How to Pick the Right Healthcare Interoperability Solution(s)

Leveraging the Untangle Health Interoperability Vendor Analysis Framework

An Untangle Health Thought Leadership Production, written by Adam Norris

With the explosion of investment in digital health solutions over the past few years, the opportunities to improve patient care and derive meaningful insights from healthcare data have grown at an incredible pace. Alongside the ever increasing number of innovative solutions, a tangled ecosystem of interoperability vendors have sprouted out of start-up and big tech companies as complementary offerings. While many interoperability vendors claim to offer plug-and-play / one-size-fits-all / easy-button solutions, I can tell you from firsthand experience things are rarely as simple as sales and marketing folks make them seem. To make sure you (as a technology, provider, payer, pharmaceutical, or other healthcare buyer of these solutions) are maximizing the value of your investment, there are a number of critical considerations to ask (and/or do diligence to answer) to both: 

  1. ensure you are clear on the goals you aim to achieve, and 

  2. identify the vendor best suited to make these goals a reality.

To help untangle the web of interoperability options and cut through the sales and marketing mumbo jumbo, my business partner (and Untangle Health co-founder) Chris Notaro and I put together the following framework to help you evaluate interoperability capabilities like the savvy buyers we all strive to be. To learn more about the full framework or to get ideas about how Untangle Health can help you deliver a winning strategy, check out our What We Do page.

Untangle Health Interoperability Analysis Framework (partial view)

Untangle Health Interoperability Analysis Key Questions

Industry Focus & Expertise

  • Does the interoperability vendor specialize healthcare? Healthcare has many unique challenges and requirements, especially when dealing with the more popular EHR vendors (e.g. Epic, Cerner, etc.), so working with an interoperability vendor who was built to handle healthcare systems and all of its many (not so) lovable interoperability quirks, will increase the likelihood your strategy matches your end solution. On top of this, going with a company with extensive healthcare interoperability expertise will maximize the potential to develop outside the box solutions to best solve your organization’s specific needs.

  • Is the interoperability vendor a technical leader outside of healthcare? Working with an interoperability vendor who is an integration innovator will pay dividends in the future by allowing you to stay ahead of the curve when it comes to new legislation, regulatory requirements, and client functionality requirements in a constantly evolving, industry-agnostic landscape.

Purchaser Priorities

  • Beyond the ability to enhance your offering, what is most important to you, the buyer, in deciding to go with one offering vs. another? This could include a multitude of factors such as the ability to support your use case effectively and efficiently at scale, the time and effort it takes to implement the solution, the total cost at scale, and many more. Articulating your objectives prior to entering the sales process, and evaluation interoperability solutions against them, will ensure you are getting the best solution for your needs.

Business Objectives

  • What is your current interoperability capability, and what are you looking to achieve with a new solution? The considerations for an organization looking to build out a core interoperability capability will be much different from those aiming to enhance their digital footprint across your enterprise or accommodate specific changes to their business at large. Being deliberate in determining exactly what you are trying to achieve before engaging with any interoperability vendor will help avoid selection bias (making a decision based on a limited or skewed set of data) and ultimately ensure the solution is a good fit for your distinct needs.

Usability

  • Who are the end-users you expect to build, implement, and maintain this solution, and does the interoperability solution align to this approach? Many offerings strive to be plug-and-play tools that can be set-up quickly and require minimal technical expertise. But those intimately familiar with healthcare interoperability know that this is rarely the case, and unless you have a deep bench of technical FTEs with not enough to do (and if you do, we should talk ASAP), the time, effort, and cost of bringing in the necessary resources can get out of hand quickly. Ensuring your technical staffing capability aligns with technical staffing requirements is another important factor to consider before taking the plunge with any vendor, especially when it comes to interoperability.

Offering Feature Sets

  • What does the interoperability vendor offer, and how does this align with your organization’s current- and future-state needs? There are many interoperability vendors, and they all offer something a little different (oftentimes, a lot different). Finding one that says it will meet your needs is easy, but going deep into their functionality and approach is important to ensure what you get is, in fact, what you need. Getting an in-depth understanding of capabilities (both out-of-the-box and custom configuration options), reference documentation available, security and regulatory certifications, and the level(s) of service they provide are all important data points that will help confirm your interoperability vendor is the best fit for your organization.

