Rupert Goodwins' Diary

Open your mouth and say "Aaaahh", please. Now, look at this chart -- it shows the current state of IT in healthcare worldwide –- and say "Aaaaaarghh!". Thank you. Briefly: it's a mess. It has to change. Much of the global healthcare industry's IT is ten years behind the times, if not more so, and a great deal is stuck in the days of the '70s and '80s when standards were for hippies and every IT company worth its salt vigorously defended its own incompatible patch. If you had to make things work together, it cost you a fortune. Such attitudes make life easy for the suppliers. You develop stuff at your own pace, your customers are locked in, and you charge what you like. It's not so nice for the customers, of course, but you can usually avoid dealing with them by hiving off a very expensive maintenance company. Plenty of cash to go around – and if some of that ends up going into the pockets of the people buying the kit, well, what of it? This is a complicated and highly technical industry, and who's to tell whether everything is exactly as described? There's just one problem with this: it can't work for much longer. With healthcare costs going through the (often leaky) roof, if we don't increase efficiency by orders of magnitude we will not be able to afford to look after our ageing population -– which is going to be us, soon enough. The healthcare business must have its own standards-driven revolution, or it will implode. There are two ways to set standards: sit around talking all day, or buy in a bespoke, non-standard system off the shelf and push it hard into the industry until the way you do things becomes the way everyone does things. Microsoft did this in the 80s with MS-DOS, building everything thereafter on the sides of the valleys that DOS cut in the rock of the industry. And now here's Microsoft again –- buying in a bespoke, non-standard system off the shelf (well, the operating table) to amalgamate clinical data for diagnostic purposes. Peter Neupert, MS's vice-president for health strategy, says that he had to convince Steve Ballmer that this was a good idea: I bet the pitch was about two lines long. Microsoft is right and wrong. The dynamics of the health system are not going to be massively changed by the introduction of the equivalent of the PC (although it is intriguing to muse about the possibilities of what the medical equivalent of the personal computer might be), which combined with advances in communication technology to overthrow the hegemony of the old ways (despite, it must be said, Microsoft having much greater affinity for those old ways than the new). The health system must and will change, but what triggers it and in what direction is still open to debate. This is the place to be, though. If you want to get into the next big wave of technology innovation, then break out the stethoscope. Everything will be up for grabs – there's gold in them thar pills.