The Verona, Wis.-based health IT giant Epic Systems is set to open its own app store, opening the door for the creation of outside mobile applications that will work with the vendor’s electronic health record (EHR) platform.
The news, reported first by the Wisconsin State Journal, was announced by Mark Bakken, co-founder and former chief executive of Nordic Consulting, the largest consultant firm working with customers of Epic, at the Wisconsin Innovation Network on Feb. 17. According to the State Journal report, Bakken said the app store will launch in a few weeks and it will “open the floodgates” for all sorts of companies to develop and market their apps, especially those in the Madison area populated by former Epic employees. “We think Epic is big now? This will cement their long-term legacy. It’s exactly the right thing to do,” Bakken said later in an interview with the newspaper. Epic spokesman Shawn Kiesau confirmed the plans but could not provide any further immediate details. It will be called the App Exchange, Kiesau said.
Bakken added that he expects the first apps to come from Epic’s customers, so that one healthcare organization can offer other hospitals and clinics the specialized programs it has developed to work along with Epic’s software. “Let’s say you want to create an app for the iPhone. Apple has automated that online. As long as you play by all the rules, they’ll publish it,” Bakken said in the State Journal report. Epic will be “publishing a road map about how to work with Epic,” he added.
There has certainly been no shortage of criticism for Epic regarding its lack of EHR interoperability; last summer, the New York Times referenced a RAND Corporation report that described Epic as a “closed” platform that made it “challenging and costly for hospitals” to interconnect with the clinical or billing software of other companies. What’s more, at a House Energy and Commerce Committee hearing last July, the RAND report was also cited by U.S. Rep. Phil Gingrey (R-Ga.), a physician who pointed the finger at EHR vendors such as Epic for their perceived lack of interoperability capabilities. Perhaps feeling the heat at the time, Epic hired a lobbying firm to fix its interoperability image.
But according to the State Journal, Bakken said the App Exchange should squash some of the criticism Epic has drawn from those who say its system is too closed. Additionally, interoperability could prove crucial as the U.S. Department of Defense (DoD) considers which team should receive a contract worth up to $11 billion over five years to install an EHR system for the U.S. military. Epic and IBM have submitted a joint application for that contract, which is expected to be awarded later this year.
Further, in an interview with HCI, Michael Elley, vice president and CIO of Owensboro Health in Owensboro, Ky., a customer of Epic’s, says that this news potentially has an immense impact on Epic’s clients. “In the future, and in some places this is already happening, physicians will not only be prescribing medications, but also applications. For Epic to go through the process of vetting these apps, and then being able to integrate with Epic itself in some form or fashion, will make that speed to market much quicker and thereby provide tremendous value to our patients,” Elley says.
Elley adds that there is more of an onus now on vendors to design apps that work specifically with mobile form factors. “Ideally, you’d like to see a convergence of the hardware and software world in some sort of form and fashion. It’s not to the level of functionality that you would see on a PC or laptop, but I do think it’s getting better and better each year,” he says. While Epic isn’t in the clinical device area, it has worked with those types of vendors on integration paths to being able to send and receive data, Elley notes. “Truly, what we want, like we had 10 to 15 years ago, is that when a physician enters the room, a chart would be hanging on the wall or door, and he or she would look eye-to-eye with the patient. That’s the kind of experience we want to deliver with the tablet rather than having the physician with his or her back to the patient,' Elley says.
What’s more, the concept of interchangeable web applications that can be plugged into any EHR was a hot topic at the AMIA Symposium last November, where HCI Senior Contributor David Raths reported from. During the SMART on FHIR session at the Symposium, executives from Cerner Corp. and Intermountain Healthcare showed off pilots of how apps initially created at Boston Children’s Hospital could easily be plugged into other health system EHRs. Specifically, Cerner’s David McCaille, M.D., vice president of medical informatics, noted that Cerner increasingly hears from its health system customers that EHRs are becoming a commodity platform and that the winners in the market will be those that make their platforms open and extensible. Health systems want vendor independence with few proprietary entanglements, he added. Apps can extend EHRs’ functionality and plug right into the clinical workflow, McCaille said. SMART and FHIR can make it happen, he said.
