EHRs and Vendors: Is Bigger Better?

December 14th, 2012 / By Jeremy Zasowski

Who has recently logged in to Facebook to see what your friends are up to?  (Anyone still have a MySpace account?) Anyone purchased something online at Amazon this holiday season?  When’s the last time you searched for something online and didn’t “Google” it?

It’s interesting that there are a select group of companies who have come to dominate our online, internet lives, and as a recent December issue of The Economist (1) points out in “Survival of the Biggest,” this comes with some positives and negatives.  Facebook owns the world of social media, aside from the Twittersphere, and is looking to capitalize on all that personal information and preferences it knows about us.  Amazon is dominant in online retail, with a third of online buyers starting their product search on Amazon, and two-thirds of all e-books downloaded coming through Amazon as well.  Apple dominates online music sales and the growing tablet market.  Google has long been the far and away leader in search and online advertising, though it is now under scrutiny having been accused of favoring search results to promote its own products and services.

These companies have risen to their dominant positions very quickly as the internet, social media, and use of mobile phones and devices have grown, and in many ways they have created the markets for their own products.  They quite often buy up smaller rivals before they become bigger competitors, and they have defended their positions with the use of patents and lawsuits to the tune of billions of dollars.

In many ways, we all benefit from what these companies have created. It is worth asking, however, what we may be giving up as these companies continue to grow and solidify their control of their slice of our online, internet lives.  Do we risk losing control of our online lives?

As I was reading this article and pondering the questions it raises, it struck me how similar these themes are to the world of healthcare IT.  There are a shrinking number of electronic health record vendors that are controlling a larger portion of the market and healthcare systems data.  As these EHRs are implemented at a hospital or health system, existing systems for document management or specialized department systems are dropped as the hospital moves onto one platform.  Healthcare systems recognize multiple benefits to standardizing their multiple inpatient, outpatient, and office record systems.  We also see EHR vendors acquiring smaller competitive or complementary companies so that they can continue to expand their offerings to their clients in such areas as population-based analytics.

There are numerous blogs and articles written about the issues users have when an EHR is implemented, and I’m sure EHRs are working to fine-tune their user workflows.  What I’m more curious about is, if the trend of fewer and fewer EHR vendors continues, and the EHR vendors that remain continue to grow in the scope of what they do, will the lack of competition limit new, truly innovative solutions?  Will EHRs allow other vendors access to a healthcare system’s data?  Will the healthcare IT market become so entrenched that new entrants have nowhere to grow?  Will companies with innovative ways of assisting physicians with patient care, or analyzing patient data to help identify at-risk patients to keep them out of the hospital, be kept out of the market because they have no access to customers and their data?  What effect could this have on hospitals and healthcare systems?  Do the benefits of EHRs outweigh these issues and risks? Only time will tell if this trend continues, but until then, I hope that companies serving the healthcare industry that have innovative ideas and solutions will continue to have an open market so that hospitals, healthcare systems, and individual patients can take advantage of the innovative new products and services they provide.

 Jeremy Zasowski is the New Solutions Marketing Manager of 3M Health Information Systems’ Emerging Business Team.