What was Old is New Again for Hospital Interface Move-In

Recently Southwestern Vermont Medical Center, Medicity and VITL met the old-fashioned way—face-to-face—at the VITL office in Burlington to complete the second phase of a hospital interface project. The goal was to build five interfaces or connections that would feed data from the hospital to the Vermont Health Information Exchange (VHIE), the statewide health data network operated by VITL.

Five interfaces were built to:

  1. Send immunization data from SVMC to the VHIE. The immunization data is then sent to the Vermont Department of Health Immunization Registry.
  2. Send patient demographics, radiology reports, laboratory results (pathology, microbiology and blood bank), and transcribed reports (information about procedures, admissions, discharges and consults) from SVMC to the VHIE.

The success of this project is meaningful for two reasons: the SVMC interfaces completed VITL's goal of connecting all 14 Vermont hospitals to the VHIE; the move-in process gathered everyone together who needed to be involved in decisions or changes with the people who could make the changes—focused and in one room—supplied with a constant stream of pizza and bagels.

There were actually two move-ins during the final stages of interface development to connect SVMC to the VHIE. An interface is basically a secure connection from one server to another server that transfers data in the internally accepted HL7 format. HL7—the acronym for Health Level 7—is a set of international standards for "the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services." Click this link for more information about HL7 standards:

Medicity—the infrastructure vendor for the VHIE—developed the move-in process as a way for the project managers, quality assurance analysts, integration analysts, hospital subject matter experts and engineers to meet face to face. Scott Bowman, a Medicity project manager, and Medicity engineer Jason Whiting said that by collaborating more closely with the VITL team the communication loop was closed quickly and the work moved forward rapidly. SVMC was brought online to send health data to the VHIE in four weeks, 16 weeks faster than the industry average of 20 weeks. By working directly together a relationship of trust was built and greater transparency allowed every member to have all the information they needed when they needed it. Ultimately this new model proved to be a great win for all stakeholders who were involved.

Phase one of the move-in involved integration and quality analysis (QA, in the quality assurance testing environment). It began in late January, 2015, when VITL hosted a smaller, in-person team at the Burlington office. At this point the hospital was not connected to the VHIE, but SVMC began sending sample health data messages to VITL as secure, encrypted files. Medicity's analysts looked at the sample messages from the hospital to make sure they met HL7 and VITL standards: if they were missing something, then fields in the messages had to be transformed to the correct format.

The benefits of meeting face-to-face during phase one (and phase two) were quicker communication and faster response time between all team members: you can't get much closer than sitting across from one another in the VITL conference room. Any changes that needed to be made were done right away because there was no delay in communicating those changes. QA/pre-testing of the hospital's messages eliminated a lot of change order tickets so they were ready to deploy the cert or client test environment earlier. SVMC could then send messages in an environment that was similar to the VHIE, where the team could see how they flowed in.

Between phase one and two of the move-in, all members of the team went home. At this point Medicity began to build a prod or production environment for the secure data feeds that SVMC would use to send their formatted health data messages to the VHIE.

The move-in team was back at VITL two weeks later, from February 10 to 12, and larger in size than during phase one. Their goal this time was to solve any remaining support tickets and to have all five interfaces ready for production. Because of the first move in accomplishments the second move-in went smoothly, and the team's goals were met a lot earlier than anticipated.

Mary Donati stated, " When SVMC arrived the second time their interfaces were turned on, and we monitored for failures but there were none!" The pre-testing phase helped the hospital create and send messages to the VHIE that were high quality and formatted correctly. There were only a few minor changes that Medicity had to make to the interfaces, but otherwise it was a very smooth deploy completed much sooner than expected.

Debra Alford, SVMC's application integration specialist stated that "the move-in was more pleasant and productive than I anticipated. I was able to ask questions on topics ranging from technical issues, end user experience, to future use of the data. Conceptual questions were answered, diagrams drawn, etc. until questions were answered and concepts were clear. No time wasted trying to find out who to contact or waiting for responses. Issues were resolved quickly. Doing the work on the spot also allowed us to work through any secondary concerns. Working away from the home office made it easier for me to maintain focus on the task at hand."

Technology has helped to improve health care outcomes in many ways, and with the additional face time as a project strategy, it paid off for the VITL-Medicity-SVMC move-in team.

VITL and Medicity Interface Move-In

Members of the move-in team include:

VITL Staff:

  • Mary Donati - Project Manager
  • Regi Wahl - Senior Project Manager

SVMC staff:

  • Debra Alford - Application Integration Specialist/subject matter expert

Medicity Staff:

  • Project Managers- Scott Bowman and Kristi Ward
  • Engineers- Jason Whiting and Billy Hansen
  • QA Analyst- Kenyon Tanner
  • Integration Analyst- Rick Glasgow