November 12th, 2008
The key to making health IT reform work
The ink isn’t yet dry on the 2008 election but vendors are already circling around health IT.
Based solely on a few lines in a stump speech and a party platform, vendors are looking forward to $50 billion in new spending over the next four years.
Specifically they say decision support technology can deliver the savings which make all this spending necessary.
But they may be putting the cart before the horse. A DSS system is only as good as the data which feeds it. Garbage in, garbage out. And the host of proprietary interests in medical computing today make most output garbage.
A single word, and concept, can change that, but it must be demanded from the nation’s new CTO.
Standards. Specifically, non royalty-bearing standards.
Ask WWTD — T in this case being Tim Berners-Lee.
The W3C has been fighting the good fight for open, non royalty-bearing standards for years. Video comes to you through plug-ins largely because there is no non royalty-bearing standard the group can plug into its own standard.
That’s an important point for health IT. Mandated standards should include only those elements necessary to getting the job done. The market can, over time, create add-ons, but these will remain add-ons until they become free so they can be universal.
HTML, and the variants of XML specific to the industry, are a good place to start. The goal should be a universal output for the industry’s structured databases. HL7 looks like another winner. Most vendors are moving in this direction anyway.
DSS systems may be proprietary, but they should work on standards-based data. High-end scans are nice, but when passed through centralized billing and record systems they should be reduced to results and standards-based files.
The simpler the rules, the simpler the standards, the more likely you are to get universal acceptance and adherence by all vendors.
Getting this through to the HIMSS vendor list would be an enormous political victory. Getting it implemented will be a hard slog. But if we can agree on the goals we at least know what direction we’re going in.
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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