EMR Interoperability and Working Together

I recently got the following email which highlights my point that the EHR stimulus money should have been focused on things like interoperability standards and not funding EMR adoption the way it is doing it. He also makes some interesting comparisons worth considering:

I see an uncoordinated money pot out there, attracting uncoordinated work on EMR. — about as effective technically as HDTV (since mid-80’s), W3C, the space station. Non-profit efforts seem to generally fail, or to work so slowly as to be irrelevant.

EMR standardization would likely benefit from an authoritative organization (similar to IEEE) that would work with existing systems as provided by Kaiser, Walmart, GE, etc. and grind out a solution acceptable to these and other major (and minor) players. Then a de facto standard would exist in a well-defined form, and other players would join the effort.

I may be wrong, but I don’t see this happening. Everyone seems to be drawing out the money and just going on their separate ways. People like me that try to help doctors into the electronic age thus have to develop their own protocols, as anything resembling a portable data standard simply doesn’t seem to exist.

Of course, whenever I think about and post something like this, I feel like it’s too late too change anything. The legislation is what it is and we have to make the most of it. It’s just really sad to consider what it could be.

I guess maybe the message to consider is that we can still start having EMR working together even if it’s not government funded.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, 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, EXPO.health, 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.


  • EMR adoption comes first before Interoperability Standards in the which came first – Chicken or the Egg game, unfortunately. Unless EMRs are adopted there is nothing electronic to be exchanged!
    We can all wish for a single God-like body to sit down and design a universal standard but that never happens in real life given the different agendas of the stakeholders involved. Interoperability standards will only evolve and one set will take hold. History is full of examples – IBM and DEC were trying to make theirs the standard computer networking platform and then comes TCP/IP that became networking standard. VHS and Beta fought out the battle and VHS won! On the other hand, proprietary Blu-Ray won the HD standard. The trick is to have a bunch of competing interoperability standards and have them fight it out. That’s how reality works, unfortunately!

  • Nari,
    Thanks for the comparisons. I loved the analogies. The only problem is that there is no competition in creating standards for EMR interoperability since the money isn’t there. Blu-Ray won big financially when they won that war. If you win the EMR interoperability standard war you don’t gain financially. That’s why the government should have provided the financial incentive.

  • The problem is more than a portable data standard on the end user, EMR, level It is the infrastructure is totally screwed. For example, it is a gov’t requirement that drug formularies be freely available. They are, but some on request, some posted on web sites, some in html, some in locked PDF, some in .doc. Each has its own format of benefits structure, some have a table of classification to list each drug’s co-pay, coverage etc some list each drug and then conditions etc etc. A poor old EMR gets blamed when it costs thousands of dollars per user or if doesn’t include all 4,000 formularies or if this dynamically changing drug info isn’t up to date!!!

    The problem is government that is a mile wide and inch thick when it comes to understanding EMR software – better just appear to be doing something by spending, or shall I say wasting, our tax dollars.

    Not even big companies like GE will fix this with there buying power becuase it is ineffeciency on the infrastructure level that an EMR vendor has to deal with – and the solution is a product no consumer can afford.

    The government needs to force formulary, HL7, lab order/result, drug numbering etc conformity and public domain publishing through legislation before we will have real mass movement to EMRs. EMRs are work arounds to these problems.

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