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This article that I saw in Variety is as good of a place as any in which to start this discussion regarding that current state of affairs in digital tools for healthcare.  How, you say?

20 years ago, if you were to ask me where I thought the on-demand delivery of entertainment would be coming from, I would have told you the big cable companies would own it.  It didn’t turn out that way, as this headline makes clear. What happened?  It is more about what did not happen. Even though Interactive TV, as it was called back then, was in a position to own streaming media, they were too big, conservative and happy with the way things were to take the needed risks and make the needed changes.  Into that vacuum came Netflix, YouTube, Amazon, etc.

Right now, the big vendors, payers, and providers of healthcare are the ones who are big, conservative and happy with the way things are.  Why change a good thing? Why fix something, that for them, is not broken?  Sure we have HL7 with all of the standards but who is really using them fully?  For a truly interoperable healthcare world, healthcare standards should be as ubiquitous as financial standards are in the world of banking. Currently I can get my money out of ATMs all over the world, but my healthcare records are pretty much stuck in whatever system in which they were created, and that system is still paper in many locations in the year 2019.

Innovation in a true sense is less likely to come from the big vendors than from the new, smaller players on the periphery.  Sometimes from academic efforts and other times from high-end products aimed at a high-end consumer.  The Tesla Example shows us that the real breakthrough innovation came from a boutique player in a high price market, not from Chevy or Ford. The academic efforts are obvious but where is the Tesla equivalent?  It is to be found in the high end retail medicine market, where the customer is king because the customer is paying for services directly.  Many consumers of elective cosmetic surgery, laser skin treatments, etc will be better served by interoperable systems offering a high value experience.  But that’s for another blog

In this monthly magazine we will explore and showcase the best of market for interoperable open source health care technology solutions, bringing you both the creators and the consumers as prime material. Much in the same way a small pizza shop uses the same electronic payments standards via Stripe or LevelUp that large players like Dominos or Pizza Hut does directly with their respective major payment processor of choice, a new emergence of shared technology, typically of open source origin, emerging from the smaller players will make their way into the mainstream where major hospitals do their work. The future is bright and full of opportunity.