Leading technology analysis firm Gartner has said the NHS IT market is too reliant on closed proprietary systems, and must follow other industries and drive to open platforms and surrounding eco-systems.
Speaking at a recent event on OpenEHR in Salford’s Media City, Gartner health analyst Mike Jones said: “I think there is an over dominance in the market in systems that are not open.”
Proprietary systems, he said, result in data becoming locked in supplier’s systems, resulting in a lack of interoperability.
Jones said the future was a move away from single solutions, following other sectors which suffered similar over-reliance on a handful of dominant mega-suites like Enterprise Resource Management, and moved away from this.
Gartner has looked at ehealth strategies in 35 countries and concluded the traditional core mega-suite EHR model, a model that Gartner had long championed, is broken when the aim is to join up a complex, ever changing health and care economy with the citizen at the centre.
“The traditional model of having an EHR on its own, as sole tech to innovate an ecosystem around is flawed, you need an open platform,” said Jones. He said about two-thirds of the countries that Gartner has looked at have all come to a similar conclusion.
“This happened in the enterprise resource planning system market 10-15 years ago where they realised they needed to have innovation across an eco-system was not going to happen by just relying on core systems.”
Instead, many have moved to a shrunken core ERP – once dominated by SAP and Oracle – that now sit within a much more diverse eco-system of business applications.
To achieve their ehealth ambitions shared by many countries, of patent-centred care, he argued the direction of travel needed, he said, was towards open platforms, and supporting eco-systems, based on open data standards.
“Gartner has seen platforms take off in many sectors, and we think the same needs to happen in health,” Jones said. “There is a huge opportunity for the NHS to create open networked platforms.”
He pointed to Android and Apple IOS as examples of platforms that have been hugely successful, because they enable many people and companies to create tools and applications that add value.
“The most important effect is the networks effect as platform grows at an exponential rate of the value it provides,” Jones said.
“Platform business is something that allows business eco-systems to create and exchange value. In health, it can be in the form of insight or care, but what it really does is match business to consumers.”
Jones, a former NHS CIO, said that there are formidable challenges in health, but some clear steps needed: “First, is leadership and culture, we have to overcome tribalism.”
“Second, we need open architectures and to move away from siloed solutions.”
Next is the strong governance and to overcome misaligned funding. Finally, he said a new approach is needed to governance of IT services and getting past idea that everyone has their own architecture.
“It needs some hard decisions from CIOs on where they see the future of their IT service, it needs much more collaboration on IT services,” said Jones. “And we need to drive requirements of markets – which currently doesn’t address the needs of eco-systems
He said failing to do so will only result in further failures. “Otherwsise, we wind up with more white elephants and a market failure. What we end up with is very low value from those core systems.”
Jones added: “Gartner’s view is that citizen-centric services need an open platform at the centre that is able to deliver person-centred care.”
Asked where to begin, he urged NHS CIOs needed to begin by requiring suppliers adhere to open data and interoperability standards like FHIR and OpenEHR, “You need to say that before we do business with you we need you to make data open and exchange data using open standards.”