The HealthIT Data Hogs of Healthcare

March 12, 2015
James Doulgeris

Data hogs from hospitals to EHR purveyors should take the investor's creed much more literally: "Pigs get fed but hogs get slaughtered."

Keeping data within one's EHR is a great business model for both large-scale users like hospitals and EHR companies alike. You can charge what you want, lock customers in, and keep competitors out. Keeping data within your own software or institution is a huge competitive advantage.

System resident EHR companies are doubling down on this model by acquiring cloud-based EHR companies. Some are moving data out of facilities and into their own cloud-based lockbox. Some are setting their table to be the single click-point as Kayak is to the travel industry.

The winner will become the data supermarket to healthcare.

Except, these strategic movements are mostly about hospital data  (which is crisis data and of very limited use in population health), and has limited value to all of the other health and care things that have to be done to move the quality, health status, and cost dials from fiscal Armageddon to sustainability.

That's where hospital-centric strategy will get hospital-centric companies into the cook pot. Healthy people without medical emergencies or crises and not needing sophisticated diagnostics and invasive procedures is bad for hospital business, so, it is understandable for companies to cater to them. Expecting a voluntary, or even some sort of sincere, attempt, however, at a 180-degree transition from a trillion dollar plus, fee-for-service-dependent medical crisis industry to the physician world of a few bucks for prevention is just, how do I put it delicately - disingenuous.

That's why we should not only be skeptical of the motives of these business models, but physicians should step away carefully and demand EHR companies to serve their needs. And, they can be pigs about it because the company that successfully becomes a data supermarket will feed the entire industry.

In the hospital world, controlling data is a competitive advantage, a point of physician control, and a means to continue to extract trillions from insurers long enough to try to make a transition or just keep the industry anchored in their harbor by their sheer size. Hogs that, when they are fat enough have eaten the economy into starvation, will become food instead.

In the physician world, sharing data is a competitive advantage, a point of hospital control, and a means to actionable information to perform population health and create analytics that will derive and extract their value from insurers by what they save, not consume. Also in the trillions. Warm, pink, fuzzy, cute, and sustainable.

This is where we come full circle to the data collection and warehouse world and the real question for the data collectors of healthcare: Are you the hogs or the pigs?

There may be better metaphors to wrap this argument around, but pigs are just so darn cute.

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