March 9, 2022 | Jessica Zeff

4 min read

Reflections on Interoperability

I can’t speak for anyone else but I tend to think about healthcare in isolation – almost as if new and emerging concepts, technologies, and challenges are unique to healthcare.  I’m thinking specifically of the fast and furious changes we’re seeing in the advancement of health information technology.  Consider the push for interoperability, adoption of FHIR, integrations, standardization of data and reporting, health apps and data sharing, data mining and analytics, etc.  Maybe I’m a bit tunnel visioned because I spend so much of my time and my personal interests lie in healthcare, specifically, healthcare policy and regulation and I don’t have as much time (or interest) to keep up with other industries.  But I don’t live under a rock either (I know: surprise!) and I’m coming to understand the changes in healthcare as part of a broader change in technological capabilities and societal expectations.   

So what triggered this moment of introspection?  I was reading an article the other day about Ford’s F-Series truck and its evolution.  It was an environmental feature in a magazine and I almost passed it up except that the phrase “software communication” caught my attention.  And those of you who may have been keeping up with my information sharing and interoperability blogs will probably understand, more than most, why that phrase caught my attention.  Being someone currently so engrossed in conversations around health interoperability and interoperable software, I immediately translated “software communication” to “interoperability” and wondered what interoperability could possibly mean in relation to a truck. 

Well, the article was really about the development of autonomous, self-driving vehicles and current development efforts to achieve that goal.  As I read with (surprising) interest, I was struck by how familiar the conversation seemed to the one we’re experiencing in healthcare.  “Oh really?” you say.  “Do tell,” you say.  Ok, since you ask, I’ll oblige!

In the article, Jim Ford, CEO of the Ford Motor Company, commented about the change from the traditional motor- and engine-based vehicles of the past to software-based vehicles of the future.  Specifically, he stated: “the real change is that we are moving to a software-defined experience for our customers.”1  Why did this statement resonate with me?  It resonated, I think, because it mirrors the changes we’re experiencing in healthcare as a result of interoperability and associated technologies, i.e., developing software that helps to define patients’ experience of and engagement with healthcare.  I’m thinking telehealth, remote therapeutic monitoring, data access, sharing and integration of data, integrated technologies, and so much more.

The CEO then continued the discussion about “software-based” vehicles of the future and the current challenges to this vision.  One of the barriers he discussed is the different electrical systems and pieces of software that make up and run various pieces of any one vehicle.  The complication being that systems and software are all designed and manufactured by different vendors and cannot communicate with one another.  The CEO used this example: “different parts of the car can’t speak to each other – the software that controls seat movement can’t talk to the software that controls the door latch.” Sound familiar?  It should.  The issues at stake as a result of these uncoordinated systems are many and varied and, as many of us recognize, include: inability for integration with other, newer technologies; inherent inefficiencies of managing disparate systems; delays in diagnosing problems and proposing fixes; lack of control of customer experience; and managing cyber-security concerns.

Okay, nice anecdote, I know, but you’re wondering what the point of this blog really is.  It’s true, there are no concrete nuggets of advice here or a take on a particular regulatory requirement.  Instead, this piece focuses on an effort to make sense of the changing regulatory environment in the health sector and connect it to more global changes around us.  In the high pressure, high stakes, and rapidly changing world of healthcare, it’s sometimes impossible to see that the changes fit into a wider picture, let alone how they fit in to that wider picture.  As a compliance officer trying to make sense of the constant stream of changes affecting our industry, it helps me to understand healthcare is not changing in isolation but as part of a much bigger vision of the future.  In fact, it inspires me. Perhaps this understanding will inspire others as well.

References:

1, 2 The New Yorker, “American’s Favorite Pick Up Truck Goes Electric,” January 31, 2022.

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