I work for McKesson as an account executive (we’re a distributor) and frequently sell ECGs to medical offices of all sizes. The number one question we always get is about integration into an EHR. It’s usually cost prohibitive for smaller offices (sometimes $10k+ upfront plus additional monthly costs) to pay the EHR companies to create a custom bridge for the ECGs to integrate with their EHR. They end up having to create a bunch of manual work arounds, and it sort of defeats the purpose of having integration capabilities. My question to you engineers is: is it possible to create some sort of middleware infrastructure (maybe some sort of API) that allows for devices to connect with a multitude of different EHRs easily. That way offices can avoid the large upfront cost of integration. The infrastructure could be a SaaS model. Essentially what Stripe did for online payments, but for EHR integration. Apologize if this is a dumb question, I’m not an engineer lol #athenahealth #cerner #allscripts #epic #healthcare #healthcareit TC: 150k YOE: 3
McKesson - yes it’s possible and it exists. Integration engines like Redox might be more helpful than talking to EMR engineers. HIPAA is not really the major barrier when working with FHIR, which is what you’d be using to integrate. I’m sure that McKesson already works with the EMRs, and it might be worthwhile asking engineers on your side who work in the interoperability space which emrs integrate best with your products.
Correct, I would agree. I work as Integration Program Manager for an EMR. Middlewares like Redox and Ellkay might be the best solution currently. FHIR APIs might eliminate the need of middleware in the near future but a lot of EMRs are still working and developing their APIs and we are still a few years away.
Correct response, HL7 FHIR standards are supposed to cover for this problem that’s causing the data isolation in the HealthCare industry…
I think that's basically what they were trying to do with that Microsoft and GE Heath joint venture years ago. They poured hundreds of millions into it over 4 or 5 years before shutting it down. But that was 10 years ago, maybe someone could make it work today.
Random question , How’s working at myriad ? Are you a swe ?
I started as a swe, transitioned to management a few years back. Like anywhere quality of life is team dependent, but it's pretty chill overall. Good wlb, we're losing some of our best swes though, bonuses and rsu grants aren't keeping up with other tech.
This is part of the reason why I joined one of the leading cloud providers. There is a huge market demand for a SaaS model around medical device integration.
Would love to talk more about the market opportunity. Can I DM you?
Curious - what does a SaaS model for integration work at a cloud level? There are some “integration as a service” companies out there, with service being the key word (as in, professional service- very hands-on). The problem I’ve seen with integrating devices through cloud is that every hospital has a different stack and different backend (even at the table level, discrete values vary place to place and you can only normalize so much)
That was the whole point of HL seven - The problem is so many different vendors like epic and Cerner came up with some thing else and didn’t stick with the standards and then it is so expensive to find someone who programs and some of these languages at this point that the companies are not willing to keep up even though it’s required for the EMR’s
TC or gtfo
Updated with TC and YOE, my bad! Lol
Here I was wondering how tc/yoe was possibly relevant to this discussion...
Really interesting stuff here in the comments, thank you everyone for your insight!
I’d agree with what a few folks have mentioned earlier - HL7 FHIR is the solution to this problem of interoperability issues. Many EMR vendors, insurance companies, provider practices, hospitals are all coming together to create a seamless exchange of information. Theoretically the concept existed around 4 5 years ago. It is only since a couple years that the development has caught some speed.
And one of the reasons that development had caught up some speed is because of regulatory push as well. That makes me hopeful of truly interoperable healthcare data in the future
DocSpera is another vendor doing EHR integrations and they've already built it out for many different EHRs
From what I’ve read their focus is on surgery, pre and post op. I wonder if anyone is doing this built for PCPs and Community Health Centers
Too much red tape for it to work. EHR vendors also have no incentive to do so
Wouldn’t their incentive be better compatibility with a myriad of devices, which improves customer experience, which then could reduce churn? I know EHRs are pretty sticky products, but it seems like going forward EHRs with better integration capabilities will be the preferred vendors. Just my guess, could be way off.
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Not an engineer, but I work on Health IT systems all the time. Some kind of middleware software is possible, but the bigger issue is getting around HIPAA restrictions and whether or not the EHR vendor will allow for the integration. It's probably best for the EHR vendor to build in integration capabilities. EHR vendors usually have a "user group" committee, where they solicit feedback from their users about needed enhancements to their systems. The more users complain about a needed feature the more likely they are to implement it. You can try to find out if McKesson is a part of those user groups or maybe there's a physician association that is a part of that user group so that they can give feedback. Usually several users from the same domain will band together to request a feature, as they have more power to make a request. Vendors are open to this kind of feedback because it makes them competitive and hopefully more likely that users will choose their system over others .