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Comment on Thoughts on PCAST HealthIT Report by VC Independent

VC Independent — Thu, 01 Sep 2011 17:58:51 +0000

very informative, keep posts like this coming.

Comment on HIE Frameworks, Generating Real Value and “Clobber-ation” by HIE’s Real Missing Ingredient: Value «

HIE’s Real Missing Ingredient: Value « — Tue, 31 May 2011 12:12:11 +0000

[...] Much of the value I list is to the benefit of a single given provider. That’s fine… as you, our loyal HIEWorks blog reader knows by now, our approach is to fill the healthcare landscape with enterprise HIEs that are valuable and sustainable, reliable and secure. Then we weave the “private” enterprise HIEs together into a public exchange fabric with technologies like NwHIN and the Direct Project: fed by the rocket fuel of competition before the fruits of cooperation. I’ll avoid digressing by referring you to our other posts, including this one that contrasts public and private HIE viability. [...]

Comment on Regional Extension Centers vs. the Competition by vswamy

vswamy — Tue, 27 Jul 2010 01:38:38 +0000

I think the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners. Looking the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models. It can be one of the possible answers to the 'safe EHR vendor' challenge as discussed by many critics. As far as implementation challenges goes, the federal guidelines for certification and usability are pretty much clear. Useful improvisation on these lines can make ones EHR's friendly to most practices of varying specialties.

Comment on Are State-based HIEs Good for Healthcare? by Todd Fisher

Todd Fisher — Mon, 21 Jun 2010 21:46:02 +0000

John, thank you for the thoughtful comment. I don’t believe we divurge as much as it may at first appear. I agree; cross-institution/state/region agreements and standards must be in place. Moreover, I completely support the various NHIN initiatives, as that is the backbone of how all this will play out, in my mind. State and other government entities implementing regulatory requirements regarding data sharing, security, consent and use, to me, however, is a far cry from actually specifying, purchasing and selling/offering technology used to support healthcare. I guess an analogy might be financial services or the oil industry. I agree that strict regulations instituted and audited by the government must be in place to protect the consumer and tangential industries. I don’t, however, believe specific technologies should be purchased by the government and offered to private organizations for use to ensure regulatory compliance. Doing so mutes competitive advantage and mitigates the desire to cut costs and improve care. Unfortunately, in a government operated environment, doing so is left to altruism and not competition. The government will have established the lowest common denominator, for lack of a better term. Based on the philosophy of minimalism, folks will do the minimum necessary to accomplish what they need to accomplish, whether that be cost savings, patient consent, or health information security.

Comment on Are State-based HIEs Good for Healthcare? by John

John — Mon, 21 Jun 2010 20:59:52 +0000

Good post Todd and for most part I agree with your overall premise, especially that heavy-handed, top-down govt strategies for HIEs are likely to falter.

Where we diverge is on the issue of the “DURSA” and how does one institute a statewide, if not a multi-state DURSA that all can live by and support. It takes more than just the technical requirements of asking a given healthcare system to have the open technology links to share data, there also needs to be a policy framework in place to share that data securely, preserve provenance, manage consent and minimize liability concerns.

Comment on What’s Your HIE’s IQ by Chuck Buck

Chuck Buck — Thu, 06 May 2010 12:29:20 +0000

Best post to-date.

Comment on HIE in 4D by All Roads Lead to HIE «

All Roads Lead to HIE « — Tue, 27 Apr 2010 12:06:19 +0000

[...] can weave together these Enterprise networks (say, using the NHIN specifications). Done properly, which requires all four dimensions of HIE, you can get to the community-wide, holistic solution faster than ”waiting for Godot” – [...]

Comment on HIE in 4D by Chuck Buck

Chuck Buck — Thu, 15 Apr 2010 13:22:31 +0000

Refreshing perspective. Thanks.

Comment on HIE “Tipping Point” by HIE in 4D «

HIE in 4D « — Thu, 15 Apr 2010 10:54:16 +0000

[...] themselves. Competition, therefore, must precede cooperation. As the market matures, however, cooperation inevitably evolves. Consumers lean heavily against healthcare’s regional nature, forcing providers to cooperate to [...]

Comment on Inter-system/Community Exchanges Lack Sustainability by HIE in 4D «

HIE in 4D « — Thu, 15 Apr 2010 10:54:12 +0000

[...] Economic dimension is best viewed as time. I’ve previously written that an economic model based on self-interest’s “invisible hand” is important to ensure sustainability. While some cooperative models have succeeded, they are, unfortunately, the exception: those [...]