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Tuesday, October 12, 2010

Ranking Interoperability

I always appreciate it when important ideas can be communicated in easy to understand ways.  One of my colleagues recently did that in a way that impressed me over dinner at the HL7 Working Group Meeting last week.  Scott Bolte describes, using the lens of "Healthcare Economics," a method to evaluate interoperability opportunities rather concisely.  

My own post on Scope and Focus was written shortly after our conversation, and I had asked Scott for help putting together a more detailed post on his topic for this blog.  I think after you read what he has to say, you will see how the two pieces are tied together. 

Scott sent me his bullet points on the conversation via e-mail, and it was so simply written, yet easily understood that I post it below without change.  Here are his words:

How to compare interoperability opportunities...
  1. high disease penetration in a population.
  2. high societal cost burden.
  3. highly motivated patients.
  4. there is a meaningful intervention.
  5. opportunity to improve situation with improved interoperability.
#1 makes sure healthcare providers will see the condition often enough to invest their time and money adopting any improved capabilities.

#2 improves the odds that payors will reimburse.

#3 is critical to healthcare provider engagement.

#4 means there is a chance to move the dial.

#5 is actually a fill-in-the-blank. The first four can be used to assess any opportunity, but in this case it's to determine if improved interoperability is worth pursuing.

People who are worried that going after only the big hitting diseases does a disservice to rare conditions should be reassured that once the improved interoperability is working, it will benefit all similar scenarios.


  1. What is the algorithm for combining these 5 items? Is this an OR relationship? AND relationship? Is one more important than the other?

  2. While one could argue about whether these are exactly the right criteria, it seems like this kind of thinking can be applied to ranking ANY HIT opportunity, not just interoperability. It's a more systematic approach that can be used by a group in evaluating diverse suggestions, all of which are "good things" but all of which consume resources, some for high benefits and others not so much. Hopefully, decision processes for HC reform and future meaningful use stages are being informed by a good set of criteria.

  3. John,

    Based on the conversation I had with Scott, this is an AND relationship. If you are missing one of the five components, you won't have what is necessary to succeed.