Medical Records, Interoperability and Portable Entertainment

Delivering Interoperability in Healthcare

Don Rosenthal
LinkedIn Profile

My medical data should move with me as easily as my music or photo library…

I made this statement in a recent TweetChat on healthcare information technology. It spread like wildfire, retweet after retweet, around the world, reaching as far as Sweden, Japan, and Mumbai. Clearly, it struck a nerve.

Not so surprising, I guess. We all take the portability of our music, photos, and videos completely for granted. But when I go to one of my docs for one medical consult, and a different physician for a second, the second typically can’t see what the first has recorded about me, or that the first has already gotten results back from a test the second is about to order, or the basic fact that I have actually seen another provider. And that’s even if they are using the same electronic medical record (EMR) system from the same vendor! (Unless they are both part of the same practice; but even then there may be issues, especially if the two doctors are in different departments or specialties.)

What’s the upshot? I don’t have one personal health record, I have many disconnected and incomplete pieces of my medical history spread out amongst all the providers I have consulted over the course of my life. Even my car has a more complete record of all its checkups. That’s not only maddening, but it’s potentially dangerous for me as well.

Most other industries have figured out this interoperability issue years ago. And not just on the personal entertainment front. What if financial institutions couldn’t send data back and forth? Would I be forced to use only the banks, retirement funds, or brokers that used the same financial software? Could they only do business with other institutions that used the same financial software? Clearly the customers would never stand for that, and vendors understood from the get-go that these systems had to interoperate in order to be useful. Why not healthcare data?

I don’t know the history but here’s a personal analysis of the present situation in Healthcare IT. We currently have software packages that are closed to the outside world. Want to send some information from one system to another? Typically both vendors will charge anywhere from $25K to $50K to build a custom point-to-point interface so they can communicate. And that’s only from one specific system to another. Want to connect to a third system? That’s another set of interfaces and another couple of big checks to write. A pretty good deal for the vendors, so there is little incentive for them to change.

But believe it or not, the rest of the software world works on a different model, and has since the early 80s.

OK. So what’s the magic that has enabled the rest of the world to not only expect but to deliver interoperability amongst the many and varied software packages out there?

Up next, can the Healthcare IT industry learn to spell “API”?

Don Rosenthal is founder and CTO of Allocade, a company specializing in AI software to optimize hospital patient flow. This post first appeared on his blog, THITSE, covering the intersection of technology, healthcare IT and space exploration. Don was part of the original team that developed the scheduling system for the Hubble Space Telescope and later created and ran the artificial intelligence application group at NASA Ames Research Center.You can follow him on Twitter @donrosenthal.