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The Surprise

Brian Klepper

Check out this March 3rd article – ( click here ) – from the recent HIMSS conference, in which Dave Garets, President and CEO of HIMSS Analytics,“gazes into the future and predicts major trends for the next 12 months.” HIMSS Analytics is the research and consulting arm of the health IT vendors’ association, and presumably on Health IT’s leading edge.

From the article:

“Q: What will constitute the surprise of 2010 – the one technology or policy or X-factor that no one saw coming.”

“A: Clinical groupware in the ambulatory market that may be the disruptive innovation of ambulatory EMRs.”

For the uninitiated, “Clinical Groupware” is a term that is rapidly gaining traction and that describes a new wave of inexpensive, ergonomic, useful Web-based care management  tools. David Kibbe coined the phrase and articulated Clinical Groupware’s conceptual framework on this blog early last year – see here and then here. He noted that it:

“…captures the basic notion that the primary purpose for using these IT systems is to improve clinical care through communications and coordination involving a team of people, the patient included. And in a manner that fosters accountability in terms of quality and cost.”

Dr. Kibbe formulated his ideas, not in isolation, but in continual discussions with innovators developing great new care management tools – e.g., Docsite, Keas, Relay Health, VisionTree, Medicity/NOVO, Salesforce, Practice Fusion – that were realizations of the concept in one form or another. A group of these like-minded developers founded the Clinical Groupware Collaborative, led now by Steve Adams, the founder of RMD Networks. If you’re working in this or an aligned area, consider joining.

Which is all by way of saying that it is a stretch to say that “no one,” especially HIMSS, saw this coming. From the moment that HIMSS became aware of Clinical Groupware – it’s newfound religion on Web-based and modular approaches notwithstanding – influential members were concerned about the trend’s disruptiveness. After all, if you’re selling EHRs for $25,000 per physician and a new competitor comes along with complete systems or highly useful modular components for a fraction of that – or even free! – the pricing shift will wreak havoc on your revenue and market cap. It’s enough to give even the most enthusiastic free marketeer the willies.

That concern found expression through HIMSS influence over CCHIT‘s – the Certification Commission for Health Information Technology – certification process. CCHIT’s criteria were initially spun to favor HIMSS members’ products, mostly old-fashioned client-server tools that are complex and not interoperable, and to stifle support of newer, more streamlined solutions like Clinical Groupware. Remember that, early on, everyone thought CCHIT certification would be the criterion for receiving ARRA HITECH stimulus funding, so the criteria could be used to steer the money, conflicts of interest notwithstanding. Fortunately, cooler heads prevailed on the HHS Policy Committee and that heist was averted, or at least it seems so at this point.

The good news is that Dave is right. Clinical Groupware is evolving rapidly and will seamlessly link tools, care teams and patients. It does look disruptive and undoubtedly is the future. If they’re watching, this should give serious pause to all those investors driving up Allscripts stock price.

Because, in the end, many old-guard EHRs – the ones Clinical Groupware will replace – produce dreadful customer experiences like the one described yesterday by John Moore. His article described a market begging for innovation, where the old guard is locked into its past market domination and excessive pricing, and the users are increasingly frustrated.

Of course the irony here is that Clinical Groupware will most surprise and disrupt HIMSS’ member organizations, the core of Mr. Garet’s constituency, who thought the matter was settled a year ago.

Brian Klepper writes about health care market dynamics and innovation.

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Dave FosterTom LeithBrian KlepperMatthew Holtbev M.D. Recent comment authors
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Dave Foster
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Is “Clinical Groupware” really a great term? Kinda centers around the clinician and not so much the linking in the patient part. I’m just sayin…

bev M.D.
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bev M.D.

Tom Leith;
Until a patient can prescribe his own drug, type his own blood or assign his own radiation dose via the EMR, I don’t think your comment is relevant.

Tom Leith
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Tom Leith

Hmmmmmm.
With all the recent discussion about how EM/HR systems amount to medical devices, how on earth will a system that accepts data from a patient ever fit into the regulatory framework the imapssioned champions of regulation want?
t

Brian Klepper
Guest

I stand corrected. I wasn’t aware of how this came about. Great term, Jeff.

Matthew Holt
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Teeny teeny historical footnote. David Kibbe is no question the father of clinical groupware, but the name came from Jeff Goldsmith in the first comment on this thread. https://thehealthcareblog.com/the_health_care_blog/2008/12/emr-use-on-the.html
Pedantry over.

bev M.D.
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bev M.D.

Thank you for clarifying that CCHIT has been more or less ejected from the process. Comments on recent previous posts seemed to obscure this fact and maintain that HIMSS is still in control of the certification process.