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Monday, February 8, 2016

The five rights of interoperability

You can find many different versions of five rights in healthcare:

  • Medication Administration: Right Patient, Right Drug, Right Dose, Right Route, Right Time
  • Clinical Decision Support: Right Information, Right Person, Right Channel, Right Format, Right Time
  • Imaging: Right Study, Right Order, Right Way, Right Report, Right Action.
  • Staffing: Right Number, Right Skills, Right Location, Right Time, Right Assignment


What are the five rights for interoperability?

I would argue for these five:
  1. Right Information
  2. Right Interpretation
  3. Right Time
  4. Right Workflow
  5. Right Value

Right Information

This defines what information is needed.  The patient lab results, their problem list, preferred pharmacy, et cetera.  I need not say right patient in this case, because right information implies right patient.

Right Interpretation

It's not enough that the information accurately reflect what I need to know, but also that it be in a format that my system can use.  Don't send me information in imperial units when I operate in metric, or bad things can happen (and not just to satellites).  Don't send me just text when so much more could be done with coded data (nor fail to send me your text when you cannot code it).

Right Time

I need it when I need it.  Don't make me get it before I need it or can pay attention to it, nor make me wait for it when I need it, nor give it to me after it might have been useful.

Right Workflow

Don't make me work any harder than necessary to get it.   You'd think right time would cover this, but it doesn't.  Think about how many times users have to jump to another system to get to the data,or are seven clicks away from it when it should just be right there at their fingertips.

Right Value

This is the kicker for me, and a point of failure that most often occurs in so many programs fostering interoperability.  It needs to provide the right value for the user to warrant the investment and effort in taking advantage of it.

Whose rights are these? These rights belong to everyone: from the patient to the doctors office to the the front office to the back office to the payer, to public health and anywhere else.

I'm neither the first person or the last to riff on five rights for interoperability. These are simply my five. Which would you include? 

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