Will Silicon Valley lead health care's next revolution -- or miss it?

Reuters.

(Editor's Note: the following commentary was co-authored with Tory Wolff, a founding partner of Recon Strategy, a healthcare strategy consulting firm in Boston.)

Silicon Valley entrepreneurs and investors have never quite been able to figure out health, and they know it.

For years, the clever technology fixes dreamed up by engineers have largely failed to take hold, their well-conceived rationality no match for the complexity of medical care, the persistence of clinical habit, and the counter-intuitive impact of existing incentives. Many of the Valley's most audacious VCs have become leery of the space, electing instead to pursue innovation elsewhere.

The new battlefield is on the technologists' home turf: information systems for electronic medical records (EMRs). Will this time be different? Are technology entrepreneurs finally ready to disrupt medicine?

Here's the context (please see our last commentary, available here, for more details). Most of the nation's largest and most prestigious medical centers seem headed towards a relatively closed health information system, driven by a single dominant private company, Wisconsin-based Epic, which excels at the near-flawless, customized installation of their client-server platform in big hospitals.

While Epic is meticulously working its way through the largest hospitals, the long tail of stand-alone ambulatory practices operate largely on a jumbled mess of EMRs, using many emerging vendors (such as AthenaHealth and PracticeFusion) with a multi-tenant model, similar to salesforce.com.

Since medical care as a whole is consolidating, the basic question is whether emerging EMR vendors will gain enough traction and offer enough capability to enable stand-alone practices to remain independent. Or will platform fragmentation put unaffiliated practices at such a competitive disadvantage that they'll be even more motivated to join up with larger hospital systems (the most important of which will rely upon Epic)?

What makes Epic particularly interesting is that its success seems to fly in the face of how so many of us -- Silicon Valley technologists in particular - have come to view innovation; it also contrasts with the much-celebrated, widely accepted strategy of open innovation.

Read more:

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