Others agree that embracing Open is critical for the future of health care. Take for example this article: Coalition Calls for Action Against EHRs That Block Interoperability. After a RAND Corporation report found that Open technologies could help lower costs and improve care, calls for interoperability are stronger than ever before.

A non-technical explanation of Open

Open means interchangeability. Take car batteries for example. How big are the posts that you connect the battery wires to? And how many volts? These attributes are standard for all car batteries, no matter who makes them.

In health care, unfortunately, the specifications can be very broad, such as HL7 including “industry standard” Continuity of Care Documents. In a car battery scenario, this breadth might allow the posts to be between 5/8” and 2” and power to be between 5 and 20 volts. So two batteries could comply with these standards, but one may have 1” posts and 5 volts, and the other may have 2” posts and 15 volts.

Could we easily use our choice of battery? Are the battery cables flexible enough to fit various post sizes? Can the car’s electrical system handle it if the voltage is anywhere between 5 and 20 volts? Probably not; they are not interchangeable. Manufacturers would have to make all sorts of adaptors and interface layers that convert the battery into what your car is expecting.

When the standard is broad, there are millions of variations possible that all comply with the specification. Building adaptors (like HL7 interfaces in health care) takes both time and money.

Better standards will lead to more innovation

Open means, in a sense, that we have much tighter specifications. So all parties can rely on the data coming and going to be a specific flavor. Vendors can create one solution that is relatively simple for clients to install.

In the olden days, pocket watches were lovingly crafted by hand. No two were alike, even from the same manufacturer. If something broke, it had to go back to the original watchmaker to be fixed or modified. And if you’re the manufacturer, you’re tied to the client until they decide to buy a whole new watch from someone else. That’s a closed system. Pause here: does that sound more or less similar to healthcare information technology today?

Is that how it should be? Should innovation be limited to the creativity of a single watchmaker? Should innovation be limited to one HIT vendor?

With Open, we get interchangeability, and with that comes the opportunity to take advantage of innovation from any direction. If there is a new clinical decision support engine, or a new device, or a new specialty-oriented tool that some clever person invents – Open means that you can have it quickly. You don’t have to wait for the gunsmith to learn how to do it, or wait for the HIT vendor to build that new innovation into the next product.

Open means interoperability. Open means adaptable. Open provides a platform for innovation.

 

Editor’s Note: For more of Stanley’s thoughts on what makes a company truly Open, check out this blog post: 6 traits of a truly Open healthcare IT company.

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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.

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