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Are EHR Companies Difficult to Work With?

Posted on September 10, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

There is an entrenched myth that EHR companies are difficult to partner with – more interested in up-front partner fees and revenue sharing than actually collaborating with 3rd party companies. Two companies are working hard to be different.

Early in the spring, I had a lengthy conversation with a group of vendors at HIMSS18 about partnering with EHR companies. I had stopped at a booth and somehow we got onto the topic of collaborating with EHR companies as a way to accelerate product development and sales. The person I was speaking with was very frustrated at the lack of response from three of the larger EHR companies. I’m paraphrasing, but her statement was essentially this: “All they want is to charge me their 5K partnership fee and then take 10% of everything I sell to their customer base. It’s ridiculous.”

At that point, several representatives from surrounding booths joined in our conversation. All of them had similar frustrations and shared similar stories of being shunted to the partnership team – which in their opinion was just a sales team in disguise – where they were told about all the wonderful benefits they would receive in return for an upfront partnership fee. I’m sure many Healthcare Scene readers can identify with these vendors.

This conversation stuck with me and over the spring and summer, I decided to dive deeper into the world of EHR partnerships. I wanted to know if the myths were true and I wanted to see if there were any companies that were operating differently. Over the past several months at every conference I have attended, I have made it a point to find out as much as I could about the various partnership programs and spoke with dozens of vendors who were proudly displaying partnership badges on their booths.

The good news is that there are at least two companies working hard to build a thriving partner ecosystem. The bad news is that many EHR companies do not have a well-defined partnership strategy and many vendors do not feel they are getting full value for their participation in EHR ecosystems.

One of the key things I learned is that there is a distinct difference between working with an EHR company on interoperability vs being part of their partner ecosystem. There have been many articles over the past few years about the difficulty of extracting data from EHRs in order to share it with other organizations involved in the care for patients. Headlines like “How disparate EHR systems, lack of interoperability contribute to physician stress, burnout” are common.

Many of the EHR companies I spoke with separate their interoperability efforts from their partnership programs. The ability to share data with others, they said, was not related to how well/not well they worked with 3rd party companies. So while it may be true that EHR companies have a lot of work to do on interoperability, partnership for some is something a few companies are doing well.

One company is Allscripts.

After HIMSS18, I had the opportunity to drop in on the fourth annual Allscripts Developer Summit in Chicago. I honestly did not know what to expect and I was pleasantly surprised at how intimate the event was. The rooms were smaller and had people sitting at round tables listening to presenters and asking lots of questions. The level of interaction between the speakers and the developers at the tables was refreshing to see.

Most of the attendees at the Summit were developers and product managers from companies that were Allscripts partners. Most of the discussions in the sessions and in the hallways centered around the latest APIs and FHIR initiatives.

The Summit is part of Allscript’s Developer Program (ADP). Allscripts recently announced that its ADP partners have together processed more than 4 Billion API data exchange transactions since the company started tracking it in 2013. In the announcement Tina Joros, VP and General Manager, Open Business Unit at Allscripts had this to say:

“We are trying to create a new mentality of innovation for our clients so that they view innovation as a path to improve overall workflows and connect with patients. We have made our API platform easily accessible and cost-effective for developers to use so that they can develop and test their solutions. This includes the ability for developers to use our FHIR APIs to meet regulatory requirements for our shared clients at no cost.”

I had the chance to sit down with Joros during the Summit and she shared with me that Allscripts does more than just provide access to their APIs. “We help companies with sales and marketing as well,” said Joros. “We coach partners that are new to the space how to ‘talk healthcare’. We help them craft and tell their stories to their target buyers. We spend a lot of time on the phone and in the field with our ADP partners. Our goal is to reduce the risk for clients to adopt new technology.”

With more than 8,000 registered developers in ADP, I asked Joros why so many companies had joined. “One of the key differentiators is the ADP Integrator tier of our program; most competitors have programs that make it easier to sign up for the FHIR APIs but they also have a vetting process in place to review companies for partnership,” said Joros. “In our ADP Integrator tier, however, companies can sign up immediately to access all our FHIR and proprietary API functionality – there is no wait or vetting by Allscripts and no fee to get started. The pricing model is designed so that companies only pay Allscripts when they are ready to go to market via a testing fee and usage-based fee. The ease of signing up and no fee to get started are unique in the industry.”

One company that has been very successful at working with Allscripts is Relaymed – a company that makes connectivity software that sends point-of-care test results directly into EHRs. RelayMed has been part of ADP for four years and had nothing but good things to say about the program.

