"Common Platform"
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They are getting there, but it’s still by request and requires patient consent. I suspect that concept has been tortured for expediency, but it’s still a hurdle. Epic and Cerner are the big dogs but Meditech is still out there as is Athena
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They are getting there, but it’s still by request and requires patient consent. I suspect that concept has been tortured for expediency, but it’s still a hurdle. Epic and Cerner are the big dogs but Meditech is still out there as is Athena
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At least. Really it’s been since HIPAA, but Obama accelerated it. I was working on it in 2003 when I was PM candidate for Indiana’s Icare Connect, which died on the vine. You should have been in the C level meetings on that.
Then I was a candidate for Kentucky’s similar effort, which also died.
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The reference labs were really the first to communicate, because they had to. But even when I started with Epic in 2012 it was a freaking mess.
One of the large barriers is just plain laziness. When I started with the Cologuard folks in 2019 they were implementing Epic and had a homegrown orders and results interface, each custom for every sender. Why, you ask? Because they knew nothing of interfaces and the hospitals hornswoggled them into believing they had no one who could customize ones to Cologuard's specification. I had worked with that spec in 2015 in Tennessee and it was very nonspecific.
So, because they did not understand that every reference lab needs pretty strict specs you have to meet in order to send orders and receive results, they had about 100 custom interfaces and were bringing more on all the time. They considered it partnering with their customers. It was insane. I tried to gently persuade them of this for which I was labeled a malcontent.
Once testing for Epic started and they realized the ungodly amount of testing and documentation it took so they could sign CLIA certification they finally came around. But they hated me for it.
This is just one story of one facet of the difficulties in connecting healthcare. HL7 was supposed to fix a lot of it but it too was too far too flexible to adapt without heavy customization.
FHIR may help. It's basically defined XML, but that is very wordy and will present its own difficulties.
Still a long way to go for, IMO, very little clinical benefit in most cases. It's really for aggregating statistics for the bean counters.
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The reference labs were really the first to communicate, because they had to. But even when I started with Epic in 2012 it was a freaking mess.
One of the large barriers is just plain laziness. When I started with the Cologuard folks in 2019 they were implementing Epic and had a homegrown orders and results interface, each custom for every sender. Why, you ask? Because they knew nothing of interfaces and the hospitals hornswoggled them into believing they had no one who could customize ones to Cologuard's specification. I had worked with that spec in 2015 in Tennessee and it was very nonspecific.
So, because they did not understand that every reference lab needs pretty strict specs you have to meet in order to send orders and receive results, they had about 100 custom interfaces and were bringing more on all the time. They considered it partnering with their customers. It was insane. I tried to gently persuade them of this for which I was labeled a malcontent.
Once testing for Epic started and they realized the ungodly amount of testing and documentation it took so they could sign CLIA certification they finally came around. But they hated me for it.
This is just one story of one facet of the difficulties in connecting healthcare. HL7 was supposed to fix a lot of it but it too was too far too flexible to adapt without heavy customization.
FHIR may help. It's basically defined XML, but that is very wordy and will present its own difficulties.
Still a long way to go for, IMO, very little clinical benefit in most cases. It's really for aggregating statistics for the bean counters.
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Very much so.
I used to think for effective change, one first had to hang all the lawyers. I think I'm changing my mind, because starting with beancounters may be even better.
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Very much so.
I used to think for effective change, one first had to hang all the lawyers. I think I'm changing my mind, because starting with beancounters may be even better.
@jolly said in "Common Platform":
I used to think for effective change, one first had to hang all the lawyers. I think I'm changing my mind, because starting with beancounters may be even better.
Which one is the root of all evil, the law or the beans?
