EMRs, IT, and The WalMart Effect

WalMart recently announced an initiative to open 400 medical clinics in their stores in the next few years.  This has the potential to rewrite the playbook on primary care clinical reimbursement models.  Further, WalMart has announced that they intend to partner with local health providers like hospitals to staff their in-store clinics. 

One could argue that this will cause an environment of consolidation in the Practice Management software space.  After all, if you have a nurse from the local hospital staffing the clinic and she has to use WalMart’s EMR system, she will want that system to pull records from her cousin Mary’s infant who was in at the acute care center last week with an ear infection.  Get it?  WalMart will be in a position to drive standardization on Electronic Medical Records, Practice Management systems, lab processing, and prescription fulfillment systems, just to name a few.

Given the incredible diversity (read: chaos) in the EMR and PHR markets, this may actually serve us well.  So what might the EMR standard of 2010 look like?  This might be a reasonable bet.  WalMart wields incredible power in it’s ability to dictate terms of engagement for it’s partners, as noted in this article.

Take Wal-Mart stores. Last month, the $218-billion discount retailer announced in a memo to each of its 14,000-plus suppliers that if they wanted to continue doing business with the world’s largest retailer, they would have to do it on Wal-Mart’s technical terms.

The company said it would now require its vendors to use new data transmission proto- cols known as EDI-INT (Electronic Data Interchange-Internet Integration) and AS2 (Applicability Statement 2) for all purchase orders, billings, invoices and pricing correspondence. The protocols allow data to be exchanged directly between partners via the Internet rather than routed through an e-mail server.

— From: http://findarticles.com/p/articles/mi_zdbln/is_200211/ai_ziff33265

The point here is simple.  The WalMart effect on health care informatics stands a very good chance of doing these things:

1. Crown a gold standard for EMR, PHR, and practice management system interoperability.  They won’t make their own, they’ll pick the winner.
2. Drive down primary care services costs, resulting in payers providing fewer coverage options.

And lastly, I believe that WalMart will do a hell of a lot better job of educating their patients and promoting self care than today’s primary care clinic model.  Why? Because they have products right there in the store to sell and promote through your personal health record on the WalMart website.

Get it?  The clinic recommends a particular glucose monitor, the store stocks it.  Better still, your recent diagnosis of Big Toe Corn Syndrome on WalMart.com links to Dr. Scholl’s corn patches.  Just a click away.

Now it can all be a click away and given how bad we screwed up our health care system we deserve it.