I am not shy about sharing my opinions. Pausing here to wait for laughter to subside. OK.
Often that is a positive, and means that I can help push a group to surface important issues that otherwise get swept under the rug. But sometimes it gets in the way, too.
I also work for Microsoft. I am on my second stint at the company, having returned in 2006 to help found the Health Solutions group after a 10 year journey through the startup world. I am really proud of what we’re doing here in HSG, and I am extraordinarily lucky to be in a position where I have a ton of freedom to choose where I focus.
A few months ago, when I read Wes and David’s “Simple Interop” posts and then spoke with Arien during the genesis of the NHIN Direct project, I got super, super excited. I spend pretty much all my time trying to get the right information into the hands of patients and providers, and it is really hard in the existing environment. NHIN Direct, with its ambition to short-circuit some of the policy and technology barriers that have slowed this down to date, represents the best chance we’ve had to really create a ubiquitous way to move beyond this quagmire.
Because of this belief, I have dedicated a huge percentage of my personal time, and that of my team, to push the project forward. The last week or so, I have been very vocal about my concerns about taking an IHE/XD* approach to NHIN Direct. I am comfortable with a number of alternative approaches, but have been championing one (SMTP) that I believe is the best path to quick and sustained success.
Somehow along the way, the conspiracy theories seem to have started to emerge. As I understand it, the central theme is that the reason “Microsoft” is pushing so hard for SMTP is that we are looking to extend our world hegemony with Outlook, Exchange and Hotmail.
My first inclination here is to giggle a bit, and then say “great idea!” But I really care about the success of NHIN Direct — so I wanted to offer a serious and public response as well.
First — the incremental units of our email products that we might sell as a result of NHIN Direct are completely irrelevant to that business. None of those groups have even heard of this project. The vast majority of providers are already Mac or Windows Office users already.
Second — we currently sell an HIE product (Amalga UIS) that includes support for the IHE/NHIN protocols. Selling more of these is incredibly material to the HSG business (and my personal commitments). So if I were simply shilling for Microsoft products, I would be better served espousing a different position.
Everything we are doing in HSG comes back to getting the right information in front of the right people so that they can make better decisions. We sell products to help with that: Amalga on the enterprise side and HealthVault for consumers. Will NHIN Direct help those products? Yes — but only if it gets used by providers and patients. Without that, it’ll just be another silo.
That’s my concern — I do not believe that the business dynamics of an exclusively-IHE/XD* implementation will enable that ubiquitous usage.
I won’t go back over all the reasons for that, especially as we are engaged in some very positive conversations about blended concepts that might get us to a consensus position. I just wanted to be clear — the Death Star is not at work here, and I’d be more than happy to speak with anybody one-on-one more about it if they have questions.