Content vs. Technology
In reflecting on the purchase of most of the assets of LucasFilm, Ltd. including the beloved Star Wars space opera by The Walt Disney Company, (http://www.rollingstone.com/movies/news/disney-buys-stars-wars-plans-new-film-20121031) I find myself pondering the conundrum between content and technology. Content is what made us fall in love with the original Star Wars Trilogy: Episode IV: A New Hope; Episode V: The Empire Strikes Back; and Episode VI: The Return of the Jedi. Sure there were, for the time, dazzling computer-motion-control space battle film sequences, and out-on-the-1977-edge special effects but the technology, in this case, only served to underscore Lucas’ creative vision, the raw humanity of the lead characters, beloved mainly due to their very-accessible flaws, and the ageless fairy-tale quality of the storyline. In brief, there was a harmonious balance of content and technology. Then Episode I: The Phantom Menace and Episode II: The Clone Wars launched and the technology was the primary discussion topic. The first movie shot completely on digital video, the human-motion control apparatus that made the annoying Jar Jar Binks CGI more life-like (and blazed a trail for Andy Serkis’ brilliant portrayal of Gollum in The Lord of the Rings via a later generation of the technology), and some entire CGI backgrounds that were stunningly lifelike without any template real-world shots behind them. Critics panned the acting and storyline, while unrepentant fans like me lined up at midnight anyway (now with our own kids in tow) to see the openings. It wasn’t until Episode III: The Revenge of the Sith, that the “second trilogy” redeemed itself with the blend of content and technology that was the hallmark of the first trilogy.
How does this all relate to the sustainable enablement of Healthcare Information Systems? Well, thinking about Star Wars got me thinking about the almost cyclic churn of content and technology in our MEDITECH-centric Universe. (No pun intended.) It’s almost a chicken and egg discussion – which came first, the content or the technology? In the case of MEDITECH, from my perspective, there has always been a linkage between the demands of the content and the creation of the technology. Laboratories need real-time information systems that could keep up with testing better than batch-based processing, so Mr. Pappalardo et als develop MUMPS at MIT. Home-run serial cabling becomes a limitation on the deployment of a MEDITECH Integrated Information System (MIIS) so a distributed terminal server management and Ethernet-friendly networking protocol emerge as part of the MAGIC release in the 1980’s. A way had to be found to highlight clinical content better so MEDITECH worked with Esprit systems in 1985 to develop their own color terminal and character graphics to complement the MAGIC operating system and an ever-expanding suite of MEDITECH technologies moving the HCIS closer to the physician. I still run into a lot of people who loved and miss the old DG handheld nursing data entry device – invented for a specific purpose by MEDITECH and DG, to which it was very well suited.
If there is a lesson here, it is perhaps the simple lesson that technology created to serve content in a specific and meaningful way always looks, feels, and seems “friendlier” than technology for its own sake. Just watch your teenager, if you’re lucky enough to have one hanging around - play a game on the Xbox versus on a PC. One is involving, intuitive, almost becomes a full-body experience – the other is a more detached, cerebral, 3rd-person experience – and the Xbox is typically 25% the cost of a PC! Many Apple Computer products have been classic examples of this, with very specific aspects of the technology design of a Mac aimed at making it a better platform for managing publishing, audio, and video versus the “general platform” design of a Wintel PC.
Technology for its own sake sometimes leads us down blind alleys. The market pushed MEDITECH very hard in the 1990’s to join the Windows world and gained a little bit in “openness” but lost a lot in terms of the stability, manageability, and efficiency of the MAGIC product. The end result ultimately satisfied the end users, but at a significant price in technology infrastructure and IT management. One could argue too much effort was expended accommodating the technology rather than enhancing the content. Although by trade I’m more of a “data plumber” than an applications guy, I was personally encouraged to see MEDITECH using the 6.0 technology platform not only as an evolution of clinical content and workflow but also as a giant stepping stone to the web. Web technology is the common language of our era, and bringing content to the web format multiplies platform and device choices while also easing the uptake of new applications and workflow by healthcare users. It effectively gets the technology out of the user’s way and lets the content shine through.
As we watch both the applications and the technology evolve, our consultants, engineers, and designers at Park Place International all understand that their role is to build sustainable environments that elevate the richness of MEDITECH’s content and the value of the clinical and administrative data by getting the technology out of the way. Arthur C. Clarke, the noted science fiction writer, said: “any sufficiently advanced technology is indistinguishable from magic.” That’s what we’re going for – that feeling that “poof – it works!” – and that’s all that really matters in the end. Wouldn’t it be just one of those odd cosmic things if Star Wars Episode VII and MEDITECH 7.0 debuted the same year?
Jim Fitzgerald is Executive Vice-President and CTO of Park Place International. Jim had to repair so many of his toys as a child that his mother began thinking he had broken them on purpose. We are happy to report that our technologists work to much more stringent RPO/RTO’s.