Still Far from Healthcare Interoperability

I think that anyone that is in this industry had to be struck by the story of ePatientDave pulling his medical history into Google Health (see my previous ePatientDave post). It’s not that we didn’t already know that it was a problem. I think that most in the medical industry know the problems associated with our data right now. However, I feel like we’re all (including myself) in a little bit of denial about this fact. The story of ePatientDave just painted a picture of how bad the data really is going to be.

The takeaway I have from ePatientDave’s experience is that we’re still a long way from having interoperable patient records. In fact, it makes my previous post about ICD-10 and EHR interoperability even more significant. Not to mention the need to simplify Health Information Exchanges.

Honestly, if we don’t simplify I’m not sure we’re going to get any of this healthcare data exchanged in my lifetime.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • The biggest issues that ePatientDave’s experience points out are the shortcomings of a disconnected PHR. In the early days of PHRs some 5-10 years ago, they were simply empty shells that relied upon patients entering and maintaining their own information – something that only a few enthusiasts really did, and thus there was minimal overall adoption. The new stage of PHR development, with Google and Microsoft trying to be data aggregators, is the passive filling of the PHR from sources “where they exist” – often insurance claims data. What becomes unmasked by this effort is the fact that “diagnosis” information contained in insurance claims data is very prone to error, as it is not something used by clinicians for ongoing care. Instead, it is often “whatever approximate diagnosis is needed to get the claim paid” and the coding used is frequently not ever fed back to the clinical record (especially given that, with the low rate of EHR adoption overall, the clinical record is often on paper).

    The only way that a PHR becomes truly useful is when it is actively connected with a physician’s EHR – where two-way communication can create a data-validation mechanism, and where the PHR data viewed by the patient is directly from the clinical (not the billing) data of the physician. The experience of ePatientDave shows how current PHRs, though they have progressed over the years, are still fairly empty shells that offer little value. See the blog post here.

    Robert Rowley, MD
    Chief Medical Officer
    Practice Fusion, Inc.

  • No doubt that he proved that billing data is really messed up. However, from my experience a LARGE number of EHR diagnosis data is the exact same as the billing data. That’s why I’ve often called many EHR just glorified billing engines.

    I can’t really argue with PHRs currently not offering much value. At least not in their current incarnation.

  • Where exactly do we now stand with the issue of interoperability? What are the core problems really as it would seem to me that the technology should be readily available to ‘translate’ all of the relative major standards? Are we making any progress with this issue?

  • Biggest issues are definitely the financial mechanisms and the policies for when you can exchange the data (governance of the data). The standards (or lack thereof) really suck too, but they can be overcome and dealt with. The technology is really the easy part.

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