Tag: Groundhog Day

It’s the Patient, Stupid

Electronic health records (EHRs) offer many valuable benefits for patient safety, but it becomes apparent that the effective application of healthcare informatics creates problems and unintended consequences. As many turn their attention to solving the seemingly intractable problems of healthcare IT, one element remains particularly challenging–integration–healthcare’s “killer app.” Painfully missing are low-cost, easy to implement, plug-and-play, nonintrusive integration solutions. But why is this?

First, we must stop confusing application integration with information integration. Our goal must be to communicate data (ie, integrate information), not to integrate application functionality via complex and expensive application program interfaces (APIs). Communicating data simply requires a loosely coupled flow of data, as occurs today via email. In contrast, integration is a CIOs nightmare. Integrating applications, when we just wanted a bit of information, is akin to killing a gnat with a brick. 

Even worse, like a bad version of Groundhog Day, the healthcare IT industry keeps repeating the same mistakes, and we keep working with these mistakes. Consultants and vendors from whom we request simple data communication solutions offer their sleight of hand, which usually recasts our problem into a profitable application integration project that simply costs us more money. This misdirection takes us down a maze of tightly coupled integrations that are costly, fragile and brittle, and not really based on loosely-coupled data exchanges, a simpler approach that allows the Internet to perform so well.

The key to unlocking the potential of EHRs lies in securely communicating (a.k.a. exchanging) data between EHR silos. If we simply begin by streaming data from EHR systems onto a common backbone, using a common currency like XML (eXtensible Markup Language), we will have solved healthcare integration in a way that works the way much of the Internet works. And this is good. When this happens, we know interoperability will work, robustly.Continue reading…