We all know that HIT moves at a glacial pace, but are there similar industries that have taken a similar trajectory and now with history in their rear-view might provide some insights into the future of HIT?  I think I've found one.

ERP is Born

In 1990, Enterprise Resource Planning (ERP) was born when the Gartner Group first coined the acronym to describe a software package that integrated the entire working of a company into a single application.  The goal was to facilitate the flow of information from all parts of the business including finance, manufacturing, and sales.  The ERP system leapt to the forefront as the Y2K bug approached - legacy systems needed to be replaced and the newly create ERP systems fit the bill.  As the Y2K bug came and went, companies realized these ERP systems, while promising in theory, were far from perfect.  Likewise, ERPs became infamous for negative ROI and implementations which were over budget and took longer than expected (seeing the similarities to HIT yet?).  Digging through archives my favorite article talks about how many of the ERPs installations were delayed to the point of not being able to meet the drop-of-the-ball deadline.  Anyone think this is going to happen as the meaningful use deadlines approach?

In the early years, the ERPs made automating the back office logistics their priority, but as time passed they began to focus more on the front-office functions such as supporting the sales staff via a customer resource management (CRM).  For those unfamiliar, the CRM is an application for documenting interactions with customers.  Or for the more software-oriented, think of ERP as the backend and CRM as the front-end.  However, these front-end applications were constantly victimized by poor usability and fragmentation (how about now?).

A New Age of CRMs

However, it took the internet, and simplification of communication to usher in a new age of CRMs.  One company emerged, Salesforce.  Salesforce leveraged the changing forces in the enterprise market to create a highly popular web-based CRM.  It leveraged the foundation laid by the ERPs, utilized the web and its business models, and promised to end software burden for its users.  What happened next is well, history.  Salesforce has taken off, and as of this writing, they are a $15B dollar company with over 100,000 customers.

As I heard this story, I could not help but make comparisons to healthcare.  Briefly summarizing:

1. The Y2K bug, much like the HITECH Act, will provide the stimulus for an enterprise foundation to be laid.  Although the merits of both of these events can be questioned, the sole fact remains, their respective industries will be changed as a result of this external stimulus.
2. Both current ERP and EMR systems are becoming known for negative ROIs and being over-time and budget.
3. Finally, the front-end systems were both notoriously unusable.

Seems like the perfect storm for the healthcare version of Salesforce.  Who/what will it be?

Note: I've tried my best to convey facts, so if there are any errors below, I apologize.  If anyone out there was involved with any of the companies I mentioned, I would love to hear from you.