Interoperability & Learned Skepticism
By Tamer Abouras
The term “peer pressure” probably first emerges as a buzzword in early adolescence. Around that time, at perhaps age 11, you’ll recall the barrage of advice from parents, relatives, teachers and the police officers in your D.A.R.E. program urging you to avoid smoking, drinking and use of illicit drugs.
Even prior to that time in your life — during which these suggestions come fast and furious and essentially endlessly all throughout your teens — you’re implored by parents not to speak with strangers (or take their candy or get in their cars). In short, to grow up — in America, at least — is to be conditioned with a healthy, necessary amount of learned skepticism.
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Above all else, there’s high importance placed upon the tenet that even if everyone around you was jumping off a bridge (or engaging in some other silly, dangerous activity), it’s crucial to retain the good sense and objectivity not to follow their collective lead — regardless of how much lobbying they use to bring you along.
Strangely, however, consensus is often expected to replace that skepticism when we enter the so-called “real world” as adults. We look to form consensus in the workplace, in any sort of organized gathering and even democracy itself hinges upon the basic principle that majority should rule, without ever questioning the morality or ethical implications of a given majority’s choice.
Which is how situations and conflicts such as the one currently going on between government and the private sector, pitting Health and Human Services and Centers for Medicaid Services on one side and health information organizations on the other, become all-too familiar and ironic.
Speaking at a panel discussion at the HIMSS 2016 conference on EHR and interoperability, Federal Times reported that Acting Assistant Secretary for Health Karen DeSalvo and Centers for Medicare & Medicaid Services’ acting administrator Andy Slavitt pushed for cooperation (through regulation) between private companies and the government.
“Physicians are hampered and frustrated by the lack of interoperability,” Slavitt said, “but it’s more practical than that. I don’t think anybody but we policy people actually use the word interoperability regularly. It’s usually, ‘I can’t track my patient’s referral’ or ‘I sent them to the hospital and I don’t know what happened.’”
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DeSalvo then suggested the way forward in order to alleviate that frustration, before Slavitt gave a rather interesting interpretation of the private sector’s inherent purpose in a free market.
“We’re working to see that as federal partners, we are giving clear signals to the private sector that we really want to see this new open, connected community of health,” DeSalvo said. “That we expect the health IT system to get on the same language. We want to get over that artificial barrier and always want to keep putting the consumer at the center.”
“There has to be a private sector commitment to a greater good,” Slavitt said. “Regulations like those that require open (application program interface) can help and they’re vital. But frankly, there are just too many ways to step in the way of true interoperability. No regulation can anticipate all of them.”
Just as a reminder: the interoperability that’s being very strongly pushed for here comes at a time when 90% of companies in all industries — healthcare or otherwise — have suffered a breach of their medical data as of 2016.
Are those words about peer pressure really any less true now just because we’re older?