5 comments

Open is the new black

So I had this crazy idea – what would happen if software designers became fashion designers?

Imagine IT folks deciding what would be “in” this season. For shoes, dresses and maybe even hairstyles. I laugh when I think about trying to get my wife to wear such things.

Fortunately we don’t all have to be fashion moguls to create and inspire. We apply our expertise to set the latest trends in IT solutions, solving some of the world’s most complex healthcare problems.

But we can only do that with an Open approach, which is the only way to foster true innovation. In healthcare IT, Open is the new black.

Open can provide real, measurable advantages

For real change to happen, the industry needs to see real advantage – clinical, financial or both. We need tools that give caregivers a higher probability of success.

Think about stock market tools, such as Bloomberg services, that cost thousands of dollars a month. Why is it successful? Because it gives the trader a tiny (but measurable) advantage over his peers. Bloomberg doesn’t create the information shown on their terminals, but it is the aggregator, the central collaborator.

Health care needs more tools that give measurable advantages. The possibilities are endless. Tools could help bring genetic analysis and personalized medicine to the physician’s practice. Maybe they make it easier to monitor patients. Or perhaps they help the patient and provider communicate with each other better. (See great examples from the Open App Challenge Phase 2 winners we announced at ACE13.)

Got a better idea for clinical guidelines? A better way to get patient data to caregivers at the point of care? If you can build a better mousetrap, Open helps you deliver a collaborative solution that capitalizes on your expertise.

Meaning, if you’re an expert grammarian or spell-checker, you can just build that piece, rather than having to build a competitor to Microsoft Word.  A solution that plays well with others, rather than building a comprehensive, standalone application all by yourself.

Closed systems are a hot mess

Imagine if Ford or Toyota or Audi said, “We care about the cost and quality of our cars, so we’re going to build everything ourselves. We’re going to build our own radios, tires, glass and steel.” It will never happen. Because the cost of a “We Make Everything Ourselves” car is through the roof. And overall quality and innovation would suffer, too.

Open means that Allscripts is going to apply the same sense as other giants of industry – we’re going to build the basic car. But we’re going to find the best tires and radios to systematically aggregate our core EHRs with our partners’ innovative solutions.

Open encourages innovation, bringing together the best minds, the most creative people, the individuals with the deepest knowledge – everyone with something to add the healthcare body of knowledge and healthcare information technology.

Open makes it easy for everyone to collaborate. With people outside Allscripts working alongside people inside Allscripts, we aggregate the best that everyone has to offer, much like Bloomberg does for traders.

Because when Open enables better patient care and financial advantages, we all win. From patients, to caregivers, to third-party developers. We’re talking about real, competitive advantages that bring about real change in health care. Some of those advantages are costly, but ALL of them help improve the quality of care that our families will receive.

Open is the new black. Try it on for size, and see the advantages for yourself.

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About the author

Stanley Crane is Chief Innovation Officer for Allscripts. In his more than 30 years of healthcare and consumer-related software experience, he has led the development of award-winning software programs including electronic health record, electronic prescribing, web-based medication sales, online physician education, resource scheduling, financial systems, materials management, medical translation software and voice recognition dictation systems. Previous to his healthcare experience, Stanley was involved in Silicon Valley, where he held positions with many well-known software companies. As the General Manager of Lotus cc:Mail, he created the first remote mail products. He was also the Vice President of Engineering at WordStar International, and Director of Applications at Ashton-Tate, managing their Macintosh products as well as dBase IV. Before that, Stanley was a founder of two Internet startups – MaxMiles, an automated frequent flier mileage aggregator, for whom he built the first versions of the product; and Shopping@Home, a company that was acquired by Allscripts in 1999 to support medication sales.

5 COMMENTS on Open is the new black

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Bob Brown says:

08/29/2013 at 10:56 am

The quality of health IT and HIE systems will only realize substantial improvement when the community understands it should take the lead in specifying the functionality of the systems they use. The CURE Project is working to provide the tools for “open specifications.”

Please visit to learn about our effort and how you can participate. http://www.The CUREProject.org.

Stanley Crane says:

08/30/2013 at 8:42 am

Thanks for your comment, Bob. I’d be happy to support CURE as a way to help exchange data between systems. (I just signed up!) I hope that when you build your new specifications for the exchange of information, it is very specific – rather than the normal HIT specs (CCD, HL7 are very loose specifications).

Looks to me like CURE represents some important aspects of Open, “capture, update, report and exchange patients’ health information”. No doubt that exchanging data would help improve the quality of the patient’s healthcare.

Our Open strategy is coming up with ways to financially benefit creative & innovative 3rd parties (and users & clients & patients) – by helping these constituents gain a financial competitive advantage, we’re reinforcing the same goals — that HIT is a team sport & we should all go to market hand-in-hand, and then we all win.

I would encourage CURE to look for a similar mechanism. Everyone is going to ask “What’s in it for me?” And there needs to be an answer to that question.

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Michael says:

09/03/2013 at 1:53 pm

Well said Mr. Crane.

The common theme is making the giant paradigm shift from reactive medicine to proactive medicine. I think the Open concept feeds into this as independent modules will each innovate to meet an expected need.

In the past large healthcare IT corporations, including Allscripts, would simply bring on the modular piece to create a whole. This led to innovation challenges associated – with too many pots in the fire – resulting in chasing the known current capital and not focused on innovation.

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Narine Manukyan says:

10/21/2013 at 7:14 pm

Great article Mr. Crane! I really appreciate your comments on open collaborations. It seems such an obvious improvement that I find it hard to believe it has not become the standard in healthcare industry. It is very exciting to see Allscripts to take the lead on open collaborations in such a great way.
In our recent work we show that when hospitals collaborate and share patient data in a private IT environment, the patient outcomes are significantly better (http://ieeexplore.ieee.org/xpl/articleDetails.jsp?tp=&arnumber=6587516&queryText%3DTeam+Learning+for+Quality).
To quote from the paper “Our model suggests that groups of similar hospitals could benefit from more open sharing of details on clinical outcomes than is currently the norm. To facilitate this, we propose a secure virtual collaboration system that would allow hospitals to efficiently identify potentially better practices in use at other institutions similar to theirs without any institutions having to sacrifice the privacy of their own data. Our results may also have implications for other types of data-driven diffusive learning such as in personalized medicine.”
Obviously the implementation of such a system will require a lot of collaborations among hospitals. Would be great to hear your thoughts on this and if you think it is possible.

Stanley Crane says:

10/22/2013 at 12:33 pm

First of all, whenever anyone comments on any of these musings, I’m thrilled. Sometimes I wonder if anyone else is thinking about these issues – openness, collaboration, more or a partner attitude – I’m always hoping that I am not the only one thinking about these issues.

And when one of you take the time to reply, its exciting to me personally.

So thanks, its great to know more & more people are thinking about the same thing.

Second, it is amazing to see a statistical proof to what I think many of us have only intuitively suspected. Physician’s problem solving brains works on data – within reason, the more data we can provide to the physician, the more we enable them to make faster decisions about a patient. And when we restrict the flow of data, we deny that physician access to the entire data landscape of the patient. So they have to either order tests (and wait for the results), or they have to use their historic understanding of similar patients. Or as an ER physician once told me, “We guess.”

Narine, thanks for sharing this link with me – it PROVES that data liquidity is important & valuable to the patient; that data collaboration is critical to all of us.

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