How to Save Money on Interoperability


bagSaddleback Leather Company makes some pretty high quality leather bags/cases and other products (disclaimer: I neither own stock in the company nor any of their products; however, I am partial to the Thin Briefcase, size medium, color black and my birthday is coming up).  Not only do they make good products, but they understand marketing pretty well.  Their tagline says their products are so good and long-lasting: “They’ll fight over it when you’re dead.”  They are so confident in the quality, their owner created a video a couple years back showing his competitors how to do a better job of creating knockoffs of his bags.  The video is pretty amusing in a dry humor sort of way.  Some spoilers: you don’t really care about the quality, you just want the look, so forget top grain leather – you can get stamped vinyl that looks exactly like it for a fraction of the cost! And putting it together doesn’t really require big adult hands – children’s hands work just as well!

It reminds me of how we see a number of health technology programs claiming they test for interoperability yet haven’t used the AEGIS test tools.  Given our understanding of how most of the other testing tools in the space work (or don’t work), we suspect some of these claims of interoperability are not based on truth.  But that’s OK, it’s not like health information exchange is a life or death matter!

We at AEGIS remain focused on helping our industry, so if you are responsible for a healthcare information system or product, we’ve put together the following approach for saving money on your interoperability testing program so you can claim interoperability without going through the hassle of actually verifying and validating (to others or even yourself) that you are…

  • Most importantly, don’t use the AEGIS tools.  Even though they’re not hard to use and they don’t cost a lot (in some cases they’re free), there are other tools out there that require even less time and effort that still allow you to check the box that says you tested – and let’s be honest, that’s all that really matters, right?
  • Change your thinking from “let’s make sure our system is truly interoperable” to “let’s do the minimum we have to in order to claim interoperability.”  The former – i.e. “doing it right” – is just too darn expensive. You’re in business to make money!
  • For heaven’s sake, once you complete your first successful test for interoperability, stop right there, stake your claim, and issue your press release: “Mission Accomplished!”  Under no circumstances should you aim for the kind of “continuous interoperability” advocated by AEGIS’ approach.  I mean, even though continuous testing is really at the heart of what it means to be interoperable, it translates to – you got it – more time and expense.  Who wants that?!
  • Try redirecting the public’s attention, because as you’ve heard, talk is cheap.  Work on convincing them that if all healthcare organizations simply implement [your system] then interoperability is solved since [your system], of course, interoperates with itself – and why would anyone need to test THAT?  While you’re at it, keep pushing other fallacies like interoperating on a large national exchange, such as the eHealth Exchange, is really not a good idea.  Small proprietary exchanges are much better – after all, you can control those without having to follow those inconvenient rules around standards conformance and demonstrating your actual interoperability on a regular basis.  Studies have shown, and politicians have proven, if you say these kinds of things enough times, people will actually believe it.
  • Don’t go with the cloud-based, automated approach that the AEGIS tools use.  Sure, that allows for self-service by development teams, and a platform that provides ever increasing value to the health information exchange community as more and more organizations contribute to the pool of test cases.  For one thing, you’re in it for yourself – who cares about helping to save the world, am I right?  For another, outsourcing testing to the overseas firm with the lowest bid means it’s out of your hands and if they don’t do a decent job, whose fault is it?  Not yours!
  • Finally, avoid spicy food before bedtime.  After all, it’s hard enough to sleep at night worrying someone in your family might actually depend on the “interoperable” product you put out there, giving short shrift to testing in order to save a little money.

*end sarcasm*

Certainly, for a real, honest to goodness high-quality testing program that ensures continuous interoperability and standards conformance, the AEGIS Developers Integration Lab (DIL) and Touchstone for HL7-FHIR platforms are the gold standards, so if that’s your goal, accept no cheap imitations or excuses.


About Michael Callihan

Mr. Callihan has more than two decades of experience in software engineering and business consulting. His expertise is in application architecture and helping customers develop best practices in enterprise software development. Mr. Callihan has worked with large government organizations including more than 10 years with the US Army, and many large corporations – HP, Time Warner, and various health care systems. His experience includes object-oriented analysis, design and programming, team mentorship, technical training, and project management. Mr. Callihan is a Project Management Institute (PMI) certified Project Management Professional (PMP) and a certified Lean Six Sigma Sensei (LSSS). He is a graduate of Carnegie Mellon University with degrees in Information and Decision Systems and Industrial Management.

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