The basis of healthcare data has not changed. Patient histories still set the stage. The exam still details how the patient looks, feels, and sounds. Vital signs are still gathered in similar ways.
What has changed is what happens to this data logistically and economically after the patient visit. First, a bloom of EHRs drove digital storage. Now, “satellite” data collectors like Apple’s HealthKit are blossoming outside the clinic. These trends have changed who controls patient data, but have also exposed healthcare to tolls from opportunistic businesses seeking to charge for data access.
What does this look like? As Politico recently pointed out, EHR vendor revenue from new implementations is decreasing. Consequently, vendors are arbitrarily charging providers, and in effect patients, hefty fees to “unlock” databases to communicate with other necessary health informatics systems. These unlocking fees can reach $50,000 per site and are pinching providers and blocking progress.
Fortunately, these economic pressures are driving innovation from other classes of vendors and startups, and this innovation will ultimately drive out EHR data fees altogether.
How does this work? Specifically, some vendors are turning to the tools already in the hands of the clinical staff like web browsers, email, scanners, and faxes to get around data fees (and avoid the pain of back-end integrations) and coupling these tools with approaches pioneered in the consumer web. Examples:
- Web companies like Tripit integrate records from hotels, airlines, and other travel databases without back-end integrations through the use of a centralized email account.
- Sites like Mint.com integrate brokerage, credit card, and bank account databases by using the consumer’s web browser and shared logins.
This sort of “front-end” integration is possible in healthcare too, and it’s where we see the market going. It will also usher in the death of EHR and EMR connection fees, because front-end integrations put control of health data back into the hands of doctors and patients. It also gives them power over the creation and storage of the data points of life. This then lets clinics eschew fees, relieves their IT teams of another task, and allows for fluid data transportability and more efficient healthcare.