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EHR Post Acquisition, 2014 Certified, ICD-10 and the Amazing Charts Future with John Squire, President and COO

Posted on April 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

I had the chance to sit down and interview John Squire, President and COO of Amazing Charts. I was interested to learn about the transition Amazing Charts has experienced after being purchased by Pri-Med and the departure of Amazing Charts Founder, Jonathan Bertman. Plus, I wanted to learn why Amazing Charts wasn’t yet 2014 Certified and their plans to make it a reality. We also talk about the value of meaningful use and the ICD-10 delay. Then, we wrap up with a look at where Amazing Charts is headed in the future.

Check out EHR videos for all of my EHR and Healthcare IT interview videos and be sure to subscribe to the Healthcare Scene youtube channel.

EMR Vendors Buying Physician Market Share

Posted on January 9, 2013 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.

Here at EMRandEHR.com, as well as in blogs across the web, we’ve been predicting that this will be the time when the EMR vendor market will begin to consolidate.  I stand by that prediction. But I have to admit that the first couple of deals I’ve tracked have turned out differently than I had expected.

Consider the acquisition of Amazing Charts by Pri-Med, a provider of professional medical education to more than 260,000 clinicians. I would have assumed that Amazing Charts would be acquired by a larger EMR vendor to fill out its offering physicians, but instead, Amazing sold to a publishing company with a huge physician base.  In retrospect, it makes plenty of sense, but for some reason I didn’t see it coming.

EMR vendor athenahealth pursued a similar strategy recently when it signed a definitive agreement to buy Epocrates, perhaps the most popular mobile application used by physicians today. athenahealth agreed to pay almost $300 million in cash for Epocrates, 22 percent more than what the mobile app vendor’s’ stock was worth on the day in question, in a move that the EMR company concedes tapped out its credit line.

But costly though the deal might have been, athena is getting a lot for its money. Buying Epocrates adds another one million physicians to its comparatively small provider base of 38,000.  If you consider the app itself plus the physician users, athenahealth’s investment seems pretty reasonable. When you consider how costly it is to acquire physicians as customers, a deal valuing them at $300 a physician doesn’t sound astronomical to me.

What I’m getting at, bottom line, is that other EMR players are likely to follow the model established by the Amazing Charts and athenahealth deals. I think this approach — buying, rather than begging for, new physician relationships — makes a great deal of sense.  What about you?

Early Signs Of EMR Consolidation Appearing

Posted on November 23, 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.

Some of you are going to tell me that I’ve jumped the gun, but I’ve got my feeling about this and I’m sticking to it. Though nothing massive has happened yet, I believe we’re officially beginning to see consolidation in the EMR world.

I was struck with this idea today when I came upon the news that physician EMR company Imagine MD was closing. According to MedCityNews.com, the cloud-based EMR company had pulled in $25 million in venture money, $10 million of that in the last 12 months. And until recently, it looked as though it had staying power; Imagine MD had been in business since 2006, well ahead of the pack of competitors pitching small medical practices.

Another sign that we’re seeing consolidation comes in the form of the acquisition of Amazing Charts by Pri-Med, a provider of professional medical education to more than 260,000 clinicians. (I wouldn’t have expected a medical education company to be the one to acquire Amazing, but that’s a story for another time.)

While I admit two examples isn’t exactly a statistical bump, it’s a clear enough sign for me that the market has begun to pull together. After all, with EMR adoption on the rise among medical practices, there’s only so many customers left to compete for, and that can only mean more closings and M&A.

The really important question, if you’re a doctor hoping to avoid a big practice disruption, is whether you can predict which direction your present or future EMR vendor is going.  That is, of course, a pretty tricky game.

But if you’d like some food for thought, you might consider checking out a previous post by John, comparing “fast EMR companies” fueled by venture capital to slower-moving types that grow organically and don’t tend to accept venture capital investments.

While there are exceptions — notably Practice Fusion, which seems to have an extremely solid business — the tech business is rife with examples of fast companies that soared high on venture capital drafts then plummeted to earth.  I’m not suggesting that you should avoid VC-backed EMR firms, physicians, but I am suggesting that you find out as much as you can about the size of their customer base, finances and strategy before you commit your business into their hands.

