Perspective is a fascinating concept. If you’ve had the good fortune to visit the Taj Mahal, you may have a picture of yourself appearing to hold the amazing white marble structure by its finial as if it were a small toy, a perspective distorting feat made possible by taking a picture from some distance away. Perspective can also improve perception. Looking at the current state of Health Information Technology (HIT) from the perspective of someone who experienced the “Straight Through Processing” surge of the 1990’s in the asset servicing industry can be illuminating. A case can be made that the complexities and obstacles presented by the Healthcare IT ecosystem are well beyond what financial firms had to deal with. I’m not looking to engage in that argument. I’m more interested in applying lessons learned through one “adventure” in standards application and cross-industry interoperability to another theater of operation if you’ll pardon the pun.
Once experience from those times was that simply defining a standard and declaring it ready for adoption proved to be more delusional than real. The real deficiencies didn’t manifest themselves until real-world attempts to utilize data across multiple providers’ and firms’ technology platforms began to raise questions of who was using the correct interpretation or “flavor” of the standard. You can find various thoughts on the current state of HIT standards adoption. There’s one here for example where the CIO of the Mayo Clinic among others give the overall industry an incomplete at best and a D- at worst. Others are more optimistic with at least one blogger declaring “Health Information Exchange (HIE) is going to take off in 2014!” It remains to be seen if the tipping point has been reached.
One thing the healthcare industry has that the financial services industry of the 90’s did not is the Certified Health IT Product List or “the Chapel”. This is a list of information technology products approved by the Office of the National Coordinator for Health Information Technology. Here at least you have an enforcement mechanism that certifies a provider’s claims to meet the standards across a number of types of systems. That may not overcome the problems that can result when data with apparently minor differences is generated on one system and processed on another, but it may provide a faster way of getting to consensus for reconciling different interpretations of the standards.
The slogan of asset servicing interoperability, Straight Through Processing, in the end proved powerful as everyone had to claim that all their transactions were processed “STP.” The healthcare mantra, currently “Meaningful Use 2,” doesn’t quite have the same cache. Maybe a punchier phrase will catch on and really make 2014 the year of HIT interoperability.