There was a great post in the Medscape EMR blog today around how many CIOs in the healthcare industry are looking at startup partners as a strategy to foster new products.  The article talked about Jim Routh at Aetna and Mony Weschler at Montefiore Health System and their approach to seeking out small and nimble companies who can develop products that are tailored to their environment.

It’s a risky proposition for sure, but one that is well suited to the new movement towards micro-applications and EHR app stores.  Add in FHIR communications with your major brick and mortar hospital systems and the potential for real change is at hand.

What’s missing, and what now needs to emerge is the ability combine apps with workflow.

Let’s think of a case in point.  I have a dermatology app.  It scans a patient for moles (watch out for the FTC!) and pushes its outputs to another app which can generate a patient report on each mole and compute a risk threshold for melanoma.  How does that push occur?  What information is exchanged?

Today there really isn’t much workflow to be found in the app space.  Apps cluster around an EHR like babies around the teat.  The EMR provides clinical information, as well as perhaps authorization features, and a central compliance role, but it is not a general purpose workflow system.  The workflows EMR’s support are always proprietary.

In my mind this is where the next great leap in interoperability is to be found.   If we can build small, superb apps and connect them with workflow, great systems can emerge.

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