Open.Epic: A (Not So Open) API


If one more person describes Epic’s new API as being “open”, I’m going to turn purple. Don’t let the URL fool you:

Last week EHR vendor Epic unveiled it’s new API (application programming interface) targeted at developers — more specifically at remote patient monitoring companies and health/wellness apps or portals. Epic seems to have had second thoughts about the site since only remnants of the landing page are still there as of today.

Not to worry. As a public service, I kept a copy and have reproduced the text below — with personal annotations/translations added.

What’s Wrong With Epic’s API?

What’s wrong with Epic’s API from a developers POV? Data goes in. It doesn’t come out. If you are a developer, this is a great way to disintermediate yourself — you create all the value, Epic captures all the value.

Would you bank at an institution that allows you to make deposits, but not withdrawals?

Despite the chatty language that was on Epic’s website, their API is a continuing extension of Epic’s ethos of control rather than collaboration. It’s downright condescending.

What part of health information exchange do they not get over at Epic?

Enough banter. Let’s get to the meat of it.

Could Google+ Be Your Platform for Care Coordination?

An earlier post — Could Facebook Be Your Platform for Care Coordination? —  resonated well with folks.

Readers and commenters (on e-CareManagement and The Health Care Blog) quickly grasped that a social networking platform could play a very useful role in coordinating our health care, yet also agreed with the conclusion that Facebook wasn’t  “it”.

So let’s ask the question again: Could Google+ be your platform for care coordination? This post will

  • Describe Google+ and Circles
  • Discuss how Google+ gets past some of Facebook’s limitations as a care coordination platform
  • Comment on Google+ as a care coordination platform (promising, but too early to tell)

Table of contents for the series--Social Networks and Care Coordination

  1. Could Facebook Be Your Platform for Care Coordination?
  2. Could Google+ Be Your Platform for Care Coordination?
  3. Google+ Shines the Light on the Value of Data Portability

Part Deux: A Rebuttal to PHR Luddites

DnaBy now most people understand the promise of pharmaceuticals being customized to “YOU” based on your individual genetic code.  While this isn’t prevalent today, we understand that this will be possible in a few years.

Let’s take a minute to consider the mechanics of how this will occur. You’ve received a prescription, and it directs the pharmacist to tailor the medicine to YOUR genetic profile.

Consider two possible scenarios of how this transaction might happen. You’re on the phone with your pharmacist:

1) “OK, you need my DNA sequence. I keep my genetic profile in my mattress…let me get it and I’ll read it out loud to you.  C, A, T, G, G, A, T… no,  that was actually a G…let me start over.  C, A, T, G, G, A, T… (19 hours later) … T, and G. Can you read that back to me to make sure you got it right?”

2) “You have permission to access my DNA sequence at my health URL (or maybe a health record bank, or perhaps hand her a flash drive, or ??).

Still think you’ll never use a PHR?

Table of contents for the series--PHR Systems

  1. A Rebuttal to PHR Luddites
  2. Part Deux: A Rebuttal to PHR Luddites

A Rebuttal to PHR Luddites

Unlike some of my colleagues, I’m not losing ANY sleep over whether personal health record (PHR) systems ultimately will be adopted and used by patients.

In my mind, the issue isn’t WHETHER, but WHEN.

Yes, I know that adoption has lagged and that surveys suggest 7% or less of the U.S. population has used a PHR.

Stay with me on this one for a minute. You’d have to have two underlying beliefs to conclude that PHR systems won’t eventually emerge:

  • That health record data will persist in non-electronic formats, i.e., paper
  • That people won’t have interest in accessing or using their health record data

Table of contents for the series--PHR Systems

  1. A Rebuttal to PHR Luddites
  2. Part Deux: A Rebuttal to PHR Luddites

Through the Lens of Disruptive Innovation: Why Direct is a Hit and PCAST is an Outcast



(click on the graphics to link to original sources)

Regular readers know that I find Professor Clay Christensen’s theory of disruptive innovation to be a useful lens to explain industry evolution. Let’s look at two recent health IT initiatives and see why one is working and the other is stalled.

