Medical Device Interoperability: Collaboration is the New Competition in the Connected Health Ecosystem

By Santhosh Nair

Santhosh Photo

A hospital is one of the most complex ecosystems that exist today. Nowhere else exists a more diverse array of players, devices and standards as a hospital. Information must flow seamlessly through the hospital ecosystem, and this needs to be sustained through the life of the patient, for treatment and care to happen in a meaningful manner. The bar for safe and effective use of devices is very high, which is why so few devices make it to market – and why many devices fail after market.

Enter medical device interoperability.  This week I spoke at the Medical Device Summit in Boston on the topic of interoperability, and it is clear that it is a very hot topic in the healthcare segment right now.

There are many definitions of medical device interoperability, but I define it as the ability of medical devices and healthcare systems to interact seamlessly with each other in order to enable better healthcare outcomes. Achieving interoperability requires: the adoption of standards, being safe, secure and connected across the ecosystem of the hospital and home, seamless integration of information through healthcare and telecom networks, and reducing the variability in workflows for treatment so as to enable a positive health outcome at the most optimal cost.

Interoperability is critical in the medical segment, but the industry has been slow to embrace it.  We live in a connected world, where data is ubiquitous; interoperability is table stakes in every other industry except healthcare. If planes, trains and automobiles can meaningfully interact and operate safely within their respective infrastructure, why can’t medical devices? Lack of interoperability is translating into skyrocketing costs and complexity in the medical industry, and is a huge roadblock to innovation in medicine.

In order to understand the barriers for interoperability, we need to look at the forces at play here. In order to ensure interoperability, three market forces need to come together.

  1. Enforcement: Regulators, healthcare delivery organizations and standards organizations must collaborate to increase the pressure on complying with the standards.
  2. Incentives: We need to devise an incentive system where a device manufacturer benefits from designing an interoperable system that works well with others. Let’s face it, this industry is an oligopoly and is extremely competitive. By its very nature, there is no incentive for one device manufacturer to connect well with another. Hence, the very system needs to be redesigned so as to nudge the device manufacturer to be interoperable. Interoperability is not where innovation happens, innovation happens at the application layers and that is where the value lies for device manufacturers.
  3. Vertical Integration: Because of the history of this industry, many of the players are vertically integrated. This causes inefficiencies and raises the costs for these manufacturers. For interoperability to be successful, it needs to be pushed down a level in system design. Once standards are defined, there is no creativity involved in implementing them – because they can be bought from an off-the-shelf supplier of standards (think TCP/IP stacks, nobody writes their own any more).

These three forces need to come together to tilt the balance in the right direction. Device manufacturers need to put more onus on their suppliers to build interoperability standards as plugins that they can adopt, as opposed to developing them in-house. This will reduce variability and allow manufacturers to focus on applications they can build around connected devices. It is important to work with suppliers that can offer support with evolving interoperability requirements throughout the lifecycle of a product.

Wind River is working with an organization that is developing these standards and we hope to make this available as part of our standard medical middleware stack.  Lots of exciting developments to come – I’ll keep you posted!


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  1. Dave

    Interoperability among medical devices has been a “very hot topic” for at least 15 years, which is how long I have working in the industry. Defining a standard that accommodates all the different types of medical data unfortunately results in bloated protocols that are costly to implement (both in terms of dollars and performance). Even the attempt my former company made to standardize communications among its own products fell victim to the desire to optimize performance for individual devices. I think this topic will continue to be “hot” for many years to come, but I would not hold my breath waiting for a solution!

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