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Health Data Sharing and Patient Centered Care with DataMotion Health

Posted on April 13, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Now that the HIMSS Haze has worn off, we thought we’d start sharing some of the great video interviews we did at HIMSS 2016. In this case, we did a 3 pack of interviews at the DataMotion Health booth where we got some amazing insights into health data sharing, engaging patients, and providing patient centered care.

First up is our chat with Dr. Peter Tippett, CEO of Healthcelerate and Co-Chairman of DataMotion Health, about the evolution of healthcare data sharing. Dr. Tippett offers some great insights into the challenge of structured vs unstructured data. He also talks about some of the subtleties of medicine that are often lost when trying to share data. Plus, you can’t talk with Dr. Tippett without some discussion of ensuring the privacy and security of health data.

Next up, we talked with Dennis Robbins, PHD, MPH, National Thought Leader and member of DataMotion Health’s Advisory Board, about the patient perspective on all this technology. He provides some great insights into patients’ interest in healthcare and how we need to treat them more like people than like patients. Dr. Robbins was a strong voice for the patient at HIMSS.

Finally we talked with Bob Janacek, Co-Founder and CTO of DataMotion Health, about the challenges associated with coordinating the entire care team in healthcare. The concept of the care team is becoming much more important in healthcare and making sure the care team is sharing the most accurate data is crucial to their success. Learn from Bob about the role Direct plays in this data sharing.

Thanks DataMotion Health for having us to your booth and having your experts share their insights with the healthcare IT community. I look forward to seeing you progress in your continued work to make health data sharing accessible, secure, and easy for healthcare organizations.

The Real HIPAA Blog Series on Health IT Buzz

Posted on April 8, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you’re not familiar with the Health IT Buzz blog, it’s the Health IT blog that’s done by ONC (Office of the National Coordinator). I always love to see the government organizations blogging. No doubt they’re careful about what they post on their blog, but it still provides some great insights into ONC’s perspective on health IT and where they might take future regulations and government rules.

A great example of this is the Real HIPAA series of blog posts that they posted back in February. Yes, I realize I’m behind, but I’ll blame it on HIMSS.

Here’s an overview of the series:

It’s a common misconception that the Health Insurance Portability and Accountability Act (HIPAA) makes it difficult, if not impossible, to move electronic health data when and where it is needed for patient care and health. This blog series and accompanying fact sheets aim to correct this misunderstanding so that health information is available when and where it is needed.

The blog series dives into the weeds a bit and so it won’t likely be read by the average doctor or nurse. However, it’s a great resource for HIPAA privacy officers, CIOs, CSOs, and others interested in healthcare interoperability. I can already see these blog posts being past around management teams as they discuss what data they’re allowed to share, with whom, and when.

What’s clear in the series is that ONC wants to communicate that HIPAA is meant to enable health data sharing and not discourage it. We all know people who have used HIPAA to stop sharing. We’ll see if we start seeing more people use it as a reason to share it with the right people at the right time and the right place.

The Easiest Form of Healthcare Information Blocking – Charge for It

Posted on March 23, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve watched the discussion around information blocking in healthcare with a lot of interest. I’ve seen many people (including the government) talk about how information blocking is a major issue in healthcare and that we need to do something to solve the problem of information blocking. I’ve read other organizations who have searched for information blocking and say they can’t find it and that people are overstating the issue of information blocking.

I do think that some people overstate how big of an issue information blocking is, but I know that it’s a problem. Sometimes the information blocking is done purposefully, but other times it’s happening without much thought as to why they should or shouldn’t take part in information sharing.

As I’ve watched this discussion evolve and the drive towards interoperability I’ve realized that what’s happening in interoperability today could very well be the easiest and most legal form of information blocking that exists: charge for the information.

When I look into the future of information sharing, I can see EHR vendors salivating at these new found revenue streams associated with data sharing. Sure, it will only be pennies or fractions of a penny to share each record. However, when you spread that across millions and millions of records those fractions of a penny really start to add up.

When I look at the interoperability options that are being built today, these options are going to be able to charge for access to this data in a very granular way. All the data sharing is easily tracked and if it’s being tracked it can easily be charged for. I expect large healthcare organizations are going to have to start creating entire budgets dedicated to the cost of interoperability.

