EHR Integrations 101: How to Avoid Common Pitfalls

EHR Integrations 101: How to Avoid Common Pitfalls

Adding a new software tool to your practice comes with its share of logistical hurdles, however, it does not need to be painful. At Mirah, we have completed integrations with a wide range of electronic health records and can offer some practical guidance to help you think through what is involved.

1. What Is an Integration?

An integration is simply a way of moving data, like a pipe moving water. For a tool like Mirah, we need to know about patients, providers, and appointments so the platform can understand who to measure, how to measure them, what to measure them with, and when. That data almost certainly already lives inside your EHR, and most EHR platforms have a standard method for vendors to access it.

Start by checking whether your new tool already supports your EHR. If so, the integration will be significantly easier and may even be turnkey.

If your new tool does not already support the EHR, there will be more to navigate. Your IT team will need to coordinate with the tool vendor to either build a new integration or find another path for moving the data. This adds both time and risk to your implementation.

Pro tip: Check with your tool vendor and your EHR as early as possible about how they intend to exchange data. If a new or bespoke integration needs to be created, expect it to take substantially more time and budget. Many vendors can also exchange CSV files as a generic method when a direct integration does not yet exist, and this approach is often all that is needed. 

2. What Data Do You Need?

This depends on what the tool does. As an example, the Mirah platform sends assessments that need to be linked with actual appointments for a specific provider. That means we need to know who your providers are, who the patients are, and when their appointments are scheduled. Other tools may need access to different data.

You will want to confirm that all of the necessary data is already present in your EHR. If it is not, you will need to determine whether it can be added to the EHR or whether it will need to come from a different source. Your vendor will likely know how to access it, but every additional platform that becomes part of the integration adds complexity, risk, time, and cost. Keep in mind that there will likely be HIPAA considerations with this data, so be sure to check with your legal team to confirm that all appropriate requirements are met before any data access is granted.

Pro tip: Take time to verify that you have all of the data your new tool requires. This may mean looking at specific fields on a record, such as making sure you have consistent patient names, dates of birth, and other identifiers. Data tends to be messy, and the more consistent it is, the fewer post-integration problems you will encounter. Inconsistent data will eventually surface as unexpected bugs.

3. Is This Integration Bi-Directional?

Many healthcare tools only need to read your data and do not need to update your EHR with any information at all. Others, however, will write data back to your EHR for your providers to view directly in that platform. As an example, some EHRs allow Mirah to write back patient assessment results.

This adds a new layer of complexity. Unlike fetching common record types (patients, providers, appointments), writeback behaviors tend to be custom-built. Each EHR handles this differently and will offer different options for what types of data can be stored and where it can be displayed. It is important to think through exactly what behavior is appropriate for your use case and to make those decisions early, before the integration work begins.

Pro tip: If writeback is necessary for your new tool, make sure you understand precisely how that data will be written back and where it will appear inside your EHR. A writeback feature that does not actually surface data where your providers can use it provides no value.

4. Establish a Timeline

Your new tool integration will almost certainly run in parallel with decisions about how the tool will be implemented within your clinical workflows. Make sure you understand the full timeline up front. If the integration is going to take three months to complete, your new tool may not be usable until that work is done, and that needs to be factored into your implementation plan. Be sure to discuss any timeline tradeoffs with your vendor so they can communicate the impact of different options.

Pro tip: Most integrations will require some form of initial data load as part of the setup process, such as fetching all current patients. Some EHRs have complexities around pulling this initial dataset, as it can be quite large. Make sure this step is accounted for in your timeline.

Conclusion

Integrations can feel intimidating at first, but with the right preparation, they do not need to derail your implementation. By clarifying what data is required, understanding whether the integration is read-only or bi-directional, and establishing a realistic timeline with your vendors and IT team, you can avoid many of the most common pitfalls. At the end of the day, an integration is simply a bridge that helps your technology work better for your providers and patients. The more planning and communication you invest up front, the smoother and more valuable the result will be.