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Saturday 23 September 2017
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Interoperability Should Be a Four Letter Word

Interoperability Should Be a Four Letter Word

Interoperability Should Be a Four Letter Word

The Velocity Interoperability Blog and Velocity Interoperability Podcast are sponsored by Velocity Health Informatics. Velocity provides both data quality and data integration as a service offerings to ensure that healthcare providers access the correct patient record with the right data for each patient they serve.

Over the past 3 years as I have interviewed over 50 CIOS on intrepidNOW Healthcare, and the single most common topic discussed is interoperability, or more accurately, the need for interoperability at the health system level and beyond, integrating their own systems, medical devices, and now IoT and #mHealth devices and integrating with everyone else’s EMRs via HIEs or other methods.

This probably isn’t first time or place that you’ve heard my opinion that the great failure of Meaningful Use was that we did not require Interoperability in any of the Stages. I believe that it should have been included in Stage 1. I am sure that there are many political and technical reasons that the powers that be ignored the most important requirement of our EHR data for each of us 300 million Americans/Patients, the ability for all data to be accesses from anywhere. It simply does not make sense to me that we would spend $38B on EHRs and not require that they interoperate.

Where exactly do we stand?

After 3 stages of Meaningful Use, not even EHRs from the same vendor for health systems in the same city interoperate. The good news is that there are 430 health systems that are sharing a common EHR, but the bad news is the remaining of our 5,000+ hospitals and ~230,000 physician practices EACH now have their own EHR. So we have all our medical record data stored in a digital format, but the likelihood is VERY HIGH that the data is stored in multiple EHRs that DO NOT interoperate.

Being that there was not an abundance of experience EHR implementation available while EVERYONE was required to implement them during the same short period of time, many providers have poorly implemented EHRs and regularly complain that the EHRs are making them less productive than they were with paper records and manual processes.

There is also a high percentage of data quality errors (duplicate medical records, lost records, etc.) in most EHRs and few organizations have created the data quality process, governance and infrastructure necessary to avoid continuing to produce new errors, much less to fix the ones that exist.

Healthcare provider organizations have developed expertise in integrating healthcare data and systems over the last 35 years as the number of systems has mushroomed, but their integrations often fall short and often cause healthcare workers to perform manual work-arounds. Most healthcare provider organizations fall WAY short of true interoperability of their IT systems whereby workflow is optimized vs. constrained by the systems.

We don’t currently have a way to identify us each as patients, such as a National Patient ID.   However, the recent National PatientID Challenge, sponsored by CHIME, could give us hope that one is within reach in the next few years.   Even so, many provider organizations struggle mightily with Patient Identification, failed eMPI implementations, and “dirty data” due to a number of process issues in getting patients “into their systems”.

What about HIEs, CommonWell and Sequoia?

Some (a small number) states, regions and states have successfully deployed Health Information Exchanges (HIEs) to share data but many HIEs have failed and many locations never had one at all. Most of the “successful” HIEs don’t have a sustainable business model and clearly HIEs won’t provide the long term answer for interoperability.

Groups like CommonWell and Sequoia have been created to work on standards and connectivity from vendor to vendor or from system to system, but they are early in their efforts and in my opinion, not audacious enough in their goals, to have the promise of solving the interoperability problem nationally. I hope they can, I just don’t see enough momentum with either to so it happening in the next 5-10 years. I’d love to be proved incorrect. 

What are we to do?

Keep grinding. There are a number of companies, organizations, and individuals working very hard to provide solutions to better integration, data quality and integrity and the Holy Grail of Interoperability. Via this Velocity Interoperability Blog and Podcast, we will bring you the latest and best successes and failures straight from the industry’s best innovators.  We will explore the current advances in technologies (HL/7, FHIR, etc) and in processes (Data Governance, Medical Record Remediation, etc) and we will share Best Practices and more as we identify them.

Join the Conversation

Please jump in and participate as your input will only improve our chances of success.  The fine folks at Velocity are interested in exploring and improving our current states of medical record data quality and interoperability and this post is the first of many posts and (coming soon) podcasts reporting on current status and solutions.  PLEASE bookmark this site and provide your input and feedback on a regular basis!

 

The Velocity Interoperability Blog and Velocity Interoperability Podcast are sponsored by Velocity Health Informatics. Velocity provides both data quality and data integration as a service offerings to ensure that healthcare providers access the correct patient record with the right data for each patient they serve.

Joe Lavelle
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Joe Lavelle

Editor-in-Chief, Healthcare at intrepidNow
JOE LAVELLE is a Healthcare Management and Technology Consultant with a record of successfully meeting the business and technology challenges of diverse organizations including health plans, health delivery networks, and health care companies for 25 years. Joe worked his way up through Cap Gemini and Andersen Consulting to the partner/VP level of at First Consulting Group, Technology Solutions Group and Santa Rosa Consulting. After running his own company, Results First Consulting, for 12 years Joe Co-Founded intrepidNow with Todd Schnick to create incredible content to dramatically improve the sales and marketing efforts of their clients.
Joe Lavelle
Follow me


JOE LAVELLE is a Healthcare Management and Technology Consultant with a record of successfully meeting the business and technology challenges of diverse organizations including health plans, health delivery networks, and health care companies for 25 years. Joe worked his way up through Cap Gemini and Andersen Consulting to the partner/VP level of at First Consulting Group, Technology Solutions Group and Santa Rosa Consulting. After running his own company, Results First Consulting, for 12 years Joe Co-Founded intrepidNow with Todd Schnick to create incredible content to dramatically improve the sales and marketing efforts of their clients.


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