Three Integration Lessons Health Care IT Still Needs to Learn

Loraine Lawson
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Shahid N. Shah, an expert on EMR/EHR systems, says health care organizations are spinning their wheels with interoperability when they should be learning something from the past 50 years of enterprise technology integration.

Sigh. I had hoped health care would be able to learn from the past 50 years of enterprise technology when it came to handling data.

“The need for and attention to interoperability in health care is palpable—more and more vendors talk about, and even more customers complain about, how it's missing from products,” Shah writes in a recent iHealth Beat column. “Service vendors are struggling to make it happen and even the government is joining the chorus to help.”

Shah is a veteran in the EHR/EMR space, with more than 24 years in health care IT. His list of credentials include being the CTO of several medical organizations, including two electronic medical records companies, and chief systems architecture at the American Red Cross. He also runs the Healthcare IT Guy blog.

Oddly enough, Shah isn’t advocating for full interoperability (it was too late for that, really). What he is arguing for is a smarter, lightweight approach to integration.

The rest of the tech world has been preaching this for about three to five years now, so you’d think this would have been considered from the start of this whole sharing health care data discussion. Instead, these initiatives have focused more on “heavyweight, industry-specific formats,” Shah writes, when lightweight approaches would have worked just as well.

“For example, instead of asking for HL7 (the health IT vendors' evolved standard) or other structured data about patients, we can use simple techniques like HTML widgets or simple pull-centric APIs to share ‘snippets’ of our apps,” he writes. As evidence, he cites the success of the Department of Veterans Affairs' Blue Button approach, which leverages app integration to open up data via APIs rather than using a structured data integration approach.

Shah suggests health care also embrace two other integration practices:

  1. Start with the basic principles of enterprise integration patterns.
  2. Use open identity management standards.

“I'm continually surprised how little attention is paid to this cornerstone of application integration,” he says, pointing to the availability of open identity exchange protocols and open source tools to support these protocols.

The technology exists. Health care would simply need to follow the trail already blazed by online companies, enterprises and even the government. What’s the hold up?

Add Comment      Leave a comment on this blog post
May 22, 2014 9:42 AM Shahid Shah Shahid Shah  says:
Hi Loraine -- thank you for the shout out in this great article. You captured most of the concepts better than I probably presented them. :-) Reply

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