Steps to Set Up a Successful athenahealth Integration

In today’s fast-paced and ever-evolving healthcare industry, digital transformation is critical to staying ahead of the curve. The demand for streamlined processes and interoperability between systems is increasing. One such system that has gained popularity is athenahealth – a cloud-based electronic health record (EHR) system. Integrating athenahealth with other healthcare systems can help providers access patient information and manage clinical workflows efficiently. However, setting up a successful athenahealth integration can be challenging and requires careful planning and execution. 

This article will outline the key steps to set up a successful athenahealth integration, from assessing your integration needs to testing and launching the integration with confidence. Whether you are a healthcare provider, a software vendor, or a technology consultant, this article will provide you with practical insights to help you navigate the complexities of athenahealth integration and achieve a seamless interoperability experience.

First, we’ll provide a high-level overview of athenahealth and look at examples of healthcare software applications integrating with athenahealth. This will help demonstrate the value and importance of integrating digital solutions with Electronic Health Record (EHR) systems like athenahealth. 

athenahealth Overview

athenahealth is a web-based Electronic Health Record (EHR) system designed to streamline clinical workflows and enhance the quality of patient care. It is cloud-based and can be accessed anywhere and anytime, making it a convenient solution for healthcare providers. athenahealth also offers revenue cycle management and population health management services, making it an all-in-one solution for healthcare providers. Various healthcare organizations use it, including hospitals, clinics, and physician practices.

One of the primary benefits of using athenahealth is its ease of use. The interface is designed to be intuitive, allowing healthcare providers to easily navigate the system and quickly access the information they need. The system also offers customizable templates and workflows, allowing providers to tailor their experience to their specific needs. athenahealth also provides robust reporting capabilities, enabling healthcare providers to track key metrics and identify areas for improvement.

Examples of Digital Health Solutions Integrating with athenahealth:

1. Patient scheduling software: Healthcare providers often use patient scheduling software to manage appointments, track patient information, and schedule follow-up visits. By integrating this software with athenahealth, providers can easily access patient information, view appointment histories, and make informed decisions about patient care.
2. Billing and revenue cycle management software: Healthcare providers use billing and revenue cycle management software to manage claims, payments, and reimbursements. Integrating this software with athenahealth can streamline the billing process, reduce errors, and improve cash flow for healthcare providers.
3. Telemedicine software: Telemedicine software allows healthcare providers to deliver care remotely using video conferencing, messaging, or other virtual platforms. By integrating this software with athenahealth, providers can access patient records, manage prescriptions, and communicate with patients in real time, all from a single platform.
4. Medical imaging software: Medical imaging software is used to store and manage diagnostic images, such as X-rays, CT scans, and MRIs. Integrating this software with athenahealth can improve clinical decision-making, reduce diagnostic errors, and enhance patient care.

Integrating healthcare software applications with athenahealth EHR can improve clinical workflows, enhance patient care, and increase efficiency for healthcare providers. By leveraging the power of integration, healthcare providers can achieve a more comprehensive view of patient data and provide better patient care. 

As a technology provider in healthcare, demonstrating that your solution can integrate into the EHRs the providers utilize is crucial for a simplified sales process. Increasing the value and time savings your solution provides to the provider will solidify your solution as a clear benefit to the medical facility. 

Steps to Integrate with athenahealth

Users expect products and applications they use to share data and developers and engineers don’t want the headache of building new connections for each customer. Privacy requirements, complex data sets, and disparate systems make integration in the healthcare and medical record space quite tricky.

Planning is the most crucial step of the process if you’re looking to connect and integrate your application with athenahealth, or any other system. Here are some recommended steps to take:

Define and Design Your Integration Use Case and Workflow

Before building any integration or interface, defining the data requirements and designing the integration flow is essential. It’s helpful to start high level and work into the integration specifics.

First, create a diagram of a connection between athenahealth and your application that outlines what initiates the integration. Integrations can be schedule-driven, event-driven, invoked via an API request, and more. When this trigger or event happens, clearly outline what information or data needs to be shared by athenahealth with your app and vice versa—Mark which data elements are requirements and which are nice-to-haves (optional).

