Summary
Medical device interoperability is improving under such efforts as the IHE initiative, but structural issues remain in the way of more complete integration. Comparison to the iPod is interesting in that consumer electronics are far more targeted to the consumer holistically than the medical industry with its myriad divides between stakeholders and within stakeholders. Manufacturers organize as a mirror of their customers, which tend to be fragmented and isolated with respect to the overall health outcome of the patient. Rather than optimizing designs based on the overall health outcome, devices are optimized to maximize the business case for purchasers of that device by itself. Manufacturers will reorganize to meet the needs of integration as the customers place a value on it. However, the vendors will pace their development of higher integration with the pace at which the customer community restructures itself so as to place a value on it, no faster.
Analysis
Generally speaking, P&L responsibility is at the level of individual units responsible for providing the highest return for their unit, which relegates interoperability between products that cross boundaries to a second-tier priority. In fact, it is often seen as a cost to the business model rather than as a way to maximize financial performance. Technology development will help, as it is increasingly possible to build solutions across the various divides that have historically fragmented the solution space. These advances include core technology such as multi-modal imaging and even fusion between imaging and non-imaging devices, as well as IT capabilities to allow practical implementations of concepts which have been desired for some time but not supported in the base technology. Many companies are increasingly speaking in terms of the care cycle and other means of describing a more holistic approach to device and solution design. However, this has often been viewed more as a marketing exercise rather than as a fundamentally new organizing principle. It is increasingly important to allocate more funding to such programs vs. the traditionally separated development budgets, to provide adequate resources for these initiatives to grow. More profoundly, it may soon be the team to reconsider the way P&L responsibility is allocated across executives, to place increasing motivation to optimize solutions related to overall health results as a whole instead of individual procedures. Arguably, it is the company that anticipates this inevitable move in the environment that will have the most to gain by it as it takes place, leaving those who have not yet understood this to shrinking market shares and decreased financial performance.
