Salesforce is betting EHRs cannot improve quickly enough to meet user-experience needs of industry.
The Salesforce Healthcare and Life Sciences summit was a shot across the bow for EHRs. There was no mistaking the content of the presentations, the message of their tools and deployments, or the explicit questions focused on users presenting different ways they have leveraged the Salesforce Health Cloud. Over and over, they were asked “Why did you choose to do this in Salesforce instead of your EHR?” The answers were all similar: The EHR was too complicated, too proprietary, too expensive. The message was clear: EHRs are a clinical and billing tool. Everything else should be done through Salesforce.
- Salesforce presented Health Cloud as a potential central workflow and data solution for healthcare, displacing EHRs as the fundamental tool for healthcare IT.
- The current perception of Health Cloud as fundamentally an outreach and engagement tool is well entrenched and will be difficult to change.
- EHR vendors are finally realizing the threats posed by companies like Salesforce and are trying to maintain their dominance. They may not have acted quickly enough.
The Platform for Everything Else
The perception of Salesforce has been that they offer a powerful, but ultimately limited outreach and campaign management solution. While customer relationship management (CRM) in other industries provides powerful tools to manage and maintain customer relationships, there have been major barriers to adoption in healthcare.
Organizations have been hesitant to look at patients as consumers, let alone customers. Providers have been reluctant to offer services, even as patient demand for them has increased. Most patient engagement is done manually, or through clunky patient portals. The result has been increasing use of more user-friendly, convenient solutions. EHRs act as a central data hub, containing all the information that has, historically, been considered relevant to the patient-provider relationship, but competition with their patient engagement and patient-facing solutions is intense and growing.
With external sources of data increasing, Salesforce spent most of the day presenting the ways they can act as a central unification and aggregation hub. Their Click Not Code functionality is a central selling point for these functions, allowing easier integration for the various potential sources of data, including EHRs, as well as analytic solutions to produce actionable insights. Rather than keeping the EHR as the single source of patient truth, they presented the EHR as one data feed of many, a source of clinical data feeding up to the main Salesforce platform.
If You Don’t Solve It, Someone Else Will
For years, EHRs have been a walled, locked-off garden. Provider organizations, which have invested tens or hundreds of millions of dollars in purchasing, deploying, and maintaining their EHR, are understandably hesitant to invest more in another solution touted as a straightforward cure-all. Over and over, HCOs say that they would rather use EHR-native tools or wait for EHR-native functionality than buy into new solutions. EHR vendors responded as if they had a captive market, one that would always wait a little longer or spend a little more.
As the demands on the EHR have grown, however, provider and patient patience has waned. EHR functionality has lagged significantly behind IT developments in other industries. App stores and innovation hubs are a token acknowledgement of their missing features. Some, like Cerner, partnered with companies like Salesforce, becoming more modular and opening their ecosystem. Others are trying to become easier to use and upgrade, and to add the features and functionalities providers and patients demand. Salesforce is betting they cannot do it quickly enough.
Data aggregation and presentation are the specialties of AWS, another Cerner partner, and Google. Microsoft announced their Cloud for Healthcare in May, offering integrated engagement, scheduling, care management, remote appointment, and monitoring tools through Azure IoT. If Salesforce does not win this market, others will not be hesitant to enter it. EHRs allowed these openings into a customer base they assumed was completely secure. Their mistake might not cost them customers overall, but they may not be the central essential pillar of healthcare IT much longer.