Becker's Hospital Review

HEALTH IT 120 15 Thoughts on Interoperability From Healthcare Leaders By Akanksha Jayanthi I nteroperability has become the holy grail of health IT. ough it is the universal goal, there is little consen- sus on how to get there. Even definitions of interoperability are varied, and remov- ing business barriers for the sake of free flow of data between proprietary vendors and organizations sometimes seems to be more of a talking point than an action taken. ought leaders are vocal on the sub- ject of interoperability. Here is what 15 of them had to say. Dan Haley, Vice President of Government Affairs, athen- ahealth (Watertown, Mass.). On defining interoperability, and the wrong way the industry talks about it: "In these policy discussions, people use the term 'interoperability' interchangeably with information exchange as though they mean the same thing. Information exchange means I send you information and you send me information. You can do that with a fax machine. Interopera- bility means I can access information that you have, and I can use it, I can change it, I know where it comes from, I know who's responsible for it. And you can do the same. "What we have in healthcare is a whole bunch of different healthcare sys- tems that are able to send information back and forth via bidirectional interfac- es. at to the Internet is what wire-based telephone systems are to cell phones." Michael Johns, MD, Founding Chairman, and William Stead, MD, Chairman of the Technical Advisory Committee, Center for Medical Interoperability. On the ethics of interoperability: "As healthcare professionals, and as an industry, we can no longer accept the status quo. It is possible to have real-time, two-way, low-cost, standards-based connectivity that enables improved decision-making and assures safety at lower cost. e technical capability exists. However, a byproduct of our fragmented national healthcare system is that vendors lack incentives to make their technologies work in a plug-and-play manner. "We have an ethical obligation to de- velop and implement plug-and-play clin- ical devices and information technology systems. Potential improvements from doing so include avoiding or reducing adverse events, transcription errors and redundant testing. Clinicians will bene- fit from reduced alarm fatigue and time spent manually entering information. Our patients will benefit from decreased length of hospital stays through our ability to im- prove the speed of information transfers and lower costs related to integrating and maintaining technologies." Joy Grosser, Vice President and CIO, UnityPoint Health (West Des Moines, Iowa). On data standards and challenges in accountable care organizations: "You just can't move quickly enough. Unity- Point Health has a significant presence in the ACO market requiring patient-level communication from both employed and independent providers. e biggest challenge is the lack of interoperability caused by an industry that does not have data standards. We are trying to get data faster so that we can both make it more actionable on the front end, as well as use it for predictive modeling for the popula- tion. You can't mandate that all healthcare organizations utilize the same systems, yet our patients need clinical information to flow from provider to provider. As an industry, we need to work together to regulate data standards." Neal Patterson, CEO, Cerner (Kansas City, Mo.). On healthcare being personal and how interoperability should address that: "One thing…we say at Cerner about healthcare, healthcare is too important not to change. Also, healthcare ultimately becomes personal. My wife [has had] stage 4 cancer since 2007. My version of this [holds up a CD-ROM, indicating it contains health records] with Jeanne are bags and bags. You do go to see doctors that are outside of the organization and you need all that information in those bags. I think it is a failure of all of us to have in 2015 the fact that Jeanne carries bags to her doctors ap- pointments where she's going to see a new doctor specialists. We have to fix that. In- teroperability is high on my list, both pro- fessionally and personally, to fix." Richard Helppie, CEO, Santa Rosa Holdings and Chairman, Sandlot Solutions. On demanding today's price for health IT and interoperability: "We're [living] in a world today where an expensive app for your PDA costs you $5, but we have health systems spending hundreds of millions of dollars and taking years to develop closed enterprise systems. As technology got more sophisticated, it's fallen in price. "Healthcare needs to start demand- ing today's price for IT. Leverage the in- vestments made and unleash information from all of the data being used in patient care, operations and claim production." Robert Wachter, MD, Chief of Hospital Medicine, University of California, San Francisco Medical Center. On healthcare leaders' idea of interop- erability: "Most healthcare leaders don't stay up at night worrying about [in- teroperability]. Don't get me wrong: they care deeply about moving information around; it's a core rationale for EHRs in the first place. But their definition of 'around' is not everywhere. Rather, they want a seamless flow of information around all the buildings they own. ey also want interoperability between their system and an outside laboratory they use, their system and Aetna's claims de- partment, and their system and the local Walgreens."

• Cover