‘Feral systems – we can’t just pretend they don’t exist’

Tomaz Gornik, Marand

(HealthTech Wire / Interview) – Tomaz Gornik, co-founder of health IT solutions provider Marand, talks about feral information systems and the need to find ways to build them in a controlled manner, rather than burying our heads in the sand and pretending they’re not there

What are feral information systems – and why does today’s CIO need to be fully briefed about them?

Feral systems are software solutions developed by individuals or groups to help with day-to-day activities. They are called feral (or “wild”) because they are used in addition to existing systems and they work around key system architecture - more often than not, without the blessing of management. On the positive side, because they are driven by end users, feral systems fill many gaps, solve real problems and can also be very innovative. All organisations have some - many some several hundred - and they are often essential for users to carry out their daily work.

What drives the end user to create a feral system, rather than use the mandated enterprise system?

Many times, the user has a need for functionality that is not supported by current systems. The first step is often to talk to IT and see if they can get new features added to their current systems. Often this is either too costly, too late or not even possible, perhaps because it is not on their vendor’s roadmap. Since the functionality is very important for the user, they have no choice but to find their own solution.

Are there any dangers of feral information systems that CIOs need to be aware of?

There are. Compliance and lack of governance is one. How can a CIO ensure these systems comply with regulation? In healthcare, security and data privacy need to be ensured. How do you do that if you have no control over how the systems are built? Also, what happens when the user responsible for the application leaves? In short, feral systems are often not managed properly and thus pose serious risks to organisations.

Feral systems will not go away, since they fill a very real need. So we need to find a way to build them in a controlled manner without compromising their biggest benefits – innovation, flexibility and speed of development. In healthcare, we need what I call the Postmodern EHR – a platform approach with a well-defined, vendor-neutral data layer and open, easy to use APIs. It enables us to build new applications quickly while ensuring the data is shared between applications and managed properly. And even if an application is retired or replaced, the data stays to be reused. Applications built on a platform then replace the feral systems of today while keeping their advantages.

I should imagine that this is quite a challenging and sensitive topic for the CIO to deal with? Have you any tips on how they might broach the issue within their healthcare organisation?

It is one of the key challenges facing today’s CIO. We can close our eyes and pretend they do not exist. But as mentioned above, feral systems pose serious risks to organisations. Obviously the first step is to catalogue them to understand how big the problem is. The next step is to define a strategy on how to build these applications in the future and how to eventually migrate the existing ones.

Is there anything else that you think particularly important to mention to HealthTech Wire readers on this subject?

There is no denying that the software architectures, particularly the monolithic megasuites we use today, struggle to cope with the demands of innovation, flexibility, ease of use and time to market that our businesses expect. This means that change is imminent.

The Postmodern EHR concept is based on shrinking of the core EHR and surrounding it with smaller, innovative, mostly cloud based applications and apps. This requires integration which is easy to achieve if these applications are built on a common set of APIs accessing the same data.  

At Marand, we provide Think!EHR Platform – a vendor-neutral health data platform with easy to use APIs and a set of tools to quickly develop new applications. The key thing about our platform is that it manages data in a vendor-neutral format, preventing lock-in thus fostering a multi-vendor environment. For example, our largest customer, the City of Moscow, uses the platform to centrally manage health data of its 12 million citizens. They use many applications from different vendors which all work off the same data by using the APIs provided by the platform. If they need to replace an application (or vendor) it does not affect the data itself. And, most importantly, this data is centrally managed, validated and secured.

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Marand

Marand’s vision for healthcare IT is coined as "Integrate. Open. Innovate." Think!EHR Platform™ is well aligned with this vision as it uses IHE-based standards to integrate existing devices, systems and data. By storing data in an open, vendor-neutral format it enables ecosystems of vendors to innovate. This approach is fuelling next generation solutions known as the Postmodern EHR.