Healthcare Interoperability is a Joke

Did you see the big news last month about healthcare interoperability? That’s right, Carequality announced support for FHIR. Next thing you know, we’re going to get an announcement that CommonWell is going to support faxing.

Seriously, healthcare interoperability is a joke.

The reality is that no EHR vendor wants to do interoperability. And it’s not saying anything groundbreaking to say that Carequality and CommonWell are both driven by the EHR vendors. Unfortunately, I see these organizations as almost a smokescreen that allows EHR vendors to not be interoperable while allowing them to say that they’re working on interoperability.

I’d describe current interoperability efforts as a “just enough” approach to interoperability. EHR vendors want to do just enough to appease the call for interoperability by the government and other patient organizations. It’s not a real effort to be interoperable. That’s most EHR vendors. A few of them are even using interoperability as a weapon to keep vendors out and some are looking at interoperability as a new business model.

Just to be clear, I’m not necessarily blaming the EHR vendors. They’re doing what their customers are asking them to do which is their highest priority. Until their customers ask for interoperability, it’s not going to happen. And in many respects, their customers don’t want interoperability. That’s been the real problem with interoperability since the start and it’s why grand visions of interoperability are unlikely to happen. Micro interoperability, which is how I’d describe what’s happening today, will happen and is happening.

If EHR vendors really cared about being interoperable, they’d spend the time to see where interoperability would lower costs, improve care, and provide a better patient experience. That turns out to be a lot of places. Then, they’d figure out how to make that possible and still secure and safe. Instead, they don’t really do this. The EHR vendors just follow whatever industry standard is out there so they can say they’re working on interoperability. Ironically, many experts say that the industry standards aren’t standard and won’t really make a big impact on interoperability.

There are no leaders in healthcare interoperability. There are just followers of the “just enough” crowd.

Let’s just be honest about what’s really possible when it comes to EHR vendors and healthcare interoperability. There is some point to point use cases that are really valuable and happening (this feels like what FHIR is doing to me). In a large health system, we’re seeing some progress on interoperability within the organization. We’re starting to see inklings of EHR vendors opening up to third-party providers, but that still has a long ways to go. Otherwise, we’re exchanging CCDs, faxes, and lab results.

Will we see anything more beyond this from EHR vendors? I’m skeptical. Let me know what you think in the comments on on Twitter with @HealthcareScene.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

4 Comments

  • Follow the money and all becomes clear. There is no money in interoperability for EHR vendors. Patients must rely on themselves and carry their records from Dr. to Dr., whether it’s the iPhone or the Android phone or paper or CDs or DVDs or brain storage. Self reliance is the only way to make sure you’re not health care compromised in an information needed situation.

  • “interoperability” could be very different if the core competency was to serve patients and those caring for them. Imagine… if it could be defined by them.

  • Barry,
    There’s no money in interoperability with healthcare organizations which is a pretty sad condition when you think of the non-profit ones.

    Randall,
    Always insightful. That would be dramatically different.

  • I agree 100%.
    We deal with interfacing between systems every day and we have found that many vendors charge exorbitant fees for enabling interfacing features like HL7, and even then we come across situations where the data made available is very minimal.
    We have also found that a significant percentage of CCDs that are sent by EMRs are implemented poorly and are either missing information or have important information in freeform text fields instead of in discrete data fields.
    In short, there is still a LONG way to go before interoperability is even close to what’s touted by the vendors and in the press.

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