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 Today in Health it, the story is the EHR Behemoths collaboration or a test of interoperability or the Vaccine Credential initiative. It's all the same story. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in health. It. A channel dedicated to keeping Health IT staff current and engaged.

PJ I shortened the url. URL was too long. So here's what you got. Bitly BI LY slash two N two six s pj Alright, start the clock. The Vaccine Credential Initiative is gonna show us how far we've come with regard to interoperability. You know, I, I, I. Took a look at this story, and if, if you rewound the clock, let's say three years, maybe four years, uh, the idea that Cerner and Epic would participate in anything together, at least anything that was more than just ACYA announcement, meaning something that they had to put their name on, like, Hey, we're, we're pro interoperability or whatever would've been unheard of.

Uh, now they are both in on the VCI, the the vaccine. Credential initiative. I'm just gonna refer to it as the, uh, VCI. So here's more on this, uh, from the article. . And I have a Healthcare IT News article here. Uh, participating organizations will agree to offer individuals with digital access to their vaccination records using the Open interoperable smart health card specification based on W three C verifiable.

Credential and HL seven fire standards according to VCIA Common Registry of issuers, along with the smart health cards accessible via digital wallet apps or QR codes, will build toward a nationwide system that more readily enables verifiable vaccination records to be access controlled and shared. And let's see.

Couple quotes. I'm gonna read more from the article. Uh, we're kicking off the most significant vaccination effort in the history of the United States. It said Ryan Howells, principal at Levitt, partners and program Manager for the Care and Alliance in a statement. Now, more than ever, individuals need access to their own vaccination and health information in a portable format to begin to move about the country safely and comfortably.

Uh, it goes on, let's see it, it's been apparent since the first covid 19 vaccines were approved. Of course. The technology and data sharing infrastructure in the US was not up to the task of managing their rollout and record keeping system failure have has already led to significant slowdowns. In some states, uh, without adequate federal support, state and local health have been forced to think creatively about how to manage these complex demands.

Sometimes even turning to off-label use of certain platforms. That could pose serious privacy and security risks. Uh, I'm gonna hit those last two sentences in a minute, but, you know, the big, so what on this is, this is a phenomenal test of what we've been doing. Uh, you know, the, the pandemic created, created this urgency, uh, around, uh.

You know, progress on, on, uh, well actually it created an urgency period. It also created a, uh, there's a political environment where it would be bad for these, uh, EMRs not to participate in this effort. You couple that with the progress that, that we've seen with fire based on, uh, 21st Century Cures, well, actually prior to 21st Century Cures.

But, uh, with 21st Century Cures, you're seeing a lot of progress around interoperability and all this stuff is coming together. And what this is gonna show us is what is possible when the will of all the players are aligned, can we make this happen? And the reality is, if we can make this happen, we can make anything happen.

You know, the speed and per proliferation of solutions is gonna tell us if we're on the right path and it's right path. And it's gonna give us a metric which we can measure all future interoperability efforts by these players. Um. You know, so what is, do you have fire capabilities within your organization?

And you may wanna get to some or expand your capabilities. Alright, with that said, I wanna go back to these last two statements real quick, uh, of the, of the article that I read. And they are, it is been apparent since I. The first covid 19 vaccines were approved, of course, that the technology and data sharing infrastructure in the US was not up to the task of managing their rollout.

And record keeping system failures have already led to significant slowdowns in some states. All right, let's just stop there. Um, yeah, I, I, I think the technology may have led to some slowdowns in some states. I think more politics has led to slowdowns In some states, uh, you could easily get caught up in.

Uh, you know, fairness, how can we make sure that everybody gets it and we don't waste a single drop of the vaccine and all this other stuff. But when you're in an urgent situation, you gotta move quickly. And yes, some people who are under the age of 65 are gonna get the vaccine. And yes, some of the vaccine is gonna go, uh, get wasted, uh, early on because of inefficiencies.

But you know what? You move. You, you, you move, you figure things out, you adjust. I mean, this is what Agile is and this is what states need to do. They need to stop, uh, sitting around trying to, trying to build perfect. You don't build perfect. You get it started. You get it out there and you see what's going on.

