TR: Would patients benefit from this kind of approach? Will we soon be able to view lots of different test results on our iPhones, for example?
IK: Yes! The platform model will greatly ease the ability for vendors of personal health records to offer connectivity or subscription services on hospital or practice platforms. This will accelerate access to the patient, including on the iPhone.
TR: What kind of third-party applications are you thinking about?
IK: Genetic testing in clinics has been available for more than 20 years, yet studies show that most doctors don’t know how to order and interpret such tests. Few EHRs support any genetic testing or interpretation of genetic tests. If you had a platform model, a number of companies, including some of the existing [direct-to-consumer] ones, could build applications to order tests and provide interpretation.
TR: The aim of the stimulus bill, obviously, is to stimulate the economy. Will this approach help?
IK: We see this as being stimulating to the economy, because it allows scores of companies to develop business plans around these applications. The basic platforms could be sold by existing vendors but be designed to load third-party applications. It would create a much larger ecosystem of competing, evolving health-care applications driven to meet the different niches of health-care practice. Urban and rural practices, for example, don’t need the same kind of support.
TR: Does the recent stimulus legislation move us in the right direction or the wrong direction?
IK: The legislation is not specific enough to endorse the platform approach or argue against it. The concern is that the money has to be spent awfully fast. If nothing particularly innovative is done soon, it’s the shovel-ready applications [which would likely closely resemble existing EHR programs] that will be implemented, and those are monolithic. We would argue that one of the most important things government could do is propose rapid adoption of a platform model that would allow third-party applications.
TR: Recent studies suggest that very few hospitals and physicians’ offices are using EHRs. How will that affect implementation efforts over the next two years?
KM: You can look at low adoption rates as a glass half empty or half full. The empty view is that we have not been successful in getting the technology out there. But we are looking at the glass as half full. There are lots of offices out there that are ready for something completely new.