I’ve written numerous times that making HIE work takes more than technology. Successful HIEs consist of predictable, reproducible processes, procedures, and technologies all supported by healthcare savvy engineering and operational personnel. So, beware of the messenger that brings good news about a new “black box” or “agent” packaged as a patented plug and play component promising to deliver complete clinical data exchange, integration, and interoperability. If such a package were unpacked, one would see either nothing, or a tangled mess unworthy of the moniker “product”.
Rational thought leads many to believe that if we are smart enough to put a probe on Mars, perform painless brain surgery while the patient is conscious, and broadcast movies on our cell phones we must be smart enough to produce a single black box capable of seamless, plug and play integration with every healthcare technology system and entity. Such thought, unfortunately, is flawed. Unlike inventing something self-contained and brand new, healthcare IT requires those of us providing solutions to simultaneously accommodate decades of disparate technologies and myriad computing environments, communication and formatting “standards” and methods of integration. I must therefore break the news that there is no single “black box” or “agent” that can handle such diverse computing needs without significant human effort. Those suggesting there are such things are selling shadows, the likes of which Plato wrote of in his Allegory of the Cave. They simply aren’t real.
Making matters worse is what I like to refer to as the patent façade. The patent façade represents a metaphorical set of blinking lights that lead the uninitiated to believe the patented component is special and uniquely able to comprehensively, almost magically, accomplish the goal for which it was created. Keep in mind that there are currently approximately seven million U.S. patents and one million U.S. patent applications. If one has an invention worth protecting, a patent is a very good way to protect that invention and the associated intellectual property. But, make no mistake; a patent does not, by any stretch, ensure the invention is worth anything, provides a competitive advantage, or in some way promise that which is patented is special.
Scalable, sustainable HIE works when solid technologies are combined with procedures and processes that are franchisable and in combination are designed to support mass customization – the ability to mass produce unique components in quantities of one and implement those components precisely when and where they are needed to accomplish the objective – HIE, integration, and interoperability. This means outstanding people, service, and technology must be organized in a manner that embraces the diversity of healthcare IT while leveraging every possible similarity. HIEs that work accept disparate technologies. They live in a world of such data and system disparity every day. Those purveyors of the shadows, the black box, on the other hand, pretend a magical solution has been developed that somehow inherently understands even that which it can’t know. So, please beware of the black box.
