Electronic Health Records

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What Does Epic’s App Store Mean for EHR Interoperability?

By Jennifer Bresnick

Epic Systems may be leaping to the top of yet another health IT category with a new app exchange, which would allow external developers to create products that would interface with Epic’s popular electronic health record system.  The Epic App Exchange would be the health IT version of Apple or Google’s app stores, and may first try to secure entries developed by Epic customers that would enhance the openness and interoperability of the famously tight-lipped infrastructure.

“We think Epic is big now? This will cement their long-term legacy. It’s exactly the right thing to do,” said Nordic Consulting co-founder Mark Bakken in an interview with the Wisconsin State Journal.  “Once they officially launch this, then it’ll be very, very easy. It will really open the floodgates for anyone that knows Epic to really get their product on the market quickly and in front of Epic’s customers. So the distribution channel is huge.”

The app store mirrors a 2013 effort by athenahealth to connect innovative services to enhance interoperability, health information exchange, and data governance for users of their products.  The athenahealth Marketplace intends to bring “the best HIT solutions to the forefront,” athenahealth CEO and Chairman Jonathan Bush said at the time. “Similar to what Amazon.com is for consumers, our platform, with the immense support of our Marketplace partners, will serve as a one-stop ‘shop’ for high-value HIT solutions.”

A spokesperson from Epic confirmed the project, which Bakken says may launch within the next few weeks.  The Verona, Wisconsin company has faced criticisms in the past about its closed systems as the healthcare industry embraces the notion of EHR interoperability, data standards, and widespread health information exchange.

While it has made a few nods towards industry integration, Epic has secured such dominance in the hospital market that it has been able to largely ignore the complaints, but it has several big projects on its agenda that may make it more difficult to continue down its previous path.

In addition to bidding for an $11 billion contract from the Department of Defense that will likely value interoperability and open architecture above Epic’s monolithic culture, moving into the ambulatory market will require more flexibility than it has shown in the hospital sphere.

Primary care providers interested in population health management or joining the accountable care movement need EHR infrastructures that can easily speak to products from different vendors.  With the ambulatory EHR market so fragmented and the priorities of physician offices changing, Epic may need to expand its interoperability strategies if it wishes to continue its slow but steady gain in market share.

The app store might be a smart way to do this.  By encouraging third parties to develop connections between Epic products and other offerings, Epic gets to take credit for promoting EHR interoperability without having to do too much of the work itself.  The company will be providing interested developers with a “roadmap” about how to work with the company, Bakken says.  More details will no doubt be forthcoming, but until then, the healthcare industry will have to do what it always does: wait at Epic’s gates until it decides to open up.





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