1. Health Platform Innovation
in an ‘Open’ Environment
Robert M. Kolodner, MD
Chief Health Informatics Officer
Open Health Tools, Inc.
& .
President, Collaborative Transformations, LLC
02/23/2012

2. Open Source “Stack”
Platforms &
Tools with
Reusable Faster to Market / Higher Quality
Components
Open Development Lower Cost for the Developer
“Apps”
Open Source “Free” Software for the User
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3. Health IT Characteristics
Now Future
• Vendor-driven market • User-driven market
• Compete on • Compete on
infrastructure adding value
• Restrict user choice • Maximize user choice
• Developer controls the • User controls the
“look-and-feel” “look-and-feel”
• Developer controls the • Users control the
workflow workflow
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4. “Square Wave Life Curve”
“To achieve this ideal, the
health system would have to
concentrate more on
wellness,
health,
prevention, and
just plain living,
bringing these factors into
balance with the attention
currently paid to diagnosing
and treating disease.”
From Michael M. E. Johns, “Panel on the Vision for Integrative Medicine: A Summary of the February 2009 Summit” in
Integrative Medicine and the Health of the Public: A Summary of the February 2009 Summit, Schultz AM et al., eds., 2009
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5. EMERGING CONCEPT:
A LEARNING HEALTHCARE SYSTEM 
A LEARNING HEALTH SYSTEM
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6. Institute of Medicine - 2000
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7. Carnegie-Mellon SEI Report - 2006
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8. Institute of Medicine - 2007
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9. Institute of Medicine –
“The Learning Health System Series”
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10. Institute of Medicine - May 2011
http://www.iom.edu/Reports/2011/Digital-Infrastructure-for-a-Learning-Health-System.aspx
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11. Health – A Systems Perspective
Patient
Healthcare Community
“System” & Society
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12. Health – A Systems Perspective
PERSON
Healthcare Community
“System” & Society
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13. Health – A Systems Perspective
HEALTH System
PERSON
Healthcare Community
“System” & Society
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14. 3 Health IT Dimensions
Personal
Health
Healthcare Population
Delivery Health
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15. A PLATFORM APPROACH TO OPEN SOURCE
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16. Open Health Tools Conceptual Architecture
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17. BUT PLATFORMS ARE NOT ENOUGH…
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18. 23 February 2012 Kolodner - Open Health Tools 18

19. How Technologies Progress
Markets are disrupted–and
products “go viral” that are
faster,
easier,
cheaper, &
more convenient
than previous ones
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20. IT Technology Evolution
HIGHER SKILLS
User
Controlled ?
Application
Programmer
MORE USERS
Controlled
Mainframe
Programmer
Controlled
Single Parallel Application
Application Applications Integration
LEVELS OF INTEGRATION
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21. Open Source “Stack”
Users Able to Self-Configure an
??
Integrated Experience
Platforms &
Tools with
Reusable Faster to Market / Higher Quality
Components
Open Development Lower Cost for the Developer
“Apps”
Open Source “Free” Software for the User
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22. Did You Know What the Future
Was Going to Look Like?
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23. Notable Quote – W. Edwards Deming
“You don’t have to change;
survival is not
mandatory.”
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24. Thank You!
Robert M. Kolodner, MD
rob@openhealthtools.org
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