I’m sitting in the Interoperability Workshop in London being jointly organised by NHS England, The Health and Social Care Information Centre and The Local Government Association (3 June 2015).
In the UK like there are a large number of projects trying to deliver integrated care that need to achieve integration of IT systems and data across multiple organisations and systems. Most of those speaking here today are trying to follow an open approach but some seem to be achieving more rapid progress implementing proprietary systems. In many ways this is to be applauded, but there is a risk that it leads people down a cul-de-sac and creates vendor lock-in.
Globally the health informatics community agree that we need to move away from enterprise based monolithic systems and bespoke “best-of-breed” integrations to community wide systems based on a platform architecture that allows components to plug-and-play sharing information, knowledge and work flows in a computable format.
For vendors the commercial opportunity of “owning” the platform is massive and many vendors from the very large, to wildly ambitious start-ups are trying to achieve this. However, in my view, and that of a growing number of others, is that an “own the platform” approach is both doomed to failure and not in the public interest,
It’s not in the public interest because it creates vendor lock-in and while in the short-term the right vendor might offer the lowest risk approach to short-term success in the medium-term vendor lock-in mitigates against agility, innovation and the achievement of good service and best value.
It’s doomed firstly because governments, health and care providers and payers increasingly understand my point above, secondly because of competitive pressures in the market; google won’t let apple, won’t let Microsoft, won’t let amazon, won’t let IBM, won’t let EPIC, won’t let TPP won’t let Orion etc and finally because unless we adopt open approaches we won’t be able to address the federation of platforms which is essential to deal with the inevitable flows between communities.
The smart money will invest in the creation of open platforms (spending a lot less than is required for an “own the platform|” play) and build business models that exploit rather than own the platform (like the Internet works!)
Those responsible for commissioning digital systems need to ensure open standards, open interfaces and open data and avoid being seduced by the vendors of proprietary solutions.