Last month I started what I think is a really important conversation about interoperability. I asked the question, “Do Hospitals Want Interoperability?” Go ahead and read the article. We’ll be here when you get back.
In response to that article and that question, Thomas Lukasik offered the following commentary on a LinkedIn thread:
Imagine one car dealer asking another car dealer to send them all of the information that they have on a customer of theirs so that they can do a better job of selling them a car. Healthcare is a business just like a car dealership, and patients are their customers, so expecting healthcare providers to support a level of health information exchange (a/k/a Interoperability) that would enable another healthcare provider to take business away from them is naive to say the least. Competition is a reality for modern hospitals.. you’ve seen the billboards. They’re more comfortable with the old school business model. Interoperabilty is a double edged sword for them.
I think that most hospitals would agree with this view, but they’ll likely only share it behind closed doors. The hospitals understand the benefits to healthcare of sharing their data with each other, but as a business it doesn’t make sense. As I mention in the article, I’m hopeful that things like value based reimbursement and ACOs can help shift that model where it does make business sense for a hospital to share their data. In fact, I think we’re heading to a day where if you don’t share data you’ll be at a disadvantage.
While we’re heading in that direction, it’s hard to face the stark reality of what Thomas says. Healthcare is still a business and healthcare leaders salaries and bonuses are based on successfully running the business. If we want to have interoperability, we have to change the incentives so that they match that goal.
Hi John,
Yes, I think those that don’t play the interoperability game will be at a competitive disadvantage. Think of it like an ATM. Imagine a bank that wouldn’t be in the network and you couldn’t travel from Philadelphia to Nashville and have access to your money. Would you use that bank? Same thing with your health info.
Besides, who “owns” your health info? This is a loaded question but I think the right answer is that you, that patient, owns your health info and should have access to it no matter where you choose to “do business”.
Interoperability is critical for the functionality of the system to actually work as it is supposed to.
Thank you for bringing this issue to our attention!
Best,
Peggy
I think Peggy’s point is well taken. There is a business case for interoperability.
Accordingly, I disagree with Lukasik’s car sales analogy. I think real estate sales multiple listing services are more on point. Real estate agents realize that they do better when they share client information, even if it means having to split a fee. The MLS increase everyone’s potential.
Hospitals that don’t push interoperability may not have really looked at the benefits, just the costs.
You should check out the whole LinkedIn thread with this: https://www.linkedin.com/groupAnswers?viewQuestionAndAnswers=&gid=136712&discussionID=5945426708512387074&trk=eml-group_discussion_new_comment-respond-btn&midToken=AQHPnISOry637g&fromEmail=fromEmail&ut=35hZpahjSIvSw1
Lots of discussion on the analogy and what Lukasik mean. Also, someone suggested the analogy might be better with mechanics sharing info with each other. It’s a good analogy, but Lukasik offers this response:
“I would take your analogy (which uses more of a “car to patient” than “dealership to hospital” model) one step further and change it to “the sharing of a specific car’s service history between mechanics working in the service departments of competing dealerships”. That comparison more closely resembles the sharing of a patient’s clinical history between providers — which is what interoperability is all about. It also illustrates a major benefit that health information exchange provides for the patient: While a car owner’s (patient’s) recollection of what’s been fixed (treated) or tested is error prone, being able to obtain a complete, accurate, and well documented service record (clinical history) on demand can help the mechanic (provider) to do a much better job.”
I think much can be learned from thinking of both of these analogies.