Perhaps the NHIN may not turn into a boondoggle?

Yet again, John Chilimark has provided the best summary-overview, that I have seen, of a possibly significant event in the rapidly evolving world of health information technology.

Below are excerpts from - NHIN: The New Health Internet?

"Chilmark has not been a big fan of the National Health Information Network (NHIN) concept. It was, and in large part still is, a top heavy federal government effort to create a nationwide infrastructure to facilitate the exchange of clinical information. A high, lofty and admirable goal, but one that is far too in front of where the market is today. The NHIN is like putting in an interstate highway system (something that did not happen until Eisenhower came to office) when we are still traveling by horse and buggy. Chilmark has argued for a more measured approach beginning locally via HIEs established by IDNs (our favorite as there is a clear and compelling business case) and RHIOs in regions where competitors willingly chose not to compete on data, rather seeing value in sharing data.
But what might happen if the folks in DC stopped talking about the NHIN as some uber-Health Exchange, but instead positioned it as a consumer-focused platform?
That is basically what happened yesterday at the ITdotHealth event where the new federal CTO, Aneesh Chopra and new HHS CTO Todd Park presented their conceptual idea to a pretty select group who had gathered together to discuss the idea of platforms in HIT to support discrete, substitutable, modular apps. (John Halamka gave a nice write-up of the event in which he participated on the first day). Chopra and Park were seeking to float this idea among the movers and shakers of new models for HIT, gauge the interest and ultimately solicit support for the concept.

Chilmark is very encouraged by the idea of the Health Internet and the new direction it is taking, creating a consumer directed and controlled interstate for the secure transfer of PHI. Not only does it finally acknowledge that at the end of the day, all the HIT spending in the world will make little difference if we do not get the one who has the most to gain, the consumer, involved, but this initiative may also create a fertile environment for innovation to occur."



My Comments and Questions:
Indeed, this event along with some of the rules regarding the creation of the Regional Health Information Technology Extension Centers offer a little glimmer of hope.

How many understand that if there are not fundamental process changes in how the data originating from patients and the physicians they trust is created, all the fancy, top-down solutions promise to be little more than a lot of expensive technotitillation?

How many in the industry and government are still mostly focused on technotitillation rather than creating the the necessary bricks that are the foundation? Who has realized that physicians are not great brick-makers or data-entry clerks?

Who has a clue that absent the data from the patient-physician interface, none of the rest of it matters very much?




"Insanity: the belief that one can get different results by doing the same thing."
-Albert Einstein