“Many EHR companies have rigid cultures that actually bias them against partnerships – the ‘not invented here’ syndrome,” commented Neil Farish, CEO of Relaymed who spoke with me over the phone. “Allscripts isn’t like that. They had a vision of an open and vibrant ecosystem. That vision is ingrained into their culture and there is support right from the top. It’s become part of their DNA. If anything, senior management at Allscripts has been paying even more attention to partners this year. They are present. They interact with us. Help from their marketing & sales teams has been easy to get and really welcomed.”

The team at Relaymed has been working with the Allscripts team to tighten and improve the level of integration between their two systems. As well, the companies together are looking at ways to expand the breadth of devices that connect to Allscripts through Relaymed.

Another company that has invested in their partnership program is Cerner.

Cerner takes a different approach when working with partners. Although they have a centralized team that helps on-board partners (legal, contracting, etc), the ongoing relationship with partners is handled directly by the team/department that works most closely with that partner. Sometimes that is the Cerner sales team. Often times it is the product team. It just depends on where most of the interactions will occur.

“No partnership looks the same,” John Gresham, Senior Vice President, DeviceWorks & Interoperability at Cerner told Healthcare Scene. “So we have to ask the key question – How does that partnership bring differentiated value to the customer? We will work with partners the way that works best for our customers. That may mean embedding someone else’s solution within our solutions, co-market their solution as part of a bundle or we may simply go-to-market together.”

It was surprising to learn that a company as large as Cerner did not have a cookie-cutter approach to partnering with 3rd parties. It would have been easy for them to put in a rigid framework but instead they adapt themselves to best suit the partnership. DellEMC, Kofax and Nuance were cited by Gresham as examples of Cerner partnerships that were flourishing.

“Customers want something seamless and not just in terms of Cerner being a systems integrator for them,” continued Gresham. “They want everything to be smooth and simple – buying it, contracting it, deploying it, integrating it and supporting it. Cerner is willing to do all those things, something that isn’t common in the EHR space.”

During our conversation, Gresham repeatedly referenced Cerner’s laser focus on delivering better patient care and better outcomes – and how that focus guided their partnership decisions. In fact, that is key to attracting the attention of an internal champion at Cerner: a clear line from the product or service being offered to customer or patient benefit.

That is exactly what happened with Goliath Technologies, a provider of IT operations software that enables IT Teams to anticipate, troubleshoot and prevent infrastructure performance issues. The team at Goliath had successfully implemented their solution at a Cerner customer. That customer spoke about their experience at a Cerner event and Jay Savaiano, Senior Director of Business Development at Cerner took notice.

“It was because of Jay and his vision that Goliath got into the program,” explained Thomas Charlton, Chairman and CEO at Goliath Technologies. “He was the first person we had a conversation with and from there everything went smoothly. He was with us every step of the way and we’re still working with Jay today. But it all started because we were able to demonstrate a clear positive impact on a Cerner customer.”

“Once Cerner decided that Goliath would benefit their customers, the process of formalizing the relationship was very straightforward and smooth,” continued Charlton. “They moved really fast. They have a fantastic team of people, very competent and focused. Everyone from contracting to legal to sales was great to work with.”

Because of the success, they have enjoyed with Cerner, Goliath has begun to put a lot of focus on their partnership with Cerner. They have begun working with Cerner developers to refine and tune their combined solutions and Goliath recently hired a new VP of Corporate Development who had left Cerner a few years ago, to help strengthen the relationship [side note the VP was referred to Charlton by people at Cerner]

“Cerner brings healthcare knowledge to Goliath,” said Charlton. “They know patient care and healthcare systems management. That deep understanding of healthcare has helped us with product development. Cerner has really helped to reshape our thinking on healthcare, patient care and Healthcare IT Operations management.”

*****

It is interesting to note that neither Relaymed or Goliath were put forward by Allscripts or Cerner respectively as example partners to speak with. Both Relaymed and Goliath were referred to me by different people who are not affiliated with either EHR company.

So if you are a software provider that is looking to partner with an EHR company what can you do to attract their attention? All four individuals I spoke with offered sage advice.

Neil Farish (Relaymed): “Avoid the transactional models of partnership where it is just an exchange of $$$. Look to the value that you as a partner are getting, the value the EHR company is getting and the value you can provide together to their end-customers. If there is value all around then the fees should be dwarfed by the value. If not, then you seriously have to rethink that potential partnership.”

Thomas Charlton (Goliath): “Have a very clear understanding of how your product or service helps deliver better care to patients. Can you show a direct line to customer or patient benefit? If you can’t then you need to figure that out before approaching an EHR company looking for a partnership. Also, joint customers are important. The more joint customers you have the more momentum you will get behind the initiative.”

