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A Look at MEDITECH’s Place in the EHR Marketplace and Where They’re Headed

Posted on February 12, 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.

Healthcare Scene was lucky to sit down with Helen Waters, VP at MEDITECH, to talk about the EHR market and MEDITECH’s place in that market. Plus, we dive into the culture and history of MEDITECH and how it’s changed. We also explore MEDITECH’s plans around innovation, integration, and value along with MEDITECH’s efforts to deploy cloud and mobile solutions. Finally, we had to talk about healthcare interoperability. We hope you’ll enjoy this wide ranging interview with Helen Waters:

After the formal interview we did above, we allow people watching live to be able to ask questions and even hop on camera to offer their insights or ask questions of Helen in what we call the “after party.” In this “after party” discussion we talk to Helen about her thoughts on the changing healthcare reimbursement landscape and what MEDITECH is doing to prepare for it. We also talk about integrating telemedicine into MEDITECH. I also ask Helen about MEDITECH’s views on EHR APIs. Check out the second half of our interview below:

We hope you’ll enjoy this look into EHR vendor, MEDITECH.

Medical Record Duplicates and Overlays Impact the HIM Workflow

Posted on February 10, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

HIM professionals are responsible for many different tasks throughout the day and the highest priority is typically on ensuring the accuracy and integrity of the medical record. There are many obstacles that can threaten the integrity of medical records including accidentally creating duplicate medical record numbers or overlaying patient information in the Master Patient Index (MPI). These issues can be costly not only in productive man hours but in potential patient care delays and HIPAA violations. Monitoring these duplicates and overlays is something that must be done daily to keep records accurate and HIPAA compliant.

I was recently interviewed by John Trader for a podcast on this subject. We discussed the downstream affects of patient duplicates and overlays and how this impacts the HIM professionals’ daily workflow.

Check out this 1 minute clip from the podcast to get a taste of our discussion:

If you want to hear more, you can download the full podcast. Thanks John Trader for having me on your podcast.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Andy Slavitt Talks Healthcare Interoperability and Data Blocking

Posted on February 8, 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.

In all the reporting around meaningful use being replaced (or as many mis-reported meaningful use ending), Andy Slavitt also made a number of other points in his talk at JP Morgan’s Healthcare conference. Much like he did with meaningful use, he live tweeted his talk. Here were a couple of his non-meaningful use tweets that stood out to me.

Has there ever been any doubt that HHS was serious about wanting organizations to be interoperable and for data blocking not to exist? There hasn’t for me. It’s been one of their main goals. The problem is two fold. First, CMS is fighting an uphill battle against the economic realities that not sharing data has been very profitable for healthcare organizations. Second, CMS only has so much power available to them to make interoperability a requirement.

Despite these challenges, CMS is doing everything in their power to encourage and promote interoperability. Put another way, they’re trying everything they can to make it so that interoperability is a wise business decision for healthcare organizations. Although, much of what they’re trying to do also harkens back to a statement I heard from Jonathan Bush, CEO of athenahealth that, “Interoperability should not be used as a point of competition.”

The problem is that today interoperability is used as a point of competition. We’re seeing that change, but it’s slow and there are still many who haven’t made the change. Plus, all of the interoperability solutions that have been offered (yes, I’m looking at the popular FHIR standard) are still quite limited in scope. They’re really just evolutions on existing interoperability and not a revolution to what interoperability should and could become.

Plus, I fear that many of these new interoperability options are really just creating a new market for vendors to charge providers. When you think about it, what’s the easiest way to block the sharing of information? Just charge too much for it. More on this in a future article.

Ironically, I think my perspective on Andy Slavitt’s comments on interoperability and information blocking are not all that different from my view on meaningful use. Andy and the people at CMS are saying the right things. They’re seeing the right dynamics at play in the market place. The problem is that they’re hands are tied in many ways and the bureaucratic process could lead to something even worse if they’re not careful. No doubt they’re dealing with really challenging, complex issues. It’s good to know that their hearts are in the right place. I just hope that regulation and legislation matches it.

HIMSS Puts Optimistic Spin On EMR Value Data

Posted on February 5, 2016 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.

After several years of EMR deployment, one would think that the EMR value proposition had been pretty well established. But the truth is, the financial and clinical return on EMRs still seems to be in question, at least where some aspects of their functioning are concerned.

That, at least, is what I took from the recent HIMSS “Value of Health IT Survey”  released earlier this month. After all, you don’t see Ford releasing a “Value of Cars Survey,” because the value of a car has been pretty much understood since the first ones rolled off of the assembly line more than a century ago.

Industry-wide, the evidence for the value of EMRs is still mixed. At minimum, the value proposition for EMRs is a remarkably tough case to make considering how many billions have been spent on buying, implementing and maintaining them. It’s little surprise that in a recent survey of CHIME members, 71% of respondents said that their top priority for the next 12 months was to realize more value from their EMR investment. That certainly implies that they’re not happy with their EMR’s value prop as it exists.

