3 Tech Things That Irk Me

Destructive APIs, a lack of interoperability standards—and their glacial pace—and Twitter are a few of the tech irritants on Scott Mace's mind this week.

This week, I've worked up a mini-rant about some of the most maddening things about information technology, in a healthcare context, of course.

1. APIs work great, until they break
Epic recently announced an application program interface (API) for its EHR software. Details remain sketchy, but I can guarantee one thing: Somewhere down the road, for some good reason, Epic will change its API and break a whole bunch of things built on top of the first API.

Don't blame Epic. It's the nature of APIs to change, particularly if the business model of the company publishing them depends on not allowing too much openness with competitors or potential competitors.

That's why we hunger for standards from groups such as HL7 to set the APIs in concrete. But standards are usually the product of vendors jockeying to deny each other any kind of competitive advantage, so they always end up being some kind of least common denominator.

Sorry HL7, but that's why your work, though important, is only the foundation work for much of the interoperability standards work (hopefully) underway at CommonWell Health Alliance and elsewhere.

2. Interoperability is coming along great, especially if you like really incremental progress
Maybe I'm not being fair, but let me tell you what crossed my desk yesterday, and you decide.

The announcement reads: "Michigan Health Information Network Completes Onboarding to eHealth Exchange; MiHIN becomes one of the first health information networks to onboard under new testing process working in collaboration with PCE Systems."

In plain English, MiHIN is inviting providers to join its service and thereby enabling them to exchange electronic medical records with federal organizations and other participants in the eHealth Exchange community.

That doesn't mean providers have agreed to exchange data. That announcement comes later, provided those providers find it in their economic interest to do so. I think ONC is still working on that part.

The announcement continues that MiHIN is the first organization to "onboard" the Consolidated Clinical Document Architecture (C-CDA), a data format required under Meaningful Use Stage 2 to support health information exchange.

PCE Systems turns out to be a behavioral health data sharing organization, and MiHIN officials note that this means HIE is moving from its focus on physical health to embrace behavioral health data as well.

It says something that this is probably going to be the biggest HIT interoperability story of the week. And it's safe to say the impact is pretty marginal on most providers. I do applaud all the participants, including Healtheway, Inc., which supports the eHealth Exchange community; and the Certification Commission for Health Information Technology (CCHIT), master of healthcare interoperability testing efforts.

I won't mind if you retweet this item, but good luck getting your summary into 140 characters.

3. Twitter is great. Twitter is maddening.
You might be surprised to learn I was a relative latecomer to Twitter. I couldn't seem to understand the value of hashtags, and often got my pound sign and my at sign confused. Around the time I joined HealthLeaders, I really got the hang of it. There's great benefit in forcing everyone's thoughts into 140 characters, even though there's no hope that it can completely cure one of FOMO (fear of missing out).

But it's far more useful than Facebook for seriously keeping up with what's going on. And don't get me started on how LinkedIn could be improved.

But Twitter is also frustrating. Just like LinkedIn, it needs some power data mining tools. TweetDeck and Twitter-based apps of its ilk appear to be great for following several hashtags on a single screen, but so far I haven't seen anything that really adds a sophisticated level of filtering to the service. And there is always the danger that if someone builds such an app, Twitter will change its API and break all those apps.

But you already know how I feel about APIs.