The meaningful use program was a tremendous success in terms of getting doctors and hospitals to digitize medical records.
Beyond that, the legacy of the program will be more mixed. Many clinicians have complaints about their federally-certified EHRs at once demanding too much information, too much clicking and typing, and yet not being able to easily share any of it.
The requirements in the second phase of the meaningful use program is questionable benefit, doctors say. For instance a cardiologist with patients mostly over 75 may not be able to email with them — because the patients don’t have or want email. A poll conducted by sister site Medical Practice Insider found that around half of doctors aren’t even planning to attest for the second phase of the MU program.
But the digital infrastructure is indeed largely in place across the majority of the American healthcare system, and its significance goes beyond the $30 billion EHR Incentive Program. The post-MU healthcare economy is coming, and one of the smaller of the major EHR vendors is angling to bring better digital services to doctors and hospitals as the self-pitched “Amazon” for the healthcare industry: athenahealth.
This year, the company is entering the hospital EHR market with an inpatient version of its highly-regarded cloud-based medical practice EHR. Through the end of the decade, the company wants to invest in startups and develop new technology “to infiltrate every corner of the healthcare landscape,” as a recent Fortune profile of Athenahealth and its CEO and co-founder Jonathan Bush described it. “The plan is we’re going to create and curate the healthcare Internet,” Bush told journalist Jen Wieczner. As Wieczner wrote:
Indeed, athena’s vision has lately shifted from automating physicians’ back offices — “scutwork,” as Bush calls it — to a grander idea of becoming a “national backbone” for the healthcare industry. At the MDP event, athenahealth execs were busily scouting startup talent as potential partners for Athena’s new online marketplace. Launched in 2013 on athenaNet — effectively the homepage for athena’s doctor customers — the marketplace is what athena unofficially refers to as its “app store.” But Bush says the model is actually more akin to that of Amazon, which lets other vendors sell on its site, or Salesforce, which distributes products made by other companies alongside its own suite of business software. “Over time we believe customers will eventually choose another competitive product, even another medical record — but on athenaNet,” says Bush. “And we’d rather have them doing that than pissed or feeling trapped or leaving us altogether.”
The Watertown, Massachusetts-based company’s ideas for the future of health information technology are notable in many respects. Athenahealth straddle both sides of American politics — Jonathan Bush is the cousin of George W. Bush, co-founder Todd Park was the nation’s second chief technology officer under President Obama. The company also espouses ideas that are progressive and laissez faire and often different from the bigger, older EHR vendors. “There is a market case for interoperability,” regulatory affairs vice president Dan Haley told me last year. His recommendation for the rest of meaningful use: “The government ought to require interoperability and step back.”
The full Fortune profile delves inside one of the meaningful use program’s biggest winners and a pretty interesting company.
Bush envisions the company’s headquarters, based at a historic arsenal on the Charles river, as “mixed-use, East Coast Googleplex,” feature fresh food vendors, a Frisbee golf course and a beer garden. Speaking of beer, Bush has been known to drink some at the company’s 387-acre resort near the coastal town of Camden, Maine, and then the next morning lead company leaders, investors and stakeholders on a jog “to a serene but bone-chillingly cold pond for a swim.”
There’s also an account of Bush encountering his cousin early on in Athena’s tenure, before the formation of the Office of National Coordinator for Health IT in 2004:
Jonathan managed to score a meeting in the Oval Office with President George W. early in his first term. Reenacting that visit, Bush imitates the incredulous look on his cousin’s face when he mentioned athenahealth: “He was like, ‘You’re CEO of a company?’ And in my head I was like, ‘Well, if you can be President, I can be CEO!’”
More importantly, though, the piece is indicative of how mainstream health IT has become, and how high the expectations are from for-profit investors. There are also expectations from taxpayers who, after all, were the main investors in the EHR incentive program. The grand ideas suggest the program is bringing new thinking and the potential for new and better digital services to what is often considered a too-arcane experience in American medicine.
