Zen Healthcare IT’s team has many creative and interesting discussions with our clients and potential clients about integration platforms and healthcare integrations. Most of these detailed and meaningful discussions are about how to effectively scale healthcare interoperability solutions for the long term, in a cost-effective manner.

We thought it would be helpful to share some of them with the broader community of organizations researching who might be the best interoperability partner for them.


What advice would you give to a healthcare organization (vendor, hospital, provider group) that is just getting started with a handful of integrations now,  but will need to be able to scale to many more in the future?


We understand that budgets and resources for interoperability projects are limited and that can make it challenging to set yourself up for success later. Zen’s approach is to offer solutions that are priced to scale with organizations as they grow, offering a very low “entry” price point for the Gemini Integration as a Service platform ($385/mo), and only charging for the professional services work needed immediately. 

In addition, we always seek to design “rinse and repeat” type integrations, to the extent possible. For example, we can connect once with a healthcare vendor’s API, and then leverage that single connection to create many different integrations with other systems. That is much more cost-effective than a lot of “point-to-point” interfaces. New data standards like FHIR are becoming more common and often required to get connected but for many organizations that don’t have the ability to provide data in these formats, we can easily help bridge that gap. 

Each organization’s needs and capabilities are unique, so we offer a “hands-free” model, eliminating the need for interface engineers on staff, and then later move to our “hands-on” model when organizations grow large enough to want to hire dedicated team members. We also always offer the opportunity to “surge” with Zen’s talented professional services team extending the capacity and capabilities of internal interface teams.


What are your thoughts on Cloud Hosting for Interface Engines / Platforms?


Many of our potential clients have considered putting an open-source or commercial interface engine in the big box hosting vendors such as AWS, Google, or Azure. There are many considerations that weigh into this decision, but here is Zen’s advice:

Interface engines do not like latency – and that is an issue. You should not assume that intra-cloud solutions on public cloud platforms won’t have latency issues, because the demands of healthcare data applications can often lead to performance issues. The solutions are not often easy to diagnose and solve as there are many factors that can contribute to significant latency issues (public cloud internal failings, narrow pipelines between data centers, poorly tuned cache’s ect.). Sometimes – message volumes within single feeds are high enough to create instability within a given instance, which means a lot of engineering time troubleshooting your environment.

Getting better database (IOPS) performance usually requires a more extensive investment in your cloud configuration, with dedicated capacity rather than the elastic scaling most people use as a justification for moving to the cloud. We strongly recommend that you consider a private cloud solution custom-built for healthcare messaging.

Security, security, security!  Integration Platforms bring their own special security requirements that grow over time. Two-factor authentication, Firewall management, VPN setup / maintenance, and certificate management are just three quick examples.  Be sure to factor this into your planning for resources and costs! (We factored those into our Gemini solution – along with the other critical controls required for HITRUST.)

Monitoring / Alerting are absolutely essential for day-to-day management of an Interface Engine / Platform. This is true both at the infrastructure level and at the interface level. How will you know if your instance is actually up and running?  How will you know whether an individual interface is up and running?  How will you know if an issue might be getting ready to happen that will interrupt your message flows (early warning system)?

We could go on – but what’s important is that you look for a purpose-built cloud solution that has already addressed all these important issues / challenges above. Gemini has all of these important aspects covered and we are happy to explain them in more detail.


I already have interface engineers, why do I need Zen?


Even if you have an internal team, it is important to provide them with tools that enable them to succeed. We have some great tools built by expert interoperability engineers for interoperability engineers that allow your team to be more efficient and understand what is happening with interfaces day-to-day at a much deeper level (Zen Insight). 

Also, with Gemini Developer, your team can leverage Zen’s proven, secure, private cloud environment, which allows your internal teams to focus on fast-tracking integration development projects, versus building, managing, optimizing, and securing the environment itself.


Could Zen act as a replacement for my internal interoperability (integration) team?


Absolutely, it certainly brings more stability and flexibility. We talked to a number of smaller organizations, vendors, and rural hospitals that struggle to maintain internal integration staff due to turnover, illness, or just scarcity of good knowledgeable resources. When that one critical individual who built the interfaces leaves, it can be difficult to bring someone else in quickly, and then even harder for them to get up to speed with existing interfaces / interface code.

Zen is already managing a large volume of interfaces today, along with the integration infrastructure. So whether you want to use Gemini and let your own interface engineer(s) manage the day-to-day interface management tasks and use us for “surge” capacity, or look to Zen as a 100% outsourced solution, Zen’s got your back. You need help, just call Zen.


Why should I choose Zen as my Interoperability Partner?


A common, but very important question! Here is our answer:

Flexibility (we meet you where you are)

While some interoperability providers position their solution to be very easy and straightforward (just write to our API!), the reality is the “API only” approach means that you can only do what their API does. Or, they may provide a hosted integration engine, but there may be gaps in messaging standards supported or the extent of professional services help you can obtain. Zen’s Gemini solutions are designed to give you a complete set of options and cover any type of healthcare messaging need, including flat files, EDI, HL7, IHE, FHIR, and other API-based exchange.

One-to-Many (Gemini is a hub with pre-built connectors)

Whether you want to connect to a national network (like Carequality), or a state immunization registry (Covid and other vaccines), an HIE or a registry, Zen has a number of prebuilt connectors to many existing networks, EHRs, HIEs, and public health agencies. So half the work is already done! This reduces costs and speeds implementation timelines.

Scalability / Security (so you transfer those risks to us)

Our purpose-built healthcare messaging infrastructure is optimized to scale to very high message volumes with HITRUST CSF-level security controls. So whether or not you actually have high message volumes, you’ve got an enterprise-class solution you can trust.


Here at Zen Healthcare IT, we have one singular focus: Helping you focus on your core mission by bringing purpose-built technology and expertise to your team. Our approach is to ensure we are flexible enough to meet you where you are. That is why we offer different versions of our Gemini Integration-as-a-Service Platform and offer flexible integration patterns. Our goal is to remove your interoperability obstacles with solutions that meet you where you are and utilize the data formats you already support.

We truly love the great conversations we have every day with our colleagues, potential partners, and clients who are working so hard every day to push healthcare forward through health information exchange. We hope that by sharing our most frequently asked questions, we help make your journey to a more interoperable healthcare system simpler. That is exactly what we are here for.


Zen Healthcare IT Case Study


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