John Gresham (Cerner): “The key to making partnerships work is mutual respect. That’s the starting point. Next comes a key question – do you have a ‘what’s best for customers’ mindset. If you have that then we have a foundation for conversation. I would strongly encourage companies to build solutions for the highest possible reliability, scalability and security.  Cerner customers expect that. Oh, and you have to have proof points to back that up.”

Tina Joros (Allscripts): “Be persistent. Come talk to us at conferences. Connect with us online. I would encourage any company signed up for the program and does not feel like it is providing value, to speak with a member of our team and let us know.  In some cases, we can find a tier that is a better fit for the company or make introductions to other associates at Allscripts, so additional areas of the business can evaluate their solution.”

Myth busted.

Origin Story: Paul M Black, CEO of Allscripts – Deep Roots and Optimism in Healthcare

Posted on May 24, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

This is first in a new series of articles. Over the coming weeks and months I will be publishing the origin stories of interesting, inspiring people in healthcare. These men and women come from all walks of life. Some are titans in the industry, others are leading grass-roots efforts. All are making an impact on healthcare.

As a self-professed comic-book geek, I am fascinated by origin stories – the account or back-story that reveals how someone became who they are today. Origin stories add to the overall narrative and give reasons for a person’s intentions. Knowing someone’s origin stories can give clues to their future actions.

Kicking off this series is the origin story of Allscripts CEO Paul Black. Allscripts, based in Chicago, serves over 45,000 physician practices and 2,500 hospitals around the world with their EHR systems and other Healthcare IT solutions. The company has a rich history of mergers. Early on they merged with Misys and Eclipsys. More recently, the company has acquired McKesson’s Health IT business and Practice Fusion.

It is common knowledge that Mr. Black has a long history in healthcare. Prior to becoming CEO of Allscripts in December 2012, he spent 13 years as Chief Operating Office at Cerner (an Allscripts rival). He has also served as an advisor to healthcare companies through his work at New Mountain Capital and Genstar Capital.

What is not common knowledge is how far back Black’s history with healthcare actually goes. When he was just 5 years old, Black accidentally consumed weed poison that was in an unlabeled vial. Luckily his father, who was the Director of the Pharmacy Department at the local hospital took him to the VA emergency room right away. As a healthcare professional his father knew that the VA had just purchased an artificial kidney machine – the very device needed to treat this type of poisoning. Spoiler Alert: Black made a full recovery thanks to his father’s quick actions and the knowledgeable staff at the VA.

To understand how lucky Paul Black was, you have to remember that back then, there were no toxicologists, no poison control centers, no detailed chemical labels and very little knowledge of poison treatments. In fact, it wasn’t until 1953 that the first poison hotline was established in Chicago by Louis Gdalman R.Ph and Edward Press MD [source: Forging a Poison Prevention and Control System 2004].

Black’s poisoning incident led his father to establish an Iowa poisoning hotline so that people in his home state could find out what to do in a poisoning situation. His work eventually led to the creation of the Iowa Poison Information Control Center – an entity that is still saving lives today.

“My father was always working on ways to improve healthcare,” recalls Black. “He built a machine that would help ensure that the right medication would be administered to the right patient at the right time. It was basically a precursor to a Pyxis machine. He got involved in computers in the early stages and was always looking for ways to use systems (whether physical or software) to solve problems in healthcare.”

Clearly the apple did not fall far from the tree.

Early in his career, Black worked at IBM where he learned “a lot about systems, software and hardware.” But more importantly, it was his time at IBM that ignited his passion for healthcare.

“I just felt good whenever I worked with hospitals and healthcare clients,” explains Black. “It was clear that working with them had a direct impact on care and on individuals in their care.”

Black moved on from IBM and joined Cerner, then an up-and-coming healthcare systems maker. There, he progressed steadily through the ranks until ultimately becoming Chief Operating Officer in 2005. Black retired from Cerner in 2007 and served in a number of advisory/board positions until he was named CEO of Allscripts in 2012.

I asked Black why he chooses to stay in healthcare.

“It’s pretty simple actually. We aren’t done yet,” states Black. “My grandfather was born in 1888 and during his lifetime we went from horse-and-buggy on dirt roads to a full interstate system with fast cars and a railroad system with fast trains. We also went from having to read your news in a newspaper to wireless radio. He even saw us land on the moon. That was an incredible amount of progress for a single lifetime. I would argue that in my lifetime we are going to see a similar leap with just as many innovations, discoveries, and life saving technologies. That’s why I stay. Healthcare is going to be a fascinating industry for the next 20+ years. Plus there aren’t many industries where you get to help the people that save lives.”

