Health Gorilla CIO: 'The industry will be cracking health IT interoperability for the next decade'

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Interoperability is today's health IT Holy Grail. Physicians, executives and vendors are all being pushed to achieve true interoperability, but like any lofty goal it takes a lot of trial and error to achieve.

Andrei Zudin, CIO of online healthcare marketplace Health Gorilla, talks the state of interoperability today and how much further healthcare has to go.

Please note responses have been lightly edited for clarity and concision.

Question: What progress do you think EHR interoperability has made over the past few years?

Andrei Zudin: While EHR adoption has dramatically increased in recent years, we have yet to see comparable levels of interoperability between the diverse platforms. Health information exchanges that started to appear in recent years were meant to solve the technical and organizational issues between the systems, but failed to do so on a nationwide scale thus far. Certain levels of success can be observed in several regions where players were able to find a working business model for HIEs.

Q: What are the biggest challenges to achieving true interoperability in healthcare?

AZ: There are many challenges on the regulatory and financial sides. On the technology side, achieving true interoperability means establishing a common set of protocols, data formats and standards. Previous attempts to achieve interoperability have had limited success. However, they gave birth to numerous electronic health information sharing arrangements, protocols, standards and data formats. Many of them are still in place in various regions, and some are fundamentally different from one another.

The challenge today is finding a common denominator for all of them to produce a seamless nationwide interoperability platform. Establishing and following the successful governance procedures to integrate all these diverse platforms into one looks like the biggest challenge to me. There are also pure computer science challenges, like establishing consistent data semantics and formats to enable common understanding of the data by all stakeholders and data quality for accurate individual matching.

Q: What will the benefits be when interoperability is achieved?

AZ: With the right information at the right time, patients will become active participants in their health, and caregivers and medical providers will become their active partners. It will also enable critical public health functions like case reporting, disaster response and disease surveillance, and support value-based payment systems. Scientists and researchers will be able to use anonymized, aggregated data for their research, leading to improved practices in medicine.

Q: How long do you think it will take healthcare to reach this goal?

AZ: The Nationwide Interoperability Roadmap, released by The Office of the National Coordinator for Health Information Technology, suggests by the end of 2017 basic connectivity and data exchange will be established between EHR systems and targets 2024 as the year when nationwide learning health systems will be fully functional. I personally find the milestone of 2017 overly optimistic due to the reasons outlined above. We will most likely see phase one of the roadmap complete by 2020.

Q: What will be the next big challenge in health IT after interoperability?

AZ: It's pretty hard to tell at the moment. I believe that the industry will be cracking health IT interoperability for the next decade or so, which will likely prove to be a challenge in and of itself.

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