Otherwise, you could end up like ImagineMD’s EMR-less customers. And if that’s not a bummer I don’t know what is.

The Fast EHR Companies and the 37Signals EHR Companies

Posted on September 4, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

I was recently reading this fascinating interview with Jason Fried, Founder of 37signals. It’s a fascinating read, as was his book Rework. I must admit that I have a similar model for tech entrepreneurship to Jason Fried and it is quite different than what’s written about by most tech websites. Jason is much less about the flash and cash part of entrepreneurship and much more about building something of value in a long term sustainable way.

As I consider on these ideas, I started to wonder about the various EHR companies and which companies fall into the various entrepreneurship buckets.

Fast EMR
The fast EMR company is usually one that’s gone out and gotten a ton of funding from venture capital firms. If you’re an EHR company that’s gone out and raised millions and millions in funding, then you have no choice but to attack the market aggressively so that you can provide a return to your investors. There are actually a number of EHR companies that fit this profile, but the first one that will likely come into everyone’s mind is Practice Fusion. There $64 million in EHR funding means that they have to get a large portion of the EHR market. They no longer have the option of staying small but successful.

Let me be clear that there’s nothing wrong with being a Fast EMR. In fact, there are a lot of good things that come out of fast EMR companies that are trying to push the envelope when it comes to EHR adoption and how EHR should be done. It is entrepreneurship at work.

Slow and Steady EMR
On the opposite end of the spectrum are what I call the slow and steady EMR companies. These companies are often self funded or took in a much smaller investment and then used revenues to grow the company much like 37signals founder described. They slowly and steadily built their product, acquired customers and generated revenue.

I believe that SOAPware and Amazing Charts are the epitome of this type of company. They were both physician founded EMR companies that have built their user base slowly over time. They’ve never gone out and gotten the millions in funding. Instead they’ve grown organically over time.

Why Does This Matter?
In my e-Book on EHR selection, I talk about why it is important for you to understand the type of EHR company you are choosing. Would you rather “marry” the EMR tortoise or the EMR hare? The choice could change your EHR experience dramatically.

Disclosure: Practice Fusion, Amazing Charts and SOAPware are all advertisers on this site, but I didn’t discuss this post with them before posting it. Although, since they’re advertisers they were likely top of mind for me when I was writing this post.

No EHR Training Needed

Posted on October 6, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

Anne Zieger over on EHR Outlook just posted an article talking about the need of training on an EHR. In the article, she quotes Dr. Bertman, CEO of EMR company Amazing Charts (Full Disclosure: They’re a sponsor of this site). Here’s one excerpt from the article:

According to Dr Jonathan Bertman, if you need extensive training to use an EHR, you shouldn’t buy it. “Doctors know how to be doctors,” he says. “They shouldn’t have to be trained to be software technicians – if they need training than it’s not a good thing.”

Here was my response in the comments of the article (and a little additional commentary for this post):
I have a feeling Dr. Bertman and I agree about training, but I think it’s over the top for him to say, “if they need training than it’s not a good thing.” Certainly many EHR software vendors require far too much training. I think that’s the point he’s trying to make and I agree 100%. However, the reality is that there are a whole lot of people that get training even on Office. In fact, there’s a whole entire industry around training on Office products. So, EHR is going to have training as well.

Another excerpt from the article:

“Compare them to Microsoft Office,” Dr. Bertman suggests. “It’s a powerful tool, but you usually don’t need special training to use it. An EHR is not more complicated than Office, and that’s how we should be looking at them.”

I’d generally disagree that an EHR is not more complicated than Office. The reality is that what you want to do in an EHR is more complicated than Office. Sure, if all I want to do is type a little bit and maybe click bold, then I’m fine. Most EHR you don’t need any training to login, browse their appointment grid, browse patients, and even create notes.

The reason for the EHR training that’s out there isn’t for these simple features. It’s for the more advanced features like is done in most Office trainings. I could be wrong, but I believe Dr. Bertman generally agrees with me on this, but it wasn’t expressed in a short quote from him.

One other interesting point is that I think a lot of people call it EHR training when in fact it’s about EHR workflow planning and training. You’re a brave person to implement an EHR without planning out your current workflows and how they’ll map to an EHR workflow. I often see this workflow planning and training covered under the broad definition of EHR training.

