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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?

Fun Friday – Siemens Healthineers Video

Posted on May 6, 2016 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As you probably know, each Friday we try and share something funny or entertaining to start your weekend. This week I’m not sure if this is funny, sad, scary, disappointing, or all of the above. In case you missed it, Siemens Healthcare renamed their business to Siemens Healthineers. No, this is not a joke. No, it’s not an Onion article. It’s too late for April Fool’s day. They really did rename their healthcare business to Siemens Healthineers. Everyone is wondering how much money they paid for that misguided choice.

Of course, to layer on the absurdity, it looks like Siemens also did a big announcement party for the new name and someone shared it on YouTube:

If you made it through the whole video, I’m sorry. You’ll never get that 3 minutes of your life back. I can only imagine how much it cost to produce that event. I guess they’re using the $1.3 billion they got from Cerner when they sold a big chunk of their EHR healthcare business to fund it.

The reactions to the name change and party in the comments of the YouTube video are pretty brutal. Here’s one example:

So they spent all this money on renting the space, bringing in all that equipment, paying people to write and sing the song, etc when they could have given all the employee’s raises.

Followed by this comment from someone who seems to have been there:

They also had a helicopter landing platform plus roadblocks for the whole area. And yes, it was just to announce the second rename in 12 months.

My comment is simply, “And we wonder why healthcare is so expensive.” I guess they’re living the principle that no PR is bad PR.

Of course, this YouTube video comment took the cake for me:

Corporate: How do we motivate our employees?
Drone: We could pay them more or improve their benefits?
Corporate: Don’t be stupid! We’ll do a power rangers routine on stage instead, it’ll be great.

Nothing like power rangers to improve company morale. Do you all feel more motivated? Go forth and be healthcare pioneers!

EHRA’s EHR Code of Conduct – Will Anything Change?

Posted on June 11, 2013 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The big news that had to be covered today was the announcement by the EHR Association about the EHR Developer Code of Conduct. The core topics of the EHR Developer Code of Conduct are great:

  • General business practices
  • Patient safety
  • Interoperability and data portability
  • Clinical and billing documentation
  • Privacy and security
  • Patient engagement

Certainly there are other areas that I would have loved to see included, like EHR usability, but if we could address each of the areas listed above we’d have a big improvement over where we are today. Be sure to also check out the EHR Developer Code of Conduct and FAQs document and the EHR Developer Code of Conduct Implementation Guide for the full details on the EHR Code of Conduct.

The problem I have with this EHR Code of Conduct is that it has no teeth. There’s no enforcement mechanism or reporting mechanism to show how an EHR vendor has chosen to implement the code of conduct. They won’t even commit to having a list of EHR vendors that have adopted it. Trust me when I say that for every element of the EHR Code of Conduct, there’s A LOT of room for interpretation.

Where there’s room for interpretation, there’s room for abuse.

Obviously, when you bring together 40 EHR vendors it’s a real challenge to create something that has no interpretation. However, it seems they could have created a way to display how an EHR has chosen to meet the EHR code of conduct guidelines.

For example, the guideline says, “We will work with our customers to facilitate the export of patient data if a customer chooses to move from one EHR to another.” Then, it even sets a minimum export of a CCD/CCDA document. We could discuss how that type of document is nearly enough to switch EHR software, but even if it was enough, there’s a lot of ways you could implement this guideline. An EHR vendor could let the customer download a CCD for each patient individually and leave it to the customer to download all 5000 individual CCDs for their patients. That meets the guideline, but would be very different than an EHR vendor that gave you a one click download of CCDs for all your patients.

This qualitative data about how an EHR vendor has implemented the code of conduct should be easily available to doctors to compare across vendors. Otherwise, it has much less meaning and a lot of doctors will get bamboozled by the impression “commitment to the EHR Code of Conduct” implies. It’s similar (and even worse) than the pass/fail EHR certification. Not all certified EHR are created equal and not all EHR Code of Conduct adopters will be equal either. Why not be transparent about how they meet the code?

In the webinar they suggested that “the industry itself will kind of make it transparent who has adopted the code and who hasn’t adopted the code.” Maybe a third party will make that data available, but it’s a lot of work without a clear mechanism to pay for the work.

