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I think there are plenty of open source projects with great UI but that aside I'm not sure I understand what you mean? What type of service for example? HIPAA

I think there are plenty of open source projects with great UI but that aside I'm not sure I understand what you mean? What type of service for example? HIPAA greatly complicates a lot of data sharing because of appropriate data privacy issues.

ethbr0 6y ago
One of the most unpleasant things about working in the medical space is how tightly coupled and poorly modularized systems are. Obviously, driven by the reasons and pressures you outlined in your parent comment. (Everything is sold and certified as a system, rather than a component) It seems like there's an opportunity for OSS to eat shared functionality, that no vendor particularly liked implementing, and then allow for closed source UIs to be built on top. E.g. EMR store/server being the open product, with {insert your preferred front end on top, for your specific use case}
- duffpkg 6y ago
  I see. PACs which are the storage and index systems for medical "imaging" data have seen some pretty big in roads. HL7 processing has become dominated by open source. There is huge institutional inertia to overcome in any corner. You really need to offer something 10X better to get over the "no one ever gets fired for using EPIC" mentality and that's a very high bar.
  - ethbr0 6y ago
    Thanks for the keyword pointers. This is a bit outside my expertise: family on provider side, but I work more on the insurance side of the house. In insurance, there seem to be some moves towards cracking monolithic systems into pieces for reasons of development agility. ACA limiting admin costs is a huge driver, as companies rightly identified lack of technical agility as a existential threat (no agility = no ability to update automated processing pipelines to changing requirements = manual processing = penalties for exceeding allowed admin costs). Also, I think there's a generational shift at the executive level from "Buy and trust vendor" to "Own, develop, and operate."
    - oogetyboogety 6y ago
      not just ACA but general market pressure to lower admin/PMPM costs due to increased competition and providers beginning to taking risk on directly in insurance

ethbr0 6y ago

One of the most unpleasant things about working in the medical space is how tightly coupled and poorly modularized systems are. Obviously, driven by the reasons and pressures you outlined in your parent comment. (Everything is sold and certified as a system, rather than a component) It seems like there's an opportunity for OSS to eat shared functionality, that no vendor particularly liked implementing, and then allow for closed source UIs to be built on top. E.g. EMR store/server being the open product, with {insert your preferred front end on top, for your specific use case}

duffpkg 6y ago
I see. PACs which are the storage and index systems for medical "imaging" data have seen some pretty big in roads. HL7 processing has become dominated by open source. There is huge institutional inertia to overcome in any corner. You really need to offer something 10X better to get over the "no one ever gets fired for using EPIC" mentality and that's a very high bar.
- ethbr0 6y ago
  Thanks for the keyword pointers. This is a bit outside my expertise: family on provider side, but I work more on the insurance side of the house. In insurance, there seem to be some moves towards cracking monolithic systems into pieces for reasons of development agility. ACA limiting admin costs is a huge driver, as companies rightly identified lack of technical agility as a existential threat (no agility = no ability to update automated processing pipelines to changing requirements = manual processing = penalties for exceeding allowed admin costs). Also, I think there's a generational shift at the executive level from "Buy and trust vendor" to "Own, develop, and operate."
  - oogetyboogety 6y ago
    not just ACA but general market pressure to lower admin/PMPM costs due to increased competition and providers beginning to taking risk on directly in insurance