CMS Head: We’re Working Toward Interoperability. Are You?

by Larry Emmott on August 16, 2018

in Health Care Politics,Paperless

From Healthcare Analytics News:

Healthcare is stuck in a 1990s time warp. That’s according to Seema Verma, M.P.H., who heads the Centers for Medicare & Medicaid Services (CMS)…

…But in spite of these steps forward, healthcare organizations still depend on faxes, CD-ROMs and paper notes. Interoperability remains elusive, and patients still don’t have access to, never mind ownership of, their medical data, which are bound to a single provider.

“What we have today is a technological Tower of Babel, where systems speak different languages, information is not communicated, records are not interoperable, and patients and providers don’t have access to the information they need to make the best decisions,”

Source: CMS Head: We’re Working Toward Interoperability. Are You? | Healthcare Analytics News

Interoperability, or more accurately the total lack of interoperability, in dental high tech has been a major concern of mine for years. Here

Despite years of committee work, standards and promises dentistry, for the most part, is dominated by closed proprietary systems which cannot communicate with each other. Developers and vendors do this on purpose to keep users captive in their closed garden. Then many have the impudence to tell dentists it is actually in the dentist’s best interest to be a captive.

There are at least three major systems used in dentistry that would have much better functionality for both dentists and patients if they were interoperable. That is, they could communicate and share data seamlessly.

Records: Right now, there is no way to transfer chart data from one office to another. If a patient leaves and office using Dentrix and goes to a different office using Eaglesoft there is no way to transfer even basic data such as patient name and address let alone chart notes or diagnosis. In fact, it is not possible to transfer an electronic chart from one Dentrix office to another Dentrix office.

Standards committees have been working on this for years, but the vendors have done nothing to improve the situation. However, to be fair, dental records need to be interoperable as a subset of medical records and medicine is an even bigger and more intractable mess than dentistry.

Radiographs: It is possible to share digital radiographs from one professional to another however the system is far from seamless interoperability. A seamless system would require either a single click or possibly a click and drag.

What we have instead is a system that requires users to locate the radiograph somewhere in the system (not always easy) open it, save it as a different standard format (usually jpg) in a designated folder then find the folder and that saved image to attach or upload.

There is a universally accepted radiograph standard called dicom however it is universally ignored by vendors.

Impressions: The newest system is digital impressions. Of the three this has the most interoperability using a standard called stl. However, the largest digital impression and CAD CAM vendor uses a completely closed system that does not even allow users to use a standard Internet service or a lab of their choice.

As a rule, vendors prefer to keep users captive and will only move to interoperability if they are forced to by the market. As long as dentists continue to buy closed systems they will be kept as captives. If dentist insist on interoperability as a condition of purchase they will befree.

 

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