A cardiac patient of the Robert Wood Johnson University Health System was having problems at about 2 a.m. She was wearing a telemetry monitor that notified her doctor, who, in turn, got the catheterization lab ready even before the patient arrived at the hospital.
But there is a harsh reality underlying that particular example.
"There are 10 other things like that we could be doing,” CEO Stephen Jones said. If not for the cost and complexity of interoperability, that is, including the “millions and millions" of dollars that Robert Wood Johnson spends on interfaces.
Joseph Smith, MD, the West Health Institute’s chief medical officer, said many people have been wondering aloud whether fully interoperable information systems and medical devices could help avoid some of the many preventable deaths each year.
If the last decade of health information management was defined by digitization, the next will be defined by the pursuit of standardization as a foundation for efficiency and innovation. That road is destined to be long and winding, however, as two standards conveners and regulators in the Office of the National Coordinator for Health IT and the U.S. Food and Drug Administration acknowledged.
But need it be so complex?
One long-time hospital executive asked that of the ONC’s chief science officer, Doug Fridsma, MD, and the FDA’s devices and radiological health director, Jeffrey Shuren, MD, during Healthcare Innovation Day this week in Washington, D.C.
If Congress can mandate universal health insurance, after all, why not universal data and device interoperability?
“Keep saying that,” Fridsma urged. Shuren added: “They’re pushing.”
But by law the FDA can't actually mandate standards compatibility across products; rather, it has to approve devices based on the developers’ intentions, Shuren explained.
And top-down mandates are not necessarily the best solutions, especially in a country as large and diverse as the United States, Fridsma added.
Fridsma said the U.S. government is taking the right approach by “doing it from the middle” and trying to corral patients, providers, health plans and technology companies and helping to align their incentives.
Shuren said the FDA will likely incentivize interoperability standards for devices, if not necessarily mandating them.
How long that takes and how much new interoperability can be created remains to be seen, however.
In the meantime, Glenn Tobin, CEO of the Advisory Board Company’s Crimson division, posed a question perhaps on the minds of many people.
“Are patients dying because of this?”
Not in the case of the Robert Wood Johnson cardiac patient, fortunately, but the Institute of Medicine attributes 200,000 to 400,000 annual hospital deaths to preventable adverse events each year.
See also:
Telecom giants paving path to healthcare
