Incrementalism. It sounds like a movement only a curmudgeon would join. Incrementalism is defined as “a policy of making changes by degrees; gradualism.” In the world of integrated healthcare, there is a danger of adopting an incremental approach – making gradual changes to the way data exchanges occur, interfaces are built, and an integrated environment is managed.

Today, taking an incremental approach to integrated healthcare may not work, especially with a tidal wave of change coming through HITECH and Meaningful Use. The gradual approach to implementing healthcare integration and information exchange (HIEs) initiatives will be easily overwhelmed. Although protecting patient data and safeguarding quality are essential, considering better ways to implement the healthcare data exchanges is equally important.

Incrementalism may no longer be a valid approach when pursuing integrated healthcare initiatives and health information exchanges within a broader community of care. Innovation needs to replace incrementalism in order to reach new levels of performance in making integrated healthcare a reality.

How do you prevent incrementalism from driving your healthcare integration initiatives? Two considerations:



Today’s farmers need to be congratulated for adopting innovative practices in order to produce more with fewer resources. The point of this is not to enter into a debate on farming best practices or still not achieving the ultimate goal of solving world hunger once and for all time; the point is that new approaches were developed and implemented to produce more food in a safer manner. Imagine if farming practices never changed while the population growth exploded. What chaos and strife would there be in the world today?

Since the purpose of this article is to open the mind and deliver another perspective, this point is not as odd as you may be thinking right now. Move this concept into the world of integrated healthcare. How many healthcare interfaces existed in the 1980s? How many in the 1990s? How many will exist in 2020? The growth in the number of healthcare interfaces has climbed steadily in the last 5 years and will rise aggressively up the growth curve in the next 10+ years. Without changing the process, technology, and approach, how will healthcare organizations keep up?

Just as farmers adopted new practices and technologies, so will healthcare IT professionals. When evaluating new methodologies, software, and hardware, it is important to adopt a farmer’s approach. How can you produce more healthcare interfaces faster and less expensively while increasing quality and manageability?



The “how” relates to the platform where the daily interface activities are performed. The platform facilitates the performance level in which the interface life cycle is staged.

The question becomes – what changes to processes or technology will take your efforts to a new plane of performance, enhance the throughput of interfaces ready for deployment, and change the total cost model for an integrated healthcare environment? Your integration platform needs to support the capability for your team to hit daily home runs.

Meaningful Use is driving significant changes. Look for the right home run to change the process, approach or technology to meet the new challenges.

  1. Adopt a farmer’s approach to healthcare integration. Think about it. According to the US Census Bureau, there are 6,799,110,780 people in the world today. In 1900, there were approximately 1,600,000,000 people. Quite a change in 109 years!
  2. Separate the first base actions from the home runs. Building HL7 interfaces need to take a methodical approach of configuring, testing, and deploying. The act of building interfaces need to be incremental in approach. These are the first base actions which need to happen every day. What needs to happen is not necessarily the issue; how it is done may be.


The healthcare IT landscape has changed. With HITECH, health IT reform has begun. Now is the time to evaluate and implement innovative approaches and platforms to meet the coming wave of healthcare integration changes.


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