Technology with teeth: #FHIR in the year of Trump and Brexit

For who hasn’t the time to watch the video of Grahame Grieve’s keynote at FHIR Developer Days 2016, here is a summary of the important things he had to say.

The central theme of his address is the FHIR community. What does it mean to be part of that community, what do you get out of it, and what’s the importance of the community for the FHIR standard?

The example of the medical profession works for health IT. There isn’t a clinician who thinks he/she is a good clinician, who is not a member of a professional society and who doesn’t contribute to that society.

What do you get out of getting engaged in the FHIR community, or in any community? What’s the business model? The business model is not about the bottom line for this year, but in three years time, when you retained your best staff.

Grahame proposes the – yet rudimentary – framework of an engagement matrix, that ranks the culture of engagement of any company and helps buyers in their procurement. If you score 0 to 2 in this matrix you are entirely focused on the short term, you won’t retain the best staff and customers will be screwed over. 9 to 11 means the opposite. [After the keynote Grahame announced a more elaborate blog on this subject.]

From a more general community perspective, it’s been a bad year. Not for FHIR, but because of what happened at the ballot box. We’ve seen populations turning away from openness, from engagement, form the community. This is counter to what FHIR is all about. This mentality shift is the single biggest threat to the FHIR community.

But Grahame Grieve is confident just the same:

“We’re open not because of some philosopy or culture, but we’re doing it because it works for what we’re trying to achieve. We’re doing it because it makes sense for our goals. We’re doing it because our values lead to outcomes that other people can’t create.”

Who will benefit from FHIR? “Give the data to the patient”, that’s nice for the digital literati but not for those who are too old or cannot afford a computer. FHIR was never just about getting the patients their data. Instead, the vast majority of patients will benefit from government controled back-end integration. Don’t get too extracted on getting the patients their data.

The final topic Grahame Grieve touches in his most engaged performance I have witnessed so far, is a phenomenon he calls alt-med. This, of course, is a variant of the dubious alt-right movement that has a reputation for being post-truth or post-fact. Facts no longer matter. Alt-med means people moving away from traditional healthcare, guided by rumours and false facts in social media. Getting good clinical information into social media is going to be a big thing for FHIR in the upcoming years.

The times we live in ask for technology that is a counterbalance to modern aberations: technology with teeth.

The video of Grahame Grieve’s keynote is available on our website.