Interconnectivity is one of the most difficult aspects of the electronic highway – if you will. The difficulty lies in two separate areas. First, there are technological hurdles in having systems that have been engineered by different teams at different companies ‘speak’ with one another. This is in large part because of the languages that the different programs speak, as well as because of variations in database structures.

This is part of the reason why the somewhat simpler concept of EHR/Laboratory, EHR/Radiology, EHR/Pharmacy and EHR/Hospital interconnectivity remains rather complex.

Take for instance some of the nationwide laboratories such as Quest Diagnostics (stock symbol DGX) and LabCorp (Laboratory Corporate of America Holdings or stock symbol LH). In order for them to be interoperable with various EMR/EHR systems, it is required that a separate Interconnect Software Bridge be written. Or, from the other perspective, each of the hundreds of existing EMR products must make a link between their database and the database of Quest Diagnostics and between their database and LabCorp. If there were only 2 laboratories in the country this would be a lot of programming. However, there are hundreds of laboratories, and assuming that any individual mid-sized medical practice may be utilizing the services of multiple laboratories, then the level of complexity expands almost exponentially.

For each of these interfaces there is no competition between the entities attempting the interface, and therefore, theoretically at least, there may be significantly more cooperation. However, as above, once you start asking EMR/EHR companies to interface with each other, not only are the technical hurdles enormous, but the business decisions needed to allow for such interfacing are sometimes at odds with the best interests of the shareholders of those corporations.