Penn State Health Milton S. Hershey Medical Center

Penn State Health Milton S. Hershey Medical Center (MSHMC) is a leading university health center located in Hershey, Pennsylvania. Annually, the center admits 29,000 patients, accepts a million outpatient visits, receives 72,000 emergency room patients, and performs 30,000 surgical procedures. Its campus includes Penn State College of Medicine, Penn State Cancer Institute, and Penn State Children’s Hospital, the only children’s hospital in the region. In 2016, MSHMC became part of Penn State Health, a multi-hospital health system serving patients and communities across central Pennsylvania. The system includes Penn State Health St. Joseph Medical Center in Reading, Pennsylvania, as well as Penn State Health Rehabilitation Hospital, various other jointly owned healthcare providers, and 78 outpatient practice sites across the region.

After Oracle Corporation sunsetted its eGate HL7 integration engine, eliminating the possibility of an upgrade path and effectively forcing its users to seek out third-party support, the decision makers at MSHMC recognized that, after a decade of using the technology, a change would have to be made.

“We had stayed on the same version of eGate for 10 years,” said Chuck Kruse, senior programmer/ analyst, MSHMC, “because we’d heard from our colleagues at other hospitals that all subsequent versions had been fraught with problems.

So once the upgrade path ended, and all hope was lost that there would someday be a better version of eGate than the one we had, there simply was no other choice. What were we going to do in the future? Without that upgrade path, given how health IT is constantly changing, and given how it’s our responsibility to ensure that our integration engine keeps pace with the growth and management of MSHMC’s infrastructure, we knew we had to investigate our options right away.”

The decision makers at MSHMC did not take that investigation lightly. “We came up with a list of 92 criteria, which informed a weighted scorecard that would ensure that all the vendors’ solutions were evaluated fairly,” said Kruse. “Next, we searched eGate forums to see which products other hospitals had migrated to and how they felt about their choices.”

Recognizing that no other interoperability platform would be able to so fully satisfy the dozens of must have criteria that MSHMC had identified, the medical center’s decision makers chose Rhapsody— a robust, proven, high-performance solution for the reliable exchange and acquisition of health data— as the successor to their eGate solution.

“We chose Rhapsody Integration Engine based on everything we had heard from the references we spoke with,” said Kruse. “They spoke of the value of Rhapsody’s support and update policies, recounted their user experiences, and detailed their total cost of ownership over both the short and long term. We were very impressed.”

The process of transitioning several hundred interfaces from eGate to Rhapsody required MSHMC to individually migrate their two sets of servers so that if any unforeseen issues occurred, MSHMC could revert its interfaces back to their current state without affecting patients.

“We migrated the first interfaces one at a time,” said Kruse, “but by the time we were finishing up, we’d found ourselves migrating 10 to 20 interfaces at a time because it was working so well and going so smoothly. There were no problems whatsoever.”

Once implemented, Kruse was immediately struck by Rhapsody’s visual programming environment.

“All my working life, I’ve heard people talk about visual programming,” said Kruse. “Every health IT vendor says their solution has helpful tools that visually represent component details, control structures, and more. With Rhapsody, you simply put the components on the screen, connect them together, and everything begins to flow. It just works. I’ve never seen a tool do that. I’d never imagined that was possible.”

Today, when an admission, discharge, or transfer (ADT) notification’s fields from one EHR vendor’s solution are presented in a sequence that doesn’t match the sequence preferred by a different EHR vendor’s solution, Kruse can easily make adjustments within Rhapsody.

“The code is almost self-documenting, because JavaScript is very clear,” said Kruse. “We have new interfaces that come in at least weekly, sometimes daily, and Rhapsody has empowered us to keep up with the demand and satisfy our users.”

Further, when MSHMC acquired another Rhapsody user, St. Joseph Regional Health Network, the experience of onboarding the network into the MSHMC system was completely straightforward— much more, said Kruse, than it would’ve been with eGate.

“I just opened up the port and the IP and let the data flow,” said Kruse.