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!

Allscripts (MDRX) Management Shakeup Spreading: Is Glen Tullman Next?

Posted on May 1, 2012 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 @annezieger on Twitter.

And Caesar’s spirit, raging for revenge,
With Ate by his side come hot from hell,
Shall in these confines with a monarch’s voice
Cry “Havoc!” and let slip the dogs of war,
Julius Caesar, Act 3, Scene 1

If ever there was havoc in the boardroom of a health IT company, this is it. Over the last several days, chairman Phil Pead (bio still up for now), CFO William Davis and three board members unceremoniously and promptly departed the management team at Allscripts Healthcare (MDRX), a company which, it’s hard to argue, otherwise seems to have been on a reasonable course for the past year or so.

By the way, this seems to have been as much an Eclipsys purge as a board purge, as all of the departing members were with the company, which Allscripts acquired in September 2010 with “a vision for a Connected Community of Health.”

Within a few days, the Board announced that it had elected board member Dennis Chookaszian as Chairman. No word yet on which unlucky CFO will be hired to face the fires of investor displeasure over the stock’s performance (see below).

It’s bad enough when a chairman and three board members split — allegedly in support of now-ex chairman Phil Pead — but when your CFO leaves, a girl’s gotta wonder whether financial improprieties will turn up later. Now, let’s be clear, I’m not suggesting that there are ANY financial issues that I know of myself, directly, but it’s never a nice thing to see Mr. CFO shove off so quickly.

What we do know is that Allscripts was slapped with a suit in 2009 alleging the company broke federal securities laws when it went live with the latest version of its EMR. Current CEO Glen Tullman and now departed CFO William Davis were named as defendents. The  accusations in the 2009 suit seem to boil down to that Allscripts failed to let customers know that it couldn’t afford to install its Touchworks 11 software properly on customer sites.

It gets even better

And now, even more fun. Perhaps to contribute to the gladiatorial atmosphere, one of Allscripts’ largest shareholders demanded Monday April 30 that its chief executive Glen Tullman resign.  (If I were Tullman I’d say “the heck with that,” gather a group of investors and buy the darned thing out from under them. Mr. Tullman, go for it!)

Anyway, it seems that HealthCor Management LP, which owns about 5 percent of Allscripts outstanding shares, thinks execs have done a bad job building the value of the stock. The fund said the stock  is “being valued well below any reasonable acquisition price,” at its Friday close of $10.30.  Other investors seem to agree with HealthCor, as the stock went  up 7.73 percent to $11.10 at the close of trading on Monday April 30.

To make sure nobody panics, the company has hurriedly announced a $200 million stock repurchase  plan, adding to a plan announced a year ago which still contains $148 million for repurchase. That should do something to keep the stock from careening down a greased slide.

Why, oh why?

Now, to the real question. Why the big shakeup in the boardroom at a time when EMR/EHR companies are extremely vulnerable to market shifts and missteps? I can’t say I’ve found any concrete reason in my research, other than storied “differences of opinion over the direction of the company.”

The financials, while they could probably be much stronger, aren’t exactly pathetic. We’ve got a 5.1 percent profit margin, quarterly revenue growth year over year of 25.5 percent and a P/E (ttm, intraday) of 28.52.  The only obvious disappointment is the big drop in share price, which fell nearly 50 percent over the last 52 weeks of trading.

And in a somewhat ironic twist, it seems that Allscripts is touting some variant of the software Eclipsys had (Touchworks) when it first ran into SEC trouble.  Allscripts may not like the guys behind the technology, but it likes the technology for sure. (Actually, I’m eager to learn more what Allscripts is doing there — drop us a note on our contact us page if you have more information.)

P.S.
  In the view of your friend and mine Mr. HISTalk, “No matter what explanations are provided, the casual observer might conclude that Glen (Tullman) staged a coup that cost the company four board members and its CFO at the worst possible time.” What do you think?

