DeSantis is responsible for all aspects of the InterSystems HealthShare informatics platform, including software development, product marketing and business development.  He previously worked with Liant Software Corporation as vice president of research & development, where he was responsible for product vision, architecture and development of object-oriented development tools.

He co-founded Oakland Group, Inc., where he served as vice president of research & development and oversaw the architecture, design and development of the C-scape Interface Management System. DeSantis got his start at Zoom Telephonics, Inc. as a senior engineer responsible for designing consumer telecommunications devices.

He studied electrical engineering at the Massachusetts Institute of Technology.

Q: You’ve been quoted as saying, “Information exchange is dead. Long live information exchange.” What did you mean by that?

A: Well, I meant that despite all the talk in 2014 about the failure of information exchange, the need to share health records hasn’t gone away. In fact, it just keeps growing. We hear examples every day of how information sharing not only works, it is changing the way care is delivered.

Q: A common theme last year was the lack of interoperability among health information systems. Do you agree with that?

A: Absolutely not. It’s an issue of problem definition. If people expect interoperability and information exchange to be an EHR software feature, then we’re going to hear lots more complaining. But if instead you think of having an interoperability platform at the center of your IT infrastructure, the outcome is much different. Then EHR vendors don’t have to worry about communicating with every other EHR. Then they can plug into a stable core that serves up current, comprehensive and credible data to caregivers, patients, dashboards and other information systems.

Q: Can you give an example of the central role played by an interoperability platform?

A: Sure. We’ve conducted several small studies recently with healthcare providers andur goal was to understand how they are managing in the midst of widespread industry consolidation – mergers, acquisitions, affiliations, joint ventures – whatever you want to call it. One of the overwhelming messages we’ve heard is that organizations that are reliant on interoperability provided solely as an EHR feature are forced to adopt “rip and replace” strategies. That is, they have to force all participants onto the same EHR. This is costly and time consuming and it limits the kinds of partnerships they can form.

Contrast this with organizations that have a strong health informatics platform, for example, MemorialCare in California, or North Shore-LIJ in New York. These organizations are able to form partnerships based on the best value for all participants without having to worry about how they will be able to share information. 

As another example, let’s look at patient engagement. The key issue is how do you give a patient access to all of their information, typically from multiple sources, in one place, to support engagement?

Generation zero of patient engagement was the visit to the doctor’s office. The problem here is that information conveyed during the visit is difficult for the patient to process and retain, and supporting paperwork is soon out of date or buried.

Generation one of patient engagement saw personal health portals such as Google Health or Microsoft’s HealthVault proposed as a way to gather and share health information. But these required patients to enter and curate their own health data. Not happening.

Generation two, the last few years, saw the rise of patient portals tethered to individual EHRs. This meets Meaningful Use requirements, but still falls short in providing complete information from multiple providers and health systems.

Generation three is based on an interoperability platform untethered from individual EHRs. It consolidates patient data from multiple sources, and automates actions around that data to improve the patient experience of care and outcomes. Instead of the patient needing to log onto three portals they  have one.

Q: Beyond interoperability, what do you see as the most hopeful development in healthcare information technology?

A: Without a doubt it’s the death of the monolithic, five-year, $60 million health IT project. Instead, we see more and more organizations looking for projects that can deliver continuous, incremental value. This ensures that what is implemented is responsive to changing business requirements and keeps clinical, business and technical interest aligned across the life of the project.  We refer to this as a vision-to-value model, and it replaces huge, siloed projects that require years to deliver returns. In this model a solid foundation of interoperability and aggregated healthcare data provides immediate value from shared, up-to-date information, and forms a platform for future growth.