Some Changes to EMR and EHR Advertising

Posted on July 25, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

As I like to do every couple months, I like to make mention of some of the new advertisers to EMR and EHR and recognize the previous advertisers that continue to renew. Plus, there have been some interesting changes to advertising on EMR and EHR that are worth highlighting.

The HealthcareScene.com blog network is now 14 blogs strong and EMR and EHR is one of the pillars of the network. EMR and EHR has seen some great growth and recorded its best month ever last month. Woot! Thanks to all of you for reading and participating in the comments as well.

In order to handle the growth of EMR and EHR and the Healthcare Scene Blog network in general, I decided to modify how I handled advertising on the site and start rotating all of the ads on EMR and EHR. That way there would be equal exposure for all advertisers on the site including new advertisers. It would also keep the site fresh for readers. Plus, as part of the change, I implemented an ad server to deliver the ads on the site.

The ad server is really exciting, because it will open up a lot of new options like geo-targeted ads (which many people have wanted) and also possibly delivering ads on a CPC (click) or CPM (impression) basis instead of the flat monthly rate that we do now. That will allow advertisers to work with a more limited budget if they can’t pay the full monthly rate. Not to mention, the ad server will be able to provide advertisers more details stats on their EMR and healthcare IT ad campaigns.

If you have more questions about the changes and EMR and EHR advertising options, you can ask on the EMR and EHR contact us page.

Now on to the new EMR and EHR online advertisers.

Quest-Medplus-Care360 EHR – I’m really excited to have Care360 as an advertiser on EMR and EHR. I’ve written quite a few times about the Care360 EHR by Quest (yes, the big lab company). I find their model and approach really interesting for an EHR company. Plus, I know they are really focused in their EHR marketing efforts and so I’m glad that they saw value in advertising on EMR and EHR. If you’re a Quest customer already, it’s really a simple decision to check out the Care360 EHR. You already have a login, they just have to activate the EHR portion. All the SaaS EHR fans out there will love their completely web based approach as well.

Amazing Charts – I love the story of how Amazing Charts became an advertiser, but I’ll save that for another time. Started by a Family Practice Physician in 2001, they’ve been around for quite a while. I’ve heard many people comment on Amazing Charts being one of the most affordable EHR software out there. Plus, with their Free EHR trial it’s easy for doctors to try it out and see if it fits with their EHR needs.

A big thanks to the slew of advertisers that renewed their ad on EMR and EHR. It’s always an honor when they say they want to renew. Thanks Practice Fusion, MxSecure, Mitochon Systems, Nuesoft, Medical Web Experts, and SequelMed.

Tomorrow I have plans to start a new EMR and EHR series. I think it’s a series that many of you are going to really enjoy!

EHR Comparison Chart

Posted on March 31, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 little while back I came across this EHR comparison chart on the Amazing Charts website. I was really intrigued. The first thing to note about the chart is that this is a page that’s designed to “sell” the Amazing Charts product. It’s actually a really smart move by Amazing Charts to use these comparisons as a way to increase their profile and compare them against many of the large EHR companies out there.

My biggest problem with an EHR comparison chart like this is that Amazing Charts conveniently decided to list themselves against a whole list of the HUGE and generally legacy EHR software companies. I don’t see the comparison chart including any of the Free EHR vendors. There are no EHR software companies that have come out in the past couple years on that list. There aren’t any of the more nimble EHR software companies that have done similar to Amazing Charts and focused on building an EHR company using revenue instead of outside funding.

Point being that an EHR comparison chart should include more of the 300+ EHR vendors that are out in the market today. If you only compare yourself to the largest and most expensive EHR software, then of course you look a lot cheaper. Plus, it seems they also focused on the most expensive EHR software from the companies that offer multiple EHR software as well.

The other challenge that they note in a footnote is that getting good pricing and EHR market share data is really hard. Most providers don’t publish it and as Dr. K mentions in this well written Future of Meaningful Use piece, “The sum of the number of installed users claimed by each of the top EMR vendors exceeds the number of practicing physicians in the U.S.”

Then, that EHR comparison chart also focuses a bit too much on the various EHR ratings services. I won’t dive into my feelings about the EHR ratings services that exist out there. Let’s just say that I wouldn’t base my EMR selection on any of those ratings services.