Bill Betten, the vice president of business solutions for medical and life sciences at Logic PD, gave DOTmed a few minutes of his time to discuss interoperability. It's a topic close to his heart. In fact, he called us from the Medical Devices Summit Midwest, where he had just given a presentation entitled, "Challenges in Creating an Environment to Support Interoperability."

Learning from past successes

In the 1990s, health care faced an issue with portability of images. CT, MR, X-ray, and ultrasound all interacted with their own company's interface but not those of their competitors. Betten says there was a big drive to define a set of standards and make all those things readable on different manufacturer platforms.
"A group started on something called DICOM," said Betten, "and today you could take images from virtually any system and make all those things interoperable." He cites the expense of these imaging modalities and the specialized training of the radiologists who used them as big factors in what drove that connectivity.

Today companies like Continua Health Alliance are establishing interoperations between weight scales, thermometers, blood pressure meters, and other smaller devices. But, Betten said, the financial challenges for connecting a handful of million dollar systems are very different from the challenges of connecting a multitude of smaller devices.

The holy grail of interoperability

When it comes to electronic health records (EHRs), Betten described a very complicated systems integration challenge, and one that will require a large data repository. "When you have a billing system, a lab test system, a medical imaging system, and a vital signs monitoring system, all that information has to integrate together," said Betten.

Another wild card, according to Betten, is the emergence of consumer products that track wellness information like calorie intake or measure the distance of a run. He asked, "How do you integrate wellness information into the illness related world?" Companies like Microsoft, Google, and Apple are already interesting players in that realm.

"If we pull more data together, including data that can be generated in the traditional fashion, and have the ability to analyze and look at it all at once," said Betten, "there are going to be new revelations around wellness."

He also sees a correlation between unified EHRs and the rise of telehealth, or access to remote experts. "The number of health care professionals is declining," said Betten, "Yet there is an increasing number of chronically ill and elderly patients." Telehealth is hampered by its own regulatory and reimbursement issues.

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