So, on to the HIMSS survey. To do the research, HIMSS reached out to 52 executives, drawn exclusively from either HIMSS Analytics EMRAM Stage 6 or 7, or Davies Award winning hospitals. In other words, these respondents represent the creme de la creme of EMR implementors, at least as HIMSS measures such things.

HIMSS researchers measured HIT value perceptions among this elite group by sorting responses into one of five areas: Satisfaction, Treatment/Clinical, Electronic Information/Data, Patient Engagement and Population Management and Savings.

HIMSS’ topline conclusion — its success metric, if you will — is that 88 percent of execs reported at least one positive outcome from their EMR. The biggest area of success was in the Treatment/Clinical area, with quality performance of the clinical staff being cited by 83% of respondents. Another area that scored high was savings, with 81% reporting that they’d seen some benefits, primarily in coding accuracy, days in accounts receivable and transcription costs.

On the other end of the scale, execs had to admit that few of their clinical staffers are satisfied with their EMRs. Only 29% of execs said that their EMR had increased physician satisfaction, and less than half (44%) said their nurses were more satisfied. If that isn’t a red flag I don’t know what is.

Admittedly, there are positive results here, but you have to consider the broader context for this study. We’re talking about a piece of software that cost organizations tens or even hundreds of millions of dollars, upon which many of their current and future plans rest. If I told you that my new car’s engine worked and the wheels turned, but that the brakes were dodgy, fuel economy abysmal and the suspension bumpy, wouldn’t you wonder whether I should have bought it in the first place?

Are You Prepared For Healthcare Ransomware?

Posted on February 3, 2016 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.

Earlier this month, a Texas hospital was hit with a particularly loathsome virus.  Leaders at Mount Pleasant, Tx.-based Titus Regional Medical Center found out on January 15 that a “ransomware” virus had encrypted files on several of the medical center’s database servers, blocking access to EMR data as well as the ability to enter data into the system.

In this kind of attack, the malware author demands a financial ransom to be paid for freeing up the data. TRMC didn’t disclose how much money the attacker(s) demanded, but it may have been an immense sum, because the hospital apparently thought that bringing in pricey security consultants and enduring several days of downtime was preferable to paying up. Although, they also probably realized the slippery slope of paying the ransom and also there’s no guarantee those receiving the ransom money will actually permanently fix the problem.

It would be nice to think that this was just a passing fad, but researchers suggest that it’s not. In fact, US victims of ransomware reported losses of more than $18 million in 14 months, according to an FBI report issued in June.

According to one news report, the average ransomware demand is about $300 per consumer. The amount demanded goes up, however, when business or government organizations are involved. For example, when a series of small police departments in Massachusetts, New Hampshire and Tennessee were hit with a ransomware attack tying up their key databases, they ended up paying between $500 to $750 to get back access to their data. One can only imagine what a savvy intruder familiar with the life-and-death demand for health information would charge to free up an EMR database or laboratory information system data store.

But the threat isn’t just to enterprise assets. Not only are hospital enterprise network attacks via ransomware likely to increase, these exploits could take place via wearables or medical devices in 2016, according to technology analyst firm Forrester Research. Such attacks don’t just use medical devices to reach databases; Forrester predicts that some ransomware attacks will disable the medical devices themselves.

Given how important mobile technology has become to healthcare, it’s worth noting that ransomware is increasingly targeting mobile devices as well. For example, a recent strain of Android virus known as Lockdroid ransomware is now afoot. While it has no direct healthcare implications, one of the things it does is threaten to send a user’s browsing history to friends and family unless they pay the ransom. The victim, who may get tricked into allowing malicious code to gain admin privileges on their device, could end up having their personal data — and perhaps data from an EMR app — sent wherever the attacker chooses.

It seems to me that the ransomware threat will push healthcare organizations to mirror their core data assets in new and heretofore unheard of ways. HIT departments will have to bring disaster recovery methods and network intrusion defenses to prevent the worst possible outcome — a hack that kills one or more patients — and quickly. Meanwhile, if a company specializing in protecting healthcare firms from ransomware doesn’t exist yet, I suspect one will exist by the end of 2016.

EHR, What’s Next?

Posted on February 1, 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.

EHR Whats Next with Dana Sellers

With the announcement that meaningful use is going to be replaced (Not to be confused with meaningful use is dead like many claimed.) along with a maturing of the EHR market, I thought it might be time to ask the question, EHR, what’s next? This discussion should include how to better leverage your current EHR investment, but also look at what other investments organizations should be making to get the most out of everything that’s happening in healthcare IT. On Thursday, February 4, 2016 at 11:30 AM ET (8:30 AM PT), I’ll be sitting down with Dana Sellers, CEO of Encore, A Quintiles Company to talk over what’s next for EHR and healthcare IT.

