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David and Goliath Commentary 

David and Goliath

In his seminal book on disruptive technology, David and Goliathbusiness guru Malcom Gladwell points out that Goliath didn’t have a chance against David who was wielding a technology that was a precursor to modern warfare where killing could be done at a distance. While the sling was not a new technology, having been invented sometime in the Neolithic period, its art was highly developed by biblical times and David had the advantages of being mobile and able to fire repeatedly at Goliath who could not get within range to inflict damage on David.

Gladwell goes on to illustrate that technologies bring down giants on a regular basis these days and that the Goliaths of the world should be very wary of the disruption that is constantly bubbling up around them. A Sebastopol startup, EHRI Inc., is positioning itself to take on the Goliaths of the hospital Electronic Medical Record (EMR) business with a disruptive mobile technology that emulates David’s sling.

‘The hospital EMR space is dominated by complex, expensive software systems that run on costly hardware and are generally very cumbersome to use. Surveys show that 94% of nurses dislike the EMR systems they are forced to use and hospitals are often paying as much as $100,000 per licensed bed for these systems, not counting hardware and implementation costs. In contrast, ‘we have developed cloud-based systems that run on inexpensive mobile devices and are easily adaptable to any hospital’s workflow’ according to Nick Smith, CEO of EHRI.

Smith likens EHRI’s position to Quickbooks and Salesforce which took over the market for small business accounting and customer resource management from companies with expensive server-based software systems. ‘We are small and nimble and are offering solutions for hospitals that are much more affordable and easier to use.’

The company recently implemented HarmoniMD at Sonoma West Medical Center in Sebastopol, a recently reopened hospital that was formerly Palm Drive Hospital. ‘One of the primary reasons Palm Drive failed was the attempt to implement one of the Goliath EMR systems’ says Dan Smith (no relation to Nick), board chair of Sonoma West Medical Center and a founder of EHRI. ‘The implementation alone cost $1.2M in consulting fees on top of software and hardware. After all of this, the hospital was not able to obtain certification for Stage 2 of meaningful use and therefore lost $800,000 in possible rewards.’

HarmoniMD is currently being installed in Kenya and Tanzania and the company is in discussions for implementations in other countries in Africa and Asia. ‘Our mission is to improve world health with affordable mobile cloud computing’ Nick Smith says. ‘Basically, our goal is to provide a full Electronic Medical Record system cheaper than the paper that is currently still in use in the developing world.’

At Kilimanjaro Christian Medical Center in Tanzania, HarmoniMD is being implemented in this 500-bed hospital and a new cancer center which will open in September. ‘This is a big hospital so implementation has to be done in stages, but the hospital’s IT team is now fully in charge of the process. Duke University has assisted with the implementation and is helping the hospital manage their networks.’

In Kenya, Matata Nursing Hospital, a 120-bed facility, is well on their way to a full implementation of HarmoniMD after a single visit from an EHRI trainer. ‘These implementations show that HarmoniMD is very adaptable and can be implemented at minimal cost while providing a full feature set for a hospital. We are now ready to take on the Goliaths with our sling of agile mobile could computing.’

While EHRI is making a big boast, the EHRI team have been successful in providing disruptive technologies to other industries including The Master Builder, which became a dominant player in the construction industry under Dan Smith. By taking on the mini-computer systems that previously dominated construction management and providing software on Apple and PC computers, Smith was able to create a nationwide market for The Master Builder.

‘Whenever a market is dominated by overpriced dinosaurs, someone will come along and take them out’ says Nick ‘and we intend to be David, not Goliath.

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