Last week we held a meeting of the Partners External Integration Committee.
Partners has and is pursuing a wide array of clinical affiliations with other providers in its region. These providers include other academic medical centers, community hospitals, physician practices, health centers, and university clinics. Sometimes these affiliations focus on a specific area, e.g., oncology, and sometimes they are broad, reflecting the mixture of patients and conditions that are seen.
The systems support being requested by these affiliations is all over the map. Merged networks and shared desktops. Access to the other’s e-mail and phone directories. Structured clinical data being transmitted from one system to the other. PDF-like summaries being sent for particular events. Share medical logic that informs one organization when something happens (or doesn’t happen) at another organization. Reports of affiliation activity. Whole scale movement of an application from one organization into the other.
I am a big believer in the national agenda and activities that are focused on advancing interoperability. And I spend a non-trivial amount of my copious free time helping to further those initiatives.
But when I look at the external integration challenges we are facing and I compare that to the national agenda, I think it’s a lot more complex and messier out here in the wilds of Boston than moving structured test results into an electronic health record, as important as that movement is.
And the diversity of integration approaches (and each of these affiliations has their unique combination of integration needs) is compounded by the need to create governance structures for each affiliation that deal with issues such as budget, who is responsible for what pieces of the integration, policies for re-use of data, and mechanisms to enforce the policies, e.g., privacy, of one organization over the staff of the other.
We (Partners) will work our way through these issues. That’s the role of the External Integration Committee. But I suspect that other organizations are also working their way through these issues. It’s probably not a bad idea to augment the national conversation to include conversations that center on the messy reality of very diverse IT approaches to supporting clinical relationships (and patients) between multiple organizations.
This will give me more opportunities to avoid real work at Partners and visit the very fine city of Washington DC.
John Glaser is vice president and CIO at Partners HealthCare System. He describes himself as an "irregular regular contributor" to HIStalk.