Last night Xconomy presented a "face off" between Jonathan Bush of athenahealth and Girish Navani of eClinicalWorks. While the two companies started with very different approaches, they have both ended up as serious players in the growing electronic medical records business. Navani said he set out to start a "life style company" with the goal of hiring "five engineers to service five hundred doctors in five years". The company became significantly larger and grew to 45,000 doctors without raising any outside capital or taking on debt. In contrast, Bush raised $50M with the ambition at the outset of becoming the major provider of EMR. While there are some subtle differences in their offerings, both companies were successful in their bid to upset what they characterized as a moribund industry whose products (with the exception of Epic who they said they respected) were overpriced and difficult to use. In fact they both said that the Affordable Care Act's subsidy for meaningful use of EHR was actually counter-productive as it prolonged what they predicted was the inevitable demise of their competitors.
What was especially interesting was that both companies described their value proposition as so much more than efficiently maintaining patient records. Bush went much further and talked about the benefits of having vast quantities of aggregate patient data which could be used to benchmark efficiency of medical practices and even provide much earlier warning of trends and epidemics than is possible today using hospital discharge records.
Of course the Holy Grail is still interoperability so that the data can travel with the patient rather than being recreated with each new provider the patient visits. Neither speaker talked of any concrete plans to bring that about although they were already discussing business models that might encourage EHR vendors and their clients to cooperate.