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Epic Hires DC Lobbying Firm To Fight Closed-System Reputation

Posted on September 15, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

For quite some time, everybody’s favorite EMR giant has a “no marketing, no government relations” policy. (In fact, Epic staffers really seem to hate journalists, but maybe they just don’t like me — who knows?)

Anyway, a few weeks ago, reports the ever-watchful HISTalk, it came out that Epic has broken its rule, hiring on DC lobbying firm Card & Associates. While you might think Epic would hire a billion-dollar behemoth, Card is a smallish firm with seven modest accounts and only one healthcare client. It must help, however, that Card is run by the brother of the former White House Chief of Staff under Pres. George W. Bush.

So what made Epic change its standard operating procedure and begin lobbying The Hill? In its federal lobbying disclosure, the EMR firm says that it’s begun lobbying to “educate members of Congress on the interoperability of Epic’s healthcare information technology.”

The timing of the outreach effort isn’t a coincidence, Modern Healthcare astutely notes. As you read this, a team made up of Epic, IBM and a handful of other technology giants are fighting other equally ferocious IT firms to win the roughly $11 billion contract to update the Department of Defense’s clinical systems.

While none of its contract competitors have a strong reputation for interoperability, Epic is seen as much worse, with a RAND Corp. study released in July calling Epic’s systems “closed records.” That had to hurt.

Unless Epic plans to hold health IT classes for Congress over the next several years, I doubt they’ll be able to make their point with largely Luddite Senators and Representatives in Washington on a technical basis. That is, Epic’s lobbyists won’t be able to convince legislators that Epic is interoperable on the merits.

But lobbyists may very well be able to break the ice on The Hill, and sell the idea that those mean, bad old health IT competitors haven’t been telling the truth about Epic. The pitch can include the somewhat matronly CEO, Judith Faulkner, who doesn’t look like the most powerful woman in healthcare or a competitor that would gladly bite your head off and spit it down your neck. Then they can roll out Epic’s pitch that its systems actually are interoperable (between other Epic installs at least). If it sticks even a little bit, whatever the $1.7 billion company spent will have been worth it.

Frankly, I find the idea of portraying Epic as an underdog in any way as downright laughable, and I bet you do too. But I simply can’t imagine another pitch that would work.

Why Don’t We Hear More from Epic, Cerner, or MEDITECH?

Posted on September 4, 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.

Epic is notorious for being “closed.” In fact, people talk about Epic being closed in so many ways, it’s hard to keep up. However, I think they are mostly seen as closed because of Judy’s decision to almost never talk to the media. In fact, it’s pretty rare that any one from Epic talks to the media. I remember when it was groundbreaking news when someone at Forbes did an interview with Judy.

Obviously, opening yourself to the media isn’t essential to making an enterprise sale. Judy and Epic have done quite well without opening themselves up to the media. In fact, their closed approach has in some cases gotten them more media coverage (see this blog post). Regardless of what you think of Epic, they are largely perceived as a black box that we don’t know nearly enough about. They have been more open with who they are and what they do in the past couple years than they ever were before, but that’s really not saying much.

While many love to talk about Epic’s closed nature, are any of the other hospital EHR vendors like Cerner or MEDITECH much more open? Last I checked, I have’t seen any of the CEOs of these companies blogging about their company and sharing their company’s culture and approach to the future publicly like we see in so many other tech companies. I haven’t seen many of the top leadership at any of these companies active on Twitter or other social media. Do any of these companies really show us any of their humanity? I can’t think of any that do.

The same isn’t true in the ambulatory world. We know all about athenahealth from Jonathan Bush who’s never afraid to bear his soul. SRSSoft and SOAPware have had really active CEOs who’ve openly shared their view of the EHR industry. Those are just a few of the examples. Why don’t we see the same from hospital EHR vendors?

I think the reason why is that it’s never been part of the culture of these companies. Changing that is a really hard thing to do. I don’t see it happening anytime soon. The closest we came to it was when the CEOs of many of these companies joined in the ALS Ice Bucket Challenge. Watching those videos made those companies a little more human. I think that’s a great thing for these companies.