The other part of the code of conduct that really bothers me is the question posed in the title of this blog post: Will anything change? I loved a question that was asked on the webinar, “What pieces of the code of conduct were an EHR vendor not doing before the code?” They skirted the question saying that they couldn’t comment on it and some other tap dancing around the question. Does this mean that EHR vendors will just use the EHR Code of Conduct’s false trust to sale more product while doing little to change operationally? I’m certain this is not the intent of the committee, but could be the end result if those adopting the EHR Code of Conduct aren’t held accountable.

I got comments from two EHR vendors about the EHR Code of Conduct. Take a look to see what SRSSoft’s CEO Evan Steele said in their press release:

“SRS has always been committed to the principles identified in the Code of Conduct—designing our products with patient safety in mind, supporting physician/patient ownership of their data, safeguarding privacy and security, and communicating honestly in the marketplace,” says Evan Steele, CEO of SRS. “We are pleased to be among the first EHR companies to adopt the formal code, and hope that all vendors will follow suit.”

And John Glaser in the Siemens comment:

“The release of the EHR Developer Code of Conduct by the EHR Association is an important milestone in the maturation of the healthcare information technology industry, and we at Siemens Healthcare are proud to have supported its drafting and ratification,” said John Glaser, PhD, CEO, Siemens Healthcare, Health Services. “The Code of Conduct includes many elements that just make too much sense to be ignored and it’s my belief that Siemens and many players in this industry have already been adhering to many of these principles. Codifying these principles and providing a transparent way to show customers that companies are going to adopt them will help propel our industry’s ability to deliver safer, more effective and more interoperable solutions.”

It’s not like an EHR vendor’s going to come out and say they weren’t following the Code of Conduct principles. They’re not going to come out and say they don’t care about the EHR Code of Conduct principles either. The question is whether they state it in public or not, will EHR vendors really change? I have my doubts without a clear mechanism of accountability.

In some ways this reminds me of the doping scandal in cycling. Everyone knew that everyone else was doing it and no one wanted to say anything to rock the boat because it would mean they’d have to admit to doing it. Once a few cyclists stopped doping, they were at a disadvantage to those who continued the unhealthy practices.

I vividly remember in the post-Lance Armstrong years an interview with Levi Leipheimer where he was asked about doping. He tersely responded, “I hope all the dopers and cheaters get caught. It’s not fair that I’m having to compete with them.” (Not an exact quote, but you get the gist) Once he stopped doping he knew he was at a disadvantage. He wanted those that were still doping to be held accountable. I wonder if we’ll see something similar play out in the EHR world. Some EHR vendors follow the letter and intent of the code of conduct while other EHR vendors continue to skate around the edges since there’s still nothing holding them accountable. Just like Levi couldn’t name names in his interview, EHR vendors won’t be able to name names either.

As I said to start this post, I love the intent of the EHR Code of Conduct. I just worry that it will do little to change the EHR world as we know it.

I’d also be remiss if I didn’t also share a comment someone made on the Code of Conduct announcement webinar. Someone obviously didn’t realize their mic was on and they said, “It’s a love fest, an EHR Love Fest!” I’m not sure who it was that said it or why exactly they said it, but it gave me a good laugh. I always love a good EHR love fest myself.

Top Healthcare IT Vendors by Revenue

Posted on May 2, 2012 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those of you who aren’t familiar with the now a year old Hospital EMR and EHR, you should check it out and subscribe to the email list. The site has been growing like gang busters and people are loving the content on that site. I’d wanted to do a hospital EHR focused website for a long time. Certainly there’s a lot of cross over between ambulatory EHR and hospital EHR, but there are also unique differences in the hospital EHR environment that were definitely worthy of their own discussion platform. Plus, we like to cover other aspects of hospital IT.

One of the recent series that Anne Zieger started on Hospital EMR and EHR is called the Top Hospital HIS Vendors by Revenue. She’s already covered the top 3: McKesson, Cerner, and Siemens. She’ll be going through the rest of the Top 10 Hospital HIS vendors by revenue over the next weeks.

It’s really fascinating and amazing to see the enormous revenue numbers that each of these companies produce. Even more amazing is that we’re really only at the beginning of EHR adoption. There is so much of the EHR market that still is out there waiting to implement an EMR solution.

Of course, the real question is which vendor is going to capture this market share and which company will eventually be created that will take the market share from the incumbents. I’m sure it’s hard for many to believe that some upstart company could take down these large companies, but it will happen. That’s the cycle that occurs over and over again. Although, I will make the prediction that we won’t see much jostling in the hospital EHR space during the HITECH EHR incentive money time frame. The opportunity to take market share will likely happen post EHR incentive money.