I spent most of this week at HIMSS meeting with customers and partners, talking interoperability with anybody who would listen.

One particularly interesting appointment was with Janet Campbell from Epic who runs the interoperability side of the product.   I found Janet to be engaging, intelligent, and an excellent spokesperson – she in no way represented the caricature of an Epic person that we come across so often in the media.

During our conversation Janet set the record straight on a couple of things. Firstly, Epic has never charged a per record transaction fee. In fact the fee structure was based upon the patient.  For approximately 2 dollars per year a patient’s record  could be exchanged as many times as necessary.   Was this excessive?  I guess that depends on your perspective.

The second point that she made was that Epic has decided to waive this charge.  Was this in response to the ONC  interoperability report?    I didn’t ask, but I think the answer is at least partially yes.

One of the things I really disliked about the ONC report was the way that healthcare developers, a.k.a Epic, were posed as unscrupulous people who preyed upon the public interest.   This seemed somewhat simplistic to me, particularly in a free market implementation of healthcare where charging two dollars to transfer a patient’s records is a perfectly legitimate thing to do.

Regardless, these new moves to remove cost barriers are welcome.  They will help us uncover the true problems of interoperability instead of focusing on the machinery of record exchange. As more records become available new problems will certainly emerge, particularly around how a physician can interpret and make good treatment plans in complex cases where there are hundreds of records and a need for aggregation and summarization.

I certainly wasn’t expecting to see Epic lead the charge, but I’m glad they did!

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