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The Next Round Of Microsoft Vs. Linux: Health Care

Both camps are making waves in the industry, which is poised for dramatic IT growth
In another development last week, the OpenVista system, a private adaptation of a system successfully implemented in Veterans Health Administration hospitals, was released as open source code on SourceForge (see story, "Open Source Goes Live"). And Tolven last week announced a deal in which Palm will bring Tolven's open source electronic health records to Palm Treo smartphones. Using their Treos, patients could access health records via the Internet. Or a patient in a clinical trial could send a doctor information about side effects in real time.

One of the key steps for open source software will be getting the "seal of approval" for interoperability and other criteria from the Certification Commission for Healthcare IT, a body created two years ago. No open source apps have it so far. After certification, the products will have to overcome concerns about reliability and how stable their vendors are, says Jay Srini, VP of emerging technologies at the University of Pittsburgh Medical Center. But it will happen. "Proprietary and open source products will coexist and be endorsed by CCHIT," she says.

Even certified open source apps will face a high hurdle in clinical applications close to patient care. "We require very high reliability, stability, and change control, so open source enterprise clinical applications may not be a good fit," says John Halamka, CIO of Harvard Medical School and of CareGroup, which runs several Boston-area hospitals. CareGroup uses Linux and the StarOffice productivity suite extensively.

MICROSOFT'S 'PIECEMEAL' PLANS

Microsoft hasn't mapped out exactly how it will go after the health care market. Microsoft last year purchased Azyxxi, a system for hospitals to access and share patient medical data. On the consumer side, Microsoft said it's buying Medstory, which has a Web search tool specialized for health information. "The perception of our actions may be piecemeal, but we're just getting started," says Peter Neupert, Microsoft's VP for health strategy. Windows is also critical, of course. Vendors offer health care applications on the Windows platform, including McKesson (clinical apps), Allscripts (e-prescribing), and NexGen (EMR).

For health care providers, no matter which apps they choose, compatibility will be critical. Standardized information exchange could reduce U.S. health care costs, the Center for Information Technology Leadership estimates, with further savings through more efficient operations. The industry, through efforts like the CCHIT and the Health Information Technology Standards Panel, is creating standards for proprietary and open source vendors to adopt.

Momentum is growing for health care IT. Nearly seven in 10 hospitals have fully or partially implemented e-health record systems, according to a survey of 1,500 community hospitals by the American Hospital Association released last week. Half report moderate or high use of IT tools in 2006, up from 37% in 2005. Doctors are still a holdout: Only 11% use e-health records, an Accenture survey finds.

Nothing Microsoft or open source developers do, by themselves, will be enough to push the laggards to change. But if nothing else, they should provide a second opinion for health care organizations that think the old approach is good enough.

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