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Interoperability in Human Terms

I was recently riding the Amtrak train from Boston to New York with friends from my high school days, heading to an informal class reunion in the Big Apple. We were sharing the usual small talk about family, friends, and remembrances of times long ago, when suddenly I heard a word I did not expect to hear.

Interoperability.

train tracks in a bed of rocks curving slightly to the left

If you’re like me, you’re always startled when you meet people in the “real” world – “real” meaning at cocktail parties, in taxi cabs, in check-out lines at grocery stores, or anywhere outside your professional life – and you find someone who has the vaguest familiarity with the kinds of things you do for a living. You hear a word that you use every day, but taken out of context, it sounds almost foreign.

In this case, my former classmate is a highly skilled triage nurse in an oncology setting, and she was bemoaning her employer’s decision to install a new workflow automation system that did not work with the existing EHR system.

“Can you imagine,” she said, exasperated, “anyone installing a workflow system without thinking about interoperability?”

As a marketing professional, I’m accustomed to using words like “interoperability” over and over in press releases, website content, and other written materials until the words begin to lose their meaning. What my old friend reminded me of was the true meaning of interoperability, and the very human toll of systems that don't connect.

And how does one measure that human toll? Consider this.

In addition to the extreme emotional stress of helping patients and their families cope with cancer, my friend has been assigned the maddening task of retyping patient records from the EHR into the workflow system. As a triage specialist who is not constantly on call, she has been deemed to have the most time to do this. Not that she actually has time for it, just that she has more time than others do.

Even though she is among the most senior members of the nursing staff, she has been distracted from her caregiving mission by this senseless clerical drudgery.

To cope with the stresses of her job, my friend revealed that she wakes up at 5am each day to allow time for a structured morning ritual of yoga, reading, and listening to calming music. All to help her prepare mentally for her day.

Interoperability is more than technical jargon or a government mandate. It is at the heart of our most personal, most serious, most painful decisions, the ones that determine life or death. You can’t hit closer to home than that.

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