The Medical Interoperability Miracle You Are Waiting On Will Never Happen
12/13/2016 12:40 PM
My new LinkedIn friend, Anne Zieger Posted a new article this morning on her site EMR and HIPAA entitled "Are We Waiting For An Interoperability Miracle?" It is well written and insightful, but for all that misses the entire point. Anne alludes to the fact that thousands of companies, tens or hundreds of thousands of people, or more, are working on this problem and simply can't come up with a workable solution. They can't solve the problem because the problem they are solving isn't the problem they think they are solving.
Smart guys, programmers, doctors, marketing people, et al., are simply barking up the wrong tree and eventually will get to the end game that Anne pointed out
"The cold reality is that eventually, the data sharing system we have — such as it is — will fall apart of its own weight, as organizations simply stop paying for their part of it. So while we might not need a miracle as such, being granted one wouldn’t hurt. If this effort fails us, who knows when we’ll have the time and money to try again."
Here is where they are getting it wrong: It isn't about interoperability. It is about a central data store that everyone reads from and writes to. You can have all the interoperability in the world, but if nobody knows who you home healthcare provider is, who the custodian of your medical records is, you, or your emergency room doctor or anyone else outside that system, will not be able to find and access your medical records.
The problem is a little like looking for your keys. You had them at one time. You know they have to be somewhere, because you got where ever you are, but good luck tracking them down. The analogy breaks down when you realize that we are probably going to be looking for a web service, with no graphical user interface, so not only is the entire internet the room your keys are in, but the room is sealed, has no lights, and you have to hire someone (a programmer) to design and construct you a power source, a switch and a bulb to even be able to look for them.
As stated above, the only solution to sharing medical data is to have a central repository. There are two viable alternatives to who designs, builds and maintains this repository: The government and health insurance companies. We all know (and had proven to us with Obamacare) that the government can't understand, or even manage people who do understand, the technology. How late was healthcare.gov and how many times did it crash in the first few weeks? That leaves insurance companies. Even if a health insurance company was savvy enough to actually build a working Electronic Medical Records (EMR) system, you still have the fragmentation of not knowing which insurance company to ask for your records. ...and it is a security nightmare.
Which brings up the point that apparently nobody can build an EMR, much less those hotbeds of technology, insurance. Pardon my sarcasm. There are two viable enterprise EMRs in the land, Cerner and Epic. Cerner is built on an amalgamation of software technologies, like nearly any big company will do in order to get productivity out of programmers they've hired and have no idea what they do. No one person has an over view of the architecture used for their offerings and it just keeps growing. Epic's offering is written in an archaic programming language called MUMPS designed in the 60s. MUMPS was pretty slick then, but that was 50 years ago. Both of these packages require weeks or months of training, are difficult to use, slow and cause great gnashing of teeth at hospitals all over the country.
If you follow along with our blog, you know that we have only once identified a problem and not offered some kind of solution. We, at Sentia Health, have designed and developed a solution that not only gives us the central repository we discussed above, but automates the entire insurance process. That means that the doctor in Switzerland who is attempting to fix the leg you broke on your skiing trip, has instant access to your medical records. Even better, the cost of your health insurance will go down by about 1/3 because we don't have any big buildings, no people adjudicating claims, give the doctors the EMR, free, and pay in real time based on the procedures they perform and document. That means they don't have to pay for an EMR, a medical coder, or a billing department. The savings is in the automation. that means saving to the consumer. The consumer him- or herself gets the 20%+ the insurance company wastes (as mandated by the ACA, and why the think they can't make money) replaced with a simple $10/month subscription fee. If your insurance is $450/month, like mine is that means you immediately save $80 (.2*450 -10). your doctor doesn't have to raise prices for years because he gets to keep the $32,000 per year he currently spends on EMR, the $40,000 he spends on compliance reporting and eliminates the coding and billing departments completely. Ad the $80 to your part of the $72,000 in savings and you get about 1/3 of the cost of healthcare just going away. The wasteful part. The business part. The part that all the Harvard MBAs waste or put in their own pockets at your current insurance company. That means that everyone will be doing things this way because it is both better and cheaper and it will organically give you your central data repository. Go look at SentiaHealth.com and tell us what you think. follow us on Facebook, LinkedIn and Twitter. Call the neighbors and wake the kids: real change is coming.
If you really want interoperability, this is the way to have it. We are testing this design all over the world today. We have beta testing going on in India, the Caribbean and soon in South America. Hang on America, we are coming. We will fix this.