While these companies have proven that you don’t need to engage their community in public to be successful, I’d suggest that the company that does start to do this will be at a distinct advantage. If the existing companies don’t decide to do it, then don’t be surprised if a new company disrupts the market with a more open and human approach. The incumbent EHR vendors won’t know what hit them and likely won’t be able to change the culture fast enough to fight them off.

Assuming you’re working on and doing amazing things for your customers, transparency can be an amazing marketing tool. If you’re not, then it’s better to hide in the shadows.

Has Epic Fostered Any Real Healthcare Innovation?

Posted on August 13, 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.

I saw the following tweet and was really struck by the question.

I think we could broaden the question even more and ask if any EHR vendor has really fostered healthcare innovation. I’m sorry to say that I can’t think of any real major innovation from any of the top hospital EHR companies. They all seem very incremental in their process and focused on replicating previous processes in the digital world.

Considering the balance sheets of these companies, that seems to have been a really smart business decision. However, I think it’s missing out on the real opportunity of what technology can do to help healthcare.

I’ve said before that I think that the current EHR crop was possibly the baseline that would be needed to really innovate healthcare. I hope that’s right. Although, I’m scared that these closed EHR systems are going to try and lock in the status quo as opposed to enabling the future healthcare innovation.

Of course, I’ll also round out this conversation with a mention of meaningful use. The past 3-5 years meaningful use has defined the development roadmap for EHR companies. Show me the last press release from an EHR company about some innovation they achieved. Unfortunately, I haven’t found any and that’s because all of the press releases have been about EHR certification and meaningful use. Meaningful use has sucked the innovation opportunity out of EHR software. We’ll see if that changes in a post-meaningful use era.

Pay at Epic – Did You Know There’s an Epic Reddit?

Posted on August 11, 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.

HIStalk recently pointed to a reddit post about the Salary, Raise and bonus structure at Epic. It’s a fascinating look at what you get paid to work at Epic. I’ll be covering that topic in detail on our Healthcare IT Today career blog. However, did you know that there’s a subreddit on Epic?

In some ways, I think this says a lot about how far reddit has come, but it also says something about the size of Epic and the type of employee they attract. The younger reddit generation is their hiring strategy.

The subreddit is quite interesting. They talk about things like lunch at Epic (cheap and good), what it’s like to be a mom at Epic, and even topics like whether you can have a tattoo at Epic. Although, this one talking about the creepy customer announcements made me laugh:

The customer announcements over the loud speaker are so bizarre. It makes me feel like I’m in a1984-esque reality with an unsilenceable propaganda machine.
I doubt they intend it to be this way, but it is all I ever feel when it occurs.
Does anyone not find them creepy?

Looks like they even preach the Epic culture over the loud speaker. I do like that their celebrating each customer win since an Epic customer win is a really big deal. Although, the description makes me wish I could hear one of these announcements.

The Epic subreditt isn’t super active, but I’ll have to keep an eye on it to see any other interesting topics that are started. Maybe start a few of my own.

Cerner’s Siemens Acquisition and the Impact on the DoD Bid

Posted on August 7, 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.

One topic I didn’t address in my post covering the $1.3 billion Siemen’s acquisition by Cerner is how this will impact the $11+ billion DoD bid. There’s a lot of discussion about what this acquisition will do. Let me pull out my crystal ball and give you my thoughts.

I personally think that this acquisition will have very little impact on which cluster of companies will win the DoD EHR contract. Some might say that Cerner gains some advantage by having some of the Siemens capabilities on board. Others could argue that Cerner will be distracted with the Siemens acquisition and so they wouldn’t be able to focus on such a large EHR contract. While both of things have some truth, I really don’t think they’ll factor into the DoD decision making.

It seems the consensus out there is people expect Epic to win the DoD contract. If that happens, the Siemens acquisition could become even more interesting for Cerner. It’s a very likely reality that whoever gets the DoD contract will lose some potential clients due to concerns about capacity. If Epic or Cerner get the DoD contract, then it’s possible that these capacity concerns will move them down a notch in people’s EHR selection process. This is a situation where Cerner will benefit from having connections to all of these Soarian customers. As I posted previously, it might be best for Epic not to win the DoD contract.

Are there other ways that Cerner’s acquisition of Siemens impacts the DoD EHR bid?

Why Might Intermountain Have Chosen Cerner Over Epic?

