INTEGRATION ARCHITECTURAL
& INTEROPERABILITY          

The rapid rise of technology and its adoption into
the healthcare field has caused healthcare organizations
to collect an accumulation of non-interoperable systems
that not only need to work together within the
organization, but are also accessed from outside.
The burden of integration usually falls on the users
of the system, who are forced often to access many
different systems to complete one task. The use of
service oriented architecture (SOA), however,
can improve the delivery of important information
and make the sharing of data across a community
of care practical in cost, security, and risk
of deployment.

Healthcare organizations today are challenged to
manage a growing portfolio of systems. The cost
of acquiring, integrating, and maintaining these
systems are rising, while the demands of system
users are increasing. Organizations must address
evolving clinical requirements as well as support
revenue cycle and administration business functions.
In addition, demands are increasing for interoperability
with other organizations.  Service oriented architecture
offers system design and management principles that
support reuse and sharing of system resources across
the healthcare organization. SOA does not require
the re-engineering of existing systems. With SOA,
existing processing can be combined with new
capabilities to build a library of services that are
used as a part of solutions. Using shared services
that are aligned with business processes, SOA
strengthens interoperability while reducing the need
to synchronize data between isolated systems.

HITECH

On February 17, 2009, President Obama signed the
Health Information Technology for Economic and
Clinical Health (HITECH) Act, as part of the stimulus
package (a.k.a. American Recovery and Reinvestment
Act (ARRA)). The main goal of the HITECH Act is to
encourage the adoption of electronic health records
(EHRs) through incentive payments to physicians.

According to the Act, physicians are eligible to
receive up to $44,000 in total incentives per physician
from Medicare for “meaningful use” of a certified
Electronic Health Record (EHR) starting in 2011.

Though we know that reimbursement is granted for
the “meaningful use” of a certified EHR, the certification
process and standards remain unclear.

MEANINGFUL USE CRITERIA

In Stage 1 beginning in 2011, meaningful use criteria
focuses on electronically capturing health information
in a coded format. The rule specifies criteria
for Stage 1 only.

Stage 2, beginning in 2013, encourages the use of
health IT for continuous quality improvement at the
point of care and the exchange of information in the
most structured format possible.

Stage 3, beginning in 2015 focuses on promoting
improvements in quality, safety and efficiency,
focusing on decision support for national high priority
conditions, patient access to self management tools,
access to comprehensive patient data and improving
population health.

How to Achieve Meaningful Use in Stage 1

• Improving quality, safety, efficiency,
  care coordination, population and public health
• Reducing health disparities
• Engaging patients and their families
• Ensuring adequate privacy and security
  protections for personal health information