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Hey EHR Guys, Data is Data

Recently, during a discussion on EHR (Electronic Health Record) systems on the Society For Participatory Medicine’s mailing list, fellow Society member Casey Quinlan wrote:

We are so not even near that, given that 800+ EHRs have created 800+ new data silos, with no effective pipes laid between them yet. That’s the hackathon that’s desperately needed now. Again, we need to draw a clear, simple picture – literally, with visuals – of what success looks like from our POV

Reading that, I just have to laugh…

I’m not laughing at what she said, it’s totally true.  What I am laughing at is that these EHR vendors are making the same assumptions that enterprise-wide systems vendors made back in the 1960’s.

Let me give you a bit of my background so that you can see where I’m coming from.  I’ve been working with enterprise-wide (ERP) software systems for 25 years, these systems include finance, purchasing, sales, inventory, manufacturing, etc.  Each of those parts of the system used to be little data silos as well, ERP tore those silos down allowing better business decisions to be made because all the data was together.

When these systems first started to emerge, the thinking was we must protect our silos by not letting it talk to other silos.  Well, pretty soon the business that were using these silos decided that that was just not going to cut it and started doing their own systems integrations work and an entire industry was born doing those integrations.

After a while of that, these vendors saw they were missing a business opportunity and working with industry, the first EDI (Electronic Document Interchange) transaction sets were born in the early 1970’s, initially for freight and transportation I believe.  These effectively broke down the silos between the different vendors ERP systems.

Right now, EHR systems are where ERP systems were in the 1960s.  They believe that they have to protect their silo (market-share) by not letting it talk to anyone one else, yes I realize there are privacy concerns but those concerns also exist in businesses not wanting to expose business strategy and financial data.

Of course, the first thing you will  hear from a vendor is that this data must be kept “safe” in our proprietary system to which I reply “what a load of crap”.  Systems are safely integrated with data security and accuracy, we’ve done it for decades.

Ask the banking industry what would happen if they could no longer carry out electronic transactions.

I believe the biggest problem is the perception that health data is different from every single other type of data in the whole damn universe.

I am sorry to spoil that perception, but it is simply wrong.  From where I sit, with 25 years IT experience, 40 years patient experience, and a humble yet always correct opinion… data is data

One more time, say it with me: DATA IS DATA.

Vendors should protect their market-share-silos by offering a better product… you know, like every other software company does. When they grow up and realize that, we will start to see some real progress, but the people buying that software are going to have to push for that to happen.

So here’s our conundrum:  We, as patients, ain’t those people.  We don’t buy it, but without us, without our data there is no market.  However, due to the fact that we are pretty much stuck with whatever system our HCPs have its difficult really have meaningful impact

We’re going to need to start pointing out systems that are not helping patients get better care, ones that make it difficult to coordinate care, ones that are still silos.  We need to point this out in the doctor’s office, online, hell gimme a bi-plane and a banner…

Then today, I was lurking on the #HITsm (Healthcare Information Technology Social Media) twitter chat and the following tweet caught my eye

@cardiologyHIT: T1: I feel a startup happening… 3rd party data translation and migration from EMR to EMR #HITsm – Mark James November 16, 2012

And he is right, but the industry already exists.  There are vendors that specialize in writing software tools that allow for disparate systems to talk to one another via EDI, they have been around for decades.  These tools allow properly identified data to be mapped into a completely different software system.  It doesn’t matter if one of the system runs on a Linux network and the other on a Windows platform, the data can be exchanged.

It seems that these EDI vendors might have a bit of valuable advice for handling our little EHR silo problem.

Whadya think? Maybe time to bring them to the table? 

© 2012 Scott Strange, Strangely Diabetic and

  • Yes, PLEASE! I’m so frustrated with the lack of communication. I’m absolutely drowning in my data, and it’s coming at me from a million different directions.

    • I know… as diabetics, our condition forces us to personally deal with more data on a daily basis than probably any other condition on the planet

  • Not to blog pimp, but I just wrote about this topic this week too (11/28 – called Downloading Data).

    There are some tiny, tiny advances like Diasend but I believe we will hit a tipping point where one company will move to meaningful open source data and the other companies follow suit so they don’t get left behind.