BIDMC’s Internal EHR and A Possible Epic Future

One of the surprising reactions for me in the announcement of Athenahealth’s acquisition of Beth Israel Deaconess Medical Center’s (BIDMC) in house webOMR platform was by John Halamka. As I mention in the linked article, it really isn’t a pure software acquisition as much as it is Athenahealth going to school to learn about the inpatient EHR space. However, John Halamka’s reaction to this announcement is really interesting.

As I read through all of the coverage of the announcement, John Halamka seems to have shifted gears from their current in house EHR approach to now considering a switch to some other external EHR vendor. This is very interesting given this blog post by John Halamka back in 2013. Here’s an excerpt from it:

Beth Israel Deaconess builds and buys systems. I continue to believe that clinicians building core components of EHRs for clinicians using a cloud-hosted, thin client, mobile friendly, highly interoperable approach offers lower cost, faster innovation, and strategic advantage to BIDMC. We may be the last shop in healthcare building our own software and it’s one of those unique aspects of our culture that makes BIDMC so appealing.

The next few years will be interesting to watch. Will a competitor to Epic emerge with agile, cloud hosted, thin client features such as Athenahealth? Will Epic’s total cost of ownership become an issue for struggling hospitals? Will the fact that Epic uses Visual Basic and has been slow to adopt mobile and web-based approaches provide to be a liability?

Or alternatively, will BIDMC and Children’s hospital be the last academic medical centers in Eastern Massachusetts that have not replaced their entire application suite with Epic?

Based on John Halamka’s comments it seems that his belief might have changed or at least he’s considering the option that an in house system is not the right approach moving forward. No doubt Athenahealth is hoping that they’ll delay the decision a few years so they have a chance to compete for BIDMC’s business.

If you look at the rest of the blog post linked above, Halamka was making the case for Epic back in 2013. I think that clearly makes Epic the front runner for the BIDMC business at least from Halamka’s perspective. We’ll see how that plays out over time.

It seems like we’re nearing the end of the in house EHR hospital. Are there any others that still remain?

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John Lynn

John Lynn

John Lynn is the Founder of, 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.

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  • There’s one other hospital with a self-developed EHR (and self-developed almost everything else, including reg/billing); it’s Holy Name Hospital in Teaneck, NJ. The CEO simply does not buy software; he believes his IT team can build anything and they have built a lot. Mixed satisfaction from the user community.

  • @John: Hans’ comment about Holy Name’s bespoke software culture interested me too, but when I dug in a bit I found a post that seems to indicate that their CEO is not quite as anti-COTS as suggested in that comment:

    @Hans: Is the article linked to below talking about the same Holy Name Hospital and CEO (Michael Maron) that you were referring to?

  • @John

    I get a different sense than you seem to RE Halamka’s post. His remarks seem to me to be more the result of his feeling pressured to jump on the Epic bandwagon — to finally “become a POD” so to speak.

    And I find his statement “Will a competitor to Epic emerge with agile, cloud hosted, thin client features such as Athenahealth? ” to be predicting BIDMC’s recent partnering with Athenahealth.

    So my takeaway is that the acute care EMR that will emerge from the union of the WebOMR, RazorInsights and Athenahealth platforms will in fact *be* that competitor that Halamka was hoping for to save BIDMC from having to become a pod.


  • TJL,
    You might be right. Although, some other interviews I heard and read that aren’t linked above, have me thinking that Halamka is now ready for an outside vendor and that he’s not sure if athena will be it or not. I think they’ll give them a fair shake for obvious reasons, but I still think Epic likely leads the pack in this race.

    I do think that Halamka likes the platform that athena is built on much more than Epic and the likes, so maybe that could help get them over the hump in many of the BIDMC people’s minds.

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