A Reality Check - Cover

A Reality Check

Bill Marriott, Executive Chairman and Chairman of the Board of Marriott International, got a lot of press in the Washington, D.C. area when I lived there. I remember one specific comment about how wealthy he was and how he was increasing his personal wealth dramatically, thereby expanding his self-indulgence. I caught myself chuckling as I reflected on the Bill Marriott I knew personally. He was an ecclesiastical leader in our community and a global industrial giant. I saw up close how he shared his wealth with many struggling individuals by making efforts to improve the community and by making large donations to major universities. For instance, he donated to the J. Willard Marriott Library at the University of Utah and the Marriott Center (a 19,000-seat arena) at Brigham Young University. But nothing said more about his approach to life than his home in Potomac, Maryland. Close to Marriott worldwide headquarters, Bill Marriott's neighborhood was full of exquisite large homes bordering on mansions. As a lay church leader, Bill Marriott had many occasions to have church members in his home. Some of those members were just scraping by, and to help them feel at ease, Bill Marriott built a rather simple, ranch-style home. On the outside, Bill Marriott was at times portrayed as an industrial giant, going after all the money he could gather, but others saw the real man, a gentle giant, prone to sharing, almost to a fault.

So how does Bill Marriott's situation apply to interoperability? It applies because there is a public view with a contrasting reality behind it. It is abundantly clear to me that the public perception of what is happening with interoperability is not in line with reality. I have seen many EMR vendors up close and personal, and there is a dramatic variance between vendors. I have had the privilege of debating, discussing, and sharing insights and thoughts with most of these industry senior executives, from Howard Messing at MEDITECH to Jonathan Bush at athenahealth - many would see these leaders as two ends of the spectrum. I have received feedback from thousands of EMR clients, many of whom I have personally interviewed. And most importantly, I have seen what these vendor executives have declared publicly, compared their statements to what has emerged privately, and seen how that has mapped to their clients' reality.

I get excited when I see these leaders proactively tackling the interoperability challenges in a public forum, like the KLAS Keystone Summit (October 2015). I get excited when their actions at forums match their clients' perspectives and align with personal conversations. I am especially impressed with a number of EMR vendors that demonstrate great passion as they tackle the barriers to sharing patient records. It goes without saying that there is equally great disappointment when vendors say one thing and their clients report a different story. One vendor reported seeing the error of their ways, and they chose to eliminate inappropriate incentives by removing the corporate revenue objectives around interoperability interfaces. That type of commitment coupled with action is deserving of a high five!

Most painful, though, is the proactive sharing of misinformation by one vendor about competing vendors or groups of vendors (e.g. Bill Marriott is a self-indulgent, money-grabbing industrial giant). To avoid the inappropriate focus on a particular circumstance, let me just say that enough is enough. The findings of the 2015 interoperability study are sufficiently specific to clear much of the air. Significant effort was taken to identify whether there is a villain, and there simply is not. Yes, there are challenges and different approaches to tackling those challenges, but our study did not find a sinister plot to prevent the exchange of data. The ongoing discoveries of the 2016 study will allow us to compare the information floating around the market with the reality of what is really happening.

It seems appropriate to quote one Keystone Summit participant attempting to simplify efforts and seeing a chance for all to work together: Once the flow of patient data is ready, the challenge then becomes getting an entire network of users to trust an entirely different network of users. When an effective connection between independent healthcare provider organizations is in place, the bigger issues surface, such as making sure that the trust agreements are in place and that legal and compliance groups are on board. It would be helpful to the industry if there were a higher level of data-sharing agreements or a minimum standard of data-sharing agreements that everyone could comply with.

If you haven't taken the time to compare your perceptions with the findings of the 2015 interoperability study, you are invited to do so. It may be painful as some of your perceptions may have an emotional foundation. Let us know where KLAS missed the boat, where we were not clear, or where we should have drilled down more.

It is time to work together. It is our goal at KLAS to shine a light on what is really happening with interoperability, and the 2016 study will help!