Thursday, May 22, 2014

Vendor Interoperability Tensions Users must insist on interoperability for Systems to be purchased.

Ultimately potential users will control interoperability.  Vendors will comply is they want to sell their systems.

Interoperability is all about vendors of EHR systems for providers and hospitals.  The Office of the National Coordinator for Health IT  (ONC) developed as part of the executive office of the President (then George W. Bush) as part of the assessment for growth and planning for this decade in all aspects of the health and governmental systems.

Despite encouragement to develop interoperable systems, and incentives for using IT growth of a network has been sporadic and in silos. It’s progress has been slowed by the need for building a sustainable business model, despite the federal mandate of it being a requirement for meaningful use, Stage III.   The business model may require variations according to the user base.  Despite the potential for significant savings it requires capital to initiate and maintain. Several HIE’s have been successful thus far.  Initially there were many failures when grants expired without ongoing financial support.

According to a report from ONCHIT and West Health Institute. In the report they urge all buyers of healthcare IT, hospitals, practices and patients to insist that technology vendors make their products interoperable to work well with each other, share data, and support open standards.   In the same report Joseph Smith, M.D. , chief scientist and medical officer of West Health Wireless Institute, said HIT buyers have yet to make it clear they want interoperability.  Part of the mission is to make buyers aware that there is something to ask for and require in their product(s).

The audience was asked what were the barriers to vendor development of interoperability. The dominant answer was purposeful strategies to maintain market share and increase switching costs.  This amounted to a vendor driven reality, according to the audience at the one-day conference on healthcare IT interoperability in February.

When asking for interoperability an essential question to answer is to specifically name the systems which their system needs to connect with, or the standards the vendor needs to meet. This hard work has already been done by ONCHIT with it’s certification through the ANSI attestation process.  The standard and technology are ready to use.  Without the specific guiding standard to the vendor vendors will have an excuse to continue their ways. Vendors may simply say the calls for interoperability are too vague for realistic implementation

Medical Devices are a new player in the game, and face even greater challenges. Fortunately the FDA will have draft guidelines this year on medical device interoperability. However draft guidance is not the same as interoperability-far from it. Interoperability is a miexture of shared demand, technical sophistication,dogged testing, and a dollop of diktat.  The power of the stakeholder group plays a major role in convincing vendors to comply.

Health IT is set apart from other IT interoperability in that it is not sufficient to just transfer data. It is also necessary to integrate that data into the workflow of those who receive the data in a form that is transparent and appears in the recipient’s EHR without a major distraction from the user(s).

Attribution: and Scott Mace, online:

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