I love the fresh debate about standards and the evolution of Health IT raised by the three Health Affairs articles. I agree wholeheartedly with the perspectives of Carol and Clay - and frequently reinforce these comments to customers, policy makers and audiences alike.
It's about the patient - not about the standards. Value in the form of patient care and business results can be improved by moving/reusing the data already in the system! There is no need to wait for 'standards'. Ultimately we need to be focused on solutions that provide value to patients….better quality of care.
If it's about the patient, we need to empower consumers to be active and engaged participants in the system and they will demand 'connected' care and more health and wellness choices. They will increasingly make physician choices based on the ability and willingness of physicians to leverage communications/connected care to improve patient convenience and outcomes. In order to have more choice, consumers need to be able to access and leverage health IT solutions: the same ones that are being used by their physicians and other stakeholders across the spectrum of care.
Health IT is a great enabler for many things (outcomes, safety, results, employee productivity, employee satisfaction) but not an end in itself. System design matters a lot - metadata is the answer to enabling exchange of info today to evolve to standard exchange tomorrow. Health IT is only one piece of the puzzle, but we can't wait for all the pieces to be in place; We need to start improving outcomes today. These beliefs have informed the design principles of the software products we introduced in the marketplace - both HealthVault and Amalga.
In addition to consumers as a change agent, I remain hopeful that the buyers of large health IT systems will wake up and demand more from their vendors; Not in terms of custom features, but in terms of a real commitment to interoperability and to unlocking the data that exists in systems already. Health IT buyers are critical stakeholders/components of the ecosystem and need to demonstrate leadership in getting us to real solutions that extract the value from HIT - and not let themselves be positioned as victims controlled by the vendors. Unlocking the data that providers and patients need to make the right decisions should be the priority, with the goal of improving patient outcomes.