The interconnection con

Every project and initiative in healthcare IT can be classified into one of two types: interconnection and the rest.

Interconnection projects, as the term indicates, all have in common that they involve improving just the exchange of data and nothing else, by actually interconnecting two or more systems, or by creating some standard that is intended to make interconnection easier. Almost without exeption, these projects are described as “improving healthcare” and almost without exception, no effort is expended on actually describing what this improvement is or means. Practically none of these projects are preceded by a reasonable cost/benefit analysis, or any other analysis of any kind.

Then you have all other projects, those that do not primarily speak of interconnection or standard structures or terms intended to make interconnections easier. Those projects are usually, but not always, meant to solve a defined and real problem, often preceded by cost/benefit analyses, and a decent technical analysis and design.

I’d say more than 90% of all projects we see in healthcare, at least those with public funding, are of the first, “interconnect”, variety. They are, as I said, usually without any decent motivation or ground work except the desire to “interconnect” for its own sake, and usually fail according to objective criteria. But note that they are usually declared successful anyway, and since the requirements were never clear, it’s just as unclear how to deem them successes or failures, so they could just as well call them a success, whatever happens.

The remaining 10% or less may have interconnection as a component, but are founded on some other functional principle, are usually scientifically and technically sound, have a real hard time getting funding, but are often successful and useful. They don’t get much publicity, though.

So, my advice to you is: if you want to contribute something real to healthcare, avoid any project exclusively having to do with “interconnections”. If you’re more interested in committee work without much risk of ever having to prove that you actually accomplished anything useful, jump on any chance you get to do “interconnection” work.

And if you’re in a budget committee and take that responsibility seriously, jump on any “interconnection” proposals and demand a detailed clarification of what exactly will be the benefit of the project, and don’t settle for “more information must be good”. That’s malarkey. If you find any other motivation that actually makes sense, please let me know.