EClinicalWorks ranks among the leading electronic health record vendors in the United States. It's third based on the number of customer meaningful use attestations to get government incentives for using EHR (behind Epic Systems and Allscripts) and second only to Epic in the number of eprescriptions filed annually.
But eClinicalWorks is also among the quietest EHR vendors—and that's how CEO Girish Kumar Navani likes it. Much of its marketing is word of mouth—90 percent of the firm's business comes from referrals, Navani says, while its footprint in larger hospitals often goes unadvertised.
The company also stayed on the sidelines at this year's Health Information and Management Systems Society's HIMSS13 conference while five other big players announced the CommonWell Health Alliance and Epic, the biggest of them all, first downplayed its omission and then cried foul. (For his part, Navani thinks "the market will take care of itself" when it comes to interoperability, and eClinicalWorks develops its technology to adhere to interoperability standards.)
The company seems to prefer making headlines on its own merit—as it did last year when it inked a 10-year deal to be the National Football League's EHR system and in February when it launched the mobile Health and Online Wellness initiative known as healow.
In an interview at eClinicalWorks headquarters in Westborough, Mass., Navani discussed these projects and offered some perspective on where healthcare is headed and what role information technology will play in its transformation.
Moving at 'Fast Pace' Toward Patient-Centered Care
Healthcare is moving at a "fantastically fast pace," Navani says. Other industries—namely, telecommunications, airlines, entertainment and retail—are consumer businesses, but healthcare is not. "We're in black box where you don't know what your bill will be until you get it," he says. (That said, the federal Centers for Medicare and Medicaid Services are beginning a price transparency initiative.)
The next 12 to 24 months will be critical to the path to consumer-centric healthcare, in which patients decide where to get care, what it will cost and what the outcome will be. Here, information is key. It's not big data— Navani says he hates the term—but, rather, "data that has an answer."
For physicians, this means knowing more about individual patients as well as their entire patient population. Before prescribing medication, for example, a doctor should be able to see if other patients are taking the same drug and if it's working for them, within seconds and presented in an intuitive manner. Such technology isn't unique, Navani says, noting that companies routinely use business intelligence software to track company-wide performance.
Making Primary Docs 'Quarterback' of Healthcare Process
With this information in hand, primary care physicians can become the "quarterback" of the healthcare experience, working with specialists to improve the care process, Navani says. This can be true even if the patient himself is a quarterback, as eClinicalWorks' partnership with the NFL intends to help teams of physicians track an athlete's progress from the point of impact (using mobile EHR on the football field) to rehabilitation and offseason recovery.
The initiative, which eClinicalWorks hopes to brings to college and high school athletic programs as well, is only one example, Navani says, that "the nucleus of care will shift from the hospital to the physician." (The accountable care organization model outlined in healthcare reform aims in large part to do just that.)
The takeaway for healthcare IT vendors? "Build tech that's physician-friendly; they will run the show for the next 20 years or more," Navani says. Those who invest in research and development are increasingly likely to stand out, he adds, while those who don't may struggle.
So, too, will those who continue to view EHR systems as "big, expensive things," Navani says, suggesting that the market is shifting to one where lightweight EHR apps and modules are downloaded from app stores.
Data Empowers Patients—But Too Much May Be Scary
For patients, an improved care experience means robust patient portal technology. If patients can see data but can't do anything with it, it's like seeing an airline fare on a travel site but not being able to book a flight, Navani says. That's the idea behind healow, a free mobile health management app in which eClinicalWorks has invested at least $25 million. The app helps patients find a doctor, check in for appointments and pay bills online. In essence, Navani says, it mimics the online banking experience.
However, the wealth of patient data could, in some cases, be too much of a good thing. As genomic research gets less expensive, it's increasingly poised to play a role in the care process. Right now, the technology for plugging it into an EHR system doesn't exist yet.
When it does, Navani suggests physicians use it sparingly. Using a patient's genome to choose the medication that best treats a certain condition is one thing, he says, but using that data to predict when a patient may contract a certain disease, or even die, is another thing altogether.