If the mobile phone market was like healthcare information technology, we would all still be using a flip phone. It would have touch tone buttons, but it would really have an interface to mimic rotary dial because our infrastructure would still require it. That’s how I feel every time I watch a keynote announcement from Apple introducing new technology.
We tend to move along our technology advancement in healthcare as if we are really making great strides. But the reality is that so far, the government has had to incentivize the market into adopting technology or embracing change. Just recently I saw someone using a character screen terminal; this year someone was still using a dot matrix printer. Of course, we are all still using HL7 and ICD-09. HL7 has been around since the '80s and ICD-09 was first published in 1979.
So the rest of the technology world moves on to smaller computing platforms, improved voice recognition, location driven push notifications, merchant transactions through smart phones and applications designed to integrate within our personal user experiences and needs. We delay changes in interfaces and coding because change is too hard.
The healthcare enterprise software market is quickly shrinking into a few select vendors. These vendors are notorious for signing long term contracts and focusing on their suite of applications, because “nobody does it better.” Financial, Clinical, Ancillary, Inpatient and Ambulatory, they each do it better than anyone else. Yet, if you lived during the IBM versus Apple days (or maybe read about it) you know that Apple’s true downfall (at the time) was open source. Being able to walk into a store and finding shelves full of “IBM Compatible” software and a very limited selection of Apple software. Apple at the time did not want anyone developing stuff for their platform. So I painfully changed from an Apple IIe to an IBM 286. Apple learned their lesson and today has over a million apps that run on their tablet or smart phone; they also now have a watch. These are Apps that drive users to their devices and their customer experience. Not all apps are great, but users don’t beat up Apple over it. The “user experience” and data moves seamlessly through mobile devices and computers.
When you look across the large healthcare software landscape you don’t see that same sense of innovation. Vendors are too busy pushing their sales staff to sell more of their modules and the sales staff are busy telling them about features clients want, so they can make changes to their modules. Nobody is standing on a ladder looking above all the cubicle spaces and yelling, “Hey! Let’s open up our code and let other people write routines that will allow our customers to do truly innovative stuff!” I have to wonder how many healthcare companies are developing truly mobile applications for the inevitable transition off desktops. How many small companies can develop truly innovative apps if the large enterprise software companies would open up their code?
The message from Cupertino (Apple's keynote) was that they had developed higher resolution screens, ways to better track wellness, improved camera optics and a new watch platform. By the way, they also are doing a software upgrade. Can you imagine if someone tried to do all those changes at once in healthcare? The crash would be heard around the industry, because at the end of the day…we are still using a rotary dial infrastructure.