I agree with a lot of what’s been posted.
Although we don’t integrate to your receiving systems – I’ll assume you know them quite well. 🙂 I’ve got a lot of experience interfacing to/from HOM(HCI, HEO, HEC, HED, etc…). All of these are applications that sit on the McKesson clinicals infrastructure (HCI). All use a single interface “engine” on their side CareLink.
We are almost fully a McKesson shop Sched/Reg thru ancillary systems.
IMHO – the top four gotchas I’ve run into with HCI are:
1) My pet peeve, HCI ACKs everything regardless of whether or not it can successfully process it. You have to manage the error logs on the HCI system itself, no notification back to the engine a problem is happening. Their logs can be quite large each day and can have a lot of extraneous junk. I actually wrote an FTP interface w/ TCL code that goes in and picks up their error logs each AM for prior day, parses it and puts the critical errors into a network location for analyst review. Not real-time, but better that letting a few weeks go by before you “catch-on” to an issue that is happening.
2) Order statuses and Result statuses are not only managed separately by ORC-1 + ORC-5 and OBR-25 respectively. HCI has multiple re-mapping tables that have to be managed to get HCI to display the statuses you want. HCI doesn’t just accept result or orders status codes as sent in HL7 fields based on a single table in HCI.
3) Routing order messages to correct system. HCI can route by what they call Performing Department. This means your MSH Sending App value is different for each Performing Department. Not an issue if each department that is built is for a single application; however, depending on how the HCI order item table is built there can be multiple departments in HCI that would go to a single application. Unfortunately, rarely have I run into vendor support that knows how to do this adeptly. We actually got stuck doing a custom table in HCI to manage this “feature” of HCI. This was before my TCL ability was very good or I could have come up with something a bit better on the engine side that what we have today.