In a recent note, I discussed the competition between the Cerner and Epic EMRs and quoted another blog, Chilmark Research, to the effect that Cerner was moving in new strategic direction, emphasizing a network of services to provide communities of care (see: Cerner Fights Back in the EMR Market: A Community Network of Services + PHR). Such an approach is sometimes referred to as the development of a care coordination platform. I concluded that Epic's approach closely coincided with the business model currently favored by hospital executives and would probably continue to succeed in the market. Vince Kuraitis responded to my note with a comment that included a link to a lecture he had recently delivered titled Platform Wars (see: Platform Wars). The presentation can also be accessed at Vince's blog (see: e-CareManagement blog).
Vince's lecture presents a different paradigm for framing the discussion about the Cerner versus Epic. In slide #31 of his presentation, he suggests that there are three types of EMR platforms: closed systems, walled gardens, and open platforms and apps. In his slide #35, he shows Epic as currently offering a closed system with the Cerner EMR, and other competing vendors, providing a walled garden. He further suggests that Cerner is now shifting to become a more open, care coordination platform. Given Vince's perspective about EMRs, a key question about hospital CEOs remains: To what extent are they interested and willing to move to an open, community-oriented, care coordination EMR platform from the closed platform Epic EMR? I hasten to add that I personally would favor an open approach because is would provide a richer functionality and would introduce more competition in the EMR market. It would also provide, in the long run, better care and more care choices to patients.
Here is a list of the issues that I think will be dominating the minds of most hospital executives regarding their choice of an EMR as we go forward:
- They want a reliable system with maximum functionality and minimal chance of failure; they will place great weight on the EMR choice of their peers in other hospitals.
- They will listen respectfully to recommendations from consultants, Medicare officials, and payers about the need for a "community network of healthcare services" and "coordination of community care." However, they will not act on such recommendations until such time that there is a strong and irreversible link between such recommendations and reimbursement.
- If and when such a strong and irreversible link to reimbursement is established, they will turn first to the vendors of their "tried and true" legacy system vendors to provide them with the required, specified new functionality.
- In short, Cerner needs to first staunch the flow of its current EMR customers to Epic. Second, it needs to convince its (now stable) installed customer base that its proposed, and more open system, will benefit the hospital in the long run and support a robust business model.
Great post! It saws strong argument to refer to the open innovation movement in government. This explanation would require far fewer friends outside this arena and is generally well accepted
Posted by: gclub | October 16, 2011 at 02:14 AM