Why our healthcare IT landscape looks like ancient China

May 16, 2016
Nick Hatt Staff Software Engineer, Tech Lead

The thing that healthcare IT and ancient China have most in common? Most people in the United States have no idea about how either work. The second? There is a lot more nuance than even scholars of both fields know.

Chinese history is both writing and rewriting itself at the same time. Recent archaelogical discoveries call into question long established traditions and myths about China two thousand years ago.

Likewise, the true nature of the beast of healthcare IT is constantly shifting, from MU to “Information blocking” to FHIR being the next big thing.

Warring States

A passing survey of recent Chinese history would have you believe that China is one big country and has been for quite some time. The reality is that China resembled Europe at one point: a collection of diverse states with different languages and traditions. They were brought together mostly through force, and intimidation.

Today, the narrative of the past is promoted today by the Communist Party, which idealizes a neat past of filial piety and harmony, a harmless, fairy-tale world, anesthetized and dull.

Much the same is the way our industry news and the ONC looks at the interoperability problem. It’s a fairy-tale world when vendors have all the control in the world. The reality is much different: health systems hold all the power, actively compete with each other, and hold all of the keys to making interoperability work.


When you take a look at an EHR it’s an insanely complex piece of software. There is a reason why they take millions of dollars and years to install. You need manpower and time to get everything perfect. Every workflow in every department is scrutinized and refined.

And making interoperability work? That takes people and time (and money) too. I’ve used LOINC codes as an example on this blog before. To get LOINC usage to a place where it helps interoperability Each health system has to:

An EHR vendor can support a lot of stuff, but you need to go into eachfiefdom to turn it on.

I’m particularly lucky to work with the best people in the business at dealing with the 特色 of each health system.


China united with war and bloodshed. Healthcare won’t go down the same way. Top-down policies will force vendors to comply, but features won’t get used unless there is actually demonstrable money/productivity gains to be had.

This means the path forward will still be tough for the near term, but Redox is well equipped for the expedition. Think of us as your emissary, and instead of carrying a tribute to an emperor we have BAAs and Security Checklists.

干杯🍻👲 嵩山.

Stay in the know! Subscribe to our newsletter.