Big Data, Overload and Oh Yeah… Interoperability
In my last blog spot, I ranted a bit on Big Data and Physician Overload. At the heart of the discussion was the multitude of mandates and regulations surrounding healthcare IT and physicians. The glut of data today including patient health records (PHR) and everything else your doctor knows about you, is accompanied by under-performing information management and maintenance practices that are moderately ineffective at best. The takeaway here is that true interoperability, or the ability of disparate systems in the hospital or physicians practice to easily and securely exchange private patient health information, generally known as protected health information, or PHI, is still not here, and is unfortunately, a long way away in the healthcare IT sector.
An intriguing question that continues to plague physicians and healthcare IT specialists alike is who owns all this data? Personal medical information obtained by physicians, nurses, and medical personnel is recorded, stored, and hopefully encrypted. This data should be readily available for transfer at the push of a button, right? At least that was the promise of interoperability and Health Information Exchanges (HIEs).
In an industry-leading healthcare IT news source, a letter to the editor commented on an article entitled Buying the Best Technology Trumps Single Source. The author of the letter offers an opinion which refutes that of the author of the article. “We may not see true interoperability in our lifetimes”, laments the letter, further adding that “standards for interoperability have existed for many years.” The preceding statements may indeed stir up a good industry debate among the best of breed in healthcare IT, but here’s the best part – the editorial and rebuttal comments were from October 2006! The interoperability debate was alive and well nearly 10 years ago, and it remains largely unresolved today.
The Office of the National Coordinator for Health IT (ONC) is the principal federal entity responsible for coordinating nationwide efforts to apply the most advanced health information technology and to support the electronic exchange of health information. A primary goal of the ONC is an interoperable, private, and secure nationwide health information system that supports meaningful use of healthcare IT data and resources.
Several collaborative non-profit groups have appealed to the ONC to let the market solve the interoperability problem. Control of medical records should be in the hands of patients and not providers, electronic medical record (EMR) vendors, or researchers, and certainly not the government. One suggestion is to create a national fully-interoperable delivery system capable of matching a patient with their medical records using a unique medical ID. Another solution might leverage interoperability and industry experts to create a platform for research, perhaps leading to the development of a consensus or de factointeroperability standard.
Despite the plethura of favorable directions in which this could evolve, the future is still uncertain. Questions with difficult answers are still looming on the horizon, such as:
- How should we centralize or decentralize health data?
- How can we protect its privacy and security?
One thing is certain. New and more restrictive regulations will only slow our pace toward true interoperability and EMR functionality. Until then, just try to stay healthy.