Black went on to say that this is a time in healthcare when strong leadership will be required to ensure we make the right decisions for the benefit of the many vs the few. He pointed at genomic testing as an example. Even though the cost of sequencing continues to drop, access to this type of technology and access to clinicians knowledgeable on how to interpret the results is not universal.

Access to care is a cornerstone of Black’s vision of a perfect healthcare system, something I asked him to describe during our conversation: “My perfect healthcare future is one where everyone has access to healthcare, not just people of means. It’s one where a payment mechanism has been figured out whereby a certain level of access is guaranteed as is a certain level of prevention.”

Black went on to say that this vision is not as far fetched as it may first sound: “My view is that there is enough money already in the healthcare system today to make this happen. If you add the dollars spent by every single player in the healthcare industry – governments, employers, patients, etc – it’s more than enough. We are at 18% GDP. It’s just not being spent efficiently.”

To reach his vision, Black feels we need to build a healthcare system where: “We get the diagnosis right the first time, there is no delay in treatment and there is active involvement from patients in their health.” The latter being the toughest challenge – motivating the average person to exercise more, eat better and make healthier lifestyle choices.

“We have to make it cool to be healthy,” says Black. “In fact we need the healthy equivalent of the Marlboro Man, which I know is an ironic and strange thing to say. But back in the day, EVERYONE wanted to be the Marlboro Man. He was what young men aspired to be like. We need the healthy equivalent to help motivate people to be more engaged in health.”

It is not surprising that Black sees Allscripts playing a significant role in making healthcare more efficient and effective. “Allscripts definitely has a role to play,” explained Black. “We will play that role by staying relevant in the healthcare industry. We have our core EHR products, but we also have four other product lines that are actually EHR-agnostic. We have our population health platform, dbMotion. We have our post-acute system, Netsmart. We have our precision medicine platform, 2bPrecise. And finally we have our consumer platform, FollowMyHealth. We will continue to push aggressively in these markets through innovation and acquisition to provide our clients with the solutions THEY NEED to deliver better care to patients.”

Allscript’s latest acquisition certainly fits with this acquire-functionality-that-clients-want strategy. On May 18th, the company acquired HealthGrid – a communication platform that delivers reminders, alerts and educational materials to patients via phone, text, and other electronic means. This functionality will be rolled into Allscript’s FollowMyHealth product line.

“I feel it’s our duty and obligation to automate the healthcare ‘shop floor’,” declares Black. “The groundwork had been laid with EHRs, but now it’s time to streamline workflows and leverage the data within these systems. We need to reduce the ‘shouting’ in healthcare (too many alarms). We need to improve User Interfaces so systems are easier to use. We need to reduce the documentation requirements on clinicians so they can go back to taking care of patients vs being data entry clerks. Computers should work for us, not the other way around.”

Reflecting on Black’s origin story you can see the thread of hope and optimism woven throughout. From his first (and positive) encounter with the healthcare system when he was 5 years old to watching his father use computers/machinery to try and improve patient care to the positive feelings he had while working with hospital clients at IBM – every experience brought him closer and closer to healthcare until he became part of the industry through his position at Cerner.

It gives me hope that an industry leader like Paul Black is optimistic about the future of healthcare. It’s exciting to learn that he is not just saying the right words, he is putting energy and investment behind them. It will be interesting to see how Allscripts will continue to “remain relevant” and be agile in the years ahead.

Be Skeptical About Health IT Research Reports

Posted on April 26, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Look, I get it. While advice from colleagues is fine, it’s even better to have an objective research organization tell you which vendors dominate the market and which seem to have a lot of fans.

You know some of the headlines, in big bold letters: “Epic has the biggest EMR market share in the US” or “Doctors are very satisfied with eClinicalWorks.” Hey, if nothing else, you can wave the report in your boss’ face if your new system doesn’t work out.

The thing is, are you getting valuable, fair, unbiased feedback from research vendors? Not necessarily.

  • Pay for play: Some research firms are getting paid to promote certain products or organizations in their reports and client notes. The payment can be as subtle as a few introductions to potential customers or a straight up bundle of cash. Sadly, not all analyst firms who engage in this practice will tell you that they do.
  • Lack of experience: While some research reports are written by senior people with a long institutional memory, sometimes they are farmed out to junior staff members with a lot less perspective. I’m not suggesting that the younger people get it wrong, but they simply can’t offer the kind of insight senior people can.
  • Beauty contests: Be warned: sometimes reports are just not about you. It may appear, on the surface, that the research firm is offering you valuable insights, but the truth is that the research isn’t that substantial. In cases like these, the firms simply line up all the vendors in a row and rate them on scales they basically make up in their head.
  • Value of the data: Sure, it’s sort of fun and interesting to know whether Epic has nudged out Cerner or MEDITECH in the battle for US market share. It’s something to share over the health IT water cooler. And it seems to give you a sense of which vendors are offering the most value. But does it really? In most case, it probably isn’t that helpful to track market share unless you hold stock in one of these companies.