Identify the Value Integrating with an EHR Provides

Integration must bring value to the end user, the customer, and your organization. In healthcare, the end user could be providers, patients, engineers and IT, administrators, operators, healthcare executives, or another persona. Healthcare technology brings value by increasing provider efficiency and access and effectiveness of care to improve patient outcomes and satisfaction. How does integrating your application align with that value?

As a developer or innovator, it’s your job to determine and define how integrating into athenahealth brings value to your users and their organizations. The best way to determine if integrating is a value add is through end-user feedback. If a customer has not explicitly asked for it, ask them directly or create a small user group to obtain validation of integration.

Simple vs. Complex Integrations

Simple healthcare interfaces like an HL7 v2 channel for ADT events or a patient demographic query are linear, single-step integrations. In modern app development, integrations can be more complex with multiple steps, conditional logic, and other reference lookups. Determine if any of these scenarios apply to your use case.

Here’s an example of a first iteration, high-level workflow design:

Review the athenahealth Marketplace and Vendor Program

In the scope of EMR integration, athenahealth has one of the more developer and innovator-friendly programs. Now that you have defined your integration requirements review them against the athenahealth API & developer documentation and different integration methods.

athenahealth supports integrating via a variety of methods, including:

• HL7 v2
• HL7 v3
• C-CDA
• IHE
• DirectTrust
• HL7 FHIR APIs
• athenaone APIs

athenahealth also supports SSO integration which enables direct access to your application for users through SAML 2.0 and OpenID Connect standards. If you intend to launch your app from an EMR/EHR context, this offering is worth evaluating as it generally provides a better user experience.

Keep in mind, athenahealth products sometimes require different APIs. Understanding what products your clients and future clients use will help you determine what API endpoints and interfaces to use.

Types of athenahealth APIs

athenahealth offers three different types of APIs: athenaone APIs, FHIR APIs, and Certified APIs. Certified and FHIR APIs are free to consume and follow standard clinical definitions and data structures. athenahealth supports DSTU2 and R4 FHIR formats.

athenaone APIs comprise a comprehensive set of API endpoints that support sharing clinical, financial, and administrative data with third-party applications. athenaone APIs require executing a standard vendor business agreement with athenahealth and are charged by API call volumes.

Changed Data Subscriptions

athenahealth supports changed data subscriptions, allowing polling for events and resource changes. This event-driven method emulates HL7 architecture and is helpful for applications that rely on a specific event(s) to drive their integration workflow.

Patient, Provider, and Back-End Apps

EMRs such as athenahealth use the SMART framework to categorize integrated third-party applications into two categories: Apps and Back-End Services. The design and requirements of your integration will dictate which type of application you should choose. The type of application will dictate the authorization pattern and conditions to access protected health information.

SMART App Launch

• If a patient is the end-user of your application, they will authorize your application to access their health data.
• If the provider is the end-user of your application, they will authorize your application to access health data from the EMR. Provider applications can support launch context from the EMR.

SMART Back-End Services

• If your application uses a direct FHIR to FHIR server connection and operates in the background autonomously or semi-autonomously, you and the client pre-authorize your application to access data.

The SMART App Launch – patient and provider-facing applications – uses a 3-legged authorization flow that requires an end-user to authorize access to data to obtain an authorization token.

SMART Back-End Services use a 2-legged authorization flow which requires apps to use OAuth client credentials to obtain an authorization token. athenahealth customers will authorize an application to access specific endpoints.

Authorization Scopes

Authorization scopes determine access for a third-party application. Scopes are permissions that an application includes in a request. The authorization server will verify that the application should have access to the requested data and appropriately authorize or deny the request.

OAuth 2.0 and scopes can be tricky. athenahealth requires you to select the authorization method that corresponds to your application and define authorization scopes in a particular way based on application type and privilege.

Develop & Test the Integration

After defining your interface and integration requirements and reviewing the authorization framework, athenahealth offers a developer platform to experiment, build, test, and validate for application.

