Do We Really Want Total Interoperability? Let’s Be Honest….

Just when I started getting excited about FHIR and it’s prospects for fostering (dare I shall say) true interoperability within health IT, we should recall whether the private sector really wants this.  The question is whether we have the will to give up something (for instance making capital investments to change existing coding and systems architecture) for the common good (the disparate parts of healthcare being able to seamlessly exchange information).

After reading this article, “at the risk of quelling the FHIR party it’s time for a reality check on the fledgling interoperability standard, if only because what’s happening now will, in hindsight, likely be the fun part.

One need look no further than those now-ubiquitous XML and associated standards, however, to understand some of the growing pains on the road ahead.

At one point in time, the old guard of enterprise IT vendors — IBM, Microsoft, Sun, Oracle to name the big guns — came together with a number of specialty shops via standards bodies to craft those web services specs.

But then each vendor would take that work back to its headquarters and essentially bend the specification as far as they could toward their own will. Did the initial version of Microsoft’s integration server seamlessly access information in an Oracle database or SAP’s applications? Not so perfectly. What’s more, Forrester, Gartner or IDC analysts were saying at the time that these companies, Microsoft specifically, weren’t necessarily all that interested in interoperating with the so-called competition.

“I would suspect this will replay itself in healthcare,” said Steven Waldren, MD, director of the American Academy of Family Physicians’ Center for Health IT. “Layer on the confounding factors such as the multiple purpose of health records, ambiguity and uncertainty in the data, complexity of health information, misaligned business drivers, and it is going to be a rocky 2017-2020.”

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