CentraCare Health System

CentraCare, based in St. Cloud, Minnesota, is a collaborative group of healthcare professionals in a delivery network that includes hospitals, long-term care facilities, clinics, and specialty care services. St. Cloud Hospital, a part of CentraCare, recently received the Thomson Reuters Top 100 Hospital award for the fifth consecutive year.

Key Benefits

  • Connecting Epic EMR to affiliated physicians
  • Saving 1.5 hours/day formerly spent correcting errors
  • Gained control over message sequencing & delivery

When CentraCare deployed a new electronic medical record (EMR) system from U.S. based Epic Systems, it expected many benefits. But it also knew that this deployment would create some problems for its legacy interface engine, eGate.

  • When eGate sent Epic’s order message to CentraCare’s laboratory information system, the lab system sometimes “errored out”. The problem was that eGate sometimes delivered Epic’s admissions message, which contained the visit number the lab system needed to properly process the order, after the order message. CentraCare needed a way to control the sequence of message delivery from Epic.
  • With CentraCare’s strategic drive to strengthen connections with external physicians by offering them use of its Epic EMR, the organization noted even more limitations within eGate. “We needed to interface with the wide variety of information systems the affiliated physicians already used, and get that data here into Epic,” explains Amy Porwoll, Chief Information Officer at CentraCare. “But there were limitations in what eGate could provide us.”
  • To overcome these and other limitations, CentraCare considered following the eGate upgrade path, which would include rewriting all existing interfaces, or looking to the marketplace for a replacement.

    Upgrading to InterSystems Ensemble

    “Once we decided a new solution would be in our best interest,” says Porwoll, “we looked at what other organizations were using and what they were saying about these products.” After narrowing the field down to three, CentraCare engaged InterSystems in a proof-of-concept project using the InterSystems Ensemble® rapid integration and development platform. With Ensemble, the integration team was able to quickly create the interfaces with external systems that couldn’t be done with eGate.

    Ensemble’s rapid development environment, performance, and rich feature set, including its embedded InterSystems Caché® database, were driving factors behind the successful proof-of-concept project and the decision to make Ensemble CentraCare’s enterprise-wide integration platform.

    An embedded database. Fewer problems. Higher productivity.

    CentrCareCentraCare found that Ensemble’s embedded database and HL7 Sequence Manager ensured that messages from Epic arrived in the correct order at the laboratory information system. “Ensemble solved the message timing problem we were having,” notes Luke Rieland, Coordinator of Ancillary Systems at CentraCare. “And it’s saving us about ninety minutes every day that we used to spend correcting those errors. It’s giving us more time to spend on the high-value projects.” Rieland also noted the benefit of Ensemble having an embedded database. “Having a fast embedded database made it possible to do the message sequencing we needed. Because of the high volume of data crossing the order interface, we wouldn’t want to do this sequencing if we had to query an external database. It would slow things down too much.”

    CentraCare gets the benefits of an embedded Caché database without the costs other databases would incur. “Initially, I was apprehensive about having an embedded database in Ensemble,” explains Porwoll. “I thought like other databases it would require maintenance by an administrator. But that’s not the case at all – the database in Ensemble just runs.”

    Taking full advantage of Epic with rapid interface creation

    Ensemble solved the message timing problem we were having. And it’s saving us about ninety minutes every day that we used to spend correcting those errors.

    Luke Rieland, Coordinator of Ancillary Systems

    With the upgrade to Ensemble, CentraCare is taking full advantage of its Epic EMR. They’re quickly completing new interfaces with departmental systems, directly integrating data from medical devices, and accessing the data within Epic and other systems in innovative ways. “We migrated 120 interfaces from eGate to Ensemble in about five months,” notes Rieland. “We like Ensemble’s ease of use and how quickly you learn the ins and outs. Also, even though it’s easy to use, you can still do some hardcore programming.”

    Ensemble powers strategic initiatives

    Ensemble has given CentraCare the power and flexibility needed to carry out its strategy for integrating affiliated physician systems with its Epic EMR. “We’ve already gone live with some providers,” says Porwoll, “and we’re finding that Ensemble provides smooth connection with outside systems.” For example, one provider had all of its data in flat files. With Ensemble, CentraCare easily turned that information into HL7 messages and brought it into Epic. “With eGate we wouldn’t have been able to do this,” notes Porwoll. “This ability to communicate between disparate EMRs is what everyone is looking for.”

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