A call to mainstream health IT
After 25 years following the technology industry for a living I have detected a pattern.
Niches are developed, then enveloped, then absorbed.
New, expert companies are needed to do the incredibly hard and valuable work of adapting what is offered by the computing mainstream to the specific needs of real customers.
One of the first examples I remember is desktop publishing.
I held a party at my home back in 1984, where two young publishers were looking for a niche they could grow with. I suggested it to them, even suggested the name.
I deserve no credit. They did the hard work. They earned the rewards. But over time desktop publishing became mainstream computing. Some vendors moved up-market, turning magazines and newspapers into desktop publishers. My friends went on to other work, into other niches, like music and video.
This happens in industrial markets as well. I've seen it in warehousing, and banking, and legal work. Over time the vendors who begin in these niches either become giants themselves, like Adobe, or they are absorbed by giants.
Medical computing is incredibly complex. Sometimes this is accidental -- an MRI file can be enormous. Sometimes this is deliberate -- HIPAA is the law.
The companies that built HIMSS were specialists at this kind of thing. Some started in the mainstream and retreated into the medical niche. Others were launched specifically to serve that niche.
But to grow enough and become mainstream the health IT niche, like all niches before it, must be absorbed into mainstream IT.
Some of this is already happening. The HIMSS show I attended in Orlando, back in 2008, was a coming-out party of sorts for both Microsoft and Google. Many of the headlines concerned the two firms' launch of personal health record systems -- Healthvault and Google Health.
But Microsoft was also launching a hospital computing system that would soon be named Amalga at that show, and IBM had a large booth as well.
Still the industry was, and is, dominated by specialists like Cerner, McKesson, Siemens and GE. Some are big companies, but these are not the computing mainstream.
The computing mainstream is companies like Microsoft, like Hewlett-Packard, like IBM and Dell. The mainstream must envelope and absorb the niche in order for the niche to become mainstream.
All this is complicated by government mandates. But it is not made impossible by them. Absorbing the specialists into the mainstream is one way this can happen. That's the trend to watch.
But the trend is set.