Open standards are important with healthcare systems. The robustness of these systems are literally life-and-death matters; it's important that experts can see the code and evaluate whether it works as it should. 

You make excellent points, Mitch, regarding the politics.  Functionally, yes, the exchanges were started in advance of Obamacare, BUT most people ARE associating it with Obamacare.  So the reality is that it will have a political flavor and those opposed will definitely be slow or resistant to joining the health networks.

You also make an excellent point, again recognizing the politics, that the full development of networks is not going to succeed until the physician/consumer acceptance is achieved.  Most of the efforts now are still top-down and there are a lot of smaller medical groups and physicians who have not bought into the concept and don't see the need.

DHagar

It's a real shame politics is involved in healthcare. It's also a shame money is involved. But since that's life in the big city (and the small village!), I think it's important that healthcare organizations, their IT departments, and government agencies -- along with insurance and all other stakeholders -- move as quickly yet safely as possible toward secure networks that can share information.

My orthopedist loves the EHR his practice uses; it's the one used by one of our three local hospital chains, and it allows him to look-up patients' records via his smartphone or iPad when they go to the ER and he gets a call. In the past, he told me, he either had to go to his office or - more likely - send one of his assistants, which cost him (then the patient and/or insurer) money to review the patient's chart for medications, history, etc. Now he looks them up on-the-fly, no matter where he is. Dr. O credits this with saving him countless hours and dollars since his office implemented it a year or two ago. 

I love that they decided to go opensource & openstandards. I believe in the long run they will really benefit for the decison

@Mitch - the final legislations did allow a lot of flexibility and independence.

@Dhagar - I do believe the HIEXes will be formed.  The HIEs are running well in many states and have already connected many silos.  The promise of data for the betterment of public health outcomes is great.  

@Kim - I am not sure I understand the question. We establish standards of practice and we issue certificates and licenses. Not sure why we would not establish standards in IT and information security and privacy.

@Alison - many HIEs started organically but if you will have networks communicate, you need standards and that is where collaboration and standards development was facilitated by the US government and incentives provided to soften the initial investments.

No one can argue with the value of exchanging healthcare information electronically. But is the current approach too centralized, too top-down, too rigid?

The fact that healthcare networks preceded Obamacare doesn't make them politically any more popular. The GOP is working hard to forget George W. Bush.