In my post about FHIR + Iguana = Profit I made a passing mention of an important event in Amazon’s history from back in 2002 – give or take a year or so.
Jeff Bezos issued a mandate:
- All teams will henceforth expose their data and functionality through service interfaces.
- Teams must communicate with each other through these interfaces.
- There will be no other form of inter-process communication allowed: no direct linking, no direct reads of another team’s data store, no shared-memory model, no back-doors whatsoever. The only communication allowed is via service interface calls over the network.
- It doesn’t matter what technology they use.
- All service interfaces, without exception, must be designed from the ground up to be externalizable. That is to say, the team must plan and design to be able to expose the interface to developers in the outside world. No exceptions.
He finished his mandate with:
Anyone who doesn’t do this will be fired. Thank you; have a nice day!
It was an extremely smart business decision. With this mandate Jeff Bezos set the foundation for transforming Amazon from a bookseller into a multi billion-dollar cloud-computing powerhouse. This is where is it all started.
It’s an exquisite business lesson in teaching us what every Fortune 500 company in healthcare needs to do. We dobusiness with just about all of you. And you all have exactly the same business problem.
You grew your businesses by acquisition. Your products have different data models, are built on different technologies, at different times by different teams. You have too many products and not enough engineers. You are all spinning your wheels with your internal integration pain.
I have talked to generations of interoperability teams at practically all the big vendors in healthcare. It’s funny how much faith seems to be placed in standards and centralizing interoperability. The first hope was that somehow Version 3.0 and the RIM was going to solve the pain. That was never going to be the case. There was no way that any of you would have the resources required to rewrite all your products to be compliant with any single data model; even if it was a great model.
The new faith is that somehow that the IHE profiles will sort things out. Sorry, that’s not going to work either.
Somewhere, somehow, someone important in one of these companies is going to read this blog. Synapses will spark and one of these giants will awaken. The right edict will go out. And for all the competitors? Watch out; you are about to be out-evolved. It will take a couple of years but the first large healthcare IT player to get their internal API-house together will have an overwhelming competitive advantage.
(And with a bit of luck your competitors won’t read this blog and will try and implement FHIR)
(Oh and to talk to all those legacy systems using HL7 from your competitors that you will be replacing: Use Iguana!)
