The Health Care Blog: JSK (national treasure) on data liquidity, and how it fits into Health 2.0. There are lots of "buzz words" now being thrown about in the healthcare space purporting to give solutions to "age old" information technology problems that other industries have struggled with for years, with some progress, and much pain, as a result of unintended consequences. HIT, although starting to open up to input from "outsiders," still appears to live mostly in its own isolated universe. So when you hear words/phrases like "data liquidity" and "substitutability" be sure that you do not "willy nilly" drink to much of this "kool aide."
For example, "substitutability" is a nice word and certainly monolithic EHR apps that want to "be everything to everybody" leave lots to be desired. The problem is that when you have too much interchange of moving parts then when something goes wrong (which it always does) then who owns the problem? This is where all the "finger pointing" starts between the vendors and the customer is always left holding the bag, usually having to "prove" to a particular vendor that the problem lies with them.
In addition, since nearly all "substitute vendors" will almost by definition be business associates, this expands the legal requirements placed upon the covered entity (CE). The more business associates (BA) the more BA contracts that are required, and with BAs now civilly and criminally liable under HITECH/HIPAA, CEs should expect these contractual negotiations to be significantly more than simply having BAs "signoff" on boilerplate agreements.
The devil will be in striking the appropriate balance between the "number of cooks" in the software kitchen and the additional complexity that results because of it. There are simply no easy answers to health care's wicked problem.
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