Health IT Market – Current State and Emerging Technologies

Question-and-answer flashcards covering key concepts from the Health IT Market lecture notes, including market leaders, interoperability, emerging technologies, and policy influences.

Which three vendors dominate the current EHR market in Acute Care and Integrated Delivery Systems?

Epic, Cerner, and Meditech.

What was Epic's foundational strategy to gain a large installed base across both inpatient and outpatient care?

To provide a single longitudinal patient record that follows the patient across all care settings, with one data model and user interface.

What is Care Everywhere?

Epic's data exchange that lets users access a patient’s Epic data across Epic sites (and later expanded to other Epic sites and beyond).

What are Carequality and CommonWell?

Cross-vendor data exchange alliances that enable interoperability between different EHR systems.

What is Epic Connect?

A strategy where a large hospital partners with a smaller hospital to sponsor Epic adoption, making it more affordable and expanding market reach.

Why do some commentators describe Epic as creating a potential monopoly in the EHR space?

Epic’s dominant market share in certain regions and its extensive installed base, though other vendors still hold significant share; governance and interoperability can mitigate monopoly concerns.

What is the Gartner term for the real-time healthcare delivery paradigm, and what does it imply?

Real Time Health System (RTHS): an enterprise that is aware, collaborative, and smart, using real-time operational intelligence to meet objectives.

List some mature RTHS technologies mentioned in the lecture.

Real-time location services, clinical communication and collaboration, condition surveillance systems, patient throughput and capacity management, real-time supply chain management, command centers, virtual care centers, and clinical documentation improvement.

Name nascent technologies in the acute care space discussed in the notes.

AI-enabled diagnosis and treatment (including diagnostic imaging), digital dictation and scribes, marketplaces for clinical decision support and quality/public health measurement, and conversational agents.

In the ambulatory market, which group is said to have the largest market share?

'Other'—a large number of vendors with a fragmented market.

Which vendors operate primarily in the ambulatory market besides the traditional EHR vendors?

eClinicalWorks, NextGen, athenahealth (among others) with cloud-based, smaller, less expensive EHRs; traditional vendors also offer ambulatory modules (Epic, Cerner, Meditech, Allscripts).

What legislation spurred ambulatory market innovation and the creation of CMMI?

The Affordable Care Act (ACA).

What does CPC stand for, and what is CPC+'s role in ambulatory care?

Comprehensive Primary Care; CPC Initiative and CPC+, which align care coordination and payment incentives with primary care delivery.

What is OCHIN and what does it do?

A non-profit healthcare innovation center providing a cloud-hosted Epic (and NextGen) instance serving 500+ community health sites and nearly 6 million patients.

What is PRAPARE?

Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences—tools to measure social determinants of health.

Which vendors dominate the post-acute care (LTPAC) EHR market, and what are some examples?

PointClickCare, Netsmart, MatrixCare, and Homecare Homebase.

What is PACIO and its focus in post-acute care?

A collaborative effort (US CMS ONC MITRE) to develop FHIR Implementation Guides for post-acute care to facilitate data exchange (e.g., functional and cognitive status).

Which policy drives interoperability and API requirements in healthcare IT, as discussed in the notes?

The 21st Century Cures Act.

What are Cerner Ignite APIs designed to do?

Allow external apps to integrate with Cerner Millennium and HealtheIntent, including SMART Health IT and HL7 FHIR implementations for population health and data exchange.

What women/tech giants were discussed as potential entrants into healthcare IT, and what happened with Haven?

Google, Apple, Amazon, Microsoft were discussed as potential entrants; Haven (Amazon, JPMorgan Chase, Berkshire Hathaway) was discontinued in 2021.

What are the major challenges for emerging technologies in healthcare IT?

Governance of multiple systems and data privacy/security with APIs; Adaptive Clinical Decision Support; IT skill sets for a portfolio of interoperable assets; implementation complexity; and certification requirements under the Cures Act.

What does the ONC workshop 'Accelerating APIs in Healthcare' address?

A year-in-review discussing how APIs will connect clinicians to better data, improve patient experience, and empower public access to data; momentum for 2021.

What is the recommended organizational approach for adopting new health IT technologies?

Strong IT governance and a skilled IT workforce to manage a portfolio of interoperable digital assets, rather than relying on a single vendor.