Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

e-MDs Acquires McKesson’s Portfolio of Ambulatory EHR Software

Posted on March 10, 2016 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 post will likely be a little bit of inside baseball for many, but I think it’s a really important subject to cover since it’s going to impact so many practices and so many doctors. The news just came out that e-MDs was acquiring the suite of ambulatory EHR software owned by McKesson. For those keeping track at home, these are 6 of the assets acquired from McKesson: McKesson Practice Choice™, Medisoft®, Medisoft® Clinical, Lytec®, Lytec® MD, and Practice Partner®.

This shouldn’t be a surprise from a McKesson perspective. At HIMSS I heard multiple stories of people talking with McKesson staff who didn’t even know the names of their EHR software. Sad, but true. The only question for McKesson is will Paragon get sold off next?

For those that aren’t familiar with the history of e-MDs, it was purchased by Marlin Equity Partners back in March 2015 and merged with Marlin’s MDeverywhere company. Marlin then went on to acquire AdvancedMD from ADP in August of 2015 as they started to stock pile ambulatory EHR vendors. With the acquisition of the McKesson assets, Marlin now owns a large number of ambulatory EHR vendors.

This shouldn’t really be a surprise to anyone. We all knew that 300 EHR vendors wasn’t sustainable long term and we know that the EHR market has matured now that the false market meaningful use created is over. Some consolidation was bound to happen and it’s no surprise that a private equity firm is rolling up these companies as they seek to find the benefits of scale. The press release notes that the combined company’s products and services are being used by nearly 55,000 providers nationwide after this latest acquisition. That’s quite a presence in the ambulatory space.

The unfortunate downside of this type of EHR roll up is that not all of these EHR software can survive under one roof. Some of them have got to go. The only question is which one(s) will survive. Unlike EHR vendor founders, private equity companies are disconnected from the original product and so it doesn’t hurt as much for them to shut down a weaker product line as they consolidate users on to what they consider the best software. I’d be shocked if we didn’t see this happen with a number of EHR software that are now under e-MD’s (and Marlin’s) roof.

I also won’t be surprised if Marlin and e-MDs continue with more acquisitions. There are still a few hundred other ambulatory EHR vendors out there.

Is Practice Fusion Heading for an IPO?

Posted on January 21, 2016 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.

The New York Times recently reported that Practice Fusion is said to have hired JP Morgan Chase to evaluate an IPO. Here’s a look at the estimated IPO number for Practice Fusion according to the New York Times:

Practice Fusion later created a way to estimate its I.P.O. valuation if revenue came in at $155 million in 2018 instead of $181 million, according to one of the people. Using the lower revenue assumption, the company could command a valuation of $1.1 billion to $1.2 billion if it goes public. It is unclear if the lower revenue estimate was made in response to the market turmoil.

Practice Fusion itself is of course not really commenting on their plans for an IPO or not. However, since it has raised $149 million to date at a valuation of $635 million, you have to imagine that an IPO is in their future. However, many big silicon valley companies have stuck to the private market lately and avoided the IPO. I’m not sure Practice Fusion will be in a similar position to them though. A look at their revenue numbers is one indication of why they’re a bit different than other companies that have raised larger rounds in the private markets:

Practice Fusion’s revenue was $26.9 million in 2014 and was expected to increase by 71 percent to $46.1 million in 2015, with the company projecting it would pare losses by 40 percent to $25.8 million in 2015, according to the document prepared by bankers and the company.

At the time the document was prepared, the company estimated revenue would hit $70 million in 2016.

I personally think that an IPO is in Practice Fusion’s future. It’s just a question of when it will happen. Certainly the market volatility we’ve seen lately isn’t helping their case to do an IPO. However, I bet the bigger challenge is going to be creating attractive revenue numbers that make sense to the public markets. I believe public markets have a hard time valuing number of users and other metrics that make Practice Fusion look attractive.

Ever since the first venture capitalists asked me about Practice Fusion, I’ve said that the company has created value. The number of doctors they were able to sign up on their platform was impressive. That’s the power of offering something for free that other doctors pay hundreds of thousands of dollars to buy. No doubt their network of physician users is a valuable asset. I hope it is since they raised $149 million to build it.

