Thanks, appreciate these insights. I've been contemplating VA's Oracle / Cerner implementation and wondered if implementing the same systems across…
News 8/30/24
Top News
PatientPay completes its acquisition of billing, statement, and payment technology vendor ClearGage.
The combined companies will have 1,600 healthcare organization clients and 1.2 million patient digital wallets.
Reader Comments
From Not So Vendor Neutral: “Re: Epic. I’ve heard from multiple sources that Epic is making deals for cash and equity as part of its Workshop program, where they give access to Epic resources while promoting those vendors to their customer base.” An Epic spokesperson provided this response to my inquiry:
We undertake a significant amount of R&D to co-develop products with Workshop vendors for the benefit of our provider community. Rather than front-loading this expense on start-ups, we’ve entered into novel financial arrangements, including warrants in rare cases. This way, the start-ups can delay the bulk of their payment until they are successful and we can share in that success. We have no intention of company ownership.
From ExMeditech: “Re: Epic hiring only entry level people. See this from Meditech’s Neil Pappalardo from a 1991 book.” Neil said this in the book “Entrepreneurs in High Technology: Lessons from MIT and Beyond,” which was written by the late MIT professor and Meditech co-founder Ed Roberts. It’s a reminder that Epic and Meditech shared some DNA and management philosophies in the early days:
We view ourselves as a family. We always hire entry level people, whether in software or sales. We don’t hire new people into managerial slots. All of our managers have been promoted from within. We want our people to join us when they’re still young and get their training here in our culture. They don’t have much experience when they start but at least they’re malleable at that age. And they learn quickly.
From Band Saw: “Re: Oracle CloudWorld. The band Journey is playing. Does the conference draw enough old dudes who care?” “Don’t Stop Believin” is my most-detested song, and I wouldn’t expect it to sound better played by the sole remaining original member in a million-dollar corporate jukebox show for IT geeks. The band’s most recent album is from 2022, but its later works are superfluous since — like skimpily talented insects trapped in musical amber – their music is indistinguishable from the 40-year-old stuff that includes that shriek-along favorite of tipsy karaoke moms. Don’t expect comradely glances between the keyboardist and guitarist, each of whom is a 50% band owner and opposing litigant in a money dispute that caused their upcoming European nostalgia-milking tour to be cancelled, and don’t expect to hear their singer – a non-English speaker from a Philippines tribute band who they saw on YouTube and hired purely because he sounds like Steve Perry despite looking as unlike him as is possible — since the audience will insist on singing along badly. The only deceased founding member is rhythm guitarist George Tickner, who according to his 2023 obituary was a registered nurse who left the band in 1975 to “pursue his PhD at Stanford University Medical School on a full scholarship.”
Webinars
September 10 (Tuesday) noon ET. “Overcoming Hurdles in Specialty Med Access Under Medical Benefits.” Sponsor: DrFirst. Presenters: Drew Hunsinger, VP of corporate business development, DrFirst; Tyler Wince, MEd, VP of product and technology specialty solutions, DrFirst. More specialty medications, which made up 80% of FDA’s new drug approvals last year, are falling under medical benefits, which challenges the patient care processes and efficiency of providers. Medication access experts will discuss how automation and unified medication management solutions can ensure better outcomes for patients and providers by addressing patient access hurdles and enhancing the ‘stickiness’ of EHRs. They will also provide insights into how regul
Sales
- Chicago-based Collaborative Bridges chooses HealthEC’s data and analytics solution.
People
EvidenceCare promotes Amy Deaton to president / COO.
Care2U promotes Lon Hecht to CEO.
Altais hires Kumar Murukurthy, MBBS (Walmart Health and Wellness) as chief information and digital officer.
Announcements and Implementations
CommonWell Health Alliance announces that Athenahealth, ModuleMD, and Solace Health are live on its new TEFCA-ready platform and QHIN that was developed with Ellkay.
University of Iowa Health Care CHIO James Blum, MD posted on LinkedIn that they have deployed Evidently’s EHR-embedded clinical decision support to all of their caregivers, of which 2,000 launched it on the first day.
Sponsor Updates
- FinThrive staff pack 576 “food paks” for Children’s Hunger Fund in Frisco, TX.
- EClinicalWorks releases a new podcast, “Say Hello to Easy Joint Documentation with EClinicalWorks.”
- Wolters Kluwer Health announces that 15 of its Lippincott healthcare journals received 37 Awards for Publication Excellence during the most recent APEX competition.
- Tegria, CloudWave, Nuance, and DrFirst will sponsor Meditech Live September 24-27 in Foxborough, MA.
- Fortified Health Security names Keenen Garnett (Deaconess Health System) penetration tester.
- Avoyelles Hospital (LA) adds Medhost’s Clinician Experience, Pharmacy Experience, and PDMP capabilities to its Medhost EHR.
- Meditech customer Ozarks Healthcare earns two EHR Experience Breakthrough Awards at the KLAS Arch Collaborative Summit.
- CliniComp earns “Great Place to Work” certification for the second year in a row.
- Revuud announces new board members Mark McDowell; Brian Litten, JD; and Scott Schubert, CPA.
- Surescripts CEO and pharmacist Frank Harvey recaps the company’s hosting of the Care Team Evolution Summit, in partnership with AHIP and the American Pharmacists Association, in Washington, DC last month.
