Wednesday, June 3, 2015

Direct Protocol and Interoperability: A good report card

Believe it or not, interoperability is happening. You just have to know where to look.

A recent post by John Halamka, Chief Information Officer of Beth Israel Deaconess Medical Center and Professor Harvard Medical School, lays out some concrete ways in which interoperability is taking shape - in large volumes, to boot. While there plenty of barriers still to surmount, the sweeping pronouncements about systems "not talking to each other" and interoperability efforts needing a complete reboot simply do not match reality.

The problem is often that specifics are lacking in the national discussion about patient data. We've
discussed on this blog the ways in defining success for interoperability can be poorly defined - lacking a connection to outcomes for patients and providers. But the same is true of failure, when we talk about how a complete lack of progress is projected onto the health IT field.

One antidote is to look at implementation of Direct Protocol. Plenty of successful case studies are out there. As Dr. Halamka describes it, Direct has provided "a foundation for health information exchange across the country." Both in state Health Information Exchanges and more locally within provider networks of various sizes, Direct is moving health data - both in service of current Meaningful Use goals and in ways that can allow for broader interoperability in the future.

Halamka raises a great point about the necessity of returning to specifics when dealing with Big Ideas like interoperability. It's easy to get frustrated with a national conversation that can be shifting, directionless and sometimes wildly inaccurate.

We should first tee up the problem and see how a technology like Direct can make solid contact. If inability to access a central hub of patient data is one way of framing the issue, then state health information exchange (HIE) success can be used as a yardstick. Combining disparate data from a patchwork of health systems is a mandate for HIEs and the data snapshot Halamka shares on Massachusetts is a highly encouraging report card for the use of Direct protocol in this process.

Progress in interoperability may be halting. But through numerous projects, we've witnessed firsthand the leaps our industry has taken.

Dynamic Health IT has worked in close partnership with MaxMD to facilitate the exchange of clinical documents across a variety of healthcare settings using Direct Protocol. With MaxMD as our HISP, we have brought Direct implementations to thousands of providers.

The capacity to use Direct protocol is required functionality for 2014 Edition certified EHR solutions. Like interoperability success stories, however, it may be hiding in plain sight. Many EHR implementations have untapped potential in Direct to ease the process of potentially challenging data exchanges like Transition of Care. If your software is 2014 Edition certified, it could be as simple as getting a conversation started about a tool that's already under the hood.