Could Standard Interfaces for EHR Data Kill the EHR Business?

I was reading some people’s comments on a LinkedIn group and it sparked this interesting question:

If you can move healthcare data wherever we want it, then will the EHR’s have to change their business model?

I think this is a really important question. I’m sure that some will question whether we’ll be able to ever move healthcare data wherever we want it. I can’t remember the exact stat, but I recently saw that a huge percentage of the granular health data is stored in lab results. We’re already moving lab result data pretty well between systems. The same can be said for eRX. We’ve kind of cracked those nuts and eventually we’ll make the rest of the data available as well.

I think the answer to the question is that EHR vendors will have to change. I’m not sure they’ll have to change their business model per se, but they will have to change. The fact that a healthcare organization could take their healthcare data and go somewhere else will mean that an EHR vendor will have to be much more accountable to the software they produce and release.

I’ve often used the comparison on my blog. It is powered by WordPress and one of the great features of WordPress is that I can export my entire blog into one file and then import it wherever I want. This makes the cost of switching from WordPress to some other blogging platform simple.

While it’s really simple for me to change, I’m fiercely loyal to WordPress. Largely because WordPress has delivered a high quality product that keeps improving in the 9 years I’ve been using it. Just because I can switch products doesn’t mean I will switch.

The same very much applies to EHR software. Plus, there are other costs that won’t be recovered if I switch. For example, training costs and configuration costs. There are certainly plenty of reasons why someone wouldn’t want to switch EHR software even if they could get their data out. In fact, I’d argue that if you’re to the point where you’re willing to go through the hassle of switching EHR software, you should do it. It’s not easy to get that uncomfortable with an EHR software that you want to go through the hassle. Although, I guess a few might be naive to the EHR switching costs.

Long story short, I think standard interfaces for EHR data wouldn’t kill the EHR business, but it would cause it to change and change for the good. I’d welcome such a change. A few EHR vendors wouldn’t, but that actually is just another reason we should make it a reality. It would be the first thing on my list if I were to create a “meaningful certification.”

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Nearly every business has customer retention as a component of their business model and EHR vendors like most other business’s work with their customers to resolve any unhappiness. Very few EHR’s actually hold their customers data for ransom after they’ve left. It just so happens that the data in question usually comes in the form of a database dump that few without the knowledge of database schema methodologies can understand. It’s not unlike inheriting a file cabinet with an incomprehensible filing systems. Many vendors provide a service to convert data from other vendors into their own database structure when new customers switch to them. Many vendors also provide a human readable read-only state for the data, sometimes for a limited time, sometimes forever (so long as you have an internet connection and the server’s don’t go offline in the case of SaaS). I think that the cases where vendors do in fact hold their customers data hostage after leaving are so old and so egregious that those of us who’ve been in the industry for a while just collectively think about them more.

    Fortunately more vendors are providing ways to export data in a way that can be both more easily humanly read and more easily imported into another vendor’s system. Even those formats though usually only amount to another type of database dump that sometimes happen to come with a way to read it.

    A few analogies to other real world product switching come to mind but I’ll just leave it at that for now.

  • “I can’t remember the exact stat, but I recently saw that a huge percentage of the granular health data is stored in lab results. We’re already moving lab result data pretty well between systems. The same can be said for eRX. We’ve kind of cracked those nuts and eventually we’ll make the rest of the data available as well.”

    Oh, no, no, no. There is a substantial part of these items that are going through as images or faxes, not as structured data. eRx is an exception, but it is a very limited data set.

    You might make more progress if you outlaw the fax machine…Or declare it insecure, then HIPAA will apply.

  • Andrew,
    I’m not seeing the same thing you describe. There are a few systems who are more open with their EHR data, but I still hear plenty of people telling me that an EHR vendor is holding their data “for ransom.”

    Sue Ann,
    Images and faxes are even easier to transfer. Those aren’t an issue at all.

  • Unnecessarily high switching costs are one of many reasons that the EHR marketplace is broken.

    Quickly (easily, cheaply, safely) moving data from the “old” EHR system to the new one is just one dimension.

    You mentioned training. What if enough of EHR user-interfaces were standard that learning one EHR would support basic learning on (nearly) all EHRs? Red and other colors would have consistent meanings in systems. Patient name and demographics would be consistently located and formatted. Etc. Today, it’s as if some cars had the brake pedals and accelerators on opposite sides. And each town could decide whether, for their stop lights, green would be “go”, “stop” or “beware of deer”.

    Standard interfaces to medical devices and other peripherals would simplify switching as well.

    Unfortunately, EHR vendors have every incentive to remain in place until the their interfaces are as quaint as the green screen terminals that preceded them.


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