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Why Systems Don’t Talk to Eachother

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In the world of business software development, there is a big problem. It may be the biggest problem of all, and we’re not doing a very good job of it.

What is all-consuming, progress-delaying issue? It’s called the interoperability problem. Or at least, it should be called that. Really, this embarrassing shortfall is so mindbogglingly widespread that it doesn’t have a name.

Miscommunication

© Flickr user Patrik Theander

A good place to see this problem is at your doctor’s office. You know how you walk in and have to fill out a zillion forms, even though you’ve filled them out before? Shouldn’t these offices be communicating with each other?

Or you head into the hospital and they ask you what you are allergic to. Shouldn’t they know?

According to a recent piece from Meg Bryant at Healthcare Dive:

Patient identification is key to enabling true interoperability, said Mark Hollis, CEO of MacPractice, a medical management software firm. Currently, there’s duplication of medical record and account numbers across the healthcare system and there’s no way of easily determining which Jane Doe is the right one in a medical emergency. “Identifying every system and database that a patient is in … that number is unique in that database,” he said.

As for interoperability, “most of us [vendors] think it’s never going to happen,” said Hollis. Why, he asked, would the government require EHRs before creating a national identifier system for patients?

That makes sense. Once there is a unique patient identifier, interoperability can start to happen in healthcare. But wait, this isn’t a new solution or a new problem. A 2014 Medical Economics article reports:

All of the 62 [Accountable Care Organizations] said that accessing data from external organizations is a challenge. In addition, half of the ACOs surveyed said that access to data even within their own organization is challenging.

“While accountable care organizations are providing quality care for many patients, even more could be accomplished if interoperability issues were addressed,” said Jennifer Corvich Bordenick, chief executive officer of the eHealth Intiative, in a news release

And here’s a great quote from an old article by the American Health Information Management Association. (And by “great”, I mean “discouraging”)

Every health information story in 2006 will circle back to one word. In one way or another, every story this year will relate to interoperability.

Connectors

© Flickr user Peter Halasz

Of course, interoperability isn’t just a problem in healthcare. Text messages go to your phone, not your computer, where emails go. Every electronic device you have uses a different charger and plug, even though they all run on electricity. The TV remote does not work with the DVD player. Hot dogs come in sets of ten and hot dog buns in packs of eight.

As that AHIMA article notes:

Interoperability is a common challenge throughout business. “One thing I think people in healthcare are unaware of is that that this problem of data interoperability is a ubiquitous problem,” Wallace says. “It is not a unique issue to healthcare. Business struggles with it in all manner of communication.”

Of course, there is some interoperability in the world. You can use a telephone to dial any other telephone anywhere in the world—even if they are in different countries, span different networks, and provided by a different telephone company. You can mail a letter anywhere in the world—using only the postage from your home country. And pretty much any ATM card works in any ATM, any credit card at any merchant. What’s the difference between systems that have achieved interoperability and those that haven’t?

The short answer is this: incentive. If you want your departments to work together, if you want your customer or vendors to use a standardized system, or if you just want people to get along better in meetings, consider the incentives.

Are you doing anything that makes it better for them to collaborate? Or, do they benefit the most from being apart?

Answer that question, and you’ve taken the first step to solving your interoperability problem. Good luck.

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Robby Slaughter
Robby Slaughter is a workflow and productivity expert. He is a nationally known speaker on topics related to personal productivity, corporate efficiency and employee engagement. Robby is the founder of AccelaWork, a company which provides speakers and consultants to a wide variety of organizations, including Fortune 500 companies, regional non-profits, small businesses and individual entrepreneurs. Robby has written numerous articles for national magazines and has over one hundred published pieces. He is also the author of several books, including Failure: The Secret to Success. He has also been interviewed by international news outlets including the Wall Street Journal. Robby’s newest book is The Battle For Your Email Inbox.
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