Concrete interoperability developments

Beth Walsh, Editor, Clinical Innovation + Technology

Rarely is there a shortage of interoperability rhetoric but this month, I’m pleased to report a concrete development on this front: Health Level Seven (HL7) International will make much of its intellectual property, including standards, freely available under licensing terms.

"This announcement is the most significant standards development in the past decade," said John Halamka, MD, CIO of the Beth Israel Deaconess Medical Center in Boston. “It ensures that every stakeholder will have ready access to the content standards they need for Meaningful Use.”

Meanwhile, the Office of the National Coordinator for Health IT (ONC) is invested in the Standards and Interoperability Framework, a collaborative initiative to develop standards for health information exchange (HIE), but the journey to completely interconnected devices will be a long one, according to the speakers of a Sept. 13 National eHealth Collaborative webinar.

“For a community to innovate, you have to have standards,” according to David S. Muntz, MBA, principal deputy national coordinator for health IT. The guiding principles behind the ONC’s standards development efforts include the ideas that: government is a platform where innovators can create the conditions of interoperability, health information needs vary and development should occur in incremental steps. 

"America's healthcare system has become far too complex and costly to continue business as usual," according to the Institute of Medicine (IOM), which released its 382-page report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. It’s too soon to know whether this report will have the same impact on healthcare as its report on medical errors (To Err is Human) released in 1999, but it’s certainly a call for improvement and today already.

"Pervasive inefficiencies, an inability to manage a rapidly deepening clinical knowledge base, and a reward system poorly focused on key patient needs, all hinder improvements in the safety and quality of care and threaten the nation's economic stability and global competitiveness," the IOM wrote. "Achieving higher quality care at lower cost will require fundamental commitments to the incentives, culture and leadership that foster continuous 'learning,' as the lessons from research and each care experience are systematically captured, assessed and translated into reliable care."

This past weekend, the CI+T staff attended the Medicine 2.0 Congress in Boston, and while the focus was on participatory medicine and how mobile health can facilitate that goal, interoperability touches on just about everything. For example, Joe Graedon, MS, a public radio show host and syndicated columnist, pointed to an online community of patients who determined a discrepancy in the length of time it took a brand name drug to reach peak concentration compared with a generic drug. “It was patients identifying a problem that no one else discovered and it led to quantitative data that confirmed their experiences. It’s an example of how connecting people can identify concerns that would never show up any other way.”

More than four-fifths of adults currently use the internet, according to research presented by Susannah Fox, many of whom are seeking health information. Each internet interaction represents an opportunity to engage with patients or to collect data on what patients care about.

Is the IOM report impacting health IT efforts at your hospital and is your facility working to take advantage of patients’ internet interactions? Please share your experience.

Beth Walsh
CI+T Editor
[email protected]