What would my blog be without a random item from weeks ago? On Tuesday I discovered a news story from Dec. 31 about an e-health strategy in Rwanda. The U.S. Centers for Disease Control and Prevention reportedly is helping to fund the installation of Internet links between the three major hospitals in the Central African country, known in these parts mostly for its brutal, 1990s civil war.

According to the story, lack of high-speed Internet is holding back a national e-health strategy, “meant to help Rwandan medical experts exchange health information with their overseas counterparts.” Those overseas counterparts included “two U.S. universities of George Washington and New Jersey.” So George Washington University in Washington, and, I presume, the University of Medicine and Dentistry of New Jersey? (Anyone know for sure? I’m too tired to hunt down that information.)

So, basically, U.S. taxpayers are financing international interoperability testing in a country with limited health infrastructure of any kind, but we can’t find more than $100 million or so (counting various HHS offices) in a $3 trillion federal budget for health IT at home? Interesting.

Yes, President Bush did discuss electronic health records in his State of the Union again this year, and yes, Sen. Hillary Clinton did give a pretty lengthy argument in favor of EHRs during last week’s Democratic presidential debate in Los Angeles, but are we really getting more than empty election-year posturing? Prove me wrong, politicians, prove me wrong.

And while we’re pondering interoperability conundrums, here’s a good one from Tim Dotson, my editor at Inside Healthcare Computing. In the Feb. 4 issue of that newsletter, he asks: “Why can’t somebody figure out a way for hospitals to share clinical decision support rules that will work on any vendor’s system instead of letting those systems go to waste because hospitals never develop their own rules?”

Good question. I suppose that’s why Cerner sold off Zynx Health a couple of years ago, but the issue is a lot deeper than one set of rules being tied to one vendor. Collaboration sure is hard, isn’t it?

P.S. Is anyone arriving at HIMSS early? I may come in as early as the Friday, Feb. 22, just because I hate 6 a.m. flights. Drop me a line if you’ll be in Orlando before Sunday.