Did you see the big news last month about healthcare interoperability? That’s right, Carequality announced support for FHIR. Next thing you know, we’re going to get an announcement that CommonWell is going to support faxing.
Seriously, healthcare interoperability is a joke.
The reality is that no EHR vendor wants to do interoperability. And it’s not saying anything groundbreaking to say that Carequality and CommonWell are both driven by the EHR vendors. Unfortunately, I see these organizations as almost a smokescreen that allows EHR vendors to not be interoperable while allowing them to say that they’re working on interoperability.
I’d describe current interoperability efforts as a “just enough” approach to interoperability. EHR vendors want to do just enough to appease the call for interoperability by the government and other patient organizations. It’s not a real effort to be interoperable. That’s most EHR vendors. A few of them are even using interoperability as a weapon to keep vendors out and some are looking at interoperability as a new business model.
Just to be clear, I’m not necessarily blaming the EHR vendors. They’re doing what their customers are asking them to do which is their highest priority. Until their customers ask for interoperability, it’s not going to happen. And in many respects, their customers don’t want interoperability. That’s been the real problem with interoperability since the start and it’s why grand visions of interoperability are unlikely to happen. Micro interoperability, which is how I’d describe what’s happening today, will happen and is happening.
If EHR vendors really cared about being interoperable, they’d spend the time to see where interoperability would lower costs, improve care, and provide a better patient experience. That turns out to be a lot of places. Then, they’d figure out how to make that possible and still secure and safe. Instead, they don’t really do this. The EHR vendors just follow whatever industry standard is out there so they can say they’re working on interoperability. Ironically, many experts say that the industry standards aren’t standard and won’t really make a big impact on interoperability.
There are no leaders in healthcare interoperability. There are just followers of the “just enough” crowd.
Let’s just be honest about what’s really possible when it comes to EHR vendors and healthcare interoperability. There is some point to point use cases that are really valuable and happening (this feels like what FHIR is doing to me). In a large health system, we’re seeing some progress on interoperability within the organization. We’re starting to see inklings of EHR vendors opening up to third-party providers, but that still has a long ways to go. Otherwise, we’re exchanging CCDs, faxes, and lab results.
Will we see anything more beyond this from EHR vendors? I’m skeptical. Let me know what you think in the comments on on Twitter with @HealthcareScene.