Open standards vs vendor lock-in: what does this mean for your healthcare organisation?
In Dutch healthcare, organisations face a fundamental choice: invest in systems built on open standards, or stick with closed platforms and vendor lock-in. This choice determines your flexibility, costs and future-readiness for years to come.
What is vendor lock-in in healthcare?
Vendor lock-in is the situation where a healthcare organisation becomes dependent on a single software supplier. The systems, data formats and integrations are so intertwined with that one supplier that switching to an alternative becomes disproportionately expensive and complex.
In practice, this means your EHR, care planning software and billing system all come from the same supplier, or only communicate with each other via proprietary connections. Your data is locked inside a closed ecosystem.
How do healthcare organisations recognise vendor lock-in?
High switching costs. Migrating to another system costs more than the original implementation, because data is stored in proprietary formats.
Limited integrations. Integration with third parties is only possible through the supplier, often at additional cost and with long lead times.
Price increases without alternatives. Annual licence costs rise, but switching is too expensive to seriously consider.
Innovation stagnation. The supplier dictates the pace of development. New features arrive when it suits the supplier, not when the healthcare organisation needs them.
10+
IT systems per healthcare institution
Source: Nictiz eHealth-monitor 2023
40%
Time spent on administration
Source: Berenschot/NZa 2023
20-40%
Additional costs with lock-in
Source: Gartner IT Contract Analysis
What are open standards in healthcare?
Open standards are publicly available specifications for how systems exchange data. In healthcare, the most important standards are FHIR (Fast Healthcare Interoperability Resources), HL7 and REST APIs. These standards enable systems from different suppliers to communicate seamlessly with each other.
The difference is fundamental: with closed systems, the supplier determines how data is stored and exchanged. With open standards, this is a shared agreement, allowing any supplier to connect.
FHIR (Fast Healthcare Interoperability Resources)
The modern standard for healthcare data exchange, developed by HL7 International. FHIR uses familiar web technology (REST, JSON, XML) and enables the standardised exchange of patient data, medication, lab results and more between systems.
HL7 v2/v3
The older, widely implemented messaging standards for healthcare communication. HL7 v2 is the most widely used standard in hospitals worldwide and facilitates the exchange of ADT messages, lab results and referrals.
REST APIs
Standard web interfaces that allow applications to request and send data. REST APIs form the technical foundation on which FHIR is built and make integration accessible to any developer.
Comparison: open standards vs vendor lock-in
| Criterion | Open standards | Vendor lock-in |
|---|---|---|
| Supplier choice | Free choice, easy to switch | Tied to a single supplier |
| Data ownership | Data in open formats, always exportable | Data in proprietary formats, difficult to migrate |
| Integration costs | Standardised, predictable | Per connection, often unpredictable |
| Innovation speed | Best-of-breed, rapid adoption of new tools | Dependent on a single roadmap |
| Wegiz compliance | Compliant by nature | Adjustments required, uncertain timeline |
| EHDS readiness | Prepared for European data exchange | Risk of incompatibility |
| Total cost (5 years) | Lower TCO through competition and reuse | 20-40% higher TCO due to dependency |
The comparison paints a clear picture: open standards offer advantages for healthcare organisations on every criterion. Vendor lock-in may appear simpler in the short term (everything from one supplier), but the long-term costs and risks are considerable.
Regulation mandates open standards
The choice for open standards is no longer merely strategically wise — it is becoming a legal requirement. The Wet elektronische gegevensuitwisseling in de zorg (Wegiz) mandates that healthcare systems must be able to exchange data via standardised, open protocols.
Wegiz (Electronic Data Exchange in Healthcare Act)
In force since 2023. Mandates phased electronic data exchange via open standards. Suppliers that only offer proprietary connections do not meet the legal requirements.
IZA (Integrated Care Agreement)
The IZA emphasises regional collaboration and digital data exchange as pillars for future-proof healthcare. Organisations locked into closed systems cannot effectively participate in regional networks.
EHDS (European Health Data Space)
The European regulation for cross-border healthcare data exchange. Expected to be phased in from 2026-2028. Organisations investing in open standards now are prepared for European interoperability.
How do you choose a future-proof approach? The CareHub approach
The CareHub ecosystem is built from the ground up on open standards. No vendor lock-in, but an integration layer that connects your existing systems via FHIR, HL7 and REST APIs. You retain freedom of choice and can replace individual components at any time without disrupting the whole.
Not replacement, but connection
CareHub does not replace your existing EHR. It connects your systems via a single integration layer, so data flows seamlessly between all applications.
Best-of-breed freedom of choice
Choose the best solution per domain. A specialised mental health system alongside a home care planning tool alongside a telemonitoring solution. CareHub ensures they work together.
Wegiz-compliant by design
All connections in the CareHub ecosystem use FHIR and HL7. You automatically meet the Wegiz requirements without additional investment.
Future-proof for EHDS
CareHub's open architecture is prepared for the European Health Data Space. Your organisation will be able to seamlessly connect to European healthcare networks.
Frequently asked questions
Can we switch to open standards without replacing all our systems?
Yes. An integration platform such as CareHub acts as a middleware layer on top of your existing systems. You do not need to replace any systems. The integration layer translates your current data flows to open standards (FHIR, HL7), making your systems interoperable after all.
What if our current supplier does not support open standards?
The Wegiz requires suppliers to work towards open standards. If your supplier does not comply, that represents a risk for your organisation. An integration platform can serve as a bridge whilst you gradually transition to suppliers that do support open standards.
Are open standards secure enough for healthcare data?
"Open standard" does not mean "open data". The standard describes how data is exchanged, not that all data is publicly accessible. FHIR has built-in authorisation and authentication mechanisms (OAuth 2.0, SMART on FHIR). Combined with NEN 7510 and GDPR compliance, data exchange via open standards is at least as secure as via proprietary connections.
What does the transition to an open-standards architecture cost?
The initial investment varies per organisation, but is generally lower than a full system migration. Because open standards enable the reuse of connections, integration costs drop significantly after the first implementation. Over a 5-year period, the total cost of ownership (TCO) is 20-40% lower than with vendor lock-in.
Ready to leave vendor lock-in behind?
Discover how the CareHub ecosystem connects your healthcare organisation via open standards. Without replacing your current systems.