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So Long, Farewell, Until We Meet Again…

July 2, 2015
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A few weeks back, I was staring at the train tracks at the Stamford station while waiting for my ride into New York. I couldn’t help but marvel at what we take for granted.

Every gauge on the track was the same size and perfectly separated by the same distance. Every single one. It wasn’t as if one section had four feet gauges spaced 12 inches apart and the other was four-and-a-half feet gauges spaced 12.5 inches apart. If one was four feet wide and 12 inches apart, they all were. 

(I didn’t personally get down there and measure, I wasn’t up for putting myself into harm’s way on a Monday morning for the sake of a blog. You’ll have to just believe me on this one.)

Gauges and spacing requirements, overseen and instituted by the U.S. Department of Transportation’s Federal Railroad Administration have been in place for a long time, in order to reduce the number of railroad-based accidents. In fact, the standard size of a gauge (four feet, 8 inches) in America was chosen as early as 1825—when railroads were first being constructed.

What impressed me is that the standardization is so fluid that we don’t even realize it. It’s just there. It’s like cell phone and internet networks, underground pipes, ATMs and any other disparate-systems infrastructure—it just happens. You don’t even think twice on the back end connectivity.

Will we get there with healthcare IT systems? Yes. It will just take time.

As many have said, comparing those institutions to healthcare is apples and oranges. There has to be a business case, like there is for Verizon and AT&T to connect, for interoperability. We’re getting there.

Value-based healthcare is on the rise. Population health initiatives are popping up everywhere.  Moreover, standards, like Fast Healthcare Interoperability Resources (FHIR) from the Health Level Seven (HL7), are gaining steam because of this. The tide has turned.

Only four years ago, when I started at Healthcare Informatics, there were just a shade over 60 accountable care organizations (ACOs). According to Leavitt Partners, there are now more than 700 ACOs. They aren’t all working, but the rising tide shows that this is a model people believe in. You see projections, like major health systems and insurers saying 75 percent of contracts will be value-based by 2020. The Medicare Access and CHIP Reauthorization Act of 2015 will only push people further in this direction.

As John Stanley, vice president of Impact Advisors, the Chicago-based consultancy, told me in a recent podcast on interoperability in healthcare: “What’s going to make people do things is a firm business requirement.” For me, I see it as not a matter of if, but when. When this happens, the networks will interoperate seamlessly and healthcare will move forward.

I write this declaration with a sense of bittersweet feelings, as this is my last blog as Senior Editor for Healthcare Informatics. I’ve been given an excellent career opportunity, which if you follow me on Twitter, I’m sure you’ll be hearing about.

I’m sad to be leaving behind an incredible team—Editor in Chief, Mark Hagland; Associate Editor, Rajiv Leventhal; Contributing Editor, David Raths; and so many more that I’ve worked with past and present. The pages of HCI were like hieroglyphics to me when I first came here. Hagland, in particular, guided me and mentored me every step of the way. While there is so much more I have to learn about healthcare, I am not the same baby fawn I was in 2011.

Quite simply, you couldn’t ask for a better team. Thank you all.

I also want to thank the people who read this publication. The reverence in which you hold HCI hasn’t always made it easy to live up to, but I appreciate every word of encouragement and constructive criticism I’ve received from you over the past few years. You’ve helped me develop as a writer, editor, and observer of healthcare. I hope we continue to interact, wherever I go.

But while I reflect back with fondness, I also find my departure to be a reason for excitement. Yes, I’m excited about my next opportunity…but I’m also excited about where this industry is headed. The word revolution is thrown around way too much in society but we’re clearly in the middle of one in healthcare. IT is driving that revolution and it’s been a pleasure to cover it for the last four years. I can’t wait to see what happens next.

 I can’t wait to see when the tracks are aligned. The possibilities, as I’ve tried to cover as editor of HCI, are endless.

Thanks again.

Please feel free to respond in the comment section below or on Twitter by following me at @GabrielSPerna



Gabriel - sad to hear that you will be leaving HCI but excited at the prospect of your new opportunity. Wishing you the best of luck and also wanted to thank you for your wisdom and insight over the years covering healthcare IT. You will be missed, looking forward to connecting with you at your new endeavor!

Thank you very much for your kind words!