Mobility Week: The Power of Open

Last week, I was chatting with one of our developers when his office lights inexplicably blinked. Perplexed, I inquired, “What just happened?” As is common working with software developers, I caught a glimpse of the future. He explained, “You just sent an email to Danny, and that makes the lights blink.” Both amazed and confused, I listened curiously as he explained the mechanics. A company called If This Then That (IFTTT) freely connects various web-enabled services, and in this case, our developers had used it to connect Gmail’s API service with Philips new Hue WiFi-enabled light bulb. Ergo, when I send an email, the office lights blink. I agree it’s a rather pointless exercise, but I submit that it illustrates an incredibly powerful example of the value of open platforms.

Perhaps a better example will drive the point home. IFTTT integrates with many services, including Automatic, a commercially available device that connects to the Onboard Diagnostics Port on most cars. This device can be configured to send real-time analytics about your vehicle and driving patterns to your mobile device. So, instead of blinking the office lights after an email, perhaps I could have it turn on the lights in my home when I park in the driveway and turn off the engine. Or in another example, when my engine turns on and I leave my driveway, my temperature on my Nest home thermostat automatically adjusts. Using open APIs, companies can securely connect their services - their creative innovations - and in so doing, create unique experiences that no single company could have delivered, or perhaps even imagined.

Perils of Master Planning

I’m reminded of a classic economics essay, “I, Pencil” by Leonard E. Read. Originally published in 1958, the essay creatively illustrates the power of human creativity through a detailed description of how a common, every day pencil comes into existence. He writes:

It is even more astounding that the pencil was ever produced. No one sitting in a central office gave orders to these thousands of people…These people live in many lands, speak different languages, practice different religions, may even hate one another—yet none of these differences prevented them from cooperating to produce a pencil. How did it happen?

The brief essay describes in great detail how millions of people, disconnected and unaware of each other’s efforts, work together to mine the raw materials, transport the cargo, produce the parts, manufacture the tools, and put the materials in place to create the most basic of objects that we use and take for granted every day – the pencil. He speaks to the limits of centralized planning and control, writing:

…no single person on the face of this earth knows how to make me [the pencil]...There is a fact still more astounding: The absence of a master mind, of anyone dictating or forcibly directing these countless actions which bring me [the pencil] into being. No trace of such a person can be found. Instead, we find the Invisible Hand at work.

Interoperability in Healthcare IT

Unfortunately, it appears that Healthcare IT is slow in adopting the very fundamental premises that have been adopted by modern non-healthcare SaaS vendors. No single vendor should be tasked with knowing all use cases in health care, just as no single person or company could build every component necessary to craft the simple pencil. No hospital should have to rely on a single company to provide all of its software needs, since neither the hospital nor the software vendor understands all that is – or, more importantly, will be – required. By allowing vendors to work together, through the use of an open platform of interoperable services and components, we are providing new opportunity for innovation and creativity to occur. In the end, open standards improve our patients’ experience in ways planned and unplanned.

This advantage is clear to both federal regulators and the VC market. The Office of the National Coordinator recently released for public comment a draft entitled Interoperability Roadmap, aimed at “promoting, facilitating, and enhancing the safe and secure exchange and use of health information nationwide”. These new opportunities will be well funded, as a recent report from Mercom Capital Group shows a doubling of the 2014 Healthcare IT investment to $4.6 billion. The transformative effects of open platforms have transformed other industries, and the rising potential of mobility to empower the patient will make the consumerization of healthcare a reality.


Imagine what would be possible if we were able to create intelligent software systems that easily and effectively communicated with one another? How would this change the experience of the users of the systems? And more importantly how would it change the experience of the patients receiving care?

While these aren’t the easiest problems to solve, there are some extremely smart individuals in the Healthcare IT space who can move this discussion forward in a way will benefit everyone at every level of the healthcare space. We need to collaborate and we need to trust one another. And when we can create a real open Healthcare ecosystem, that bulb in our office will have even more reasons to blink.

What questions do you have?

Jeffrey R. Zavaleta, MD, is Chief Medical Officer at Graphium Health.