Completing a Seamless Application Integration Experience

John Murray: When we went live with the application, it worked. They all stood around and said, "Wait a minute, we're live? Where's the crisis? Where's people running around with their hair on fire?"

Host: That's John Murray, national accounts manager for Clinical Computer Systems, the developer of OBIX. In this episode, he walks us through the process of developing an integrated app that makes it easier for nurses to document information at a patient's bedside and provide a higher level of care.

John: He didn't have to have his interface analysts spend days testing the interfaces between our two organizations. That was already completed by OBIX and MEDHOST.

Host: This is Health IT on the Record, presented by MEDHOST, a show that dives into how health information technology innovations impact every aspect of a health system, from multi-hospital networks down to individual patients. John outlines how a spirit of collaboration allowed his team, in close partnership with MEDHOST, to work through the scenarios clinicians face day after day. Enjoy the conversation.

John: Hi. My name is John Murray. I work for Clinical Computer Systems, the developer of the OBIX Perinatal Data management application. My role is the national accounts manager and I oversee the relationships between large IDN entities within healthcare, as well as our relationships with our different EHR vendors.

Host: Welcome, John. It's really nice to talk to you, because we've had the chance before to actually meet in person. It wasn't that long ago we were at the National HIMSS Conference. We got to meet over at the MEDHOST booth. We had the onsite podcast lounge  and you and I got to chat there.

So this is going to be a good follow-up conversation. And our purpose today to talk a little bit about the value of integration from the clinical perspective. And that's what you will be really speaking to from the OBIX perspective. And we've had some other conversations on this topic with this relationship between you all, with MEDHOST, so I'm excited to get this kicked off.

So how about we start first with just kind of giving us an illustration of what is happening at the bedside with mom and baby and just the overall scenario. And then we're going to really zoom in to what's happening behind the scenes after all the software's all rolled out and in place.

John: Sure. Just a proviso. I am not a nurse or an RN, so my clinical expertise is somewhat limited, but I can give an idea. I've been in this industry a while. What happens at the bedside is – the nurse is – her foremost responsibility is to provide adequate care to the patient, both mother and baby, as labor progresses.

What our role is, is we are the perinatal EMR. What we're doing is our integration with MEDHOST really sets us up as the perinatal EMR. Everything that's documented within the labor and delivery space happens through OBIX. And what we do through our system integration with MEDHOST is we send information between the two systems that is really seamless to the end user.

Our goal when we develop software, our goal when we're looking at these applications is to really make it easy for the nurse to be able to document, but first and foremost, to provide that high level of care that everybody expects when mother comes in to deliver her baby. We spent a lot of planning, a lot of development work, and a lot of testing in order to provide this seamless integration at the bedside, and I think a great example of that is the single sign-on with patient context.

Host: Excellent. I love that overview. Kind of paints the picture of what is happening and a little bit about the why as well, because at the end of the day, it's all about creating the high-quality care for the nurse at the bedside.

So for having you on, I know you are not a nurse, and that's great, because in this perspective, we're going to be really talking more about the behind the scenes. What's happening with the software? What's happening when you can partner up and create something better together?

Take me now behind the scenes. So we just walked through a scenario where everything's working great. Everything's been rolled out. It's better care, but how did we get to that point? Can you rewind it there?

John: Yeah. What we did initially is we came together with MEDHOST, had some very high-level discussions with their executive team, and then based upon that, kind of the preliminary discussions, we brought our best people from OBIX. They brought their best people from MEDHOST, and then we did the scoping session of okay, let's look at different interfaces that we've done in the past. Can we do them with the technology that exists between the two organizations? So that was the first thing. We have to see if we can actually do these interfaces.

Once that was completed, we sat down with them and built the interfaces and then began testing. So, Clark, there's really a lot of work, behind-the-scenes work that goes into that, and there was a lot of sessions, testing sessions, development sessions, and trying this, and trying that. Sometimes it's hit or miss. It's trial and error. But at the end, it just works.

Host: It's like the magic at the end and the user doesn't know what goes into it.

John: Yeah. The magic just works. It's like if you pick up your phone and want to use an application, you don't know all of the development, the sweat equity, that went into that application. The application just works and you expect it to work. That's the same thing with the nurses at the bedside. Specifically, with single sign-on and patient context, they're basically working between two applications, MEDHOST and OBIX, and the single sign-on is a big win for the nurse, because she doesn't have to sign out of one system, sign back into another. It's all wicked together through this interface.

So that's a real time-saver, but more importantly, it is a real risk mitigator, because the nurse knows that if she's looking at patient Smith in MEDHOST, and she uses the single sign-on interface, she is looking at patient Smith's fetal strip information. And subsequently, if she changes over to another patient, it automatically, through all the back end, through all of the development that we did, changes that patient in context. So you're always looking at the right patient.

Host: That makes sense. I liked how you were starting to share some of those behind-the-scenes activities, the developing, the testing of different scenarios. So let's unpack that a little bit more. I know there's a lot that goes into it. A lot of the users don't know what goes into it.