Once this happens smaller healthcare organizations are going to be blocked out of accessing the data. However, they won’t be literally blocked out of accessing the data like they are now. Instead, they’ll have access to the data, but the cost to access the data will be so much that they’ll be unable to access the data due to the high costs.

If you’re someone who’s a fan of information blocking, this is the perfect solution. No one can tell you that they couldn’t get access to the data, because they could get access to the data. All they had to do was pay for it. The fact that they couldn’t afford to access the data is a different issue. I expect this day will come sooner than we think.

EHR Vendor Commitments to Make Data Work at #HIMSS16

Posted on March 2, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I think back on the first day and a half of HIMSS, I think that this might be the biggest news of the conference so far:

It seems that most people see this as a hollow commitment. Some might argue that we’re jaded by past history and they’d be right. However I’d make a different argument. Interoperability is hard and there are plenty of incentives not to do it. I don’t see this changing because EHR vendors commit to being interoperable.

Let’s be honest. Saying that they’ve “committed” doesn’t matter if they have no skin in the game. There’s no payment for successfully creating a product that’s interoperable. There’s no penalty for not being interoperable. That’s not ONC and HHS’ fault. They only have the levers that the government provides them. There are just so many easy ways for EHR vendors to feign interest in a real commitment to interoperability without actually executing on that vision.

While this type of announcement at HIMSS doesn’t really make me think that the dynamics around healthcare interoperability will change, I do like HHS’ decision to have EHR vendors work out the interoperability problem. If the government couldn’t solve interoperability with $36 billion in incentive money and penalties to boot, do we really think they can do anything to change the equation? At least on their own. This has to be an industry focused effort or it won’t happen.

While I must admit that I’m slowly becoming a skeptic of ever achieving true interoperability of health data, I think we will see point examples where data is being shared. I’m always intrigued by great companies who realize that they can’t be everything, but they can be something. I think we’ll see more of more companies like this.

Expecting Evolutionary, Not Revolutionary at #HIMSS16

Posted on February 26, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most of you know, I’m deep in the weeds of planning for the HIMSS 2016 Annual conference. Actually, at this point on the Friday before HIMSS, I’m more or less planned. Now I’m just sitting here and wondering what things I might have missed. With that said, I’ve been preparing for this live video interview with the Samsung CMO which starts in 30 minutes (it’s recorded in case you miss the live discussion) and so I’ve been thinking about what I’m going to see at HIMSS. As someone who follows the changes in healthcare technology every day, I’m expecting lots of evolutionary changes and very little revolutionary.

As I think about it, I’m trying to imagine what someone could announce that would be revolutionary. That includes thinking back to past HIMSS to what announcements really revolutionized the industry. I can only think of two announcements that come close. The first announcement was when the meaningful use regulations were dropped right before the ONC session at HIMSS. Few people would argue that meaningful use has not revolutionized healthcare IT. Certainly many people would argue that it’s been a revolution that’s damaged the industry. Regardless of whether you see meaningful use as positive or negative, it’s changed so many things about healthcare IT.

The second announcement that stands out in my mind was the CommonWell health alliance. I’m a little careful to suggest that it was a revolutionary announcement because years later interoperability is still something that happens for a few days at the HIMSS Interoperability showcase and then a few point implementations, but isn’t really a reality for most. However, CommonWell was a pretty interesting step forward to have so many competing EHR companies on stage together to talk about working together. Of course, it was also notable that Epic wasn’t on stage with them. This year I’ve seen a number of other EHR vendors join CommonWell (still no Epic yet), so we’ll see if years later it finally bears the fruits of what they were talking about when they announced the effort.

The other problem with the idea that we’ll see something revolutionary at HIMSS 2016 is that revolutions take time. Revolutionary technology or approaches don’t just happen based on an announcement at a conference. That’s true even if the conference is the largest healthcare IT conference in the world. Maybe you could see the inkling of the start of the revolution, but then you’re gazing into a crystal ball.

