My research group, Children’s Hospital Informatics Program, just released a statement of principles in designing the next generation of Health IT, and folks are picking it up. The key concept is substitutability, or what software/Internet architects have called loose coupling. The idea is to build modular rather than monolithic systems, and ensure that the modules are connected in loose enough ways that innovation is possible within each component independently of the others. Sounds kinda obvious, right? Not so in Health IT, which is only just now starting to get the point of the Web.
So, for example, if you think your system fits the bill because anyone can write a Java module/extension, you’ve got it wrong. Loose coupling means you’re not forcing one programming language on everyone else, rather you’re embracing the open protocols of the Web.
The work we’re doing with Indivo X, our open-source/free Personally Controlled Health Record, is exactly along those lines. But it’s not just about PCHRs. Really, the entire Health IT ecosystem needs to adapt to the loosely coupled way.