are available in a previous blog post.

Code set

Also referred to as HL7 tables, vocabulary or code table. It is a list of codes and their meanings used to codify information included in HL7 messages. Codes could be defined by the HL7 standard itself or information systems.

For instance, here is the list of suggested values for patient gender as proposed by HL7 [...]

Now we’re coming full circle. Throughout Chapters 6 through 10, we talked about creating interfacing artifacts, assets, and documentation: profiles, gap analyses, test plans, test messages, test systems, and workflow maps. In this chapter, we explain how you can get maximum value from all the work you put into creating all of those. 

Why Document?

By documenting your profiles and specs, you can much more easily troubleshoot issues and tweak configuration once your interface is live. Plus, if you created electronic – [...]

In the last chapter, we explained what to aim for in test messages and message samples. Next you need to map out your processes and workflows to understand how your interface can support them.

For example, your clinical workflow may look like this: a patient is admitted in the Emergency Department via the departmental ADT system. The doctor on duty orders lab work and the patient is admitted to the hospital. The admission is now recorded as an in-patient in the [...]

In the previous chapter, we covered what you need to know when testing your interface. While the right test tool is helpful, you need to feed it the right message samples and test messages. After all, messages impact the entire interfacing lifecycle.

So what makes messages “right”? Namely, you need message samples and test messages that reflect your environment: your ADT message flow, your specific lab codes, and your case mix – whatever information your interface is intended to share.

Just as [...]

The HL7 interface lifecycle. You need to test during Configuration, Validation, and Maintenance.

In the last two chapters, we covered some of the requirements-related artifacts you need. Now it’s time for testing, which you conduct at different phases in the interface lifecycle: during configuration and development; during the formal validation phase; and during maintenance.

“Why test?,” you ask. When you start to develop and iterate on your interface, you run tests to avoid introducing new problems – you check and test [...]

This chapter helps you set up a crucial HL7 requirements document: the gap analysis. Once you have profiles for your source and destination systems, you need to capture a list of all the gaps existing between the two systems in a requirements document. You unearth this list by conducting a gap analysis, which will tell you what’s missing and what needs to be bridged by the interface. In essence, a gap analysis captures the differences in messaging between the new [...]

No-brainer Message Player buttons

Message Player, our free HL7 listener/router utility designed for HIT software developers, interface developers, and interface analysts, is now out.

You might have seen other HL7 listeners and routers out there. What makes Message Player different is that it’s dead-easy to use. There are no bells and whistles. It’s independent of other software and engines, so once you’ve downloaded the installation package, you can run it on a desktop machine and get going quickly.

Why Use Message Player

first [...]

The first five chapters of this Survival Guide have helped you think strategically about your interfacing project. Now we’re going to dive into the nitty-gritty of what you need in an interface specification and/or HL7 profile (note: we use the terms specification, conformance profile, and profile interchangeably in this chapter).

An HL7 interface specification should list:

1. Interface name

How do you refer to your interface in your integration environment? Some organizations manage thousands of interfaces. If you’ve got 10 or 20 interfaces, [...]

After you’ve assessed clinical interoperability issues (covered in Chapter 4 ), you’ll be ready to start building interfaces. If you’re building your interfaces in house, you’ll be dealing with clinical system vendors. And if you’re outsourcing interface development, you’ll be working with consultants. Either way, you want to know what issues to avoid. That’s where this chapter comes in handy.

Make Sure You Check Off These Boxes

Conduct your due diligence on the following points and your interface project is much more [...]

With Meaningful Use in full swing, chances are your hospital organization is implementing an EHR or converting to a new system or upgrade. Watch out: when you implement a new system or migrate from one to another, it can impact your systems’ ability to continue exchanging information. That’s why many organizations call upon third-party vendors for guidance and project assistance. You just need to make sure you stay in control and avoid hidden expenses as you work with these vendors. [...]

Wishing you a wonderful holiday season and New Year!

We covered many details about interfacing architecture and data exchange in Chapter 2. All that said, your main challenges are not with the plumbing, or with the methods used to transport or route data. In fact, interface and integration engines handle this quite well.

Interface Engines Don’t Address The Real Issue

The real issue is with data formats, workflows, and meaning – and interface and integration engines don’t address these problems. It’s quite common for two or more departments (and by extension, [...]

In Chapter 1 of the HL7 Survival Guide, we covered what it takes to exchange data. To help you make the most suitable choice among interfacing approaches, we’ve laid out the pros and cons of each approach or set of capabilities.

