To solve healthcare interoperability, we must 'solve the surround'

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To solve healthcare interoperability, we must 'solve the surround'

October 30, 2020
Dr. Peter S. Tippett
By Dr. Peter S. Tippett

Interoperability in healthcare is a national disgrace. After more than three decades of effort, billions of dollars in incentives and investments, State and Federal regulations, and tens of thousands of articles and studies on making all of this work — we are only slightly better off than we were in 2000.

Decades of failed promises and dozens of technical, organizational, behavioral, financial, regulatory, privacy, and business barriers have prevented significant progress and the costs are enormous. The Institute of Medicine and other groups put the national financial impact somewhere between tens and hundreds of billions of dollars annually. Without pervasive and interoperable secure communications, healthcare is missing the productivity gains that every other industry achieved during their internet, mobile, and cloud revolutions.

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The human toll — on both patients and clinicians
Too many families have a story to tell about the dismay or disaster wrought by missing or incomplete paper medical records, or frustration by the lack of communications between their healthcare providers. In an era where we carry around more computing power in our pockets than what sent Americans to the moon, it is mystifying that we can't get our doctors digitally communicating.

I am one of the many doctors who are outraged that the promised benefits of Electronic Medical Records (EHRs) and Health Information Exchanges (HIEs) don't help me understand what the previous doctor did for our mutual patient. These costly systems still often require that I get the 'bullet' from another doctor the same way as my mentors did in the 1970s.

This digital friction also has a profoundly negative impact on medical research, clinical trials, analytics, AI, precision medicine, and the rest of health science. The scanned PDF of a fax of a patient's EKG and a phone call may be enough for me to get the pre-op done, but faxes and phone calls can't drive computers, predictive engines, multivariate analysis, public health surveillance programs, or real-time alerting needed to truly enable care.

Solving the surround
Many companies and government initiatives have attempted to solve specific components of interoperability, but this has only led to a piecemeal approach that has thus far been overwhelmed by market forces. Healthcare interoperability needs an innovation strategy that I call "Solving the Surround." It is one of the least understood and most potent strategies to succeed at disruptive innovation at scale in complex markets.

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