In the July/August edition of Washington Monthly author Phillip Longman, a senior fellow at the New America Foundation, delivers what I think is a misguided punch to the commercial software industry. His article, “Code Red—how software companies could screw up Obama’s health care reform” offers up a couple of examples where CPOE/HIS implementations using proprietary commercial software solutions went terribly wrong. He then uses these as evidence for why open source software, particularly the VistA solution that came out of code developed by the Veteran’s Health Administration, is what’s needed to fix the IT mess in healthcare.
I don’t think the argument is about open source vs. commercial software. The argument should be about what works and what’s required to address the needs of healthcare workers and the health industry. Over the years, I’ve written and lectured extensively about what it is that healthcare workers must have from the information systems they use; the best information worker tools on the planet, a multitude of data input options, a more standardized and intuitive user interface, applications that extend to and work well on mobile devices, solution interoperability, and a lower total cost of ownership. On that last point alone, there’s plenty of evidence that open source is often not the lowest cost option.
Mr. Longman and I would agree that dumping billions of federal dollars in incentives on hospitals and physicians may not be the best way digitize healthcare; not without careful analysis of what it is we are trying to improve and how software contributes to that improvement. I can also agree with another passage in Mr. Longman’s article where he writes; “because proprietary systems aren’t necessarily able to work with similar systems designed by other companies, the software has also slowed what should be one of the great benefits of digitized medicine: the development of a truly integrated digital infrastructure allowing doctors to coordinate patient care across institutions and supply researchers with vast pools of data, which they could use to study outcomes and develop better protocols.”
That sounds to me like a clear endorsement for Microsoft’s Amalga Unified Intelligence System. Amalga liberates unstructured health data from systems and silos (proprietary, open, or other) and provides a truly integrated digital infrastructure where powerful yet intuitive analytics tools can be applied to turn data into knowledge and insight into action.
The health industry has been woefully underserved by the information technology industry. Too much of what’s out there was designed way too long ago by software engineers, not clinicians. But that is beginning to change. In fact, here at Microsoft we now have scores of clinicians working on the solutions we develop. Superb contemporary EMR and HIS solutions (both proprietary and open) are now coming to market. But we mustn’t get distracted or lose focus on what it is all about. It’s not about whether proprietary or open source software is better. It’s about how we use that software to improve the cost, access, safety, care team collaboration and quality of patient care and the health of citizens around the world.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft