tag:blogger.com,1999:blog-3503957686158274288.post5182437519626639059..comments2024-03-12T12:32:15.598-05:00Comments on On Health Care Tech & Policy: o-PatientsMargalit Gur-Ariehttp://www.blogger.com/profile/08777722834145614546noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-3503957686158274288.post-62835893802817060492012-07-12T22:28:32.425-05:002012-07-12T22:28:32.425-05:00>> "The pleasure was all mine....."...>> "The pleasure was all mine....."<br /><br />Oh, I'm sorry but I'll have to disagree with you there - I enjoyed it too ;-)Thomas Lukasikhttps://twitter.com/Sparkensteinnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-69968426923953695312012-07-12T22:18:18.896-05:002012-07-12T22:18:18.896-05:00Absolutely :-)
The pleasure was all mine.....Absolutely :-)<br /><br />The pleasure was all mine.....Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-87514095674291402012-07-12T22:06:09.844-05:002012-07-12T22:06:09.844-05:00I do agree with you that there's currently no ...I do agree with you that there's currently no compelling business case (read: strong motivation) for EHR vendors to "open up" their products, and that the "typical" Patient is not demanding that to happen -- and I never said otherwise.<br /><br />So can we just shake hands and retire the debate?Thomas Lukasikhttps://twitter.com/Sparkensteinnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-78528369593102339862012-07-12T20:41:37.545-05:002012-07-12T20:41:37.545-05:00No you did not,and I am not discounting your answe...No you did not,and I am not discounting your answer.<br /><br />The argument here was that open APIs are not an imperative from most patients perspective. Not by a long shot.<br /><br />I do agree with you that there are many use cases where open APIs could be helpful to third party developers trying to bring their products to market. <br />The problem is that unlike twitter, there is no business case for an EHR vendor to open up their platforms to others. If they were besieged by demand to build all those patient facing apps, and had no resources to accommodate the demand, then maybe. I may be wrong, but I don't see that happening anytime soon.<br /><br />BTW, if you just want to get and put data, what's wrong with plain old EDI? There are tens of thousands of those working in real time and doing just fine.Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-725983104137124882012-07-12T19:21:52.272-05:002012-07-12T19:21:52.272-05:00>> "patients having the ability to edit...>> "patients having the ability to edit their records does not require open APIs. It requires that the vendor provides this functionality in their product"<br /><br />And again you move the cheese in an attempt to discount my answer. I presented the "Patient Self-Service Application built by a 3rd party developer" in response to your asking for a valid Read/Write use case. I never said that such functionality could ONLY be provided by a 3rd party, or that it REQUIRED an open API.. did I?Thomas Lukasikhttps://twitter.com/Sparkensteinnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-13518058789080471522012-07-12T17:28:55.230-05:002012-07-12T17:28:55.230-05:00Without belaboring this too much, patients having ...Without belaboring this too much, patients having the ability to edit their records does not require open APIs. It requires that the vendor provides this functionality in their product, and some do that while others will be doing that in the future if, and only if, customers want such feature.<br /><br />APIs are for third party developers. It has to make business sense to the original software owner. Allowing third party software to write to your clinical database is not something to be taken lightly and my guess would be that it will not happen anytime soon for any serious EHR vendor.Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-4605780243725449642012-07-12T15:58:46.104-05:002012-07-12T15:58:46.104-05:00There are both "book length" and "R...There are both "book length" and "Reader's Digest version" answers to your question(s), but let me try some that could (almost) fit into a text message:<br /><br />RE [Q1]: they'd need [a] an appropriate use case (see my answer to your final question below) and [b] a lot of good security<br /><br />RE [Q2] An API is as simple or complete as the API provider wants it to be, and the services that result would be more or less based on the vision, imagination and creativity of those taking advantage of the API, not necessarily the API provider's<br /><br />RE your final question, inability to envision an API supporting insert, update or delete: enabling Patients to maintain (adding, updating, correcting or even removing) selected portions of their own specific data in the EHR/EMR of a Provider is something that has been under consideration and discussion for quite some time now.Thomas Lukasikhttps://twitter.com/Sparkensteinnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-29103174114109214572012-07-12T12:40:45.074-05:002012-07-12T12:40:45.074-05:00Fair enough...
