EMR Landscape Is Still Not A Level Playing Field For Small Tech Vendors

By Christine Kern, contributing writer

Report finds lack of real-interoperability particularly for smaller vendors.

In achieving true national interoperability, the Department of Health and Human Services (HHS) has indicated the flow of information is fundamental. Yet, despite the centrality of this initiative, significant barriers still remain to actually meeting these goals, as Health IT Outcomes reported.

Among the accepted challenges of EHR products on the market, as Health IT Outcomes wrote, are the fact they are “cumbersome from a data entry perspective, counter-intuitive to clinical workflows, and aren’t conducive to interoperability.” As the study noted, this means many healthcare workers are finding ways to work around the system, rather than utilizing it to be more productive.

Now, a Health 2.0 report found integrating digital solutions into big vendors’ EMRs is challenging for smaller health tech companies. In the survey of more than 100 small health tech companies, the majority of EMR vendors did not support any integration. The only two exceptions were Allscripts and athenahealth. This study supported the claims the larger, legacy EMR vendors do not allow newer vendors to integrate with them. Further, the surveyed companies that accomplished integration reported the EMR vendors' application programming interfaces (APIs) were either "not great" or "poorly designed".

The survey was supported by the California Health Care Foundation, and found, “The complaint is true: it’s hard for smaller health tech companies to integrate their solutions with big EMR vendors. Most EMR vendors don’t make it easy. But it’s also a false picture to say that it’s all the EMR vendors’ fault, and it’s also true that there is great variety not only between the major EMR vendors, but also in the experience of different smaller tech companies dealing with the same EMR vendor.”

What the study found was cost was the biggest barrier to integration, and “integrations can and have been done with all vendors including those regarded as the most difficult to work with.” Of the approximately 30 percent of small health tech companies surveyed that had not yet integrated, nearly all said EMR integration would be nice to have, but it wasn’t valuable enough to justify the investment or they were not far enough along in their own evolution to attempt it.

When asked which EMR vendors were easiest to work with, participants put Allscripts, athenahealth, and McKesson at the top, while Epic, Cerner and GE were about 50-50. Next Gen and eCW scored as least helpful.

But while cost has been touted as a major barrier to interoperability, this study found that is not necessarily the case. Costs were not the largest deterrent for integration considerations among smaller tech companies since most of the big EMR vendors did not require an integration fee and half of the tech companies that responded to Health 2.0's survey had complicated APIs.