Thought Leaders

Scanning recent headlines, it is difficult to ignore the fact that radio-frequency identification (RFID) is receiving substantially more ink than bar coding. Even in healthcare, the consensus seems to be that bar coding is no longer cutting-edge and that RFID is the newer, more advanced auto-identification solution that healthcare IT leaders have been searching for. However, the origins of the two technologies reveal that they have peacefully coexisted for several decades. In fact, the first bar code patents were issued in 1952 just a few years after the British used radar-activated transmitters, a system similar to modern RFID, to identify friendly planes from German aircraft during WW II. And, while bar coding was finally gaining commercial traction in the 1980s, RFID scientists were busy developing automated highway toll collection systems.

There’s a problem with imposing top-down HIEs on localized healthcare communities. They may not work.

One interesting problem with health information exchanges (HIE), as we know them today, starts with the implied promise in the name itself. There is little to no focus on actual information exchange; rather, most HIEs are about consolidating information and channeling access to that information. Yet healthcare communities have a real need for an efficient means of exchanging data.

Not long ago, the head of technology at a hospital was mainly concerned with how data networks were functioning and whether workers could access the electronic files they needed. Other hospital department heads handled equally important but unrelated purchasing decisions, facilities management and medical equipment.

There is certainly a business case for establishing interconnectivity between the U.S. and Canada, though neither government would particularly like to acknowledge it.

Several incidents of recent years explain why healthcare consumers remain concerned about the privacy, security and confidentiality of their personal health information. In 2006, a database containing sensitive information about veterans and their families was stolen after a U.S. Department of Veterans Affairs employee violated policy and took the data home. In 2007, a security lapse exposed the personal information of more than 9,000 Concord (New Hampshire) Hospital patients, leaving their names, addresses, dates of birth and Social Security numbers unprotected on the Internet.

Public health officials seek to mitigate the impact of health-related events through early detection and rapid response. These events can be predictable, such as the flu season, and unpredictable, such as bioterrorism or food-borne illness. The challenge for biosurveillance is to rapidly identify and characterize these events amid the backdrop of other health and illness patterns. Traditional disease surveillance relies upon vigilant healthcare providers to report suspicious cases presenting to them. While valuable, this is a passive process and, barring greatly heightened levels of awareness, detection is often delayed.

Efforts to establish regional health information organizations (RHIO) in various parts of the United States over the past few years have experienced decidedly mixed results. In 2007 alone, we saw failed or otherwise curtailed RHIO initiatives in Santa Barbara, Calif., and northeastern Pennsylvania, just as the Delaware Health Information Network (DHIN) was going online and CalRHIO (California Regional Health Information Organization) received $1 million in grant money to help continue the important progress it had been making.