by Wes Rishel | October 28, 2010 | Comments Off on Surescripts Announcement Confirms Simple Interop Incremental Approach
Gartner analysts do not write vendor evaluations on our blogs. However, I published a Gartner First Take on the Surescripts announcement on Thursday at Surescripts Changes the Health Information Exchange Game. First Takes are available for a limited time. While available, they are free to everyone, not restricted to Gartner clients.
First Takes are very short by design. In this post I want to expand on the significance of this product as an example of a health information service provider (HISP) as described in the NHIN Direct Abstract Model.
From my early blogs on Simple Interop a fundamental goal has been to carve out a role for technology providers that was much simpler than the complex responsibilities of an HIE. An HISP has to follow special rules because it is handling healthcare data but the rules are much simpler when it is not vehicle for looking up patient data. The HISP has to assure that the sender and receiver are valid healthcare entities and be prepared to disenroll them if they lose that status. However, it does not have to manage a consumer consent role because it is only pushing data from one authorized healthcare entity to another. Consent is determined by the sender according to HIPAA and whatever additional rules it chooses to imply.
Our feeling was that the simplified role would attract companies that would start up without grants and creatively find value propositions to repay their investment. We did not want to overconstrain the role for fear of blocking innovative solutions. In this sense standards that are minimally constraining invite more innovation than “soup to nuts,” full-stacks.
We also recognized that offering provider directories was a substantial challenge, recognized but unmet in the original proposal. Using a tried-and-true incremental Internet approach the plan was to standardize a little and get it into real use, and then come back to the next steps. We felt that NHIN Direct would get initial usage at the community level. Healthcare Internet identifiers would be conveyed on business cards, letterheads, and other out-of-channel means sufficient to get a first bolus of real-world use and, by the way, provide substantial help to healthcare delivery organizations attempting to demonstrate meaningful use of their EHRs by push-based exchange of healthcare information. Not the ultimate solution, but good enough to start.
This notion of enabling free enterprise seems to have paid off. Here is a self-funded vendor stepping up to the HISP role and, by the way, able to leverage a large book of existing physician relationships to accelerate on-boarding and provide national directory assistance for Internet identifiers.
I would not be at all surprised to see other technology vendors enter the same market soon, leveraging their own special assets to attract critical mass. The good news is that if all the vendors support NHIN Direct, exchange among their networks will be straightforward. The challenge that remains is to arrange a directory service that crosses their networks, maintains the integrity of up-to-date information and protects the privacy of physicians.
Under the incremental Internet approach, that is a challenge for a future day.
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