Health IT can learn from the iPhone and ATMs

Health information technology is hot right now, with President Obama's stimulus package steering $19 billion toward a plan to computerize healthcare records. How successful any national system will be depends on how flexible its architects make it, two Boston doctors say in today's New England Journal of Medicine.

Flexibility is critical because the system will be expected to function in a new healthcare world not yet created with technologies yet to emerge, Dr. Kenneth D. Mandl and Dr. Isaac S. Kohane of Children's Hospital Boston write. Another article in the journal, described in this story in today's Globe, reports that only 1.5 percent of US hospitals have a comprehensive electronic health records system in place.

Health IT can look to new products like Apple's iPhone or old ones like ATMs to see how a basic platform that anyone can use or write applications for works better than isolated products that don't talk to one another or allow for programs to be swapped out for new and different uses. The World Wide Web may be the best example of interoperability of software applications.

To achieve such flexibility, there must be open standards that encourage customization and innovation, the authors say. Oversight to protect patients and respect the time of physicians using the system should be put in place, too.

"Medicine is increasingly becoming a knowledge and information industry, but it did not invent information technology or the Web. It makes sense to draw on other sectors' successes in making this type of transition, and they teach us that if we are to use information technology to improve health care, the variety of practice sizes and styles needs to be complemented by collections of information functions that are packaged on a consistent platform," they write. "The applications enabling these functions should be as substitutable as different stethoscopes in a doctor's office."

Mandl and Kohane are the developers of Indivo, a personally controlled health record used by Dossia, a coalition led by Intel.