Rhapsody Health Solutions Team

Being Innovative in Health IT: What is the Balance?

June 23, 2010

With new requirements and demands challenging health IT, a question arises – How innovative should we be in our approach?

Last week, Farzad Mostashari, Deputy National Coordinator for Programs and Policy at the Office of the National Coordinator for Health IT, made a call for “bold incrementalism” to help promote widespread health IT adoption. It is an interesting phrase, but one that may not fit quite right for what needs to be done to achieve Meaningful Use.

A better call may be “bold balance.” It may be a subtle difference, yet an important one. “Bold incrementalism” implies a begrudging approach with maybe a little spice to making progress. Conversely, “bold balance” implies a robust platform which can support innovation and let it flourish.

To get to Meaningful Use, incrementalism is not going to cut it; having a balanced, robust platform will provide a better foundation to pursue the bold plans being driven by HITECH.

In a recent white paper – A Balanced Approach to Meeting Healthcare IT Compliance, we discussed the importance of taking a balanced approach when implementing healthcare interoperability initiatives. Illustrated below is a two-by-two matrix to use when evaluating your approach.

Balanced Approach Matrix

To take the bottom half of the diagram, patient care providers will not survive effectively by just having low IT fundamentals (i.e., just IT “plumbing”) in place; the bottom half is incremental IT. More needs to be in place in order to meet the growth in interfaces and the expanding requirements being driven by HITECH.

However, without the right IT fundamentals implemented, any innovative approach attempted will likely fall short of success. There is a need to have a solid IT foundation in place to support innovation or newer approaches to solving many of the healthcare integration and IT challenges. Having the right IT fundamentals in place moves your approach into the top half of the matrix.

When in the top half of the matrix, a balance is struck between maintaining pure IT fundamentals, versus introducing and using more innovative solutions to meet the increasing requirements coming from internal departments and external forces (e.g., referring physicians, hospital-to-lab exchanges, HIEs, etc.).

Essentially, a balance is necessary in how IT is approached to support EHR connectivity projects, HIE initiatives, and other patient data exchanges which are required to meet today’s demands. There is a need to have a mix in approach – good IT fundamentals with an innovative slant while staying away from the fringes.


To meet the growing number of interfaces and healthcare interoperability requirements, approaching the new challenges with the old approach will not work.

  • Budgets will not support it – older technology solutions may require a higher level of internal resource requirements to support it.
  • People will not be able to keep pace with the workload – more and more demands will require changes to how projects are approached, how interfaces are developed and testing, and how an IT environment is managed.
  • Processes will become frustrating to navigate without the right blend of IT fundamentals and innovation – growing throughput will quickly outpace outdated processes not supported by the right technology to facilitate greater data flow and complexities.

It is important to be methodical while maintaining the vision of where your organization and supporting technologies need to go. Moving forward, the key words for technology solutions will be:

  • Flexibility to meet different healthcare standards easily in the exchange of patient data
  • Adaptability to meet the different communication protocols to securely exchange patient data
  • Stability to maintain the support models of added applications and people involved in the process
  • Choice in how to address the skill set requirements and constraints to support a growing IT application and interoperability environment

Innovation is essential in health IT in order to support the coming wave of changes, but a balanced perspective must be maintained. This will prevent moving your resources too far out into the fringes and losing sight on what really needs to be done to achieve your requirements.

Health IT must achieve the right balance, because realizing the vision of HITECH hangs in the balance of making the right decisions on approach. It is more than incremental IT; bold initiatives and approaches must happen but supported and launched from a balanced, robust platform.
Additional White Paper to read: 
A Platform for Healthcare IT Innovation:  Achieving Your Strategic Objectives with the Right Infrastructure

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