The second problem for me personally is that I see and communicate with so many of these companies throughout the year. In just the last 6 months I’ve seen a lot of the HIMSS 2016 companies at various events like CES, RSNA, MGMA, AHIMA, etc. With that familiarity everything starts to settle into an evolution of visions and not something revolutionary.

Of course, I always love to be surprised. Maybe someone will come out with something revolutionary that changes my perspective. However, given the culture of healthcare and it’s ability to suppress revolutionary ideas, I’ll be happy to see all the amazing evolution in technology at HIMSS. Plus, the very best revolutionary ideas are often just multiple evolutionary ideas combined together in a nice package.

What’s Next in the World of Healthcare IT and EHR?

Posted on February 24, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In the following video, Healthcare Scene sits down with Dana Sellers, CEO of Encore, a Quintiles Company. Dana is an expert in the world of healthcare IT and EHR and provides some amazing expertise on what’s happening in the industry. We talk about where healthcare IT is headed now that meaningful use has matured and healthcare CIOs are starting to look towards new areas of opportunity along with how they can make the most out of their previous EHR investments.

As we usually do with all of our Healthcare Scene interviews, we held an “After Party” session with a little more informal discussion about what’s happening in the healthcare IT industry. If you don’t watch anything else, skip to this section of the video when Dana tells a story about a CIO who showed the leadership needed to make healthcare interoperability a reality.

We Share Health Data with Marketing Companies, Why Not with Healthcare Providers? Answer: $$

Posted on November 20, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those who don’t realize it, your health data is being shared all over the place. Yes, we like to think that our health care data is being stored and protected and that laws like HIPAA keep them safe, but there are plenty of ways to legally share health care data today. In fact, many EHR vendors sell your health care data for a pretty penny.

Of course, many would argue that it’s shared in a way that complies with all the laws and that it’s done in a way that your health record isn’t individually identified. They’re only sharing your health data in a de-identified manner. Others would argue that you can’t deidentify the health data and that there are ways to reidentify the data. I’ll leave those arguments for another post. We’ll also leave the argument over whether all this sharing of health data (usually to marketing, pharma and insurance companies) is safe or not for a future post as well.

What’s undeniable is that health data for pretty much all of us is being bought and sold all over health care. If you don’t believe it’s so, take a minute to look at the work of Deborah Peel from Patient Privacy Rights and learn about her project theDataMap. She’ll be happy to inform you of all the ways data is currently being bought and sold. It’s a really big business.

Here’s where the irony comes in. We have no trouble sharing health data (Yes, even EHR vendors have no problem sharing data and lets be clear that not all EHR vendors share data with these outside companies but mare are sharing data) with marketing companies, payers and pharma companies that are willing to pay for access to that data. Yet, when we ask EHR vendors to share health data with other EHR vendors or with an HIE, they balk at the idea as if it’s impossible. They follow that up with a bunch of lame excuses about HIPAA privacy or the complexity of health care data.

Let’s call a spade a spade. We could pretty easily be interoperable in health care if we wanted to be interoperable. We know that’s true because when the money is there from these third party companies, EHR vendors can share data with them. The problem has been that the money has never been there before for EHR vendors to be motivated enough to make interoperability between EHR vendors possible. In fact, you could easily argue that the money was instructing EHR vendors not to be interoperable.

However, times are changing. Certainly the government pressure to be interoperable is out there, but that doesn’t really motivate the industry if there’s not some financial teeth behind it. Luckily the financial teeth are starting to appear in the form of value based reimbursement and the move away from fee for service. That and other trends are pushing healthcare providers to want interoperable health records as an important part of their business. That’s a far cry from where interoperability was seen as bad for their business.

I heard about this shift first hand recently when I was talking with Micky Tripathi, President & CEO of the Massachusetts eHealth Collaborative. Micky told me that his organization had recently run a few RFPs for healthcare organizations searching for an EHR. As part of the EHR selection process Micky recounted that interoperability of health records was not only included in the RFP, but was one of the deciding factors in the healthcare organizations’ EHR selections. The same thing would have never been said even 3-5 years ago.

No doubt interoperability of health records has a long way to go, but there are signs that times are changing. The economics are starting to make sense for organizations to embrace interoperablity. That’s a great thing since we know they can do it once the right economic motivations are present.

