Getting interoperability efforts on the right track
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| Mary Stevens, CMIO Editor |
Railroads drove the Industrial Age, and now “we have an Information Age set of activities in healthcare tied to an Industrial Age way of managing the data” that hinders data-based and evidence-based decision making, says Jonathan B. Perlin, MD, PhD, chairman of the ONC’s HIT Standards Committee.
Regarding standards for health information exchanges (HIEs), “the Transcontinental Railroad needed the same gage of rails” to span the continent, “but implied behind that is the measurement of the gage also [must] be the same. To assure that interchange of information can occur effectively and securely requires fairly explicit specifications of standards,” Perlin explained. The HIT Standards Committee and other federal entities are working with a range of stakeholders to find and developing HIE standards will ensure that the “tracks” for moving data are uniform and reliable across settings.
George Conklin, senior vice president and CIO of Christus Health, used a different railroading term in a recent interview with CMIO. “While we fully support the directions being taken by the ONC and what’s happening from a healthcare IT perspective, we also proceed very concerned about HIEs in general that have not gone through the same kind thought process that we have around establishing the standards for the information that’s out there. My big fear is that we’re going to create another major train wreck, because we’ll just be packing together a lot of information and throwing it in the face of the clinician," Conklin says.
"If there’s no way of getting exactly the information that the clinician needs to him or her, they’re going to stop using these things before very long...Or they will make very bad judgments" based on data that isn't necessarily valid, he says.
Plenty of other healthcare IT pros share these concerns, which might be why David Blumenthal, MD, National Coordinator for Health IT, issued a statement about the National Health Information Network (NHIN) last week. Blumenthal said NHIN's capabilities are undergoing a "natural evolution" to support a variety of HIE needs, reinforced by trends that are leading toward widespread multi-point interoperability.
“The federal government is working to enable a wide range of innovative and complementary approaches that will allow secure and meaningful exchange within and across states, but all of our efforts must be grounded in a common foundation of standards, technical specifications and policies,” Blumenthal stated.
"The NHIN is not a network per se, but rather a set of standards, services and policies that enable the internet to be used for the secure exchange of health information to improve health and healthcare," according to Blumenthal's statement. It might also enable standardized tracks that keep health information exchange running smoothly, preventing train wrecks.
Mary Stevens, Editor of CMIO
mstevens@trimedmedia.com