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August 6, 2010 News 13 Comments

From Astonished: “Re: University Medical Center of Southern Nevada in Las Vegas. They have selected McKesson over Epic as VOC.” Oh, my. They should print up a lot of signs now that say, “Remember, this one was cheaper.”

8-5-2010 8-24-29 PM

From Patty: “Re: your logo’s head. I spy your cartoon likeness at the MBA HealthGroup booth at ACE. Your head is smaller than I imagined it would be.” I checked it out during the opening reception and you are right — they apparently lifted my logo’s image, which cost me a pretty penny to have custom drawn. They need to do something clever to placate me, so I’ll go by their booth again Friday to see if they’re creative enough to have come up with something. Stop by and ask them. I take enough heat from literalists who don’t get the intended irony of the pipe-smoking doc.

From RumorReporter: “Re: Eclipsys and Allscripts. Word on the street is that once the merger is completed, all finance functions will be relocated to India. So who is coming out on top here?” Unverified. It’s probably not a big deal (if it’s true) as long as it’s the grunt stuff that makes up a lot of what finance does.

8-6-2010 1-22-39 AM

From You’ll Know Who: “Re: Sunny Sanyal. The former McKesson Provider Technologies president now the CEO of T-System.” Unverified.

From PrettyKitty: “Re: Epic Beaker LIS. After a four-year project rolling out Epic to 10 of their hospitals and replacing existing systems in an effort to standardize, Sisters of Mercy Health System is developing Epic’s Beaker lab application for their next two hospitals to be implemented in the second quarter of 2011. They had been retaining and integrating the previous lab systems — Cerner and Meditech — but have been told that Beaker is ready. They are in the selection process for a Blood Bank system since Epic will not offer that.”

From Dino: “Re: Kaiser. They say they have 99.96% availability. At least now we know that $5 billion doesn’t even get you five nines of uptime. They have come a long way from aiming for 99.7%, though! Remember that Oakland forced Pleasanton to come up with a ‘revised systems availability formula’ a few years ago — a formula that would have made Arthur Andersen blush. It basically only counts the power being off in the data center as downtime. Still, if you’ve got $5 billion and some change, you can get a nice, fully (and somewhat frequently) functioning EMR than can help improve and save lives. We just need to get the cost down and the reliability up, and then we’re good to go.”

From Iggy: “Re: Healthport. Rumor has it that they are about to unload much of the non-release of information portions of their business. Wonder if they are shedding non-profitable lines of business to make a go of going public again?” The release of information and PM/EMR company filed for a $100 million IPO a year ago, but postponed it in November because of market conditions.

8-6-2010 12-49-01 AM

A reader sent over an internal announcement from the CEO of Saint Peter’s Healthcare System (NJ). They’re cutting 200 positions and have parted ways with their executive director and CFO. The reader points out that they’re spending millions to replace Cerner with McKesson.

Eclipsys announces Q2 results: revenue up slightly, EPS $0.03 vs. -$0.07. They also announce a new Sunrise customer – South Nassau Communities Hospital.

8-6-2010 1-09-19 AM

ONC adds an information site for EHR incentives.

A story by The Huffington Post Investigative Fund says that ONC and FDA are at odds over federal oversight of EMRs. The story led off describing upgrade-related Cerner problems at Trinity Health that included posting orders to incorrect patients and a four-hour downtime because of medication order problems.

I told you on 7/30 that Ingenix was rumored to be buying Executive Health Resources, which helps hospitals with reimbursement, quality, and efficiency. The acquisition was announced Wednesday.

Pennsylvania insurer Highmark will pay bonuses to physician practices that meet Meaningful Use EMR requirements.

I’ll have to keep it a bit brief tonight since I’m tired from lots of endless Mandalay Bay walking and schmoozing, Allscripts beer, extended treadmill time, and typing on my laptop keyboard, which I don’t like much. I’m uber behind on e-mail, but I will try to catch up over the weekend.

E-mail me.

From Allscripts Client Experience 2010

I’m in Las Vegas, checking out ACE 2010 as an attendee. Full disclosure: Allscripts invited me and comped the registration and hotel, but I’m paying otherwise. I’m still anonymous to them and I told them I was going to report what I saw and heard objectively. I don’t usually go to user meetings, but I knew the timing would be perfect to hear what people think about Meaningful Use and PM/EMR systems.

Note: the questions I asked were opened ended, such as, “What products do you have and how do you like them?”, so I was not asking leading questions that were positive or negative. Still, I can’t say for sure that the comments I got were representative of the Allscripts customer base. And keep in mind that I have no hands-on experience with any Allscripts product, so I’m just a wide-eyed noob at this conference.

