“But they are to me,” he responded, “since they are both all about information on the patient.” This got me thinking.
His background is in HIT, whereas mine is in enterprise software and biotechnology. I think that explains our different perspectives.
I experienced how consumer internet technologies, broadly grouped as Web 2.0 and social media, sped past the capabilities of enterprise software. Simplicity and speed created a much more satisfying end user experience. It became a cliché that users were frustrated by enterprise software – they wondered why enterprise search can’t be as fast and easy as Google, and file storage and sharing as easy as Dropbox.
There are two reasons why enterprise software cannot match modern consumer software:
1. Enterprise software must have much more functionality to meet business and regulatory requirements, which means there are many more options 'cluttering' the user interface and development lifecycles are much longer
2. Neither enterprise software vendors nor their organizational customers can afford to build the infrastructure that consumer vendors such as Google can. It was recently estimated that Google has almost 2.4 million servers in thirteen global data centers!
So enterprise software has to do more with much less. It is complex.
I was reminded of this when reading the recent Forbes interview of Judy Faulkner, CEO of Epic Systems, a major vendor of electronic medical records (EMR) systems in the US.
“Epic makes software for mid-size and large medical groups, hospitals and integrated healthcare organizations – working with customers that include community hospitals, academic facilities, children's organizations, safety net providers and multi-hospital systems. Our integrated software spans clinical, access and revenue functions and extends into the home.”
“Digital health start-ups talk of disrupting an inefficient health care system, and established companies such as Epic. Do you think they’re naïve, or is it putting you on notice?”
“Both. People would tell us: ‘How come you guys haven’t solved health care yet?” We have watched time after time people who want to fix it, and who don’t understand the financial side of things, that it doesn’t change much, the complexity of health care. Chief information officers will come in from outside of health care, and realize how much harder it was than anticipated. But, there are all sorts of creative things that you can do in health care, like genomics, that’s the fun part of health care, as medicine becomes more creative. I don’t think in the enterprise (hospital) space, it’s easy to get in.”
She’s absolutely right the enterprise space is hard to enter. And while patients may be at the centre of EMR database design, EMR systems are not built for patients, they are built for hospitals and other healthcare enterprises. And that is why digital health for consumers is very different – the patient is the customer.