HIT Think

Why the industry should not stand in the way of interoperability

Tipping point. Peer pressure.

These two bits of sociological leverage may be enough to make interoperability move forward faster, with no turning back.

They came together on Sunday evening, as HHS Secretary Sylvia Burwell outlined the organizations, vendors and professional associations that declared to commit to three simple objectives in information sharing.

fred bazzoli hdm

Actually, I think the presentation undersold the breadth of the lineup of organizations that now say they will support information exchange. There are about 15 major EHR vendors on the initial fact sheet, and other commitments were coming in Monday morning. The fact sheet also listed 16 healthcare provider organizations, including some of the most widely respected in the nation. And, for good measure, there are 16 of the nation’s largest and most influential provider, technology and consumer organizations.

Momentum toward interoperability has been around for a while, even before the notion of meaningful use was around. Many people have long thought it would be nice if patient information can be shared.

Unfortunately, there’s been little financial reason to go to the time, expense and effort. And competitive pressures have been too much to overcome.

Now, with industry consolidation and rapidly shifting reimbursement incentives, some of that opposition is beginning to fade. Improving the ability to share information becomes more important as providers aim to treat patients better, especially those for whom they hold increasing financial responsibility for their care.

Still, longstanding inertia is hard to overcome. There has always been a concern among many that holding patient data in a non-exchangeable format somehow gives them a competitive advantage. And from the vendor side, making data easily transferable raises fears that providers would have an easier time switching systems. If they’re going to do THAT to you, make ‘em suffer.

But it’s clear that federal agencies are intent on increasing the stakes.

This inability or lack of willingness to exchange information is now being termed “information blocking.” While federal officials are not exactly ascribing blame to providers or vendors for the fact that information exchange doesn’t happen, that is not exactly neutral terminology. Eventually, the notion that someone is “blocking” information exchange will take on a negative connotation. It’s clear that failing to exchange information will be increasingly viewed in a negative way.

And with the announcement that a multitude of organizations are committed to sharing information, there is a vehicle to begin work from a common base. The three core commitments are not crazy talk; they’re simple notions of enabling consumer access to health data, not blocking that access and adhering to standards that can make that easier for everyone.

"Eventually, the notion that someone is “blocking” information exchange will take on a negative connotation. It’s clear that failing to exchange information will be increasingly viewed in a negative way."

There’s cunning logic in picking these three targets as commitments. As of Sunday, it has become really uncool to not be a part of this group. If you’re not, what does it say about your organization? We don’t think consumers should see their data; we block access, yes; and we’re not smart enough to do things in a standardized way? And you probably also kick puppies and steal coins out of a blind beggar’s hat.

This base of three core commitments also provides a launching pad for the nation’s healthcare organizations to take the small, incremental baby steps needed to continue progress toward really helpful, beneficial, cost-effective data exchange.

Doubtlessly, there’s a long way to go, and the simplicity of the three core commitments belies the difficulty in achieving them. Major side issues, just to name a couple, include the ability to absolutely nail patient identities 100 percent of the time, without expensive human intervention; and consistent medical terminology that would enable easier data exchange between systems.

But despite these and other hurdles, there is the potential for critical mass, for federal officials to leverage commitments and ask (hopefully not demand) action. The real magic will happen as these participating organizations hold each other accountable and march arm in arm to a better interoperable place.

For reprint and licensing requests for this article, click here.