Intense Focus on Interoperable Health Records Not Reflected in EHR Vendor Capabilities or Near-term Product Plans

Chilmark Research's latest report finds interoperability capabilities in EHRs evolving too slowly to support the application ecosystem needed to enable value-based healthcare.

Jul 23, 2015, 07:43 ET from Chilmark Research

BOSTON, July 23, 2015 /PRNewswire/ -- The rapid expansion of value-based reimbursement (VBR) is exposing unmet needs for active coordination – care, financial, and administrative – within and between healthcare organizations (HCOs). Active coordination requires straightforward, real-time access to data across organizations and applications. Today, the most highly valued source of patient data is in electronic health records (EHRs). Routinely referred to as "platforms," EHRs fail to live up to the modern understanding of this title as they are architected to perpetuate and extend data silos, foreclosing opportunities for more active coordination.

Most EHR vendors regard their core clinical systems as comprehensive and inviolable – few readily admit that provider needs are have long outstripped existing EHR feature sets and ongoing development efforts. Healthcare end-users have elevated expectations based on consumer-facing application ecosystems or "app stores" – built on the technical foundation of open APIs in a cloud-based environment. The EHR market is ripe for the development of an application ecosystem to rapidly extend functional capabilities and remedy usability deficiencies. But first it needs open APIs and a Platform-as-a-Service (PaaS) for developers. This is but one of many findings in Chilmark Research's latest report: Moving to Open Platforms: EHR Vendor Strategies and Assessment.

This research found that independent software vendors (ISV) have mixed opinions of the capabilities offered by EHR vendors. Some survive, and even thrive, but always at the sufferance of major EHR vendors. Others survive in the shadows, taking pains not to attract any attention from EHR vendors for fear of being shut out. This report characterizes the interoperability capabilities of prominent EHR vendors. Current technology interfaces that provide data after the fact, non-disclosure agreements, data access fees, and the lack of reasonable software tools for developers are all obstacles to the development of extensions by ISVs or HCO developers. The report describes how the leading candidate for open APIs in healthcare – HL7 Fast Healthcare Interoperability Resources (FHIR) – is being implemented by EHR vendors. This new technology offers the most potential to provide real-time access to data across applications and organizations and may ultimately give rise to PaaS-based ecosystems.

Lead author and Chilmark Research analyst Brian Murphy notes, "Open APIs will ultimately form the basis for the interoperable health records that patients and providers are demanding. The work being done by the major vendors to support FHIR is only the beginning. In the next year, we expect healthcare technology contributors – IT vendors, payers, health information organizations (HIOs), and others to move beyond endorsement to actual implementations. FHIR APIs will eventually replace much of the data exchange technology painstakingly assembled over the last thirty years with modern ideas of open, distributed computing. Programmers will access data where it lives rather than where it has been staged, leading to rapid improvements in IT functionality, usability and genuine choice in applications to use."

The report concludes that the healthcare market is quite ready for API-driven extensions to clinical and financial applications. Leading IT vendors will need to API-enable their core products if they wish to foster a PaaS ecosystem that accelerates their ability to address unmet needs of end users. Currently, EHR vendors are better positioned than any other HIT vendors to become true platform vendors as they are still at the center of physician workflow, hold the keys to clinical patient data, and still command the lion's share of IT resources and subsequently attention from HCO C-suites. This is their opportunity to lose if they fail to innovatively create a true ecosystem around their offering.

This report provides a snapshot of several EHR vendors' interoperability capabilities, or lack thereof, as well as a review of their nascent API programs. A similar report, to be published in late 2015, will provide a similar analysis of what other IT vendors serving the healthcare sector are doing to enable their own PaaS strategy. This second report will also include an analysis of how other well-known providers of interoperability solutions (i.e. CommonWell and the Sequoia Project (formerly HealtheWay)) are contributing to the development of a more platform-centric approach that can deliver an application ecosystem to healthcare.

The report is available to subscribers of the Chilmark Advisory Service or may be purchased separately. For more information, visit Direct inquiries for purchase should be addressed to Sean Campbell at

About Chilmark Research:
Chilmark Research is the only industry analyst firm focusing solely on the most transformational trends in healthcare IT. We combine proven research methodologies with intelligence and insight to provide cogent analyses of the emerging technologies that have the greatest potential to improve healthcare. We do not shy away from making tough calls, and are respected in the industry for our direct and thoughtful commentary. For more information visit:

For media inquiries, please contact the author:
Brian Murphy
617 230-0623

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SOURCE Chilmark Research