Let ask you a couple of questions ...Fair enough...<br /><br />Let ask you a couple of questions then: <br />1) What do you think is needed for an EHR vendor to agree to have someone "put" data into their database?<br /><br />2) as far as I know, APIs allow you to do more than just get data and insert data into a database. What type of services do you envision an EHR vendor should provide through these APIs?<br /><br />If it's all about exposing the data model, sharing the schema and providing read/write access to the database should suffice. I can see select access. I cannot envision insert/update/delete under any circumstances.... Am I wrong?Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-24169658204318010202012-07-12T12:15:05.829-05:002012-07-12T12:15:05.829-05:00>> "Are we really at a point where a la...>> "Are we really at a point where a large EHR vendor should entertain creating a platform for plugins to its EHR?"<br /><br />You are mixing up several different ideas, including interoperability, extensibility, and openness. <br /><br />For example the "plugins" you describe are to support 'extensibilty'. Having a "pluggable" architecture is not the same as providing an open API. <br /><br />Many open APIs do not support writing "plugins".<br /><br />Twitter provides an open API -- but they don't do so to enable you to write "plugins" for them. It exists so that you can get and put data.<br /><br />And it doesn't have to be "massive extract of raw data" as you put it. How does the existence of an open API dictate the quantity of data that you request?<br /><br />Please try to stick to the point: having an open API doesn't lead to or require any of the things that you are bringing into your argument.Thomas Lukasikhttps://twitter.com/Sparkensteinnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-59338440318708844272012-07-12T09:17:04.574-05:002012-07-12T09:17:04.574-05:00I know, Thomas. However, open APIs are not easily ...I know, Thomas. However, open APIs are not easily created for a very large software product that was never architected with open APIs in mind. With all the changes required for Meaningful Use, and the need to compete on the new mobile platforms, vendors have very little time for other things. Even very large vendors.<br />That is not to say that open APIs is not a great thing to have. The question in my mind, and others may disagree, is how important is it to have open APIs, instead of, say, ability to receive and send data in standardized formats? <br />Are we really at a point where a large EHR vendor should entertain creating a platform for plugins to its EHR?<br /><br />The institutions that buy these billion dollar babies can and do extract data from their EHRs for research and extensive analytics (Kaiser comes to mind). I don't know who else needs or should have access to massive extractions of "raw data".Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-78796613569207244502012-07-12T07:18:59.344-05:002012-07-12T07:18:59.344-05:00>> "..it would be wiser at this point t...>> "..it would be wiser at this point to spend our scarce resources on health services with broader appeal and better utility" <br /><br />I don't think that "the same dollars" are competing somehow, or that resources are scarce. Do you have any idea how much vendors charge for Healthcare IT systems? <br /><br />It can run into the multi-Billions (yes - that's with a 'B') for many large hospitals.<br /><br />HCIT vendors can certainly afford to re-invest some of their profits into providing open APIs and better access to the data that their software is collecting. <br /><br />TJLThomas Lukasikhttps://twitter.com/Sparkensteinnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-4994700210045258772010-10-26T11:15:36.654-05:002010-10-26T11:15:36.654-05:00Which is fine, but somebody has to "bring up ...Which is fine, but somebody has to "bring up the rear", particularly seeing that it consists of the vast majority of people.Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-80176877643805589822010-10-26T10:50:11.325-05:002010-10-26T10:50:11.325-05:00Unfortunately, if we wait for for the o-patients t...Unfortunately, if we wait for for the o-patients to understand the need for and to take the lead on innovation we'll be waiting a long time. I'd rather follow the e-patient into the future.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-39453565807661314502010-10-25T04:11:12.851-05:002010-10-25T04:11:12.851-05:00Amen! Please see my keynote at the Estonian eHealt...Amen! Please see my keynote at the Estonian eHealth Conference: http://www.icmcc.org/2010/10/18/patient-expectations-in-the-digital-world-tallinn-2010/.<br /><br />Lodewijk BosLodewijk Boshttp://www.icmcc.orgnoreply@blogger.com