The EHR landscape is changing rapidly, and executives at the two companies with the largest hospital market share, Epic and Oracle Cerner, are in a race to dominate the next iteration of health IT.
Both see their companies expanding beyond the hospital-based EHR to power a larger IT infrastructure. Larry Ellison, co-founder and chief technology officer of Oracle, revealed a plan to build technology for the complex healthcare system after acquiring Cerner in June. Oracle plans to modernize Cerner and build it into a complete source of information about an individual's healthcare. He also said the system will be interoperable and have virtual care capabilities and expanded clinical trial capabilities.
"We're building a system where the health records, all American citizens' health records, not only exist at the hospital level, but they are all in a unified national healthcare database," Mr. Ellison said during a June 9 presentation. "The national database solves the data electronic health record fragmentation problem."
Oracle plans to use a low-code tool to develop the next generation of Cerner.
"We expect to have our first pretty complete new Cerner health management product out within 12 months, which is something we never could have done with the previous generation of databases or previous generation of application tools," Mr. Ellison said during Oracle's quarterly earnings call in mid-September. "But all of that has changed. … Our new generation of application development tools is going to enable us to modernize Cerner technology at a rate that would be inconceivable a couple of years ago."
The vision is simple: Oracle would continuously update records for hospital databases into a national database so physicians have the latest information on care delivery. The execution of this plan is much more complex, especially since health systems across the country are switching to Epic EHR.
Epic had the largest market share of acute care hospitals heading into this year, at 33 percent. Several more systems announced switching to Epic in recent weeks, including 11-hospital Emory Healthcare in Atlanta. Trinity Health in Livonia, Mich., also announced plans to transition Clive, Iowa-based MercyOne to Epic after fully acquiring the system earlier this year.
In August, Epic CEO Judy Faulkner revealed plans of her own to expand Epic's reach at the annual User Group Meeting. The company has made moves this year to transition its EHR to the cloud, committed to interoperability and added a life sciences program to speed up clinical trial and therapy development.
"We are building a nationwide health IT infrastructure to connect the different parts of healthcare," Ms. Faulkner told the crowd.
Epic also has Cosmos, a large data platform collecting information from 162 million patients and 5.7 billion healthcare encounters at 1,063 hospitals and 22,500 clinics. The large amount of healthcare data is impressive, but the company continues to work on interoperability and new functionalities including natural language processing and incorporating more artificial intelligence.
"We will continue to expand our work to develop a national health IT infrastructure that connects patients, providers, payers, genomic sequencing labs, life sciences companies and more," Alan Hutchison, vice president at Epic, told Becker's. "Together, these connections will help to build bridges between the disconnected parts of healthcare, supporting higher quality care and advancing the development of lifesaving therapies."