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Monday Morning Update 7/1/13

June 30, 2013 News 18 Comments

6-30-2013 3-59-13 PM

From Zaphod Beeblebrox: “Re: Allscripts. The second successful activation occurred this month for Allscripts in a UK NHS hospital. This one was on time and on budget. The previous one (Salford) was three months early and on budget. Almost unheard of in the UK NHS marketplace.” The announcement from Liverpool Heart and Chest Hospital says it went live on Sunrise 15 months after their project started. UK hospitals are indeed tough customers as vendors always underestimate the localization challenges, so those Allscripts accomplishments are significant. Sunrise has always been a good product but under iffy executive leadership. The challenges for Sunrise going forward are integration, since Cerner and Epic usually tromp Sunrise easily in that regard, and wariness of the company by prospects after the previous management ran the Allscripts ship aground. A lot hinges on North Shore – LIJ, which is probably locked in no matter what because of the money and energy they’ve spent. I’d want them as one of site visits if I were a prospect, making sure to veer off the planned hospital itinerary and seek out frontline clinicians since Sunrise should excel in that regard. I’d really pay attention to the medication management aspects. And watch those KLAS scores, which if the company can turn itself around, should start to move up a couple of quarters from now.

6-30-2013 3-56-18 PM

From Indoor Privy: “Re: Intuit Health’s patient portal business. Allscripts and others are in discussions to acquire. More details may be coming Monday.” Unverified. I’ve always been amazed that Allscripts put its entire practice EMR strategy at risk by choosing a third-party patient portal in the former Medfusion, acquired by Intuit in May 2010. Intuit was apparently looking for some kind of consumer finance play that would be complementary to Quicken, but like most big companies toe-dipping in healthcare, their impact was minimal and the healthcare business is rumored to have never made a profit.

6-30-2013 3-23-08 PM

Two-thirds of poll respondents don’t routinely take all of their PTO. New poll to your right: should McKesson’s customers care that John Hammergren’s pension will be at least $159 million? Your“yes or no” answer isn’t descriptive, so click the comments link after voting and explain your thought process.

Johns Hopkins Medicine will work with Walgreens to open a new East Baltimore, MD drugstore that will develop health and wellness programs for all Walgreens locations, including offering non-emergency urgent care services delivered by nurse practitioners backed up by Hopkins primary care doctors. It’s a brilliant move since chain drugstores have a massive geographic footprint and often serve as the de facto shopping center for urban areas, allowing Walgreens to scale offerings without additional fixed costs or overhead. The company can make money even if the urgent care service doesn’t because, unlike other medical facilities, a Walgreens store has a lot of higher-margin products to sell to cash-paying customers. It’s also nice for locals because of easy access, shorter waits, and lower cost. High-margin, ambitious, and scandalously inefficient hospitals keep erecting higher and more-expensive figurative walls around themselves and are buying up all the physician practices, so the best hope for affordable, accessible care and health advice may well be chain drug stores.

6-30-2013 4-38-07 PM

Paul Henry (ADP/AdvancedMD) joins CareCloud as VP of small group sales.

It turns out that BlackBerry’s Phoenix-like rise from the ashes has been mostly hype so far, as the company admits that sales of its new products failed to stave off a Q1 loss and will likely result in continued losses in Q2, sending the stock into the toilet Friday down 28 percent for the day. The exuberant analysts are now back to business as usual, i.e. wondering what the flesh-picking buzzards might be willing to pay for the pieces and parts in a fire sale.

A ED medical scribe company touts its success at two Arizona clinics that use its services to avoid having its doctors waste time documenting in the EHR. According to an orthopedic surgeon at on of the clinics, the scribes “may will have saved the clinic by helping with the implementation of the new EMR.”

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I’m intrigued that in the promotional video above there’s a cheap, in-window air conditioner behind Kevin Parks, MD, medical director of San Antonio Community Hospital (CA), that appears to be held in place by badly cut plywood and what looks like Scotch tape (00:20).  They’re expanding the ED to 52 beds, with the opening scheduled for this year, so it’s probably a temporary solution (and looks like it.)  

