"We should be using a method of evaluating quality measures; I became a lot less confident in our system of quality measures because I don't see the evaluation happening."
To understand how Trotter thinks, you have to immerse yourself in what has made open source, with its meritocratic ways, successful in IT. "Collaboration without meritocracy is communism,"
Trotter says. "You have to have a meritocracy, so if you and I were working together, and we get to have equal votes on what ideas get implemented, then we have a problem, because you get a hundred people in a room, the lowest common denominator will always get the vote. If you look at HIMSS and the American Medical Association, any of the big associations, unfortunately, the lowest common denominator is what those organizations very frequently spew out. The exact opposite happens in the open source community."
With all the challenges still ahead for healthcare IT, count on Trotter to be raising those skeptical eyebrows a bunch more, and then getting back to work and urging others to join him.