Before 2020 spiraled into pandemic, social, economic, and political unrest, I expected interoperability to be the hottest topic in healthcare. There are a number of reasons for this.

Consumers became unruly, asking simple questions like “in this modern era, why can’t my specialist see my electronic health record?”
Providers and health systems have attempted to adopt modern digital health tools, but have found difficulty in integrating these tools with their legacy EHR systems.

In response to these industry-wide problems, and without a private-sector path forward, the federal government released sweeping, and some would say “heavy-handed”, set of interoperability regulations designed to create the appropriate rules and incentives to solve these problems. These regulations are rooted in Biden’s 21st Century Cures Bill, passed at the end of the Obama administration. But the actual rules and enforcement were introduced in Trump’s. This unprecedented bi-partisanship tells us at least one thing: the government has lost faith in EHR vendors and the health systems and providers that use them, to solve it on their own.

Today’s show is the first of our second season of the Redox podcast. I thought it’d be a good time to unpack the word interoperability. This concept in healthcare has more depth, history, and complexity than syllables. So why is it such a big deal? How did we get to this place? And why did the government feel the need to step in?

To help me with the unpacking, I invited my friend and colleague, Brendan Keeler to join us. Brendan is a product leader at Redox, helping to translate industry demand into Redox supply. Before Redox, Brendan worked on interoperability at Epic both domestically and internationally. I’ve found his views on the space to be particularly insightful and concise, and lean on him constantly as I grapple with emerging trends.

Highlights from the conversation:

2:27 - Three types of interop: Integration, Enterprise Interoperability, Patient Auth
7:11 - Common standards used for each type of interoperability (HL7v2, C-CDA, FHIR)
11:50 - Will FHIR start to replace other interoperability standards
15:14 - The regulatory push towards ubiquitous use of FHIR
19:03 - Why banking didn’t need the same regulatory pressure
23:51 - If we want ubiquitous adoption of FHIR, we should have penalized the use of HL7v2
26:12 - How the Big Fax will forever hold back innovation in US healthcare
27:06 - Takeaways on interoperability for developers, providers, patients, and integration analysts

Brendan, you’re the man. Thanks for joining the show and sharing your take on the current state of interoperability in healthcare. Find Brendan and continue the conversation on Twitter: @healthbjk. He’s a great follow.

If you liked today’s show music, we’ve got to thank Redox’s very own Stephen Herrera who gave up what would have been a prosperous career as a DJ to join our operations team.

#27 Nikita, Nikhil, and Niko