Register a Developer Portal Account

Any developer or organization wanting to integrate their application needs to sign up for an athenahealth Developer Portal account (unless you want to use Intely – which is pre-authorized and can handle your integration needs out-of-the-box). The portal will provide OAuth 2.0 credentials to authorize your API requests.

After creating an account, you must create and register your application. Here is where you will make the critical App Category selection to determine your authorization flow.

Using the Sandbox to Build and Test

After signing up for a developer account, you can make test API calls to the global sandbox account. The developer portal allows you to create test calls directly from their browser application and Postman before programming the requests into your application’s code base. It is an excellent ‘crawl, walk, run’ approach to designing, building, testing, and validating API integrations.

Preview Base URL: https://api.preview.platform.athenahealth.com/v1/{practiceid}

Preview Token URL: https://api.preview.platform.athenahealth.com/oauth2/v1/token

Preview practiceId: 195900

Production Base URL: https://api.platform.athenahealth.com/v1/{practiceid}

Production Token URL: https://api.platform.athenahealth.com/oauth2/v1/token

athenahealth’s API architecture makes it easy to make requests to multiple clients by simply changing the practiced path variable. Each athenaone customer has a unique practiceId corresponding with their athenahealth tablespace and instance.

Submit for athenahealth Marketplace Approval

A few prerequisites exist to deploy your application for a production client and list your app in the athenahealth Marketplace. First, athenahealth wants an identified mutual client to serve as the initial deployment target. Second, athenahealth will provide you with a business agreement that defines the cost of per-usage APIs and the Marketplace. Third, you must submit a detailed technical specification for your application and the integration.

Technical Specification

The technical specification isn’t anything crazy. The document outlines the overall integrated workflow and your application’s specific API calls to athenahealth. There are some specific security questions, so be ready to explain how your application and integration secures and ensures privacy of patient data. Additionally, you’ll need to provide the triggers and call frequency for each API call.

Mutual Customer

Once you have a mutual customer or targeted deployment, athenahealth will create a dedicated preview account with front-end access for validation. The dedicated preview environment will come with a different practiceId. To make API calls to your dedicated preview account, ensure you replace the path variable in the base URL.

API Design Review

After you submit the technical specification document, athenahealth will assign an API design consultant to review your integration. Don’t be wary of this step, as it’s pretty helpful. The design consultant will review the process to ensure you can go live with your integration and highlight any possible improvements.

Production Approval

After completing the above steps and integrating with your dedicated preview account, you will showcase the workflow and integration to your API Design Consultant. athenahealth will either approve the application for production use or suggest reworking the integration.

After athenahealth has given the green light that your application is production ready, you will need to deploy your application within 70 days. If not, another production readiness and approval call will be necessary.

When you go live with the application for your initial mutual client in production, there is a five-day monitoring period to ensure the integration operates appropriately. After the five-day monitoring period is complete, athenahealth will add your application to the Marketplace. Once in the Marketplace, other athenahealth customers can request and use your application without additional approval.

Enhancement Requests

Healthcare and EMR integration is rarely static and often needs to change. If you need to change the marketplace integration, such as switching API calls or adding new API calls for additional data or app features, you log an enhancement request to your athenahealth Marketplace representative.

Benefits of Integrating a Healthcare Software Application with athenahealth 

Integrating a healthcare software application with athenahealth can bring a plethora of benefits to healthcare providers. Here are some top advantages healthcare providers can experience by integrating their software application with athenahealth.

Improved patient care 

Integrating with athenahealth can supply healthcare providers with access to comprehensive patient data. This allows providers to make informed decisions and provide accurate diagnoses and treatment plans, ultimately improving patient care. athenahealth’s care coordination tools also enable healthcare providers to collaborate more effectively, leading to better patient outcomes.

Integration can help patients access their health data and communicate with their care team through a single platform, enhancing patient satisfaction, reducing confusion, and promoting more effective care coordination. This can help ensure seamless care transitions between providers and settings by allowing providers to easily share patient data and care plans, reducing gaps in care, and improving patient outcomes.

Streamlined Workflows. 

