An Insider’s View of Interoperability

One of the first projects that I was assigned, when joining HIMSS in 2000, was staff liaison for IHE (Integrating the Healthcare Enterprise).

I will never forget my first IHE Technical Committee meeting. The members sat around a U-shaped table, heads down at their laptops, speaking with accents from their various countries of origin, and using acronyms and jargon commonly found in the landscape of standards development. Needless to say, I felt both overwhelmed and challenged; feelings that have recurred often in my decades-long informatics career.

Interoperability is hard work. Since those humble beginnings, and with the guidance of thousands of volunteer leaders including clinicians, systems engineers, device manufacturers, consultants and staff from professional societies and government agencies, IHE has published technical frameworks for 12 content domains.

Today, those specifications enable, for example, the exchange of images for eye care, continuity of care using discharge summaries, and the transfer of patient care device data into the EHR, thus reducing manual data entry and the chance for errors.

The IHE Technical Frameworks, freely available for download, are a resource for users, developers and implementors of healthcare imaging and information systems. They define specific implementations of established standards to achieve effective systems integration, facilitate appropriate sharing of medical information and support optimal patient care. And they are used as the foundation for health information exchange in the U.S. as well as other countries.

This past week, IHE USA convened the 14th annual IHE North American Connectathon, the health IT industry’s only large-scale face-to-face testing event. As a result of this weeklong geek fest, more than 100 health IT companies will claim conformance with IHE profiles, a giant step on the difficult and winding path toward interoperability. To their credit, these companies have committed substantial time and resources to advancing the health information exchange capabilities of their products.

Other steps along the path to interoperability have been added, including the HIMSS Interoperability Showcase™. This interactive, expansive demonstration takes interoperability to the next level, allowing the vendors and organizations that pass the Connectathon to participate in the clinical scenarios that help HIMSS13 attendees envision potential improvements in their workflow and even more importantly – patient care delivery. 

But the path toward interoperability doesn’t stop there. And this is where you can play an important role.

HIMSS, RSNA, and a host of other professional societies have sponsored efforts to advance information exchange for more than a decade. Health IT vendors, suppliers and medical device companies have funded their technical experts, paying the participation fees, and making the ultimate investment of adding IHE profiles to their products. This collective group of committed organizations and individuals has pushed the interoperability snowball uphill, and now, we need your help in creating the demand.

We have heard your cries for interoperability, and we have responded. We now have standards and frameworks, and testing events, and demonstrations, and even, IHE certified products. But we need you to require these IHE profiles and interoperability capabilities in products in the marketplace.

So, how can you help?

  • Educate yourself so that you know what IHE profiles and interoperability capabilities are available and how to ask for them.
  • Include them in your Requests for Proposals.
  • Insist upon them in your systems selection process.
  • Test them in product demonstrations.
  • Negotiate for them in your contracts.
  • Buy products with IHE Integration Statements using the Product Registry.
  • Leverage them in your organization.
  • Talk about them with your peers. Join the conversation on Twitter @IHE_USA.

Until customers and stakeholders demand and implement these information exchange capabilities, the path to interoperability will continue long, winding and difficult, and our patients will not get what they deserve: seamless and secure access to health information whenever and wherever it’s needed. And, in this way, we can work together to improve the quality, value and safety of healthcare.


About Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN

Joyce Sensmeier, RN-BC, MS, CPHIMS, FHIMSS, FAAN, is HIMSS Vice President, Informatics.
This entry was posted in Blogging, Health IT, HIMSS Events, Interoperability & Standards, Patient-Centered Systems and tagged , , , , , . Bookmark the permalink.

One Response to An Insider’s View of Interoperability

  1. Joyce:

    I respect your position and applaud the accomplishments. However, I believe that so many thoughtful people, in sick care, accomplished work but so much more demonstrated interoperability needed to be shown to make a difference. We have been looking for interoperability for 10 years at great expense to the US taxpayer. The drive for interoperability was promoted as a game changer, i.e., improvement in effectiveness and efficiency leading to reduced cost of care. The demand for interoperability is more than an individual acute care requirement it is a strategic community health need. When vertically integrated acute care groups or ACO’s attempt to transition patients between and among facilities within their communities discharge summaries may not provide the necessary information to promote continuity nor transition of care. Nor will discharge summaries support the need for seamlessly sharing both structured and unstructured information between and among clinicians, laboratories, educators and researchers. Therefore, more must be accomplished and soon. I believe interoperability supporting end-to-end encryption, authentication and authorization at the person level, not the machine level, are critical to the establishment of interoperability integrity and credibility in the market place. Without the critical ingredients noted it may be difficult for the practitioner to trust current interoperability salesmanship. The industry would be served if it adopted DIRECT BASIC constructs, and instituted practical interoperability solutions.

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