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Monday Morning Update 7/26/10

July 25, 2010 News 16 Comments

7-25-2010 6-14-06 PM

From Gamara: “Re: Epic. Random stuff found in Googling Epic.” Good sleuthing, although some have turned up previously The following organizations appear to be going Epic: Stormont-Vail HealthCare (KS – above), University of Colorado Hospital (CO), The Mount Sinai Medical Center (NY), Maricopa Integrated Health System (AZ – old), University of Miami Health System, South Broward Hospital District.

From LookingForAnswers: “Re: Epic. They’re winning deals like Cerner did 15 years ago when they were small. Cerner seems to be a revenue-churning machine that the public can participate in by buying stock. The only people who benefit from Epic are the owners and/or Judy. Which company has made more millionaires? Which company will change the face of HIT for the long run?” Here’s the real question: why can’t Cerner, with all its billions in market capitalization and name recognition, compete with Epic for new sales? As has been asked of other Goliaths (Microsoft, GM, Dell, GE, etc.) how could Cerner, given its ample lead time and resources, let the once-tiny David called Epic beat them year after year? My theory is threefold: (a) even entrepreneurial big companies naturally evolve into highly ineffective corporate bureaucracies that are motivated by fear and executive entitlement, the antithesis of innovation; (b) publicly traded companies let their numbers drive their business instead of vice versa, and (c) corporate Darwinism would have Cerner just buying Epic outright, but Judy throws a wrench into that evolution by refusing to sell the company.

But all is not lost: we don’t know Epic’s profitability, so Cerner may be beating them where it counts. And we know that Cerner has built a business that could weather Neal’s transition or sale to another organization, but we don’t know that with Epic. What I care about most is why Epic beats Cerner for every important deal, which would seem to indicate that Millennium isn’t up to the task. In other words, a $6 billion market cap company with a single, fairly low-rated product line that’s getting hammered by a smaller and much higher-rated competitor should think about developing a better product. Here’s another way to look at the value of ongoing R&D: the only company that beats Cerner consistently in new sales is also the only one with a newer product.

7-25-2010 6-18-25 PM

From JA: “Re: Epic. More details on the Yale and Epic adventure.” Yale Medical Group describes their plans for Epic, also mentioning that a CMIO will be hired who will share time with the School of Medicine and Yale-New Haven Hospital. The specific Epic features that seemed to seal the deal were the obvious ones: ambulatory-inpatient integration and MyChart, areas in which Millennium is clearly inferior.

From Dave U. Random: “Re: Epic. Google RGHS+Epic.” Rochester General Health System has chosen Epic.

7-25-2010 6-20-22 PM

From SEC Fan: “Re: University of Michigan. CareWeb does many things well (less than they claim), but they have installed Eclipsys Sunrise over the last five years for inpatient. Interesting that after 3+ fails at EMR, they get one right and now replace it.” Thanks for reminding me. That’s another big Eclipsys loss to Epic, six years after the contract was signed and less than two years after Sunrise went live at UM.

From The PACS Designer: “Re: Windows Phone 7. The mobile phone marketplace will have more competition soon, as Microsoft has announced the beta for Windows Phone 7.” It had better be good if it’s going to displace the iPhone, Android, and BlackBerry this late in the game. I don’t see Microsoft as being good at come-from-behind victories; it’s better at running a prevent defense to protect the leads it generated a couple of decades ago. On the other hand, Windows 7 was a hit, so maybe they’re finally getting it.

From Vendor CEO: “Re: HIStalk. I have really enjoyed watching your progression. It’s kind of like watching the New York Times and Murdoch sites (HIT rags) try to get customers to pay for their sites while hordes of readers are rushing to all the free specialty news sites (HIStalk). Fascinating!” Thanks. Maybe I’m the open source alternative, a marginally skilled but enthusiastic spare bedroom pseudo-journalist trudging home to a PC after a long day at the hospital.

Listening: new from Grand Mal, which sounds like the Rolling Stones playing a smoky New York club in 1973.

Tom Ogg is named CIO of Akron Children’s Hospital, coming from Oakwood Healthcare Systems (MI).

Stuff you can do here: (a) put your e-mail in the Subscribe to Updates box to your right and be the first to know; (b) use the Search All HIStalk Sites box to dig through all HIStalk-related sites, including the 7+ years since HIStalk has been around; (c) send me your secret information and rumors via an anonymous Rumor Report, the lifeblood of HIStalk; (d) Friend or Like us on Facebook; (e) support my sponsors by giving their ads an occasional look and click; and (f) send in a pitch-free Readers Write article.

7-25-2010 5-37-44 PM

Not many readers think the final Meaningful Use requirements are too hard for providers to meet, but beyond that, it’s pretty much even as to whether they’re too easy or about right. New poll to your right: who benefits most from Most Wired-type awards?

A reader mentioned a JAMIA article last week, eliciting only a general reply from me since I didn’t have access to the full text version. Thanks to the folks at AMIA, who read my comment and hooked me up with anonymous access to their site so I can give a better answer next time around.

This from Weird News Inga: a medical practice sues its landlord over rights to a meteorite that crashed through the roof and into their examination room. The landlord claim it belongs to them, but the doctors say the landlord plans to renege on their promise to sell it to the Smithsonian for $5,000. The doctors say they’ll honor that deal and send the money to Doctors Without Borders for Haitian relief.

These rumors come up all the time, but once again Oracle comes up as a potential acquirer of Cerner. An Oracle VP supposedly claimed the company will spend $70 billion on acquisitions over the next five years, which always leads to talk about vertical markets such as healthcare, which means Cerner.

Duke University researchers develop software to predict MRSA drug resistance, offering it free to researchers.

