The majority of people who attended the Healthcare Information and Management Systems Society's annual conference last week in New Orleans likely would agree that the formation of the CommonWell Health Alliance--in which five electronic health record vendors, led by Cerner and McKesson, agreed to work together for improved interoperability--was the event's most notable news.
But what exactly does it mean for the health IT industry as a whole? Is true interoperability finally a real possibility? Or, as Epic officials said following the announcement, is the collaboration more of an attempt to stay competitive with the Verona, Wis.-based EHR giant? I asked Marc Probst, CIO of Salt Lake City-based Intermountain Healthcare, and National Coordinator for Health IT Farzad Mostashari for their thoughts on the collaboration.
"It's all about standards. We're directionally right, but we're 10 years late, or more. I think we're approaching it as a community, and I'm not sure that's going to solve the problem. The government needs to take a role in defining what these standards are, and getting them in place so that we can more quickly reach our destination. I wouldn't say I'm on the majority side of that conversation, but, HL7's had, what, 30 years? SNOMED's been there for a long time. We can't get there. There's too many divided interests in trying to get to the end," said Probst (pictured left).
"To me, it's as simple as driving on the right side of the road, or using a single gauge of railroad across our country. Someone needs to define that and say 'go do it.' We also need time. They need to set these things--they need to do it now--and then they need to say '15 years from now, everybody's driving on the right side of the road so we don't have absolute chaos, which is what we [currently] have. Interoperability is a huge part of the answer, and it's been evasive for all the wrong reasons. CommonWell, without Judy [Faulkner], leaves a big hole in that discussion," he told FierceHealthIT.
Mostashari called the effort a "welcome change."
"CIOs and hospitals and vendors have been complaining that patient matching is a tough nut to crack across institutions, so they're creating a service that, when you register a patient and they show their driver's license, they're going to get them a voluntary, permanent identification token. So when that patient goes somewhere else and they show their driver's license, you know exactly who that person is. This is a service that can be operated on top of whatever information exchange protocols or agreements you have. That's all it is. They're saying, 'this is a service you might be interested in,' Mostashari (right) said.
"As I understood it, it was meant to be an open service for all to use. What I think happens sometimes--and I've got to say, sometimes fanned by the media--is that people love a fight, and the competitive juices of the CEOs gets flowing a little bit, and they get a little carried away and competitive in how they talk about their efforts. I think people should take a step back, think about what's in their interests and their patient's best interests and the provider's best interests and the public's interest. What this shows is, there is a market for interoperability. We see vendors competing now, fiercely on the basis of how open are they to cross-vendor exchange and interoperability. What a welcome change," he said.
My take? While Mostashari is right to be optimistic about the change in tone from the vendors, I agree with Probst that national standards ultimately must be implemented. Patients shouldn't be limited in their healthcare choices based on vendor discretion, even if it appears they're on the right track. After all, the road to perdition is paved with good intentions, too.
Health information exchange is too important an issue. - Dan (@FierceHealthIT)