6 reasons today's health IT systems don't integrate well
Although the healthcare community has been clamoring for integration of its IT systems for decades, the industry is still in a rather elementary stage when it comes to useful and practical systems integration, according to Shahid Shah, software analyst and author of the blog The Healthcare IT Guy.
"Our problem in the industry is not that engineers don’t know how to create the right technology solutions or that somehow we have a big governance problem," he said. "[Although] those are certainly issues in certain settings, the real cross-industry issue is much bigger – our approach to integration is decades old [and] opaque, and [it] rewards closed systems."
Shah outlines six reasons today's health IT systems don't integrate well.
1. They don’t support shared identities. These shared identities include single sign-on (SSO) and industry-neutral authentication and authorization, said Shah. "Most health IT systems create their own custom logins and identities for its users, including roles, permissions, access controls, etc., stored in an opaque part of their own proprietary database," he said, adding that ONC should mandate all future EHRs use "industry-neutral" and well-supported identity management technologies, so each system has, at least, the ability to share identities. "Without identity sharing and exchange, there can be no easy and secure application capabilities, no matter how good the formats are," he said.
2. They're too focused on "structured data integration." Instead, said Shah, systems should be focused on practical app integration in the early phases of a project. "In the early days of data collection and dissemination, it's not important to share structured data at detailed, machine-computable levels first, [but it's more] important that different applications have immediate access to portions of data they don't already manage." Once app integration is in good shape, he continued, then it's time to focus on structured data integration, and all the governance and analytics associated with it. "When we do structured data integration too early, we often waste time because we don't understand the use cases well enough, so we can't iterate to best-case solutions," he said. "We're driven to worst-case implementations."
[See also: 5 technologies every hospital should be using.]