Ignorance of the Major EMR Software Vendors is Not Bliss
By Tyler Smith
We in healthcare IT have found ourselves in a pretty sexy industry. You know that is true when Silicon Valley is practically banging down the doors to get in and KPCB’s John Doerr states that he would really like to see an open source competitor to Epic created. Damn, so Valley money admits it is losing to a slowly built behemoth in Madison – not a brand spankin’ new startup it missed an angel round on.
Needless to say, HIStalk’s Startup columns are a quite timely addition to the blog. I particularly enjoyed reading Marty Feisenthal’s explanation of the elite JPM conference. Having heard about the conference from banker friends (not HIT colleagues), his column removed much of the mystique. Being a fellow Atlanta resident and having visited the Atlanta Tech Village before, I also have greatly appreciated Michael Burke’s articles on the experiences of an HIT founder in Atlanta.
I recently co-founded a startup that aimed to bring efficiency to the Epic staffing arena by using very simple tools already in place in other industries. I do not want to call it the Uber of Epic staffing – for fear of sounding like a hack – but the basic idea was a connection platform with ratings for Epic certified consultants. While we have put the project on hold due to some shakeups on our technical team and also due to slow buy-in from provider organizations (our target clients), the pause in the action has given me time to reflect on the current state of HIT startups – particularly those looking to nibble on the enterprise EMR vendors’ scope of services.
Along with Mr. H and most readers here, when anybody from the outside comes and brings a new idea to the HIT table, I am usually skeptical. For starters, most entrants do not understand the complexity of the hospital / provider organization buyer or the provider organizations’ importance in the system. In theory, I love the idea of patient advocacy and patient-centric apps, but if providers or the systems that house them aren’t buying it, you better have something that patients see as life or death (read: an HIV curing drug, not a sleep tracking app) if you want them to fight the entrenched stakeholders for you or with you to make your startup relevant or widely used to truly create positive clinical outcomes.
Secondly and most importantly, many of these outsiders do not understand the current state of the EMR vendor landscape, and if they do, they arrogantly think they can steal market share while the enterprise systems watch from the sidelines. True, Epic and Cerner’s UX can appear very basic from an end user stand point and it often appears that the enterprise systems do not appear to be covering even close to all the functions that could be automated in a hospital or healthcare delivery organization. However, it would be naïve to think that these vendors have no big plans to tackle all of these remaining un-automated functions in the near future. When they do, unlike many of the new startups, these vendors will be able to simply make an additional sale to their already heavy client lists instead of having to undergo the arduous process of breaking down the doors to just get on the approved software vendor list at a major healthcare system.
The truth is that healthcare IT is a B2B market, not a consumer market. Organizations do not make purchasing decisions overnight, and thus while an app may actually do something better than an organization’s EMR, it better be a lot better for a healthcare provider organization to consider even meeting with the startup’s sales team.
This is not to say that I think that clinical apps which could be potentially developed and which will lead to improved clinical outcomes should not be attempted. What I am really saying is that before delving into development, HIT startup founders should take a much more serious look into EMR current state.
Even more importantly, startups should also consider what logical next steps vendors will be taking in their product offerings and research timelines as the massive implementation phase winds down and optimization becomes a priority for the vendors’ in house development teams. If there really is a competitive advantage which the startup has over these behemoths in the development of an EMR related application, then by all means go for it. But if not, it is probably best developing something far outside of the current or near future EMR vendor scope.
Easy for me to say as I sit on the sidelines and consult on EMR projects, I know. And you can object and say I’m siding with the status quo. Regardless, it pays to do your homework on the massive vendors. They aren’t going to crumble and they certainly aren’t going to let their clients get on products that encroach on their turf without a very solid battle.
In closing, I would ask any hopeful HIT entrepreneur: what is your startup doing that an established EMR vendor could not accomplish without a system update or by adding a new application which would seamlessly integrate with their current lineup?