The real question for me around Practice Fusion isn’t whether they created value. Instead, the question is how valuable is what they created? I once heard Peter Thiel suggest at their user conference that Practice Fusion was building the platform for healthcare. Building that would be worth multiple billions of dollars. However, Practice Fusion hasn’t built anything close to that since Practice Fusion is doing nothing in the hospital EHR space. It’s naive to think that Practice Fusion could compete in that piece of healthcare. Not to mention they have a very small part of the hospital owned ambulatory practice space where the trend is to go with the integrated hospital EHR solution.

Long story short, I think that Practice Fusion will do an IPO. I could even see them doing an IPO for a billion dollars. I’m sure that’s what Ryan Howard, Practice Fusion Founder and former CEO, wants so he can claim his startup unicorn status. Although, I’ll be interested to see how Practice Fusion’s revenue grows between now and an IPO. The golden age of EHR is over and we’re entering the dirty slog of EHR sales and EHR switching. I don’t think that makes for a compelling story for investors.

Bold Insights from the #MGMA15 Keynote Kickoff

Posted on October 12, 2015 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.

Yesterday was the start of the MGMA Annual conference in Nashville. The event kicked off with a really great opening keynote from MGMA’s President and CEO Dr. Halee Fischer-Wright. While most keynotes from organization Presidents are boring and dry, I loved how candid and straight forward Dr. Fischer-Wright was in her comments. She definitely is pushing forward a new vision for the organization.

Here’s some highlights I tweeted from her keynote:


This reminds me of my post on EHR induced PTSD. I could have easily called that post Healthcare Buzzword induced PTSD.


Pretty brave of her to be so bold. I’ll be interested to hear people’s reactions.


I agree with her that Healthcare has changed, but I’d also argue that healthcare is still changing. That just compounds the problem.


I agree that apathy is an extraordinary challenge. Most doctors and healthcare professionals feel paralyzed and feel that they can’t do anything to make a difference or change the trajectory of where healthcare is headed. That’s a good thing since that’s a perception you can change. Apathy because people don’t care would be a much harder challenge.


This leads to some apathy as well, but also is converting to anger.

Needless to say I was impressed by Dr. Fischer-Wright. Appropriately, Jeremy Gutsche spoke after Dr. Fischer-Wright and commented about the need of organizations and people to take risks and fail. Much of the learning we get comes from taking risks and accepting that sometimes we’re going to fail. I think that’s where Dr. Fischer-Wright is taking the MGMA organization. She’s looking at big, ambitious goals. She might fail at some, but I predict that those that don’t fail are going to make a big difference.

ComChart EHR Stops Selling Its EHR

Posted on September 23, 2015 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.

Almost 2 years ago, one EHR vendor decided to not go after meaningful use stage 2. At the time I wrote about how that EHR vendor should have used that decision as an extraordinary marketing opportunity for their EHR. They could argue that they were focused on the doctor’s needs and not on government regulation. It was the perfect marketing opportunity which I believe they botched.

That EHR vendor was ComChart EHR. Botched marketing opportunity or not, the ComChart website has been updated to inform ComChart users that the ComChart EHR was no longer available for sale to the public. A letter then follows which outlines that the President of ComChart, Hayward Zwerling, M.D., will continue to use the ComChart EHR in his practice until he retires and will provide updates he does for his practice to others who already have the software. ComChart also has a read-only license option for those doctor who choose to leave ComChart, but still want access to their old records. This method of shutting down an EHR stands in stark contrast to other EHR shutdowns that no doubt left doctors high and dry.

At the end of the letter, Dr. Zwerling argues that more technology is not going to solve healthcare’s cost and quality problems. I agree completely. It’s not about more technology. Technology in and of itself doesn’t solve anything. It’s a tool in the toolbox. It’s certainly not the solution to all of healthcare’s ills.

