Facilitating Interoperability

October 18th, 2013

Cross-Posted 10/18/13 from The Health Affairs Blog

BK 711Health Affairs report on health information interoperability by staffers of the Office of the National Coordinator for Health Information Technology (ONC) provides a good enough summary of the situation. But it also is not news, and falls under the Bob Dylan Rule: You don’t need a weatherman to know which way the wind blows. From the article: “In general, limited interoperability across vendors, low motivation to share information in a fee-for-service payment environment, and the high cost of interfaces remain substantial barriers to widespread health information sharing.”

Two difficult but solvable structural problems block our exchange of health care information. The first is the “transport protocol.” Most health care data transport approaches lack the strong privacy and security safeguards that other industries now consider essential. The same industry that is moving toward clinical applications of mobile health, genomics, and nanotechnology still primarily relies on cumbersome, expensive faxes to transmit clinical information between organizations.

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An Archipelago of Health Information Islands

Brian Klepper

Posted 12/27/12 on Medscape Connect’s Care and Cost Blog

My wife Elaine was hospitalized for 6 days recently with an array of ailments related to her advancing cancer, so diagnosing and addressing her problems required a multidisciplinary approach. In addition to the nursing and support staffs, she was tended by an emergency physician, two hospitalists, three gastroenterologists, a pulmonologist, an infectious disease physician and an interventional radiologist. With the exception of one specialist who had performed a procedure on her two weeks earlier, this episode was the first time any had met Elaine.

Each clinician was familiar with her status before visiting her, because the health system has an enterprise-wide electronic health record (EHR) that aggregates information into each patient’s chart. The hospitalists coordinated the care process and also touched base with Elaine’s primary care physician and her oncologist.

In other words, the system worked exactly like we hoped it would but often doesn’t. Especially in complex cases like this, the likelihood of a positive result is enhanced if the team members have access to the same complete information, and if someone – in this case the hospitalists – quarterbacks the activity.

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Getting An EPIC Opinion Off My Chest

Vince Kuraitis

Posted 12/1/11 on e-CareManagement Blog

We need to be far more explicit in asking a subtle but critical question

What are acceptable bases of competition in health care?

My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:

It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors

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AAFP Partners With Surescripts On A New, Secure Electronic Messaging Service For Physicians

BRIAN KLEPPER

Here’s an extraordinary development in the ongoing efforts to break down the barriers of a lack of interoperability standards and incompatible technologies!

The American Academy of Family Physicians has partnered with Surescripts, a firm that connects physicians with drug prescribing services, to announce a new collaboration, AAFP Physicians Direct, that will allow the AAFP’s physician members to easily and securely exchange information electronically.

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