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Open Healthcare

Would it shock you if I were to label US healthcare as broken?

You’d be the only surprised one in the room if it did.  Of course it’s broken.  Yet when healthcare is discussed before governmental panels, around dinner tables or by workplace watercoolers, the conversation invariably focuses on who should pay for it and how much they should fork over.  Any deliberation on how to actually fix healthcare is relegated to afterthought.

So basically, a system that is vital to our well-being and to our social fabric is in total disrepair and we are all opting to pay for it first, fix it later and understand it never.  Try this same approach with your car next time it breaks down and let me know how that works out for you.

Outrageous expense might stand out as the most glaring of healthcare offenses; but the fact remains that it is not the root problem, but rather a symptom of it.  Before we all start bickering over who should be writing the check, let’s determine what we are actually getting for our money and assess any core flaws.

The heart of the problem is that healthcare operates as a closed system.  Critical patient data – the medical blueprint – of every patient out there is stored in Electronic Medical Records.  System-wide access to this information is limited and cumbersome at best.  It is often times blocked entirely.

There are two broad schools of thoughts when it comes to the administration of EMR platforms.  The first is to block off access to third-party developers; electing instead to innovate strictly in-house.  ‘Innovate,’ is a term I’m using very loosely in this context; because this dedication of some EMR brands to sealing themselves in a tomb and maintaining eternal possession over their technology is the surest way to stifle innovation, not promote it.  If one were to attempt to comprehensively map out all healthcare data, the chart would show a segmented, compartmentalized system.  Patient data is spread across numerous competing EMR platforms, legacy systems and databases.  Information sharing amongst these pockets of critical data is not built into the healthcare apparatus; but it is vital to any healthcare professional intent on an informed clinical decision workflow.

The glue between the aforementioned information segments, the conduits for true data-flow through the system are ultimately the result of third-party access and innovation.  Which brings us to the second approach to EMRs, the one of forward-thinking EMR-vendors, such as Allscripts and athenahealth.  These companies realized early on, much like Apple and Android, that competition amongst themselves should not preclude opening their APIs to third-party innovation.  Not only does this not hurt the bottom line for these companies, it is the surest way to bring about long-term success.  Oh, and a nice side-effect is that it also helps doctors and improves patient care, but I digress.

With Emerge, our initial attempt as a third-party developer was to integrate with all platforms.  A noble goal perhaps, but about as surmountable as boiling the entire ocean.  Ultimately, we learned that rather than trying to be all things to all people, it would be wiser to collaborate with like-minded entities and promote our values across the realm of healthcare.  We found such partners in athenahealth and Allscripts.

The Allscripts Developer Program (ADP) opens API access to outside developers, facilitating brisk technological growth and effective collaboration.  The athenahealth MDP (More Disruption Please) Network is dedicated to disrupting healthcare as it exists today and drives innovation through openness.

The synergistic effect of an open healthcare marketplace is, simply put, better outcomes in healthcare itself.  More efficient, better informed doctors deliver better care to their patients.  Yet, this obvious, non-radical concept demands radical disruption take place before becoming a reality.

What does open healthcare do for us, as innovators?  Well, I’ll speak for my company here.  Our access to platforms which – through no direct fault of their own – contain digitized heaps of unusable data, allows us to offer the market four key advantages over any closed system:

- 1 - Instant comprehensive search of all patient data– scanned documents (OCR), free text notes, and structured records.

- 2 - Visualization of the above search results and customizable dashboarding for a faster, cleaner and more intuitive user experience.

- 3 - Patient population management made possible by the ability to see and analyze allpieces of information; and, consequently, pinpointing potentially at-risk patients based on any number of factors.

- 4 - Security and risk-reduction. An EMR platform can, on occasion, crash or experience downtime.  But we can provide a facility with continuous real-time access to the latest EMR data during such an occurrence; and full recovery in the event of a compromising system hack.

None of that would be possible without open access to our partner platforms; and the question would then become Who would lose?  To which I can reply Who wouldn’t lose?  Our business model might suffer under such a scenario.  But it wouldn’t end there.  The technology offerings of our partners would be greatly diminished and, in turn, so would the outcomes of their end-users employing our solutions.  Those end-users, to be clear, are medical facilities treating real patients who deserve the very best care possible.

Open Healthcare is not the better of two options.  It is the only option.  It is a must.  So before deciding who pays for healthcare, let’s ensure the money is paid into a viable system.  Otherwise, we will all pay.  Dearly.

Scott Finfer, CEO and Co-Founder Emerge Medical Data Intelligence


Scott Finfer is the CEO of Emerge Medical Data Intelligence, a company dedicated to removing the barriers between caregivers and critical Electronic Health Record data.  emerge’s solution, ChartScout, empowers medical professionals with swift, reliable access to EHR data via comprehensive patient-chart search and visualization capabilities; as well as customizable context-specific dashboards.

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