IT Procurement, Happily Ever After

If Aesop were writing today, he might spin a cautionary tale about the selection of electronic health records. The moral? A proprietary system that looks like a golden goose may turn out to be a costly pile of sour grapes. Or something like that.

Some smart guys at Harvard are working to rewrite that too-familiar story. Supported by a $15 million grant from the Office of the National Coordinator (the IT arm of HHS), Dr. Isaac Kohane and Dr. Kenneth Mandl of the Children's Hospital Informatics Program and Harvard Medical School are developing a health information technology infrastructure that will support third-part applications much the way the iPhone does.

Rather than being locked into an expensive system that promises to do it all, users of such a platform could cherry pick the best apps from a universe of developers. According to Children's Hospital news release:

The platform architecture, described as a 'SMArt' (Substitutable Medical Applications, reusable technologies) architecture, will provide core services and support extensively networked data from across the health system, as well as facilitate substitutable applications--enabling the equivalent of the iTunes App Store for health. This will stand in stark contrast to the way health information systems have been designed and implemented to date."

Kohane and Mandl first described the concept in a Perspectives article (March 2009) that appeared in The New England Journal of Medicine. The platform will encourage "evolution, competition, innovation and efficiency" in health care technology, they said.

The grant is one of four, totaling $60 million, awarded through the Strategic Health IT Advanced Research Projects (SHARP) program that seeks to address key challenges in the adoption and meaningful use of health IT, noted the news release. The grants were part of a larger group of awards totaling $144 million.