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Health care software is being forced to be interoperable soon in the US. The 21st Century Cures Act requires it (https://en.m.wikipedia.org/wiki/21st_Century_Cu
by aabaker99 5y ago
Health care software is being forced to be interoperable soon in the US. The 21st Century Cures Act requires it (https://en.m.wikipedia.org/wiki/21st_Century_Cures_Act https://en.m.wikipedia.org/wiki/21st_Century_Cures_Act). One interesting and, to technologists, disappointing aspect of the regulation is the complete lack of a standard by which to interoperate. There is no prescription for any data format for any type of health information. Health software companies are only required to provide a hyperlink to a web page that describes the data format.
This is a step in the right direction but it certainly doesn't enable the anything that looks like the developments we have seen around the internet due to its open protocols. Health care will be "interoperable" without any of the compatibility or interfaces the TFA wants. We need regulators who understand the technology and have a much higher standard for interoperability if we are to demonopolize the internet.
- jdavis703 5y agoWe’re much better off letting the market decide on the best standard. Imagine if XML had become the only legal standard for data transfer. Or SAML the only one for authentication. While one single standard is preferable, regulators should give the market time to evaluate which standard is battle proven.
- aabaker99 5y agoI agree requiring XML could have been a disaster. Still, the law seems to need to require more of we are to more meaningfully achieve interoperability. What's stopping companies from coming up with pathological data formats or generally making the data available but not easily available? Could the law specify some necessary characteristics of the data format? What if there already is a popular standard (http://fhir.org http://fhir.org)?
- ajsnigrutin 5y agoIf the standard is open (so that anyone can read the documentation and write a fully capable parser), it really doesn't matter what the standard is exactly.
- dillondoyle 5y agoPlaid for healthcare startup?
- redmattred 5y agoRedox + Health Gorilla both do this
- tyingq 5y agoI'm skeptical that will do anything. Healthcare tried to be interoperable with the HL7 protocol. Which worked out so well that software companies sell "hubs" to translate between the different vendor flavors of HL7.
- jeswin 5y agoThat's not true as a generalization. The newly mandated HL7 FHIR standards are a huge step forward in interop [1], and we've seen varying but progressively improving levels of support from all leading EHR vendors. The immediate deadline mandates patient information to be made available via FHIR, with more data segments to follow. Prior to this each vendor had a custom API, and getting integrations working was an enormous effort. There are a bunch of companies who offer a standardized API around various EHRs, such as Redox https://www.redoxengine.com/ https://www.redoxengine.com/. Now most of them have started supporting FHIR, as a way to ingest and expose data. FHIR isn't comprehensive yet, but it'll get there at its own pace. 1: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index https://www.cms.gov/Regulations-and-Guidance/Guidance/Intero...
- aabaker99 5y agoI confess I don't know much about CMS. What is in scope? Or, what is available in FHIR? The Cures act includes all PHI plus anything that could be used to make medical decisions.
- 0xbadcafebee 5y agoIt's quite comprehensive. The things you're talking about are covered under FHIR L4 and L5 (https://hl7.org/fhir/ https://hl7.org/fhir/).