6-30-2013 7-25-12 PM

Jackson Health System (FL) want taxpayers to provide $830 million for facility and equipment upgrades over the next 10 years, including $130 million for computer software and hardware. The health system hopes voters will approve a property tax increase to pay for the improvements, which it says will make it competitive.

The widow of a UPMC-Mercy Hospital (PA) diverticulitis patient sues the hospital for not performing surgery on her husband over 15 months’ of treatment before his lower intestine burst, claiming that the man’s medical record was flagged with a note that he had no insurance.

A Nebraska medical practice notifies more than 2,000 patients that their demographic information has been exposed when the doctor loses the thumb drive that he wore on a lanyard a round his neck.

Long-time HIStalk friend Dave Miller, vice chancellor and CIO of University of Arkansas for Medical Sciences, explores his artistic side by playing a variety of ensemble roles in a North Little Rock, AR community theater production of “Jesus Christ Superstar.”

Vince wraps up his Epic HIS-tory this week, ready to move on to Siemens in next week’s edition.


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6-30-2013 4-03-36 PM

  • Aventura employees cooked and served dinner to children and families at Ronald McDonald House of Denver this weekend.

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "18 comments" on this Article:

  1. Um, Allscripts just purchased Follow My Health (Jardogs) as its patient portal solution for the future, and will leverage it with dbMotion to complete its population health integration strategy. Allscripts and Intuit’s patient portal relationship, while still intact, has been miserable for both clients and vendors alike with Intuit’s portal being uninstalled in numerous Allscripts accounts.

  2. Allscripts has been getting great outcomes lately, and in turn, favorable press and stock performance–primarily due to delivering on client promises. As much slack as the prior executive team received, what GlenTullman and Lee Shapiro did was nothing short of amazing (similar to Judy and epic). No other vendor out there has the spread of products that Allscpits has:

    1) Sunrise Acute
    2) Sunrise Ambulatory
    3) Enterprise EMR and PM for 100+ groups
    4) FollowMyHealth
    5) dbMotion
    6) Professional EMR and PM for 1-99 groups

    Epic does/did a great job of integrating inpatient and hospital owned outpatient clinics–no doubt about it. Kudos to Judy and her team. However, and I mean a HUGE however, that model gets turned upside down with ACOs and value based care. I believe Allscripts is as ripe as any vendor out there to tie all the different settings of healthcare together. Yes, I realize that is waaaaaaay easier said than done.

  3. Oh, and does it seem like Care Cloud is just Athenahealth with a new name? why are so many people jumping Athena’s ship? I would assume Athena’s culture and recent stock performance must have made a lot of happy workers with fat 401k’s….

    Regardless, Care Cloud is late to the party. I can see them picking up the ever shrinking 1 doctor practices, but cant envision them winning and kind of enterprise clients. Too small of a compnay for a hospital to throw their A/R behind.

  4. All of these deals innovations, BUT, where is the beef? That is, where are the outcomes and cost data? Some one is making beacoup bucks, but I have not seen medical care, drug, or health insuramce prices go down,

  5. Your new poll question should actually read, “Should McKesson’s customers care that it’s CEO’s pension equals .0013% of a singe year of McKesson top line revenue?”

    The answer then becomes an obvious and un-wealth-envy based……..no.

  6. With ObamaCare, I’m not sure I understand the need for publicly owned health care facilities. Those facilities were a safety net for the uninsured and those that couldn’t afford health care. But now that universal health care is in place why does Jackson Health System think taxpayers should pony up to upgrade their facilities and it’s systems? Privately held systems are and have already done so without taxpayer help (unless you include the incentives under ARRA). If Jackson Health System wants to stay competitive it needs to find a way to do so without public funds.

  7. Actually, Universal healthcare is not in place. If it was, you would know by comparing your tax bill to previous years.

    Open Enrollment starts in October. This is going to be an interesting next few years.

  8. OGMD: can you be more specific about how Epic’s model “gets turned upside down” with ACO’s? Inquiring minds want to know.