They say 3,500 people are attending, which I believe since at least 3,000 of them were in the Starbucks line at 7 a.m. due to logistical challenges that I don’t need to explain since we attendees heard the gracious Allscripts apologies all day, from Glen Tullman on down. But no kidding, that was the longest line of people I’ve ever seen, at least 2-3 hours’ worth snaking back hundreds of yards (you people are seriously hooked on caffeine), and the buffet lines weren’t much shorter. It didn’t bother me since they had fruit and drinks in the meeting area anyway, so I was just as happy with a protein bar and a Diet Pepsi.

Some observational bits:

  • Half the attendees were first-timers, the registration person told me.
  • The lunch buffet was the best I’ve ever had at a conference. In fact, the overall meeting logistics were outstanding, from the handouts to the music to the friendly Allscripts people always willing to guide folks to their meeting room or connect them with an Allscripts contact.
  • On the other hand, I don’t want to see another orange shirt for a year or two.
  • A couple of users told me their Patient Portal (which I was told is the former Medfusion, but I don’t know that for sure) attempted implementations were disappointingly unsuccessful. They liked the promise of the portal, but said it was not ready for prime time. That’s a problem since it’s basically required to meet MU requirements. It’s obviously a key part of the Allscripts strategy (and an expensive recent acquisition for Intuit), so getting those problems fixed is key. There were demoing some pretty cool online payment functions.
  • Related to that, several users said their main gripe with Allscripts was releasing and pitching products that aren’t ready (not uncommon for vendors in general).
  • One user said the QA of Allscripts is much better than before.
  • I saw a couple of iPads in use.
  • Glen is an excellent speaker. Most of those I heard were good, except one who inserted the dreaded conversational crutch “sort of” every 2-3 sentences. Nuance was in the Hub and I wanted to ask them to use their speech recognition capabilities to set off a siren each time she did that, which should provide operant conditioning to help her stop. This is a near-epidemic – when I edit my interview transcriptions, I have to exterminate dozens of “sort ofs” in probably half of them.
  • The biggest news to me was the announcement of the Allscripts Referral Network, a service that lets users of Allscripts products communicate with each other. People seemed to be pretty happy about that announcement, including a practice manager and a consultant I talked to. Glen said they’ll open it up to users of other vendors’ EMR products by the end of the year.
  • Odd products that had surprisingly fanatically supportive users that I talked to: Homecare and Tiger.
  • I wanted to look at Payerpath, but I forgot to stop by. Maybe tomorrow.
  • A couple of people said they felt the meeting felt more like a heavily orchestrated cheerleading session and sales opportunity than something geared for their benefit. Hopefully they’ll get more out of it in the remaining sessions. I saw some very meaty sessions on the agenda, especially in the more specific technical and product tracks, so I’m pretty sure there are nuggets to be mined through careful session choices.
  • I went to the Professional roadmap meeting. A show of hands made it clear that even though MU awareness is nearly universal, very few attendees are really ready for Meaningful Use. Based on the graph shown of client release levels, a great percentage of Professsional’s 2,000 sites will need some serious upgrading. Most are on Version 8.3 and down.
  • I saw one person wearing a badge that said “No Hybrid EMR”.
  • I got no indication that MyWay is on the outs. They showed its MU deliverables and I spoke to several users who love that product, including some surprisingly large ones (one Enterprise EHR customer said semi-seriously that they were considering replacing it with MyWay). I think it’s a keeper for the company.
  • I asked one somewhat unhappy Enterprise user what they would be using otherwise. They hated Epic and said the product to beat was Greenway. Another liked Sage Intergy, saying it was truly integrated between PM/EHR instead of the “two screens” method of visual integration.
  • I talked to a handful of Enterprise users. That group seems to be the least happy with Allscripts, with gripes that include unresponsive support, lack of proactive contact from reps, the cost of buying the Stimulus Pack vs. Analytics (Allscripts was a bit evasive on pricing, turfing users off to their reps, but promised to make it right for customers who have purchased previous products), database bloat caused by the technical method of updating physician notes, and some obvious residual bad feelings from the premature TouchWorks Version 11 upgrades that caused significant practice disruptions. It’s always hard to keep the bigger customers happy, I guess, but Allscripts needs to do some work to delight that constituency again from what I heard.
  • I got the sense that all of the Allscripts growth has strained communication capabilities (reps not calling back, no direct access to support people, etc.), which may explain some of the new customer tools that Glen introduced.
  • One person bragged on how great their remotely performed upgrades are, with everything done overnight or over a weekend by Allscripts.
  • Glen showed an “upgrade wizard” thingie called the Upgrade Enablement Center that was explained further in the Enterprise MU session. It was created for migrating Misys users to Professional, with parts of it used by the customer and parts by Allscripts, but they said there’s work remaining for it to be finished. They said they had cut migration downtime from 4-6 days to 4-6 hours with the tool. One user said they had experience with it and thought it was great.
  • One Enterprise customer said they have no worries about meeting MU requirements since their doctors happily enter their own orders.
  • Glen also announced a new Web service that allows customers to one-stop-shop a lot of Allscripts services and communicate with each other.
  • Allscripts announced a new Web-based project management tool, where a client chooses their desired date for a the Stimulus Set upgrade and the application backs them into a schedule that Allscripts can work from.
  • Eclipsys was barely mentioned, probably since it’s not a completed transaction yet.