Advantages

Trade-Offs

Point-to-Point

Get up and running quickly if you have a few systems only.
Small system volume makes it easier to work with
Works well and is cost-effective for fewer than five healthcare information/clinical systems as infrastructure investment in minimal and complexity is reduced.
Easier [...]

Regardless of the HL7 version you choose to for interfacing, the first step is to define your healthcare integration strategy – will you use a point-to-point architecture? Do you need an interface engine? What integration capabilities do you need? Your choice will impact the scoping of your project, so it’s critical to nail down your strategy from the get-go. The key takeaway? Integrating several systems will require more extensive mapping and configuration than simple point-to-point architectures.

Interfaces Enable Data Exchange – [...]

HL7 interfacing – you can’t live without it but that doesn’t mean you have to suffer as you work to connect the systems that make your environment hum along. This guide will help you get a firm grasp on all the challenges, standards, and choices you need to make along the way, whether you’re developing interfaces on your own or working with a third party.

Why You Need the HL7 Survival Guide

Whether you’re an analyst or manager in a hospital or [...]

Been working in the HL7 integration trenches and solving tough problems?

Have a great tip for HL7 analysts and other members of the healthcare integration community?

Now’s your chance to share.

We’re working on putting together a new reference guide called The HL7 Survival Guide, for healthcare integration analysts and developers.

Why an HL7 Survival Guide?

There is great documentation from HL7 International and solid training available for new HL7 analysts and developers. But once you’ve got the basics under your belt, where do you [...]

Definition

Interface Black Box Syndrome is characterized by lack of visibility into the critical details that can hurt an interface. It can affect any hospital IT leader who is responsible for interfacing, but the most susceptible are dependent on 3rd parties and/or consultants. Fortunately, Interface Black Box Syndrome is treatable, and there are ways to reduce the risk that the syndrome will recur.

Symptoms

The signs and symptoms are almost always chronic and sub-acute. But they can explode into a world of expensive [...]

Over the years, most hospital IT teams have developed their own HL7 test messages and logs, which they use over and over again for system testing and interface validation. These logs may not be 100% accurate for the task at hand but hey, they’re good enough, right?

Not really.

“Good-enough” logs don’t contain the latest lab codes. “Good-enough” logs with just 10 or 20 or even 50 patients don’t contain the volume you need for load and performance testing. “Good-enough” logs miss [...]

Implementing or upgrading HIT systems and applications doesn’t mean much these days if they remain data islands unto themselves. Interfacing is the key to connectivity. But far too many teams rely on the drawn-out iterative processes of trial and error to get their interfaces created and tested. With interface counts reaching into the hundreds per hospital, your organization must find a way to get leaner and do more with less.

We’re sponsoring an educationally focused webinar where you’ll hear from CIOs [...]

Here are some of the most common issues I’ve come across when speaking with newly appointed hospital IT leaders faced with interfacing and integration issues.

1. I have hundreds of HL7 interfaces already (I think), and I am being asked to clean house. Where do I start? Start by inventorying your interfaces. Get a sense of how many interfaces are out there and document the systems they connect.

2. Are my interface consultants providing me with all documentation I am entitled to? [...]

We’re happy to announce that Caristix has made the list of Top 25 Up and Comers among Canadian ICT companies. Check out the Top 25 list here.

The list is part of the Branham300 list, which has been tracking and ranking IT and tech firms within Canada for the past 20 years. The list is widely considered to be a leading source of intelligence on Canada’s ICT industry.

Caristix is in great company on the list, which includes some of the hottest [...]

Caristix was selected to present at Interconnected Health 2012 recently, and we focused on a new concept, HL7 Interface Lifecycle Management.

Up till now, there’s been a sort of unspoken assumption in the industry: interfacing is a linear event based on simple drag-and-drop configuration within an interface engine. However, if you look at all of the tasks that are involved in interfacing, it is far more helpful to model interfacing as a lifecycle.

Here’s why.

HL7 provides a framework to support the process [...]

Implementing systems doesn’t mean much these days if they remain data islands unto themselves, but far too many teams rely on the drawn-out iterative processes of trial and error to get their interfaces created and tested. With so many connections at play, your organization must find a way to get leaner and do more with less. We’re sponsoring an educationally focused webinar on this topic. You’ll hear from CIOs who have blasted away key bottlenecks in integration, leaving them able [...]

