From obscurity to fame

In 2004, few in healthcare knew what interoperability was; today it dominates the technology discussion
By John Andrews
12:00 AM

Hard to believe that interoperability was once an unknown concept that few were aware of or cared about. And it wasn’t that long ago that this was reality. Just go back one decade.

In 10 short years, interoperability has vaulted from obscurity to the limelight, serving as the cornerstone for advanced healthcare information technology. It is a meteoric rise that has its strongest proponents marveling at its swift evolution.

Interoperability’s origins actually go back 14 years to the first Integrating the Healthcare Enterprise Connectathon – a demonstration exercise among IT vendors that has gained tremendous influence and participation in recent years. This year’s IHE North American Connectathon will be held Jan. 27-31, for the last time in Chicago before moving to Cleveland in 2015.

“To me what is most impressive is HIMSS’ and IHE’s foundational work to create standards-based building blocks for interoperability, which is enabling widespread health information exchange across the globe,” said Joyce Sensmeier, IHE USA President and HIMSS vice president of informatics. “IHE specifications are at the core of most public and many private health information exchanges, and it is the foundation for the eHealthExchange initiative and HealtheWay specifications that are in use in organizations across the country.”

In the short course of a decade, there has also been a notable uptick in national projects around the world, Sensmeier said, with Latin America and the Middle East becoming the newest participants leveraging the IHE technical framework for their national projects.

“It is very rewarding to see the IHE vision created 14 years ago being realized,” she said.

Gauging the remarkable growth of interoperability over the past 10 years can be achieved by looking at participation figures from the IHE Connectathon since 2004. The numbers were modest in ’04 as they featured 30 participating organizations with 24 systems, drawing approximately 1,500 visitors and utilizing approximately 2,500 square feet. By contrast in 2013, the event had 103 participating organizations and 118 systems, drew some 6,000 visitors and required 42,000 square feet.

Not without challenges

Interoperability growth has not come easily – there has been a lot of heavy lifting associated with bringing it to the forefront of the healthcare industry’s IT advancements. Since the creation of the Office of National Coordinator for Health IT and Standards (starting with IT czar David Brailer) in 2004 by the George W. Bush administration, system analysts have seen more than their share of difficulties in conceiving, developing, promoting and elevating interoperability, Sensmeier said.

“The most difficult aspects of interoperability have been synching the consensus-based standards work with the national agenda – heavy lifting for sure,” she said. “With multiple changes in the White House and agency leadership at the ONC, there have been many stops and starts in setting the direction for our national efforts.”

Standards work has been exhaustive for proponents, who have volunteered tens of thousands of hours on this project. It is labor-intensive work, with complex technical components requiring a consensus to complete. National leadership must provide the guidance to keep all the moving pieces and parts moving in synch, Sensmeier said.

“This work is a marathon, not a sprint and we have had to start over a number of times,” she said. “We need to collectively set the vision and stay the course to enable seamless and secure access to health information whenever and wherever needed.”

Windy City windup

Expectations are high that the 2014 Connectathon will surpass all previous events, and organizers have ambitious plans for the last Chicago demonstration before moving to Cleveland. This year’s Chicago showcase will feature the rollout of the New Directions testing track, designed for testing of innovative health IT applications still in development. Testing services offered in the New Directions track will be sponsored by the IHE USA’s partnering organizations in the healthcare IT industry.

As a result, the Connectathon has expanded to include three offerings – the Connectathon Classic, which consists of traditional testing; the IHE USA Certification track, now in its second year; and the New Directions track.

“This program will provide a collaborative and flexible environment for industry groups to come together and test new and innovative approaches to interoperability,” said Michael Nusbaum, New Directions program manager. “Each cohort will connect to the Connectathon infrastructure, but will operate independently with its own organization and vendor participants, and managed by their own project managers. Participants in this track will be helping to define future interoperability technologies and techniques that will benefit the HIT industry as a whole next year and beyond.”

Alexander Lippitt Jr., senior director of standards and interoperability at HIMSS, adds that “the New Directions program picks up the gap between conception and regulation and there is a lot of discipline that goes into it.”

Among the initiatives that coalesce with New Directions are the HIMSS Health Story Project, Continua’s Plugfest and ONC’s S&I Framework Health eDecisions.
Another high point is the Connectathon Conference on Jan. 29, featuring keynote speaker Doug Fridsma, chief science officer and director of the Office of Science and Technology for the Office of the National Coordinator for Health Information Technology. At ONC, Fridsma is responsible for all programs that are focused on providing a foundation for interoperable health information exchange.