Interoperability All Over Again

by Phil Hemmings, Director, Global Industry Marketing, CSC Healthcare and Life Sciences

This time it’s for real

Last week in the United States, the National Coordinator for Health Information Technology published Connecting Health and Care for the Nation (PDF), a draft “Nationwide Interoperability Roadmap” for healthcare.

In the report’s opening letter, the National Coordinator calls for, “a set of standards that allow more seamless, yet appropriate, sharing of electronic health information for ‘small’ (individual patient), ‘big’ (population level and beyond) and ‘long’ data (wrapping around the individual and telling their health story over time).”

The Report’s Introduction goes on to say that, “secure, efficient and effective sharing and use of electronic health information … is an important contributor improving health outcomes, improving health care quality and lowering health care costs.” (These three imperatives, by the way, which the IHI has identified as the Triple Aim for Healthcare Reform, seem to me to be a profoundly helpful way of cutting through the complex clutter of healthcare rhetoric.)

Not a small aim then. And it’s something we see echoed in healthcare systems across the globe. In the United Kingdom, for instance, the recently-established National Information Board has set the aim that, “All NHS funded care services are expected to have digital and interoperable systems that remove the limitations of paper records and slow bureaucratic systems by 2020.”

Indeed, it’s not a new aim either. Over a decade ago, England’s then Prime Minister set out his intent as follows, “If you live in Birmingham, and you have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you.” The National Programme for IT, which was intended to deliver this lofty goal, was routinely described as the biggest civilian IT project in the world.

What’s different now? Why is this time different to the others? Well, we’ve learned a lot, put in place a lot of foundations, and, crucially, expectations have changed. Put simply, technology is pervasive now, and the current and next generations of clinicians and patients will no longer accept that it doesn’t join up. In a world where I can order a book and routinely track its delivery progress across multiple systems, it’s no longer acceptable that I can’t do the same with my blood test results.

The call is out to healthcare technologists everywhere to move to the next generation of fully interoperable technologies. Getting there will require vision, determination and a lot of intensely detailed hard work: existing systems will need to be modernized; important legacy systems will need to be maintained and opened up to the outside world; and new functionality will need to be layered on top. But it can be done. And if we don’t do it, there’s no doubt someone else will find a way. Whoever does it – and I’m staking a claim for CSC to be part of it – interoperability has got to be good for all of us.


  1. I read your post with great interest. My background is in medical practice, Health IT and HIE development.

    The need for interoperability and continuous improvement in interoperability is well understood and has been a fundamental goal for Health IT since the David Brailer era and development of regional RHIO’s. The ongoing leadership of IHE (Integrating the Health Enterprise) in the US is another large important arena of work in Health IT that highlights interoperability.

    I’m curious for the CSC Healthcare service providers and their Healthcare clients that engage in all forms of Health IT improvement, what are the defined value propositions that support ongoing Heath IT efforts? (Meaningful Use might be an example of a guideline to finding value). The document.cited here for national interoperabiliity goals makes multiple references to value – however it is hard to find the deeper defintions of the value. Examples of value definitions with business focus might be: how to help providers determine which is the ‘better’ treatment approach, who are the ‘best’ qualified providers, and how can patients find the best treatment and providers?

    As a provider of Health IT services, it would be good to hear back from contributors throughtout the CSC global network on how value is defined and measured. As a capability that CSC can offer, this ability to define and measure value seems like it would be quite ‘valuable’ (if you will) to help define CSC as a leader in service delivery.


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