Every so often, an organization must look to evolve its application infrastructure. One of the essential elements of this infrastructure is Enterprise Application Integration (EAI) environment. And in healthcare, the middleware or interface engine is the heart of the EAI strategy. Introducing or replacing an interface engine in this environment can be a daunting and expensive task. But when IT chooses and implements the right solution, the benefits to the organization can be amazing.
Middleware in the healthcare provider market has long been dominated by two or three vendors with mature products. Over the past few years however, acquisitions, consolidations and new technology have led some to question which direction should they take when buying or replacing their middleware platform.
As with any system selection, a thorough understanding of the things to look for in a vendor and their offerings will allow your organization to choose the most appropriate, cost effective solution that will serve you for years to come. Aside from feature/function, there are other things to consider. In this article, I have outlined some of the common considerations when selecting a middleware vendor.
Feature/Function
The basics must be covered to even entertain a vendor solution today. For healthcare providers the minimum requirements would include:
· Guaranteed Message Delivery
· First In/First Out message process (when required)
· Support for standard communications protocols like SNA, TCP/IP and File Transfer
· Native support for messaging standard such as HL7, ANSI X12 (HIPAA), and XML
· Support for database connectivity via ODBC
· Support for Web Services
Based on existing and emerging industry trends, the following could arguably be considered requirements from today’s technology:
· Open architecture such as JAVA, C++, VB
· Ability to run on multiple hardware and OS platforms
· Able to run in the prevailing high-availability models
· Availability of complete libraries of standard messages structures
· Support for source control and version management
· Ability to customize communications clients
· Centrally managed administration and configuration
· Alert notification mechanism
Scalability
There are many paradigms utilized in the available tools today from traditional Hub and Spoke to Federated, to Peer to Peer. The size and complexity of the organizations business model often dictates this requirement. A stand alone hospital running a single vendor solution with limited outside interface requirements simply does not have the same requirements as a multi-facility, best-of-breed Health Care Organization (HCO) serving as a regional reference laboratory. All paradigms can be made to work, but have obvious implementation considerations that affect complexity and cost.
Skill Availability
Regardless of any vendor claims, no middleware package can be learned with proficiency in a week. Although most solutions require substantially less programming for typical interfaces than in the past, all solutions are simply technical tool kits that enable the integration process. Access to quality training, the local recruiting environment, and the availability of vendor or third party resources is important in a product selection. Things for consideration include:
· Is the technology used proprietary or open? Will I be able to find these skills in my geographic area?
· Does the vendor supply quality training at sufficient frequency for the engineers and management?
· How robust is the vendor’s professional services organization or can I find third party consultants when needed?
· Are there other large and aggressive organizations in my geographic area that will hire away my trained and productive staff?
Security
HCO’s continue to identify and remediate IT security risks. Often forgotten in this process are the middleware tools. The very tools designed to break the barriers of application limitations and responsible for business content connectivity and delivery. Not to mention, they are themselves applications, and should be evaluated and secured just as any application in the enterprise. Vendors should be able to confidently address their solution’s security model and available technology to enable secure communication with internal applications and external trading partners.
Community Support
Never underestimate the benefits of an active and open user community. These communities or user groups can be of immense benefit to the engineering and support staff throughout the life of the solution. The activity and openness of the community and the vendor’s support can be instrumental in the solutions success. You can evaluate the effectiveness of these communities by answering the following questions:
· What is the activity level of established user groups? ie. Code and library sharing, success stories, conferences, and open discussions.
· Does the vendor support the user groups by providing mechanism for collaboration?
· Does the vendor monitor and contribute to discussions?
· Does the vendor filter negative content in user group discussions?
· Are third parties, such as consultancies, welcome to participate?
Cost
Each vendor has a different model for solution pricing. Some offer enterprise licensing, some charge by connection, some have third party costs. As with any purchasing decision, be sure to consider the hidden costs with implementing a vendor solution. These include: hardware, third party development software, training, consulting, source control, annual support, database licensing, connections, etc.
Support
When the integration environment goes down, you need help immediately. When you have questions or problems about the product, you can’t afford to halt an implementation for a week or more. How effective a vendor supports its clients is critical in the selection process. Evaluate the vendor’s various support options and associated cost. Talk with other similarly sized organizations and their personal experience. Ask the vendors what support metrics they internally track and what their goals are. In the new era of the “electronic hospital”, the interface engine is the central hub of business process activity, and you must feel confident that vendor can support the organization adequately.
Each of the leading middleware vendors can get an HL7 message from point A to point B. That is where the similarities end. The vendor’s focus and strategy, product architecture and functionality, ability to support their customers, and cost differ significantly. There is a best choice for each organization, understanding these aspects can help your organization make the right choice.
Santa Rosa provides expert assistance in assisting our clients in making the right technology choices. Please let us know if we can be of help to you organization.
Dan Rounds, Associate Partner