Here’s the full letter from the ComChart website:

Dear ComChart Users;

I want to thank you for your years of support and encouragement. Some of you have been using ComChart EMR for more than 15 years. You have provided me with the encouragement, ideas and support which I needed to create the best EMR for the small medical practice. I am not bragging; ComChart EMR has literally had the highest KLAS rating from 2006 – 2012. In the 2012 ranking, ComChart EMR again had the highest overall score (92.9) and the highest Product Quality Rating (8.4) in the Ambulatory 1-10 Provider category.

Unfortunately, my experience with the recent ComChart EMR upgrade has convinced me that I should stop selling ComChart EMR as more than half of the offices have had upgrade problems.

I believe the technology underlying ComChart EMR has gotten too complicated for smaller offices and the “upgrade” process is too slow for larger offices. In addition, I am not in complete control of the IT situation, I am reliant on Filemaker, Inc and the plugin makers and other HIT vendors and the faxing program companies as well as OS updates – all of these vendors create problems that I have to “solve” and which are beyond my ability to control.

I intend to continue using ComChart EMR in my office until I retire, or I am forced by external factors to give up ComChart EMR. I believe I have another decade in practice. I will continue to develop ComChart EMR for my practice and make these upgrades available to you should you choose to continue to use ComChart EMR. I will continue to support your practices as I have done to date.

If you decide you are not going to continue using ComChart EMR, I would recommend that you purchase a “read-only license”. That will allow you to continue to access your records, read your records, print out the records, for as long as you need them. The read-only license comes with no technical support. Because of this, you need to be careful about changing operating systems on the computer that is running your read-only version of ComChart EMR.

As some of you know, I’ve blogged about health information technology in the past. Although I am a firm believer that health information technology helps me run a more efficient practice, there is a scarcity of data demonstrating that health information technology improves the quality of health or reduces the cost of healthcare at the societal level. Despite this lack of data, the Federal Government has felt it appropriate to apply financial penalties to physicians who do not use the health information technology software specified by the Federal Government and in the manner mandated by the Federal Government. To a large extend, this problem has occurred because the large EMR/EHR vendors now have undue influence over the Federal Government’s HIT initiative.

I have periodically blogged on the topic of evidence-based medicine as it applies to health information technology. Unfortunately, my comments have fallen on deaf ears.

Personally I am convinced that the solution to the healthcare cost and quality problem does not lie in the application of more/better health information technology. While the data would suggest that health information technology can have a marginal impact on the quality of care, and maybe even on the cost of care, it is not THE solution to a health care cost/quality problem. Politicians should stop listening to the IT geeks and the larger EMR vendors and begin to look at the published data about the efficacy of Certfied EMRs/EHR and Meaningful Use and start listening to the practicing physicians. Believing that more health information technology will solve the healthcare problem will only delay the process of finding a real solution to a very large problem.

I wish my users all the best, and I really appreciate the support you have given me over the years. If you have any questions, feel free to call me on my cell phone or email me, anytime, as you have done in the past.

Hayward Zwerling, M.D.
President ComChart Medical Software

Ways to Not Rank EHR Vendors

Posted on September 16, 2015 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.

One of my pet peeves is organizations that put out rankings for EHR vendors that are based on really low quality factors and metrics. I’ve put a graphic I recently found at the bottom of this post. The graphic uses user adoption level, search traffic, and social media presence to rank “The 10 Most Popular EHR Products.” Yes, the image is at the bottom of the post, because I don’t think you should pay much attention to the ranking. Let’s talk about why.

First, I’ll give credit to them for putting their factors in the graphic itself. Many organizations that put out these rankings don’t even share their methodology for ranking EHR vendors. Although, this compliment falls flat on the first factor: user adoption level.

EHR User Adoption Level
They obtained this ranking and score from a survey of software users. Of course, they don’t say anything about how this survey sample was collected, how they selected who participated in the survey, etc. Long story short, I can think of probably 1000 ways that this sample is going to be biased. There are literally 300 EHR vendors out there. I need to consult my statistician friends, but I can’t imagine the random sample you’d need to get in order to estimate the users of 300 EHR vendors. Plus, there are so many ways to bias this sample based on region, hospital EHR or ambulatory EHR, hospital size, practice size, specialty, etc etc etc.

