Reflections on the history of interoperability in hospitals.

Objective: To discuss the origins of HL7 and its subsequent impact on interoperability in hospitals.

Process: Reconstruction of historical events from review of personal notes, interviews with key participants and review of relevant publications.

Conclusions: The first versions of HL7 were based on the StatLAN protocol developed at the University of California, San Francisco and later commercialized by Simborg Systems Corporation.

The wave has finally broken: now what?

In 2005, the authors published a paper, 'Will the wave finally break? A brief view of the adoption of electronic medical records in the United States', which predicted that rapid adoption of electronic health records (EHR) would occur in the next 5 years given appropriate incentives. The wave has finally broken with the stimulus of the health information technology for economic and clinical health legislation in 2009, and there have been both positive and negative developments in the ensuing years. The positive developments, among others described, are increased adoption of EHR, the emergence of a national network infrastructure and the recognition of clinical informatics as a medical specialty.

There is no neutral position on fraud!

In 2005, Dr David Brailer, our first National Coordinator for Health Information Technology, had a vision of widespread adoption of electronic health records connected through networks run by regional health-information organizations. An advisory panel recommended at that time that proactive fraud management functions be embedded in this emerging information infrastructure. This has not occurred.