Interview with Practice Fusion’s CEO, Ryan Howard, about mobile EHRs.

I’m a believer that EHRs are going to move ever more onto mobile platforms and I’m curious what that might mean for the larger EHR market. In order to help answer that question, I spoke with Practice Fusion’s CEO, Ryan Howard.

Practice Fusion is launching mobile EHRs in Q1 of 2010, and although, Howard wasn’t as convinced as I am that mobile EHRs were the killer app for health care, he does believe that web/SaaS-based EHRs were really the only sensible option to support mobile EHRs.

Here’s the short version of the interview:
Q. How might SaaS EHR providers benefit from the shift to mobile?
“If you’re going to build a mobile (EHR) application, you essentially have three options:
1. You can build a native application that allows you to interact with the on-site system, but these are problematic because they still follow the same silo-based instance, you can’t share information among coworkers, if you’re a doctor you can’t hand off information to a nurse and you can’t pull in the power of the internet. 
2. You can have a hosted model with online access to a system, but these still need to point to a server or farm of servers somewhere. They are not a true SaaS play. Allscripts is one example. They still have the fundamental problem of not being able to share information across institutional boundaries. 
3. Or, you can have a fully hosted model on the internet that’s ideal for browser-enabled devices, that already runs web services and has the APIs developed and allows sharing of critical information in care. Building mobile applications for these systems is a natural fit.
What this comes down to is that a shift toward mobile will be a disaster for old-school proprietary client-server vendors that have their businesses built on ongoing fees because it will only bring more attention to their failures. Moving mobile means moving to web services and that just doesn’t fit with their business model or the way their companies are structured. How can they go from selling big, expensive proprietary systems to free or low-priced options? How will they convince their sales forces to promote these options?”
Q. Do you see a shift toward mobile EHRs?
“We get a lot of requests for it. It is one of our most requested features and we’ll be coming out with cross-platform (iPhone, Android, Blackberry) mobile solutions in the Spring of 2010, but I’m not 100% convinced this is the way physicians are going to want to interact with the EHR. I don’t see the same ability to interact with the same depth of information on these screens. The iTablet might be interesting, but I’m that’s not really mobile to me. It seems that will be browser-based access on a slightly larger screen, similar to netbooks.”
Q. What about your competitors?
“iChart, eClinicalworks and Allscripts I know are providing some mobile apps, but the functionality is so far limited, they have many of the problems just described and it’s unclear that people are buying.”
Q. Have you heard about Epic’s new trial with Stanford to deliver an iPhone app?
“I haven’t followed that, but I’m not overly concerned about what Epic’s doing. You look at Kaiser and what have they spent, $4 billion on Epic?
All industries have adopted SaaS in one form or another at this point. The economic imperatives are just too great to go in a different direction. Many of these legacy systems will not survive.  Unified authentication on a single platform of networks of networks with all data in real time and aggregated gives us the ability to do the things we did for our recent H1N1 reporting. There’s a huge value in being able to provide updates to the entire system automatically and do reporting across the network. This is also going to be critical for ARRA/HITECH. Practice Fusion can roll out required functionality much faster than traditional vendors.”
With these kinds of things in mind, there has been a lot of talk about secondary use of EHR data. Kaiser just received a grant to do some studies. Are you looking at secondary use of data?
“This is an area of huge interest that we are tracking, but don’t have any specific plans at this point.”

Next post will discuss the various options for implementing mobile medical applications.

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