At the heart of healthcare interoperability is The Seqoia Project and Carequality. I was blessed to attend their combined annual meeting to hear from some of the leading experts in healthcare interoperability. A lot of information was shared including some very technical, complex, and nuanced conversations. Not to mention the excitement of everything that’s happening with TEFCA and QHINs.
Below you’ll find many of the key insights and perspectives that stood out to me at the annual meeting along with a little bit of commentary for each.
It’s always great to hear from Micky Tripathi. When he was introduced, this talk was compared to Bill Russell’s farewell tour in the NBA when he’d announced this retirement. The analogy was apt for Micky Tripathi who is wrapping up his time with ASTP (Formerly ONC). He received a well deserved standing ovation recognizing the work he’s done to push forward interoperability in healthcare.
One of the achievements that Micky Tripathi seemed most proud of was getting the full regulatory framework for Information Blocking in place including penalties. I was fascinated to hear that the majority of information blocking reports has been from providers. My guess is that most of those provider information blocking reports were for individuals. Those are troubling for the individual patient, but I wonder if the bigger issue is larger scale information blocking.
I think that most of us that were waiting for HTI-2 were kind of disappointed with the final rule. Essentially, ASTP decided to split it into two rules. So, the good stuff is still coming in HTI-3 (or is it HTI-2.1?). I’ve heard a number of theories of why it was divided. I won’t opine on those speculations here, but the real message is there’s more to come.
Data is always good. As you’ll see in a video interview that’s coming soon, this adoption is in line with what The Sequoia Project expected. As Micky Tripathi said, these numbers may be small compared to some of the national networks, but you have to start somewhere.
This panel on “Is it treatment” was probably the best panel of the whole conference. It illustrated how complex defining the treatment use case can be. Michael was right that you kind of know it when you see it. However, if you haven’t defined it, then can you enforace it?
This use case gave a lot to ponder on the treatment use case. The reality is that the details really matter and slight changes can really change the answer to the question. The challenge is there are lots of edge use cases that have to be considered. As one person said, there are some treatment use cases that are clear. Let’s focus on those and then we can work on the edge cases.
Defining what is treatment really is complex. No doubt this will be an ongoing conversation for many years to come.
We’ll be sharing the full story of Anny McCollister using ChatGPT and information blocking to get access to her medical data. Watch for that video soon, but it’s true that it’s great she was successful getting her info. However, she shouldn’t have been blocked in the first place.
If you thought defining “treatment” was a challenge, collecting and managing health data is a tangled mess too. Holly Miller’s analogy described the mess perfectly.
Part of the challenge of reconciling the data and sharing data has to do with the variety of federal regulations and state requirements. Plus, sometimes those are at odds. This is even more challenging when provider organizations mostly just want to do what’s right for the patient.
There has been a lot of talk about a cybesecurity bill coming and possibly some money for healthcare to address cybersecurity. The panel of policy experts were confident we wouldn’t see one in the lame duck session. They did feel like we’d have someting in 2025. Although, some argue that this seems unlikely in the next administration. Of course, you know how I feel trying to predict politics.
I think there are a number of definitions of directories. It was also really amazing to hear how people see directories as a way to build trust in interoperability. We definitely can see the value of directories. However, it also seems like no one has a really good way to make sure they’re up to date and trusted. I’m told some FHIR directories are doing it though.
The dispute resolution process was a major topic of discussion at The Sequoia Project and Carequality annual meeting. Considering it’s the first time that a dispute resolution has come, we’re going to see some changes now that we know how it goes. One of those areas is trying to figure out the balance between privacy and transparency in the dispute resolution process.
This anecdote reinforces the challenge of the dispute resolution process. It was the first time and so we didn’t have the practice needed to refine the process. Maybe it’s better that we don’t have a lot of practice with it.
This may have been the most interesting comment to me. Paul compared it to an issue you have with your neighbor. You don’t go straight to the police on your neighbor. First, you see if you can work through the issues. Then, if you can’t work through the issues informally, then the formal dispute process is there for you.
There is a fascinating push and pull to data sharing. A lot of patients just assume the data is being shared and they’re shocked when it’s not. Although, there are some nuanced cases where we don’t want the data shared. Adam Davis is right that those often get the headlines and are the loudest.
The FBI special agent speaker was pretty fascinating. He definitely provided some needed transparency into how the FBI can help you and how it can’t. Everyone that heard him talk will definitely leverage the FBI if and when an incident occurs.
I was also blown away by this example of a breach that led to an even crazier phishing attack. Hackers never cease to amaze me with their creativity. It’s incredible and scary. Daniel Polk highlighted that when a breach occurs you have to become hyper vigilante because you’re especially vulnerable during that time.
Those are some of the major highlights from The Sequoia Project and Carequality Annual Meeting. What do you think of these insights? What would you add? Let us know on social media.
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