A promising strategy for reversing unsustainable trends of rising healthcare costs is to modernize and transform the health-care information exchange (HIE), i.e., the mobilization of health-care information electronically within and across organizations (payer, provider, pharmaceutical, pharmacy, laboratories, imaging facilities, etc) within a region or community. The current HIE is inefficient and error prone. It is largely paper-based, fragmented, and therefore overly complex, often relying on antiquated IT.

Within the context of a healthcare organization, or across organizations, information is stored in silos of applications. It is not uncommon to see a 300 bed hospital with over 300 disparate applications for administrative, clinical and financial applications.

Although the adoption of interoperability standards is on the rise, the variety and complexity of these standards leaves a healthcare organization with a limited IT staff almost incapable of handling the integration challenges. Unless healthcare organizations adopt a flexible, reliable and highly performant information integration strategy to integrate financial, administrative and clinical data across siloed systems, the following trends will remain good topics for global debate without true enablement while healthcare costs continue to rise.

new national or state government mandates such as Severity adjusted DRGs, HIPAA Claims Attachment, Quality Transparency, Pay-for-Performance, Universal coverage to name a few evolving business model shifts from organization centricity to patient centricity, entitlement-basis to outcomes-based, and a retail product/service model including a consumer-usage-driven healthcare model to name a few

Some of the information integration problems that need resolution to support healthcare interoperability include:

	Ontology integration/mapping (e.g. SNOMED to ICD-9-CM/ICD-10-CM)
	“Wide area”, secure, auditable, fault-tolerant data federation supporting a declarative query language, for interoperability on the community, regional, and national levels
	Fast, semantics-aware XML data transformation (e.g. HL7 v2.x -> HL7 v3 CDA) and normalization using ontologies
	Fine-grained privacy policy specification and enforcement within and across HIEs
	Tools to help users define favorite subsets/transformations of existing ontologies through which they prefer to query/retrieve data, based on already-defined atomic

Business Domain Expertise:

PluralSoft combines years of Information Management experience along with healthcare domain expertise to deliver solutions to any healthcare organization by leveraging our proprietary solution frameworks and our technology partnerships.

A sample of our domain expertise is:

	re-engineering claims processing platforms for a payer
	building the next generation specialty case management solution for a payer
	delivering an medical chart portal for a transcription services provider
	delivering an EMR with clinical analytics for an IPA
	delivering financial and clinical analytics for an IDN
	delivering HEDIS™ reporting for a payer

Our Solution Framework:

We leverage our Information Analytics Framework in delivering data warehousing, business intelligence and analytics solutions to our healthcare clients. The components are:

	An integration engine framework :
	Conversant in multiple healthcare protocols such as multiple flavors of HL7, HIPAA X12 transactions and NCPDP Based on Channel Architecture, with each channel consisting of originating and terminating endpoints which can be a combination of TCP/MLLP, SOAP, RDBMS, File system, JMS and FTP/SFTP. Each channel in turn can have an arbitrary number of filter and transformers to transform the incoming message. A simple and robust ESB (Enterprise Service Bus) with requisite security and audit trail
	Clinical Data Repository modeled using HL7 RIM and combined with years of creating flexible and normalized data model
	A Controlled Medical Vocabulary system to normalize concepts and to cross-reference medical code-sets across competing standards
	A Meta-thesaurus to link the code-sets in pre-defined ontologies
	Flexible data warehouse models which is populated by the Integration Engine, to link clinical, administrative and financial information to provide hindsight, insight and foresight into operational business intelligence
	Web based reporting tool to enable information visibility to the right stakeholder at the right time with secure access
	A patient portal with access to consolidated personal health records, collaboration with clinicians in various settings, related consumer analytics and the like to support consumer/patient-centric business models

Our Technology Expertise:

PluralSoft staff has expertise in various technologies whether open-source or closed-source and collaborates with our technology partnerships to deliver Information Integration solutions to healthcare organizations faster, better, cheaper.

For more information on how PluralSoft can help you overcome information integration challenges in a healthcare environment, please contact us.