Sep 15 2013

NTakes: Divergence in Health Information Technology

Published by at 3:00 pm under Uncategorized

Health care still exists in an iPhone versus Android world. We speak of our health care “system,” but that term implies rationality that is lacking when it comes to exchanging data.

Here is a personal example. A friend facing a major surgical procedure decided to secure a second opinion. He requested and received relevant portions of his medical record — on paper, at 75 cents a page — along with a CD containing imaging studies that had been done. His initial care was provided at a major teaching hospital, so he went to a similar medical center for the second opinion. But, when he presented the CD to the consulting physician, the response was, “We can’t use that.” It was in a format not compatible with the IT system at the second hospital.

“They knew where the CD was coming from. Why didn’t they warn me about that in the first place?” my friend wondered.

But, why should that have been necessary? Shouldn’t medical systems speak the same language?

On a much larger and incredibly expensive scale, health information technology has developed along dozens of proprietary lines, making the iPhone-Android divergence seem paltry in comparison. Numerous projects are being undertaken to have these disparate systems become “integrated” — a Rube Goldberg undertaking that by nature is overly complex and destined to be fraught with problems. We need only to look at the decades-long effort to “integrate” Defense Department and Veterans Affairs electronic health records. VA’s VistA is an open system built for clinicians that has proven itself over the years, gaining for VA the title of best health care in the U.S. DoD has gone the commercial, let’s-plug-pipes-and-wires-together approach and is still struggling to have a system its users actually want to use. (See Tom Munnecke’s open letter to Secretary of Defense Chuck Hagel).

Just sitting here at my iMac, I can have Amazon and Facebook connect or instantly send to Twitter an interesting article from almost any website. It’s all in the magic of the URL — a semantic approach to data.

Healthcare IT systems could use some of that magic. But, it will take a different sort of magic for the proprietary firms with mega dollars on the line to be willing to evolve to a more rational, web-like approach to health information.


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