Q&A: The proving ground for interoperability
The Interoperability Showcase at HIMSS10 in Atlanta earlier this month boasted a record number of vendors collaborating, more products working together and more scenarios than ever, on nearly an acre of show floor real estate. It shows the evolution of interoperability from a far-away ideal to live, viable options in support of improved patient care, says Lisa Spellman, MBA, CPHIMS, HIMSS senior director of informatics, and secretary, HIMSS-sponsored Domains, Integrating the Healthcare Enterprise (IHE) International. CMIO spoke with Spellman as she was heading to a HIMSS Interoperability Showcase in Barcelona in Barcelona, Spain.  

How did the HIMSS10 InterOp Showcase compare with previous years?

Spellman: It went very well, based on a couple of different outcomes. One is involvement. We had 80 different participants and they tested more than 96 systems in the showcase. We’ve had steady growth in participation. The number of stories we show – scenarios – was also up, as was the connectivity that’s happening with multiple systems.

Do you think involvement was driven by the Federal Health Architecture’s CONNECT, or other federal interoperability mandates?

Spellman: There definitely are different drivers each year and it’s always interesting to see what’s on people’s minds. We were really pleased at the opportunity and partnership between the FHA and the rest of the showcase because [having IHE and FHA] partner in the same space really showed where all of this is headed. We had people who came to the showcases just to see the work that was happening in the FHA area, and others came to the show not even knowing that the Nationwide Health Information Network demo area was there.

In general, are Interoperability Showcase exhibitors considered the best of breed from the IHE Connectathon?

Spellman: When the Interop Showcases first started, in 1997, they were strictly a demonstration venue showing work with IHE profiles. As the landscape has changed and evolved, so has the showcase. In 2008 and ‘09, we started to show the HITSP construct in there. Last year and this year we started to show the work that’s happening on the federal level. It’s a nice snapshot of the current complex healthcare environment.

It’s not that IHE isn’t a major part of what we’re doing – it’s still about 80 percent of what we’re doing – and IHE is still used around the world. But there are issues that are important to particular local landscapes, and in US right now, that’s HITSP. In Barcelona, we will be showing work with the IHE profiles and we’ll have a demonstration platform for EPSOS [the Euopean Patient Smart Open Services] , which is [somewhat] equivalent to HITSP. EPSOS is a project where 12 countries in the European Union are getting together to create a shared EMR and PHR.

So the Interop Showcases have really evolved nicely in to a demonstration platform that’s relevant for whatever market you happen to be in. It’s lead by the work that’s happening within the IHE, and then partners with other entities to say “OK, here’s 80 percent of the story,” but in each country, they have their tweaks to put on that.

What emerging interoperability efforts are worth watching?

Spellman: One interesting area is around clinical research. If there’s one thing that’s challenging, its clinical research trials—pulling thousands of folders and figuring out who’s eligible. You start with huge [numbers] of prospects, so finding participants can be a multiyear process.

One of the IHE profiles allows implementation of research into standard healthcare workflow. It will make clinical trials much easier because you can pull information right out of the EMR, and that will speed up quantity and quality of trials.

Another one is what IHE and FHA CONNECT are doing in biosurveillance—working with the CDC to provide bidirectional reporting between physician practices and the CDC. Right now, [that information] has to go by fax or paper form from physician office to the state public health office or to local or regional authorities, and then to CDC. It’s difficult to do—doctors are busy, hospitals are busy—so often data isn’t provided as quickly as it could be. Providing that directly to the CDC, the ability to do surveillance and see an outbreak of something is going to be dramatically improved.

The third interesting area is medical device connectivity. Now that you have medical devices connecting to one another, the FDA and other [agencies] are looking at that, saying that creates a new model. So part of what we also showed in showcase was being able to take information directly from medical devices into an EMR and sent where needed, and I think we’re going to see a lot more of that in the future.

Why should a practice or CMIO care about what’s going on in IHE?

IHE is not the only solution, it’s one path. But that’s not the right first question: The real question is what do CMIOs want to do to improve their medical practice or their organization. What are they trying to achieve? Then it’s [identifying] the solutions to help get them there. Hopefully IHE and HITSP are in the right place if they’re looking to make those changes.