I’m sure that many of you have read the always insightful and intriguing Vince Kuraitis and his e-CareManagement blog. If you haven’t you should start doing so now. I just recently came across his post called “Getting an Epic Opinion Off My Chest” about the proprietary solutions and walled gardens that have and are being created in healthcare.

He starts off really strong with the following points:

What are acceptable bases of competition in health care?

My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:

It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors

It’s NOT OK for care providers to compete on the basis of controlling or limiting access to patient health information. It’s just not right.

He later goes on to assert that in many industries the idea of creating proprietary, non-interoperable technology is an acceptable means of competitive differentiation, but Health Care is different.

Certainly there are people’s lives involved in this and so it’s a different animal all together. If I can’t transfer my music from one MP3 to another it might be unfortunate, but having a loved one die because the right healthcare information was stuck in a closed system is a much more serious issue and one that should require careful consideration.

Outside the ethical reasons to support the benefits of access to patient information, I think there’s a great business case for doing so as well.

One example of the business case I outlined in my post about EMR data liberation. That’s a subtly different situation than what Vince described, but I believe you can make the business case for the benefits of an open system.

For those familiar with SalesForce.com, they could have easily been a few hundred million dollar company on the back of their CRM software. They could have then expanded into other related business verticals as they built off a closed garden. Instead, they opened up their system to allow a lot of other companies to build on their Force platform. As a platform, they’re a multi-billion dollar company.

Why healthcare IT vendors can’t see the value of open is a bit beyond me? I guess some might argue that the GE and Microsoft announcement was a step towards this type of open environment. Based on the analysis I’ve read, I think this is part of their vision for what they’re trying to create.

Whether Microsoft and GE will be able to execute on the vision of the platform is still not clear. However, what I believe is clear is that directionally this is where the market will eventually go. There will be a healthcare platform that does a great job connecting heterogeneous systems.

So, yes, I think that morally the right thing to do is to open your system, but I also think it makes great business sense to do so as well. The closed garden strategy might work well in the short term, but long term open always seems to find a way to win in a much bigger way.

Mobile Healthcare Expo
I recently signed up to be a media partner for the Mobile Health Expo in Las Vegas. It’s happening October 19,20, and 21st and it looks to be a really interesting conference with some really power players in the mobile healthcare market.

I’ll be “moderating” a couple sessions on Wednesday, but that’s just misuse of a term. I’m going to be introducing the speakers and opening it up for question and answers as needed. I of course will be doing the HITECH and mHealth session by Vince Kuraitis and then I also was asked to do the session titled “The Role of Mobile in Professional Marketing Programs” by Robert Kadar.

I must admit that I’ve gone pretty light on the mobile healthcare and mHealth coverage on this site. Hopefully this conference will open my eyes to some new elements of mobile healthcare that I hadn’t considered before.

Of course, if that doesn’t work, it looks like they have some pretty good parties. It is Las Vegas after all.

If you’re planning to attend, I’d love to meet up with you.

MGMA Annual Conference
I was hoping to go to the MGMA annual conference in New Orleans October 24-27, but it doesn’t look like it’s going to happen. I thought I had a vendor who was going to sponsor my flight and hotel in return for sponsorship of my posts from MGMA, but that fell through. There’s always next year. I hear that registrations numbers for MGMA are way up. If you’re planning to go, I’ll be interested to hear how it goes.

Vince Kuraitis opened my eyes to a new term called the “Penguin Problem” and applying it to EMR adoption. Here’s the principle:

Economists call it “The Penguin Problem” — No one moves unless everyone moves, so no one moves.

Considering our paltry 15% or so EMR adoption rate, it seems like this is an apt description of EMR adoption as well. It does seem like many doctors are on the sidelines waiting for the first adopters to stick their proverbial heads out of the water and show all the other penguins the fish they’ve gotten.

The problem as I see it was that far too many doctors were coming out of an EMR implementation and showing all the other “penguins” (doctors) that there were few “fish” (money and benefits) to be found. However, about a year ago I was seeing a shift in this perspective. Doctors were starting to see a number of very successful EMR implementation and very happy EMR users. I felt about a year ago that the penguins were ready to move and adopt EMR software.

Then, the EMR stimulus money hit. It was like a big seal just swam in front of the penguins and so many of the doctors decided to just wait a little bit longer before making the jump.

What I don’t understand is why all the doctors were on the verge of implementing an EMR before the HITECH ARRA EMR Stimulus money are now so reticent to make the jump. If the EMR was going to be a benefit to your clinic before the stimulus money it will still be a benefit now. The EMR stimulus money should just be a bonus for you.

No doubt healthcare is currently missing out on the real network benefits that will be found when all the doctors “move” and implement an EMR.

This weekend I talked to a doctor who’s worked his entire career (15 or so years) in an environment with an electronic medical record. He just couldn’t imagine how anyone would practice medicine without the computer and an EMR. The clinics I work with feel the same way about EMR.

In Vince’s article, he takes a bit different angle on the “The Penguin Problem” and EMR adoption so go read hist blog post as well. I’m not quite as optimistic as Vince about the HITECH act’s effect on EMR adoption, but I am very optimistic about EMR adoption in general. Good EMR software is out there and more stories of successful implementations are happening every day.