I also am not sure what they consider “regular users” of the system. Does that mean my 5 front desk staff count as well or is it just providers? Plus, if you look at the scores for the vendors taht are listed, Cerner and Meditech should be much higher when it comes to user adoption level. In fact, it’s possible they have more users than Epic which has the highest ranking possible for user adoption level.

I do think that user adoption level is an ok way to rank EHR vendors. The fact that many healthcare organizations have spent a bunch of money on an EHR vendor is one sign of an EHR vendors popularity and it’s worth considering what’s popular when evaluating software of any kind (including EHR software). However, does anyone have a really good way of analyzing how many users an EHR vendor has? The closest I’ve seen is meaningful use attestation data and it has its weaknesses. Long story short, I’m not buying the user adoption level rankings below.

EHR Search Traffic
Google has a great tool where you can compare search traffic for various keywords. I’ve used it before to compare the popularity of terms like EMR and EHR (They’re about even with EMR still ahead). While this tool is cool and very interesting, is that how you determine how popular an EHR vendor is? What if that EHR vendor has had some major security breaches and everyone is searching their name to find out about the breaches? That seems to be a sign that the EHR vendor is popular, but not for good reasons. Plus, how do you know when someone is searching for the Epic EHR versus Epic the movie and a few million variations of the word epic? Not to mention, if you have Jonathan Bush as your CEO, you’re going to get more searches than other EHR vendors just because of his vibrant personality (was that the politically correct way to describe it?).

Long story short, search traffic is an awful measure to use when ranking EHR vendors. I know some really amazing EHR software that have very little search traffic. I don’t think that’s a bad thing. They’ve focused on creating great software, partnering with doctors, and creating direct relationships with their users. Their search traffic certainly won’t reflect that piece of the puzzle.

EHR Social Media Presence
What’s in a like or follow? Yes, those are the factors the graphic below used to evaluate EHR vendors social media presence. They do weigh this factor less than the others. Does a like or follow on Twitter, LinkedIn or Facebook mean you’re popular? Do you know how easy it is to buy followers if you want to look like you have a lot of followers? $5 per 1000 followers is easy to get. Plus, these counts don’t matter as much as which people are following you and how engaged they are with you on social media. That matters a lot more than follower counts.

I don’t want to totally discredit an EHR vendors involvement in social media. That might be a sign that the company stays up to date and involved with the latest technology changes. It might mean that they’re engaged with and interested in their customers. Then again, it might not. Many EHR vendors just use it as a way to broadcast their company and not actually engage with people. Some EHR vendors don’t even participate in social media at all. That’s not an evil thing, but it might be worth investigating more and seeing if their lack of involvement in technology is seen in other aspects of their product offering.

So while I see value in evaluating an EHR vendor’s social presence, you can’t evaluate and rank it based on likes and followers. A much more complicated assessment is needed.

Conclusion
I understand that many organizations are grabbing hold of any means to differentiate the 300+ EHR vendors out there. It’s certainly a challenge I know first hand. However, I hope that healthcare organizations don’t get led astray by poorly done rankings like the graphic below. There’s always more to the story. If EHR rankings were easy, I would have done them myself a long time ago.

Top 10 Most Popular EHR Vendor Infographic

EHR Usage – Best and Worst States

Posted on September 11, 2015 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.

A recent Becker’s article used some CDC data to rank the best and worst states when it comes to EHR usage. Here’s the top 8 states for EHR usage:

• North Dakota — 79.1 percent
• Minnesota
• Montana
• North Carolina
• South Dakota
• Utah
• Wisconsin
• Iowa — 64.7 percent

And here are the bottom 6 states:

• Tennessee — 38.5 percent
• Florida
• Louisana
• Nevada
• Rhode Island
• New Jersey —29.2 percent

What’s ironic is that just this week I was talking with someone about me writing this healthcare IT blog from the healthcare hub known as Las Vegas (that’s a joke for those following along at home). This person commented that Nevada was way behind on EHR adoption and then they added the small caveat, right? I acknowledged that we were behind, but I must admit that seeing Nevada on this list kind of makes me sad. No one wants their state to be on the bottom of anything.

