I have recently read a couple of articles exploring the evolution of Electronic Medical Record (EMR) solutions from application focus, to platform solution capability and their benefits. While the established EMR providers have evolved into broad platform solutions, there are still inherent issues and gaps that need to be addressed if they are to provide true platform capability. There is also an argument, that given newer and evolving technologies, reliance on a solution platform may not be as important now as it might have been in the past.  

Most of the major EMR solution providers evolved from developing a specific departmental solution, and then expanded into other clinical and patient admin areas over time. Through this process most of the established EMR providers are built on technology that facilitates their own interoperability. Cerner is an example where the organisation started with a laboratory management solution in the early 1970’s and evolved to where they are today, with what may be considered an end-to-end platform solution. The perceived benefit from these types of solutions is an end-to-end reliable EMR platform capability.

However, a platform is more than just its own inherent functions.  A true platform will support other solutions through easy integration and support evolving technical capabilities. These capabilities allow the organisations using them to leverage and maximize their initial investments and to support their ever changing clinical delivery processes and objectives. Most established platforms today don’t necessarily facilitate the flexibility and interoperability with disparate or niche type solutions, or the evolving importance of technology such as mobility, as health delivery models move from just an acute focus to a stronger focus on community. In fact, due to their commercial models and technology they tend to inhibit choice, by not offering open ecosystems and open API’s (Application Program Interface). It is because of this history, technology and competitive strategies that true platform capabilities do not exist.

There is a new generation of organisations such as Sláinte, which are taking advantage of these limitations. Web based, flexible and robust technologies provide cost effective solutions that can help health delivery organisations to maximize their existing investments, or that can interoperate with a number of solutions that minimise the reliance on platforms. At the end of the day, solutions need to be flexible, need to be able to interface easily for required interoperability and be quick to implement for fast return on investment and clinician satisfaction. Current platform technology tends to inhibit all of these.