[nikanj]

EPIC and Cerner are doing their best to, simultaneously:

1) Appear to be open, ready for innovation and playing fair (so hospitals don't replace them)

2) Maintain their position as gatekeepers, and use that position to extract as much revenue as possible. New startup wants to deploy tech at your hospital? Hospital probably will end up paying more to Cerner for the integration, than the new tech.

[mxwll]

You hit the nail on the head.

Building anything on top of EPIC is unbelievably painful. You either pay EPIC engineers to access their "Dark API's" or pay $$ for their certifications.

Very few of these big medical device start-ups are actually integrating with patient records at a significant scale. Every instance of EPIC or Cerner is different and there is a lot of manual work needed to get up and running with live data in the patient record.

[grwthckrmstr]

Sounds EXACTLY like an industry ripe for disruption

[nradov]

The EMR market for hospitals and large clinics really isn't ripe for disruption. This isn't an industry where a startup can quickly hack together an "80% solution" as an MVP and sell to some early adopters. Due to regulatory requirements and legitimate patient safety concerns any new entrant needs to be a 100% solution from the start. Otherwise they'll never make it past the first vendor down select.

There may be some limited opportunities for disruptive innovation in niche markets like smaller medical specialties with unique requirements, concierge medical practices, genetic counseling, etc.