After brushing my teeth this morning, I jumped right in and read all about how the VA wants feedback as it pursues commercial EHR system from my buddy Shahid Shah at Healthcare Guys. You all know that there are two big commercial EMRs they have to choose from, Cerner and Epic and both of them are train wrecks costing hundreds of millions per installation. Guess who pays THAT, dear reader? You do. Both Cerner and Epic have several abject, unacceptable failures causing the hospitals in most cases to go back to paper records as a better alternative. But, I thought to myself, nobody wants to read another rant on how Epic and Cerner are figuratively (literally if you throw in the insurance companies) ruining the world, and we can do (and have done) it better, so I kept reading the news.

Ok, you got me, I mentioned it anyway.

Then I ran across this on HIStalk from my favorite anonymous probably Doctor working for a non-profit hospital, about Apple and how they are getting into healthcare. If you didn't know, we feel that Apple hasn't had aproduct worth mentioning since LISA in 1983. Apple is a marketing company and was propped up by Microsoft for decades until the iPod, which was a horrible idea that addressed a problem solved better by EVERYBODY else. There hasn't been a single innovation made by Apple since 1983, which could presage their success. Nope. They dumbed the technology down until it was almost unusable, then touted it as "easy to use" while charging prices that were multiples of what everyone else was and then created the wholly uneccessary Application Market. You don't need apps, you have the internet. So I was amused at best to hear that Apple is getting into healthcare.

So Tim Cook says this:

"We've gotten into the health arena and we started looking at wellness, that took us to pulling a string to thinking about research, pulling that string a little further took us to some patient-care stuff, and that pulled a string that's taking us into some other stuff," he says. "When you look at most of the solutions, whether it's [sic] devices, or things coming up out of Big Pharma, first and foremost, they are done to get the reimbursement [from an insurance provider]. Not thinking about what helps the patient. So if you don't care about reimbursement, which we have the privilege of doing, that may even make the smartphone market look small."

Really. Let's count a few of the ways Apple hates money.

• Most expensive products in its industry
• Creating the 'app' industry (anything done in a mobile app could be done in a free web app)
• Inserting itself into the music industry, soaking up money from musicians.
• Proprietary interfaces (plugs) that only fit Apple products and change with every iteration

Even worse, he takes it back by saying (healthcare) "may even make the smartphone industry look small." Talking out both sides of his mouth there. Here is what he sees: the global automobile industry generates about $3.5 trillion worth of business. The global health industry generates about $9 trillion, nearly three times what the automotive industry does. Out of global GDP of $74 trillion, that's a huge chunk.

The end of that story is that Apple has some gifted people in engineering and software who can demonstrably get some stuff done. Apple is also a marketing company led by a bunch of bean counters and MBAs who have zero interest in anything BUT making money, Tim Cook included. I'm going to watch Apple closely as they put their little cutesy spin on healthcare and most likely fail spectacularly.

Watch with me.

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