I did end our discussion by saying that maybe being on the bottom could be a good thing. In other states, they may have rushed their EHR selection and implementation process. If you’re going to choose the wrong EHR or not spend the time to implement the EHR properly, then it might be better to not have an EHR. With that said, I’m still pro-EHR and I hope my state catches up and implements the right EHR in the right way.

Is your state on the list? It would be interesting to see if there’s a correlation between states that have adopted EHR and the quality of care those states provide. Of course, the real challenge is knowing how to measure quality of care.

Healthcare Hype Cycle Graphic

Posted on September 8, 2015 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.

There is a lot of really interesting things happening in healthcare. Many are trying to change healthcare as we know it today. Many have the promise of lowering costs, improved care, and better health. However, each of these movements, initiatives, or trends are at different points of the famous maturity lifecycle.

Bonnie Feldman shared the following graphic which shows many of these healthcare changes on the hype cycle:

Here’s a larger version for those who can’t read the smaller Twitter embedded image:
Healthcare Hype Cycle

I should mention that this graphic is focused on Autoimmunity, but you could see how this applies to so many areas of healthcare. A few minor changes and it would be all of healthcare. What other items would you add to this hype cycle? Would you move anything on the chart above farther along the line or backwards on the line?

The Dawn of The Community EMR

Posted on May 29, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While many healthcare stakeholders would like to see clinical data shared freely, the models we have in place simply can’t get this done.

Take private HIEs, for example. Some of them have been quite successful at fostering data sharing between different parts of a health system, but the higher clinical functions aren’t integrated — just the data.

Another dead end comes when a health system uses a single EMR across its entire line of properties. That may integrate clinical workflow to some degree, but far too often, the different instances of the EMR can’t share data directly.

If healthcare is to transform itself, a new platform will be necessary which can be both the data-sharing and clinical tool needed for every healthcare player in a community. Consider the vision laid out by Forbes contributor Dave Chase:

Just as the previous wars impacted which countries would lead the world in prosperity, the “war” we are in will dictate the communities that get the lion’s share of the jobs (and thus prosperity). Smart economic development directors and mayors will stake their claim to be the place where healthcare gets reinvented.

In Chase’s column, he notes that companies like IBM have begun to base their decisions about where to locate new technology centers partly on how efficiently, effectively and affordably care can be delivered in that community. For example, the tech giant recently decided to locate 4,000 new jobs in Dubuque, Iowa after concluding that the region offered the best value for their healthcare dollar.

To compete with the Dubuques of the world, Chase says, communities will need to pool their existing healthcare spending — ideally $1B or more — and use it to transform how their entire region delivers care.

While Chase doesn’t mention this, one element which will be critical in building smart healthcare communities is an EMR that works as both a workflow and care coordination tool AND a platform for sharing data. I can’t imagine how entire communities can rebuild their care without sharing a single tool like this.

A few years ago I wrote about how the next generation of  EMRs would probably be architected as a platform with a stack of apps built over it that suit individual organizations. The idea doesn’t seem to have gained a lot of traction in the U.S. since 2012, but the approach is very much alive outside the country, with vendors like Australia’s Ocean Informatics selling this type of technology to government entities around the world. And maybe it can bring cities and regions together too.

For the short term, getting a community of providers to go all in on such an architecture doesn’t seem too likely. Instead, they’ll cling to ACO models which offer at least an illusion of independence. But when communities that offer good healthcare value start to steal their patients and corporate customers, they may think again.

EMRs Should Include Telemedicine Capabilities

Posted on May 22, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The volume of telemedicine visits is growing at a staggering pace, and they seem to have nowhere to go but up. In fact, a study released by Deloitte last August predicted that there would be 75 million virtual visits in 2014 and that there was room for 300 million visits a year going forward.

These telemedicine visits are generating a flood of medical data, some in familiar text formats and some in voice and video form. But since the entire encounter takes place outside of any EMR environment, huge volumes of such data are being left on the table.

Given the growing importance of telemedicine, the time has come for telemedicine providers to begin integrating virtual visit results into EMRs.  This might involve adopting specialized EMRs designed to capture video and voice, or EMR vendors might go with the times and develop ways of categorizing and integrating the full spectrum of telemedical contacts.

