Health Data Integration Must Be for the Whole Clinic

As health clinics, dentists, and specialists gradually reopen during what we hope is a reprieve from the first COVID-19 wave, lapses in effective data sharing come into glaring view. For instance, some friends told me that when they arrived at a clinic, the receptionist handed them paper forms and pens. The receptionist would say, “Just keep the pen. We don’t want it back–we’d just have to resanitize it.” And I thought, “Is this necessary in the year 2020?”

No, handing pens to patients shouldn’t be necessary. Digital data integration is crucial, not just to quash infections–because keypads are also a major vector for transmitting bugs–but to make sure that a prescription is ready when the patient leaves the office and walks to the pharmacy, and to prevent errors when a technician transfer vital signs from a monitor to the patient’s health record (EHR).

Health IT vendors, particularly since the passage of the 2009 HITECH Act, focus on integrating EHRs. But integration should really extend to every system in the clinic or hospital: billing, pharmacy, practice and workforce management, biometric stations that authenticate staff, and so on. As Josh Douglas, CTO of Bridge Connector, points out, the time spent by a patient in the doctor’s office is only a tiny part of their interaction with the entire health care system.

Douglas told me what Bridge Connector is doing to integrate the whole health care institution. Like many services, they read records from the relevant systems, extract fields, and convert the metadata (field names and attributes) into an internal format so that the data can be converted to whatever output format the recipient needs. They work with vendors to make sure to take in and emit the compatible format for each vendor. Current partnerships include the major EHR vendors Epic and Allscripts, along with Salesforce for business functions.

The competitive advantage Bridge Connector offers is a “no code” user experience. That is, instead of an API that requires programming, they offer forms that are easy to understand and can be filled out by a subject matter expert, such as a clinician or registration desk person. The fields that Bridge Connector takes from the incoming format show up in the form, clearly highlighting the fields that are required by the recipient format. Thus, the staff person is guided to include all the necessary information, so that when a patient registers later, the EHR will not reject the data.

Form presented by Bridge Connector to staff person for intake of patient data
Form presented by Bridge Connector to staff person for intake of patient data

Douglas says that the no code environment champions “citizen integrators.” This means that staff without a programmer can complete integration tasks that have typically required IT staff. Most environments still offer integration through an API, or worse still, formats such as HL7 or custom XML that are difficult to parse. The clinician has to meet with an IT person and painstakingly explain what data needs to be tranferred, and where. Then time elapses while the IT person tries to carry out the task, creating unnecessary room for error. The Bridge Connector interface lets the end user–even a clinician–choose everything quickly and accurately, with instant results.

Another design feature of Bridge Connector is easy extensibility. They follow the classic Internet principle, “Be liberal in what you accept, and conservative in what you send,” so that the system isn’t confused if a new field turns up. This should help users integrate more and more elements of the standard hospital and clinic environment, thus giving what observers like to call a “longitudinal” or “360” view of the patient.

Or in short, no more being handed a form and a pen to fill out when you get to the doctor.

Bridge Connector has been in business for about two and a half years, and now has more 90 customers that together serve thousands of health care facilities. The company offers full service throughout the product life cycle: installation, building the tools, and maintenance.

Most of my own columns in health IT concentrate on clinical data, which has to be integrated better to improve patient care and derive research benefits. But real-life institutions are enormous collections of diverse systems that help patients, clinicians, and staff. We need IT that can get these things working together in order to eliminate waste in the health care system.

This article is part of the #HealthIT100in100

About the author

Andy Oram

Andy Oram

Andy Oram writes and edits documents about many aspects of computing, ranging in size from blog postings to full-length books. Topics cover a wide range of computer technologies: data science and machine learning, programming languages, Web performance, Internet of Things, databases, free and open source software, and more. My editorial output at O'Reilly Media included the first books ever published commercially in the United States on Linux, the 2001 title Peer-to-Peer (frequently cited in connection with those technologies), and the 2007 title Beautiful Code. He is a regular correspondent on health IT and health policy for HealthcareScene.com. He also contributes to other publications about policy issues related to the Internet and about trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business.

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