Blog Posts
- Customer Obsession & Epic UGM Highlights (Health Data Movers)
- Steering Your Practice Towards Success (EClinicalWorks)
- 4 Key Customer Insights on AI Adoption (Five9)
- Irreverent, enlightening, and interesting: My experience on the OverReaction Podcast (Get-to-Market Health)
- EHR Consulting 101: Enhancing Patient Care Through Technology (HCTec)
- Leveraging Social Drivers of Health Data and Analytics for Enhanced Patient Access, Adherence, and Health Equity (Inovalon)
- The Evolution Of Telehealth: Time To Bust Some Old Myths (KeyCare)
- Achieving cost savings and elevated care with the Expanse MaaS model (Meditech)
- Wound Care Documentation: The New Rules (Net Health)
- How NeuroFlow’s Maternal Mental Health Care Pathways Support Parents at Every Stage of Pregnancy (NeuroFlow)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
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The fact that tTIL that the White House gatecrasher left that hubby and married Journey’s Neal Schon is yet another reason to keep coming back to HISTalk
And now I found out that Cain (the keyboard player) is married to Paula White, the televangelist Trumper grifter. A finer couple of wives I cannot imagine. no wonder those boys stay on the road playing the state fairs so much.
Journey played Citi Field with Def Leppard and Steve Miller (who is 80 and was excellent in person) earlier this month and were great. I had no idea about the Trump connections at the time. They sounded great though Def Leppard best of the 3.
“…we’ve entered into novel financial arrangements, including warrants in rare cases. … We have no intention of company ownership.” Readers, make no mistake: owning warrants is owning part of the company. Epic’s statement sounds like a rhetorical workaround to avoid admitting that they are acquiring part of another company. Acquisition isn’t allowed under Epic Principles – “do not be acquired” is the short name, but their principles also require that Epic will not acquire other companies.
I’m filing this news under, “evidence Epic is straying from its principles”.
By your logic, Epic couldn’t invest in the stock market. Fully acquiring a company is significantly different than having a stake in a company, which is significantly different than having the option to invest in a company.
The problem is the conflict of interest. When you own a warrant, you make more money if the company’s value grows. Therefore, Epic has incentivized itself to favor the companies in which it owns warrants over other companies. Imagine a new vendor approaches Epic with an identical product to the one owned by the Warranted company, which offers to pay cash to integrate with Epic. Epic would be incentivized to say no to suppress competition for the company in which they own a warrant (to ensure a positive financial return on their investment). I do not know that Epic does this, but suppressing non-warranted companies would lead to higher profits for Epic. Most US companies would favor that approach. I feel like that’s obvious. The less-obvious part is that Epic’s Principles, practiced as part of Epic’s culture, do not align with the US corporate culture of focusing solely on increasing profits. Therefore, Epic customers assume Epic will “do the right thing” and keep themselves neutral. That’s nice, but it’s like Epic finance planted a forbidden profit tree in the garden of Epic and then told their managers Adam and Eve to never eat the profit apples because if they did, it will hurt Epic’s culture. Epic should never have planted the profit tree in the first place.
What does a ‘warrant’ mean in this context? Is it related to an option?
I believe it is this: https://www.investopedia.com/terms/w/warrant.asp
So an option, but one provided by the original company.
Lake Superior Software (which became LSS Data Systems) and Patient Care Technologies (PtCT) offered add-on functionality for Meditech systems (ambulatory & home health, respectively). Meditech invested in both, providing funds and expertise to help them along. Eventually, both were absorbed by Meditech. Perhaps Epic is still following Meditech’s lead.
The issues with Epic, whether they involve warrants, acquisitions, or other matters, all point to a deeper problem: the company’s lack of transparency. Epic’s unique ownership structure allows it to avoid many public disclosure requirements, enabling this opacity. This is particularly troubling for a company that manages critical data for over 60% of US taxpayers and operates in what is effectively a monopoly—or at the very least, a duopoly—in a market that produces software essential for 18% of the US GDP.
If you read the statement, it sounds like a simple “IOU” to me. Startups don’t have cash on hand, and so if anything this seems intended to *level* the playing field between established companies and those trying to get started.
Ask them the same about Epic Toolbox
Re: Neil P – Judy has said in several of her history storytelling moments that she got advice from Neil when starting Epic, so the similarities are not surprising. And they work.
Well, they work up to a point.
I’ve made it my business to compare and contrast the company cultures of Meditech and Epic. Yes, they are the same in a lot of ways… but there’s something different too. And the difference is important.
Meditech’s culture is old, and for the most part they undervalue customer input. When you ask for something the application does not currently do, Meditech’s first response is almost always, “the way we do this is… (fill in the blank)”. And (fill in the blank) consists of something the application already does.
Meditech’s people are very good at supporting the app as it stands. They routinely have deep knowledge. But they have trouble thinking outside the Meditech box and this is a limiting factor.
Epic seems to have a more open company culture. Customer input is more valued and that makes them more flexible. Epic seems more aware of industry trends and more responsive to those trends.
Here’s another sign, their support of international customers. Meditech finally added a (tiny) amount of international support to their application, just a handful of years back. Epic seems to have pretty robust international support, much deeper and broader than anything Meditech does. I used to support a McKesson EMR and they had international support for literally decades.
You don’t need to persuade me that the Quarter-to-Quarter culture that is prevalent in public companies, has undermined those companies’ long-term thinking. Both Epic and Meditech seem to have done a good job at supporting a long-term, big-picture plan. This critique goes beyond that.
Meditech is parochial in a way that Epic is not. That’s my conclusion.