Healthcare Interoperability is Solved … But What Does That Really Mean? – #HITExpo Insights

Posted on June 12, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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 and LinkedIn.

One of the best parts of the new community we created at the Health IT Expo conference is the way attendees at the conference and those in the broader healthcare IT community engage on Twitter using the #HITExpo hashtag before, during, and after the event.  It’s a treasure trove of insights, ideas, practical innovations, and amazing people.  Don’t forget that last part since social media platforms are great at connecting people even if they are usually in the news for other reasons.

A great example of some great knowledge sharing that happened on the #HITExpo hashtag came from Don Lee (@dflee30) who runs #HCBiz, a long time podcast which he recorded live from Health IT Expo.  After the event, Don offered his thoughts on what he thought was the most important conversation about “Solving Interoperability” that came from the conference.  You can read his thoughts on Twitter or we’ve compiled all 23 tweets for easy reading below (A Big Thanks to Thread Reader for making this easy).

As shared by Don Lee:

1/ Finally working through all my notes from the #HITExpo. The most important conversation to me was the one about “solving interoperability” with @RasuShrestha@PaulMBlack and @techguy.

2/ Rasu told the story of what UPMC accomplished using DBMotion. How it enabled the flow of data amongst the many hospitals, clinics and docs in their very large system. #hitexpo

3/ John challenged him a bit and said: it sounds like you’re saying that you’ve solved #interoperability. Is that what you’re telling us? #hitexpo

4/ Rasu explained in more detail that they had done the hard work of establishing syntactic interop amongst the various systems they dealt with (I.e. they can physically move the data from one system to another and put it in a proper place). #hitexpo

5/ He went on and explained how they had then done the hard work of establishing semantic interoperability amongst the many systems they deal with. That means now all the data could be moved, put in its proper place, AND they knew what it meant. #hitexpo

6/ Syntactic interop isn’t very useful in and of itself. You have data but it’s not mastered and not yet useable in analytics. #hitexpo

7/ Semantic interop is the mastering of the data in such a way that you are confident you can use it in analytics, ML, AI, etc. Now you can, say, find the most recent BP for a patient pop regardless of which EMR in your system it originated. And have confidence in it. #hitexpo

8/ Semantic interop is closely related to the concept of #DataFidelity that @BigDataCXO talks about. It’s the quality of data for a purpose. And it’s very hard work. #hitexpo

9/ In the end, @RasuShrestha’s answer was that UPMC had done all of that hard work and therefore had made huge strides in solving interop within their system. He said “I’m not flying the mission accomplished banner just yet”. #hitexpo

10/ Then @PaulMBlack – CEO at @Allscripts – said that @RasuShrestha was being modest and that they had in fact “Solved interoperability.”

I think he’s right and that’s what this tweet storm is about. Coincidentally, it’s a matter of semantics. #hitexpo

11/ I think Rasu dialed it back a bit because he knew that people would hear that and think it means something different. #hitexpo

12/ The overall industry conversation tends to be about ubiquitous, semantic interop where all data is available everywhere and everyone knows what it means. I believe Rasu was saying that they hadn’t achieved that. And that makes sense… because it’s impossible. #hitexpo

13/ @GraceCordovano asked the perfect question and I wish there had been a whole session dedicated to answering it: (paraphrasing) What’s the difference between your institutional definition of interop and what the patients are talking about? #hitexpo

14/ The answer to that question is the crux of our issue. The thing patients want and need is for everyone who cares for them to be on the same page. Interop is very relevant to that issue, obviously, but there’s a lot of friction and it goes way beyond tech. #hitexpo

15/ Also, despite common misconception, no other industry has solved this either. Sure, my credit card works in Europe and Asia and gets back to my bank in the US, but that’s just a use case. There is no ubiquitous semantic interop between JP Morgan Chase and HSBC.

16/ There are lots of use cases that work in healthcare too. E-Prescribing, claims processing and all the related HIPAA transactions, etc. #hitexpo

17/ Also worth noting… Canada has single payer system and they also don’t have clinical interoperability.

This is not a problem unique to healthcare nor the US. #hitexpo

18/ So healthcare needs to pick its use cases and do the hard work. That’s what Rasu described on stage. That’s what Paul was saying has been accomplished. They are both right. And you can do it too. #hitexpo

19/ So good news: #interoperability is solved in #healthcare.

Bad news: It’s a ton of work and everyone needs to do it.

More bad news: You have to keep doing it forever (it breaks, new partners, new sources, new data to care about, etc). #hitexpo

19/ Some day there will be patient mediated exchange that solves the patient side of the problem and does it in a way that works for everyone. Maybe on a #blockchain. Maybe something else. But it’s 10+ years away. #hitexpo

20/ In the meantime my recommendation to clinical orgs – support your regional #HIE. Even UPMC’s very good solution only works for data sources they know about. Your patients are getting care outside your system and in a growing # of clinical and community based settings. #hitexpo

21/ the regional #HIE is the only near-term solution that even remotely resembles semantic, ubiquitous #interoperability in #healthcare.
#hitexpo

22/ My recommendation to patients: You have to take matters into your own hands for now. Use consumer tools like Apple health records and even Dropbox like @ShahidNShah suggested in another #hitexpo session. Also, tell your clinicians to support and use the regional #HIE.

23/ So that got long. I’ll end it here. What do you think?

P.S. the #hitexpo was very good. You should check it out in 2019.

A big thank you to Don Lee for sharing these perspectives and diving in much deeper than we can do in 45 minutes on stage. This is what makes the Health IT Expo community special. People with deep understanding of a problem fleshing out the realities of the problem so we can better understand how to address them. Plus, the sharing happens year round as opposed to just at a few days at the conference.

Speaking of which, what do you think of Don’s thoughts above? Is he right? Is there something he’s missing? Is there more depth to this conversation that we need to understand? Share your thoughts, ideas, insights, and perspectives in the comments or on social media using the #HITExpo hashtag.