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Not to invite criticism, and as an honest attempt to improve understanding, I wanted to call out what I would argue is a weakness or gap in understanding.  I saw this article: HIT Think Three rising technologies that will impact healthcare in 2018.  I have written about HealthIT and interoperability several times before, and I have done so since I have been in and around interoperability in other industries for many years.  I have seen many mandates for interoperability in numerous industries – and few really work.  The challenge ends up being focused on:

• What do we mean by interoperability – as in what needs to be exchange?
• What is the outcome or goal that changes as a result of this interoperability?

My criticism falls central to the title of this article since the three technologies listed includes, “interoperability”.  For me, interoperability is not a technological issue.  IT and technical folks can easily (and do readily) create interoperable messages and API’s.  Anyone who has experience with good old fashioned EDI knows all that they need to know to achieve this – and to discover why such work rarely yields the value originally sought.

The article nicely captures the goal – which is even defined by law – but the article does not explain the barriers as to why mandating such exchange of data or “working together” of differently designed systems (otherwise known as integration) tends not to meet the needs that led to the idea of interoperability in the first place.

Interoperability actually, in my view, exists at different levels.   There is a technical level and this is the easy part.  There is needed, to yield that value I note, semantic interoperability.  In other words, the meaning of the data being exchanged in the API’s that support “technical interopability” needs to governed.  It rarely is.  And HealthIT seems little different to many other industry initiatives I have been closer too, hence my comment.

And to make my point, I even believe that to complete the design, there needs to be process interoperability.  If the business process that spans organizations (assuming a shared outcome is defined) that consumes or shares semantically consistent data is not explicit, no amount of cool technology will cope with the embedded complexity and noise.  AI might help, at some point, but it can’t replace the basics here.

Taken together, a process dictates the needed data that then needs technology in order to share and move it.  I noted this 3-tier model a number of years ago (2003) in New P2P Solutions Will Redefine the B2B Supply Chain.  I am continually amazed at how old ideas keep coming back to haunt new initiatives.

My colleague, Barry Runyon, who is an analyst that covers healthcare (I do not), has written on HealthIT and interoperability.  One of his recent note nicely captures the real challenges, and his work actually mirrors mine though we use different terminology, which is ironic when you think about it…  See An Overview of Healthcare Interoperability and Key Considerations for Upcoming Challenges.

My previous blog on the topic: HealthIT Continues March toward Interoperability – Perhaps.

Category: health-it  healthcare  interoperability