EHR Vendors Tap Software Developers To Expand Reach

10 Mobile Health Apps From Uncle Sam

Electronic health record (EHR) companies are beginning to partner with outside software developers to help them ramp up new applications for care management, population health management and patient engagement. Athenahealth, Allscripts, and eClinicalWorks (eCW) all are placing big bets on this approach, although eCW is tilting more toward mobile health apps than the other two vendors are.

This week, Athenahealth announced a new partnership with Mashery, a provider of application programming interface (API) management technology and services, to APIs to the health IT developer community. The aim is to develop "best-of-breed, HIPAA-compliant health care applications that can be easily introduced and integrated within health care provider workflows," according to the news release.

The attraction for developers: a potential market of 40,000 providers that use Athenahealth's cloud-based EHR. "We're providing the data and knowledge from our cloud-based network, a captive audience for developers to innovate for, and an online sandbox to do it all in," said Kyle Armbrester, director of business development for Athenahealth, in a statement.

[ How do smartphones and tablets fit in at U.K. hospitals? You might be surprised. Read NHS Moves Slowly Toward Mobile Health IT. ]

Allscripts last summer announced an agreement with Microsoft to expand Allscripts' application developer program in an effort to encourage more firms to write apps for the Windows 8 OS. Allscripts hoped to ride a Windows 8 wave that never materialized.

Nevertheless, Allscripts still offers developers its Helios software development kit (SDK), and more than 200 developers have signed up to use it. As of last summer, more than 30 products were available or close to release. Allscripts also encourages software firms to build new apps for care management based on Microsoft's Dynamics CRM.

eClinicalWorks (eCW) unveiled its new patient engagement subsidiary, Healow, in February. eCW plans to invest $25 million in the project this year, and Healow already has 50 employees who do nothing but write apps and expand its platform, eCW CEO Girish Navani told InformationWeek Healthcare. All of the first mobile health apps at Healow were programmed by employees, he said, but that is about to change. Healow has partnered with an outside developer to create home telemonitoring apps, and it plans to turn Healow into an "app store" with a wide range of consumer-oriented mobile applications. All of these will be connected to the eCW EHR.

Healow already offers internally developed apps that manage a consumer's providers and patient portals; manage medications and reminding patients to take them; store key health data and reminders about appointments; and communicate with providers and receive health alerts.

Soon, Healow will provide a standardized API and an SDK to developers that want to partner with it, but it won't accept offers from every company with an app, Navani said. A company's implementation of the Healow API will have to be "validated," he said, and Healow will have to certify that the product meet its standards.

"We want to make sure the consumer will have a good experience," he said.

eCW also wants to ensure that the mobile health apps on the Healow platform are ones that physicians would consider prescribing to their patients. According to an eCW survey released in January, 93% of physician respondents find value in having a mobile health app connected to their EHR. The same percentage of doctors also believe that these apps can improve a patient's health, and nearly as many say they'd be likely to recommend an app to a patient.

The big reason why mobile health has failed to achieve its potential so far, according to Navani, is that "apps that don't have a coach, counselor or provider in back of them don't work." So his plan is to connect these mobile health apps to physicians through their eCW EHRs.

To that end, the next version of the EHR, to be released in June or July, will have "a clinical rules engine that can consume patient data [transmitted from mobile or home monitoring devices] and come up with recommendations" for providers, he said. For example, if the system noticed that a patient with congestive heart failure had sent in data indicating weight gain, the rules engine would notify his or her doctor.

eClinicalWorks is not the first EHR vendor to try to sift mobile health app data for relevant information. One of Allscripts' outside developers, MyCareTeam, screens data from mobile monitoring devices used by patients with chronic diseases. But eCW appears to be the first supplier to integrate this sifting mechanism into its core functionality.

"If we do only the consumer side and forget the provider side, it's going to be a failure, and vice versa," said Navani. "We're making sure that eClinicalWorks invests in tools that are good for the providers, while the consumer side of our company is building tools for patient engagement."

Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital The Right Health IT Priorities? issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.)