Dear Advisor: Why is it so Hard to Integrate with EHRs? 

(Or) Why I Don’t Recommend Integrating with an EHR, especially in your MVP 

Originally published on September 2022, updated for relevancy in April + October 2023

Having helped a number of hospitals in CA improve the quality of care by making data-driven decisions in real time for the first time – and having mentored a number of start-ups in the HealthTech space as an advisory board member of CTIP and through other start-up communities, there’s one piece of advice that I keep sharing almost every time: please, please, please don’t center your HealthTech’s product/service strategy around the requirement of integrating with a hospital’s electronic health record (EHR, AKA electronic medical record or EMR). Here’s why. 

Before we get started, please note

I'll assume that in the "build vs buy" debate (more details below), you're on the side of developing it yourself because it's really core to the moat of your product offering; if that's not the case, please consider outsourcing this (more details below).

Part 1: Why I Don’t Recommend Integrating with an EHR for Your MVP?

The reasons are more nuanced than you’d think:

Because this access to healthcare data is so limited (understandably to protect the privacy and security of the patients), and depending on the Master Service Agreement (or similar) that Cerner had at each hospital, Oracle decided to buy Cerner for $30 billion, to have access to this data to then be able to build data-driven/AI-driven capabilities on top of it, for example, help hospitals reduce operational costs or for doctors and nurses to have an early-detection system [ref] for when a patient’s health begins to deteriorate. 

Part 2: Advice on What to Try Instead

Just as I don’t recommend including AI in your MVP, I don't recommend you try to integrate with an EHR, even if you think it should be core to developing your product offering. Instead, here are some things to try:

Part 3: Parting Advice

At the end of the day, we’re on the same mission: improving our customers’ and patients’ lives! Hope this advice helps you avoid the most common pitfalls of a HealthTech start-up.

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