Excerpt from Casino Healthcare by Dan Munro. Part 1 of 3.
The voices around healthcare interoperability are becoming louder, more frequent and more urgent ‒ which is a great thing. Recently the fires were stoked again by both Leonard Kish (here) and then even more urgently by Paul Levy with this provocative headline ‒ “We’ve been swindled.” The key quote by Paul ‒ at least for me ‒ is this one:
Our national interest does not coincide with those corporate strategic interests.
He’s right, of course, but it also made me think of another quote by Florida Governor Rick Scott.
How many businesses do you know that want to cut their revenue in half? That’s why the healthcare industry won’t reform the healthcare industry.
We can debate Rick’s personal credibility for this quote another time. As the founder of Columbia Hospital Corporation (at age 34) which bought HCA (in 1994) to become (in 1997) the world’s largest commercial healthcare enterprise ‒ his business credibility for this exact quote is beyond debate.
For those who follow me on Forbes ‒ I’ve written about interoperability in healthcare a fair amount starting early last year with a 5‒part series on the topic. That series launched with coverage of a keynote by Malcolm Gladwell (here) at a daylong summit on interoperability sponsored by West Health. The importance of the topic and the intersect with other aspects of healthcare IT (patient safety and cybersecurity to name just two) have prompted me to continue adding coverage to this critically important healthcare topic.
Some of the latest demanding insistence around interoperability in healthcare misses many of the key historical overlaps which I think are worth reviewing. Two in particular.
The world of packet-switching technology had a similar dilemma during the early days of its evolution as the driving force behind the internet using a very young standard called internet protocol (or IP). As a group the emerging router and switching vendors ‒ names like Cisco, 3Par, Juniper, Brocade, Ascend Communications, and Lucent ‒ even truncated the word so that it could become more manageable.
In that world interoperability is referenced simply as “interop.” They still hold an annual event called simply Interop ‒ but the needs around basic packet switching have been largely resolved (or avoided) and so the needs have greatly diminished ‒ as has the size and scope of the annual event.
Before moving to Las Vegas in 1994, the show attracted about 65,000 attendees and then consumed the Las Vegas Convention Center, often in its entirety. Today it’s a much smaller event at the Mandalay Bay with about 10,000 attendees each spring and about 300 vendors. In fairness, Interop now has four distinct venues around the world ‒ so the show is more globally dispersed. For purposes of comparison ‒ HIMSS ‒ the annual healthcare IT extravaganza is well on its way to about 40,000 in attendance and over 1,000 vendors.
My point with that is simply to recognize the trajectory and intersect of an important technical discipline ‒ network and data interop. Whether we realize it or not we’ve successfully navigated the unknowns of network interop for over 45 years. That world has had its battles and most of those have been successfully navigated or avoided outright. Today, the global internet largely works (and sometimes fails) because of those technical and business settlements.
That’s not to say all is perfect harmony or without big glaring challenges, however, and that’s the technical vulnerability of networks that interoperate easily (security and privacy). I’ve also written about the challenge of security and privacy because it intersects so directly with what’s becoming the richest single gathering of individual data at scale ‒ our health data.
Next week in Part 2 we’ll take a closer look at the intersection of data interoperability and data security in healthcare. In Part 3 ‒ the conclusion ‒ we’ll look at the competing business interests and the logical road ahead.
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