...which is strongly suggestive, that the VA's problem with Cerner implementation? It's coming a lot more from the VA, than…
A New York Times article reports that Wal-Mart will begin selling small-practice physician systems through its Sam’s Club division, pairing Dell hardware with software from eClinicalWorks in a complete package that include installation, ongoing maintenance, and training.
Marcus Osborne, Wal-Mart’s senior director of healthcare business development, was quoted as saying, "We’re a high-volume, low-cost company and I would argue that mentality is sorely lacking in the health care industry."
Sam’s Club will offer the package this spring starting at under $25,000 for the first physician in a practice and $10,000 for each additional doctor. Ongoing costs will be $4,000 to $6,500 per year.
The package will include a Dell desktop or tablet PC installed by Dell technicians and software-as-a-service applications from eClinicalWorks.
Wal-Mart says it got the idea from its own in-store clinics, which use the same technologies. It says it’s role is simply to bundle the products together into an affordable and accessible offering. "We’re the systems integrator, an aggregator," Osborne said.
David Brailer was quoted as saying, "If Wal-Mart is successful, this could be a game-changer."
I’ve asked Girish Kumar of eClinicalWorks for more information. Meanwhile, your comments are welcome.
UPDATE: notes from speaking with Girish Kumar Wednesday afternoon. Sorry that they are terse and a little raw, but I had 15 minutes between meetings at work and Girish was in the car on the way to the airport.
If a physician buys from Sam’s, will it be the same product, implementation services, and support that eCW offers directly?
Absolutely. We’re trying to make it simple. Everybody says EMRs are hard and implementing change is hard. We realize that. We’ve been doing SaaS since 2003 and have invested a ton on a data center. We wanted system that is ready out of the box, configured, with content, although it will still require on-site implementation and services. It’s the same in terms of product, services, training, but faster and easier to deploy.
Why would a customer buy from Sam’s? Do they save any money? Can they choose a no-services option?
Wal-Mart used its Sam’s Club division because it has a lot of small business customers as corporate members. They buy ongoing stuff every month, not just simple things like gloves and bandages, but have a corporate account and buy copiers, payroll software, etc. They don’t have to go into Sam’s. You call a corporate number, get an assigned representative, talk to them about what you need, and the item is shipped. eCW salespeople will still show the product and talk to the customer. There are packages we want to give them that are pre-configured. The customer will not pick blindly – they will still consult with an eCW person.
Will Wal-Mart do its own advertising and marketing?
There will definitely be a significant campaign. They have 200,000 healthcare professionals today as members, mostly as doctors.
Any projections on volumes?
I have to keep that confidential, but there was a lot of planning on the eCW side. Investments have increased, made the company even more ready. This can have a significant impact on how physicians look at, evaluate, and purchase EMRs. We would like to see taking it away from being a niche sales process, where sometimes we confuse the customer, to make it a very streamlined process so that a customer can make an educated decision. They know how many days to go live, how many days training, cost, etc. eCW does 30 Webinars every week that every customer has access to with a live attendant and all Sam’s members will be able to avail themselves of that.
We believe we are the largest SaaS EMR in the country with 4,000 physicians. If we include hospital customers hosting affiliated physicians and RHIOs, that’s another 4,000. That’s 8,000 today of our 25,000 physicians. We’re trying to leverage that scale to make it easier and cheaper to deploy.
Do you anticipate any product changes?
For primary care, we spent two years working with New York City. We put into the product all the content needed to run a primary care practice – templates, order sets, clinical decision support. That is years of content that we jointly developed. That is all pre-packaged with the product – it’s not just the software any more. On the specialty care, we have about 50 specialty databases. All of that will be available pre-configured when they sign up. When the trainer shows up, all the content will be there and if we want to change it, we can change it together. We will go live with a comprehensive data repository with clinical decision support at no extra cost for the content.
A primary care doctor can go live with the system as it is, with rich content.
What does this to do the competitive landscape?
We’ve always taken tremendous pride on our leadership on price and functionality. 97% of eCW customers surveyed said their total costs met their expectations when they bought and implemented eCW. 93% of physicians said the EMR met or exceeded expectations. I still have to worry about the 7% and I lose sleep about it more than I take advantage of the 93%, but if a package with those numbers is readily available, people will ask the question: if I’m able to get a comprehensive product that people are happy with at this price point with content and support, why should I spend more? Price visibility will be black and white. No longer will you see those quotes saying an EMR will cost $300,000. You will see more informed questions, pricing pressure, and frankly, higher expectations if content is provided. I don’t want to take six months to implement PM and another six months for an EMR. This is a unified product we’re offering, by the way, both EMR and PM. We’re offering five days of implementation on site with the Sam’s Club package and they can buy more for $750 a day plus travel, but our track record is that we can do it in five days.
What are the benefits to eClinicalWorks?
There are many benefits. We want to be a company with 100,000 physicians using our product and 100 million patients whose lives are positively affected by it. There’s a lot more work to be done, but this platform gives us more opportunity.