Interoperability: Consider it inevitable

HIMSS 2013 brings big news announcements
By Bernie Monegain
12:00 AM
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There was no shortage of big news made  -  or announced  -  at the 2013 HIMSS Annual Conference & Exhibition in New Orleans last month. Also, to capture the imagination, was a star-studded slate of keynote speakers  -  not Hollywood celebrities, but healthcare IT luminaries  -  among them an eloquent former president, an innovation visionary, a newly minted CEO who led his New Orleans healthcare system, and the nation's health IT chief   -  each dispensing inspiration and hope for a bright healthcare future. 

It's hard to compete with lines such as, "There's nothing we can't fix," (President Clinton), and "Don't tell me that healthcare can't change. It can. There's a lot of what seems to be resistance; it's just uncertainty." (National Coordinator of Health IT Farzad Mostashari, MD). 

Amid all of this fanfare, it was a news conference held outside the convention center at the hotel down the street that generated the most buzz, and perhaps offered the most promise for change. 

Six of the major players in healthcare IT:  McKesson  -  and its subsidiary RelayHealth  -  Cerner, Allscripts, Greenway Medical Technologies and athenahealth announced their commitment to interoperability and to teamwork via a new organization they formed together, CommonWell Health Alliance. It's a union, McKesson CEO John Hammergren said, open to all vendors. 

The Interoperability Showcase notwithstanding, competitors working together in a serious partnership was not heard of 10 years ago. In more recent years, the expectations for interoperability have been elevated in several ways, not the least of which, are the efforts led by the Office of the National Coordinator. 

Then there's the market. The users of electronic health records, the healthcare providers around the country are beginning to demand more from their EHRs. They want them to be easier to use, for one thing, more intuitive, and they recognize that for data exchange to work  -  and it must work  -  systems have to be able to talk to one another. Data exchange is a prerequisite of interoperability, says Doug Fridsma, MD, chief science officer and director, Office of Science & Technology within the Office of the National Coordinator. But, standards have to be developed so that the information exchanged is understood. "If I write my message in French, (and you can only speak English), there is no way for you to automatically use the information that has been exchanged without risking losing something in translation," he notes in a recent blog. 

As elusive as interoperability has been, the time has come, and people from every part of the industry  -  government officials, policymakers, providers, patients and vendors  -  are taking it seriously, including the newly minted CommonWell Health Alliance. 

Competitors may have derived competitive advantage in keeping data within their systems alone. Those days are coming to an end. 

During his keynote at HIMSS13, Mostashari put up a slide that showed 24 percent of healthcare organizations had achieved interoperability. "Twenty-four percent is nothing to celebrate, even if it's triple what it was three years ago," he said. He assured the audience he would "do what it takes to get this to be the top curve."

"But we need a business case," he said. "We're going to make it more profitable to share than to hoard. Noone should make a profit making patient data hostage."

Arien Malec, vice president, for McKesson's connectivity business, RelayHealth, was the driving force behind the development of the Direct Project at the ONC. He told Healthcare IT News Managing Editor Mike Miliard that the CommonWell Health Alliance plans to take interoperability to a nationwide scale, and put it on a similar fast-track. 

"We're thinking we can do the same  -  tight cycles, getting it done  -  which forces a lot of issues to come to the surface and get solved. That's the best way to get these things to happen. And the agreements those people on the stage signed were not trivial agreements. They weren't just words. They were committing organizations to the resources to get this to happen."

We say the CommonWell Health Alliance is no ruse, but a serious effort, having recognized that interoperability is a piece of the future of healthcare. You can't consider it done. Smart people differ on when it will be achieved. But, consider it inevitable.

As former President Clinton said in his keynote: "You can't keep defending the status quo."