As someone with no skin in the game but a lot of conference experience, ACE is fun and well run. The company has obviously grown hugely and has a pretty big vision, although with a few inevitable rough spots in execution that are probably inconsequential in the big picture. I’d like to hear from my fellow attendees who are real customers, though, so please leave a comment if you’re at ACE. You know how conferences are – you can ask a bunch of people and all will report different conclusions.

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Currently there are "13 comments" on this Article:

  1. EMR’s patient safety cover-up! People being threatened. People dying in the corridors while nurse’s play on EMR’s! Why wont Mr. Histalk reveal how may people his website kills every year? EMR’s are medical devices. Hire more Amish nurses. Death. Doom. Somebody may be able to audit my work.

    Beat you! :p

  2. Was in Las Vegas. There are intense worries amidst industry workers and consultants that the FDA is going to do what everyone knows is the right thing to do, that being to enforce the applicable law for assuring safety and efficacy and post market surveillance. In addition, I heard that the crash of the Cerner system at all Trinity hospitals was for much longer than what the PR guy stated in the Huffington Post. Like doubling it, with hundreds of patients affected. I could not wait on the Starbucks line and I agree with you about the orange.

  3. I think its a safe bet that most of the Eclipsys/Allscripts finance department staff will stay in the US. However, there is a possibility that a large portion of the internal functions will be relocated Raleigh, NC.

  4. Re: McKesson win over Epic at Southern Nevada. As someone who has used Epic and who also uses McKesson inpatient and outpatient systems, I have to say that McKesson is coming on strong. The acquisitions of the past few years are now talking to each other and to Relay Health. It won’t be long before they can deliver an end to end solution a la Epic and at a much better price. Over time it was bound to happen: the Epic shine wears off as other vendors catch up and market pressures decrease the cost of everything.

  5. McKesson over Epic-after reading HISTalk for a while, you have to wonder what the love affair is with Epic. Fact is McKesson was probably half the cost of Epic-it’s hard to justify spedning double on anything these days!

    [From Mr. HIStalk] There’s no love affair with Epic, with which I have no experience, but rather a criticism of McKesson, with which I do.

  6. Fair enough! And I have no love for McKesson either, and although Epic seems to be the best out there right now, I just have problems with the following:
    1. The cost-its outrageous
    2. No way, all the customers who’ve contracted with Epic are going to get quality installs-there’s just not enough good trained installers to do all the work.
    3. Since Epic has a minimal sales team, how do they take care of their customers after the install?

  7. Would you rather be McKesson’s prized client for $50 million or a face in the Epic client crowd for $100 million?

    Sometimes getting alot of TLC as a key client trumps having those couple additional pieces of functionality that clinicians may not ever use anyway.

  8. @Skeptical: On what do you base your statement that Epic’s cost is outrageous? If you are looking at the total cost of implementation reported by the organizations implementing Epic, and compare that to only the amounts in the press releases of other vendors, you are not comparing the same thing – publicly traded companies will only mention what they receive, health care organization will present their total costs, including hardware, additional staff, consultant fees, etc.

    As far as I know, in terms to TCO over a period of 5 or 10 years, Epic compares favorably to most other vendors (for organizations of the same size, of course).

  9. This “Blah” fellow doesn’t seem to have a conscience about health IT safety.

    Instead, seems to have a little devil floating over his head whose pitchfork’s holding freshly printed money.

  10. You can look at costs anyway you want and Epic is significantly more expensive than McKesson. Acquisition costs or long terms costs, add in customers expense as well and Epic is still more expensive.

    Example-a midwest 2 hospital system, both facilities less than 200 beds paying $52M for Epic software and install-not long term costs. My guess is the same would be less than $25M for McKesson.

    And Dophins Fan is correct-most comanies acept Epic would provide you with a Cleint Executive and most likely a PMO to assure issues are resolved etc.. i do not know what Epic does but understand their sales force is small and inexperienced.

  11. I had the honor of dinner with a clinical subspecialist in surgery who uses OP Epicare, which cost this doc’s hospital system millions and still has interface problems with its in hospital CPOE and EMR system. I was shocked, literally shocked, to hear that this senior specialist types in front of the patients and when the patients are being kept waitning for more than 2 hours, the doc merely stops typing and takes it home to do after hours. Now that is an excellent way of practicing medicine at a self proclaimed “tertiary” medical center, don’t all opf you agree?

  12. @Skeptical: I have heard the same thing as the Anonymous above about the costs in the long run. Whether or not that is true, selecting and implementing another vendor and then switching to Epic is more expensive than choosing them in the first place.

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