Claudia Williams, Former Senior Advisor to the White House CTO and current CEO of Manifest MedEx, recently commented about one of the ideas she took from the TEFCA webinar and strong reliance on the IHE spefications:
In the TEFCA webinar… what are the pluses/minuses of such a strong reliance on IHE specifications? Let me just say… CCDAs are here to stay!
— claudiawilliams (@claudiawilliams) August 4, 2021
CCDAs being here to stay is an interesting finding. I’m not sure many of us would have believed that it would last this long. Keith Boone, did reply that they’ll just be on FHIR in the future. The question is how long will this take? We hear a lot about FHIR, but it’s still a massive work in progress. Williams also went on to point out how long it takes for a digital transaction to become truly standardized and predictable in healthcare. She highlights why this is important to her and other HIEs.
As an HIE aggregating data from many providers we rely on common use patterns and widely deployed approaches that meet with little skepticism. We are looking for scale and low friction. The only options that meet those thresholds today are HL7 V2 and CCD queries or push
— claudiawilliams (@claudiawilliams) August 5, 2021
Be sure to check out the full thread for even more nerdy healthcare standards talk including resources from John Moehrke. In fact, Moehrke points out that new features are never created without some demand and/or benefits. This is the challenging chicken and egg problem of healthcare interoperability standards. It’s also why I wish the meaningful use stimulus money would have been focused on healthcare interoperability as opposed to specific EHR adoption. That money would have created the motivation to create and adopt the standards. Sadly, TEFCA doesn’t have the same carrot or stick that the HITECH act had.
As we are now, it’s a really slow process to create and adopt standards since the incentives aren’t often there. The recent announcement that Direct Trust is now at 2.6 Billion messages and accelerating since hitting the 2 billion mark in Feb 2021 is an example of how a standard can accelerate once it’s mature. Plus, direct was part of the meaningful use and EHR certification requirements so every EHR vendor incorporated it into their system. The problem for healthcare interoperability standards today is that getting there is an uphill climb with the current incentives and penalties.