Case Study – Lab ACORD & HL7 Integration

PilotFish Middleware Integrates Medical Lab Data

Standardized Integration Approach Delivers for Leading North American Laboratory

One of North America’s largest labs was on the verge of being buried under a mountain of requests for integration from insurance providers, hospitals, other labs and government entities. In this case study, learn how they partnered with PilotFish to reduce their backlog with a unified approach to data transformation and transmissions to reach the peak of integration capability.


The client is a health and wellness solutions leader and one of the largest providers of laboratory testing in North America. They offer data analytics services as well as health and insurance solutions. Their clients include patients, healthcare professionals, governments, regional health authorities and hospitals. Their partners include other types of healthcare facilities, sponsors of clinical trials, organizations, carriers and other medical laboratories. Their services span the gamut – from specialized insurance services, medical and genetic testing to digital health and wellness programs.


As one of the largest laboratory companies on the continent, the client is faced with an unending stream of internal and external integration requirements. Their business model requires that they adapt to the technical capabilities and preferences of its very diverse mix of clients and partners. The client had successfully developed an architecture for addressing connectivity challenges and built a team to skillfully execute the implementations. However, the growing need to establish data flows with new clients and partners, new flows with current clients and partners and their ongoing maintenance of existing systems was rapidly taxing their bandwidth and technology stack’s capacity to deliver. IT backlogs were severely limiting their ability to deliver high-quality customer service and to expand.

The client was also required to support a variety of data standards. The client managed a growing insurance segment that required the implementation of ACORD XML messaging for life policy underwriting. ASTM was a common source or target data format for the integration of their medical devices and equipment. Lab orders and results were transmitted in the HL7 format. And they regularly had to translate to and from custom formats including CSV, positional flat files and XLS.

PilotFish was initially selected to address the client’s insurance integration requirements utilizing the ACORD XMLife standard. By implementing PilotFish, the client was able to provide flexible, custom integrations to their clients and data exchange partners while insulating their internal systems from one-off code that was difficult to maintain. The client was able to use PilotFish to receive requirement orders (e.g., ACORD 121) and to send requirement status and results (e.g., ACORD 1122, ACORD 1125, ACORD 103) in whatever flavor or format was required. Thus, they were able to perfectly align with their partner’s and client’s technical capabilities and preferences to fully support their business model.

It quickly became evident that the speed of implementation, reduced maintenance effort and quality of deployed integrations made PilotFish a superior solution to any of their existing tools.  Also, unlike the others, PilotFish could support all of the data standards for their mix of business.

At about that same time, new executive management had been brought in to digitally transform their business.  The incoming executive identified integration as an area of strategic importance and one that required immediate attention. Based on the earlier success achieved with their insurance business and an appreciation for PilotFish’s integration expertise in general, the client invited PilotFish to conduct an assessment of all of their systems, workflows and processes around integration. PilotFish accepted the invitation and assembled a small team of its experienced solutions architects to work with the client’s staff to analyze technology gaps, uncover inefficiencies, identify workflow issues and develop an actionable plan.

The assessment provided a review of the then-current state set of technologies. This included regionally disparate laboratory information systems (LIS) based on “big iron” and midrange servers. Commercial systems among these included: Pervasive, Omnitech, Merlin and Aplis. Integrations were intricately stitched together by using a combination of commercial technologies (including Microsoft BizTalk, Interfaceware Iguana & Chameleon) as well as custom code. 

Analysis also revealed that the high volume and complexity of data integration had reached a level unanticipated at the time of the design of their current architecture. New client implementations were taking too long. Staff was overwhelmed with backlog requests. The knowledge and time required to maintain existing interfaces continued to compound workloads. The client’s ability to manage and maintain existing integrations and implement new data exchange partners was not possible with the then current process and technology stack.

Part of the analysis included the PilotFish team meeting with the client’s staff to perform a retrospective analysis of past implementation efforts. Emphasis was placed on understanding the calendar time, actual hours worked and any roadblocks encountered. Once this analysis was complete, a profile of a “typical implementation” was created.  Bottlenecks were cataloged and a list of related, actionable improvements were quantified and prioritized based on the value and implementation effort.

The findings were not atypical. The client’s technical architecture was an amalgam of technologies that had accumulated over the years. Each component served a purpose – yet over time, the conglomeration of tools led to a growing maintenance burden and an ever-steeper learning curve for new staff members.

Aside from the delays directly attributed to technology – client communication, requirement discovery and analysis, testing, and debugging were identified as the most time consuming and risk-prone phases of the average project. 


Shortly after the completion of the assessment and PilotFish’s delivery of an action plan, the organization embarked on a series of improvements to both its business processes and underlying technical infrastructure. 

The plan included the overall simplification of their integration architecture. The team was able to make significant progress towards gradually reducing the number and complexity of the systems involved in any given interface. The implementation of the PilotFish Integration Engine Solution Suite was extended beyond insurance to the client’s other lines of business. This consisted of the eiPlatform (as the central enterprise service bus) and the eiConsole Integrated Development Environment (IDE), for the data transformation framework. The eiConsole provided a Graphical Automated Interface Assembly Line process for connecting any two or more systems, irrespective of data format or connectivity protocol.

The plan also included the implementation of automated regression testing. The client’s number of data manipulation points and the co-mingling of partner-specific transformation rules created an environment ripe for regression issues. The programmatic comparison of known-good pairs of input and output files prior to any production deployment significantly reduced this risk and the corresponding time spent on remediation, when issues did occur.

The client’s relationship with PilotFish evolved along with the company’s growing prominence in the clinical sphere. The laundry list of technologies previously used to support integration across the enterprise was slowly retired in favor of a standardized architecture built around the PilotFish Integration Engine Solution Suite


By reducing the number of integration tools employed, the client was able to simplify the technology stack that was required to build, operate and maintain interfaces, integrations and process orchestrations.  PilotFish could support all data standards and integration requirements with a common approach. Having a single integration tool to learn and understand improved collaboration across multiple integration project teams.  Much of the configuration and data mapping could now be handled by business analysts, thus enabling a more agile approach to configuring integrations. This increased the productivity of the software engineering staff by a factor while simultaneously improving the quality of their output.  The client was finally able to begin reducing the backlog of IT projects. 

Improved operational productivity and efficiency were not the only benefits.  By dramatically reducing the time to deploy new interfaces and onboard new customers, the client improved customer service and was able to realize new revenue sooner. 

Since its founding in 2001, PilotFish has been solely focused on the development of software products that enable the integration of systems, applications, equipment and devices. Billions of bits of data transverse through PilotFish software connecting virtually every kind of entity in healthcare, 90% of the top insurers, financial service companies, a wide range of manufacturers, as well as governments and their agencies. PilotFish distributes Product Licenses and delivers services directly to end users, solution providers and Value-Added Resellers across multiple industries to address a broad spectrum of integration requirements.

PilotFish will reduce your upfront investment, deliver more value and generate a higher ROI. Give us a call at 860 632 9900 or click the button.

HL7 is the registered trademark of Health Level Seven International.

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