"Alvin B. Marcelo" wrote:
>
>
> I agree Wayne. The 3rd Visible Human conference ended last week and one of
> the speaker's comments on standardization struck me:
>
> He said: "All healthcare is local."... I expect the same will occur with
> medical information systems. The information requirements of end-users
> [except those required to be submitted by law] vary widely.
>
> Acknowldeging this, how then should we approach the work to be done by the
> alliance? Where is the common ground?
>
I am not that pessimistic about localization. Having discussed business
practices with my UK colleagues, I was struck by how much their business
needs (versus clinical care needs, which I know less about) were the
same as the one's we face in the US. There is a stiking difference in
who pays, but the underlying information needs are virtually identical.
That lead me to thinking about common process's and the notion that
application's are just expressions of those process's. So we need are a
rich set of process's and a highly expressible building architecture.
Workflow orientation seems a natural. That way, local practices are
just different assemblies of the same process's into various workflows.
Andrew Ho also said this in a different way when he said "a modular
architecture with clear
separation of interface, business logic, and underlying implementation
(to render and support the interface and logic)".
On the related thread of vendor lockin and switching costs, Hal Varian
(formerly of Michigan Economics Dept. and now Dean, School of
Information Management and Systems UC Berkeley) has done a lot of work
on the electronic economy, pricing models and switching costs. In
general you can find Hal's work here:
http://www.sims.berkeley.edu/~hal/people/hal/papers.html
In particular you might want to look at these:
Locked In, Not Locked Out
http://www.thestandard.com/article/display/0,1151,2173,00.htm
Economic Incentives in Software Design
http://www.sims.berkeley.edu/~hal/Papers/Software.pdf
