Readers Write: ViVE 2024: Enthusiasm Mixed with Caution Around Interoperability

ViVE 2024: Enthusiasm Mixed with Caution Around Interoperability
By John Blair, MD

A. John Blair III, MD is CEO of MedAllies of Fishkill, NY.

As a first-time attendee of digital healthcare conference ViVE, I wasn’t quite sure to expect prior to the 2024 event in Los Angeles. However, amidst all the inevitable talk of artificial intelligence and the massive chaos caused by the Change Healthcare saga, I found the event to be well conceived to maximize learning and networking with an efficient, upbeat approach. I enjoyed checking out presentations of all types on the floor, then was able to conveniently chat in meeting rooms with leaders of companies following sessions and panels, making the event a great opportunity to meet with people.

As a founder of a Qualified Health Information Network (QHIN), I attended the event to get a feel for the state of interoperability across the industry.

For the unfamiliar, QHINs were created under the Trusted Exchange Framework and Common Agreement (TEFCA), a federal regulation guided by the Office of the National Coordinator for Health Information Technology (ONC). A QHIN is a network of organizations working together to share data. QHINs will connect directly to each other to ensure interoperability between the networks they represent, with the goal of improving patient care through faster, more accurate data exchange.

QHINs achieved a major milestone in late 2023, when ONC announced that they had become operational. After completing the rigorous TEFCA onboarding process, we were one of five initially designated QHINs by the ONC. With QHINs now operational, I was enthusiastic to learn more about how the market is responding. With that, here are five major takeaways from ViVE.

• A focus on interoperability. The interoperability area of ViVE was terrific. There were continuous presentations and panels on one of three small stages that lent themselves to engaged and pertinent discussion. Also, because all the booths were interoperability companies, the interaction and discussions were rich and fruitful.
• QHINs spark a mix of enthusiasm and caution. As a representative of a recently designated QHIN, I was enthusiastically received everywhere, leading to informative and fruitful conversations. Although there is strong interest in and hope for TEFCA, understandable skepticism remains. There was a counterbalance between a high level of enthusiasm for TEFCA as a catalyst to significantly increase and improve interoperability to skepticism about the ability for a public-private effort of such magnitude to move much quickly.
• Privacy concerns. Individuals and organizations are concerned about privacy protections in TEFCA. Understandably, with all of the cybersecurity and privacy incidents happening, TEFCA’s massive scale has privacy and security professionals worried. However, those individuals close to the activity and process tend to agree that planning and adequate measures are taking place.
• Let me stand next to your FHIR. There is strong interest in TEFCA being a catalyst to move FHIR to scale. FHIR has made great progress and holds real promise, but achieving FHIR at national scale will be difficult. TEFCA is seen by many as the best way to address the challenge.
• Wanted: More use cases. Non-treatment use cases under TEFCA are needed, and the sooner the better. I had several conversations with individuals and companies interested in Individual Assess Services and Health Care Operations. They all want this to get live as soon as possible.

Perhaps the most relevant, concise remark I can make about ViVE is that I’m planning to attend next year. See you in Nashville.