The HL7® Survival Guide — Chapter 2: Pros and Cons of Interfacing 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 to get going quickly when you’re starting from scratch
• No need for technical resources; vendors can set up interfaces

• Harder to grow/evolve over time because systems are tightly coupled together and any change to one might impacts all others
• Doesn’t scale well since there will be N(N-1) interfaces in ecosystem (e.g., 5 systems – 5(5-1) = 20 interfaces)
• Inflexible – systems must understand other systems’ expected data structure and semantics
• Limited monitoring capabilities
• Costs can grow rapidly if you rely on vendor to change or add new interfaces

Advantages

Trade-Offs

Interfacing Capabilities

• Mediates transport protocols between systems
• Scales elegantly to reduce number of interfaces required (N + 1)
• Centralizes and facilitates monitoring of message flows and interfaces
• Systems are loosely coupled, enabling you to add new interfaces and modify existing ones without impacting other systems
• Provides tools and infrastructure so interface adapts to different HL7^® message and data formats
• Reduces interface costs by using single application capabilities across all applications
• Reduces dependency on multiple vendors for changes to message format

• Steep learning curve – need to be well versed in a specific vendor’s technology to develop interfaces
• Vendor lock in can mean additional costs for integration engine infrastructure, as well as costly interface engine technology conversion that involves large projects impacting several systems

Advantages

Trade-Offs

Integration Capabilities

• Includes workflow management features that enable the interface to respond as clinical workflows evolve and that offer a more flexible migration path for systems and ecosystems
• Provides a single point for system integration to ensure consistent management
• Built to scale

• More complex and expensive than smaller-scale interface engine due to shortage of skilled analysts and need for extensive training
• Expensive software licenses
• Need to create a dedicated team (if you don’t already have one)