Health IT interoperability by example

...with all the confusion and the limited progress of general health IT interoperability, electronic prescribing (eRx) has moved smartly from concept to operations over a similar time period. There are certainly differences and caveats related to using eRx as an example for the broader activity. And many prescriptions are still not executed electronically – but interoperability is not the reason. And there are some clear lessons to learn here.

Part of the interoperability problem is it means a lot of different things to different people. In its most complex and abstract form, interoperability and particularly "semantic interoperability" can involve complex medical concept representation issues or highly technical medical device connections. But for many people interoperability means general information exchange – like sharing a prescription electronically between a provider and a pharmacy – as the majority focus of what practical interoperability needs to be. Yes, even in eRx, complex knowledge representation is needed for really helpful decision support, but you can get the process "going" with simpler considerations. And if the process is not "going" you can't get to the decision support anyway.

The health IT interoperability area is so confused now that we really need to look to some very practical examples of where interoperability has been solved, at least at an entry-level, and stop some of the hand-wringing, angst, and casting about. The federal government moving into the next administration and the post – Meaningful Use era, particularly needs to focus its attention and programs to develop "entry-level" interoperability to justify the public's 30 billion dollar EHR investment and make EHR data serve broader health outcomes for patients and populations...