I’m so old I actually learned to “word process” on a thing called a typewriter. When I truly learned to word process it was on a Franklin computer provided by the high school where I was teaching. Although you probably have never used a Franklin computer they were actually – briefly – famous in the mid 1980’s but not for their quality. Apple filed a law suit against Franklin for copying Apple’s operating system code. The outcome of that suit shouldn’t be surprising since you are likely reading this on an Apple product. Many other technology companies and products have come and gone since then. With each “death” people like me are left sitting in front of obsolete technology.
Fast forward to the EHR technology boom. When there are published lists of the “top 100 EHR’s” and approximately 600 different vendors, you can rest assured there will be some EHR deaths. Personally in my emergency department we are now moving to our fourth EHR. The first died before we even got it fully deployed. The second EHR was jury rigged for doctors from a nurse EHR the hospital deployed. The third one was guaranteed to be the latest and greatest. Now it is soon to just be the latest as we move to another greatest.
Watching the EHR market it seemed that one 800 pound gorilla was emerging and might be the safe place to hang one’s hat. Epic seems to be everywhere. I fully expected them to get the government DOD contract and be well on their way to Microsoft “status” in the EHR milieu, but they didn’t. EHR’s, like any technology, will come and go. And just like my school district buying Franklins – which worked as well as an Apple since it mostly was an Apple productJ – it is tough to always pick a winner.
It is a certainty that there won’t be 600 vendors left standing in a few years. In that sifting process there will be lots of people, clinicians, left holding their worthless products. For a large hospital or healthcare system picking a loser can be a costly mistake but one from which they can recover. However, for a small technology company or startup integrating with the wrong EHR could be deadly.
One benefit of the government mandated EHR’s is that they collect digitalized data. Part of the purpose of collecting the population health data is to better guide future care at reduced costs. The upside for new healthcare technology companies is that the data is generally easy to obtain from any EHR in the form of a report. These reports give a company the value of EHR information without integration. In other words, a new company doesn’t really have to pick an EHR “winner”.
For example, Incendant utilizes the reports generated by any EHR in a drag and drop process to enroll groups of patients into our patient engagement and monitoring program. We could be more “integrated” with specific EHR’s but why? The cost of integrating with each EHR could be prohibitive and they might not even be a company next week. Additionally, since the EHR vendors have a different objective – meet meaningful use requirements set by the government – they can be reticent to discuss integration. And finally, if a healthcare organization has been through EHR deployments, you can bet the IT department won’t be anxious to help with another integration and deployment.
EHR companies will have winners and losers. The future of new healthcare technology need not hinge on picking an EHR winner or loser. Utilizing the data (reports) generated by and available from any EHR gives a small, new company the value of “big data”. At the same time it does it without the headache and cost of integration while avoiding the gamble of having to pick an EHR winner.