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Ask the Expert: Epic Integrations

Epic. You know the name. You (or your customers) use the platform. But how exactly do you make the myriad of Epic applications work with your other technologies? Here to share his knowledge: Cyrus Bahrassa, Bridge Connector Senior Manager, Vendor Relations, and former Epic Implementation Director. 

In his seven years at Epic, Cyrus managed implementation projects from his home base in Madison, Wisconsin, as well as in five European and Middle Eastern countries. Now, Cyrus leads a Bridge Connector team focused on compiling knowledge and creating tools to facilitate efficient healthcare integrations.

Below, we share an exclusive interview in which Cyrus offers insights on Epic integration best practices based on his unique experiences. 

What are some of the different approaches to Epic integrations that you’ve seen?

Epic integrations are feasible through a variety of methods and technologies. For example, Epic supports both traditional, “tried-and-true” integration approaches such as HL7 interfaces, X12 interfaces, DICOM integrations, and also more modern applications and methods for integrations through APIs. 

Epic supports a sizable variety of FHIR APIs, but they also have some proprietary APIs to help address concepts and workflows that FHIR doesn’t accommodate. 

Where are these different Epic integration options available?

There are some API integrations available through what they call their Epic on FHIR program that basically gives you access to FHIR APIs. This is how you can retrieve the data classes required by the ONC, the Office of the National Coordinator of Health Information Technology. Epic App Orchard gives you access to additional APIs beyond Epic on FHIR. 

For instance, our app Patient Create automates patient creation in Epic through the intake process. If your new patient intake workflow begins outside of Epic, this app will seamlessly bring those patients into Epic and ensure they are ready for downstream processes like scheduling.

How can you overcome common Epic integration challenges?  

I’d say the hardest part of an Epic integration isn’t the actual execution, but figuring out the best way to integrate according to unique workflows and business needs. At times there’s almost an alphabet soup of terminology out there that can be very confusing for somebody who is not intimately familiar with it.

To truly address business challenges, you need to understand your workflows and what you need from your data. You can do this by asking yourself:

  • What data do you need to flow in and out of Epic?
  • What frequency do I need data delivered and when do I need it?
  • What user is participating in this process? 
  • What is the ideal experience for the user, both in my application and in Epic?

If you level set there, then the rest flows naturally.

With large software platforms like Epic, it can be challenging to get in contact with the right people to execute your integration - especially if you don’t know specifically what you need to integrate. Not to mention that Epic works with many large health systems that have numerous software systems and complex workflows, which can make it even more difficult to orchestrate an integration.

If this is a significant challenge for your organization, an integration vendor like Bridge Connector can leverage existing relationships with EHR vendors to move your project along more expeditiously. 

What should you avoid when integrating with Epic?

Integrating with Individual Modules: Historically, there’s been a lack of interoperability within healthcare IT, even between systems owned by the same vendor. Epic has taken a different approach where they never acquire other companies and other software. They always develop their own. 

The advantage of that is that they have been able to build a highly integrated system where there may be multiple modules that you experience and see as a user, but all modules are based on a single platform in a single database. 

siloed data base model showing multiple modules feeding one integrating system
single database model from epic with one database feeding integrating system

So all that data is unified and shared among all the different modules. When we do our integrations, we’re connecting at that database level, not at the individual front-end modules. 

Adding New Technology during an Epic Install: Epic installs are a beast – one of your proudest accomplishments when it’s all done, but a massive undertaking nonetheless. Adding new technology in the middle of an install only complicates the implementation in progress. That tends to be a really big lift.

I recommend getting Epic live first and then integrating other applications. That may not be the right approach for everyone, but in general, having Epic live will allow the organization to solidify their workflows and more accurately pinpoint their integration needs.  

How do you plan for an Epic integration?

Let’s say we figured out the technical pieces, but how do you actually pull it off? The best piece of advice I can give you is to build a strong, collaborative team with a detailed project plan that outlines both time and budget requirements. This means making sure you have the right people staffed and the right time budgeted as soon as possible. You can expect a large variety of people to be involved both on your side and on the Epic side. 

If you’re working with another vendor partner like Bridge Connector, you’ll have that team involved to help you coordinate all the moving pieces and to help you get your foot in the door. 

Expect to work on the technical end to make sure that communication between applications can actually happen. For example, if you’re leveraging APIs, you want to make sure that the Epic server can talk to your server and vice versa. 

And there are some important things around credentials, public and private keys and certificates, et cetera, at a technical level that need to be figured out and put in place to ensure implementation success. 

Any tips for long-term success?

You want to make sure you have allotted time, not only for the configuration of the Epic integration, but also for testing. Epic organizations, in my experience, are extremely diligent about testing and want to make sure that there will be no adverse impacts to other workflows or downstream systems.

Also, ensure that you get user buy-in. I’m a firm believer in user acceptance testing (UAT) because it offers the opportunity to get real-world feedback from those who use the technology most frequently. Not only does UAT improve the quality of the final solution, but it also helps you proactively find issues and reduces the likelihood of problems down the line. Once you’ve completed this step, you’re ready to go live.

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