If you’re going to be at Interconnected Health 2012 (April 2-4) in Chicago, check out the session with Jean-Luc Morin, VP R&D here at Caristix. Jean-Luc’s session is on Monday, April 2. He’ll be talking about HL7 integration and how to move from trial and error to predictable project outcomes.

Jean-Luc’s presentation will introduce the concept of Interface Lifecycle Management, which covers 7 key stages that every healthcare organization goes through when they implement interfaces. These stages include scoping, configuration, validation, [...]

One of the things we realized when we formed Caristix is that the biggest pitfall in HL7 interfacing isn’t coding or setting up the interface. With modern interface engines, that’s relatively easy. The real struggle is knowing how a system is constructed, where the gaps are, and what needs to be coded – this drives the work. In fact, when this scoping is handled effectively, all other aspects of interface creation and management go well. But when this stage is [...]

Typically, when you start an interfacing project, there’s a getting-your-feet-wet stage. “Where’s the MRN in that feed? Does it have leading zeros? Who’s got the lab codes? What do the z-segments contain?” There are a whole lot of questions at this stage. One question cascades into another. You check the interface documentation. Then send an email. And pretty soon, you’re in the deep end, with scope creep, a runaway timeline, and very little real data (read: specifications and test messages) [...]

One of our Cloak customers is de-identifying close to 14 GB of clinical data coming from several healthcare information systems (including 2 ADTs and a lab system) at an IDN. This customer is asking some great questions that would help other Cloak users get more out of the software. Here’s an excerpt from our conversations.

The NK1 segment is giving me trouble. Specifically, field 5, the address. I created a sample message with this as the NK1.5 content:

123 EASY ST^Arlington^VA^22207

The NK1 [...]

One of our Cloak customers is de-identifying several GB of clinical data coming from several healthcare information systems (including 2 ADTs and a lab system) at an IDN. This customer is asking some great questions that would help other Cloak users get more out of the software. Here’s an excerpt from our conversations. We’ll be posting new Q&As in the coming weeks.

Is there a means by which the names in a message can be de-identified, i.e. patient, physician, etc., without [...]

Healthcare IT blog HIStalk featured Caristix in a series on innovative companies developing technology products for hospitals, providers, and others in healthcare.

Here’s what one of our users at a major HIT vendor had to say about Caristix technology when he was interviewed for the article:

What problems have you solved using Caristix products and what impact has that had on your organization?

We are seeking ways to continuously improve our customer enablement process for our product. An activity in that process is [...]

HL7: What You Don’t Know Can Hurt You

How many times do hospital IS/IT directors come across this scenario?

Your hospital has just signed on the dotted line for a new EMR. It’s meant to streamline clinician workflows, facilitate improved quality of care, and help meet all-important Meaningful Use targets. And all you have to do is interface it.

You’ve got a budget, a timeline, an interface engine, a couple of developers, a couple of analysts, a pile of legacy systems to integrate [...]

In a previous post on interface documentation and sample HL7 messages, I touched on four guidelines for using sample messages. We’re working on software that will make it easier to use sample messages effectively in your HL7 integration projects. The software is called Caristix Reader, and it will be available free of charge upon release. A beta version is now available for download and evaluation here.

Caristix Reader and Sample HL7 Messages

1. Message Structure Caristix Reader captures message structures from sample [...]

When it comes to interface documentation formats, we’re all about using whatever analysts, project managers, and developers find helpful: Word site surveys, Excel lists, wikis, whatever works. Those tools are perfect for handling the baseline information around inbound and outbound channel specifications and transport specifics.

In recent customer conversations and in discussions on LinkedIn, one practice stood out: the use of sample messages to understand real-world systems. Sample messages contain a wealth of information about the systems that need to connect. [...]

Agent de support au service technique

Nous ouvrons un poste, basé à Québec, pour notre nouveau service technique. Les responsabilités de notre unité technique sont multiples et variées chez Caristix. Le terme « unité technique » convient d’ailleurs mieux à cette unité d’élite. Nous cherchons un collègue bien particulier, qui soit avant tout prêt à s’impliquer dans la réalité d’une entreprise en démarrage, quelqu’un que le terme « start-up » ne rende pas anxieux !

Les tâches de notre nouveau collègue seront [...]

Technical Support Rep

We’re looking for a full-time, Quebec City-based support rep. This isn’t your typical tech and/or sales support position. We’re seeking one very special individual: first and foremost, someone who gets startup life and loves it. This special someone also gets product management and the voice of the customer.