For what it’s worth, I’ve written several in-depth research reports of my own, and I feel pretty good about the industry analysis I did. But thankfully, none of the publishers suggested that I was the Oracle of truth. I simply gathered up a pile the facts and tried to fit them together.

In saying all this, I’m not suggesting that health IT industry research is a waste of time. If a report offers context, input from your peers and no-nonsense answers to questions you have, it may well be worth the price. But don’t let one of these firms sell you a bunch of hot air.

 

Five Not-so-typical meetings at #HIMSS18

Posted on March 7, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

As the first day of the #HIMSS18 exhibit hall dawned, I had mentally prepared myself for a series of meetings where we would be discussing the product updates, client signings and releases of new thought-leadership content. Fortunately, the universe decided to throw a curveball and I ended up with no fewer than five meetings that were completely different than what I expected.

Meeting 1 – Nuance

I had the opportunity to sit down with Nuance at #HIMSS18. I wrote an earlier post about their #AI Marketplace and I fully expected to listen to an update on that effort plus learn details about the company’s recent announcement of a multi-year collaboration with Partners Healthcare. They surprised me by speaking instead about the importance of their work in the area of incidental findings.

Brenda Hodge, Chief Marketing Officer of Nuance Healthcare spoke passionately about the work that Nuance is doing to help ensure incidental findings are brought to the attention of primary care physicians. Through their AI prioritization algorithms and natural-language-processing capabilities, Nuance has plans to capture this potentially vital imaging information and highlight it so that the right clinical interventions can be applied sooner.

It was the fervor and fire with which Hodge spoke that was the not-so-typical part of our meeting. It was fun to share that moment with a kindred spirit, passionate about improving healthcare.

Meeting 2 – Voalte

The good folks at Voalte provided me the opportunity to do something I have never done at HIMSS – moderate a meetup. We assembled a fantastic group of panelist: @ShahidnShah @innonurse @drandrew76 and Angela Kauffman (from @Voalte) had a lively discussion about Physician Communications. The meetup was even better than I expected.

The conversation flowed easily. Online engagement was high. A good sized crowd gathered to listen. It was a fantastic way to start the day. We captured the meetup on video so watch for clips from the meetup on the Healthcare Scene YouTube channel once we recover from #HIMSSanity.

Meeting 3 – TigerConnect (Formerly Known as TigerText)

I stopped by for a quick chat with the team at TigerConnect – the company formally known as TigerText – to talk about their recent rebrand. This meeting was atypical of ones I have had at HIMSS because it was solely focused on their marketing rather than on their products. It was refreshing to have the chance to get a behind-the-scenes view of their recent rebranding initiative.

TigerText is a pioneer in the field of secure communications in hospitals and their brand had become well-established. Unfortunately the “Text” portion of their name was becoming a limitation as their company expanded into adjacent spaces and extended their platform’s capabilities. In just a few months, they made the decision to rebrand and executed it in time for #HIMSS18.

I’ll be writing a more in-depth piece on this after HIMSS, but felt it was worth mentioning because I have never had this type of frank, honest marketing conversation at HIMSS before.

Meeting 4 – Lenovo Health

I stopped by the Lenovo Health booth to see what new things were happening – especially since I had the chance to attend their HealthIT Think Tank event last year. I came for news and I ended up taking a selfie with a custom-made sign. It was energizing to just do something fun in their booth. It was 10 minutes of being creative and capturing a moment in their space. You can see how big our smiles are in the pictures we took.

Meeting 5 – Cerner

The team at Cerner reached out a few days ago and asked to get together. By pure chance, they suggested a time that had recently freed up on my calendar (one of the few open spots I had). I honestly did not read the request carefully before agreeing to it. I thought I was going to be part of a press briefing that was being broadcast. It turned out that the Cerner team wanted to me to be part of their onsite podcast.

We ended up have a wonderful conversation about Day 1 of the HIMSS18 exhibit hall. It was a free-flowing discussion that I was not expecting. You can listen to the podcast here.

It was so much fun that we continued chatting for 20min after we wrapped the recording. At the end I had the opportunity to officially welcome the Cerner podcasting/social media/marketing crew to #pinksocks. Like the Lenovo Health meeting earlier, it was a rare chance to create a lasting memory. I will not soon forget that #pinksocks gifting – the enthusiasm, surprise and good feeling was just incredible.

