Monthly Archives: January 2013

From Dinosaur applications to 99 cent EHR

Those Europeans… Hard at work on a Sunday.  At least the nice folks at the mHealth working group (mobilehealth@lists.hl7.org) were kind enough to pass along the notes from today’s conference call where thoughts and concerns about the entrance of mobile health application into the industry were discussed by 20 or so attendees.

Found among those comments labeled “concerns” was this most interesting bit:

[to] Force the kind of agility that is natural for mobile apps into dinosaur applications [emphasis added] (e.g. large EHRs)

It may be among things so obvious that it ‘goes without saying’ as the saying goes, that the “natural agility” not to mention economy of mobile apps threatens a titanic and cathartic smack down onto the heads of traditional EHRs; particularly those “serving” hospitals.

What I think one of the 20 or so participants was suggesting is that entire multimillion EHR suites may at once give way to a horizontally integrated cloud of mostly/partly mobile applications nevertheless led by the inherent economy of such. Funny how the adage rings true: The more things change, the more they stay the same.  Starting mid-decade [2005ish] the mantra in the EHR industry was the chant: “best of suite” over “best of breed”.

And so it went that hospitals began chucking their birds’ nest integrations of heterogenous departmental systems in favor of nice and tidy homogenous single brand systems; to save money. Now it seems that an order of magnitude of economy found in the synergy of mobile computing dominance and the general momentum of cloud services is pressing irrevocalbly upon the traditional EHR market; to save more money.

And this is precisely where the naysayers of third party mHealth apps in support of legacy EHR expansion into mobile utility go off the rails clutching their homogenous bliss like the last twinkie on a deserted island. “Don’t worry”, they say, “they [big EHRs] will ‘go mobile’ and vaporize third parties overnight..” Perhaps. But that’s like saying that affixing a pair of angel wings on an elephant puts it on aerodynamic par with the peregrine falcon. It just isn’t quite the same thing.

As Mark Cuban points out, there are exponential cost advantages and agility available to brand new companies with brand new products that legacy brands from decades ago can only dream about.  So is a $.99 hospital EHR in our future? Perhaps.  But if Moore’s Law still means anything, it could at least get down to $99.00.  And compared to the current cost of hospital EHR systems, that’s a rounding error… on the cost of one day’s training for the typical fare. Nevermind the cost of an entire system! Whatever the potential, it’s going to be huge.