Declining value of the EMR walled garden? An emerging signpost from Cleveland Clinic

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Quick follow-up to our post about the Epic-eClinicalWorks deal: Today’s Healthcare Informatics has an interview with Martin Harrison, CIO of Cleveland Clinic, was asked what is the biggest strategic IT challenge right now. His answer?

The challenge element is partly being driven by the complexity of the challenges in this value-driven world. So all the care providers belonging to this collaborative probably will not belong to the same organization. So the biggest challenge to my mind right now is the effectiveness of interoperability. We talk about it a lot, but the effectiveness and sophistication are going to have to improve considerably.

One can imagine why this issue is now top of mind for Harrison. Cleveland Clinic is an Epic shop and the system has launched an affiliation with Promedica in the Toledo area and acquired Akron General – both of these systems appear to run McKesson and my guess is that this is unlikely to change soon:

  • The Promedica deal is an affiliation with uncertain lines of decision and probably not a lot of incremental capital to spend. Promedica’s decision to use McKesson is also relatively recent.
  • Cleveland Clinic’s partner in the Akron General acquisition (Community Health Systems) also operates McKesson and is probably comfortable with it (or at least uncomfortable with footing the bill for an Epic implementation) and Akron General’s own shaky economics won’t support it either.

If more and more of Epic’s premier customers start facing challenges like Harrison, Epic will likely decide the walled garden has diminished strategic value (what I called Scenario 2). We can then Epic to try to strike more standards-based deals with other big EMR operators to reduce the cost of retrofitting interfaces in legacy implementations and possibly make it easier to create links in future implementations.