Epic’s EHR has grown exponentially over the past few years and now dominates medium and large practices, as well as many of the major health systems across the country. Epic already provides a host of integrative features for providers and patients including EpicCare Link, Bedside, Care Everywhere, myChart (patient-controlled portal), Haiku (mobile and secure physician access to patient records and imaging), and Lucy (a freestanding patient personal health record).

With the ubiquity of Epic in the healthcare marketplace, there has been a lot of buzz about a planned addition to that suite – the Epic App Exchange. Although details haven’t been released, descriptions of the Epic App Exchange liken it to the Apple App Store. Epic will provide the instructions for creating and integrating apps with Epic’s network infrastructure. This would potentially open Epic to app developers to produce innovative solutions for Epic customers to improve patient care.

The news broke a few weeks ago at a Wisconsin Innovation Network by Mark Bakken, co-founder and former CEO of Nordic Consulting and founder of HealthX Ventures, where the Epic App Exchange was touted to be the next big thing that would “open the floodgates” for app developers and “cement [Epic’s] long-term legacy.”

For some that have followed Epic over the past 2 years, this may conjure memories of the release of Open.Epic with hopes that it would lead to greater interoperability. However, Open.Epic only allowed developers to input data from patient wearables and sensors passively into Epic and the API did not allow free exchange in and out of the Epic system. The recent Epic App Exchange announcement has been met with tempered hope and excitement, as the ultimate utility depends on as-yet unreleased details.

The question becomes how “open” will this Epic App Exchange be and will any and all developers have access to the API. At this time, it is impossible to know whether the Epic App Exchange will only be an exchange of apps for its closed-system customers, or whether it will be open to developers and innovators to create products on top of the Epic system, thus propelling the country towards greater national interoperability.

The Epic App Exchange comes prior to the announcement of the final contract for the Defense Healthcare Management Systems Modernization (DHMSM) and Department of Defense. The DHMSM program has a mission to “acquire, test, deliver, and successfully transition to a state-of-the-market electronic health record (EHR) system” for it’s 9.6 million beneficiaries and 153,000 personnel across 1,200+ worldwide locations. Key features to incorporate include a “patient-centric system” that is “flexible and open” and “enable full patient engagement in their health.” The report by DHMSM also emphasized the importance of interoperability and “collaborative partnerships to advance national interoperability.” There are 4 teams being considered for the DHMSM and DoD contract worth upwards of $11 billion over a few years. One of the 4 teams includes Epic partnered with IBM.

In order to move healthcare forward and focus on value and quality in medicine, there is a tremendous need for national interoperability of electronic health records. To make this dream a reality, it will take some of the major players in healthcare IT, like Epic Systems, to allow developers to create innovative solutions on their robust network infrastructures. We hope that the Epic App Exchange is a step in the right direction, but the devil lies in the details and we don’t have those details yet.

S.K. Steven Houston III, MD is a 2nd year vitreoretinal surgery fellow at Wills Eye Hospital in Philadelphia, PA. Prior to fellowship, he completed ophthalmology residency at Bascom Palmer Eye Institute at the University of Miami. Dr. Houston is interested in evidence-based research of digital and mobile health solutions to help shape the future of healthcare and provide the best, quality care for patients. Dr. Houston can be followed on twitter at @trieyedoc.