In every era, technology holds the promise of the future and the intrigue of the present. The concept of healthcare information technology interoperability plays that role in healthcare today. Improved patient care, fewer medical errors and lower healthcare costs are both researched and accepted as the benefits of health IT and management systems. Yet, as the nation continues its transition from paper to digital records, the pace is slower than expected and needed.
The past 30 to 40 years have brought new and important developments for the electronic exchange of patient health information. Rather than follow a direct path to interoperability, the industry has experienced many bends in the road.
As the 1960s and 1970s progressed, so did the use of computers. Developments of this era enabled the future marketplace to transition from paper-based to electronic forms of communication.
During the 1980s, incompatible computers could now communicate using different network protocols with the introduction of the first commercially successful multiprotocol routers. The advent of the World Wide Web in 1989 meant computer users could access the Internet to globally share ideas and knowledge.
Visionary leaders and clinicians at LDS Hospital in Salt Lake City, Brigham and Womens Hospital in Boston and the Veterans Affairs Department were among the first to create electronic medical systems. These systems could be accessed simultaneously from multiple locations by multiple providers.
A computer standard known as digital imaging and communications in medicine helps integrate computer systems so that the picture archiving communication systems could share images from different computer systems and deposit them in one location.
In the 1990s, new technologies included first-generation bedside terminals and an expansion of open-source technology for greater interoperability between systems. Health Level Seven and other standards organizations worked then, and work now, to establish usable standards in healthcare. To better enable the use of standards and improve the way computers share information, the Radiological Society of North America and the Healthcare Information and Management Systems Society, established Integrating the Healthcare Enterprise, or IHE, in 1998; it is now a global initiative, used in Asia, Europe and North America. Systems developed with IHE profiles communicate better with one another, are easier to implement and enable care providers to use information more effectively.
In 1999, the Institute of Medicine released To Err is Human, linking the deaths of 98,000 patients a year to medical errors. With this revelation, the healthcare improvement stage was set for the new century. The industry connected and strived to work together for better patient care and fewer medical errors.
The Certification Commission for Healthcare Information Technology, American Health Information Community and Healthcare Information Technology Standards Panel were established as the government and private sector joined forces to address the need for standards and certified electronic health-record products.
Personalized healthcare using genomic data, patient-managed health information, regional health information exchangesthe paths of the health information technology evolutionary tree are numerous. They are also uncertain. While the actual route may yet unfold, the way we proceed is clearcollaboratively, with coordination and seeking the maximum payoff in efficacy.
The recent selection of LMI Government Consulting and the Brookings Institution to lead the effort to transition the AHIC to a private enterprise can be the vehicle for us to take to the next place in health IT evolution. LMI and Brookings are committed to a transparent, collaborative and coordinated effort that will further already initiated efforts to identify interoperability issues; standardize technology and policies; achieve the certification of products; and accelerate the adoption of health IT through a forum for a wide array of stakeholders.
But as this new AHIC takes shape, we must be prepared to retain best practices and discard ineffective solutions. As we embark on this new journey, consider these lessons learned.
The healthcare field is the source of the most dedicated, tireless and giving volunteers. Volunteers for AHIC, the HITSP and CCHIT projects have taken on most of todays meaningful work advancing interoperability.
Interoperability is about making healthcare better, not about supporting or creating governmental policy. Deciding priorities of which clinical and business practices should be addressed is a healthcare decision. An independent certification commission has demonstrated that all healthcare stakeholders can reach agreement on what is needed and what is realistic.
Achieving standardization is not simple or glorious, but it is necessary work. Critics of this effort abound, but financial supporters seem sparse and unavailable.
Compliance testing and product demonstration is a separate process from standardization and certification. This check-and-balance system helps ensure product integrity by the time it gets to market.
More than 26,000 attendees are expected at this weeks 2008 HIMSS Annual Conference & Exhibition in Orlando, Fla. With so many of the industrys leadersand volunteerstogether at this gathering, lets continue the discussion and collaboration to ensure that we see the dawn of nationwide interoperability that we have worked to achieve.