The EMR Race is Over, Long Live EMR Extender Tools!

I've been increasingly talking about the concept that the EMR race is over, and that EMRs now serve as the infrastructure and platform upon which innovative companies will develop "EMR Extender Tools", in areas such as: Physician Productivity (e.g. healthfinch), Decision Support (e.g. Zynx), Business Intelligence (e.g. DrEvidence), and Patient Outreach (e.g. Healthloop).  This seems to resonate well with mature EMR users since they often feel like the EMRs they have are rather stagnant - and the vendors will be focusing for years on just getting basic things right and fulfilling Meaningful Use, and thus has no ability to add innovative features.

This is particularly relevant as a recent article came out asking, "What is the future of healthcare innovation now that Epic has become the dominant EMR player?"  The author offered a variety of scenarios, but I think Mr. HISTalk had the best analysis when he said:  "Companies should stop fixating about mounting a full frontal attack on Epic that’s sure to fail and instead innovate on building products and services for Epic’s large client base just like the companies that coexist successfully with Meditech."

Oh yeah!  Now we are talking about an ecosystem that will really let innovation flourish (I think it will be Epic and a few others).  Big Kudos to Allscripts and Greenway for walking the walk and being the first to launch official "platforms" for allowing third parties to build tools upon them.  And nod of the hat to other EMR vendors who are at least talking the talk - even if their "Platforms" are not quite launched yet... such as GE, NextGen, AthenaHealth.  And here is hoping that Epic and ECW will eventually come around and create official platforms to encourage innovation... I think they will eventually move to this, and/or their customers will do it for them.  Finally, I'll be closely following a few other companies trying to build "Uber-Platforms" in this space, including Optum, Aetna's Medicity and the GE/MS spinoff Caradigm.

Of course, how cool would it be if we had one platform upon which any third party vendor could integrate their tool... and it would magically work with any EMR?  Oh wait, we actually do have the government sponsored SMARTPlatform... now we just have to get the vendors to agree to work with it!  The geniuses behind this platform (Kenneth D. Mandl, M.D., M.P.H., and Isaac S. Kohane, M.D., Ph.D.) just wrote another NEJM article (Escaping the EHR Trap — The Future of Health IT), if you are interested in hearing what they think the future should look like.  Here are a few good quotes from their article:

• “[T]here’s a clear path toward better, safer, cheaper and nimbler tools for managing healthcare's complex tasks.”
• “Programs should not be held hostage to EHRs that reduce their efficiency and strangle innovation,” the authors concluded. “New companies will offer bundled, best-of-breed, interoperable, substitutable technologies … that can be optimized for use in healthcare improvement. Properly nurtured, these products will rapidly reach the market, effectively addressing the goals of ‘meaningful use,’ signaling the post-EHR era, and returning to the innovative spirit of EHR pioneers.”

Getting back to reality (meaning we don't have seamless platforms to do all this yet)... I do think we are seeing an explosion of small companies creating great niche products and figuring out how to work with EMRs.  So whether there is an official platform or not, the EMR Extender Tools are here to stay and they are only going to grow bigger and better!

Past Blogs on this topic
* Rise of the EMR Extenders (March, 2011)
* EMR Apps Taking Off (April, 2012)