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The healthcare landscape is changing

It’s not news that the healthcare system is going through a period of rapid growth. The Affordable Care Act (ACA) created an imperative for coverage, introducing millions of new people into an already over-stretched system. There are countless new regulations and agencies to contend with and regulations touching everything from patient information to pharmaceutical testing. Insurance marketplaces mean many patients will go outside the standard HMO for at least some portion of their care, creating challenges in transferring data. And the disruptive technologies of SaaS, mobile, and cloud are creating an array of health-related applications and self-serve solutions that allow users to track and improve their own health, or work directly with specialists, cutting out insurance or hospitals altogether.


And this is just the American market.

Healthcare companies are being pushed and pulled from all sides to modernize quickly while still improving care and cutting costs - two difficult and seemingly conflicting tasks.

Cloud-based technology also offers a tremendous opportunity: a way to truly improve patient outcomes on a mass scale, securely open data to third-parties, and create new revenue streams. And ironically, the basis of this opportunity lies in the aging, heavyweight legacy systems at the heart of most large healthcare companies. The solution lies with integration.

In this article we’ll discuss the challenges facing healthcare providers, and highlight how these challenges can be addressed by integration.

The current state of healthcare

It’s an interesting time in healthcare. Traditional healthcare companies—hospitals, HMOs, insurance, practitioners, and more—are providing medical services using a combination of paper records, on-premises computer systems, and cloud technologies. A heavily regulated system, providing a nearly unmatched array of specialty services, is now contending with three very different and disconnected protocols for storing patient data. Yet somehow the system keeps continuing to run.

But we’ve reached a pivotal moment: The legacy systems at the heart of healthcare companies are in some cases decades old, and their benefits are nearly negated by their shortcomings. They are used across the enterprise, but they are incredibly expensive to maintain, they are difficult to connect with other systems, and they create more frustration for staff and patients than benefits. One could argue that the only thing keeping these legacy systems in place is the amount of valuable data they house and the numerous systems they support.

At the same time, software as a service (SaaS), cloud technologies, and mobile devices are driving users to demand more and better services. Moreover, these new technologies are giving them an avenue to pursue health care outside of the traditional healthcare billing model. Activity and biometric trackers let consumers monitor their own bio-data, and see real-time changes in those metrics, enabling behavioral self-corrections that traditionally could only come from appointments with a doctor.

Despite all these tech advancements we’ve seen, many consumers still rely on hospitals and visits to general practitioners. More than actual adoption, what mobile and cloud technologies have done is change the level of consumer expectation. The lack of healthcare data integration and interoperability is leading to a variety of very real challenges that could threaten the continued viability of providers if they fail to adapt. While the ACA offered consumers market-based medical options, SaaS and cloud technologies are exposing the whole healthcare industry to the true force of a free market.

Meanwhile, doctors and nurses are frustrated at the increasingly elaborate hoops they have to jump through to send and receive patient data, and the fact they’re spending more time managing data transfers and less actual time with patients. And new regulatory bodies are requiring more secure data storage and transfer protocols.

Integration explained

Healthcare companies have a more valuable and more complete sets of consumer medical data than any SaaS provider, and they can leverage this to gain a real competitive advantage. All they need is to connect the foundational software systems on which that data lives to the cloud in a secure, extensible, efficient, and cost-effective way.

Integration in this case, means connecting legacy systems to the cloud with enterprise-level communications layers like integration platforms as a service (iPaaS) and enterprise service buses (ESB). Robust integration solutions allow healthcare companies to utilize hybrid integration—leveraging the strength, customized workflows, and deep organizational knowledge of legacy systems, while still being able to connect to technologies like cloud storage, cloud collaboration, and SaaS applications.

A robust hybrid integration solution should provide:

  • Security: A messaging layer acts as a buffer between the cloud and core systems, meaning no third-party is getting direct access to data.
  • A HIPAA and compliance tool: As regulations change, a messaging layer can normalize data outputs, and ensure data transfers or presentation of data to patients and third-parties adheres to HIPAA and other data protocols.
  • HL7 interoperability: Most core healthcare software was built and installed years, or even decades, before the HL7 protocols that govern the formatting and transfer of patient data; integration layers can act as an data normalizing tool.
  • Agility and extensibility: iPaaS allow companies to quickly “spin up” new applications and new third-party integrations without any custom coding or brittle point-to-point connections that directly touch core systems.
  • New revenue streams: Communication layers allow healthcare companies to quickly create APIs, opening healthcare data to both in-house and third-party developers and allowing providers to realize new ways of generating revenue with existing data.
  • Competitive advantage: The hospitals and healthcare companies that enable connectivity will have a leg up on traditional competition via better patient options and reduced overhead costs, and on disruptive SaaS companies by leveraging existing infrastructure and market reach in combination with better use of data.

