The federal government is encouraging interoperability of health care systems within regions but not on a national level. Do you think this approach is the right one, or is it likely to create more silos of information? Conklin: As noted above, we are seeing both increasing mobility and disaster response as reasons for a more national answer to the problems we have today. This does not necessarily mean a centrally mandated and driven IT solution, but more thought around the entire system of health care and better answers to the problems that plague it today. The right kind of information systems infrastructure will evolve out of that.On the other hand, while there is much appeal to have a single standard that all health information exchanges in the country would have to adopt, the burning question then becomes, "What entity defines that standard?" Who is involved in making the tough decisions that need to be made to come up with a standard that is workable for as many segments of the health community as possible? How involved does the federal government need to be in this standards-creation process? If the feds are heavily involved, that opens a whole Pandora's box politically in terms of data privacy and the notion of government dictating to industry that will inevitably receive pushback. So, I remain kind of on the fence with regard to this question and am eager to see how things play out.
Temple: Frankly, I am ambivalent about the "regional" approach the federal government is employing. I understand their desire to allow different regions to do things their own respective ways (kind of like the concept of "home rule"), but that does open up the unfortunate situation of silos of information and also reduces the ability of these regions to exchange data with one another down the road.