The Dangers of Too Much Ambition in Health Information Exchange

See on Scoop.ithealthcare technology

What is an over-architected HIE?


Put simply, it’s one that tries to do too much for too many with not enough money and time. It tries to establish an all-encompassing infrastructure and service to meet multiple, heterogeneous current and future requirements of multiple, heterogeneous current and future customers. It tries to do all of this with a shoestring budget and staff. And worst of all, it focuses more on long-term potential “big-bang” value at the expense of short-term, realizable, incremental value. Or as one HIE organization’s promotional material put it, the value proposition is to be a “one-stop shop for Clinical and Administrative Information.”


The counter to the over-architected HIE is the incremental or phased HIE, which focuses specifically and radically on concrete, discrete, value-generating and self-standing steps and does not tie its fortunes to a specific future end-state whose horizon is further than the range of our ability to navigate. I was recently describing my concern to a health care system executive, and he said, “Yes, well, but we just want to jump to the end.” By that he meant, build the final solution infrastructure and services right away to solve the big problem of creating a “one-stop shop,” and assume that by-products of that long-term effort will keep everyone motivated along the way. My concern reached new heights after that conversation.

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