Interesting: All Children’s Hospital (FL) will become part of Johns Hopkins Medicine (MD). In related news, the governor of Maryland wants to position the state as a health IT leader, citing a statewide HIE, EHR implementations, and recruitment of HIT professionals.

E-mail me.

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Currently there are "16 comments" on this Article:

  1. “Here’s the real question: why can’t Cerner, with all its billions in market capitalization and name recognition, compete with Epic for new sales?”

    I first emailed Cerner two weeks ago, then I called them early last week looking for information on one of their products. This on behalf of one of the biggest hospital groups in the country. I still have not heard back from them, via phone or email. Thats pretty shocking. That and the product has consistently been shown to fail. They just don’t seem to want it anymore.

  2. PeachEater:

    No HIE in play here – even though the physician could access the record from Maui, he was forced to FAX the information to the hospital.

  3. Re: Epic – there is another overlooked factor that may explain the current Epic ‘revenue-churning’ phenomenon. It is what I like to call the “lemming effect”. In the pro fee space first there was MCSI, then Science Dynamics then IDX and now Epic. Unfortunately even though Epic has a very strong product, many healthcare institutions buy them now simply because they are afraid of being left behind and if “everyone is doing it, I should too”. My Mom used to have something to say about that kind of thinking…

  4. I think University of Michigan is keeping Eclipsys inpatient and using Epic outpatient. That would explain why they announced the deal at $20 million. No way you could do Epic both in and outpatient for $20 million.

  5. Re: Windows 7 phone. I’m not sure how well this phone will fit in with the current market, or how it’d perform better than MS’s (many) other attempts at producing a competitive mobile device. I have been pleasantly surprised by Windows 7 on my new computer though: it’s got some definite improvements that I’ve already become used to, and yearn for when I switch back to my older XP model. Whether that translates as well into a phone I’ll leave for better judges than I.

    Speaking of smart phones, I’d love to hear from any users/owners how well the new Federal Register website works on a mobile platform. It’s just been launched today, and includes some great new features.

  6. How in the world is Epic going to execute and implement all those large systems??? There are more yet to be announced!

  7. From everything I have heard, the Windows Phone 7 will be underwhelming at launch. Its only potential strength at this point is its developer tools, which are Silverlight-based. Only hands-on experience will answer the main questions, which are:

    a) Will the Silverlight sandbox have sufficient access to the phone? If not, it will turn out like Java’s J2ME–useless.

    b) Will the Silverlight environment run fast enough? There’s a reason why both Android and the iPhone allow native (low-level) API calls.

  8. I’ve had the same thoughts about the Epic parallel with Cerner from many years ago. It will be interesting to see if Epic handles the massive growth better than Cerner did. If not, they will eventually be headed in the same direction.

    It is far simpler to keep a smaller live client base happy (and with fewer modules), but once you get a huge installed base and a plethora of modules, AND are still trying to implement a large quantity of new clients, the challenge to a vendor is significantly harder — and that is where Epic is now.

    I wish them well and do think being a private company is in their favor. Back when we went with Millennium 12 years ago, Epic wasn’t a possibility. I suspect if we were making the decision today we’d follow the recent masses to Epic, though I’m not yet convinced that we would be much better off in the long run.

  9. Any investment banker worth his or her salt would advise Judy to cash in now, at the peak of success. It’s going to be more and more difficult to manage the burgeoning portfolio of accounts, and more and more likely that Epic will find itself challenged by as yet unknown new competitors. Imagine the bidding war which an Epic sale would generate. Unimaginable riches.

  10. Judy will never sell. NEVER GO PUBLIC is commandment number one. And if you think Judy is going to take the advise of an investment banker, you don’t know Judy. Didn’t Epic have a billboard in Madison a few years back that simply said MARKETING SUCKS-Epic Corporation ?
    Making money is not her favorite thing, getting the bulk of the country, or the world, on an enterprise number, now that is what floats her boat.
    Personally I think it was refreshing for hospitals to have an alternative to the Ken doll boring suits that came in selling the “other” products. She picks her customers, calls her own shots, no press releases that mean nothing, no BS.

  11. I am wondering what your opinion of the Dell/Perot Consulting Business is as a long term venture. Do you see them around in 10 years, or do you see them fizzling out sooner? Any additional comments / inputs would be welcome.

  12. Yale Medical Group describes their plans for Epic, also mentioning that a CMIO will be hired who will share time with the School of Medicine and Yale-New Haven Hospital.

    I fought this exact battle bewteen YNHH and YSOM 15 years ago. Email me (via Mr HIStalk) for why I think such a position is not a good idea.

  13. Cerner promises too much, too soon – they have trouble saying “no” during the sales cycle to big clients. They do a terrible job meeting their software delivery commitments, and they do not invest enough time and money into testing the software and fixing defects. They have never wanted to do that. The software is so tightly integrated between all their products and single architecture (which I think is a good thing), but it also means that the code has complex tentacles – you change one simple thing in one area and it has negative effects in other areas/products.

    Cerner is a superior product to EPIC in many ways, unfortunately, a lot of the featues within Cerner are not as reliable as the fewer features in EPIC. A feature is only good if you can use it. EPIC promises less and delivers slightly more. Cerner always promises more than they can deliver – by the date they promise.

    At the end of the day, people will trust and gravitate to the products that do what they say they will do – even if it is less than what they want.

    But, I still believe (although many will disagree with me) that Judy’s older architecture and antiquated programming language will eventually catch up with her. I know it hasn’t happened quite yet – but someday, she will be forced to rewrite everything whether she wants to or not.

  14. The #1 commandment is “Never mention patient information to anyone.” “Never go public” is the first principle. Otherwise, Certifiable pretty much hit it on the head.

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