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Intelligent Healthcare Information Integration 1/26/11

January 26, 2011 News 7 Comments

Root Beer & Hope Floats … But Not All EHRs

This week, a colleague from Georgia wrote me about his parallel EHR search. His group had also ended up choosing Peak Practice after an exhaustive search, a search they have also again begun, looking for its replacement. But, after a few nice words about following along here on HIStalkPractice, yadda, yadda, his next three sentences were perhaps the most telling:

“Anyway, we’ve been busy doing our own demos. Initially, I wanted to be very thorough and consider almost all that’s available. My partners are not as patient and I’m getting tired of it, too.”

He then asked about a few specific products: two pediatric specialty-specific (Office Practicum and PCC) and two more broadly focused (Greenway and athenahealth). He mentioned several more that he had “no desire to even look at” and finished with another telling statement/question:

“I know nobody can predict the future of mergers, acquisitions, and decline of once solid-looking products (Encounter Pro, and Clinician/PeakPractice, etc.) but do you have any insider information or gossip from the health IT industry about the stability of and future direction of [EHR vendors]?”

Boy, oh, boy, Dr. Bu, are you feelin’ me, or what?!

To top it off, on that very same day, a market analyst at Software Advice, which provides software selection services for multiple industries, wrote me and I quote:

“In short, the EHR market has accelerated as a result of government subsidies. But vendors are having a tough time keeping up with the growth. As a result, we expect to see major consolidation in the market. Some will get acquired, others will just get left behind.”

Ain’t that the truth? The CEO at Software Advice, Don Fornes, had recently written a good piece on EHR Vendor Viability. In it, he notes that it’s not all about size, that execution and corporate management will be key. He further notes how tough it is for providers to assess the financial viability of EHR vendors and suggests that we could use a good A.M. Best for EHRs. Of course, he offers their Guide to Assessing Medical Software Vendor Viability, which, I promptly downloaded – also, “of course.” (Obviously they are trying to promote their software selection service, but at least it’s free to providers).

This line from the very first page started the old smoke drifting up from my ears again: “Or let’s say the vendor doesn’t go out of business, but they get acquired by another company. In this case the acquiring vendor informs you that they will ‘sunset’ the product and cease support within two years.” I couldn’t tell whether their guide was written before or after my birthday last year, the day I learned about the sunsetting of my EHR, but I sure wondered. It seemed as they had written it directly at/to me!

While I enjoyed reading what Don had written and what their Guide said, it still left me with same sour after-aroma that Dr. Bu and I now smell (i.e., having lived through three acquisitions of our chosen product, we can now only to watch it rot like a pumpkin in the sun after being sliced from the corporate vine). And Don’s article, while informative about the current state of the industry, only heightened my sense that rotting pumpkin aroma will be spreading from more EHR vines soon.

So, when it comes to concerns about the longevity potential of my next EHR and its vendor’s financial viability, unless I want to pay some consultant fees which I can’t afford, I’m left to a few choices:

1) Go with what my VAR (the original source of my current EHR) chooses and hope they’ve done good homework;

2) Go with one of the choices of my local REC and hope they’ve done good homework;

3) Try Software Advice’s “free FastStart Consultation” and hope they’ve done good homework;

4) Await the “A.M. Best for EHRs” (which may never come) and hope they do good homework; or,

5) Look for guidance from my Higher Power and hope I do good homework.

Best I have right now, Doc Bu. (I do recommend a good nose plug, just in case nobody does good homework. And naps. Naps are good. EHR hunting IS exhausting.)

From the trenches…

“Hope is the feeling that the feeling you have isn’t permanent.” – Jean Kerr

Dr. Gregg Alexander, a grunt in the trenches pediatrician, directs the “Pediatric Office of the Future” exhibit for the American Academy of Pediatrics and is a member of the Professional Advisory Council for ModernMedicine.com. More of his blather…er, writings…can be found at his blog, practice web site or directly from doc@madisonpediatric.com.

Comments 7
  • Gregg, you made many excellent points. As someone who has worked with close to 100 EHR vendors I agree that the area of EHR selection is fraught with peril. The Stage 1 MU certifications that have been awarded is a case in point. The range of these products to support the demonstration and documentation of MU is all over the map. This is the ‘open secret’ that no one is talking about. Stage 1 has been about achieving buy in from vendors, providers, and hospitals. I have particiapted with many of my clients in testing with every major ONC-ATCB and have been impressed with the quality and diligence these entities bring to the table. However, they must test and certify based on criteria not of their own making. I believe many Stage 1 certified applications (especially the home grown) will never be able to achieve Stage 2 certification.

  • No one mentioned the ability to communicate outside of the Practice. Just about everyone (EHR) can gather and report information, but allowing a Practice to be part of the continuum is essential. Only one company can do that. Allscripts.

  • oh, and eClinicalWorks, and it’s half the price of Allscripts MyWay.

  • let’s also look at the fact that Allscripts purchased this product that is ‘sunsetting’ in an effort to push all its current users to the Allscripts products. eClinicalWorks is privately held, has no debt (and never has) and no intentions of changing either of those facts, sounds solid to me. also, they guarantee compliance with the government regulations in every contract. cslader at gmail.com

  • Gregg, as usual, I knew I can rely on you to give excellent advice and thought-provoking ideas. Just as I was starting to build a case for my first choice for my next EMR and negotiated successfully on some items, I was informed that Allscripts does not have an export utility tool to migrate clinical data from PeakPractice to any other EMR and there is no definite plan to write one or definite timeline of when to expect one. Someone (you?) needs to gather all current users to force Allscripts to give us something better than “we don’t have one” and “we don’t know when”.
    Thanks again for the insightful enrty. I’ll explore all 5 choices you mentioned (especially the 5th one!) and then I can rest.

  • “eClinicalWorks is privately held, has no debt (and never has) and no intentions of changing either of those facts”

    Nice sales pitch, but I think the docs on here have heard that one before…..

  • Looks like ALLSCRIPTS has your attention….

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