Integrating healthcare software with athenahealth can streamline workflows by automating data transfer and reducing duplicate data entry. This eliminates the need for manual data entry, freeing up time for healthcare providers to focus on patient care. Additionally, integration allows healthcare providers to share patient data and communicate more efficiently across multiple systems, reducing errors and improving care coordination.

The integration allows healthcare providers to share patient data and communicate more efficiently across multiple systems. This can reduce errors, avoid duplication of efforts, and improve the speed and accuracy of care coordination. Integration with athenahealth enables the seamless flow of data between different healthcare systems, reducing the need for manual data entry and the potential for errors.

Better Data Management 

athenahealth enables healthcare providers to manage patient data more efficiently and accurately. By integrating their software application with athenahealth, healthcare providers can ensure increased data accuracy, eliminating the risk of errors and reducing the need for manual data entry. With improved data accuracy, healthcare providers can make more informed decisions and provide better patient care. Additionally, improved data analysis tools enable healthcare providers to identify trends, monitor patient progress, and make data-driven decisions.

Better analytics and reporting: Integrating healthcare software applications with athenahealth can provide healthcare organizations with better data analytics and reporting capabilities. This can help providers identify areas for improvement in care coordination and make data-driven decisions to enhance patient care.

Access to comprehensive patient data: Integrating healthcare software applications with athenahealth can provide providers with a comprehensive view of a patient’s health record, including medical history, test results, and treatment plans. This can help providers make more informed decisions and coordinate care more effectively.

Improved Data Accuracy: Integration with athenahealth ensures that data is entered accurately, consistently, and in real-time, which reduces errors and inconsistencies in the data.

Enhanced Data Security: athenahealth is a HIPAA-compliant platform, which means that patient data is protected through stringent security protocols, ensuring that patient data is kept safe and secure.

Efficient Data Retrieval: Integration with athenahealth enables healthcare providers to access patient data, including medical history, test results, and treatment plans, enabling them to make informed decisions quickly and easily about patient care.

Increased Revenue 

Integrating healthcare software with athenahealth can lead to increased revenue by improving efficiency and enhancing billing and coding accuracy. With streamlined workflows and reduced errors, healthcare providers can see more patients and improve their billing and coding accuracy, resulting in more accurate reimbursements.

Other revenue benefits include:

Improved billing processes: athenahealth’s billing and revenue cycle management software can help healthcare providers improve their billing processes, reduce errors, and maximize reimbursements, leading to higher revenue and increased profitability.

Faster claim processing: Integrating healthcare software with athenahealth can speed up the claims submission and processing process, reducing the time it takes for healthcare providers to receive payment. This can lead to improved cash flow and higher revenues.

Better patient engagement: athenahealth’s patient engagement tools can help healthcare providers improve patient satisfaction and loyalty, leading to increased patient referrals and higher revenues.

Increased efficiency: Integrating healthcare software with athenahealth can streamline workflows, reduce manual tasks, and improve overall efficiency, allowing healthcare providers to see more patients in less time and increase revenue.

Overall, integrating healthcare software with athenahealth can help healthcare providers improve their billing processes, speed up claims processing, engage patients more effectively, increase efficiency, and ultimately increase revenue.

Common Challenges with athenahealth Integration

Different Products, Different Capabilities

As touched on in a previous section, athenahealth API support is different for some products. athenaone supports all API endpoints and can integrate via any API on athenahealth’s developer documentation.

Other athenahealth products support API endpoints, such as FHIR, and network interfaces, such as inbound and outbound HL7. However, FHIR is often restricted to read-only, and athenahealth does not support all event types and channels.

Ask prospective customers what athena product they use to overcome this hurdle early on. Getting aligned with a Marketplace Partner Success Manager and API Design Consultant early is essential as they will guide whether Marketplace API integration is available for the practice. If not, there are generally still ways to build a successful integration without going through the athenaone Marketplace.

API & Usage Cost

athenaone APIs aren’t free like FHIR and Certified APIs. The API call fees are very reasonable compared to other EMR vendors. However, it’s still a factor to consider when designing an integration and bringing on new customers.