So just for context, when you're going through that developing phase, and you're going through the testing, what are the kinds of issues that are getting worked on? How long does that process take? Why do you all – you as in OBIX and MEDHOST, why are you working so hard on that phase, and then, what kind of takes steps towards the actual launch and the implementation?

John: Yeah. I mean, when you're doing development work like this, you come in at the outset with assumptions. You assume that their software is going to be like other software that we've done development work in the past, and as you really dig into this type of integration work, you find out that's not the case. The real neat thing about working with MEDHOST is they brought an excellent team of people together, and we brought our best team together as well. We would many times sit in a room in Nashville and kind of go through different scenarios and try this, try that, and then we'd run up against some of these issues, because assumptions we made about their software were incorrect.

The neat thing about it is they always brought the development resources. They tested it out. They said, "Hey, would it be possible to maybe send the data in this format or that format?" And nine times out of ten, MEDHOST, after they looked it up, they said, "Oh, absolutely. Yeah, we can do that." So there was a real good spirit of collaboration that went on between the two teams and I think that's ultimately why the integration package that we have is as robust and as successful out in the field.

Host: Health IT on the Record is brought to you by MEDHOST. With over 30 years of experience, partnering with providers nationwide, MEDHOST is helping evolve better solutions for healthcare management through innovative workflows and technologies. For more information, visit www.medhost.com. Let's jump back in.

Host: Now let's zoom forward, zoom into the future when from the moment you're working on this, you're testing. You're throwing things against the wall and proving it, continuing to progress forward. Now, when you get to that implementation day, can you walk me through those steps before you go to actually implementing? It's a big deal, MEDHOST, OBIX at the facility. Walk me through what the outcome is.

John: Absolutely. One of the real benefits of the integration and the level of work that we did developing these integration points is the end user. There's very little input or resources that they have to bring to bear. All of these interfaces have been tested between OBIX and MEDHOST. We look at workflows. Every facility is going to have a different workflow, so we take into consideration the different workflows, but we know that the interfaces are tested, ready to go, and that's a real benefit.

And anecdotally, I can just tell the IT director, he was elated that he didn't have to have his interface analysts spend days, hours and days testing the interfaces between our two organizations. That was already completed by OBIX and MEDHOST. So that was one thing he actually said. He was amazed at how little amount of time and effort he had to dedicate from his team. Because let's face it, it's a smaller facility. Most of their IT people are doing a variety of different tasks, so taking those people to really focus in and work through deep levels of integration testing between MEDHOST and OBIX, it's a challenge for them.

And the good news was, we do all that behind the scenes before we even deploy it in their test environment. Now we certainly let the end user look at the system before we go live, but the majority of the testing between our two applications is completed and ready to go, and Rick Smith, the IT director, was just delighted at how little intervention he and his team had to have.

And even more so when we went live with the application, it worked. I mean, I think they all stood around and said, "Wait a minute, we're live? Where's the crisis? Where's people running around with their hair on fire?" That really didn't take place, because we do so much of the testing beforehand, that for us to take it from a test environment over to a production environment is – our goal is to make them as seamless and non dramatic as possible.

Host: I love that story. It all makes sense. And a moment ago, you were talking about the single sign-on and other features and other outcomes like that, that ultimately, it's going to save time. You talked about it being less risky. What else happened? When you do a successful deployment like this, when you can collaborate and do the testing in advance, what other outcomes are you getting?

John: We talked about an application, how it just works. And single sign-on is a great example of that. Single sign-on is seamlessly integrating two different applications. You don't have to sign out of one application and sign into the other. You're just seamlessly going back and forth between the two applications. It's a time-saver for the nurse. It's also a very big risk mitigator in the fact that you always know that the patient you're looking at, that's the fetal strip that you're making your clinical assessment.

Another component of this integration is the integrity of the medical record. That is paramount in the medical legal world is you need to ensure that what is being charted in OBIX is also reflected in MEDHOST. And integration that we've done maintains that integrity so you're not putting the hospital, the clinician, or the physician at risk of having something in MEDHOST saying something entirely different in OBIX.

Through that integration, through that development we did, it says the exact same thing, and that makes risk managers, and that makes executives feel very good about this type of integration and the fact that it helps to lower their risk profile.

Host: Makes sense. It's all about – I think you said this a moment ago – less end user drag, making this as seamless as possible. And yes. So I think that answers all the questions that I had today.

I really appreciate your perspective that you brought to this, kind of walking through the story why this matters, the value of the integration from the clinical perspective all the way down to really what's happening behind the scenes. So I really appreciate your time. I'm looking forward to reconnecting with you sometime again down the road.

John: Okay. Thanks, Clark. I enjoyed it.

Host: Thanks for listening to Health IT on the Record, presented by MEDHOST. For more stories and content like this, be sure to visit medhost.com/resources. Thanks.