Electronic Health Information Exchange — Way More Complicated Than Getting Money from an ATM

“If banks can exchange funds electronically through the ATM system, why can’t my doctor and hospital exchange information electronically?”

Keith Boone’s concise article “A Doctor is Not a Bank” explains why this conclusion about healthcare interoperability is overly-simplistic.

…and Keith’s article reminded me of an even deeper explanation presented in the National Academies’ Frontiers of Engineering series — Why Health Information Technology Doesn’t Work, by Elmer Bernstam and Todd Johnson. The table below summarizes the differences between health data and banking data.


Top 20 iPhone Medical Apps: No Connection to EHRs…Yet

iMedicalApps recently published its list of Top 20 Free iPhone Medical Apps for Healthcare Professionals.

What struck me about the list is that the state-of-the-art is stand alone applications — I didn’t see any that had any connection to an EHR (electronic health record).  Here’s the top 5 to give you a flavor of what’s on the list:

  1. Medscape
  2. Micromedex
  3. New England Journal of Medicine
  4. Epocrates
  5. Free Medical Calculators

I expect that this list will begin to look very different in coming years as EHRs continue to open their platforms to outside developers…and applications will increasingly be integrated into direct patient care.

Doctors Love iPads. What Does it Mean? What Does it Mean?

After attending the largest annual health IT conference of the year — HIMSS 11 –  John Moore reported that “nearly every EHR vendor has an iPad App for the EHR [electronic health record], or will be releasing such this year.”

Doctors love iPads…not surprising? But, how might you explain this?

There are at least two different possibilities:

  • Coincidence Theory
  • Conspiracy Theory

The Coincidence Theory

So doctors want to access EHR software through the iPad…what’s the big deal?

Apple has built a great new hardware platform with the iPad. There’s nothing else like it in the marketplace.  While other companies are building competing tablets, Apple’s has been the only viable option in the market for over a year.

Complimentary Webinar — An Impending Marriage: Electronic Health Records (EHRs) and Care Management Software


Webinar Title: An Impending Marriage: Electronic Health Records (EHRs) and Care Management Software

The presentation will be geared at practicing clinical case managers in health plans, hospitals, disease management companies, and similar organizations:

  • Describe market forces driving integration of EHRs and care management software. 
  • Review care management software survey data and stimulus funding for EHR adoption. 
  • Describe a 3 stage framework for the evolution of EHRs and care management software. 
  • Characterize benefits to patients and impacts on care manager responsibilities.

The event is sponsored by HealthSciences Institute and the PartnersinImprovement Alliance.


Friday, February 4, 2011
11:30 am Eastern Time
10:30 am Central Time
9:30 am Mountain Time
8:30 am Pacific Time

Your Presenters:

Vince Kuraitis JD, MBA
Better Health Technologies, LLC

Garry Carneal, JD, MA
Schooner Healthcare Services

More Information and Registration:  Click here.

Comments to ONC: PCAST HIT Report Becomes a Political Piñata

The PCAST Report on Health IT has become a political piñata. 

Early Feedback on PCAST 

Like many of my colleagues, I was taken aback by the release of the Report in early December 2010 — I didn’t know quite what to make of it. Response in the first week of release was: 
  • Limited. The first commentaries were primarily by technical and/or clinical bloggers. The mainstream HIT world had remarkably little initial reaction to the Report. 
  • Respectful of the imprimatur of “The President’s” Report and noting some of the big names associated with the report (e.g., Google’s Eric Schmidt and Microsoft’s Craig Mundie.)
  • Focused on technical and/or clinical perspectives around two broad themes.
    • The vision is on target:  “extraordinary”, “breathtakingly innovative”.
    • These guys didn’t do all their technical homework. The range varies, but the message is consistent. 

Today’s POV on PCAST 

What  a difference a six weeks makes.