Perspective: Lack of interoperability is killing digital health startups

The outlook for healthcare startup success isn't great — an Accenture report finds half of digital health startups are expected to fail within two years. But perhaps some of these failures are no fault of the company and instead are the result of an inhospitable technology environment.

In a contributed piece for Tech Crunch, John Sung Kim, founder of Five9 and DoctorBase, wrote startups face significant hurdles when trying to integrate with legacy systems. Longstanding vendors aren't willing to integrate with new software and platforms, whether for political, economic or any other reasons, Mr. Kim wrote.

Mr. Kim shared several examples of trying to integrate his DoctorBase platform with hospitals and vendors who were not open to integration. In one case, a hospital wanted to adopt the DoctorBase software, but needed to integrate it into its legacy EHR. Mr. Kim wrote that the EHR vendor sent a "diplomat" to DoctorBase to understand the features and said integrations are a long process due to HIPAA. "They then went to the hospital and convinced them that integrating would cost several million dollars, and that it was largely unnecessary, as they were planning on building those same features anyway. What a coincidence," Mr. Kim wrote.

Mr. Kim doesn't say the blame falls entirely on vendors, as the federal government did not include interoperability standards or requirements in the first stage of meaningful use. Open application programming interfaces were not required, so when hospitals adopted EHRs to attest, many platforms weren't open.

"As any engineer knows, most software applications have APIs; it's simply a business choice whether to publish them or not," Mr. Kim wrote. "The Feds could have required that software vendors wanting to be certified for meaningful use stage 1 publish their APIs at the critical first stage of this multibillion-dollar program, and require only nominal costs for startups to pass an incumbent vendor's security checklists."

It is these types of organizations, those that publish their APIs and are proponents of open platform visions, which will succeed and allow digital startups to be successful.

"Many courageous, innovative tech entrepreneurs come into healthcare at significant risk to their finances and careers," Mr. Kim wrote. "It's a shame that in addition to the array of challenges digital health startups face, interoperability into the legacy systems of their customers still remains a primary roadblock."

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Mercy: Designing the nation's first virtual care center
Mayo's Epic implementation requires new substation; McKesson, Vocera report rising revenues; IBM Watson takes on Apple Watch — 9 health IT key notes

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