One Student’s Perspective on Electronic Medical Records

Posted on December 7, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’ve had the good fortune in the past year or two to watch one of my daughters’ favorite babysitters blossom into a full-time nursing student at the University of West Georgia. Not only do my girls benefit from her great bedside manner, including an infinite amount of patience, but I get an occasional inside glimpse into the world of digital medical record keeping in the greater Atlanta area.

Her training at West Georgia has taken her to Children’s Healthcare of Atlanta – Egleston, Wellstar Cobb and Austell, Fayette Piedmont, Tanner Medical Center and Gentiva Healthfield Hospice. She graciously offered to share her rookie’s perspective on the electronic medical records – including SCM/Quest (Allscripts Sunrise Clinical EHR system) and Meditech – she has used at several of the facilities she has trained in.

How long have your healthcare training facilities had EMRs in place?
All except Gentiva Healthfield Hospice – in-home hospice care, for the most part, sticks with paper charting. If they were to make the switch to an EMR, they would have to have access to a central database from their personal computers/iPads/Blackberries, etc. All others have had some sort of electronic database for at least five years.

How intuitive did you find them to be in your first training sessions/rounds?
Once I had been trained in the first system I encountered, the rest seemed very user-friendly. They have been in use long enough now that they are efficient and fairly self-explanatory.

They all allow an employee to cluster patient care and spend enough time with the patient because the time stamp on documentation can be changed to the time that the intervention was completed. For example, I could complete a full assessment on a patient, bathe them and administer their medications without having to document in the computer every few minutes. I could just open their EMR after completing their care and add the correct time stamp on my documentation.

What were the easiest to use, and what were the most difficult?
Meditech was the most difficult to use, perhaps because I had limited access as a student. It was difficult to find complete admission notes and patient histories.

Speaking from a “rookie’s” perspective, what would you tell vendors of these systems to better their products?
Add a patient verification requirement before each documentation session, i.e. each set of vital signs, medications given, etc. (Something simple, like a box with the patient’s name and DOB and an “Ok” button)

Did your supervisors express any enthusiasm or dissatisfaction with any particular systems?
All expressed enthusiasm, but they also were concerned any time a system was to be updated with even minor changes. Fayette Piedmont uses one EMR system for Labor and Delivery, and a completely different system for the rest of the hospital. This means, for the staff, that a new baby’s records have to be re-entered into a new system once they are discharged from labor and delivery and admitted to the NICU or postpartum unit. It also means the pharmacy has difficulty accessing vital information when, for instance, they need to know a baby’s weight to send the appropriate dose of medication to the NICU.

How aware are you of post-implementation training that goes on with EMRs, based on the facilities you’ve trained at? Do your supervisors ever mention it?
Once an employee is hired, they usually must display proficiency with the charting system within a specified training period. When Fayette Piedmont updated SCM/Quest, they did not retrain each employee, but they did send out a packet with a detailed description of the changes. From what I have seen, the older nurses who may have preferred paper charting at one point do not seem to have any problems with the electronic charting.

Have you been made aware of any increase/decrease in positive clinical outcomes as a result of physicians/nurses using these systems? Any examples you feel comfortable sharing?
The major changes to these systems each time they are updated usually involve the addition of safeguards. For example, the newest version of SCM/Quest has the patient’s name, weight, room number and allergies on every page of the charting system, and in multiple locations on the page.

For the employees who pay attention, this has reduced many documentation errors. There is also an embedded link to drug guides in every electronic medication order with explicit instructions and safe dose ranges. For the employee who knows these features are there, they are a tremendous help, and they do serve to protect the patient. It is still possible to document in the wrong patient’s chart, without realizing it, in any system.

Needless to say, it will be interesting to see how her experience with EMRs changes as she continues her studies and then moves into the professional world of nursing, which will likely coincide with healthcare facilities continuing to move through the various stages of Meaningful Use.

Stay tuned for next week’s post, in which I’ll profile an EMR educator, and find out what other students are facing when it comes to EMR training. In the meantime, what sort of healthcare IT-related challenges will our new workforce face in the coming year? Please share your thoughts in the comments below.