Postmodern EHR

Traditional monolithic EHR architectures focus on stability and standardization at the expense of agility. Along with innovation, cloud based deployment and integration of things, agility is the main differentiator when describing the requirements of application architecture for the Postmodern EHR. Achieving agility is impossible for the vast majority of healthcare applications today as they are an inseparable mix of code for user interface, decision logic, workflows and data definitions. New architectures promote agility and reuse by turning the applications inside out and layering the four types of programming into portals, rule engines, process engines and XML data. Let’s look at some examples, layer by layer:

It seems the pattern is clear. From best of breed to integrated (mega)suite to a new world of innovative, agile, mostly cloud based and multivendor solutions. This is what Gartner calls “Postmodern”. According to Christensen, disruption like this becomes possible when the established players start exceeding the requirements and expectations of their customers, providing only sustaining innovation – i.e. adding more and more features to their products. This is what was happening in the personal productivity space with the Office products. Similarly, the ERP market today has well defined requirements and this allows the newcomers to disrupt, meeting the base expectations and adding innovation and agility while lowering costs.