Three Key Capabilities to Manage Population Health

Posted on April 7, 2015 I Written By

The following is a guest blog post by Marc Willard, President of Transcend Insights.
Marc Willard - Trascend Insights
The health care industry’s transition from fee-for-service to value-based reimbursement models demands a dramatic shift in how medical information is used and shared. The ability to generate a single, comprehensive patient view from an individual’s acute care, ambulatory care and wellness data is vital to support this transition. Ten years ago, the technology to move data out of silos to create real-time, physician-friendly, patient-centered population health management (PHM) systems was simply not available.

Fast-forward to 2015, where recent technological breakthroughs are fueling a new era in PHM that promises to help patients achieve their best health while allowing health care systems to create population health platforms that reward value, improve outcomes and reduce costs. For PHM vendors to successfully navigate this profound shift in the health care industry and provide actionable insights on an individual’s complete health care and health status, they need to deliver three key technologies:

  • Community-wide interoperability;
  • Real-time health care analytics; and
  • Intuitive care tools.

Community-Wide Interoperability

In developing a successful PHM system, one of the greatest challenges is working with disparate electronic health record systems that are not designed to communicate with each other, consequently keeping patient data entrenched in silos. Nothing is more frustrating for health care systems, physicians and care teams than dealing with multiple views and logins that impede the flow of information.

For PHM vendors to be successful, they must offer sophisticated health information exchange technology that integrates both clinical and claims data from diverse sources into a single, comprehensive patient view. Recent advances in cloud-based interoperability technology allow health care systems, physicians and care teams to literally get on the “same (electronic) page” with their patients’ complete health care history and real-time treatment strategies.

Interestingly, for health information exchange technology to successfully meet the needs of PHM, we must think beyond traditional electronic health record system interoperability. In addition to integrating data from health information generated outside the four walls of the hospital in ambulatory settings, successful PHM companies will be able to incorporate the valuable insights generated from the latest wearable health technologies that track activity levels, heart rate and other health information into a single, comprehensive patient view. This patient engagement is crucial in the new value-based reimbursement environment, with its focus on wellness and preventive medicine. PHM companies must know how to capture it and deliver meaningful insights to physicians and care teams without overwhelming them.

Several capabilities are required to ensure successful PHM, including bi-directional semantic interoperability, master patient indexing, both clinical and claims data capture and integration, real-time information sharing, results distribution and order processing, care and consent management tools, and of course privacy and security.

Another aspect that is crucial for interoperability is unobstructed access to patient information within traditional silos, so that data can truly be shared. Allowing data to flow requires open systems and interoperability standards that are clean, and widely and easily adopted.

Real-Time Health Care Analytics

A strong PHM tool combines community-wide interoperability with real-time health care analytics capabilities. Effective health care analytics should be able to identify evidence-based gaps in care, drug safety concerns and other opportunities for health improvement while ensuring compliance with the latest clinical guidelines and national quality measures to maximize reimbursement.

Yet the true value in health care analytics is the ability to deliver these insights quickly and simply at the point of care. Every minute counts in health care delivery, and even a five-minute delay in processing information is unacceptable during an office visit, as the physician needs to move on to his or her next patient in a timely manner.

Rather than processing health care data in batch mode, over hours or days, a real-time analysis engine should process data in milliseconds. This enables more informed decisions at the point of care to further ensure that every individual can achieve his or her best health. Physicians now have the ability to take a longitudinal view of how these analytic insights contribute to their patients’ past, present and future health.

Effective real-time health care analytics also allows physicians and care teams to compare an individual’s health status against population benchmarks. By doing so, they can track clinical trends such as readmission rates to further support intervention strategies, reduce risk and decrease costs.

Intuitive Care Tools

Physicians and care teams are more willing to utilize real-time insights generated by sophisticated analytics if they can be easily accessed in a matter of seconds, with just one or two clicks. Even more useful is mobile technology that provides a single, comprehensive view at the physician’s fingertips.

When developing intuitive care tools, PHM vendors should consult directly with physicians to better match and accommodate their unique information needs. For example, offering physicians access to comprehensive clinical trends across a population provides vital insights. When equipped with this information, physicians can improve care delivery through proactive interventions that create meaningful change.

