Q&A: Role of an integration engine in a large Louisiana health system
West Jefferson Medical Center is a not-for-profit, 435-bed full service community hospital located in the greater New Orleans area. Recently joining the LCMC Health System, the West Jefferson interface team has been chosen to lead the integration effort as part of a large Epic conversion. Along with Epic, Corepoint Integration Engine will be rolled out across the five hospital system, replacing multiple legacy engines.
A customer since February 2007, the West Jefferson integration team has completed many integration challenges. Sr. IT Director Al Respess and Sr. Integration Analyst Garrett Meynard recently carved out some time to talk to us about their future plans as they combine with LCMC.
As West Jefferson assimilates with LCMC Health, are there efforts to integrate all the different systems?
Garrett:We are in a fortunate position where West Jeff is playing a key role. We’re leading the way when it comes to the architecture, the infrastructure of systems, and the interfaces. Corepoint Integration Engine is the interface engine of choice and we will start connecting and migrating all these other interfaces from the other hospital systems to Corepoint.
One of the first migrations would be, of course, the LSU (Louisiana State University) system. They’re using Siemens OPENLink. We’re looking at 30 or more connections on that side that will end up being moved to Corepoint.
Then, we’re implementing Epic.
You have used Mckesson Star and Cerner in the past. Why the shift to Epic?
Garrett: Epic is the foundation that the other hospitals in the system will be working from. Additionally, our CIO has experience working with Epic. Management trusted the competence of the hospital teams not currently using Epic to make the move. That’s where the choice came in, and for Al [Respess] and I to say, “Bring it on, we’re ready.”
You’ve had lots of experience with system migrations and upgrades, do you have a playbook you follow?
Garrett: We’ve gone down this road a few times, and not just when we talk about migrating clinical EMRs. We’ve also migrated multiple PACS systems, RIS systems, and different financial systems.
Al: I think what we can say is that the engine has always met the challenge. It never got to a point where we couldn’t get it done.
How will the size of your integration environment be impacted during this transition?
Garrett: We have seen growth initially, and then as we figure out how we want to integrate everything together, we’ll probably start shrinking interfaces as we consolidate systems. That’s where the engine plays a key role, by helping us transition systems. We’ll have connections up and running while we build out new systems, establish connections, and then phase other systems out.
How will the engine help with your move to Epic?
Garrett: In a number of ways. Right off the bat, when we talk about the basic architecture we want to build, we’re likely going to have a second data center. We’ve got our data center locally, which is predominantly a virtual platform. There’s a second data center housed at a sister hospital, which is also predominantly virtualized, where we will have Corepoint Disaster Recovery.
We’re looking at an active/passive set-up, and with that we’re going to leverage Corepoint Integration Engine 2016.1 with SQL Server to create a SQL Server cluster. That’s going to be a big deal.
In addition, the engine gives us such great flexibility to stand up these connections, and our partnership with Corepoint is fantastic, with wonderful support. When we need a new connection only for a short amount of time, we’re always able to get those implemented extremely fast. That really helps us out.
The transition will start with using Epic as our core, bringing those interfaces from Epic into Corepoint, then figuring out what we can consolidate.
Again, the ease of use for Corepoint is what really stands out. It’s just so flexible and easy to use. If somebody just needs a basic connection, I can have that done in five minutes. It’s really a credit to Corepoint how quickly I was able to get into and accomplish different things inside of the engine.
Al: I think that’s a key advantage – the ability to rapidly implement interfaces and make changes. I’ve had my hands in (other legacy engines), and the way you can build and test within the Corepoint configuration tool is outstanding.
Another advantage is the administration console for monitoring. We distribute the console to the user department so they can see their own interfaces, and those analysts handle probably 80% of the work on those interfaces. It takes a load off of what we have to support day-to-day and allows us to focus on architecture.
Garrett: The Administrative Console really speeds up patient care, along with the ability of getting a result inside of our EMR quickly. The PACS administrator doesn’t have to wait on us to fulfill his support ticket. He’s able to get right in, find the result quickly using the search features, click on it, do the resend, and he’s done. It sends the result over, and we get it filed into our EMR.
Any lessons learned that you can share with other health IT professionals?
Garrett: One of the biggest lessons that we learned, particularly with Cerner, is to get as much as you can out of the systems into the engine right up front during implementation. We found it difficult and time consuming to wait on vendors for outbound feeds. If it’s feasible, get all results, order types, and everything you can, over to the engine.
Although you might not be sending all the information immediately, somebody is going to want it down the line. We’re going to follow that course with Epic.
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