Last week’s call by the federal government to have the majority of individuals and providers sharing data at a nationwide level by 2017 may just be the second phase of a three-phase process aimed at improving care with better data.

“Interoperability is sequentially the next big step” in a years-long process, says C. Martin Harris, M.D., Cleveland Clinic’s chief information officer. First, there was about a decade of electronic health record investment. Now there will be about a half decade of serious work on interoperability, Harris says.

“That will bring on the age of what I call knowledge management, which today is called analytics,” he says. The three stages overlap and the development of knowledge management — in its utter infancy — depends heavily on the previous step, he adds.

“You have to execute properly on interoperability or you will get incomplete knowledge management,” he says.

And Harris’ prescription for getting the platform for interoperability is not to put the decision-making in the hands of the government, it should be given to the patients who make decisions by essentially voting with their feet.

“The federal programs have a role, but they’re not the only drivers in the marketplace,” Harris says. “I truly believe patients will tell us which interoperability plays are the most effective,” he says. As they choose and use personal health records, that decision will drive which EHR systems are most successful, if regulators stay out of that decision. “The federal government has a role as a convener and as a standards-setter going forward,” he says.

That wasn’t exactly the conversation I was expecting to have with Harris, who was a keynoter at the IHE North American Connectathon Conference 2015 in Cleveland last week, but it was interesting for sure.

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