No @ Sign for Healthcare

I recently heard Arien Malec from ONC summarize the biggest challenge of Healthcare Information Exchange (HIE) in one simple phrase:

There’s no @ sign for healthcare

It’s a really basic idea, but sadly cuts straight to one of the core reasons HIE isn’t happening. We don’t have a great way to authenticate, verify and address health information to another provider.

Twitter has created this interesting concept of using @ to specify people. For example, you can find me @techguy and @ehrandhit. It’s amazing how quickly Twitter has created a whole new set of addresses where we can communicate with other people. Certainly it’s not designed for healthcare, but it’s amazing that they could create this whole new address system for people and organizations. And trust me when I say that Twitter is a great communication and collaboration mechanism.

One of the main reasons the fax machine is so successful in healthcare is that each clinic has a unique identifier, their fax phone number. I’ll be writing more about the fax machine in the future, but HIE needs to solve the problem of a verifiable address that’s unique to each healthcare provider if we want to move beyond the fax machine.

It seems like the people behind NHIN are trying to address this challenge, but they still have a ways to go. Does anyone else know of other ways people are trying to address the missing @ sign in healthcare?

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.


  • Hi John – I can think of another topic, although not really related to this one. In my life from IT services, I have come to accept, that even a Small Business has its domain, DNS servers and Exchange or some sort of secure mail. In healthcare, it was a rude awakening – all the Providers and their staff using gmail, AOL, Yahoo, Hotmail accounts. And here we are talking about all the great stuff without addressing basics……………….. I am not sure if I am the only one surprised!!!!!!!!!!!!!!

    Another topic for you interesting blog…

  • Hi John,

    First and foremost I enjoy reding your website. A colleague of mine sent me this link about waht some vendors are doing to retain/capture the EMR market.

    I figure I share it with you and let you decide if it’s worth sharing it with your reading community.

    Have a great day,


  • Bill,
    That’s a good question. I’m not familiar enough with all the ways that The National Provider Identifier is used. Would there be a risk in using it? Is that the number that’s used for controlled substances? Is that a reason why they might not want that number getting out? It’s a good question though.

  • Anthony,
    What specifically is wrong with using those free email services? Medical information shouldn’t be sent by almost any email system. I guess you could set up an internal email system with encryption, but I don’t see that happening much.

    I guess I just think we need to get beyond email as a healthcare communication mechanism since it’s not secure and most people wouldn’t know when it is secure.

  • Carlos,
    Looks like a pretty straightforward sales page to me. Is there something I’m missing? Feels like you’re just trying to spam the comments with links to a sales page. I’ll leave it for now, but don’t spam this site. I enjoy the spam/delete option too much;-)

  • John,

    First of all, I very much enjoy your sites. I reference all three, and commend you on your hard work and dedication.

    In response to comment #1/4, the NPI is a public identifier. CMS maintain the NPI Registry here.

    In response to #2/5, the e-mail topic has several facets to it. Aside from the security aspect (on which I basically agree), and from a pure business perspective, I believe practices should have a web identity they maintain (i.e. a domain) and require employees of the practice to utilize it. I’ve seen too many practices with employees who register with local/regional hospitals, clinics, HIEs/HIOs, medical societies, etc., using their personal e-mail. The person leaves, and the practice owner (i.e. the physicians) have no control over, or visibility into, that persons e-mail account, and they spend hours of lost time, trying to figure out how to re-associate (electronically) with these entities. Use of general mailboxes, within a business’ domain name (i.e., that the business owner maintains, would mitigate this. Someone leaves, another person steps in, and the e-mail contacts remain the same.

    Thanks again.

  • Mark,
    Thanks for referencing the sites and I’m happy to hear you’ve found them useful.

    Are you saying that NPI shouldn’t be used because it’s public, or what are you trying to say? Are you agreeing that it could be used as a method of sharing information with other doctors?

    Interestingly, I’ve seen some interesting web apps that have all the doctors in the US loaded into their database and they’re kind of creating these virtual social networks of doctors so that the doctors can communicate and possibly share information with each other. Pretty interesting stuff done with a whole wide variety of public and purchased information.

    It’s pretty academic these days to get an email with your own domain. At least for those who are comfortable using Google Apps. It’s awesome and free. I see a post about this coming in the future. I always laugh when some docs email is doctorsmith289182@oneofthepopularfreedomains.comThe numbers on the end just make me laugh.

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