Archive for April, 2015

Interoperability and Accountability

Friday, April 17th, 2015 | Permalink

Recently ONC released its Interoperability Roadmap as a framework for the transmission of clinical electronic health records consistent with the goals of the HITECH Act. The ‘Roadmap’ has been criticized as actually delaying Interoperability because of an emphasis on theoretical concepts rather than realistic implementation steps. And Interoperability is widely viewed as failing.

Defenders of the Roadmap say it is ‘not my problem’. Rather it is the problem of the industry and, to some, that reflects the industry’s ‘inability’ to overcome its competitive profit model and cooperate with other vendors in developing interoperable linkages.

Competition aside (not limited to vendors) this may not be the major problem with Interoperability. Interoperability assumes the knowledge of accurate electronic endpoints for the effective transmission of clinical information. Since these endpoints do not exist, the IHE (Integrating the Healthcare Enterprise) has developed specifications for ‘Provider Information Sources’ for Directories that are to contain the endpoints. The theoretical construct assumes literally thousands of these sources collaborating in a seamless fashion. This vision explicitly ignores both (1) the complexity of the multiple relationships between providers and organizations and (2) the underlying and fundamental rate of change in both demographics and these relationships. Rather than seamless communications there is the alternative view of misdirected clinical information to expired organizations or providers, to the wrong organizations or providers, or simply residing virtually without delivery. And who would be accountable?


April 2015
« Nov   Oct »