Supported Modalities

  • Does the interoperability vendor support the modalities you and your client systems leverage in the use cases you are looking to enable? Many interoperability vendors support API-to-API integrations, but other modalities (like HL7, FHIR, X12, and flat files, to name a few) are very common in healthcare and can cause significant functional challenges for otherwise straight-forward workflows. This is especially true for use cases that leverage non-API modalities but require real-time or action triggered activities. Knowing the modalities you and your clients will leverage (both today and in the future), and how the interoperability vendor can manipulate those modalities to enable the desired workflow, is essential to maximizing the value of your integrated solution. 

Deployment Types Supported

  • Does the interoperability vendor support the deployment strategy for you and your clients today, and in the future? More and more, we are seeing healthcare data being moved to the cloud. Yet many interoperability vendors in the healthcare space began when patient data was exclusively stored on-prem. Getting a thorough understanding of how your interoperability vendor’s solution can work (or not work) based on your deployment strategy today, and in the future, may be a deciding factor, especially based on the heavy lift required to set-up an interoperability solution between each player of your solution’s ecosystem.

Use Cases Enabled

  • What is the interoperability vendor’s track record for the use cases you are looking to enable? As we’ve discussed, many interoperability vendors will say they can do it all, and with enough time and effort (read: investment), this is probably true. In the meantime, you will almost always be better off going with an interoperability solution that has an established track record (read: reference clients) enabling the use cases you are prioritizing. Additionally, understanding where past interoperability experience can be applied to future use case success can be challenging, so having a trusted advisor with your best interests in mind can be a real game changer – both reducing the risk of going with the wrong vendor for you and saving time in the evaluation process.

  • Is a deep discount worth the risk of going first? In life (as in healthcare technology), innovation and disruption are rarely achieved by the faint of heart. Even so, you’d be hard pressed to find someone who doesn’t gain confidence after seeing someone else take the plunge and come out unscathed first. While interoperability innovators, especially start-ups, may offer significant discounts and loads of free services to a buyer looking to go first, be certain that you are aware of the all risks of going with an unknown player (i.e. someone who has never succeeded in delivering your high priority use cases), or a vendor venturing into uncharted territory (such as a company with success in patient engagement use cases expanding into revenue cycle workflows). Having a detailed understanding of your company’s risk appetite (across timing and cost, brand reputation, and workflow or feature goals), as well as your interoperability vendor’s resource availability (I’d have much more confidence in a Fortune 500 company than an seed-funded startup) is a good starting point. At the same time, be mindful that some scenarios are ripe for the taking. If an early stage interoperability start-up just raised $10M+ and you’re their only client, or you have the brand power to make or break their reputation to deliver, their success is your success, and vice versa. In some cases, being first can be worthwhile, but for most of us, choosing to go second (or third, or 25th) is a much more attractive option.

Closing Thoughts

As healthcare takes aim at digital transformation, interoperability is a growing necessity for organizations looking to unlock the value of innovative technical solutions. There are a number of offerings that are successfully filling this need, but most accomplish this in different ways that may work better (or worse) for your specific need. Don’t be afraid to think outside the box. In some cases, the best option for your business may be to work with more than one vendor to enable different capabilities or use cases. Achieving an end-state with multiple vendors can be an uphill battle, especially as salespeople are trained to say they are “the one” and startups will frequently offer free consulting and advice aimed at keeping you monogamous with them. As valuable as this advice often is, remind yourself that (like most B2B sales) just about everything terms-wise is negotiable.

While having a clear picture of your organization’s priorities and what it is trying to accomplish is important, it is only half the battle. The other half is arming yourself with the key questions and considerations to look out for as you navigate the many players in this space. The best way to avoid this pitfall is to invest in a trusted and experienced ally from the beginning, whose sole purpose is to look out for your best interests and priorities, regardless of the vendor (or vendors) you select. While true in many situations, this upfront investment is especially worthwhile in healthcare interoperability due to the high set-up and switching costs. Beyond this, bringing in someone who knows their way around will almost certainly save you money in your vendor contracts (and/or open the door for partnership rather than up front commitment, depending on the leverage you bring to the table). 

To begin the discussion about your organization’s situation and its specific interoperability needs, feel free to reach out at: Let’s Talk.