Posted on July 14, 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.

An anonymous person on HIStalk gave some really interesting insights into Intermountain’s decision to go with Cerner instead of Epic.

Re: Intermountain. The short-term choice (three or so years) would have been Epic, but we went with Cerner because of Epic’s dated technology, Cerner’s openness, and the feeling that we would be more of a partner than a customer with Cerner. The partnership is more than words. We’re working closely with Cerner and their horde of sharp, dedicated people on the implementation. We have some pieces they don’t and those are being built into the Cerner system, while some of our own development efforts have been redirected since Cerner already has that functionality. The first rollout is scheduled for December and I think it will go well due to the way the teams are working together. Unverified.

This is the best analysis of Intermountain’s decision to go with Cerner that I’ve seen. As in every billion dollar procurement decision, it’s always got other nuances and pieces that go into the decision making process. However, the above analysis gives us a good place to start.

Let’s look at the main points that are made:

1. Is Epic technology more dated than Cerner?

2. Is Cerner more open than Epic?

3. Will Cerner be more of a partner than Epic would have been?

I’d love to see Judy’s (Epic CEO’s) comments on all of these. I’m sure she’d have a lot to say about each of them. For example, you may remember that Judy described Epic as the most open system she knows. Ask someone who wants to get Epic certified if they’re open. Ask a health IT vendor that wants to work together if Epic is open. Ask even some of their smaller customers who want to do things with Epic if Epic is open. They’d all likely disagree that Epic is the most open system.

I’d love to hear people’s thoughts on each of these three points. I think it will make for a really lively discussion that will help us get closer to understanding the reality of these assertions.

However, reality aside, I can tell you that the public image of Epic vs Cerner certainly confirms all three of these points. Whether Intermountain indeed used these points as part of their decision process or not, I don’t know. What I do know is that it wouldn’t surprise me at all if they did think this way since there are many in the market that believe and share all of the above three impressions.

More of the Siemens Healthcare Back Story

Posted on July 10, 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.

One of the things I love about blogging is the comments that I receive. Many of them come in the comments of the blog, but just as many get emailed to me privately in response to my posts being emailed to readers. Every once in a while I want to share the emails I receive with the readers (Note: You can now subscribe to all of the Healthcare Scene emails in one place). This is one such response that I got in response to my post about Siemens Selling its Health IT business.

I remember the good ol’ days of being a 25+ year SMS Unity customer. Siemens who had recently purchased SMS told us that Unity would be going away. They showed us Soarian (which at the time was not actually built) and said that they would move us there for free. Of course, since it didn’t yet exist we would have to transition to Invision first for about a year. That would also be free. However, they would have to expense us for professional fees which they estimated to be in excess of $1,000,000. This is how we became a Meditech customer.

This kind of back story is what makes healthcare IT so interesting and so challenging. Many who want to enter the healthcare space forget about all this history and they usually fail. The very best hospital health IT companies that I know usually do an amazing job pairing new innovations and technologies together with someone who understands and has been part of this history. Pairing the two together is a powerful combination.

Siemens to Sell Hospital IT Business?

Posted on July 9, 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.

This is some interesting news for the hospital health IT world:

Siemens (SIE) AG is exploring a sale of its hospital database and information-technology unit to focus on energy and industrial businesses, according to two people familiar with the plans.

The German engineering company is evaluating options for the business, and no final decision has yet been made, said the people, who asked not to be identified because the considerations are private. The unit could be valued at more than 1 billion euros ($1.4 billion), said one of the people.

Siemens Chief Executive Officer Joe Kaeser is seeking to focus Siemens around “electrification, automation and digitalization” and has already sold off $2.3 billion euros since late 2012. It seems like Siemens healthcare product line fits great with the digitalization focus, so there’s likely more to the story. My guess is the Siemens healthcare business hasn’t been doing well (Thank you Cerner and Epic) and so he’s looking to get out while there’s still some value in the business.

If you’re a Siemens healthcare customer, you probably welcome this change as well. Hopefully a sale will infuse the company and the product with a new energy that will produce some better results for their customers. Maybe I’m talking to the wrong people, but those I’ve met on Sorian are basically ho-hum about the product. No doubt it will be interesting to watch.

