>Having worked for an EHR company at one point, the author misses the main reasons for a lack of interoperability: government regulations regarding "meaningful use" that allow physicians and hospital systems to receive financial incentives to offset the costs of the software.
Ha! "Meaningful Use" is not the reason for lack of interoperability. The lack of interoperability existed before "Meaningful Use". My pet theory: The individual companies don't really want it. Oh sure, at conferences and trade-shows everybody says the right things, but in their heart of hearts, they want to be firmly in control of data in order to make it as painful as possible for the customer (i.e. hospital) to move away from them, or even integrate a competing product.
"Meaningful Use" is tied to the regulations that also govern the glacially-developing interoperability standards, and is only achieved through certification. What "meaningful use" actually means is still not very well defined from what I know (I'm now in the financial industry so I haven't kept abreast of the current state of EHR regs.) So even if the industry settled on a standard themselves, they can't be sure adopting it or the non-existent government decreed standards would meet certification even for meaningful use. And meaningful use and interoperability are the result of HIPAA from 1996.
Doctors and hospital systems are hesitant to adopt any EHR solution because they will receive huge subsidies from the federal government in the form of tax-breaks as long as they are using a certified solution, which is the only way many smaller practices will be able to afford adopting EHR systems. There is a lot of uncertainty around committing to an EHR solution because the practitioners can't be convinced that the EHR systems will meet cert, so they're dragging their feet, which really retards the growth and revenue of the industry.
I think if there was a standard for interoperability that everyone knew would meet cert (which ties into "meaningful use"), we wouldn't be having most of this conversation.
>"Meaningful Use" is tied to the regulations that also govern the glacially-developing interoperability standards, and is only achieved through certification.
"Meaningful Use" is largely agnostic to the underlying standards. It rewards (or punishes) outcomes but its aim is to increase electronic patient record usage.
>So even if the industry settled on a standard themselves, they can't be sure adopting it or the non-existent government decreed standards would meet certification even for meaningful use.
That's not really an issue. The standards are the way they are because there are no dominant players that can push through a standard unilaterally, and as I've said, the big players just don't care enough about standards outside of marketing, and they downright hate them if it means an easier time for a competitor to supplant them on-site. The interoperability mess is not due to MU in any 'meaningful' way. It was there before MU, it's there today, and it'll be there after MU.
Ha! "Meaningful Use" is not the reason for lack of interoperability. The lack of interoperability existed before "Meaningful Use". My pet theory: The individual companies don't really want it. Oh sure, at conferences and trade-shows everybody says the right things, but in their heart of hearts, they want to be firmly in control of data in order to make it as painful as possible for the customer (i.e. hospital) to move away from them, or even integrate a competing product.