Forrester principal analsyt Boris Evelson thinks there are a lot of obstacles to electronic medical records and plans to tie performance to Medicare and Medicaid payments. These obstacles include errors in existing applications, a lack of data transparency, incomplete standards and missing master data. But they can all be boiled down to one, core problem: Integration.
"...most healthcare IT executives I talk to name three top challenges that they face every day: integration, integration, and integration," writes Evelson in a recent Information Week column about integrating health care technology.
Evelson paints a grim picture of health care's integration challenges. He's not the first to raise serious questions about health care data and integration-you may recall Joe Bugajski of the Burton Group warned a national records management system would be "biggest data integration challenge ever undertaken by the IT industry" in April.
But whereas Bugajski seemed to offer some hope that the government could solve these challenges by starting small and bringing in the best and brightest from the IT integration community, Evelson, an expert in business intelligence, seems skeptical the government can do anything other than waste money.
He's particularly skeptical the $19 billion for medical tech initiatives included in the Recovery Act can make a dent in the integration problems the medical community faces. In fact, he terms this "questionable spending," pointing to a mistake-laden $22 billion UK program that was supposed to transform the UK's National Health Service information infrastructure. "Surely, we should learn from the mistakes of others, not our own," he opines.
He believes the free market and strong IT leadership will save the day, as leading BI vendors enter the healthcare IT market and other factors come into play, including an understanding of how better IT can save lives.
Not to let my liberal slip show, but I can't help but point out that there's nothing stopping these factors from actually going ahead and fixing the situation. And yet ... they haven't.
Also, $17 of that $19 billion is for providing an incentive to hospitals, doctors and so on to invest in electronic medical records systems-a big difference between the UK system, which was for a national infrastructure. It seems to me that money could be used to subsidize buying systems from the very vendors Evelson says will rescue health care records.
But maybe I missed something.
Despite what I would term the piece's questionable political hypotheses, Evelson does offer a few solid tips on how those in the healthcare industry can address its integration challenges"
- Invest in BI, which Evelson says can be used to justify data integration spending. Evelson says it's a small step that you can leverage into a bigger investment, by using BI "to start exposing your data problems, and demonstrate to key stakeholders what data issues you have and how you can address them."
- Consulte outside expertise on BI before you invest, such as-duh-Forrester's BI wave or other analyst reports. By the way, Forrester did throw in a complementary copy of its most recent BI wave, and that's linked at the bottom of the column.
- Opt for plug-and-play solutions. " Use compatibility and out-of-the-box integration with these leading BI tools and platforms as a measuring stick to evaluate other healthcare IT applications," writes Evelson.