Exploring the Emergence of Open Platforms in Healthcare: Design Considerations and Experiences from an Initial Case in Norwegian Primary Care

Abstract

Despite significant efforts on improving interoperability of health information and lowering socio-technical cost of replacing clinical applications, healthcare organizations and professionals struggle with fragmented and non-interoperable Health Information Technologies. This paper describes the emergence of open platforms, which may alleviate challenges related to interoperability issues, weak integrations, siloed data repositories, and numerous legacy systems within healthcare. Using a proposed platform initiative in Norway, we explore the open platform phenomenon with a socio-technical lens, and highlights four key topics that have produced tension and merits consideration from the involved stakeholders: i) Procurement strategy and vendor neutrality, ii) Ability to facilitate flexible use, iii) The use of standards and separation of data and application, and iv) Strategies for development and governance of standards. We further discuss the related implications and design considerations necessary to support complex patient pathways and provide clinicians more flexible and effective systems.