Healthcare Interoperability – Learning From Proprietary PC History

Interoperability; Some vendors have the unmitigated gall to try and keep their systems proprietary. When they refuse to make code or training available to others, competition will have difficulty achieving interoperability and customers will not be able to move too far from the vendor and their own profitability is secured. Competition is greatly reduced.  Capitalism at its finest.

A long, long time ago in a land far away, 4 vendors in the minicomputer and PC markets attempted to do just about the same thing. Wang, Data General and Digital Equipment were almost totally proprietary. Interoperability was little more than a dream. Proprietary would secure success.  The fourth company was the leader in the PC world. They also were not able to communicate with competitors and vice versa. For years, IBM compatible meant the difference between success and failure. Why? Try profit. If you control a market and can keep others away, profits remain high.   After a time, as with IBM there will come a time that giving up the proprietary nature of the product will cause an increase in sales and profits.

Throughout the 80’s and 90’s IBM’s competitors and some large users complained bitterly about all four company’s proprietary nature. The 3 minicomputer companies “bet the farm” that they could succeed by being proprietary. IBM did the same. The rest is history. One won and three lost.

Epic is in the same boat as those four. Being proprietary is increasing their profitability currently.  As time progresses will Epic decide that the time is right to allow the competition access to their product and code and, like IBM, will they do it at the right time to remain the market leader.  Any bets?

About the author


Paul Smith


  • Interesting comparison. I think we’re starting to see the same thing play out for Microsoft. Proprietary has served them well for a long time. I think it will serve the Epic’s of the EHR world very well for a long time too. It’s a lot harder to switch a multi hundred million dollar EHR out than a set of PCs.

  • Do you think ACA – under that law epic has to give access to patients. Epic can’t refuse patients?
    Do you think Epic will try to change the law under republican congress?

  • Paul might have different thoughts on this subject, but Epic does give the data to the patients. Although, there are a lot of ways to give data to the patient. Plus, the bigger issue is getting that data to all a patient’s doctors. Many patients don’t want to be there own patient data exchange.

    I don’t think Epic will do anything different from what they were doing before, so I don’t think the republican congress will make any difference. In fact, Judy (CEO of Epic) was an adviser and supporter of Obama, so if anything they’re less influential now. Although, they did just hire a lobbying firm. That seems more like part of their effort to win the DoD contract though.

  • Only reverse-engineering of the IBM BIOS allowed the first successful PC (Compaq) to be created, and not with IBM’s blessing, to say the least.
    Your story as an example is just as valid, in my opinion, because what are the odds someone will reverse-engineer your IP at just the right time to keep you as the market leader?

Click here to post a comment