Completing drive toward healthcare interoperability will be challenge by Ed Burns.
From the post:
The industry has made progress toward healthcare interoperability in the last couple years, but getting over the final hump may take some creative thinking. There are still no easy answers for how to build fully interoperable nationwide networks.
At the Massachusetts Institute of Technology CIO Symposium, held May 22 in Cambridge, Ma., Beth Israel Deaconess Medical Center CIO John Halamka, M.D., said significant progress has been made.
In particular, he pointed to the growing role of the Clinical Document Architecture (CDA) standard. Under the 2014 Certification Standards, EHR software must be able to produce transition of care documents in this form.
But not every vendor has reached the point where it fully supports this standard, and it is not the universal default for clinician data entry. Additionally, Halamka pointed out that information in health records tends to be incomplete. Often the worker responsible for entering important demographic data and other information into the record is the least-trained person on the staff, which can increase the risk of errors and produce bad data.
There are ways around the lack of vendor support for healthcare data interoperability. Halamka said most states’ information exchanges can function as middleware. As an example, he talked about how Beth Israel is able to exchange information with Atrius Health, a group of community-based hospitals in Eastern Massachusetts, across the state’s HIE even though the two networks are on different systems.
“You can get around what the vendor is able to do with middleware,” Halamka said.
But while these incremental changes have improved data interoperability, supporting full interconnectedness across all vendor systems and provider networks could take some new solutions.
Actually “full” healthcare interoperability isn’t even a possibility.
What we can do is decide how much interoperability is worth in particular situations and do the amount required.
Everyone in the healthcare industry has one or more reasons for the formats and semantics they use now.
Changing those formats and semantics requires not only changing the software but training the people who use the software and the data it produces.
Not to mention the small task of deciding on what basis interoperability will be built.
As you would expect, I think a topic map as middleware solution, one that ties diverse systems together in a re-usable way, is the best option.
Convincing the IT system innocents that write healthcare policy that demanding interoperability isn’t an effective strategy would be a first step.
What would you suggest as a second step?