Top 10 Recent Quotes on Healthcare Interoperability


Much print has been dedicated to interoperability over the past several months. At issue is whether the government (ONC) should attempt to solve healthcare interoperability or continue the course and let the market solve it (or perhaps some in between). We will be discussing this issue with our partners at our annual GPAC event next week in Boston. To prime the discussion – and as part of our interoperability blog series – we present the top 10 recent quotes on the issue:

  1. Interoperability may not have gotten enough attention in the early days of Meaningful Use’s electronic health records (EHR) gold rush, but it’s now taking center stage as healthcare providers, government agencies, vendors, and committees consider how to support the exchange of data easily and securely. It’s very easy to point fingers at folks. People underestimate how challenging this work is,” Sawyer told InformationWeek. “I think the vendors are being cautious before spending lots of research and development money before a standard is more clearly defined.

    -Alison Diana, Information Week, “Healthcare Interoperability: Who’s The Tortoise?”

  1. If Big Data is the new oil in healthcare, clinical business intelligence is the refinery.

    -Brendan Fitzgerald, HIMSS Analytics, “Infographic: The future of clinical & business intelligence in healthcare”

  1. Congress doesn’t think that the marketplace has created the interoperability it thought it was mandating in the HITECH Act. The right question is: How do we ensure that patients, clinicians and caregivers all have read and write access to a patient’s longitudinal health record in real time? More generically, how do we ensure that the right information gets to the right person at the right time?

    -Flow Health Blog, “Beyond Interoperability”

  1. “information blocking” – I believe this concept is like the Loch Ness Monster, often described but rarely seen.   As written, the information blocking language will result in some vendors lobbying in new political forums (Federal Trade Commission and Inspector General) to investigate every instance where they are getting beaten in the market by other vendors.  The criteria are not objective and will be unenforceable except in the most egregious cases, which none of us have ever experienced. We are in a time of great turmoil in healthcare IT policy making.   We have the CMS and ONC Notices of Proposed Rulemaking for Meaningful Use Stage 3, both of which need to be radically pared down.   We have the Burgess Bill which attempts to fix interoperability with the blunt instrument of legislation.  Most importantly we have the 21st Century Cures Act, which few want to publicly criticize.   I’m happy to serve as the lightening rod for this discussion, pointing out the assumptions that are unlikely to be helpful and most likely to be hurtful

    -John Halamka, Life as a Healthcare CIO Blog, “21st Century Cures Act”

  1. The good people in Congress recently asked ONC: When it comes to the nationwide roll-out of a connected health IT system, are we getting our 28 billion dollars’ worth?

    -HealthBlawg “Locked Down or Blocked Up? ONC Report on Health Information Blocking”

  1. The bill abolishes theHealth IT Standards Committee and proposes to have the work of developing interoperability standards contracted out though usual procurement channels, and reviewed and approved by NIST and the Secretary ofHHS in addition to ONC. It also requires attestations by EHR vendors as to their products’ compliance with the interoperability standard, and it calls for the creation of a federal website that will have full transparent pricing for every certified EHR (and its components and interfaces) 

    -David Harlow, JD MPH, Principal, The Harlow Group LLC, “Whither Interoperability”

  1. The U.S. healthcare stakeholders include patients and individual physicians. Unfortunately, these two stakeholder groups are seldom represented in technical standards organizations and, more importantly, have almost no purchasing power when it comes to electronic health records or health information technology. This contributes to the slow rate of progress and has created significant frustration among both patients and physicians. The beauty of patient-driven interoperability is that ancillary infrastructure is helpful but not mandatory. As with auto-pay transactions with your bank, directory services are not required and certificate authorities are already in place. Certification tests would still be needed but the the Internet provides ample examples of open tests and self-asserted certification that would bypass most of the delays associated with legacy methods.

    -Adrian Gropper, MD, The Health Care Blog, “Patient-Driven Interoperability”

  1. I believe that the sufficient conditions for interoperability include the following:
    *A business process must exist for which standardization is needed. As Arien Malec put it recently, ‘SDOs don’t create standards de novo. They standardize working practices.’
    *A proven standard then needs to be developed, via an iterative process that involves repeated real-world testing and validation.
    *A group of healthcare entities must choose to deploy and use the standard, in service of some business purpose. The business purpose may include satisfying regulatory requirements, or meeting market pressures, or both.
    *A ‘network architecture’ must be defined that provides for the identity, trust, and security frameworks necessary for data sharing in the complex world of healthcare.
    *A ‘business architecture’ must exist that manages the contractual and legal arrangements necessary for healthcare data sharing to occur.
    *A governance mechanism with sufficient authority over the participants must ensure that the network and business frameworks are followed.
    *And almost no healthcare standard can be deployed in isolation, so all of the ancillary infrastructure (such as directory services, certificate authorities, and certification tests) must be organized and deployed in support of the standard.

    -John Halamka, Life as a Healthcare CIO Blog, “Standards Alone are not the Answer for Interoperability”

  1. Sometimes things are so ill-advised, in hindsight, that you wonder what people were thinking. That includes HHS’ willingness to give out $30 billion to date in Meaningful Use incentives without demanding that vendors offer some kind of interoperability. When you ponder the wasted opportunity, it’s truly painful. While the Meaningful Use program may have been a good idea, it failed to bring the interoperability hammer down on vendors, and now that ship has sailed. While HHS might have been able to force the issue back in the day, demanding that vendors step up or be ineligible for certification, I doubt vendors could backward-engineer the necessary communications formats into their current systems, even if there was a straightforward standard to implement — at least not at a price anyone’s willing to pay

    Anne Zieger, EMR & EHR, “HHS’ $30B Interoperability Mistake”

  1. This is one of the most public and noteworthy conversations that has taken place on the issue of patient identification. It’s time that Congress recognize the inability to accurately identify patients is fundamentally a patient safety issue.

    Leslie Krigstein, CHIME Interim Vice President of Public Policy,  EMR & EHR News Blog,  “Patient ID Highlighted as Barrier to Interoperability during Senate HELP Hearing”

 

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