Sutter Health Ready To Deploy HIE, But Can It Succeed?

Posted on June 30, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Sutter Health doesn’t have a great reputation when it comes to EMR implementation. Late last year, when we reported that Sutter’s Epic EMR crashed for an entire day, comments came pouring in about the company’s questionable approach to training its staff on using the system.

According to Epic consultants who’d been involved in the project, Sutter leaders decided that Epic experts were there to “facilitate” training done by inexperienced in-house teams, rather than actually teach key users what they need to know. The result was strife, disorder and anxiety, according to several consultants who’d been involved. Since then, Sutter has connected its EMR to five medical foundations and 17 hospital campuses; by next year, it expects the EMR to connect to information on 3 million patients. But there’s no reason to think it’s changed its training strategy, which could cast a bit of a pall over the new project.

Now, Sutter Health is building out a health information exchange, working with Orion Health, which will tie together hospitals and doctors both inside and outside of its network across northern California. Sutter plans to begin deploying the HIE in phases this summer, starting with data integration with the Epic EMR and extending to testing exchange of inbound and outbound data. If the project works out, it seems likely that it will be a plus for every provider that does business with Sutter.

The question is, will Sutter do a better job of managing this process than it did in rolling out its EMR? While it’s easy to boast that your plans are going to be a “gamechanger” for the market, it’s hard to take that claim at face value when your EMR implementation hasn’t gone so splendidly.

Certainly, Orion is a reputable HIE vendor which has been praised for having strong products and service. And Sutter certainly has the financial wherewithal to see such an effort through. The thing is, if Sutter leaders (seemingly) took a wrongheaded approach to the all-important issue of EMR training, who knows what curveballs they might throw into the process of rolling out an HIE? Even if its EMR has stabilized and Sutter has somehow gotten past its training hurdles, its past missteps don’t inspire confidence.

If I were with Orion, I’d draw a firm line where training was concerned, as Sutter’s past strategy only seems to have cast its last major HIT vendor in a bad light. If not, I’d make sure the contract had a workable bailout clause…or be prepared for some serious headaches.

AHA urges agencies to speed up EMR choice expansion

Posted on June 23, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In a move that shouldn’t surprise anybody, the American Hospital Association is urging CMS and the ONC to hurry up and finalize new rules which would expand choice for certified EMRs.

The AHA letter argues that its members are on the verge of walking away from Meaningful Use. But if CMS and the ONC speed ahead with with the new proposed rules — which would offer more choice in specific meaningful use requirements they must meet this year — hospitals will be much better equipped to proceed.

Why the rush? Well, for one thing, the letter argues, time is of the essence for hospitals, which have to decide their meaningful use strategy for fiscal 2014. If they must make choices before the new rule is finalized, it could cause them “significant financial and operational harm,” the AHA contends.

Meanwhile, if the agencies don’t push these rules through quickly, “many providers are likely to conclude that they cannot meet meaningful use this year and abandon the program,” wrote Linda Fishman, AHA senior vice president of public policy analysis and development, in a letter to CMS Administrator Marilyn Tavenner and National Coordinator Karen DeSalvo, MD.

The letter also takes on other issues. It asks that CMS and ONC clarify the rules implementation, offer more flexibility in the reporting of clinical quality measures, shorten the MU reporting period for 2015 in analyze lessons learned from Stage 2 before finalizing Stage 3’s start date, according to HealthcareITNews.

The AHA’s letter comes at a challenging time for the meaningful use program generally, which has of late attracted broader attention than it has in the past.

Not only are industry groups pressuring ONC, legislators are too. For example, at a recent health IT conference, U.S. Rep Tom Price, MD, R-GA, argued that meaningful use is “maybe not even doing what needs to be done as it relates to patients and physicians.”

In his remarks, Price argued that meaningful use could be improved by keeping the patient front and center, making sure patients know they own their health data and establishing an interoperability standard.  But he suggests that because the MU program roadmap was laid out in the HITECH Act, it’s not as fluid as it should be and doesn’t accommodate such concerns.

The reality, however, is that there is no simple way to get interoperability; right now, we’re lucky if individual EMRs meet providers’ needs.  Despite the demands from other stakeholders, health IT vendors still have a lot more to gain by creating islands rather than interoperable products.