Day 1 takeaway – small moments, lasting memories

For me, Day 1 of the HIMSS18 exhibit hall was all about creating lasting memories from small moments. It wasn’t about the big splashy announcements, but the open/honest conversation. As I reflect on the day, I can’t help but smile at the how the stars aligned to give me a day at HIMSS that is the ideal we strive for in healthcare. Imagine if all across the healthcare ecosystem, clinicians were able to have small moments with patients that were open, honest, free-flowing as well as conversational and where both left the encounter feeling energized.

We need more days like this.

Is A Cerner Installation A “Downgrade” From Epic? Ask This Guy

Posted on January 8, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I don’t know if I’ve ever quoted a letter to the editor in a column for this publication, but I have to this time. I thought it had an interesting story to tell.

The letter, written by a patient at the Banner University of Arizona Medical Center in Tucson, offers a scathing critique what he sees “degradation of services” taking place after the institution switched from an Epic to a Cerner EHR, a change he refers to as a downgrade throughout the letter.

Since the “downgrade,” said the patient, John Kimbell, appointments take much longer. “Three weeks after the downgrade, my 30-minute appointment took three hours and 40 minutes,” he complains.

His other concerns include:

  • Data exchange problems: “My local doctor has TWICE sent results of a scan to my oncologist, and they never arrived.”
  • Privacy issues: With the automated paging system gone, “nurses call out names in the waiting areas in each clinic,” Kimbell notes.
  • Useless information: After Kimbell’s most recent appointment, he says, he was “handed out a 13-page printout that gave 12 pages information I didn’t need.” Before the Epic to Cerner switch, he reports, he was able to access this information online.
  • Communication issues: Kimbell says he never gets telephone call reminders of appointments anymore.

As Kimbell sees it, the quality of care has slipped significantly since Epic was switched out for a Cerner system. “All the cancer patients I have known while a patient there are in need of better care than Banner now provides,” he writes.

It’s important to note here that the Epic-to-Cerner switch-off took place in October last year, which means that the tech and administrative staff haven’t had much time to work out problems with the new installation. It may be the case that the concerns Kimbell had in late December won’t be an issue in a couple of months.

On the other hand, I do think it’s possible that as the letter implies, UMC owner Banner Health may have had reasons to push the Cerner install into the facility, most particularly if all of its other properties already operate using Cerner.

Regardless, if everything is as Kimbell describes, let’s hope it all gets back in order soon.  From the looks of things, UMC seems to offer a renowned cancer treatment program. Let’s hope that a quality program isn’t undermined by IT concerns.

Cerner $10 Billion VA Contract Comes To Screeching Halt

Posted on January 5, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

After Cerner captured the massive multi billion dollar contract to roll out its EMR for the Department of Defense, everyone was a bit stunned, as many thought Epic was a lock for the job.

Cerner seems to have been conducting the rollout as promised, so there’s that. But when it comes to its performance in meeting the requirements of its $10 billion contract with the VA, things aren’t looking as good. Apparently, Cerner’s DoD implementation isn’t sharing data well with Cerner’s VA systems. Oops.

According to Politico, the Cerner contract with the VA is running into serious questions about its capacity for fluid data sharing. The VA’s Cerner rollout has been held up by questions about its ability to interoperate with the DoD system.

VA Secretary David Shulkin, who’s perhaps the biggest critic of Cerner’s efforts, had his agency issue a request for information looking for examples of data-sharing solutions. Shulkin is proposing that the VA conduct tests of the system’s capacity for interoperability, in which the department would send patients through the VA system and see whether it can share useful data with the VA along the way. If the test has a bad outcome, it’s likely to ramp up the tension considerably.

What makes all of this particularly embarrassing is that the VA awarded the contract to Cerner without conducting the usual bidding process, largely because the agency believed having its own Cerner implementation would make it easier to share data with the DoD. Good luck with that, folks.

I’m sure that key managers on the VA project are freaking out at this point.  The combined multi billion dollars the DoD and VA have entrusted Cerner with represents a massive commitment, and when a customer that size starts questioning whether they’ve made a good investment, the ground must have begun trembling under Cerner’s feet. Not to mention the consultants from Leidos, etc who are charged with delivering a massive chunk of the project.

It’s hard to imagine that Epic isn’t seeing if it can take advantage of the situation. While it may not have the ability to horn in on the contracts themselves, I’m sure that it’s making sure customers know about what’s happening, and using the news to suggest that Cerner doesn’t have its act together.

I don’t know what will happen if the VA continues to find fault with Cerner, but it can’t be pretty.