Getting patients involved in the health care equation is equally important when developing intuitive care tools. For example, real-time insights available via mobile point of care solutions allow physicians to maintain eye contact with their patients, have a more meaningful discussion and improve the overall patient experience. As a result, mobile point of care solutions can help physicians encourage their patients to become active participants in their own health, for example, increasing a patient’s medication adherence to help with reducing readmissions.

In addition, once we understand a patient’s total health status and health care needs, physicians and care teams can recommend customized wellness programs that directly address current or future health care concerns. Patient engagement tools as well as a single, comprehensive consumer view can help empower individuals to take control of their own lifestyle choices. For example, smoking cessation classes, nutrition counseling or exercise programs, can help keep individuals healthy and minimize the need for medical interventions.

Keep the Focus on the Patient

With the movement from fee-for-service to value-based reimbursement models, the demand has never been greater for population health management systems that accomplish the industry’s triple aim: improving population health, enhancing the patient experience and reducing costs.

PHM vendors can simplify this transition by developing platforms that offer community-wide interoperability, real-time health care analytics and intuitive care tools. The health IT industry’s transformation must continue to be centered on the patient, whose health and well-being remain the focus of today’s population health management initiatives.

About Marc Willard
Marc Willard is the president of Transcend Insights, a wholly owned subsidiary of Humana Inc., dedicated to simplifying population health. The company, which launched in March 2015, represents the merging of three leading health care information technology businesses: Certify Data Systems, Anvita Health and nliven systems. For more information about Transcend Insights, visit: www.transcendinsights.com.

Element-Centric or Document-Centric Interoperability

Posted on February 17, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A recent Chilmark blog post on national healthcare interoperability mentioned two approaches to healthcare interoperability: element-centric interoperability and document-centric exchange.

As I think back on the thousands of discussions I’ve had on interoperability, these two phrases do a great job describing the different approaches to interoperability. Unfortunately, what I’ve seen is that many people get these two approaches to interoperability mixed up. In fact, I think it’s fair to say that meaningful use’s CDA requirement is an attempt to mix these two concepts into one. It’s one part element data and one part document.

Personally, I think we should be attacking one approach or the other. Trying to mix the two causes issues and confusion for those involved. The biggest problem with mixing the two is managing people’s perception. Once doctors get a small slice of cake, they want the rest of it too. So, it’s very unsatisfying to only get part of it.

Document-Centric Exchange
The argument for document-centric exchange of healthcare data is a good one. There are many parts of the patient record that can’t really be slimmed down into a nice element-centric format. Plus, there’s a wide variation in how and what various doctors document. So, the document format provides the ultimate in flexibility when it comes to outputting and sharing this data with another provider.

Those who are against document-centric exchange highlight that this is really just a modernization of the fax machine. If all we’re doing is exchanging documents, then that’s basically replicating what we’ve been doing for years with the fax machine. Plus, they highlight the fact that you can’t incorporate any of the granular data elements from the documents into the chart for any sort of clinical decision support. It might say your allergies on the document, but the EHR won’t know about those allergies if it’s stored on a document you received from another system.

While certainly not ideal, document-centric exchange can still be a nice improvement over the fax machine. In the fax world, there was still a lot of people required to get the documents faxed over to another provider. In the document-centric exchange world this could happen in real time with little to no interaction from the provider or their staff. The fact that this is possible is exciting and worrisome to many people. However, it would facilitate getting the right information (even if in document form) to the right people at the right time.

Element-Centric Exchange
We all know that the nirvana of health information exchange is element-centric exchange. In this exchange, your entire health record is available along with a series of meta data which tells the receiving system what each data element represents. This solves the allergy problem mentioned above since in an element-centric exchange the allergy would be stored in a specific field which notes it as an allergy and the receiving system could process that element and include it in their system as if it was entered natively.

This last line scares many people when it comes to element-centric exchange. Their fear is that the information coming from an external system will not be trustworthy enough for them to include in their system. What if they receive the data from an external system and it’s wrong. This could cause them to make an incorrect decision. This fear is important to understand and we need our systems to take this into account. There are a lot of ways to solve this problem starting with special notation about where the information was obtained so that the provider can evaluate that information based on the trustworthiness of the source. As doctors often do today with outside information about a patient, they have to trust but verify the information. If it says No Known Drug Allergy, the doctor or other medical staff can verify that information with the patient.

