Then there was the process by which Trotter and coauthor David Uhlman arrived at the title for their book, Hacking Healthcare: A Guide to Standards, Workflows, and Meaningful Use.
"We debated that issue, who was going to be pissed off by this book title," Trotter says. "We spent a lot of time thinking about that, and then we came to the conclusion that all the right people would be pissed off by that title. So we decided that we would move forward under that rubric. So yes, there are people who don't like the title and don't like the thesis, and in general, I find that completely and utterly okay."
Trotter is bullish on the future of crowdsourcing healthcare IT. "I just realized, way back when I was doing my very first systems, that I wasn't the smartest person I knew who was working on the problem I was working on, and that I wanted to collaborate and be ruthless about collaboration," Trotter says. "I always did everything I could do to get my work out there in front of people who I thought were smarter than I was."
Like a lot of open-source advocates, Trotter struggles with IT seesawing between setting standards to promote interoperability and promoting innovation through open-source projects. "It's a curve ball for the whole healthcare system," he says. "MITRE [a not-for-profit organization that operates research and development centers sponsored by the federal government] did an analysis which showed a fairly reasonable correlation between the complexity of the clinical quality measures and the rate at which they were adopted in the EHR developer community. More studies need to be done on that.