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Military EMR efforts aside, open-source technology still an unknown

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Color me cynical, but I usually assume that progress in a fast-moving industry like technology isn't going to be driven by the military. After all--meaning no disrespect to the capable folks in military IT--a bureaucracy that could choke, oh, several thousand horses usually isn't good for fostering innovation.

However, fellow editor George Lauer of iHealthBeat notes, this time around the military may be helping to lead the revolution. As he points out, with President Obama pushing the use of open source technology for the VA (its renowned VistA system) and the Department of Defense (Connect from Sun Microsystems), the whole health reform effort could be pushed in the direction of using open source, as well.

Now, I'm not sure I buy some of Lauer's other arguments in favor of a health IT open source shift. Sure, it may be true that, as he notes, CCHIT's holding open source session at HIMSS09 was some sort of landmark. And the idea that HIMSS is showing its commitment to open-source technology is impressive--after all, it is one heck of a powerful trade group with the right corporate connections. Sadly, no revolution was ever completely won by the brilliant but odd ponytailed guys with the Perl scripting jokes on their t-shirts. (Hey, all my 'nix geek friends are like that--aren't yours?)

All said, it remains to be seen how deep any supposed support for open source health IT--and open source EMRs--really goes when the spotlight cools down. Talk is cheap here, especially if it's politically en vogue to sound open source-friendly. As open-source devotees know, since the inception of the movement commercial vendors have tried to prove they were cool by talking the open-source talk. (Hey, even today, with Linux desktops reaching the consumer level, saying you do open source definitely still provides some street cred.)

Ultimately, the main point Lauer makes is hard to debate. After all, there's no juggernaut like the DoD, and when you throw in the VA, it's scary to contemplate how much concentrated influence is involved. That's got to affect other government choices, and the consumer health IT biz has to follow. The question is whether the whole idea will get stalled or diverted, which are also DoD specialties.

I guess what I'm saying here is that if I were a stock picker, I'd give health IT companies based on open-source technology a cautious buy, but not a wild one. After years of seeing open source's promise diluted and delayed in industries across the spectrum, I'm hard to win over. What about you? - Anne

Last week's HealthFinance and Healthcare Editor's Corners:
Surprisingly little buyer's excitement at HIMSS09
Is your patient advocate an advocate--or a defensive tackle?

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Comments

Anne,
I think your analysis regarding open source is spot on. If DoD's penchant for enormous cost over-runs isn't reined in, we'll all suffer for it, not just open source. The anti-EHR lobby is counting on high level, costly failures to make their case. Nothing like a big failure to make status quo look just fine.

DoD's failures are driven in part by cumbersome contracting mechanism that slow development cycles which then sets up projects for failure as they are overtaken by technology developments or for huge cost over-runs as they try to catch up with the horse that's already out of the barn.

I hope there is enough courage, foresight, and commitment to avoid the well know paths of failure.

Christi:

This is Assistant Editor Dan Bowman. Thank you for your commentary. It's always useful to hear what our readers thoughts are on the various subjects we write about. That being said, what do you, as a reader, see as our strengths as a publication? What about our weaknesses? What would you like to see more of? Feel free to email me at dbowman@fiercemarkets.com. Thanks again for your feedback.

I am all in favor of open source, but have some doubts about how people get paid for their efforts. Maybe some companies can get open source developed if they offered it for free, but attach advertising to it. Afterall, isn't that what brings all of us the Fierce publications?

By the way I love the format of the Fierce Publications. I can skim the articles, and choose the ones I am interested in, and skip the rest.

The VA system uses MUMPS a legacy language with none of the minimal features necessary in a modern world. Just because it is free, would you consider using a Model T or a Kodak Brownie? There are a thousand technologic reasons for not using computer products developed in the 60's - especially when it is writted using an orphan language like Mumps.

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