For decades, industries have haggled and coded and bargained their way into shared data standards. Each agreement has made great technical advances possible and grown markets into forms which could hardly have been imagined before.
Traditionally, the idea has been agreeing on interoperable standards is a form of enlightened self-interest. The equasion “interoperability=larger markets=more pie for everyone” has nearly always managed to take root even in industries as brutally competitive as networking. Consider where we’d be without 802.11 for WiFi, for example. If WiFi manufacturers had staged a prolonged battle over standards, and the reach of WiFi didn’t blossom everywhere, the Internet as we know it might not exist.
Well, here in EMR vendor land, we’ve somehow passed the exit marked “coopetition” and wandered off into interoperability nowhere land. Sure, tell me about the CommonWell Alliance, which looks, on the surface, something like industry cooperation, and I’ll retort, “too little, too late.” And do I even have to say that the idea that Epic supports everybody is something of a laughing matter?
Maybe, after seeing how miserably the EMR vendor industry has failed to come together to share data, it’s time to force the matter. I read that ONC honcho Farzad Mostashari has occasionally threatened to do just that, but hasn’t followed through with any proposed regs on the subject.
What if the FCC, the FDA and the ONC (which are now taking comments on a regulatory framework for health IT) decide to look at standards, pick a winner and shove it down the ever-living throat of every uncooperative vendor hoping to create dependency on their way of doing things? That would include Epic, of course, which today, hears countless hospital CIOs say they had to buy their product because everybody else did.
Don’t get me wrong, this is a very, very serious matter; any regs that attempted to force interoperability would impose untold billions in costs on vendors, not to mention their customers. But if interoperability is the real prize we’re ultimately hoping to gain — the big EMR enchilada — is it possible that it’s time to take the risk anyway? I don’t know, but I certainly wonder. How about you, readers?