A Network of Networks – Major EHR Developments Per Halamka

In my ongoing series of Major EHR Developments from John Halamka (see my previous EHR In The Cloud and Modular EHR Software posts), his third major EHR development from the Technology Review article is: A Network of Networks.

Halamka basically says:
-Most people think doctors and hospitals exchange healthcare information (they don’t)
-New standards are being integrated with EHR that will make it happen
-There won’t be one large database of health records
-Many regional data exchanges are happening
-There will be multiple Health Information Service Providers (HISPs)

I agree with most of these ideas. Although, I think it still faces two major challenges.

The first challenge is the standards challenge. Sure we have CCD. Oh wait, we have CCR. Oh wait, they merged, kind of. Oh wait, now CCD has multiple flavors. Oh wait, what kind of standard is it if there are multiple standards of the standard? I think you see my point.

The second challenge is whether HISPs and the other regional data exchanges have a viable future. I’ve talked to a lot of people about these exchanges and I have yet to hear someone clearly articulate a viable model for these exchanges. My favorite was the HIE expert who told me they’d figured out the model for HIE. So, I asked what it was and they gave me some convoluted answer that made no sense to me. Maybe I’ve just missed it, but I’d love to hear someone try to describe a viable HIE model.

I do predict we’ll see Fax slowly phase out over time. Although, I think it will more likely be replaced with a fax like service on the internet (Direct Project?) as opposed to some other sort of Data Exchange. It will probably best be described as Fax 2.0.

About the author

John Lynn

John Lynn

John Lynn is the Founder of 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.


  • Hi John – another thing which you will see in the near future is the Provider Directory similar to DNS that can route and publish information. Its moving in the right direction and like all things good might take time to devlop to a full fledged model.

  • That’s one of the proposed plans; but ONC is looking at all the options. Interoperability is another key initiative which is moving forward at a good clip; we are one of the few EHR vendors doing pilots on Transition of Care (ToC) and Lab REsults Interface (LRI). S&I Framework is priority and you will find more information at http://wiki.siframework.org/Home

    Its getting there John. And there are many participants working dilligently on these intiatives. Will keep you posted. As always good to read your blog everyday.

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