We often see health care systems (and the IT in health care) as different and not comparable to work that has been done in other areas. However, I think there is a lot that we can learn from other industries.
Coordinating a billion lines of code
The Software Engineering Institute’s (SEI) report, “Ultra-Large-Scale Systems: The Software Challenge of the Future” sought to answer the question:
“As more and more systems become interconnected and have to work together, how do we manage an interacting code base that exceeds 1 billion lines of code?”
The reality is that different health IT systems (when they are connected together and interoperable) could collectively represent much more than 1 billion lines of code.
Ultra-large scale systems are not about a single software application, or a couple of applications working together, but rather an “ecosystem” of interacting software systems. In health care, small practices may have:
a billing systema clinical systememailweb portals, andother IT systems.
Most medical centers have 20 or 30 different computer programs that work together to take care of patients. Take 20 or 30 different programs, multiply that by the number of medium to large medical centers in the country, add in the small practices, and we are talking about thousands of programs that need to work together.
Building that from the top down isn’t going to work