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Time Capsule: WWJD: What Would (Steve) Jobs Do If He Worked in Healthcare IT Instead of Apple?

September 6, 2013 Time Capsule 13 Comments

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in June 2009.

WWJD: What Would (Steve) Jobs Do If He Worked in Healthcare IT Instead of Apple?
By Mr. HIStalk


I’m having an identity crisis. After working exclusively with Windows PCs for decades, I bought a Mac for a family member.

The MacBook is easy to use, sleek, and full of eye candy. Its lit-up Apple logo exudes barely contained and self-aware hipness. I’m not fully convinced that it’s not just “different” instead of “way better” than the usual PC clones running Windoze, but I admire Apple for using its advantage as a proprietary hardware/software vendor to package cool design, thoughtful engineering, and a boffo user experience into a machine that ends up doing pretty much the same stuff you can do on a PC, only making you feel smug while doing it.

All the Mac people I’ve known were artsy types. I figured them to be right-brainers who were too preoccupied with social protests and making vegan brownies to handle manly computer tasks like using Regedit or spending a pleasant afternoon reinstalling WinXP after running out of options to fix one corruption or another. And, Steve Jobs in his jeans and turtleneck was one beret short of being a full-on artiste, while Microsoft gave us the hyper-annoying loudmouth Steve Ballmer as the cartoonish, kill-our-enemies capitalist pig who was ideally cast for the political climate of that time.

I’m convinced there’s a fortune to be made for someone to create the healthcare IT equivalent of Apple.

The industry is a lot more like Windows than Mac. Systems were clearly designed with user experience and brilliant design way down on the list, which is pathetic given that busy doctors and nurses are supposed to use them happily and constantly while not killing patients. Instead of Apple-like control over the entire ecosystem, customers just buy whatever systems they want, throw them in the same data center, and then fuss when the end result isn’t exactly seamless.

Systems break a lot, they disappoint their owners, and they are a long way from being cool. Fanatic loyalty to a product or company is unheard of, not too surprising considering that vendors titrate their effort (and quarterly expense) to a customer satisfaction level that’s only very slightly above the “let’s kick these guys out and start over” level.

Epic is kind of Apple-like. They have a quirky CEO who has an unwavering agenda, a funky campus, products that carry a premium price and never get de-installed, and tight control over their ecosystem. They hire easily influenced kids instead of other vendor’s retreads. Their customer list is relatively small but cult-like, jostling for space at the annual Verona gathering like Apple-heads annually migrating to California.

Epic does shun one of Apple’s core competencies, however: slick marketing that intentionally creates a world-against-us mystique. People still talk today about that shocking and downright arrogant 1984 Super Bowl commercial that declared war between an Macintosh-empowered creative class and oppressive Big Brother mainframers portrayed as storm troopers (which was really more of a minor skirmish since Apple wasn’t exactly a force to be reckoned with back then).

On the physician EMR side, you’ve got companies that have some Apple characteristics as brash giant-killers: eClinicalWorks, athenahealth, e-MDs, and a few others. Big companies have bought some of the potential Apples, although it’s hard to simultaneously bring them into the corporate fold while not screwing up what made them interesting in the first place. (What would you get if GE bought Apple? GE.)

So here’s my business advice (understandably highly valued and sought after since I’m a wage slave in a non-profit hospital who knows nothing about business): now’s the time to start up a physician systems company using Apple as the model. The market is fragmented, some of the major players and their technologies are stuck in the 1980s, Uncle Sam is throwing money around like only someone with a currency printing press can, and the number of doctors doing “none of the above” on an electronic system is 80 percent. Getting even 5 percent of that market would be a fantastic business.

And here’s my highly secret strategy that nobody would think of: hire a few people from Apple to show you how to do it. The reason HIT products and companies look alike is because the same people were involved, floating from one job to another and bringing their same preconceived notions along for the ride.

You’ll know when you’ve succeeded: users will clamor to have your lit-up logo on their laptops to show everyone how cool they are.

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13 Responses to “Time Capsule: WWJD: What Would (Steve) Jobs Do If He Worked in Healthcare IT Instead of Apple?”

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  1. 13
    FLPoggio Says:

    Cj Carver – Apple not exclusionary? Then how come I can’t change the battery in my IPad, Iphone, etc?

    And I have read on this web site in several recent posts where Epic is far from ‘exclusionary’. Within the last week I read where they give the source code to their clients so they can link to it and better understand the design, see Reliant Health piece:

    Anybody have a copy of the Apple source code?

  2. 12
    Cj Carver, RN, BSN Says:

    I’m pretty sure Steve Jobs would not have developed such an exclusionary system as Epic.

  3. 11
    FLPoggio Says:

    Chris…”Apple wouldn’t touch this industry because it is a quagmire trying to treat patients that don’t want to change their lifestyle”

    Good comment, as the video I posted shows, Apple did ‘touch’ health care, got burned and got out (along w MSoft, Google, and 50 other Fortune companies over 30 years). So you may have some very valid points.

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