Microsoft’s HealthVault brings lots of partners to the table. And so far it’s announced one major EMR vendor as a partner. That partner is Allscripts and this morning I got to talk with CEO Glen Tullman. Glen explained his take on Microsoft’s business model, why Allscripts is interested in getting involved and also gives a brief update on NEPSI–Allscripts’ online eRx initiative. Here’s the interview.
First, I have tried eRX and it doesn’t work. I guess that’s why Allscripts is parterning with Microsoft because they have a history of making products that don’t really function.
Second, I was invited to Allscripts EMR conference in San Diego. Their sales people are ridiculous. They want to do anything, but show you their product. I have literally asked about 20 times to their San Diego sales rep to show me the product and he does NOT return any phone calls. I even had dinner with the Allscripts people and still there is never a demonstration of their product.
I listened to the Allscripts interview, and I really appreciated it. Matt, please keep more timely interviews like this coming!
However, I didn’t hear a reason to change my earlier comment on HealthVault: it will take 5-10 years before the information that will feed into it is complete enough for most patients to be useful and able to out-compete plan-sponsored PHRs that use claims data.
A few unanswered questions:
1. How many hospitals and physician groups are going to be motivated to create an interface to HealthVault and sustain it? What’s in it for them? We have a similar problem here to the one that plagues most RHIOs.
2. Is there reason to think that the various EMR vendors will all create interfaces with HealthVault, instead of splitting into various camps? Google is still to roll out its web-based PHR, WebMD is doing its thing, etc. My guess is that many major vendors won’t make it easy for their clients to connect to HealthVault, and few providers will be willing to take the extra time and expense to do so until there is a clear business case. And given that, we can expect consolidation and true interoperability in the PHR market to take some time.
There are a number of other problems. A tiny fraction of the population is going to enter their own health data. Moreover, physicians often don’t trust or respect self-entered data, which is a de-motivator even for those who may be inclined. Given that, we need auto-population of data for PHRs to be used widely. In order to achieve that, we of course need data in a form that can be automatically uploaded to a PHR. Less than 20% of health data is currently on an EMR system. We’re not going to hit 50% in 5 years unless there are government mandates. Let’s say that does happen, though. Even then, half of all healthcare data won’t even be in a format that is available for automatic uploading to the web PHR. Most people, therefore, are not really going to find these PHRs useful for at least that long.
I’m not dismissing what Microsoft, AllScripts, etc. are trying to do. Glen Tullman knows that getting EMRs into small practices is one of the biggest hills to climb for the universal PHR to become a reality, and NEPSI is a good start in that direction.
I just think the reality is that we are probably close to a decade from having the average person able with a couple of clicks get all their pertinent medical history displayed in a single place, and which can then be used to send the information to their physician electronically and to help them manage their health more successfully.
In the meantime, the health plans are competing for these patient eyeballs and they have far greater interoperability and consolidation of data at this point. If they continue to move forward with their plans for portability, this will in the near term be a more attractive PHR for most people. The exceptions will be patients who tend to get their health care from one provider organization (a multi-specialty group or an integrated delivery system). For those, a provider-sponsored PHR would be most attractive and available in many cases. But you don’t need HealthVault for that.
By the way, simultaneous to all this are efforts to construct a NHIN. Eventually, wouldn’t the best approach be to construct a PHR-viewer which patients can authorize to pull data from the NHIN? Why should we create a separate PHR system that requires its own interfaces directly to EMRs, rather than just use the data exchange systems that will be created for the NHIN? Will HealthVault change how it pulls data as parts of the NHIN go up in regions of the country?