Today, here’s a guest post from the founder and CEO of Zoeticx Clarity Cloud solution for interoperability.  My comments here are above the line below and this is reproduced with his assessments on the future and is in response to the former director of ONC, Dr. Loonsk.  I have have written about 3 posts on Zoeticx at the Medical Quack here as the money savings is huge with their platform and something to take a look at with platforms today as more and more are emerging, I read it every day and the pot for spending on Health IT is not getting any bigger, as a matter of fact it’s starting to shrink so CIOs are in a spot today to determine what do we “need” and what would be “nice to have” to be blunt. 

You read me all the time talking about questioning ROI on non relevant data that everyone feels they “have to have” and granted it’s not always easy either.  Dr. Halamka, not too long ago on a blog post (Life as a Healthcare CIO) said the same thing as he had budgets that he has to maintain and so he’s doing the same thing, evaluating what is needed to run the hospital business for both clinical and financial systems in an effort to deal with the complexities we have today. 

I just said today that our new DOJ leader needs to be a “hybrid” and when it comes to Health IT, there’s nobody better than Dr. Halamka showing the value of being a “hybrid” with his background being both computer science and an emergency room doctor, so he has more than one point of view and gets in there with hands on use of technologies in the ER.  As a matter of fact I really don’t know where the US Health IT efforts would be without his input as it’s that vital as again he’s “grounded” with good balance, which we could use a little bit more of that today with others.   Here’s the backlinks on Zoeticx if you want to read and watch the videos. 

Zoeticx–EHR Agnostic Clarity Healthcare Platform, An HIE Requiring No Data Warehousing For Interoperability, Answers The Call for Less Disruption With Actionable Medical Information Flow

The second post expresses a 3-6 years compatible time line for the ONC adaptation from Zoeticx.  Zoeticx supports an Open API / Open architecture and I have mentioned many times there’s no need for a centralized data base to maintain with current engineering, and that’s where the savings come from.

Zoeticx Clarity Server - Middleware HIE Will Save Millions Maybe Billions With HIE And Has 3-6 Year ONC Compatible Time Line, Works Using APIs, Web Apps Where Nobody Has to Swap Out Their EHR…

So read through and use the links and form your own opinion, see some new software engineering attempting to contain cost and add a good work flow solutions for doctors.  Zoeticx is EMR agnostic.   As I have stated before, there’s already an Allscripts, Epic and generic java API written.  Demonstration video at the end of the post with short Consultation demo.  BD 

Practical Steps Addressing Healthcare Interoperability

A response to Dr. John Loonsk’s “Where’s the Plan for Interoperability?”

Thanh Tran

CEO / Founder, Zoeticx Inc.

Dr. John Loonsk’s blog, “Where’s the plan for interoperability?” posted on Healthcare IT News September 22, 2014 poses a direct question on EHR Interoperability.

Coming from the former ONC Director of Interoperability and Standards, the blog outlines the challenges towards healthcare interoperability:

1. Infinite extensible architecture

2. Discipline towards execution – Interoperability is not about bright and shiny object solutions, it is about the much less glamorous work

3. Silos EHRs and Silos Standards

4. Not focusing on the core challenges i.e. patient engagement

5. HITECH and Meaningful Use focus must be beyond EHR Vendors

The above 5 key points outline the challenges healthcare face, both in term of deriving a national standard or reaping the benefit of the transition from paper to electronic environment. Dr. Loonsk touched on the patient centric model as a critical missing link to any solutions presented today. In short, where is the patient – in the landscape of healthcare today?

From a patient centric perspective we would like to offer a practical, low cost solution and roadmap in addressing healthcare interoperability:

1. Patient-centric model: Any standard development must start with the patient. Addressing the patient needs would eventually align every other aspect required for interoperability. It is the patient who needs to have all his / her clinical data connected, presented seamlessly to care providers.

2. Focus on clinical data: Care providers ‘speak a universal language’ – it is the patient clinical data. Regardless of how a patient’s heart rate is stored (e.g. different database format and syntax), to a care provider, it is simply heart rate. From a patient centric approach, the model is based on clinical data. To support healthcare, all vendors must be adopted to that universal language for care providers.

3. Open API / Open architecture: With the patient-centric clinical data model we support an open API / architecture thus sealing away the healthcare applications required to operate on the data from the deployed EHRs infrastructure.

4. Adopt a standard model and open API while leaving the task for translation to EHR vendors: Tightening the model and the API would force the issue of translation to a universal model. ONC should focus on tightening the rule with compliance to that model and leave EHR vendors with the task to do the conversion from its proprietary clinical data to the universal model.

5. Patient directory services: Patient engagement would start with the patient outlining which healthcare institutes he / she would have his / her records at. The creation of a standard patient directory service would open accessibility and support of patient care continuum without the required data duplication as suggested in HIE. HIE is static in its approach where going with patient directory service with access via gateway and leave the data at the source would be ideal for healthcare. With this approach, EHR vendors would still have its stickiness in healthcare institutes making them easier to adopt to the new model. At the same time, the patient directory service, coupling with the access approach at near time would give care providers the ability to retrieve the complete view of patient medical information.

The above approach addresses most of current shortcomings:

1. Loose standard definition (CDA)

2. Lack of focus entity (not patient centric)

3. Incorrect emphasis from HITECH (EHR vendors) and impractical approach for implementation due to additional components such as centralized HIE database.

Our proposed solution is available through the Zoeticx approach which starts with focusing on the patient, clinical data and an open architecture to support near time access to the EHRs.


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