Mind to Market

Friday, May 28, 2010


Without getting too technical; interoperability is the ability of different systems to work together. We can look at the banking system for an example: you have an account at Big Money Bank and need some cash. Only problem is the ATM you’ve found belongs to First National Bank. But, because the two banks interoperate, you are able to get cash out of the ATM (for a fee) even though you don’t have an account with the bank that owns the ATM You are in fact paying for the convenience of interoperability.

So many systems today interoperate that we may just take it for granted. Our electronic devices can plug in to any utility in the country and operate just the same. We can use computers built by a variety of different manufacturers that run the same software and operate more or less the same. We can take these computers and connect them to the Internet and access Web sites in more or less the same way. Then we can go to a hospital and ask to be admitted and… Wait a minute. They’ve never heard of us, they don’t know where we’ve been or who’s seen us, and they don’t know what our problem is. In other words; interoperability has yet to make it into healthcare.

In the bad old days, a year or two ago, you could get your old hospital to fax your records to your new hospital. If you weren’t in a hurry and your old hospital could find your paper records With the advent of electronic records your old hospital prints out the record, stuffs it into the fax machine and faxes it over to the new hospital. Not a big improvement. This may satisfy the bare minimum requirements for data exchange but does not meet what would constitute interoperability. One of the barriers to interoperability is the lack of general standards. What one hospital may call a heart attack another may call a myocardial infarction. And that’s if they’re both speaking English.

Why does this matter? I like the hospital I go to and don’t plan on going anywhere else so why is it important that my medical records can be exchanged with another hospital? There are numerous good reasons for interoperability between health information systems, the topic for another blog or seven, but one seems pretty compelling for consumers. Say you’re away from home, on vacation or a business trip, and have an accident which requires immediate medical attention: someone rammed your rental car. You would not be able to travel to your regular hospital and would be required to be admitted to a local emergency room. Paramedics at the scene, or doctors in an emergency room, could identify you and access pertinent medical information that may be relevant to your treatment, i.e. you’re on blood thinners and may be in danger of excess bleeding. This is information that you would freely give the doctors, but you may not be capable of doing so at the time of treatment.

As if this isn’t reason enough for interoperable health information systems, the HITECH Act of 2009 has included requirements which can only be fulfilled by systems that interoperate. This Act comes with several incentives for compliance as well as penalties for non-compliance to healthcare providers. It appears that the time for interoperability in healthcare has arrived, how it will be played out is another story.

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