eHealth system interoperability

Healthcare systems around the world are in rapid transition, moving from traditional, paper-based practices to computerized processes and systems based approaches to service delivery. The term eHealth is widely used to refer to the use of information technology systems in health care. eHealth is trending upwards, in many different ways: (a) increased expectation for improved system outcomes, (b) increased funding, (c) recognition by patients, providers and funders that it offers solutions to healthcare problems. In 2009, the American (US) Recovery and Reinvestment Act set aside $36.3 billions to help hospitals and physicians to computerize patient medical records by 2015. The European Union and Canada also have programs with similar incentives and goals. While organizations are busy deploying eHealth information systems to better manage the quality and the delivery of health care services, from scheduling, billing, and health care records to the control of life-critical devices and clinical decision support, they face challenges that have to do with the overall complexity of healthcare, access to skills, and lack of interoperability among healthcare information systems. It is not surprising that existing eHealth systems are built in “silos” (functional, organizational, technical) and lack the ability to interact effectively. Lack of interoperability poses a serious risk to be able to connect through the use of technology the “continuum of care”. Achieving eHealth interoperability is difficult because of the inherent information complexity of the health care domain. Challenges include technical issues as well as socio-political and legal problems. Enabling the electronic flow of digitized healthcare information has implications for both clinical and administrative processes as well as privacy and confidentiality. If these challenges can be overcome, the potential benefits to be gained from healthcare interoperability are enormous. It has been estimated that creating a national standardized system of health information exchange in the United States would yield a net benefit of over $75 Billion per year (Walker et al. 2005). That estimate does not take into account the benefits that could accrue from improved clinical care. But we need to remember that neither financial nor clinical benefits will materialize if we do not pay attention to other factors including the design of work processes and team communications (Pirnejad et al. 2008). The motivation for this special issue was to invite contributions that touch on the various facets of the healthcare interoperability problem: people, processes, and technology. This special issue is intended for researchers and practitioners in the domain of health care information systems, including academics in health information science, computer science, software engineering, management and technology policy, as well as the rapidly growing group of IT workers and managers in the health care industry. The papers in this issue promote eHealth system interoperability as an important current frontier in information system research and practice and discuss a range of open challenges, potential solutions and experiences with current http://www.som.buffalo.edu/isinterface/ISFrontiers/