Will clinical groupware get beyond the buzzword stage

There's no such thing as a clinical groupware system a doctor can buy now, and the clock is ticking.

There's a new buzzword in health IT. Clinical groupware.

A new group dubbed the Clinical Groupware Collaborative describes it in a white paper as "supporting the Internet as a platform for standards-based Health IT applications delivered as modular and interoperable applications and/or services."

The hope is that the cloud can halt a squeeze now facing family physicians.

Hospitals and other controlling stakeholders in small practices are offering hardware and software they say delivers on the promise of meaningful use and that sweet, sweet stimulus cash.

But there's a catch. You're tied to the vendor who got you the stuff.

This isn't good enough for reformers like Brian Klepper and David Kibbe. They want "network available services," as Tim O'Reilly calls them, so doctors aren't tied to hardware, software, or the lock-in of people behind those offerings.

These new Web-based platforms allow distinct functions to interact with and leverage one another, creating a robustness of capability and productivity that was unthinkable in earlier, more limited hosted arrangements. Thinking of these platforms as merely running remotely-hosted applications is to miss their possibilities. Clinical Groupware, a very powerful and practical medical application of this model, is the revolution ahead that will foster intense competition among vendors vying for platform real estate.

The promise is great, but there's an inconvenient truth, namely the timing of clinical groupware's arrival on the scene. As Kibbe and Klepper note, this stuff doesn't exist yet.

Geekdoctor John Halamka at Harvard has just gotten a grant to look into network-platform architectures. There are bits-and-pieces of solutions at SaaS companies like Allscripts and Practice Fusion, and in the iPhone app store.

He calls it what he is studying "SMArt” (Substitutable Medical Applications, reusable technologies) architecture." Another good buzzword.

But there's no such thing as a clinical groupware system a doctor can buy now, and the clock is ticking. The first meaningful use deadline requires that systems be working for six months by the fall of next year. Waiting for perfection is always the enemy of the good in technology.

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