I have been reading through some of the Healthcare Information Technology Standards Panel's interoperability standards and support documents posted on their Web site and find them hopelessly obtuse. These are just a small subset of the deliverables expected from the HITSP given the number of detailed use cases that have been published.
This field needs an architecture that is simple, clear, understandable and gets something done. Fully specified process interoperability from the get-go as in the HITSP approach is unlikely to get defined, designed, vetted, implemented, tested, deployed, trained and used before new requirements or technologies eclipse the original specs and designs.
Meanwhile patient data is moving around electronically slower than bank credit, which is to say sporadically if at all. It would not be so troublesome if we were talking about one vendor or one organization understanding and deploying these standards; but we must get all vendors and all users consistently using them for reliable data interchange, which is a much more daunting proposition. Maybe the W3 standards of the Internet should be our messaging environment and we can start by implementing secure e-mail protocols between electronic health records.
Am I being too naive or IT challenged? I will feel more encouraged when I can send a static clinic document from my health record system to another providers EHR for inclusion into a patient record, or even just the message Hello World, without needing a dedicated interface or IT professional to facilitate the transaction. We are not there yet and I do not find much solace in these thousands of pages of HITSP documents unless AHIC 2 can wrest the process away from the information technocrats and drive toward a simpler, more implementable plan.
Simplicity trumps perfection.
James Mhyre, M.D.Practicing general surgeonProliance SurgeonsKirkland, Wash. To submit a letter to the Modern Physician Reader Blog, click here. Please include your name, title, company and hometown.