As HIE becomes more popular, organizations benefiting from HIE are increasingly cognizant of the wonderful, value-added capabilities HIE can offer beyond the vanilla exchange of clinical information. Just what makes HIE “intelligent”. I can tell you: algorithms and computer-based logic are only part of the answer.
I’ve been giving the notion of an “intelligence” engine designed to manage data transformation, communications, and integration considerable thought. After reading Outliers by Malcolm Gladwell, I’ve distilled down the “intelligence” needs of HIE into two basic categories. If you’ve read Outliers, you are familiar with the chapters in the book entitled “The Trouble With Geniuses, Part 1” and “The Trouble With Geniuses, Part 2”. Without providing a book report, allow me to address the two categories of “intelligence” that I believe are necessary to ensure HIE works – the same categories Gladwell discusses in “The Trouble With Geniuses, Part 1”.
First, traditional IQ is a measure of only one type of intelligence – convergent intelligence. HIE with convergent “intelligence” encapsulates such features as patient matching algorithms, alerts, auto-generated reports, and notifications – essentially any feature built on the premise that answers can be determined or inferred from the existence or lack of available data (i.e., the engine converges on the right answer and acts accordingly).
Gladwell, however, goes on to describe a second type of intelligence – divergent intelligence. This type of intelligence is not measured by traditional IQ tests. It focuses, rather, on the ability to be creative or facilitate creativity and ingenuity. For example, just how many different uses or variations on the available universe of data can be gleaned such that ultimately value and quality is added to patient care? There’s not one answer but multiple uses. HIE with divergent “intelligence” is represented through HIE flexibility, such as configurable preferences and options used to enable flexible information routing and filtering. Such features are representations of divergent intelligence in that HIE has access to a universe of data; flexible configurability provides the capability to allow every consumer of that data to utilize it however they want/deem appropriate, within the constraints of healthcare and privacy regulatory, legal, and ethical boundaries. (e.g., How many uses are there for a Discharge Summary? Where should it go, where shouldn’t it go, clinical, administrative, financial, etc…).
Here’s the bottom line: When folks discuss HIE in terms of algorithms, and “intelligence”, ask yourself if the discussion is inclusive of flexibility that enables creativity or is it strictly a manifestation of rules designed to provide a single answer. To make HIE work, both forms of “intelligence” are necessary – convergent and divergent “intelligence”.
Footnote: I’ve placed the word intelligence in quotes in most contexts during this posting, because true intelligence extends well beyond that which can be represented by systems. Moreover, there are entire fields of study involving artificial intelligence that are not the subject of this brief posting nor is such a field currently part of the HIE vernacular – maybe someday.
Best post to-date.