Your days will be varied. You might be demoing to prospects one day, troubleshooting with a customer the next, and delivering in-depth training the following week. And throughout it all, you’ll [...]

We’ve shipped our latest software to beta testers. And we’ve given the product a name: Caristix Reader. Like Adobe Reader, it’s free.

Looking for more info on the beta and Caristix Reader? Here’s a stack of FAQs from our on-boarding calls with beta testers.

What does it do? In a nutshell, Caristix Reader “reads” HL7 interface specifications:

Reverse-engineer an interface profile or specification from a stack of HL7 messages.
Navigate the profile, and edit it. Consult it whenever.
Send a profile to a colleague or [...]

We’re now accepting beta users for a new software application that will simplify the scoping of HL7 integration projects.

Who’s Eligible

Hospital IT team members who work on healthcare integration, interfacing, and HL7.
Limited to hospital employees in the US and Canada.

About the Product

The software enables healthcare IT analysts and developers to grasp how data flows through a system. They can do this minutes, not after hours of poring over a spec. The software also automatically documents the associated real-world interface specification. This [...]

Stéphane Vigot, Caristix co-founder and president, is presenting today at the International Startup Festival, a new conference on the business of startups. He’ll be pitching to investors, media, and thought leaders from all over.

We’re thrilled to have this opportunity. Caristix is among 12 finalists, who were picked from over 120 applicants from around the world. Startup and tech blog Next Montreal profiled all 12 finalists over the past few days. Read about the other finalists here.

We think it promises to [...]

We’ve just released Test v1.18, Caristix software for testing HL7 interfaces. This release includes two new features.

Database Connection Library

Caristix Test now includes a library for your database connections. This helps you manage multiple database connections more easily. Rather than configuring the connection each time you change databases, simply select a pre-configured connection from a list.

New HL7 Message Formats

Outbound HL7 message tasks can now send content in HL7-ER7 or HL7-XML formats.

Feedback Link

All Caristix applications now include a feedback link (support@caristix.com) under [...]

This week’s roundup covers enterprise data modeling, a possible slowdown in the Meaningful Use timeline, a new HIE software release, and interoperability.

Enterprise Data Modeling: 7 Mistakes You Can’t Afford to Make via www.information-management.com This article isn’t healthcare-specific, but there are several good pointers for architects working in IDNs and HIEs — any healthcare integration initiative, as a matter of fact. Key takeaway: a data model has to reflect business needs and be transparent. Easier said than done.

Federal Health IT Panel [...]

This week, we have a couple of HIE news items out of the US Midwest, a new Canadian iPad/ICU implementation, and a warning not to use Dropbox for healthcare data.

Information Exchange: Know Your Use Cases via cmio.net All about the Cincinnati-area HIE, HealthBridge. EHR feeds to 29 vendors, 60+ EHR versions, all on an Axolotl system and Mirth MUx.

Chicago Hospitals Embark On Long HIE Journey via nversel They’re putting together a subscription-based model for providers; vendors share the risk. Read [...]

We’re starting a new feature on the Caristix blog: a quick weekly roundup of noteworthy news, articles, and comments on healthcare integration and healthcare IT.

This week we have interoperability in Stage 2 and 3, an interview on medical device integration, and thoughts on refills from EMRs.

Enjoy!

The cloud outage and its impact on EMRs via @EntegrationBlog Yesterday, a data center belonging to cloud computing leader Amazon went down, taking dozens of web-based applications with it. Read about the 3 questions a [...]

HL7 Interfacing Advice from the Indiana Health Information Exchange

The largest health information exchange (HIE) in the US is located in Indiana. It connects 80 hospitals, and serves 10 million patients as well as 19,000 physicians. IHIE members participated in a recent meeting of the Central Indiana Beacon Community and posted their slide decks here. The presentation that resonated for us was Mapping Interfaces by Dr. Mike Barnes, Dan Vreeman, and Amanda Smiley (PDF).

Their killer quote: “Interface programmers are the only [...]

Information Week ran an article this week on protecting patient data. The article wasn’t on one of the usual suspects — a HIPAA violation or a breach in a production system. Instead, this was notable because we’re finally seeing one of the hidden dangers in healthcare IT coming to light: unsecured patient data sitting in development and test systems. Our industry needs to start addressing this issue.

Information Week cited a survey where 51% of organizations don’t protect patient data used [...]

Jean-Luc Morin, VP R&D at Caristix, has a guest post on Shahid Shah’s blog, Healthcare IT Guy. Shahid’s top-ranked blog covers healthcare IT, EMR, EHR, PHR, medical content, and document management.