Making Stress Your Friend, Not Your Enemy – #CHIME17 Keynote Twitter Roundup

Posted on November 1, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week I’m at the CHIME 2017 Fall Forum in San Antonio. It’s a great event that is no doubt the largest gathering of healthcare CIOs in one place. Today they kicked off the event with a great keynote speech from Kelly McGonigal that reframed stress in a really unique way. Here are some of the tweets that captured the essence of Kelly’s message.

You can see there are some powerful reframes when it comes to stress. It’s amazing the impact that just thinking of stress as a positive thing in your life can have on the outcomes. That’s a lesson we can all use since we all experience stress.

Along with the keynote, CHIME also did a great tribute to Neal Patterson, CEO of Cerner who passed away recently. It was very nice to take a moment to talk about Neal and his impact on the healthcare IT industry.


DirectTrust, CHIME Deal Not All It’s Cracked Up To Be

Posted on September 7, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Recently, CHIME and DirectTrust announced a deal that sounded pretty huge on the surface. In a joint press release announcing the agreement, the two organizations said they had agreed to work together “to promote the universal deployment of the Direct Trust framework and health information exchange network as the common electronic interface for health information exchange across the U.S.”

Their plans include making the Direct exchange network available anywhere they can, including hospitals, medical practices, pharmacies, labs, long-term care facilities, payers, insurers and health departments, and to top it off, on applications. If things go the way they planned, you’ll hardly be able to kick a health IT rock without finding Direct under it.

As I noted earlier this year, DirectTrust is on something of a roll. In May, it noted that the number of health information service providers who engaged in Direct exchanges grew to almost 95,000 during the first quarter of this year. That’s a 63% increase versus the same period in 2016. The group also reported that the number of trusted Direct addresses which could share PHI grew 21%, to 1.4 million, and that there were 35.6 million Direct exchange transactions during the quarter, up 76% over the same period last year.

Sounds good. But let’s not judge this in a vacuum. For example, on the same day DirectTrust released its first quarter results, the Sequoia Project kicked out a press release touting its performance. In the release, Sequoia noted that its Carequality initiative was under full steam, with more than 19,000 clinics, 800 hospitals and 250,000 providers using the Carequality Interoperability Framework to share health data.

In considering the impact of Carequality, let’s not forget that late last year it connected with rival interoperability group CommonWell Health Alliance. I don’t know if you can say that interoperability effort can corner a market– the organizations using the rival health data sharing networks probably overlap substantially—but it’s certainly an interesting development. While the two organizations were both allied with a leading EMR vendor (CommonWell with Cerner and Carequality with Epic), the agreement has effectively brought the muscle of the two EMR giants together.

I guess it’s fair to say that the Carequality alliance and DirectTrust may own interoperabililty for now, rivaled only by the stronger regional HIEs.  That’s pretty impressive, I admit. Also, it’s interesting to see an accepted health IT organization like CHIME throw its weight behind Direct. I wouldn’t have expected CHIME to dive in here.

That being said, when you get down to it, none of the groups’ capacity for sharing health data is as great as it sounds. For example, if Epic’s Care Everywhere exchange only transmits C-CDA records, you have to ask yourself if Carequality is working at a higher level. If not, we’re in “meh” territory.

Bottom line, it seems clear that these organizations are winning the battle for interoperability mindshare. Both seem to have made a fair amount of progress. But between you and me in the lamppost, let’s not get excited just yet.

IT Leaders Question Allscripts Acquisition of McKesson EIS

Posted on August 31, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Not long ago, I shared the results of a poll featured on HISTalk on the potential benefits of the Allscripts acquisition of McKesson EIS. The poll asked readers “Who will benefit most from the proposed acquisition of McKesson EIS by Allscripts?”

Roughly equal numbers of respondents said Allscripts customers would benefit (29%) and McKesson customers (27%). However, a new research report from Reaction Data suggests that many of their peers doubt that things will work out for McKesson customers or even do much to build Allscripts’ market position.

A number of health IT leaders quoted in the report say they’re fearful that McKesson solutions will get short shrift under Allscripts management. Others suggest that both vendors are behind the curve, especially McKesson, and that Allscripts is unlikely to spend enough money on it to catch up to current standards.

