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Siloed Systems or Siloed Data?

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Siloed Systems or Siloed Data?

Categorical funding, insufficient resources, and lack of agency vision keep public health systems isolated and unintegrated – a phenomenon often referred to as “siloed” systems. In ...

Categorical funding, insufficient resources, and lack of agency vision keep public health systems isolated and unintegrated – a phenomenon often referred to as “siloed” systems. In a 2007 white paper on the Evolution of Public Health Information Systems I argued that public health agencies needed to think about enterprise-wide systems integration, and several models from distributed, to cooperative, to more centralized were offered for consideration. More recently the action has shifted to interoperable systems (see both the ONC Nationwide Interoperability Roadmap, and my reaction to it in The Interoperability of Things). Interoperability focuses more on the implementation of standards that permit data to flow between systems rather than on combining disparate systems into larger objects to facilitate data sharing.

While this distinction between system integration and system interoperability does have implications for system architects, at the end of the day users are concerned about data. It is more important to focus on siloed data rather than siloed systems as a way to break the impasse that often arises when an agency tries to improve its operational or analytical capabilities. Agencies should consider many different strategies – system redesign, Commercial and Government off-the-shelf (COTS/GOTS) solutions, Master Data Management (MDM) strategies, service-oriented architecture (SOA), Open Source components – but always focus on the impact on the user and ultimately on the user’s experience. And of course as time goes on agencies will want to exchange data with systems outside of public health more and more which requires even more flexibility.

HLN at AIRA 2016

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HLN at AIRA 2016

HLN delivered several presentations at the 2016 AIRA National Meeting including: A presentation on Open Source strategies and issues for IIS A presentation with Bill Brand fr ...

HLN delivered several presentations at the 2016 AIRA National Meeting including:

It was truly a great conference. And congratulations to NYC CIR for winning the Center of Excellence award, and Kim Salisbury-Keith from RI KIDSNET for winning a volunteer service award!

New Articles: Interoperability; Information Blocking

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New Articles: Interoperability; Information Blocking

Two new articles written by Dr. Noam Arzt, President of HLN, have been published in the most recent (Fall 2015 - just published now) issue of the HIMSS Journal of Health Informatio ...

Two new articles written by Dr. Noam Arzt, President of HLN, have been published in the most recent (Fall 2015 – just published now) issue of the HIMSS Journal of Health Information Management:

  1. The Interoperability of Things is an essay about the state of health data interoperability in the US and it grew largely out Dr. Arzt’s experience working on the ONC Nationwide Interoperability Roadmap.
  2. Fighting Information Blocking in the Emerging Learning Health System is a feature article offering perspectives on the emerging issue of “information blocking.”

Reflecting on Past Technology Predictions

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Reflecting on Past Technology Predictions

I recently came upon two pieces I had written on technology trends in the distant past. The first was written for the strategic technology plan of a major US research university. I ...

I recently came upon two pieces I had written on technology trends in the distant past. The first was written for the strategic technology plan of a major US research university. I wrote this piece based on a set of campus forums, vendor presentations, literature review, and just pure speculation. One of my favorite lines: “While it’s too soon to tell how the race to wire America will end, it’s possible that we’ll all be watching our telephones and answering our televisions by the end of the decade as the boundaries between phones, TVs, and computers begin to disintegrate.” That was in 1993.

Patient Matching and HIE: Do We Even Have a Strategy?

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Patient Matching and HIE: Do We Even Have a Strategy?

Accurate patient matching continues to be a challenge in healthcare, especially in an HIE environment (see my earlier HIMSS posting). No simple solution appears to be at hand. The ...

Accurate patient matching continues to be a challenge in healthcare, especially in an HIE environment (see my earlier HIMSS posting). No simple solution appears to be at hand. The issue is also inextricably linked to issues of patient identity which are also difficult to solve at our current level of technology. Several approaches have emerged, however, which do not yet seem to be converging. I would characterize the major approaches as follows: