The question of whether a healthcare organization should use a best-of-breed approach to health information technology or convert to a fully-integrated solution is a tricky one—and something hospitals and health systems have wrestled with for a long time. As interoperability between systems is crucial, it often requires organizations to choose which system is more suitable for them and their needs. These organizations, particularly those expanding to provide greater care coordination for their patients, are facing new challenges as they need to track patients wherever they are cared for, whether in a post-acute setting or in the comfort of their own home.

Consider, for example, the complex, detail-rich patient discharge process. Although an integrated solution may house patient clinical and financial data that are essential for the discharge process, other solutions may not be able to fully match the patient with the most appropriate post-acute setting or enable timely and data-driven care transitions. On the flip side, a legacy care coordination software may foster a better transition, but it may not be able to capture all the necessary clinical and financial information as easily as an integrated tool could. Because the discharge process has many moving parts, if the legacy solution doesn’t merge with other health information technology systems, there is a greater chance key information could be lost in the transition. Additionally, simple tasks, such as logging on to the care coordination tool or sending specific patient data to other settings can become quite onerous. If the process is too difficult, then staff may start to skip critical steps, resulting in less than optimal use of the technology and subpar care.

Weighing your options

On one hand, remaining with a legacy system that incorporates many customized solutions allows an organization to sustain a high-degree of functionality across a number of diverse areas. The technology can dive deep into tasks, supporting detailed processes that generate strong data and foster patient-centered care. However, oftentimes these vertical offerings may not fuse well with each other, making it difficult to be or remain interoperable and share information between providers and across settings, further resulting in duplicative workflows, challenging reporting and care gaps. In addition, upgrading or switching systems can be immensely cumbersome, time-consuming and expensive.

On the other hand, with an integrated solution, organizations can maximize the technology to ensure information and data flow freely across the system, leading to more streamlined operations, tighter reporting and robust analytics that facilitate problem identification and resolution. However, because this kind of technology addresses multiple priorities at once, it frequently only scratches the surface on certain processes and procedures, potentially resulting in a decrease in performance or the need to add bolt-on products to keep things status quo. Furthermore, integrated solutions can affect productivity while users are re-trained or have to take the time to learn a whole new system. This can slow down processes that were once user-friendly or limit user capabilities until they feel up-to-speed on the technology. Additionally, beyond initial up-front costs, there can also be unexpected fees and additional charges for implementation, staff training and extra support.

The Department of Veterans Affairs is the most recent high-profile organization to tackle this choice, opting to replace its legacy system with a market-leading integrated product that allows for more seamless information sharing across the agency and with the Department of Defense. Although there are significant advantages to the move, there are also potential challenges the agency will have to navigate.

Realizing the best of both worlds

Although the debate surrounding integrated solutions continues, organizations seem to favor the larger health information systems’ technologies. In fact, the main two vendors in the market serve more than 50 percent of today’s hospitals and health systems, and that number appears to be growing. If an organization is debating on switching systems, it will have to make a choice, legacy or best-of-breed. One idea to help sway the decision is to look for a system that prioritizes interoperability and integration and that maximizes value and throughput. When solutions directly interoperate, they can provide top functionality, allowing entities to take advantage of the best aspects of each kind of technology, further ensuring high-quality care while reducing costs.

Revisiting the care coordination example mentioned above, if an organization seeks software that is able to seamlessly integrate with the horizontal technology, the care coordination tool becomes part of everyday workflow. Imagine a care coordinator who is working in an integrated electronic health record and with a mouse click, easily launches the care coordination solution. The screens look similar and the staff member may not even be aware that he or she is “leaving” one technology for the other. With a few more mouse clicks, providers can securely and safely send out patient information and queries to potential post-acute providers, receiving responses about various organizations’ availability in a matter of minutes. The care coordinator can even send key information from the patient’s medical record to the post-acute facility before the patient leaves the hospital, so the post-acute provider can prepare for the patient’s arrival. This can expedite a seamless care transition, reducing the likelihood of gaps in care or missed treatments that can lead to an unnecessary hospital visit.

As the market continues to shift and vendors continue to make those difficult decisions whether to stick with their traditional system or switch things up, it’s important to determine which type of software will best meet their needs and budget in the long term, but more importantly which system will help deliver the best care and patient outcomes.

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In his role as President and CEO, Luis Castillo has responsibility for all aspects of the company’s product development and delivery, as well as its financial performance and growth. "Lu," as he is affectionately known, joined the CQuence team in 2014, and assumed leadership of Ensocare a year later. Prior to that, he spent more than a decade working in various senior-level IT sales, service, marketing and business development roles for Siemens Healthcare. Lu has deep experience in product life-cycle management, supply chain management, customer relationship management and alternative markets. Lu is a sought-after participant in strategic initiatives and global partnership efforts. He earned his Bachelor of Science degree in political science from Haverford College in Pennsylvania.

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