Medcurio

There are two interviewees, both of whom are integration

developers, denoted as R1 and R2 in the transcript below.

So today we’re chatting about Medcurio VennU and how it’s used at your company. Before we jump into that, could you give a brief overview of the company and your roles there?

R1: We’re a large healthcare system, and our corporate IT entity, within which we both work, focuses on the integration space—facilitating the relay of data between our applications as well as with external organizations. Our daily tasks involve supporting APIs, HL7 feeds, and file transfers. My expertise lies in HL7 and FTP, while my colleague specializes in APIs.

What was the need that drove you to look for a solution like Medcurio VennU?

R2: We received requests to share data from our EHR with Salesforce for the call center in real time, but our EHR vendor had not developed the necessary APIs. VennU enables us to access almost all data elements in our EHR and transfer them to Salesforce via APIs, addressing the gaps in our data exchange.

Your EHR is Epic. Does Epic have APIs that could be used?

R2: They do have APIs, but Epic’s Interconnect APIs are non-modifiable and have limited customization, such as adding a specific field that isn’t currently present. We always assess Epic’s tools for suitability, but we frequently encounter gaps. Traditionally, requesting Epic to add a field would entail a lengthy development cycle. To address these challenges, we now integrate VennU to pull the specific data we’re looking for, and we combine it with the existing Epic Interconnect output.

R1: Epic’s database offers numerous applications, but accessing data directly can be a hurdle unless you use existing tools or request Epic to provide a solution. If the data isn’t accessible through the UI and you need to query it, especially when it’s on a SQL server, you’d typically probe the database directly. However, Epic’s structure doesn’t accommodate such back-end access easily, due to its proprietary nature.

What are some of the capabilities that Medcurio provides over and above the native access you might have to your Epic database?

R1: The Medcurio development team has leveraged their expertise with the InterSystems IRIS database structure (which is leveraged by Epic) to design VennU’s query engine. This engine effectively parses internal data and delivers it through an API in the form of an HTTP response.

R2: We could access specific data from the Epic database if we had specialized Epic database programming capabilities in house, but most organizations lack that skillset. VennU, however, has the expertise to create a product that simplifies this process. With VennU’s solutions, querying for specific data becomes straightforward—no need for intricate programming, just click and drag to obtain the desired data.

Is this mostly for a read-only use case? Are you just trying to extract data and pull it into your Salesforce instance, or are you trying to push data back into Epic as well?

R2: It’s read-only. We don’t write anything back into Epic.

R1: At this time our organization is not writing back into Epic. This is not current VennU production functionality but it is on the product road map for VennU.

How is the implementation and setup process?

R2: We weren’t involved in the initial implementation. In terms of ongoing updates, the quarterly release processes include comprehensive support. They provide an overview, outline upcoming features, and assist with the installation.

Do you have additional use cases for Medcurio VennU besides the customer service aspect?

R1: We’re utilizing VennU for displaying emergency room wait times on our web app and website. Patients can use the same APIs on our website to choose the emergency room with the shortest wait time, which significantly reduces waiting periods. It’s been very useful.

R2: We use master data management for provider and location information. Additionally, we use an application named Compass for patient information management. Our integration with Salesforce CRM facilitates extensive patient outreach, particularly for value-based care, post-discharge follow-ups, referrals, and appointment reminders. These activities are structured as Salesforce campaigns or journeys, which utilize Epic data provided by VennU to determine patients’ preferred communication methods, such as text messages or emails.

Previously, we relied on Epic’s MyChart for patient communication, but it only reached about 60% of our patients. Now, using patients’ cell phones or email addresses, we can significantly expand our outreach capabilities.

How does Medcurio VennU fit into your workflow?

R2: We use it to facilitate the extraction of specific data elements from the Epic system. We start by identifying the required Epic data fields and determining the corresponding INI and item numbers, which are essential for locating the data within the Epic cache database. Using VennU, we select the desired data element and set parameters to define our search. During development, our Epic application specialists provide test patient cases, allowing us to run configurations in VennU to retrieve the data. The data retrieval usually works seamlessly, but Medcurio provides support for complex data extractions if needed.

Once the data is acquired, we transfer it into Salesforce via an interface sequence that involves Epic activity triggers. Activities such as phone number updates, appointment scheduling, or health record changes in Epic initiate a data flow through our interface engine, Rhapsody, to MuleSoft. MuleSoft then uses the patient ID and activity type to trigger VennU to retrieve the relevant data. The data is sent back to MuleSoft, where it is loaded into Salesforce Health Cloud using various APIs, formatted as a JSON payload.

What do you see as the key strengths of Medcurio VennU?

R1: Ease of use is a significant strength. I can understand the basics of how to use the application and retrieve data with minimal training. The ability to build an API configuration that meets my needs is a testament to the application’s user-friendliness.

Additionally, Medcurio’s support is outstanding. Their team is responsive, quick, diligent, and knowledgeable. They’re always ready to assist, regardless of the time or issue, which has been a key feature of their service.

R2: I would agree with that. We turned to VennU to complement Epic’s capabilities. We needed a way to fully access and retrieve our data. VennU’s user interface is intuitive, and the support is exceptionally responsive, which has significantly accelerated our speed-to-market for various projects. With VennU, our data access is faster, allowing us to complete projects more swiftly.

Do you see any areas for improvement?

R1: Our partnership with VennU has been very positive. On the rare occasion a bug arises, their team is exceptionally responsive and quick to resolve it. This efficiency and collaboration prevent any issues from becoming significant deterrents or frustrations for us.

R2: We have to manually track and document some data, as the application doesn’t provide storage for it currently. But overall they’ve been excellent partners. Whenever we discuss our needs, they’re responsive and make the necessary updates.

R1: Improvements could be made to VennU engine settings within our application’s database environment, as they sometimes revert or change during upgrades or installations. The VennU application installs a component on the database server that handles data retrieval for the VennU application. The VennU engine settings, such as throttle speed, GRefs, and the amount of disk space used for API queries, are optimized for each engine and are used in different environments like production, test, development, and reporting. Although these settings are stored in the IRIS database within the VennU application, we’ve observed that VennU application updates can alter them. To manage this, we’ve created an external spreadsheet that documents all VennU engine settings. In the event of changes post-upgrade to the VennU application, this spreadsheet serves as a reference to restore the original settings in the VennU application’s engine settings page.

Do you have any advice for people who are looking for this type of solution?

R2: Make sure you have the proper infrastructure and connectivity in place. Those topics can be complex, but it’s important to have experts ensure that your VPN, firewall, and overall connectivity are adequate to support your organization’s needs.

R1: I don’t think we’ve tapped into the full potential of VennU’s application. There are numerous use cases still to be explored and leveraged.

R2: I agree. In the coming year, we hope to leverage more data through VennU in various projects. The key piece of advice I have is to ensure the performance meets your expectations, particularly the speed of data retrieval. Medcurio has been successful in returning data in milliseconds, enhancing user experience on mobile apps by providing immediate access to information like upcoming appointments. This performance is likely related to server capacity and power, which are critical factors in achieving such speeds.