Interoperability At The Tipping Point

Whatever you call it – a tipping point, a paradigm shift, an inflection point – we are on the verge of a fundamental shift in the way human services are designed, built and delivered across America.  Of course it is not by chance, but rather the dividend of a tremendous investment of energy, devotion, creativity and courage by many people who have worked tirelessly to challenge the norms and create the conditions necessary to enable change to happen.   

Nearly four years ago at the 4th Annual Stewards of Change Conference a hundred senior human service leaders gathered from across the nation to discuss how we could help accelerate implementing information-sharing and interoperability.  During the second day of the conference we watched the inauguration of President Obama together. It was an inspiring moment, many of us had tears in our eyes and everyone had optimism in our hearts. When we originally planned the conference we had no idea it was going to occur during the inauguration, nor did we anticipate that the nation would elect the first black president. It was indeed an authentic ‘kumbaya’ moment.  As it turned out we couldn’t have picked a more poignant date.

I think of that conference as the satellite inauguration party for health and human services.  It was a truly inspiring experience.  Collectively we created the first national vision map for a person-centric, connected health and human services system. Some of those ideas have subsequently been incorporated into local, state and federal policies, programs and practices.

Yet despite the momentum and optimism we cannot rest. The proverbial table has been set, a few appetizers have been served but the meal is still cooking.  In other words, actualizing the vision of interoperability at scale will require doubling down our efforts to take full advantage of the opportunities that have matured over the past few years. New policies, guidance and financing are enabling change in a unique and once-in-a-career way.  A few of the critical change drivers include HITECH (Health Information Technology for Economic and Clinical Health), ARRA (American Recovery and Reinvestment Act) , PPACA (The Patient Protection and Affordable Care Act), and OMB Circular A-87 which relaxes the complex and vexing cost allocation requirements for cross utilizing funding to share technology costs through 2015.  Together these changes enable and encourage state and local governments to build or modernize new systems that interoperate, share data and leverage investments to offer ‘no wrong door’ solutions.  The results will be integrated eligibility, streamlined enrollment, better service coordination, robust data systems and flexible technology that can adapt to new requirements and change.  The potential is real, but we must act now before the opportunities slip through our fingers.

Huge risks remain that could scuttle the opportunity of a lifetime.  The next phase will require even more courage, data, creativity and chutzpah to challenge norms, invent new ways of doing business, collaborate more closely and act with conviction in the face of uncertainty, skepticism and the daunting forces of inertia, fear and status quo. 

It is easy to encourage people to take risks but what are some success stories that that provide hope, encouragement and support for innovators?  What are some specific actions that local, state and/or federal agencies can take in the short or long-term to encourage innovation and support the expansion of interoperability?
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