Many healthcare organizations adopt a “best of breed” philosophy regarding their information systems. In many cases, they want the best practice management system for professional billing, plus the best EHR for clinical documentation, plus the best hospital PM/PA system for technical and facility billing, etc. Sometimes, they would rather implement one system that can do it all but due to financial constraints or contractual agreements, they are obligated to maintain their multi-system/multi-vendor environment.
In such complex integrated environments, it is imperative to maintain Single Source of Truth (SSOT) crosswalk documents to help the organization’s IT, finance, and operations teams connect the applications together. When integrating new practices or departments into the enterprise, it is especially crucial that the implementation teams understand how not to tangle those connections.
In a recent project, an organization attempted to transition newly acquired physician practices from legacy RCM and clinical systems onto their enterprise solution, which consisted of a diverse environment of practice management, clinical, hospital financial, and ancillary systems. Despite those enterprise systems being in place for several years, it was a surprise to learn that the organization had never taken the time to specifically document how all of their departments and locations in the source practice management system mapped to corresponding values in the downstream systems. The provider entries in the various systems had also not been reconciled, which sometimes caused interface failures.
As the project manager representing the practice management system initiating the visit/encounter process, I offered to create a catalog of master mapping (crosswalk) documents which would be used to design the application builds and connect each department, location, and provider in system A to the corresponding values in system B, system C, etc.
Once the various IT teams agreed upon the exact values that represented the “dots to be connected” in each system, project sponsors endorsed the mapping documents as the Single Source of Truth (SSOT) to be referenced for all implementation activities. The SSOT documents were then utilized by all teams to correlate application build mapping variables between the multiple RCM, EHR, and ancillary systems.
Armed with the knowledge of how the key data elements for each system reconciled to each other, the implementation teams could formulate detailed future state workflows, business requirements, technical cutover plans, and integrated testing scripts. Whenever interfaced transactions failed during integration testing, most issues could be easily traced back to values that were not in sync with the SSOT documents.
Maintaining current and accurate crosswalks and SSOT documents may seem like a no-brainer in an environment with multiple disparate systems that must communicate with each other. However, it can be tedious and time-consuming work and when time and resources are both limited, many organizations overlook its importance. Many hours of redesign, rebuilding, and re-testing could be avoided if time was spent wisely by first identifying critical integration points and connecting the dots.