Joseph Smith’s testimony addressed the need for interoperability and then went on to look at how we might get there. He drew from examples of interoperability in other industries:

Standards-based interoperability allows e-mail to work seamlessly across different servers, cars to fill-up their gas tanks at different filling stations, phone calls to be completed between different head-sets, and yet, when it comes to our health care, information is stuck in multiple non-communicating silos as lifesaving devices are forced to work independently.

Those examples show that standards can be a promising, long-term solution. A number of organizations are working on this approach. However, Smith pointed out that “no single effort has reached critical levels of adoption.” One such project is Integrating the Healthcare Enterprise (IHE), which creates profiles based on existing standards. Another is the Medical Device “Plug-and-Play” (MDPnP) Interoperability Program, focused on “providing interoperability building blocks (use cases, standards, a neutral lab environment and open research tools) and changing clinical and market expectations of what can be achieved.” Recently, AAMI (the Association for the Advancement of Medical Instrumentation) launched a partnership with Underwriters Laboratories (UL): the partnership aims to work with existing standards and “map them into a framework and address further safety issues where applicable.”

Some or all of the above approaches may prove successful in future years, though it’s difficult to tell now which ones they might be. If you don’t need to address interoperability for some years yet, then your best strategy may be to wait and see. It’s more likely, though, that you’ll need to address interoperability sooner than later—to reach Meaningful Use targets, to free up clinician time, or to eliminate errors from hand transcription.

In that case, waiting for industry-wide standards to emerge is not a viable option. And when (or if) such standards do emerge, there will be the question of what to do with the population of devices that are now in use. If future standards are not backwards-compatible then today’s devices would be orphaned: in our current economic climate, that would be impractical.

These are exactly the problems that medical device integration (MDI) was created to solve. MDI can provide interoperability today, working with today’s varied population of devices and broad landscape of vendors. If you’re evaluating MDI solutions, be sure to look for one that is vendor-neutral and can easily accommodate new devices as they appear on the market. That will give you the flexibility for achieving interoperability and maintaining it—whether or not the future brings new standards into play.

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Interoperability went to Congress recently. Or, to be more precise, interoperability was the topic of a March 20 hearing in front of the Subcommittee on Health, which is part of the House’s Committee on Energy and Commerce.

Joseph Smith, from the West Health Institute (WHI), testified about the need for interoperability; his full testimony is available here.

• The problem: “While all of our Internet-enabled devices freely and instantaneously share e-mail and information, the medical devices that surround our most acutely ill patients most often function completely blinded of the critically important information being collected by other such devices only inches away.”
• The solution: “We view interoperability as the ability of medical devices and health care systems to seamlessly communicate and exchange information to improve the delivery of care.”

At the hearing, WHI also released their new white paper on The Value Of Medical Device Interoperability (available for download here). The paper gives a detailed analysis of the potential cost savings from interoperability, amounting to some $36 billion a year. The biggest share of those savings would come from two sources.

• Shortening the length of hospital stays: $17.8 billion. “Delays in receiving test results hinder decision making, unnecessarily extending the length of ED visits and inpatient hospital stays. Medical device interoperability, by pushing test results to the clinician, would accelerate decision making, reducing length of stay.”
• Eliminating hand-entry of data: $12.3 billion. “Significant cost results from clinician time spent manually entering information. Widespread interoperability could save nurses’ time valued at nearly $12.3 billion, or 7 percent of total nurse salaries…. These efficiency gains would likely translate into the ability to serve an increasing volume of patients with the current number of nurses and increase the amount of nurse time devoted to direct patient care.”

Smith’s statement of the problem, and the potential cost savings, highlights the value of interoperability. In the next post, we’ll look at how to achieve it.

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