Jeremy Bikman from KATALUS Advisors wrote this interesting comment on a LinkedIn discussion I was participating in:
Perhaps there is a place for MUMPS but only if healthcare continues to thumb its nose at the prevailing technology trends. It’s hard for me to envision healthcare to continue to embrace a technology that doesn’t like to play nicely with other non-MUMPS systems. If there were real advantages to it you would see a fair number of high tech firms utilizing it (Facebook, salesforce.com, Twitter, Spotify, etc).
If your goal is to have an enterprise system with a database that has some scale to it and certainly has good speed, and you don’t really care about interoperability with other systems, then MUMPS is certainly a good viable option. But IMO, the days of healthcare IT being insular, and moving out of phase with the rest of the tech world, are numbered.
I found this comment incredibly interesting. Mostly because I’ve never personally believed that the fact that many of the larger healthcare IT and EMR systems are built on MUMPS was any part of the reason why healthcare entities aren’t interoperable. I’m a tech guy by background, but I’ve never worked on a MUMPS software system myself so I don’t have first hand knowledge of MUMPS in particular. However, it seems wrong to “blame” MUMPS on the lack of healthcare data interoperability.
I guess the way I look at it is that no matter which database back end you have, you’re always going to need some front end interface to take care of the transport of the healthcare data to another system. Is this any harder with MUMPS than another SQL or even NOSQL database? From my experience it shouldn’t matter. I’d love to hear if there are reasons why it is harder.
I also don’t want to give the impression that Jeremy is trying to say that MUMPS is the only reason that healthcare IT has been so insular and closed. I’m pretty sure he agrees with me that a lot of other factors that have stopped healthcare from sharing data. I just don’t believe that MUMPS is one of those reasons.
Of course, the question of whether MUMPS should continue in healthcare is a different question. In fact, I wrote about MUMPS in healthcare IT and EMR here.
What are your thoughts? Is MUMPS the problem with healthcare interoperability? What are the other reasons stopping healthcare interoperability?
Update: Jeremy Bikman provided the following clarifying comment in the comments of this post:
Good points John. I really should have clarified. MUMPS is not really the issue (although I still stand by my assertion that if it was such a superior technology you’d see it all over Silicon Valley, RTP, etc). The main issue is really with the walled garden (w/ razor wire and machine guns along the top) approach of the major EMR/HIS vendors that have it as their foundation.
The more control you exert over your clients and the harder you make it to connect with other systems, the more money you can make…at least in the short-term.
John’s thought: I still look forward to the discussion around MUMPS and interoperability and healthcare interoperability in general.