Dr. John Halamka cites 4 major barriers to healthcare interoperability

John D. Halamka, MD, CIO of Beth Israel Deaconess Medical Center and dean of technology for Harvard Medical School, both based in Boston, discussed his thoughts on healthcare interoperability during a recent interview with athenaInsight.

"Healthcare doesn't have interoperability to the extent other industries do," Dr. Halamka said. "We're really the last industry."

To explain why healthcare lags other industries when it comes to interoperability, Dr. Halamka shared four thoughts:

1. Regulation varies by state. "In Massachusetts, we have a set of laws, and those laws are generally friendly to interoperability," he said. "But in New Hampshire, it's illegal for a government entity to hold your data because that's too much government in your face. What's required in one state is illegal in another state."

2. There's no nationwide patient-matching system. "How do I even know who you are? Maybe your name is misspelled, or maybe there are other people in the country that have your name," Dr. Halamka explained. "So, if I'm sending data from place to place, how do I even make sure I commingle the right data? We don't have a nationwide patient-matching strategy."

3. Providers don't have a nationwide directory for one another. "How does a doctor in Florida get the electronic address of doctors in Massachusetts? We don't have any kind of national directory of electronic inputs," he said.

4. Hospitals don't have an economic incentive. "There's the biggest hurdle: economic incentive," Dr. Halamka said. "If there is a business case to share the data, an enabling policy, and easy-to-use technology, then data usually flows. If you said, 'Doctors won't be paid until their data goes to the patient or to the next provider of care,' in two weeks we'd have interoperability to a much greater extent than we have now. We just don't have quite that incentive."

To read Dr. Halamka's interview with athenaInsight, click here.

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