JUN 23, 2014 6:49pm ET

A Real Enterprise Approach

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HIT leaders frequently tell us there's been a sea change in their relationships with board and top C-suite executives. After years of trying to get heard, the head honchos now "get it" technologically, acknowledging the mission-critical importance of IT through increasingly large investments.

However, a number of recent conversations I've had with CIOs and other health informaticists gives me the sense that there are still disconnects between executives and IT professionals about what "enterprise computing" means.†

Delivery systems and hospitals increasingly are becoming shops for enterprise vendors that can bring an entire suite of information systems to the table, led by a flagship electronic records program. I haven't heard of many cases where that goes smoothly. Typically, committing to enterprise IT means many user-friendly and sophisticated systems have to be swapped out for less functional ancillary systems that require enormous resources to get up to speed.

Equally important, it means whole swaths of established HIT vendors, many of which are true innovators, are being frozen out of the market, not to mention start-ups offering unique solutions that can't fit into an enterprise IT environment.

I recently interviewed Stan Huff, M.D., chief medical informatics officer at Intermountain Healthcare, about his efforts to spearhead a consortium of providers, vendors, integrators and others that will focus on building a standards-based services architecture to enable applications to work on any "enterprise" platform.

Huff, like many others, is frustrated that his organization can't easily plug decision support and other applications into its environment-to pursue an enterprise computing approach beyond an enterprise platform. He's quick to note there are no bad guys here--enterprise vendors are offering value to their customers, but that value is limited if those platforms don't enable innovative applications from other vendors to be embedded into clinical operations.

What's needed, he says, is a new paradigm in which the whole ecosystem of software is available and not limited to applications that have to pass through a single enterprise vendor. It's a rethinking of what "enterprise computing" means, and it's a technological and strategic shift that needs to happen if the industry is going to continue to advance for the benefit of all patients. (Click here to read my full interview with Dr. Huff.)

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