Are Healthcare Integration Engines Needed?

In a perfect world, we might ask why health systems need to purchase an integration engine. The standards used by integration engines are pretty widespread and every EHR and Healthcare IT vendor uses that standard. Why then do we need an integration engine in the middle?

I’m sure there are a lot of reasons, but two reasons stand out the most to me are: integration costs and flavors of standards.

Integration Costs
It’s amazing how expensive it is to build integrations with EHR and other healthcare IT software. I still look back on the first lab interface integration I did. I couldn’t believe how expensive it was to do the integration and how the vendors were happy to nickle and dime you all along the way. Many of them look at it as a secondary business model.

While an integration engine can’t solve all these costs, if you have a large number of integrations, the integration engine can save you a lot of money. This includes the integration engine’s experience integrating with multiple vendors, but it also means you can often only pay your EHR vendor one time instead of getting charged for every integration.

Flavors of Standards
If you’ve ever managed an integration, you know how miserable it can be. Each side of the integration implements their own “flavor” of the standard (which makes no sense, but is reality) and that flavor can often change as the various software gets updated. It’s no fun to manage and often leads to interface downtime. You know the impact interface downtime can have on your providers who don’t understand the intricacies of an interface. No one likes something that previously just worked to stop working.

This is where integrations engines definitely shine. Their whole job is to manage these types of changes and ensure that they’re prepared for the change. If they can’t do this right, then you should search for a new integration engine. Plus, integration engines usually have tools to help you manage this and to update this as vendors change (and they will change).

Will Integration Engines Survive?
In the perfect world, we wouldn’t need an integration engine. Healthcare is not a perfect world. In fact, it’s far from it, so I see integration engines sticking around for a long while to come. They’re quite entrenched in the business processes of most large healthcare organizations.

While at the HIMSS Conference, I was talking with Summit Healthcare and they noted that they have 1 client that’s sending 5 million messages per day (Yes, I said per day!). That’s a lot of messages and that’s only one client from one integration engine. Hearing that number illustrated how valuable these integration engines are to an organization. It also flew in the face of healthcare not being interoperable. However, it illustrates how much data needs to be shared if we had true interoperability since those 5 million messages only includes a small portion of health data that could be shared.

We’ll look at diving into integration engines in more detail in future posts. I think they’re an important backbone of what’s happening in healthcare IT and many don’t realize it.

About the author

John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • Hi John, It is true that vendors saw integration as a secondary line of business. It is also true, that without a standard data model, vendors were very much left to their own devices with regard to database design. This led to the proliferation of integration technologies in the 1980s and more specifically in the 1990s. End users got tired of the cost of funding bespoke interfaces.
    Of course one of the main reasons for their development was that it was impossible to keep both sides of the interface “in sync” and therefore use of an integration engine helped to stabilize the environment by in most instances, only having to modify one side of the interface. They also made it easier to develop interfaces.

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