With so many companies discussing healthcare integration, you might feel the need to jump on board and establish a solution for your company. However, before implementing healthcare integration, you must understand the total cost of ownership (TCO) and the factors that contribute to it.

What does this include? TCO covers more than the initial price of building and deploying healthcare integration engines; it encompasses any cumulative costs, from maintenance and updates to training and unforeseen expenses. Calculating TCO should give you a picture of your total investment, both immediate and long-term. 

For example, let’s say you buy a very cheap second-hand car. You might feel good about the initial cost, but if the car has numerous problems, you will spend a lot of money fixing it, and you might spend more than if you bought a pricier but well-kept car.

Investing in a healthcare integration engine is much like buying a car. Before purchasing, you should consider the long-term costs to reduce surprise expenses and ensure maximum return on investment.

Unpacking the layers of complexity in healthcare integration

While healthcare integration is not difficult to begin, it can quickly devolve into complex cases. The solution might seem easy, but problems will soon reveal themselves and become complicated to deploy in real-life scenarios.

For example, if you want to engineer a solution that processes different message types without duplicating code, it is almost certain that new messages, or message types, will be introduced as the system expands. HL7 messages are not all standard, and the data from these messages will need to be updated across multiple databases, and you will need to maintain data integrity. 

You also must account for security. You will need mechanisms for recovering failed messages, editing and resending them and tracing all activity. In this scenario, you are accounting for more than data accuracy; you must also ensure accountability and resilience in the face of potential system failures or external threats.

What contributes to the total cost of healthcare integration?

Initial engineering time

The beginning phases of building a healthcare integration engine can generate significant time and costs. To start the project on the right foot, developers must spend time understanding the healthcare domain and requirements and navigating technicalities specific to the integration engine. This phase is about more than simply coding a solution; it encapsulates designing architecture, testing initial builds, and ensuring the solution integrates properly with existing systems.

Third-party tools and platforms

When considering healthcare integration engines, it’s tempting to gravitate toward free trials or community editions. While they offer immediate cost savings, these versions often have limitations regarding functionality, scalability, or support. Cheaper software platforms may not have all the needed features, and scaling could become difficult.

Additionally, cheaper software solutions could have hidden costs in the future. You might need to add third-party platforms to extend functionality or grapple with the limited customisations you have to get what’s needed from the platform. Over time, what appears to be a budget-friendly choice can evolve into a more expensive undertaking that erodes your resources.

Long-term support and maintenance

When starting on healthcare integration, it can be easy to overlook the cost of system maintenance in the long term. Over the years, software updates, security patches, and compatibility checks with other systems will contribute to growing expenses. 

These costs are not just monetary; they involve dedicated resources to ensure the system remains functional and up-to-date. As the system matures, it will need regular updates to keep pace with changing healthcare standards, evolving technology, and user needs. This continuous cycle of refinement and adjustment means that engineering teams must dedicate consistent time, even after the initial deployment, to guarantee system reliability and efficiency.

Technical debt

Technical debt refers to the future costs and challenges that arise if you cut a corner during development and have to ‘pay’ for that debt in the future. For example, when you have to add a new feature or extend the system, previously undetected problems will arise and require a solution. Think of it as taking a shortcut and facing a longer, more complicated route later.

Opting for these shortcuts in the early stages of solution development might seem efficient, offering immediate time or cost savings. However, these decisions often lead to more complex problems down the line. This can result in longer development times, harder-to-fix issues, and greater expenses in the future when trying to rectify or build upon the existing system.

Why a comprehensive product might be worth the investment

Pre-built integration tools can cut costs for building integration software from scratch. However, before investing in a third-party solution, you need to evaluate the features and customisations available to assess if the total cost of ownership could be higher in the long run. There is no point in purchasing a cheaper tool that you have to replace in a year. 

Even if it appears more expensive initially, selecting a comprehensive integration engine often proves its value over time. Such products are generally designed with broader functionalities, catering to myriad scenarios and challenges. This holistic approach can lead to smoother integrations, better compatibility, and fewer unexpected costs in the future.


Healthcare integration offers critical capabilities that enable providers to share data and improve patient care. However, healthcare integration engines can rack up costs, including the time spent to engineer the platform, provide support and configure any third-party tools.

When selecting an integration engine, you need to adopt a forward-thinking approach. An informed choice, considering both immediate functionalities and long-term capabilities, will ensure a sustainable, efficient, and reliable healthcare integration solution.

Fluffy Spider builds healthcare integration engines

We help companies build a future of connected digital healthcare by making existing systems interoperable and modernising infrastructure to unlock the potential of new technologies.

We can collaborate with you to identify relevant opportunities using modern web services and standards for health information exchange, like HL7 and FHIR (Fast Healthcare Interoperability Resources). We enable interoperability with the technology used by the medical software industry, including those used by large healthcare providers such as Government health departments.

You can visit our Healthcare Integration Services page for more information.

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