Four Philosophical Questions on the Trinity of Healthcare IT

Thursday, March 10, 2016 | Larry Sobal

I write these blogs on Sunday afternoons, and while pondering a different Trinity earlier today my mind wandered, as it sometimes does, toward analogies with health care. If there is a trinity of healthcare IT, I think it is: Security, Big Data Analytics, and Interoperability. It just so happens that all three are in the news right now and the issues surrounding them lead to interesting philosophical questions.

Let’s start with the most visible issue. Many of you are likely paying some attention to the FBI’s request that Apple build a backdoor into the iPhone used by one of two shooters in the December attack in California. What you may not have been thinking about was whether the outcome could threaten the security of personal information, such as health data, stored on other iPhones. Question #1: Do you believe that allowing the FBI to access the phone would set a precedent that potentially threatens the privacy and security of millions of iPhone users, or users of any other device that has personal information?

Last week the Supreme Court, in Gobeille vs. Liberty Mutual Insurance Company, ruled in a 6-2 vote that efforts by Vermont and at least 17 other states can't force health insurers to turn over reams of data revealing how much they pay for medical claims. Vermont, like many other states, is attempting to gather and analyze health data aimed at improving health care quality and reducing costs. Question #2: Is this decision a serious blow to creating the “Big Data” necessary to objectively assess and offer transparency related to health care performance?

Hackers using malware infected the institution's computers, preventing hospital staff from being able to communicate from those devices and forced the hospital to temporarily return to manual documentation.

Next, you may have read about a recent incident where a California hospital's IT systems were taken hostage for an entire week. The assault on Hollywood Presbyterian occurred when hackers using malware infected the institution's computers, preventing hospital staff from being able to communicate from those devices and forced the hospital to temporarily return to manual documentation.

Although ransom attacks are still relatively rare, cyberattacks on hospitals have become more common in recent years as hackers pursue personal information they can use for fraud schemes. The hospital agreed to a confidential payment to regain control as quickly as possible. Question #3: Should the hospital have settled with the hackers or will this encourage similar copycat incidents?

Finally, the annual HealthCare Information and Management Systems Society (HIMSS) concluded last week in Las Vegas. Obama administration officials kicked off the extravaganza with a pledge from 17 major health IT developers, 16 large health care provider organizations and 17 health care associations and medical societies to (among other things) use federal standards to promote interoperability. Question #4: Is this just another example of political chest thumping, with minimal results, or is real interoperability on the near horizon?

As is true when contemplating the other Trinity, there are many perspectives and ways to look at related questions. How one answers those questions can reveal a lot about one’s beliefs. What do you think? Please take a minute and share your perspective with a comment.

 

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Larry Sobal is Executive Vice President of Business Development at MedAxiom. He has a 35-year background as a senior executive in medical group leadership, hospital leadership and insurance. As part of his current role, Larry consults, writes and presents on topics relevant to transforming physician practices and health systems.

 

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