Health IT: Providers unhappy with HIE vendors' sharing capabilities

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Health Information Exchanges (or HIE's) have sprung up in recent years as a mechanism to facilitate the transfer of patient medical records between care providers. They are an extension of the EMR system, an area in which the Federal Government has poured millions of dollars over the past few years. Yet this brand new survey shows the problems that persist with HIE's. Customer satisfaction ratings have declined for 10 out of 11 of the major HIE vendors in the US according to the survey cited by this article.


The main problem seems to echo the issues brought up in lecture this week--in a word, interoperability. Unfortunately, this article raises more questions than it answers. Why--despite so much government money--does the EMR/HIE system still struggle? Or more specifically, what aspects of the healthcare system are creating the biggest roadblocks?

With respect specifically to interoperability, why does medicine fall in the bad zone of Bob's "Agreement on Conceptual Model" vs. "Agreement on Implementation Model" chart? As a fairly scientific discipline, is medicine conceptualized all that differently across care providers? Is it implemented  that differently across providers? Have large government programs like Medicare not pushed EMR implementations closer together over the years for the purposes of getting doctors/hospitals paid?

And finally, within the context of 202, it might help to consider: what type of interoperability problems does medicine struggle with? Are they syntactic, structural, or semantic?

Link to article: http://www.fiercehealthit.com/story/hies-report-dissatisfaction-vendors-sharing-capabilities/2012-11-06