Jean-Luc’s article covers 6 questions hospital CIOs and IT directors should be asking vendors about interface documentation.

Here’s an excerpt:

At first glance, documentation doesn’t seem like a CIO-level concern. In a typical implementation cycle, the team gets a few specs from a vendor. Someone signs off on an interface configuration document. [...]

A few weeks ago, I was working on an HL7 v3 project with an outside partner and the discussion turned to market adoption. We came to the conclusion that it’s not exactly taking off — at least, not as quickly as you might expect. Apart from meaningful-use initiatives around CDA in the US and the big push by Canada Health Infoway, I don’t really see much traction in North America. I’m going to come right out and say this: from [...]

Wishing you a happy, healthy, and joyous holiday season and New Year!

Definitions

We’re continuing with our series of posts on patient data de-identification. This week, we’re reviewing a set of definitions of common terms. This list will become the glossary for upcoming posts on HL7 de-identification and protecting sensitive healthcare data. We’re looking for feedback on this list. Feel free to add your nuances and/or related terms in the comments…

De-Identification or Anonymization

An umbrella term for removing or masking protected information. In a more specific sense, the de-identification process removes identifiers from a [...]

In healthcare IT, no matter where you work, you’re faced with protecting patient data. Many countries have regulatory frameworks to address patient privacy and the use of health information. In the US, HIPAA regulates the use of PHI (protected health information). In Canada, the law is called PIPEDA (Personal Information Protection and Electronic Documents Act). PIPEDA regulates the use of consumer data in a number of industries, not just healthcare. Plus a few Canadian provinces have their own privacy legislation [...]

Some organizations call them HL7 conformance profiles, others call them HL7 interface specifications. They’re all talking about a description of the data format used for exchange between systems within a care facility.

The terminology might not be consistent, but the challenge is: documentation. How do you document conformance profiles so that the description is up-to-date and trustable?

3 HL7 Documentation Issues
1. Creation is Time Consuming

Documenting an HL7 specification requires a fair amount of effort. Applications exchanging data through the HL7 standard usually [...]

I was in Philadelphia this week for the 2nd Annual Canada-US eHealth Summit (PDF). Now, this wasn’t a big conference like HIMSS. But it was a great opportunity to break open our silos and share knowledge and stories across the border. Plus, we got to hear from a handful of respected HIT leaders, including John Glaser, CEO of Siemens HIT, and David Levine, head of a major Canadian regional health agency.

Here are 15 highlights from the presentations.

Ripped from the headlines: [...]

First of all, a big thank-you goes out to all the folks who signed up for our beta. Because of your input, our products are a lot more useful and a whole lot more compelling than a few months back.

Betas Are Good For Branding and Messaging, Too

Our beta users provided great feedback on user workflows and functionality, which we incorporated into this release. They also delivered a healthy pipeline of enhancement requests. Plus we identified (and fixed) bugs.

We also got [...]

Caristix Launches HL7 Integration Management Software for Healthcare Vendors and Hospital IT Teams

HL7 Interface analysts and engineers eliminate time-consuming manual work to leave more time to bridge healthcare data gaps through interface engines, HIEs, and more.

Quebec City, Canada, November 5, 2010 — Caristix, an HL7 integration software company serving healthcare vendors and providers, today announced the release of new software designed for interface analysts and engineers. Caristix™ Conformance and Caristix™ Test software help close information gaps before work begins on [...]

When provider organizations are on a tight deadline to implement or upgrade an EHR, EMR, HIS or other clinical system, setting up a test or staging system can seem like just another procedural hurdle. So it couldn’t hurt to just do the final testing in the live, production system, right?

Wrong.

Why It’s Tempting

It might seem quicker to simply tag test data as “Test Patient1″ in “Bed #1-T” and get it into the production EMR or HIS. You skip duplicate server (or [...]

Here’s what Barry Holleman, Vice President, Clinical Technologies, at Cardinal Health Canada had to say recently about Caristix:

“Cardinal Health Canada was seeking ways to cut HL7 interface validation time on our product deployments, without sacrificing quality processes. We were aiming to cut 20 to 25% off our troubleshooting time. Instead, Caristix software enabled our interface engineers to streamline troubleshooting much more significantly. In one case, what was a 2 hour task now takes just 10 minutes.

“I would also like to [...]

