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Do Hospitals Want Interoperability?

Posted on November 17, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I’ve had this discussion come up over and over again today in a series of discussions that I’ve had at the NYeC’s Digital Health Conference in NYC. Many people are blaming the EHR vendors for not being interoperable. Other people are blaming standards. Some like to blame HIPAA (which is ironic since it was passed to make health data portable). There are many more reasons that people give for why healthcare isn’t exchanging data and that interoperability isn’t a reality.

Although, in all of these discussions, I keep going back to the core question of whether hospitals and healthcare organizations really want that healthcare data to be interoperable. As I look back on the past, I can think of some doctors who’ve wanted it for a while, but I think the healthcare industry as a whole didn’t really want interoperability to happen. They would never admit this in public, because we all know on face that there are benefits to the healthcare system and the patient for interoperability. However, interoperability would have been a bad thing financially for many healthcare organizations.

It’s one of the dirty little secrets of healthcare. Sure, the EHR vendors never provided the interoperability functionality, but that’s largely because the healthcare providers never asked for it and largely didn’t want that functionality. They were all a little complicit in hiding the dirty little secret that healthcare organizations were benefiting from the inefficiency of the system.

I’m extremely hopeful that we’re starting to see a shift away from the above approach. I think the wheels are turning where hospitals are starting to see why their organization is going to need to be interoperable or their reimbursement will be affected. ACOs are leading this charge as the hospitals are going to need the data from other providers in order to improve the care they provide and lower costs.

Now, I think the biggest barrier to interoperability for most hospitals is figuring out the right way to approach it. Will their EHR vendor handle it? Do they need to create their own solution? Are CCD’s enough? Should they use Direct? Should they use a local HIE? Should they do a private HIE? Of course, this doesn’t even talk about the complexities of the hospital system and outside providers. Plus, there’s no one catch all answer.

I hope that we’re entering a new era of healthcare interoperability. I certainly think we’re heading in that direction. What are you seeing in your organizations?

Hospital Consolidation

Posted on January 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

There are a number of trends happening in healthcare right now that are hard to ignore. Plus, they are going to absolutely change the dynamics of healthcare as we know it. I think one of the biggest trends we’re seeing is the healthcare consolidation.

Healthcare consolidation is happening as hospitals come together and as hospitals buy up physician practices. I’ve heard some people argue that soon we’ll only have about 15 companies that own all the hospitals in the US. That seems pretty aggressive, but I think consolidation will likely amount to that many major ones with some minor ones in areas where the major corporations don’t really care.

In a lot of ways, consolidation of hospitals can be a great thing. Consolidation can often mean a lot of cost savings for the hospitals since you can merge departments and gain savings. Plus, your buying power is larger and so you can get the same goods at a lower cost. As we continue to move towards the ACO world consolidation can be a good thing as well since you need everyone involved to make an ACO a success. What better way to get them involved than to have them all in one company?

Also, if all the hospitals are under one company, then it makes for easy exchange of healthcare data between hospitals. Oh wait, for some reason healthcare still hasn’t figured this one out (Yep, we can’t even share healthcare data within a private HIE very well). Maybe this will change.

While there can be many benefits to hospital consolidation, there can also be a number of huge challenges. What if a doctor works for a hospital and they hate the EHR (or insert other reason as you see fit) that the hospital uses? If the hospital system owns all the hospitals in that area, then the doctor doesn’t have much choice. Same goes for a patient who wishes the hospital provided more advanced services. They’ll try to go to the hospital across town and find that it’s the same company and the same processes.

At that point, what incentive does the hospital system have to really truly improve? Sounds like a monopoly waiting to happen to me.

I asked someone how we stop the hospital consolidation. He said, “We don’t.” It’s a fast moving shift that can’t really be stopped. So, we just need to learn to adapt to the new environment.

It will be interesting to see how the EHR world plays out with hospital consolidation. Is a hospital system going to force a certain EHR on their acquired hospitals so they have one EHR to serve all? I bet the answer is they’re likely going to have a number of EHR software in every hospital system. This is going to require a change in mentality for many.