Orchestration vs. coordination, part 1

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As a long-time healthcare IT guy, I spent a lot of time thinking about information systems and how different elements in those systems work together.

I love the elegance of systems that work together in the most perfect ways. The human body is the best example of that.  Some of our internal systems are perfectly coordinated …our visceral nervous system ensures our heart continually beats to pump blood everywhere it’s needed throughout our body. Other human systems, like our central nervous system, use our spine and our brain to take coordination to a whole other level, that I call orchestration. Orchestration by the central nervous system manages our body’s activities and allows us to do amazing and fun things like walking, running, climbing, talking and singing.

Outside of healthcare, I’ve observed interesting examples of IT systems that are interoperating at some level of coordination and orchestration. For example, regardless of where you sit on the NSA spying debate itself, I think applications like automated visual surveillance are amazing examples of IT orchestration. These visual surveillance applications can automatically pull data from multiple sources, apply algorithms to look for particular elements in that data, then deliver results to those who need them to take the appropriate action. It’s really amazing technology.

In healthcare IT, we’re not at the orchestration stage yet, and to provide better patient care, we need to get there fast. Healthcare information systems in their current state are very much autonomic, in that they can really only do a single function instead of a purposefully orchestrated set of movements. For example, you can integrate healthcare IT systems today using standards like HL7 and DICOM, but those standards really don’t do anything more than their specific point to point configurations allow.  There is no real intelligence in the machine.  Given all the technology and data that is available today, we can build systems that focus on a patient’s health by understanding what they’ve been through and help determine what path they should take to be well.

A starting point for developing systems that are orchestrated should be a common set of goals.  My suggestions for goals would include:
•    Enable patient care with timeliness, patient safety and quality as their objective
•    Help physicians make appropriate decisions
•    Provide resources to educate physicians as well as patients
•    Monitor a patient’s health and make suggestions to them about preventative maintenance
•    Stop the duplication of procedures
•    Remind patients and their providers of issues to follow up on
•    And much more  

Basically … The information systems used to treat you, me and our loved ones should make the data in their silos freely available to other information systems for the purpose of making our lives better.  

What do you think? Can healthcare information systems get to orchestration, and if so, where do you think will be the biggest benefit? Add a comment below or let me know what you think via Twitter @pnradinfo.

Originally posted on: 8/7/2013 8:00:00 AM

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