Wes Rishel

A member of the Gartner Blog Network

Wes Rishel
VP Distinguished Analyst
12 years at Gartner
45 years IT industry

Wes Rishel is a vice president and distinguished analyst in Gartner's healthcare provider research practice. He covers electronic medical records, interoperability, health information exchanges and the underlying technologies of healthcare IT, including application integration and standards. Read Full Bio

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The Health Internet

by Wes Rishel  |  October 19, 2009  |  1 Comment

I just Googled “‘Health Internet’ Aneesh” and found 723 responses. I wonder what the over/under is for 2000 by the end of the month?

Given that the statements from Chopra and Todd Parks have been fairly general, they are treated like ink blots. Each blogger interprets them to find what he loves or hates and writes a brief essay on that. My particular essay will be that I love it and to list the issues that I hope it solves.

In healthcare we have four basic interoperability challenges.

  1. Reduce the friction of personal health information flow between the providers in the course of care transitions and between providers and other stakeholders for aggregate management of care.
  2. Reduce and increase the friction of personal information flow among healthcare providers, consumers, and a broad class of stakeholders such as patient advocates, providers of special services. We need to reduce the technical barriers to sharing information with consumers and create a positive incentive to do so. At the same time we need to provide consumers with substantial reason to trust that their intentions to limit information sharing are not betrayed. As they trust their control of this health information the increasingly become a force compelling healthcare providers to provide information. In effect the consumers are both the agents of (good) friction and the lubricant.
  3. Enable rapid technology innovation without requiring it. Computers are actually doing a lot of good in healthcare now and the challenge that innovators face must include “changing the tires on the moving car,” a sentiment that has often been expressed as “no rip and replace.” This matters particularly when working on the first challenge.
  4. Avoid “innovation dead ends” such as the fax machine. It was not so many years ago that the pre-fax epitome of healthcare interoperability was pieces of paper sent through the U.S. Mail. In that context the fax was a wildly disruptive piece of innovation. It needed no new infrastructure outside of an extra phone line, had fewer security vulnerabilities than the mail, was fully upgradeable from paper (as long as you didn’t use color and accepted blotches and pixelation), and no standards were required that hadn’t already been hashed out by the telecomm industry. It was the very strength of the fax machine that has limited our ability to replace it. The comparable challenge in today’s interoperability world do establish standards that are easy enough to enable rapid grown and don’t freeze progress just one step forward.

Some will ask if there is truly a difference between the first two challenges or whether meeting the second challenge wouldn’t also take care of the first. I hope to address that more in a future blog and to present ideas on how we can meet all four of these challenges.

1 Comment »

Category: Healthcare Providers Interoperability Uncategorized Vertical Industries     Tags: , , , , ,

1 response so far ↓

  • 1 Mark Frisse   October 20, 2009 at 6:14 pm

    Your comment about both reducing and INCREASING friction caused me to reflect. It’s a great construct. At the end of the day, health care is really about trust. I do believe #1 and #2 are about different aspects of care. I would be interested in knowing why you placed #2 after #1. I would perhaps have changed the order.