Peter Machell wrote:
> On 30/04/2006, at 9:34 AM, Andrew McIntyre wrote:
> 
>> Hello Peter,
>>
>> Well, thats not really google, its a monopoly by stealth.
> 
> On the contrary, Google set out to build the best super computer on the
> market, found a free service to give them exponential growth and are now
> making more money than you and I could imagine. They followed this
> recipe exactly.

There is a very interesting article on Google's management style here:
http://online.wsj.com/public/article/SB114601763677436091-RZdaVtvykRAz4EhCKs0KervA0Eo_20060503.html?mod=blogs

Personally I don't see Google as stealthy monopolists, or at least far
less so than just about any other large (non-open source) IT company.
Google actively encourages other companies and individuals to leverage
their infrastructure to create "mash-ups", but the fact that the
infrastructure is accessible to end users at almost no cost and via the
Internet means that it is very readily substitutable - a fact of which
Google is aware - but unlike many other IT companies, they don't let
that fact bother them.

Amazon are also showing signs of "getting" the new Internet paradigm of
a substitutable and interoperable way of doing things, although apart
from S3 and Mechanical Turk, their Web services are still a lot more
introspective than Google's. Nevertheless, if you have not done so, take
a look at the Amazon Web services home page, especially the Mechanical
Turk Web service, which is such a powerful and far-reaching idea that it
frightens me: http://aws.amazon.com

The other thing which both Google and Amazon demonstrate is that due to
the enormous economies of scale and concentrating powers of the
Internet, it is possible to provide stunningly powerful, effective and
reliable services (such as Google Search and just about every one of
their other "products" such as Gmail) at almost no cost per individual.
Sure, the Google server farms that power their services cost billions
(or at least many hundreds of millions) to establish and run, but they
are all paid for by every one-hundredth search someone clicking on a
text add (and perhaps every hundredth such text add click-though,
someone actually buying something from a vendor). Personally, I've never
clicked on a Google text add, ever, but the tens of millions of people
that do click on them from time-to-time support my use of Google - to
the benefit of everyone.

Here is a thought: how long before we see a Gehr - by which I mean not
Good Electronic Health Record, the precursor to the openEHR project, but
rather Google EHR? Seems likely to me, especially in the US where health
care funding and delivery is so fragmented and the various
interoperability/data sharing initiatives are making only very slow
progress despite govt funding - see
http://australianit.news.com.au/articles/0,7204,18772550%5E15317%5E%5Enbv%5E15306,00.html

Of course, any shared EHR is only as good as the interfaces between it
and the clinical information systems which feed it (and to a much lesser
extent consume information from it). But Google would never be so silly
as to try to write or control such interfaces itself - that's not its
style. Rather, it would provide an open, published (and probably
surprisingly simple) API or other interface specification for its EHR,
and allow software vendors, individuals, start-ups etc to write the
necessary interfaces. What sort of consent and access control model
would Google EHR use? Many. Google would realise that no one model suits
everyone and every circumstance, so it would allow users of the system
to invent and define their own models using a set of consent and access
control "primitives" which it provides and which can be mixed, matched
and combined with additional mechanisms and services provided by third
parties in all sorts of ways which Google nor anyone else would have
thought of beforehand. All this would be paid for by discrete text
adverts visible when each consumer views their EHR record.

As an aside, if it is smart (and it tends to be), Google should adopt
openEHR or something very much like it as the basis of its (putative)
Google EHR - and then provide the social networking tools to allow all
the necessary but yet-to-be-done development of archetype and
composition definitions to take place at a much faster pace than
otherwise. But the
accept-that-change-in-data-requirements-is-inevitable-and-continuous
approach of openEHR would seem to be a natural fit for the Google way of
doing things.

Of course, many companies and governments are already trying to provide
their own version of such a "Google EHR", but very few have both the
size to provide the necessary economy of scale AND the laid-back,
laissez-faire approach that Google has. Anyway, it is a brave new world,
at least for the minority of the world's population able to afford a
connection to cyberspace.

Enough punditry for one day...

Tim C
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