Operability Before Interoperability

I recently read an interesting Meaningful Use article in which David Blumenthal said, “Before you can create interoperability, you have to create operability.”  While providers are scrambling to meet Stage 1 criteria, creating and maintaining the operability of core systems is an obstacle that many providers don’t see going away any time soon.

One patient access director recently told me of a problem with her registration and eligibility systems that is echoed by many of the providers I speak to every month: when there are upgrades or new rules put into the system, other rules disappear or parts of the system stop working.  She doesn’t anticipate these problems ever going away, and neither do so many other providers who experience the same problem with their rules-based and particularly customizable solutions.

So, my question is this: When you experience upgrades and changes to your rules-based and customizable solutions, what do you do to prevent broken bridges, disappearing rules and customizations that go AWOL? Are there any simple answers or best practices out there?