  9. @David

    Probably the same amount all of the other companies (Healthland, Siemens, MEDITECH, etc) paid….nothing.

  10. OGMD: Have I missed the news of multiple Allscripts wins? Your response here of predicting Allscripts to start tying all of it together is the same old song that’s been playing for the last 3 years. Nothing has changed an Allscripts is not winning any new deals.

  11. @ Nasty Parts, thought you would never ask. A quick Google search will yeild the below, sure there are more if you search for longer than 3 minutes. All are in the past 6 months or less. Let me know if you need more:

    Pro Medica:
    http://www.nasdaq.com/article/allscripts-wins-a-major-client-analyst-blog-cm255997

    Phoneix Children, beat Epic, Cerner, et al.:
    http://investor.allscripts.com/phoenix.zhtml?c=112727&p=RssLanding&cat=news&id=1787696

    Resolute Health, brand new health system (“Greenfield”). No legacy system to consider, purely based off what they belive the future of hospital life will be like:
    http://investor.allscripts.com/phoenix.zhtml?c=112727&p=RssLanding&cat=news&id=1790477

    Bronx Lebanon:
    http://finance.yahoo.com/news/bronx-lebanon-selects-allscripts-revenue-130100467.html

    UK hospitals, last I heard two very large ones were looking to replace Cerner: http://finance.yahoo.com/news/allscripts-wins-major-uk-client-183002268.html

  12. @ Dr. Lafsky

    Here’s what I meant:

    Old Paradigm: Keep patients within your four walls; don’t let them leave the acute or ambulatory foundation practices; sloth as much insurance money as possible while the patient bounces between ambulatory and acute without losing the patient to other health systems/providers in the community;. If you can keep them inside your house all the data you will ever need is at your fingertips; no need to share/exchange records; readmission means more money in the bank; primary docs getting poorer; hospitals getting fatter

    New ACO Paradigm: need to exchange clinical data outside of your walls; primary providers empowered as the quarterback; readmission = bad; open IT platforms allowing for outside interfaces; fee-for-schedule becomes less common type of revenue; p4p; post-discharge care/instructions become centric to patient care; ability to track a patient through all settings of health care

    Epic’s answer to the latter is to install Epic everywhere. good luck getting the small doctor office/rehab/PT/home care/nursing homes to spend +100k per doc on epic and +12 months to implement it. Epic has no HIE, epic’s portal only works with epic EMR. It built for an old model which to my understand is being turned upside.

    The above is my understanding of what I believe the future might look like; hence where my opinion originates from.

    Thanks

  13. OGMD – OMG! you’re so lost and confused.

    Yes, Epic allows it’s organizations to extend to the community, but it also interoperates with many other HIEs and EHRs directly via both the Healtheway (fka NwHIN) and now the new Direct Exchange protocols. These have been live for some time, are public and included in other’s press releases.

    OGMD – of you’re wrong on this, what else are you misinformed on?

    Maybe a bit more reading and a bit less writing would be in order…

    For reference: http://www.iheusa.org/docs/IHEWhitePaperProfilesandCCDExchange_001.pdf

    http://www.informationweek.com/healthcare/electronic-medical-records/ehr-vendor-promotes-standards-based-inte/240012694

  14. @Doin the math

    Why look at net revenue? Isn’t net income what matters if you really wanted to look at the math? When his pension is ~11% of the company’s annual net income, it paints a totally different picture.

  15. @ correcting. Haha you made my point. You cite ccd and direct as epic’s hie strategy. Both are hardly strategy at all. Any vendor can claim those two items. Like I said, epic has nothing unique/proprietary, to connect epic will have to look outside its platform and its not going to be pretty.

    Btw, my read to write ratio is 1000:1.

  16. OMG no! OGMD. All I did was prove you’re wrong and misinformed.

    Your point is WRONG! Just WRONG! Spelled W R O N G.

    Wrong in English.
    Mal in Spanish.
    Falsch in German.
    Mícheart in Irish (apparently they have their own language – who’d have thunk it)

    Just Wrong.







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