Uh, let's go back to the first part of this. It's been apparent, uh, since. Uh, you know, since the first covid 19 vaccines were approved, that the technology and data sharing infrastructure in the US was not up to the task of managing their rollout and record keeping. Uh, that's also true. I mean, we did a story earlier on in this, um, in today in Health It where we talked about the, uh, the challenge of getting this out that, you know, the EHR providers.

Had mechanisms for this, but they were tweaking it. Uh, you know, there's no vaccine quite like this. Uh, the flu vaccine is not like this. Um, and, and so we, we didn't really have a good mechanism. Plus, you know, the first set of people that were getting this were the employees. Uh, we didn't have a good way of tracking that, and in some cases, and then bringing.

Where we're tracking the employees versus the EHR, how we're tracking patients, uh, the EHRs, uh, not having that, those, alright, so we, we solve those problems. We, we, we got fields set up in each one of those things. Now they have to talk. I. By the way, this shows the problem with an interoperability by EHR alone, uh, mentality, which is shared across a lot of healthcare.

Uh, you know, sometimes you have to talk to other systems. You have to talk to your, uh, your employee tracking system. You have to talk to, uh, the pharmacy, uh, the local pharmacy who's also distributing the vaccine or other health systems who are distributing the vaccine. Uh, you have to talk to the Athena Health.

Uh, providers and you have to talk to the, uh, practice fusion, uh, providers and you have to talk to, I mean, I, there there's just others out there that you have to share information with. And so yeah, this, this sort of was the whole tide analogy again, that the tide went out and it revealed what we had with regard to, uh, data sharing infrastructure.

And a lot of that's on us. For having this EMR centric view of interoperability, you have to be able to share with organizations outside your EHR just because you consolidate on a single EHR and you can share with, you know, 50% because of the, uh, uh, market share of your EHR provider, you can share with 50% of the health systems across the country.

That's still amazingly inadequate, especially when you get to a situation like sharing vaccine information. Across your community. Uh, the other, you know, the other statement here, without adequate federal, uh, support, state and local health care have been forced to think creatively about how to manage these complex demands.

Uh, you know what's interesting about this? Um, I'm glad for the lack of federal support. I think there's people out there who think we could have put together a federal program, uh, in the middle of a pandemic that would've adequately tracked the vaccine and all this other stuff. You don't start building that in the middle of a pandemic.

It, it just doesn't happen. Plus the fact, uh, the federal government will never be as close to the communities that they serve as the state governments, as the local governments, as the local health system. If anybody should know how to share this information and get people in line and get shots in arms, it should be the local health system.

And if it's not the local health system, it should be the counties. If it's not the counties, it should be the states. And then the federal. The federal is, is like a, a safety net If we can't figure out how to do this. And yes, it is uneven because some health systems haven't figured it out. Some counties haven't figured it out.

Some states haven't figured it out. But you know what? We're in the middle of a pandemic. You get things done, you get it out there, you know that there's gonna be a, a little bit of broken glass, some inappropriate people are gonna get the vaccine. Some vaccine's gonna get wasted. I get it. Um, but you get, you, you keep movement.

Uh, and, and you, you rely on the fact that, you know what? We're gonna, we're gonna be able to . Produ, there's an abundance mentality that says we're gonna be able to produce more vaccine. Eventually we're gonna have a, a, you know, more vaccine than we can actually distribute, and we're gonna have to really focus in on our education.

But at the end of the day, I like the fact that, you know, the federal government didn't step in here heavy. In fact, in, in a bunch of states, the states didn't step in heavy and they pushed it down to the, uh, to the counties and the local, uh, local health systems, uh, who really should understand their communities.

Uh, that's probably enough for today. Uh, . I, I love this. This is, this is gonna be a great test. We'll see, because in the future, uh, you might have, uh, a large EHR provider saying, yeah, we can't do that kind of interoperability, and we're gonna be able to point back to this and say, yeah, but you did it here and I think we can do it again.

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