Should Personal Health Information Reside in Silos-Continued?

There have been several replies to my previous post about data silos.

They questioned my definition of "silo" as a "repository" and made the point that the existence of silos are not only caused to technological issues, but also to constraints involving:

• Legal factors, such HIPPA, state regulations, contractual agreements  
• Human factors, which are things that affect the input and output of the data, such as control issues, distrust, tradition, if it ain't broke don't fix it mentality, etc. 

I responded by saying that, to me, “repository” simply means “storehouse” (a place where data are stored). When a repository has constraints that prevent the data it contains from being shared with other repositories, then each of those repositories is a silo with respect to the other repositories. At the same time, however, any of those repositories that do share data are not respective silos. That is, a repository may be a silo with regard to one respository, but not another.

In any case, my previous post focuses primarily on the technological constraints of silo’ing with regard to incompatible software, databases, etc.

That means that a repository may be silo’ed from other repositories for:

• Technical reasons, such as lack of software/database interoperability; this is a vendor/developer-related issue. However, if data are exchanged between repositories using paper, fax, voice, or other non-software/database methods—then the repositories would NOT be silos, imo, since data are being exchanged.

• Nontechnical reasons, which include legal and human factors. In this case, even if the software/databases are able to exchange data between repositories, the repositories would not do so, which means that they continue to be silo’ed from each other.