Borders are for Crossing...

Over the past 20 years, The US and Canada have shared an increasing number of patients and an equally growing investment in health information technology, culminating in the parallel creation of Canada Health Infoway and The Office of the National Coordinator for Health Information Technology.

Despite this past decade’s dramatic increase in the health information technology (HIT) industry, borders throughout the world have become less traversable and the sharing of technology more difficult. People are uneasy or even unable to transfer of data across borders because of complicated and often conflicting security measures. Trade regulations are poorly documented and ill-suited to modern technology. Many technologists are afraid to attempt crossing borders because of anti-terrorism measures and ever-changing documentation requirements.

In discussions with vendors and CIOs on both sides of the US-Canadian border, a constant theme is “The Border.” The government policies of the past 8 years have made the border, in the words of one CIO, “sticky and opaque.” Americans are unsure about export regulations being rushed out by the Department of Homeland Security. As many Canadians in technology are of Southeast-Asian descent, they are often afraid to try crossing the US border. Even carrying a laptop in from either country is now seen as a potential risk to the sensitive patient data it might contain.

Organizations involved in cross-border trade are confronted with differences in culture, practices and expectations. Vendors cannot successfully deliver to healthcare providers’ expectations, and organizations have increased management overhead with every cross-border supplier. All of these inefficiencies of culture and commerce drive costs up and productivity down for all parties on all sides of any border.

Very good work is being done by groups like HIMMS and OHITX to facilitate technological sharing issues. But the issues of cultural dissonance, tangled government protocols and the common human factors have been ignored. Now there is an organization to address these human issues of cross-border sharing--The International Health Information Technology Association, IHITA.

IHITA is a trade association of healthcare technology professionals for healthcare technology professionals; developers, providers, administrators and technologists. Members are in government, business, clinical care and academia across the US and Canada.

IHITA is dedicated to;

Business Support: helping the HIT industry successfully deliver products that improve patient care and healthcare delivery systems within and across all borders by offering members and member organizations education, partner/resource introduction and cultural-knowledge services

· Published studies

· Partnership guidance

· Research and development of cultural commerce knowledge resources

Government Relations: improving patient care options and resources by reducing the negative impact of borders on the HIT industry’s ability to deliver by Educating and advocating governments and government personnel for tools and regulations to enable cross-border trade and transfer of HIT products, personnel and data.

· Better documentation of NAFTA visa requirements for transiting personnel

· Treaty enhancement to enable electronic transfers of clinical data across borders

· Clarification of Ex/Im regulations for technology

Philanthropy and Research: building the global HIT knowledge base by developing learning and solutions to pervasive healthcare delivery problems by working concurrently with multiple governments and NGOs in identifying and researching solutions to common, “borderless” problems.

· Studies to deepen insights into strategic trade challenges in the global HIT marketplace

· Joint US-Canadian technology solution for First Nations chronic, at-home care issues

These challenges impact patient care and safety every day. IHITA is looking to clear these hurdles and make The Border simply “invisible.” We’ll keep you posted….

Nat'l Health IT Week from DC

I'm here at the National Health IT Collaborative for the Underserved in Washington today. The meetings are lasting all day, and I am a member of the Policy workgroup. Members of the workgroup come from a variety of places; provider networks in Californiaand Michigan, Morehouse, The Office of Minority Health and Capitol Hill. Much of this morning's discussion was about ARRA funds and how the remote, rural and underserved community providers would access those funds.

Those at the table from the Hill were pretty energetic about the ARRA funding allocations to regional health networks. They feel that the RFPs have been written to such a tight profile as to be "self selecting." It is already known which big players in health management will qualify. There are now discussions in California to enable access to these funds through "subcontracting" to local networks. There is a requirement that for a Regional network to qualify, it must have a minimum of 100,000 people. By aggregating these "local"'s numbers, the big players can then have the qualifying numbers, and the local clinics can access funding.

There was also a strong sentiment about bringing the smaller, rural/remote providers together to examine their HIT wants and needs. By documenting this aggregate market, vendors can be educated to develop and deliver more integrated and interoperable technologies---This is very reminiscent of last week's article on the Canadian market. MORE ON THAT LATER.....