University of Louisville

UofL Health is an academic health system consisting of four acute care hospitals (including UofL Hospital), four ambulatory/surgery centers, a rehab hospital, a behavioral health hospital, and a medical group. UofL Health serves patients from every county in Kentucky, seeing over 1.5 million patients in the last year, and employs more than 12,000 highly skilled healthcare professionals. UofL Health provides Louisville’s only Level I Trauma Center, as well as the region’s first certified stroke center and first hospital‑based telemedicine network.

When the UofL Hospital decided to leave a joint operating agreement with another organization, they needed to build a brand‑new IT infrastructure and migrate 135 existing interfaces — without disrupting patient care. They had 18 months, filled with hard deadlines, to complete the migration. And the UofL Hospital data center was nearly maxed out, right from the beginning.

As planning progressed, UofL Hospital’s CIO noted that integration had been the holdup on every large project he’d ever been a part of. That prompted Darren Powell, AVP of applications, to vow, “Well, it’s not going to be here.”

Meanwhile, the three‑person integration team was also tasked with building a foundation that could scale with future growth, including planned mergers and acquisitions (eventually becoming UofL Health) that would add 200 more interfaces and more than double data volumes.

Powell wanted to continue using the Rhapsody technology he had trusted in previous roles, including as part of the joint operating agreement. With a fresh IT slate, he chose Rhapsody as a Service (RaaS), hosted in the Amazon Web Services cloud platform. Migrating to the cloud unlocked several advantages, including:

• Enabling the small team to focus their efforts on the transition, rather than building and administering a new back‑end system
• Establishing an engine footprint that could grow seamlessly over time
• Allowing for a quick implementation that avoided disrupting service or patient care
• Meeting strict security and disaster recovery requirements

With the Rhapsody team managing the cloud infrastructure, the UofL Health team could identify and decommission outdated interfaces, then standardize naming conventions, architectures, and routings for the new infrastructure.

After the UofL Health integration team created and configured the necessary user accounts, they installed the integration engine and established network address translation rules that allowed the EHR and other systems to communicate via VPN.

Within six months of implementing Rhapsody, the three-person UofL Hospital team stood up 25 newly developed interfaces and migrated 135 more. They developed three types of routes: initiation (bringing messages in and detecting duplicates), translation (mapping and extracting HL7 message properties), and delivery. Together, these routes enable seamless data exchange, even to and from the hospital’s previous partner.

Throughout the process, UofL Hospital needed just one single, scheduled downtime, which minimized disruptions to patient care.

UofL Hospital established a medium‑engine footprint that was poised to grow into a large engine. That planning ahead paid off: just a few months after the initial migration, UofL Hospital seamlessly brought over another 200 interfaces from new acquisitions.

Today, UofL Health has deployed Epic within its ambulatory locations, bringing the network to over 1,200 connections, 700 production routes, and 400 production HL7 interfaces. RaaS bridges connections between their EHRs, Epic and Cerner, by sending HL7 messages between the two. And UofL Health has the flexibility it needs for future growth, with an unlimited RaaS license that allows seamless scaling.