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Health Information Exchange Needs A Simpler Model
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SaneIT
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SaneIT,
User Rank: Ninja
11/14/2013 | 12:47:49 PM
re: Health Information Exchange Needs A Simpler Model
"Athenahealth CEO Jonathan Bush: "Health information exchange should be a verb and not a noun. Exchange activity will iterate dramatically over time,""

I think Jonathan Bush hit the nail right on the head. Having a background that includes passing mortgage data between financial institutions the exchange needs to be a more "active" solution. While I see the benefits of the email solution and having machine readable transactions it's not as if it's incredibly difficult to build a solution that polls servers for each of the exchanges and pulls the files over. We did this 15 years ago to batch mortgage documents and get them to and from the banks we used for funding loans. It's a much bigger project than setting up a mailbox but it would be well worth the effort. The mailbox solution sounds like a first step, I wouldn't be surprised if they have the next version in the wings ready for testing.
TerryB
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TerryB,
User Rank: Ninja
11/13/2013 | 6:26:14 PM
re: Health Information Exchange Needs A Simpler Model
From an IT perspective, it doesn't make sense to have 50 states do the same thing independently. And I'm not sure I agree every state's government is going to be better than federal government. But I appreciate your insight on process as someone who actually worked with this health care stuff. Interesting debate topic.
David F. Carr
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David F. Carr,
User Rank: Author
11/13/2013 | 5:18:54 PM
re: Health Information Exchange Needs A Simpler Model
With government, it's always hard to tell whether decentralization is being used for sound architectural reasons or just as a way of passing out contracts to more vendors.
MyW0r1d
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MyW0r1d,
User Rank: Strategist
11/13/2013 | 3:07:54 PM
re: Health Information Exchange Needs A Simpler Model
There is one very good reason to do this state by state - avoiding the creation of yet another overstaffed, dysfunctional federal government dinosaur managing peoples PII data like so many failed Federal IT projects. Let the states manage the day to day administration efforts (enrollment, changes, upgrades, etc) but oblige them to use a standardized transmission format to those charged with federal oversight or interstate verification/validation systems (if someone from Texas was in Florida on vacation and a provider needed to verify coverage). Standardized EDX has been a cross to bear for the healthcare for decades (at least 1998 when I worked in an HMO). The secure email and standardized XML reporting have already proven a functional model in a number of European nations and there has been work on an interbank information exchange using standardized xml formats for years. IMHO this discussion however should have been concluded as one of the initial planning milestones after signing ACA into law three years ago.
David F. Carr
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David F. Carr,
User Rank: Author
11/13/2013 | 3:02:44 AM
re: Health Information Exchange Needs A Simpler Model
Or should centralized HIEs truly be centralized -- one national exchange. Is there any good reason for doing this state by state?
cbabcock
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cbabcock,
User Rank: Strategist
11/12/2013 | 6:01:16 AM
re: Health Information Exchange Needs A Simpler Model
Yes, health information exchanges cry out for simplification, but unless they start out with a shared architecture in a single health care cloud, they will inevitably re-mire themselves in complexity. before any exchange gets built, there ought to be a federal requirement for a report, which could be drawn up by any Carnegie Mellon computer science student for $100, that would outline a simple but workable architecture for dozens of state exchanges based in a single, shared cloud architecture.


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