From HIS to EHR to EMR

It’s been more than ten years since the HITECH program within the American Recovery and Reinvestment Act began offering incentive payments to hospitals and doctors to encourage the use of electronic medical records. Medical providers that were already using electronic systems also received these payments when switching vendors.

The end result was that President Obama distorted the well-established and competitive medical information software market. This paved the way for a single privately-held company — Epic Systems — to become dominant in the market, despite its products being, by far, the most expensive.

Marketplace covers the recent acquisition of Cerner by database giant Oracle, but with no mention of Epic. Cerner has the government contracts for hospitals within the Department of Defense and, separately, the Veteran’s Administration.

The fact is, medical records within Epic’s huge installed base can be shared seamlessly between providers, if they so choose. I have seen this for myself, and appreciate the convenience. With Epic on track to eventually manage 75% of all non-military medical records in the United States, the government might want to consider an antitrust case against the company it helped to promote.

Ultimately, the solution is to force a standard format for medical records that can be shared between medical providers using different software systems. How likely is it the government will pursue that route to level the playing field, rather than a direct antitrust case? I see neither happening anytime soon.

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