CHALLENGE OF TRUE INTEROPERABILITY & WHY IT MATTERS

Data Path - Ryoji IkedaBlog post by Joe Babaian (previously published on hcldr.org #hcldr)

In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged.  – HIMSS

Information is not knowledge.  – Albert Einstein

Ripped from recent headlines:

Group Seeks Federal Standards for HIT Interoperability – Bipartisan Policy Center

EHR Interop With Long-Term Care Providers Wanted, but Who Will Pay? – CMS

Before that genomics revolution, we need interoperability…  – MedCity News

Why Jonathan Bush thinks big vendors like Epic, Cerner will ‘collapse’ – Healthcare Dive

EHR vendors slammed for interoperability struggles. – CIO

The biggest challenge we face is liberating patient data from EHR systems to make it interoperable. – David Kendrick

Unless you’ve been totally detached from the healthcare system, you’ve seen and heard the buzz around interoperability. Actually, the lack thereof. No matter if you are a hospital CEO, a patient with a sore throat, or a healthcare policy wonk, you know that things are dire.

Let’s look at the HIMSS definition – the key parts are exchanging the data and using the data that has been exchanged. As Einstein noted, data alone is not knowledge and that is exactly where we find ourselves today. After you visit the urgent-care clinic and get diagnosed with strep, do the labs, diagnosis, and treatment automatically show up at your PCP, the ED the next day when you get sicker, or the ambulance crew that finds you collapsed at work? No.

The largest EHR vendors are competing ferociously for market share. Recently Cerner, to much surprise, beat out Epic for the major VA/Department of Defense contract worth $4.3 billionatheanahealth CEO Jonathan Bush notes:

The opportunity that came with the DoD contract was to build a national health information network that could ensure patients’ health information could follow them no matter where they went. Given the DoD’s decision, I’m not optimistic we will see this.

What do we need to do? The calls for “fixing” this are myriad, but it’s not happening at anywhere the scale needed. The government calls for interoperability every time it’s discussed, yet contracts like the Cerner deal are based on incumbent technology with many promises. Senator Lamar Alexander, chairman of the Senate Health, Employment, Labor and Pensions Committee recently said:

Information blocking is one obstacle to interoperability

Senator Alexander’s comment is the tip of the iceberg. All of this matters for reasons that are very basic to our healthcare system, economy, and growth. When I say “Access” think “Coherent, useful, and meaningful access” vs a printout or data file that’s just so proprietary as to be opaque:

  • Access to your data at all times allows for prompt continuity of care
  • Access to your data allows for huge cost savings in non-duplicated care, diagnosis, investigations
  • Access to your data allows for medical teams to use, learn from, and more properly integrate lessons learned from your care
  • Access to your data allows for healthcare information to be analyzed in aggregate on a massive scale for trends and emergent issues

You’ve heard enough. Now is the chance to discuss and look at your ideas, solutions, and paths to fixing this.  Do consider the implications along with the community of professionals, entrepreneurs, patients, clinicians, administrators, lurkers, and advocates! Consider the following key questions:

  • T1: How urgent is the need for true healthcare data interoperability and why?
  • T2:What experiences have you had with lack of interoperability?
  • T3: Do you see incumbent providers willingly getting “on board” or will further market forces/regulation come into play?
  • T4:What can we as healthcare leaders do today to change the current state of interoperability? Can it be done?

Resources

HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, 2nd Edition, 2010, Appendix B, p190. http://www.himss.org/files/FileDownloads/HIMSS%20Interoperability%20Definition%20FINAL.pdf, accessed August 01 2015

“Group Seeks Federal Standards for HIT Interoperability.” Greg Slabodkin, HealthData Management, July 30 2015 http://www.healthdatamanagement.com/news/Group-Calls-for-Health-IT-Standards-50982-1.html, accessed July 30 2015

“EHR Interoperability With Long-Term Care Providers Wanted, but Who Will Pay?” Ken Terry, iHealth Beat, July 2015 http://www.ihealthbeat.org/insight/2015/ehr-interoperability-with-longterm-care-providers-wanted-but-who-will-pay, accessed August 01 2015

“Before that genomics revolution, we need interoperability, patient engagement and privacy.” Meghana Keshavan, MedCity News, July 27 2015 http://medcitynews.com/2015/07/before-that-genomics-revolution-we-need-interoperability-patient-engagement-and-privacy/, accessed July 30 2015

“Why Jonathan Bush thinks big vendors like Epic, Cerner will ‘collapse’.” Katie Bo Williams, Healthcare DIVE, March 4 2015 http://www.healthcaredive.com/news/why-jonathan-bush-thinks-big-vendors-like-epic-cerner-will-collapse/370733/, accessed August 01 2015

“EHR vendors slammed for interoperability struggles” Kenneth Corbin, CIO, July 24 2015 http://www.cio.com/article/2952402/ehr/ehr-vendors-slammed-for-interoperability-struggles.html, accessed August 01 2015

“CIOs ‘surprised’ at Cerner DoD win.” Michelle Notebloom, Healthcare IT News, July 31 2015 http://www.healthcareitnews.com/news/cios-surprised-cerner-dod-win Accessed Aug 02. 2015, accessed August 01 2015

“Cerner beats out Epic for Massive 10 4.3 billion year DoD contract” reddit discussion, July/August 2015 http://www.reddit.com/r/epicsystems/comments/3f472p/cerner_beats_out_epic_for_massive_10_43_billion, accessed August 02 2015

Image Credit 

data.path by Ryoji Ikeda  https://flic.kr/p/gdMrKi

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