The Giant Sequoia as a Metaphor for Advancing Interoperability

Interoperability in healthcare has come a long way over the past 15 years.

That much is evident when you hear Surescripts Chief Marketing Officer Melanie Marcus and Sequoia Project Chief Executive Officer Mariann Yeager in conversation about where interoperability in healthcare has been and where it’s going.

In the podcast, Yeager’s story begins in Nashville, where she got her start in health IT, and ends in northern Virginia, near Washington, D.C., with her current role as head of the Sequoia Project, a public-private effort to advance interoperability nationwide. The Sequoia Project seeks to build a “network of networks” by engaging the broadest group of stakeholders possible.

When asked to provide a definition of interoperability, Yeager said it’s simple: “Interoperability is about having your health information follow you, wherever you get care, so that the information is available when and where it’s needed.”

Catching the country music (and health IT) bug in Nashville

"What about country music?" Marcus asks Yeager playfully. “You didn’t go for that instead?”

It was fun for Yeager, early in her career, to live and work in the artistic community of Nashville, where music wafts from the bar and restaurant windows of Lower Broadway day and night. But Nashville is where Yeager got her start in health IT. “I worked for a health plan, believe it or not,” Yeager says. “And I found myself in the heart of health IT ever since.”

Painting with the brush of incrementalism

On advancing interoperability, Yeager cites incrementalism as the way forward. Painting with a broad brush doesn’t work. We can’t snap our fingers or wave a wand and make interoperability happen nationwide.

“When we try to take a broad brushstroke and move the entire market in one fell swoop, it’s tough,” Yeager says. Incrementalism, in contrast, boils down to pinpointing a concrete and specific use case, such as the early case for e-prescribing. “Incrementalism is a philosophy that we hold dear at Sequoia, and in my career, I’ve found that it has worked really well.”

The sequoia as metaphor for interoperability

The famous sequoia tree is known for its soaring height—but it doesn’t stand alone.

“You see them reach their greatest heights when they’re in a forest together,” Yeager says, “because of their shallow, interconnected root system.” Sequoia root systems—unlike those of the lone sycamore, for example—support tremendous growth.

“That’s what we’re really about,” Yeager says of the Sequoia Project. “We’re about bringing people together, collaborating and connecting to reach great heights.”