Their comments included the following observations:

  • I don’t see Allscripts as a major player in this space anymore and the acquisition will likely further stress the enterprise. Perhaps in combination they can cobble together a suite of tools, but integration will likely be clunky at best for some time.” – CIO
  • I do not see that McKesson brings anything beneficial to Allscripts, other than more users. McKesson’s products are very different from Allscripts’ current products and so will further dilute their efforts to bring quality product forward.” –CFO
  • McKesson is behind. Does not look like a smart choice moving forward.” –Director of IT
  • Just like Cerner buying Siemens, we were told they would support it and yada yada, here we are on Cerner after having to drop much more cash than we should have been required to.”—CIO

it’s worth noting, for the record, that all the feedback on the acquisition wasn’t negative. Positive comments included the following:

  • Combining Paragon, as the only true integrated, Microsoft SQL-based, hospital and ambulatory HIS on the market, with a solid vendor that focuses exclusively on HIT, is a win-win for the healthcare industry.” – CIO
  • “McKesson was losing and continues to lose ground on EHR systems to Epic and Cerner. They are withering on the vine. This acquisition will help them solidify their position in the market.”– Vice President of Finance

Still, most health IT leaders seemed to think the deal wouldn’t help either party that much. In particular, they were skeptical that McKesson’s high-profile Paragon solution was salvageable. “Paragon…is antiquated,” wrote one manager of information technology. “It will take a big bag of money and a lot of time to fix that.”

To summarize, while HIT execs conceded that the merger might buy Allscripts some customers and time, they felt it wasn’t likely to benefit their organizations. In fact, some argued that the deal could actually undercut the future of their McKesson systems: “Allscripts may focus on their own EMR and how those products I have with McKesson will interact with them rather than on McKesson products as a whole,” worried one director of information technology.

On top of everything else, the previous analysis by HISTalk doesn’t inspire much confidence that the acquisition will work on a corporate level. The analysis asserts that EMR vendors should be judged by the number of 250+ bed hospitals they have as customers, and points out that Allscripts controls only 6% of that market. (Epic, in contrast, has 20%, the article notes, citing HIMSS Analytics data.)

If I’m reading this right, it seems that Allscripts will take two mediocre and/or unfashionable solution sets and try to crossbreed them into a more popular set of tools, in the process scaring whatever loyal customers they have left. All sarcasm aside, I’d like to ask: Has this ever worked before?

Nurses Still Unhappy With EHRs

Posted on August 21, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new research report looking at nurses’ perceptions of EHRs suggests that despite countless iterations, many still don’t meet the needs of one of their key user groups. While the statistics included in the report are of some value, the open text responses nurses shared tell a particularly important story of what they’re facing of late.

The study, which was conducted by Reaction Data, draws on responses from 245 nurses and nurse leaders, 85% of whom work for a hospital and 15% a medical practice. Categories in which the participants fell broke out as follows:

* Nurses                                          49%
* CNOs                                            18%
* Nurse Managers                           14%
* Directors of Nursing                     12%
* Nurse Practitioners                       2%
* Informatics Nurse                         2%
* VP of Nursing                               2%
* Director, Clinical Informatics        1%

As with most other research houses, Reaction gets the party started by offering a list of vendors’ market share. I take all of these assessments with a grain of salt, but for what it’s worth their data ranks Epic and Meditech at the top, with a 20% market share each, followed by Cerner at 18%, Allscripts with 8% and McKesson with 6%.

The report summary I’ve used to write this item doesn’t share its stats on how the nurses’ ranked specific platforms and how likely they were to recommend those platforms. However, it does note that 63% of respondents said their organization wasn’t actively looking at replacing their EHR, while just 17% said that their employer was actively looking. (Twenty percent said they didn’t know.)

Where the rubber really hit the road, though, was in the comments section. When asked what the EHR needed to improve to support them, nurses had some serious complaints to air:

  • “Many aspects, too many to list. Unfortunately we ‘customized’ many programs, so they don’t necessarily speak to each other…” —Nurse Manager
  • “When we purchased this system 4 years ago, we were told that everything would be unified on one platform within 2 years, but this did not happen and will not happen.” –CNO
  • “Horrible and is a patient safety risk!” –RN
  • “Coordination of care. Very fragmented documentation.” –CNO

So let’s see: We’ve got incompatible modules, questionable execution, safety risks and basic patient care support problems. While the vendors aren’t responsible for customers’ integration problems, I’d find this report disheartening if I were on their team. It seems to me that they ought to step up and address issues like these. I wonder if they see these things as their responsibility?

In the meantime, I’d like to offer a quick postscript. The report’s introduction makes a point of noting – rightly, I think – that the inclusion of a high percentage of non-manager nurses makes the study results far more valuable. Apparently, not everyone agrees.

In fact, some of the vendors the firm met with said flat out that they only want to know what executives have to say – and that other users’ views didn’t matter to them.

Wow. I won’t respond any further than to promise that I’ll stomp all over that premise in a separate column. Stay tuned.