Finally, there’s one other advantage that may be more meaningful than all of these others combined: Integrated healthcare can improve the lives of both doctors and patients.

Doctors want to practice medicine, and that means interfacing directly with patients. Allowing the free-flow of data between core systems and the cloud frees doctors up from paperwork and the difficulties of sharing patient information with third-parties like radiology labs and pharmacies. This, in turn, means doctors can better care for patients when they’re sick, and also care for them when they’re well—the same preventative medicine offered by SaaS and mobile health.

How hybrid integration can help: 3 real-world examples

Current problem

Long wait times for paper lab results can lead to misdiagnoses or conflicting diagnoses.


Installing an agility layer atop legacy systems allows IT and infrastructure teams to create APIs to enable the secure and accurate transfer of data to radiology or phlebotomy, meaning technicians can prepare for arriving patients in real-time. Likewise, an integration layer can receive lab results much faster, and with less chance for mistakes. Finally, these results can be shared in real-time with specialists and HIPAA compliant EMR collaboration tools. What once took days can be done in minutes, meaning primary care physicians and specialists can work off a holistic, single view of the patient.

Current problem

Cost and lost revenue. Legacy systems are expensive to maintain, and point-to-point connections are extremely fragile; the system is a passive repository for data.


Integration layers can act as master messaging choreographers, normalizing all data into and out of core systems, and between all other systems within a healthcare company’s infrastructure, whether on-premises or in the cloud. With this messaging layer in place, point-to-point code can be extricated, ultimately increasing agility. IT can now quickly spin up or spin down integrations without requiring a team of engineers, as the right solution contains an out-of-the-box tool kit for working with dozens of data formats and data transfer protocols.

Moreover, enabling IT to build APIs and SDKs, allows provider and patient data to be securely accessed by third-parties to build new applications, driving possible revenue shares. And hybrid integration opens data while keeping the traditional provider at the heart of the relationship between their patients and the third-parties with which their patients are interacting. Even when a patient is working with a mobile app, they’re still relying on the hospital to enable the experience.

Current problem

HIPAA is a moving target, causing existing point-to-point integrations to quickly fall out of compliance. Constantly requiring engineering dollars and exposing the hospital to regulatory fines or lawsuits


The best integration solutions contain tool kits for adherence to the regulations of specific industries. Messaging layers can create an extra layer of security by acting as an intermediary and firewall between the outside and core systems, and as a compliance tool, meeting the exact security and data standards of HIPAA or other regulatory agencies. A modern integration solution will be much easier to keep in compliance with regulations. And finally, as a third-party product, it is the responsibility of the integration solution to manage ongoing software updates and upgrades that will keep the entire system in compliance with changing government regulations.

Innovation happens on the edges. Healthcare providers that rely on legacy systems may think they can’t keep up, but there is a middle ground: An integration layer on top of traditional legacy systems opens proprietary data in an agile, secure way, enabling innovation both internally and externally - even in an industry as old and difficult to modernize as healthcare.

The MuleSoft solution

MuleSoft’s Anypoint Platform™ enables connected healthcare. MuleSoft’s integration solutions for healthcare have helped hospitals create truly comprehensive electronic medical records (EMR) by allowing core systems to feed and be fed by multiple third-party apps. MuleSoft’s solutions for healthcare allow data to flow seamlessly between healthcare and non-healthcare systems, whether on-premises or in the cloud, by supporting healthcare information standards such as HL7 and MLLP. Anypoint Platform has helped providers create a single view of their patients, and at the same time given patients more access to their own information. It has helped improve patient outcomes, drive new revenue, and cut costs.

Finally, Anypoint Platform has helped address the difficult to quantify but perhaps most important metric: Patient and doctor satisfaction. With MuleSoft’s Anypoint Platform, patients see better results, and doctors get more time and better tools with which to achieve their true goals: helping patients.

Learn more about Anypoint Platform and about MuleSoft’s healthcare solutions »

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