The University of Louisville Hospital was managed by a partner organization and, consequently, all IT services were provided through the partner organization as well.

When the hospital board made the decision that, effective July 2017, the hospital would leave that partnership and operate independently, staff knew they would need to set up the technical infrastructure to continue operating efficiently without detriment to or the disruption of patients.

THE PROBLEM

“This was going to be a huge undertaking as we were essentially starting from scratch, and there were over 100 University of Louisville Hospital interfaces on our partner organization’s engine,” said Darren Powell, director of interoperability at the University of Louisville Hospital. “We needed to very quickly stand up our own engine and ‘lift and shift’ these interfaces to our environment.”

PROPOSAL

University of Louisville Hospital went live with Rhapsody as a Service in early 2018. Rhapsody is a healthcare interoperability and data connectivity technology and services vendor. RaaS, powered by Amazon Web Services cloud technology, provides the hospital with rapid and scalable interoperability capabilities, connecting disparate technologies within the healthcare system and moving them to the cloud.

“We evaluated three interface engines: Open Link, Cloverleaf and Rhapsody,” Powell explained. “We ultimately selected Rhapsody based on the considerations of project duration, risk and cost of transitioning our interfaces. RaaS, hosted in the cloud, offered an interoperability platform that supported rapid migration and deployment of previously created interfaces, all while meeting the strict security and disaster recovery needs.”

MARKETPLACE

There are many interface engines for healthcare organizations on the market today. Some of the vendors of this technology include Cloverleaf, Corepoint Health, Dynamic Health IT, Infor, Interfaceware, InterSystems, MuleSoft and Open Link.

MEETING THE CHALLENGE

The University of Louisville Hospital is using RaaS to distribute files, reports and HL7 messages throughout the organization, as well as to and from outside organizations. After determining the memory and disk space requirements, RaaS was installed into Amazon Web Services, and the hospital established a VPN connection to the RaaS server.

“The Rhapsody implementation team then created and configured initial user accounts for UofL Hospital, and customized the delivery settings for notifications,” said Powell. “UofL Hospital installed the integration engine configuration files which were supplied by the previous organization and the networking team established the network address translation rules to ensure the EHRs and ancillary systems could interface with Rhapsody via the existing VPN connection.”

"The RaaS service allowed UofL Hospital to quickly deploy and migrate 95 interfaces from the former partner’s engine and to develop new interfaces to support the Cerner implementation, this all while building more than 25 net new interfaces in a four-month period."

Darren Powell, University of Louisville Hospital

Once appropriate variables for IP addresses and ports were modified, RaaS established connectivity to these systems, allowing for quick implementation and testing without disrupting the hospital’s service, he added.

RESULTS

The hospital has been able to use RaaS to send hundreds of millions of messages both internally and externally. For example, between University of Louisville Physicians Group and the Kentucky Health Information Exchange.

“The hospital has also set up what is, essentially, an FTP engine on top of RaaS to distribute custom reports via FTP and secure e-mail to recipients,” Powell explained. “The RaaS service allowed UofL Hospital to quickly deploy and migrate 95 interfaces from the former partner’s engine and to develop new interfaces to support the Cerner implementation, this all while building more than 25 net new interfaces in a 4-month period.”

Since that time, the hospital has added an additional 100 communication points to its production environment, all while staying under budget for the entire duration, he added. Further, engine uptime has exceeded 99 percent, he said.

ADVICE FOR OTHERS

Powell advised that healthcare organizations should let an interface engine vendor handle the hardware, security and disaster recovery concerns while the hospital team stays focused on building interfaces and day-to-day operations.

“The RaaS option allowed us to work with the Rhapsody sales team to create the economic model that we needed as a 3,000-person start-up company to go ahead and deploy the product without having to make major investment here locally in data centers, hardware and a Linux administrator – things that would have slowed us down and required a large amount of capital upfront,” he concluded.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com