And as virtual visit data becomes increasingly important, providers and health plans will begin to demand that they get copies of telemedical encounter data.  It may not be clear yet how a provider or payer can effectively leverage video or voice content, which they’ve never had to do before, but if enough care is taking place in virtual environments they’ll have to figure out how to do so.

Ultimately, both enterprise and ambulatory EMRs will include technology allowing providers to search video, voice and text records from virtual consults.  These newest-gen EMRs may include software which can identify critical words spoken during a telemedical visit, such as “pain,” or “chest” which could be correlated with specific conditions.

It may be years before data gathered during virtual visits will stand on equal footing with traditional text-based EMR data and digital laboratory results.  As things stand today, telemedicine consults are used as a cheaper form of urgent care, and like an urgent care visit, the results are not usually considered a critical part of the patient’s long-term history.

But the more time patients spend getting their treatment from digital doctors on a screen, the more important the mass of medical data generated becomes. Now is the time to develop data structures and tools allowing clinicians and facilities to mine virtual visit data.  We’re entering a new era of medicine, one in which patients get better even when they can’t make it to a doctor’s office, so it’s critical that we develop the tools to learn from such encounters.

Allscripts (MDRX) At Important Moment In Its History

Posted on May 21, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Allscripts has announced plans to move more of its software development and operations to India, while cutting 250 jobs in the U.S., or about 3.5% of its 7,200-member workforce.  While this is significant enough as it is, it’s an even more important leading indicator of how Allscripts may perform going forward. Here’s how I think things will net out.

Making a “rebalancing”:  The company has called the changes a “rebalancing” of staff which will allow it to respond more effectively and efficiently to shifts in its software design and product dev plans.

But the decision didn’t happen in a vacuum, either. Allscripts recently reported taking a $10.1 million loss for the first quarter ending March 31. That’s down from a loss of $20.7 million for Q1 2014, but the company still appears to be struggling. Allscripts’ overall revenue dropped 2% to $334.6 million for the quarter ending March 31, compared with Q1 of 2014.

What’s next? What should providers draw from these numbers, and Allscripts’ plan to shift more development work offshore? Let’s consider some highlights from the vendor’s recent past:

* Despite some recent sales gains, the vendor occupies a difficult place in the EMR vendor market — neither powerful enough to take on enterprise leaders like Epic and Cerner directly, nor agile enough to compete in the flexibility-focused ambulatory space against relentless competitors like athenahealth.

* According to an analysis of Meaningful Use data by Modern Healthcare, Allscripts is second only to Epic when it comes to vendors of complete EMRs whose customers have qualified for incentives. This suggests that Allscripts is capable of being an effective provider business partner.

* On the other hand, some providers still distrust Allscripts since the company discontinued sales of and support for its MyWay EMR in 2012. What’s more, a current class action lawsuit is underway against Allscripts, alleging that MyWay was defective and that using it harmed providers’ business.

* Partnering with HP and Computer Sciences Corp., Allscripts is competing to be chosen as the new EMR for the U.S. Department of Defense’s Military Health System, and is still in the running for the $11 billion contract. But so are Epic and Cerner.

The bottom line: Taken together, these data points suggest that Allscripts is at a critical point in its history.

For one thing, cutting domestic staff and shifting dev operations to India is probably a make or break decision; if the change doesn’t work out, Allscripts probably won’t have time to pull back and successfully reorient its development team to current trends.

Allscripts is also at a key point when it comes to growing place in the brutal ambulatory EMR market. With players like athenahealth nipping at its heels from behind, and Epic and Cerner more or less controlling the enterprise market, Allscripts has to be very sure who it wants to be — and I’m not sure it is.

Then when I consider that Allscripts is still in the red after a year of effort, despite being at a peak level for sales, that tears it.  I’m forced to conclude that the awkwardly-positioned vendor will have to make more changes over the next year or two if it hopes to be agile enough to stay afloat. I believe Allscripts can do it, but it will take a lot of political will to make it happen. We’ll just have to see if it has that will.