While clinical end-users count on interfaces to deliver the functionality and interoperability they need, IT stakeholders need to be sure everyone involved gets the steps and costs involved. Especially since interfacing takes up 20 to 40% of an implementation project timeline. Here’s a quick overview to get everyone on the same page.

HL7 Interface Lifecycle

Scoping

An interface analyst scopes the interfacing project.
The analyst performs a gap analysis based on the client’s current information system environment and the new system to be [...]

Yesterday, CCHIT launched their ONC-mandated test and certification program and delivered a one-hour webcast on their process. Slides and a recording are available on the CCHIT site.

One thing is clear. Certification is just the first step. Certification means that the EHR system or module meets NIST testing criteria for functionality and security related to Stage 1 Meaningful Use measures. But implementation and related integration issues still loom in the background.

At least three objectives in the core and menu sets require [...]

I recently had a discussion with some of our partners around conformance profiles and templates. Collectively, we haven’t come across an industry-standard template. Some organizations build their own. Others decide to go without because templates can take time and effort to set up. We think a conformance profile should help you clearly and concisely communicate what your system expects in terms of data exchange. In healthcare, this isn’t a trivial task. Learn more about conformance profiles in healthcare, which we [...]

Definition

Let’s start with the formal definition, introduced by the HL7 organization in the v2.5 specification. Here is an excerpt from section 2.12:

Definition: An HL7 message profile is an unambiguous specification of one or more standard HL7 messages that have been analyzed for a particular use case. It prescribes a set of precise constraints upon one or more standard HL7 messages.

In other words, this is a description of the data and messages that an interface sends and/or receives. The description covers [...]

What can you do to improve the HL7 interface validation process on your next implementation project?

I was on-site at a hospital where a vendor was doing a product upgrade. The vendor and the hospital IT team were both committed to getting it done right, so the 2-week interface validation was thorough. That investment pays off. The upfront work pays off down the line in reduced help desk wait time and service calls.

Based on this experience, here are 4 tips to [...]

There seems to be two conflicting needs in software testing in healthcare: traceability and test performance.

Traceability Traceability is the ability to link your requirements to your tests:

In healthcare, regulatory compliance is on the side of traceability. Reasonably enough, regulators want to know that products actually do what they’re designed to do. Traceability provides that chain of evidence.

Test Performance However, traceability can come at the expense of test performance — defined as how efficiently a product can be tested both for [...]

In Part 1 of this series on HL7 gap analysis, I covered the need to identify gaps before starting to configure an interface, and explained why gaps happen. Today, I’m going to talk about gap analysis steps and the limitations you need to plan for.

Gap Analysis Steps 1. Obtain vendor conformance profile. Vendor analysts start out with an HL7 conformance profile for the product they’re deploying. The profile documents the specific trigger events and segments used by the application. It [...]

Nine times out of ten when a hospital deploys a new software system, the new system will need to exchange data with existing information systems in order to deliver on expected value. Even with fully integrated vendors like Epic and others, hospitals still have data from flowsheets from monitoring systems and medical devices to pull in through an interface.

Many vendors provide connectivity libraries and most hospital deploy interface engines to cope with connectivity and interfacing issues. But before they can [...]

We’ve had great feedback from early users of Pinpoint software. They aren’t just using Pinpoint for interface troubleshooting. They’re also incorporating the software into their gap analysis workflow. In this context, gap analysis is the process of documenting the HL7 interface gaps between new software and legacy systems.

Here’s one way Pinpoint can make this process a little quicker.

Start with a Message Log Analysts usually start with a raw message log from the provider, covering a few days of transactions. The [...]

Now that we’ve gone live with our new website, we’ve also launched our first product, Caristix™ Pinpoint software for troubleshooting HL7 interfaces.

What Does Pinpoint Do?

If you’ve ever received an HL7 message log with thousands of messages and segments, you know you’re in for a few hours of scrolling… just to find a handful of messages that you need for a troubleshooting task. Pinpoint lets you find the target messages in a few minutes rather than a few hours.

Who Is Pinpoint [...]

Hello and welcome to the new Caristix blog! In this first post, we’ll cover a little background about what you can expect from this blog. And we’ll introduce the people who’ll be writing here.

HL7 Is Where It’s At

We’ll be covering interfaces, integration, and interoperability in healthcare information technology. Topics will include:

software development and testing. What makes healthcare so different? We’ll be talking about that.
HL7 interface scoping and configuration. HL7 is all about configurability. Which is why… Every. Single. Implementation. Is. [...]