May 16, 2006

Q&A: Girish Kumar Navani, CEO, eClinicalWorks
Ari Friedman
It takes a small business to know a small business. That may well be the motto of the approximately 5,500 small physician practices that have chosen eClinicalWorks for their EMR. Working in a market with notoriously low health-IT adoption rates, eClinicalWorks has grown dramatically from its conception during a conversation between five friends. Health-IT World News sat down with CEO Girish Kumar Navani for his take on the business.

Q: How did you get involved with eClinicalWorks?
A: Five of us used to always talk about what kind of company we would do together. When we asked my brother-in-law, a physician, “What goes on in your practice?” he said, “It's all paper.” “How do you schedule patients?” He says, “Paper.” “How do you write prescriptions?” He says, “Paper.” And that's pretty much how eClinicalWorks got started.

Why target this market?
Well, it's the largest market in the United States, but it's a lot more difficult deploying a product in a small physician practice. A large practice has more infrastructure. Also, unlike a traditional sales model, hiring reps to go knock on doors, here you cannot knock on doors because there are too many doors to knock on. People go to Google to search the Web. They should want to call eClinicalWorks if they are going to buy an EMR. It's a matter of making sure that we have a lot of successful implementations.

Why isn't EMR adoption higher among small physician practices? Why do your customers number about 5,500 instead of hundreds of thousands?
If you'd asked me the question in 1992 -- “Why is cell phone adoption so low?” -- I wouldn't say that the cell phones are not good per se. Over time people start realizing the benefits. [Furthermore] now we have wireless computing and tablet PCs. But this was not the case five years ago. Right now, we can't say that  adoption is low. Adoption is on the curve of a trend which is going to go on for seven years. It's not slowing down.

Any particular hardware that you're looking forward to?
These new devices that Intel and Microsoft just talked about. [Origami]. Essentially it is a mobile computer that is slightly bigger than a PDA. I think that's going to help EMRs.

eClinicalWorks provides both an ASP and an installed model. Which one do you see prevailing?
A small practice cannot afford to invest in [in-house] data backup. Five years from now, you and I will not be talking about the in-house model.

Would a national health information exchange infrastructure drive massive EMR adoption?
I think there will be a jump even without the national network. When these local nodes start coming into being, we're going to find patients gravitating towards doctors that are connected, because they'll have all their histories. That's going to be a catalyst for physicians buying it. The national-level model I think will be an afterthought.