Kia ora @dmeiklejohn , this looks great and promising! Indeed, there have been recent discussions about the importance of interoperability usability: Electronic Medication and Prescribing in Aotearoa New Zealand - #41 by oliviaclendon
How can it be ensured that the NZCDI ensures data is in a usable format post exchange?
One of my mentors explained his thinking on interoperability and standards: mandate conformance testing. One of the first technological standards mandated by policy in the US was weights to measure imports arriving on ships, to accurately tax goods. Two weights, from different companies, actually had to weigh the same amount if they both said ‘one pound’. Trusting that a company’s weight with ‘one pound’ stamped on it, was not sufficient to regulating how much tax should be charged per pound.
The way we explained this in the below publication is:
The $37 billion EHR MU/PI incentive program [55] emphasizes exchange of health information as a key function of HIT to improve care coordination. Though some increase in health information exchange has occurred [18], functional electronic exchange remains poor [37,46,48,53,56–59] and may relate to how policy incentives were implemented. The criteria for successful receipt of funds from the MU/ PI EHR programs included “Care Coordination” and “Health Information Exchange (HIE2)” as two of eight policy objectives in place during this study. Manual data download for “Care Coordination” and data entry for “HIE” were allowed, but neither objective required bidirectional electronic health information exchange [31,60]. The lack of policy mandate to verify how exchanged information is presented to the receiver may explain the poor function and integration of data from external sources into EHRs. Electronically received information needs to be displayed in ways that make it easy to consume, reconcile into existing records, and respond to. Though simultaneous display of data, in a single view, from two sources has been required by MU/PI programs since late 2012 [61], specific display of CCDS data elements parsed from electronically received summary records was not stipulated in attestation criteria. To drive improved usability of received data, policies may need to focus on improving information systems that parse and incorporate CCDS data elements into EHRs.
A complementary approach might be mandating conformance testing, which would likely have an important impact if linked with mandates of exchange but may be politically challenging [62]. Conformance testing could require accuracy and completeness when comparing data in a sender’s EHR with data in the interoperable document, including deleting duplicate aggregated data.
HIT Rural Coordination.IJMI.gill_2020.pdf.pdf (481.7 KB)