If your application polls changed data subscription endpoints too frequently or you invoke API calls from user actions in your app’s interface, there is a risk of running up some fairly substantial API usage costs.

Best Practices for Successful athenahealth Integration 

Integrating a healthcare software application with athenahealth can be a complex process, but it doesn’t have to be.  However, following best practices can help ensure a successful integration. Here are some of the best practices to consider for successful athenahealth integration.

Determine the Integration Scope 

Determining the scope of the integration is an essential step in ensuring successful integration with athenahealth. The scope of the integration refers to the extent to which the healthcare software application will be integrated with athenahealth. To determine the scope of the integration, healthcare providers should consider several factors, including:

Business Goals: The integration should align with the healthcare provider’s business goals, such as improving patient care, increasing efficiency, or reducing costs.

Data Requirements: The healthcare provider should identify the data that needs to be shared between the healthcare software application and athenahealth. This includes patient data, clinical data, billing data, and other relevant data.

Workflow Integration: The healthcare provider should consider how the integration will impact their workflows, including how data will be entered, updated, and accessed by different stakeholders.

Integration Complexity: The complexity of the integration should be evaluated to ensure that it is feasible and within the healthcare provider’s technical capabilities.

Integration Timeline: The integration timeline should be established, taking into consideration the amount of time required for development, testing, and deployment.

By carefully determining the scope of the integration, healthcare providers can ensure that the integration is aligned with their business goals, meets their data requirements, fits their workflows, and is feasible within their technical capabilities. This can help ensure a successful integration with athenahealth and achieve the desired benefits.

Identifying the first mutual client and the specific integration goals is a crucial step in the integration process. The first mutual client refers to the healthcare provider who will be the first to use the integrated healthcare software application and athenahealth.

By identifying the first mutual client, healthcare providers can establish a clear roadmap for the integration and ensure that the integration goals are aligned with the needs of the client. The specific integration goals should be established based on the client’s unique requirements and should focus on solving their specific pain points.

For example, the integration goals could include:

Streamlining patient registration and scheduling: The integration could enable the healthcare provider to seamlessly schedule appointments and register patients using data from athenahealth.

Automating billing and revenue cycle management: The integration could automate the billing process and reduce manual errors, ensuring that the healthcare provider receives timely reimbursements.

Improving care coordination: The integration could enable the healthcare provider to share patient data with other healthcare providers, improving care coordination and patient outcomes.

Enhancing reporting and analytics: The integration could provide the healthcare provider with real-time access to data and insights, enabling them to make data-driven decisions and improve their overall performance.

By identifying the first mutual client and establishing specific integration goals, healthcare providers can ensure that the integration is focused on solving specific pain points and meeting the needs of their clients. This can help increase the chances of a successful integration and maximize the benefits of integrating with athenahealth.

Use Established Standards. 

Using established standards is critical to ensure a smooth integration process. Following industry best practices and using standardized data formats can help reduce errors and ensure interoperability between systems. It’s also essential to consider data security and privacy regulations when using established standards.

Following the best industry standards means adhering to the guidelines and recommendations set by industry organizations and governing bodies. For example, healthcare providers should follow the guidelines set by the Office of the National Coordinator for Health Information Technology (ONC) for promoting interoperability in healthcare.

Using standardized data formats means using a common language or format for exchanging data between different healthcare systems. Standardized data formats, such as Health Level Seven International (HL7) and Fast Healthcare Interoperability Resources (FHIR), enable seamless data exchange and ensure that the data can be easily interpreted by different systems.

By following the best industry standards and using standardized data formats, healthcare providers can benefit from:

Improved Interoperability: Using standardized data formats ensures that data can be exchanged seamlessly between different healthcare systems, improving interoperability and enabling healthcare providers to access and use patient data more efficiently.

Reduced Errors: Standardized data formats reduce the potential for errors and inconsistencies in the data, which can lead to improved patient care and outcomes.

Better Data Management: Following the best industry standards and using standardized data formats can help healthcare providers improve their data management processes, ensuring that data is accurate, consistent, and up to date.

