A lot of talk has been done lately on the importance of interoperability of EHR software. Many people point to health information exchanges when talking about this EHR interoperability. I must admit that almost all of the interoperability and health information exchange discussions I’ve seen recently leave me lost. Maybe I’m just not that smart, but I also think it’s possible that people are trying to bite off more than they can chew.
I’d like to see a simplified method for exchanging health information. Let’s break it down into bite size increments where we can actually have achievable goals and solvable problems. For example, let’s start with something like prescriptions, allergies or labs. Let’s get those right and then add on top of those functioning standards.
I previously posted the comparison of the Transcontinental Railroad to EHR interoperability. The reason it was so successful with the railroad was because they only had to standardize the gauge of the railroad. We should apply that same type of simplicity to exchanging patient information and we’ll see better results.
Since this is specifically a data-based problem, I think this should be done in the same way other data exchanges have been standardized over the web between different servers, operating systems, programming languages, etc… Namely, via XML using SOAP or REST based API’s. The point is to define the basic standards of language and structure, but dont define the medium or the transport vehicle. This approach has allowed the largest (and smallest) data-exchanging giants on the web go where no websites have gone before (ebay, Amazon, Facebook, Google, etc..).
I think that the first thing that has to be determined is what type of network connectivity exists. Are there legal issues of doing this over the web? Should it not be done on a private network?
Hugh,
You’ll never be able to get a private network to be able to do this across so many disparate offices. I believe the network technologies are now that to make this possible. I think the legal and logistical issues are what slows most of this down now.
[…] From what I can tell, it seems like CKM is essentially a wiki-like platform for displaying and improving these clinical standards (or archetypes if you prefer). I really think that the power of the crowd is the only way clinical standards are going to be defined, so the idea of a wiki-like website where people can collaborate around clinical standards sounds exciting. My only fear with it all is that if I’m having trouble cutting through much of the technical jargon, I wonder how many doctors will want to participate in this discussion. This seems like a really noble goal, but I can help but question if CKM and openEHR are not keeping EHR interoperability simple. […]
[…] and the context of that healthcare information. I still can’t help but think that we need to simplify our goals for EMR data sharing into small achievable […]
[…] What causes my eyes to roll back in their sockets is the “RHIO like” obstacles I hear associated with planning efforts around HIE – in anticipation of ARRA funding. https://www.healthcareittoday.com/2009/04/08/simplification-of-health-information-exchanges-a… […]