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To me the question comes down to money. How much is it going to cost to create a modern, technology-aided health infrastructure that is actively utilized, in a

by Gatsky 12y ago

To me the question comes down to money. How much is it going to cost to create a modern, technology-aided health infrastructure that is actively utilized, in a top-down fashion? I think the answer is a lot more than we would guess, and a lot more than anyone is willing or able to pay. I don't think a startup really wants to be in this space, even though it seems like a great idea. The size of the necessary workforce, the legal complexities, the complicated interface with government and regulatory bodies and the enormity of the required indemnity make life impossible. I mean Dropbox of all companies has Condeleeza Rice on their board to smooth over dealing with the government - the mind boggles who on earth a successful startup in the healthinfotech space would need on their board, but half of congress might be a start... I would stop trying to kill yourself dealing with hospitals, it isn't worth it. They are run by either status quo bureaucrats or cost slashers. The only way to reform things is bottom-up - creating applications that patients or clinical staff will use en masse outside of a hospital's IT system eg on their smart phones.

bduerst 12y ago
The EMR industry has a huge bureaucratic barrier to entry, which is why you don't see it technologically progressing at the rate of other industries. The space is dominated by major players that have existed since the 1980's (Epic, Cerner, etc.), which also employ the technology of the same era (MUMPS, Caché, etc.). If anyone is going to disrupt the EMR industry, it is going to be a bigger company that can sink the costs necessary to get up to speed for an entire HMO, and a couple HMO's willing to take the risk of piloting the software.
- leonth 12y ago
  I want to add that a lot of value of the EMR system comes from integration - i.e. smooth data flow between touch points / care areas / visits / institutions. So it is rather hard to disrupt the industry using the typical "disruptive technology" idea because your niche solution may not play well with the rest of the system. And the incumbent has every incentive to make integration with a potential disruptor as difficult as possible.

by Gatsky 12y ago

bduerst 12y ago

The EMR industry has a huge bureaucratic barrier to entry, which is why you don't see it technologically progressing at the rate of other industries. The space is dominated by major players that have existed since the 1980's (Epic, Cerner, etc.), which also employ the technology of the same era (MUMPS, Caché, etc.). If anyone is going to disrupt the EMR industry, it is going to be a bigger company that can sink the costs necessary to get up to speed for an entire HMO, and a couple HMO's willing to take the risk of piloting the software.

leonth 12y ago
I want to add that a lot of value of the EMR system comes from integration - i.e. smooth data flow between touch points / care areas / visits / institutions. So it is rather hard to disrupt the industry using the typical "disruptive technology" idea because your niche solution may not play well with the rest of the system. And the incumbent has every incentive to make integration with a potential disruptor as difficult as possible.