Enhanced Data Security: Standardized data formats enable better data security and protection of patient privacy by ensuring that data is transmitted securely and can only be accessed by authorized users.

In summary, using the best-established standards and standardized data formats can help healthcare providers achieve improved interoperability, reduced errors, better data management, and enhanced data security. By adopting these standards, healthcare providers can ensure that their integration with athenahealth is successful and delivers the desired benefits.

Conduct Thorough Testing 

Conducting thorough testing is a critical step in ensuring a successful integration with athenahealth. Testing the integration thoroughly before deployment and in different environments can help identify and address any issues or bugs before they impact patient care or business operations.

Before deployment, healthcare providers should test the integration in a staging environment that closely mirrors the production environment. This ensures that the integration is thoroughly tested in a controlled environment that is separate from the live production environment. It also provides an opportunity to test the integration with real data and workflows to ensure that it functions as expected.

Testing the integration in different environments is also important. Healthcare providers should test the integration in different scenarios and use cases, including those that mimic different workflows and user experiences. This helps identify any potential issues or errors that may occur in different environments and ensures that the integration is robust and can handle a range of use cases.

Some key considerations when testing the integration include:

Integration Testing: Integration testing involves testing the integration between the healthcare software application and athenahealth to ensure that data is exchanged accurately and seamlessly.

Functional Testing: Functional testing involves testing the individual functions and features of the integrated system to ensure that they work as intended.

Performance Testing: Performance testing involves testing the speed and scalability of the integrated system to ensure that it can handle the expected volume of data and users.

User Acceptance Testing: User acceptance testing involves testing the integration with real users to ensure that it meets their needs and expectations.

By conducting thorough testing, healthcare providers can ensure that the integration is reliable, robust, and meets their needs. This can help minimize the risk of downtime, data loss, and other issues that can impact patient care and business operations.

Maintain Communication.

Maintaining clear and effective communication is crucial for ensuring successful integration with athenahealth. Healthcare providers should keep the communication lines open and address any issues promptly to ensure that the integration runs smoothly.

To keep the communication lines open, healthcare providers should establish regular communication channels with their software vendors and athenahealth representatives. This includes regular check-ins, status updates, and progress reports to ensure that everyone is aware of the project’s status and any potential issues.

In addition, healthcare providers should establish clear lines of communication with their staff, ensuring that everyone involved in the integration is aware of the project’s status and any updates. This helps ensure that staff is prepared for any changes or new workflows that may arise as a result of the integration.

Addressing issues promptly is also crucial. Any issues that arise during the integration process should be addressed promptly to minimize their impact on patient care and business operations. Healthcare providers should establish clear escalation protocols to ensure that issues are addressed by the appropriate parties in a timely manner.

By maintaining open communication and addressing issues promptly, healthcare providers can ensure that the integration with athenahealth runs smoothly and achieves the desired outcomes. This helps minimize the risk of any disruptions to patient care and ensures that the integration delivers the expected benefits.

Conclusion; TLDR

Planning is key for any successful integration. Define the use case and identify the value it provides. Understand simple/complex integrations & types of APIs.

Review the athenahealth marketplace & vendor program, then develop & test the integration via registering a developer account, sandbox testing & submitting for marketplace approval.

Integrating digital health solutions with athenahealth creates many added benefits such as improved patient care through access to comprehensive patient data, care coordination tools, and seamless care transitions. Added value will be realized via streamlined workflows through automated data transfer and reduce duplicate data entry. Additionally, having your software interoperable with athenahealth allows for better data management with improved accuracy, enhanced security, and efficient data retrieval. Plus, increased revenue from improved billing processes, faster claim processing, better patient engagement, and increased efficiencies.

Common challenges include different breadth of product capabilities, API & usage costs.

Best practices for successful integration include determining the integration scope, identifying the first mutual client, establishing specific integration goals, and using established standards.

Thorough testing ensures reliability.

Intely is tried, tested, and proven with athenahealth integration! If you’re interested in having a strategy session around your use case, we’re happy to help!

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