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CTO: EHR market challenges and how this technology will evolve

The former CTO of Epic Systems Corp. and current CTO of Pure Storage discusses the challenges facing the EHR market today and shares his thoughts on how he thinks EHRs will evolve.

Meaningful use has seemingly run its course and EHRs have been widely implemented at hospitals and healthcare organizations. Where will the EHR market go from here?

Vik Nagjee, formerly the CTO for Epic Systems Corp. and currently the CTO of global healthcare solutions for Pure Storage, an enterprise data flash storage company based in Mountain View, Calif., shares his thoughts on the challenges facing the EHR market today and how he sees EHR vendors evolving in the future.

What is the biggest challenge facing the EHR market right now?
Vik Nagjee: Without innovations, specific organizations are starting to see a lot of talent draining where a lot of their very top physicians and providers and researchers are deciding to go to different organizations that do offer the opportunities for better innovation. Why is this innovation piece so important? The innovation piece is top line and bottom line driven. In order to be able to innovate, the organization needs to be able to have an IT infrastructure that gives the rest of the organization the ability to innovate.

Vik NagjeeVik Nagjee

The electronic medical record vendors are trying to figure out how to best use all of this data that's coming in. So there's a concept … brought up in about 2014 I think, it's called HTAP, Hybrid Transactional/Analytic Processing. The whole idea for that was to say, "Okay, look, I have my data, my discreet data, which is for my electronic medical record and this is used for my everyday patient care. What was your weight when you came in? What's your temperature? What's your blood pressure?" Those types of things.

But then I have all of this other data that's really, really valuable which is stored in not only text spaces or notes, so if somebody's writing notes as to what your chief complaints were and so on and so forth, but then also data elements that are captured that are potentially outside of your existing visit. So in today's internet technology days, I wear a Fitbit. I'm sure you know a lot of people that do, collecting all of this data and pulling it into your overall health record and profile. The idea is how do you take all this data and make it actionable, how to use something to say, "I want to be able to know when a particular person is predisposed to a particular situation," and then take action on it.

The electronic medical record vendors are trying to figure out how to best use all of this data that's coming in.
Vik NagjeeCTO, global healthcare solutions, Pure Storage

What are EHR vendors hoping to evolve into? For example, are they aiming to become informatics companies? Or something else?

Nagjee: I've seen both sides of that and coming from Epic I have a little bit of a different slant. So the approach at Epic is very, very altruistic. It's essentially all about patient care and patient outcomes. Epic has a very, very open system and what Epic has done is invested a significant amount of R&D dollars and implementation dollars in terms of making sure that the data that's in the electronic medical record is available as appropriate to other systems in the ecosystem. Here's why. Sharing data is the only way to be able to do things across larger bodies of data. … How about we learn from this very wide swath of data and custom-tailor and build a plan to resolve your specific instance of breast cancer based on what it is that's the underlying cause. That's precision medicine. That's big data in healthcare. That is where you get the benefits of collaboration rather than turning into a, "I am going to get a hold onto my data and sell analytic stuff of my data and you can go and do the same off of your environment."

That's where I see the world going. That's where I urge the world to go.

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