Epic Aura: Technical Implementation

Health Data Movers has had an exciting year working with specialty diagnostic labs on Aura projects.  Aura has been a game changer for quicker and easier integrations. I caught up with Janaque Fernando, a senior integration engineer who’s been with HDM for over two years,  to understand the technical side of Aura implementations.

Mel: How does Aura configuration differ from point-to-point interface configuration?

Janaque:  Point-to-Point has been a gold standard of integration for decades. Two of its drawbacks are speed of implementation and support cost long term. For each integration, organizations need to spin up a new pair of Epic interfaces or determine whether they can utilize an existing set. They’d also need their interface engine team to manipulate the message data structure to vendor requirements and maintain connections in perpetuity. This combined with Epic application build often means a timeline of 4-6 months.

Epic’s Aura network solution is lightweight and dramatically streamlines this process. Healthcare organizations only need to maintain one pair of Epic Lab interfaces to connect with all performing labs on the network. There’s no need for healthcare organizations to involve their integration engine since Epic normalizes all the data sent through Aura. Epic utilizes its existing Care Everywhere phonebook to simplify connectivity while maintaining appropriate security protocols. This reduces both support complexity and maintenance. By using Turbocharger packages and an Aura interface, implementation timelines are shortened to about 6-8 weeks per organization.

Healthcare organizations always have a backlog of projects lined up and having an integration that is fast and easy to set up will make Aura integrations increasingly more attractive over time.

Mel: Is there anything you wish you knew before beginning your first Aura project?

Janaque: From an integration perspective, the bulk of the analysis and setup lands outside of Epic and on the lab side of the integration. While a lab needs to set up a lightweight Epic instance, the major goal of the implementation is to normalize how Epic stores and sends information to meet the lab’s needs. The actual setup for the Epic build is relatively lightweight, but the real work is in translating Epic workflows and fundamental data structures into the lab’s system. Throughout our Aura projects, we have developed documentation and integration strategies to ease data flow between all systems. 

Mel: There is a lot of talk about how Aura saves customers time. Where are the time gains specifically?

Janaque: There are many areas where significant time is gained when pursuing an Aura implementation instead of a point to point integration:

  • Customer Application Build: Healthcare organizations are provided a checklist of the build and setup required for the Aura project. This is combined with a Turbocharger package that significantly reduces the amount of work for the customer application teams. While a portion of the build needs to be done manually, having some of it automated is a big gain and reduces areas where build could be set up incorrectly.
  • Customer Interface Build: If a customer is already connected to the Aura network, there’s extremely little interface setup required. The Bridges and Interconnect teams may be nominally involved when initially confirming connectivity, but the connection and routing is handled automatically by Epic’s Care Everywhere network.
  • Connectivity Setup and Maintenance: While not as flashy as some of the other Aura benefits, interface connectivity maintenance for point-to-point integrations adds up. By using Epic’s secure Care Everywhere network and removing the need for integration engine work, a large section of setup and maintenance is removed from the equation.

Mel: This sounds like a smooth process. Can you share a challenge you encountered? 

Janaque: HDM’s long history of Epic project experiences set us up for success when tackling this new type of integration. There are several unique challenges that an Aura project brings. Epic’s lightweight and normalized interface design brings speed but may not initially meet the comprehensive needs of the lab.

Our team collaborated with both Epic and lab resources to find solutions for data gaps. We had the experience to know when and where to push back or drill down to find solutions to root problems.

Mel: You mentioned experience enabling the team to understand the big picture and dive into the details when necessary. Could you share where HDM’s expertise is most beneficial?

Janaque: Aura projects involve implementation of a unique pared down Epic instance. When setting up an Epic instance for Aura, there will be some elements of a typical Epic install that are required and some that aren’t. Having implemented this multiple times, our team has valuable knowledge of the setup needs. Additionally, our analysts have the certifications and experience to cover multiple Epic Applications, reducing the total number of analysts needed. Knowing the strengths and weaknesses of Aura integrations, we can anticipate potential problems and creatively design solutions for technical constraints. In addition, the HDM Aura team can leverage our other engineering, integration, and data migration teams for knowledge, advice, and support. Combining our technological expertise with our clinical and operational workflow knowledge, we can build solutions tailored to both labs and their partnering healthcare organizations.

Our time embedded in diagnostic lab teams grants us a valuable insight into the specific needs labs have for integrations. We use this perspective to translate those technical needs into the required Epic setup to meet those needs. Our team has worked closely with lab operations, technical teams, and sales. We’ve created and are constantly expanding our HDM Aura Toolkit. This contains established materials and proven strategies for these projects. We use these tools for a variety of purposes and audiences. This includes things like project tracking, technical documentation, design strategies, and education. Combining our experience and tools, we significantly remove friction throughout the project maintaining project momentum.

Aura is a relatively new addition to Epic and our team has built strong working relationships in the space. It’s been exciting to work with our partners to create these integrations. As more organizations join the Aura network, more healthcare providers will have access to specialty orders bringing quality care to patients.