The other major challenge with element-centric exchange is that medical information is really complex. Trying to narrow a record down to specific elements is a real challenge. It’s taken us this long to get element-centric exchange of prescription information. We’re getting pretty close there and prescriptions are relatively easy in the healthcare information world. We’re still working on labs and lab results and anyone whose worked on those interfaces understand why it’s so hard to do element-centric exchange of health information.

This doesn’t even address the challenge of processing these elements and inputting them into a new system. It’s one thing to export the data out of the source system in an element-centric format. It’s an even bigger challenge to take that outputted document and make sure it imports properly into the destination system. Now we’re talking about not only knowing which element should go where, but also the integrity and format of the data in that field. Take something as simple as a date and see the various formats which all say the same thing: 2/17/15, 2/17/2015, 02/17/2015, February 17 2015, Feb 17 2015, 17/2/2015 etc.

Where Is This Heading?
As I look into the future of interoperability, I think we’ll see both types of exchange. Document-centric exchange will continue with things like Direct Project. I also love these initiatives, because they’re connecting the end points. Regardless of what type of exchange you do, you need to trust and verify who is who in the system so that you’re sending the information to the right place. Even if document exchange using Direct isn’t the end all be all, it’s a step in a good direction. Plus, once you’re able to send your documents using direct, why couldn’t an HIE of sorts receive all of your documents? We’re still very early in the process of what Direct could become in the document-centric exchange world.

I think we have a long ways to go to really do element-centric exchange well. One challenge I see in the current marketplace is that companies, organization, and our government are trying to bite off more than they can chew. They are trying to make the entire patient chart available for an element-centric exchange. Given the current environment, I believe this is a failed strategy as is illustrated by the hundreds of millions of dollars that the government has spent on this goal.

I look forward to the day when I see some more reasonable approaches to element-centric exchange which understand the realities and complexities associated with the challenge. This reminds me of many organizations’ approach to big data. So many organizations have spent millions on these massive enterprise data warehouses which have yet to provide any value to the organization. However, lately we’ve seen a move towards small data that’s tied directly to results. I’d like to see a similar move in the element-centric exchange world. Stop trying to do element based exchange with the entire health record. Instead, let’s focus our efforts on a smaller set of meaningful elements that we can reasonable exchange.

While the idea of document-centric exchange and element-centric exchange simplify the challenge, I think it’s a great framework for understanding healthcare interoperability. Both have their pros and cons so it’s important to understand which approach you want to take. Mixing the two often leaves you with the problems of both worlds.

6 Healthcare Interoperability Myths

Posted on February 9, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

With my new fascination with healthcare interoperability, I’m drawn to anything and everything which looks at the successes and challenges associated with it. So, it was no surprised that I was intrigued by this whitepaper that looks at the 6 Healthcare Interoperability Myths.

For those who don’t want to download the whitepaper for all the nitty gritty details, here are the 6 myths:

  1. One Size Fits All
  2. There Is One Standard to Live By
  3. I Can Only “Talk” to Providers on the Same EHR as Mine
  4. If I Give Up Control of My Data, I’ll Lose Patients
  5. Hospitals Lead in Interoperability
  6. Interoperability Doesn’t Really “Do” Anything. It’s Just a Fad like HMOs in the 90s

You can read the whole whitepaper if you want to read all the details about each myth.

The first two hit home to me and remind me of my post about achieving continuous healthcare interoperability. I really think that the idea of every health IT vendor “interpreting” the standard differently is an important concept that needs to be dealt with if we want to see healthcare interoperability happen.

Another concept I’ve been chewing on is whether everyone believes that healthcare interoperability is the right path forward. The above mentioned whitepaper starts off with a strong statement that, “It’s no tall tale. Yes. We need interoperability.” While this is something I believe strongly, I’m not sure that everyone in healthcare agrees.

I’d love to hear your thoughts. Do we all want healthcare interoperability or are there are a lot of people out there that aren’t sure if healthcare interoperability is the right way forward?