A Glimpse into the Future of the EMR and How Unbundling May Cause its Demise: [INFOGRAPHIC]

The EMR is alive and well in healthcare today, (although most doctors and staff are not happy using the EMR in its current form).


Trying to do it all EMR Features

Bundling is the act of taking many features (usually too many) and developing a software program that tries to do everything a user wants in one package.

While that may seem like a novel idea, the issue arises where the software tries to be a jack of all trades, and a master at none. Almost every EMR and practice management solution incorporates to many features that work but not optimally.  This dilutes the effectiveness of the solution and frustrates the end user.

Too many features…

    • ambulatory clinical data
    • inpatient clinical data
    • practice management
    • patient communication
    • prescription filling
    • patient scheduling

  • billing
  • meaningful use compliance
  • population health
  • specialist referrals
  • patient engagement
  • risk management
  • and more…


Ask your staff if they enjoy using the software you have purchased.  

(Very large majority will say no)


Craigslist History (One feature —-> many)


Craigslist began in 1995 by Craig Newmark as a simple event site for his friends in San Francisco.

Eventually people started using it to add job postings, personals and other services. After many years it grew to what we know today, a site where you can almost do anything.   While it is nice to use one piece of software that tries to do everything well, most of the time it does not accomplish the goal and users want alternatives that are simpler and add more value.


The art of unbundling

Have you noticed a trend occurring in software over the past few years?  Small startups are entering the space and creating amazingly simple, yet valuable tools as the  diagram from Andrew Parker displays.

Craiglist and EMR

 Craigslist  taught users that commerce, education, relationships, and more, could be managed online and opened the doors to newer breeds of companies to flourish.


So what does that mean for the EMR?

The EMR has a serious problem, they are too expensive, hard to use, take too much time to get up and running, training takes too long, and most doctors and staff hate using them due to the complexity.

As more and more hospitals and clinics get used to the idea of moving their data to the cloud, we will start seeing many amazing startups biting off small chunks of the EMR features and do a better job then then EMR could do by itself.

Companies listed in infographic:


Click on image to enlarge:

Feel free to share the image or comment below on what startups we missed.

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Jonathan has a proven record of entrepreneurial success in the healthcare field. As the founder and CEO of referralMD, he is responsible for architecting the framework of referralMD, while managing enterprise sales, marketing, pipeline and channel development. As a thought leader in the space, Jonathan's 300+ publications have been syndicated on healthcare's top websites and shared millions of times.
2016-11-07T20:23:12+00:00 By |12 Comments
  • Badri


    That’s a nice analogy. If you notice, we have come a full circle. Earlier, they had islands of applications developed in different languages and platforms that would never talk to each other and so the concept of ERP came in and was embraced by the enterprises only to become white elephants themselves. Now you have independent applications for CRM, Billing, HR, Payroll back in the game as SaaS with a small but significant difference. With API’s they all talk to each other.

    Likewise, I see the medical or healthcare IT fragmenting or ‘unbundling’ to use your term but they also create the big problem of training doctors and their staff on the different products and technologies.



    • Thanks Badri for the comment. If the product is simple, training is easy. If it is complex, such as the EMR, training takes months if not longer.

  • I have some thoughts on how to fix this but it will take a decade or longer to fully come to fruition. Here is to waiting.

    • Tim Cook

      The ‘fix’ is technically available. See the links above as well as the latest release at launchpad.net/mlhim-specs The problem is the sociological issues of convincing developers to use it.

      • Agreed, this has always been the case with any software, getting the users to “use” . It is all about the marketing.

  • HIT Wannabe

    This is real, and is happening faster than might think. It’s already happening in the Imaging/PACS world with VNA. Now that the HCIS vendors are capturing data and storing in their databases with standardized nomenclature (ie Snowmed, RXNorm, LOINC etc.) the ability for niche vendors to write an app that pulls the data out of the proprietary db’s and into a true workflow oriented and mobile app specialized for specific tasks is closer than ever!

  • TheMDofTruth

    No physician/hospital/health system will be willing to use 25+ systems simply for the benefit of usability and functionality.

    • They are already using 500 to 1000 legacy systems that do not communicate with each other. The new tools coming out will have open api’s allowing data to flow freely between applications (if built correctly).

      Talk to your CTO he will show you how many applications are currently in use, it is hard to think that they can keep up. (Just think about why IE 6 is still being used, it is because the vendors do not upgrade their software to work on anything else)

      Thanks for the comment.

  • The point is not that unbundling is good, it is that ehr as a platform is better. Keep in mind that the ehr vendor must build the platform and invite secure and value add partners to the table, such that economic benefit is shared. Any other view is niave IMO an historically proven unsuccessful , look at salesforce as the prototypical example

    • In theory yes, in practice no.

      Most EMR’s are built on pre-2000 software code stacks that have no API’s and are very poorly built from a user experience perspective.

      Thanks Tom for your comment

      • Andrew Schoenecker

        This is true, but there are work arounds that can bridge the way to true interoperability.