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Interoperability Needs More Than Fired-Up Buyers

Scott Mace, for HealthLeaders Media, March 25, 2014

None of which is to say we should despair of striving for healthcare IT interoperability. I am pleased that West Health Institute and the Gary and Mary West Foundation have formed the Center for Medical Interoperability to drive this cause.

"We've got real people hired into these jobs, many with very deep technical chops to try to push us, because we do see this as a bit of a campaign. It's not going to be over at one meeting or with one paper," Smith said. The list of participating health systems has yet to be released, and time will tell how successful this new center will be.

ONC's Role
One thing, however, is pretty ironic about the ONC's participation in this new interoperability push. Not only did ONC deliberately pull away from issuing specific guidance of its own on health IT interoperability in 2013, it also could be argued that the meaningful use program which so far has funded $22 billion of HIT technology in the U.S. is partly responsible for our current tower of IT babel.

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2 comments on "Interoperability Needs More Than Fired-Up Buyers"


Joseph M. Smith, MD, PhD (3/25/2014 at 7:32 PM)
Scott [INVALID] Thanks for the interview. Would agree with much of what you said, particularly that energized and aligned buyers are necessary but likely insufficient, hence the call out for specific actions by clinicians, patients, vendors, regulators and payers as well. And to clarify one point, the meeting and resultant paper were directed at the broader issue of interoperability, including medical device interoperability, where the voice of the buyer has not yet been raised.

Frank Poggio (3/25/2014 at 5:24 PM)
Well there ya go again! Got a problem - blame the vendors. We all know they are the real Satan of systems interoperability. Hey, wait a minute. Wasn't it the vendors that started HL7 almost thirty years ago? Promoted CCOW and other tools? Well it must be the vendors because if banks can work together so I can get money out of any ATM around the world and the debit makes it to my account instantly – why can't health care vendors do that? After forty years in healthcare IT I'll give you five reasons: 1)First of all, if health care and medicine were as simple as banking we'd all go to our loan officers when we cut our fingers off. True financial transactions can be complex but no- where as complex as trying to figure out why Johnny keeps vomiting. 2)Every time we think we have ironed out a 'EBM standard' somebody comes up with a new medical protocol or research study that upends it and requires more and different data, to support (or challenge) it. See PCA test, mammography, sepsis diagnosis, Pap tests, etc. 3)Computer technology keeps changing, not only the hardware but the software and data tools as well, not to mention the telecommunications improvements over the last thirty years. To be sure they have helped, but see item 5. 4)When a provider buys a new specialty system (say an anesthesiology system) he/she wants the latest tools running on the latest op systems. But they do not want to change out all the underlying mission critical systems like CPOE, meds management, etc. This makes for real fun interop project. 5)To maintain software stability and keep glitches down a basic rule of IT is to NOT change anything unless you absolutely have to. Change causes pain and interoperability is usually the first to suffer. Yet the providers want new enhancements, the feds want MU tools added, and medicine keeps finding new deceases and procedures to address them. Stop the changes and see interop work! Lastly if you think commercial industry is a heaven of smooth interoperability, next time you are at the airport take a long look at the screen that comes up for the ticket agent. Believe it or not they still use 'character filled green screens' running under state of the art operating systems like Windows XP and then type in cryptic codes to get you a seat change. Then if you need to change flights to another carrier they actually have to PRINT out a ticket that you take to your new carrier. Now that's what I call interoperability! Why can't healthcare be more like that? Frank Poggio The Kelzon Group KelzonGroup.com