The President's Council of Advisors on Science and Technology (PCAST) submitted their findings and report several weeks ago. The resulting "buzz" is, as one would expect, mixed. While some celebrate the findings of their review of existing HITECH strategy and architecture, many others are questioning the interests of the participants. The merits of personal interest and whether they influenced the specifics of the report should be debated – somewhere. In the meantime let's look at the crux of the findings: Current efforts and policies within MU do not go far enough to ensure patient data is interoperable beyond the HIE. Bottom line. This is a problem.
The goal of HITECH is to create a national, international even, network of healthcare data that ensure physicians, hospitals, and care givers have a complete view of the PHR. Without standards associated with how data is captured, stored, archived or interfaced between organizations, we're looking a lot like Kansas. Silos as far as the eye can see. With so many millions (billions?) being subsidized and spent on HIE's it's time to pause and consider how much farther down this path we should go before implementing a true standard that normalizes data in a way that can be shared beyond a few providers who agree regionally to share information.
With such criticism of existing architecture, and the departure of David Blumenthal, someone needs to step up and carry this message forward. The recommendation of PCAST was to let government drive the standards with free market carrying forward the solutions. This, while at times misguided, is perhaps the best course we can take. I prefer to let free markets drive best practices. However, we are out of time. With the first MU payments near, the proverbial blood is in the water and the sharks have arrived. Free markets will seek their own level but standards will take years and currently there are not the adequate market structures around reimbursement and data sharing to bring about a standard quickly enough.Let's bring together representatives from ONC, clinicians, healthcare executives and private industry vendors to formulate a standard. Without a standard we risk wasting billions and creating another bubble within the HCIT industry. The statement was made: The emperor has no clothes. It's time for someone to have courage and affirm the report, someone with the power and influence to slow things down enough to re-chart our course. There is no time to waste.
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