You can join my live conversation with Dana Sellers and even add your own comments to the discussion or ask Dana questions. All you need to do to watch live is visit this blog post on Thursday, February 4, 2016 at 11:30 AM ET (8:30 AM PT) and watch the video embed at the bottom of the post or you can subscribe to the blab directly. We’ll be doing a more formal interview for the first 30 minutes and then open up the Blab to others who want to add to the conversation or ask us questions. The conversation will be recorded as well and available on this post after the interview.

With an amazing depth of experience, Dana’s been through a wide variety of healthcare IT cycles. I can’t wait to hear Dana’s thoughts on what’s going to happen with meaningful use, how can healthcare organizations better leverage their EHR investment, where are we really seeing analytics and other buzzword worthy terms breaking through, and what other technologies are on the horizon that will improve healthcare? Please join us Thursday and share your experience as well.

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

EMR Usability A Pressing Issue

Posted on January 29, 2016 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.

A few months ago, in a move that hasn’t gotten a lot of attention, the AMA and MedStar Health made an interesting play. The physicians’ group and the health system released a joint framework designed to rank EMR usability, as well as using the framework to rank the usability of a number of widely-implemented systems.

What makes these scores interesting is not that they’re just another set of rankings — those are pretty much everywhere — but that the researchers focused on EMR usability. As any clinician will tell you (and many have told me) despite years of evolution, EMRs are still a pain in the butt to use. And clearly, market forces are doing little to change this. Looking at where widely-used systems rate on usability is a refreshing look at a neglected issue.

To score the EMRs, researchers dug into EMR vendor testing reports from ONC. This makes sense. After all, though the agency doesn’t use this data for certification, the ONC does require EMR vendors to report on user-centered design processes they used for eight capabilities.

And while the ONC doesn’t base EMR certifications on usability, my gut feeling is that the data source is pretty reliable. I would tend to believe that given they’re talking to a certifying authority, vendors are less like to fudge these reports than any they’d prepare for potential customers.

According to the partners, Allscripts and McKesson were the highest-scoring EMR vendors, gaining 15 out of 15 points. eClinicalWorks was the lowest-scoring EMR, getting only 5 of 15 possible points. In-betweeners included Cerner and MEDITECH, which got 13 points each, and Epic, which got 9 points.

And here’s the criteria for the rankings:

  • User Centered Design Process:  EMRs were rated on whether they had a user-centered design process, how many participants took part (15+ was best) and whether test participants had a clinical background.
  • Summative Testing Methodology: These ratings focused on how detailed the use cases relied upon by the testing were and whether usability measures focused on appropriate factors (effectiveness, efficiency and satisfaction).
  • Summative Testing Results:  These measures focused on whether success rates for first-time users were 80% or more, and on how substantive descriptions of areas for improvement were.

Given the spotty results across the population of EMRs tested, it seems clear that usability hasn’t been a core concern of most vendors. (Yes, I know, some of you are saying, “Boy howdy, we knew that already!”)

Perhaps more importantly, though, it can be inferred that usability hasn’t been a priority for the health systems and practices investing in these products. After all, some of the so-so ratings, such as that for the Epic product, come from companies that have been in the market forever and have had the time to iterate a mature, usable product. If health systems were demanding that EMRs be easy to use, the scores would probably be higher.

Frankly, I can’t for the life of me understand why an organization would invest hundreds of millions of dollars (or even a billion) dollars in an EMR without being sure that clinicians can actually use it. After all, a good EMR experience can be very attractive to potential recruits as well as current clinicians. In fact, a study from early last year found that 79% of RNs see the hospital’s EMR as a one of the top 3 considerations in choosing where to work.

Maybe it’s an artifact of a prior era. In the past, perhaps the health systems investing in less-usable EMRs were just making the best of a shoddy situation. But I don’t think that excuse plays anymore. I believe more providers need to adopt frameworks like this one, and apply them rigorously.

Look, I know that EMR investment is a complex dance. And obviously, notions of usability will continue to evolve as EMRs involve — so perhaps it can’t be the top priority for every buyer. But it’s more than time for health organizations to take usability seriously.

Is An Epic Investment Bad For Health Leaders’ Job Stability?

Posted on January 28, 2016 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 now, the buzz has been that at least one EMR vendor was a safe bet for everyone involved. “No one ever got fired for choosing Epic” has begun to seem as obvious a sentiment as “No one ever got fired for choosing IBM” in hospital C-suites. And certainly, in previous times that was probably true.

But it’s beginning to look as though at least in some cases, Epic has not been as safe a choice as health execs had hoped. In fact, while it’s not exactly a fully-fledged trend, it’s worth noting that Epic-related costs and technical issues have led to job losses for hospital CIOs, as well as other operational leaders, in recent times.

Perhaps the most recent example of Epic-related job attrition took place earlier this month, when the chief information officer and chief operating officer of Denver Health Medical Center. According to the Denver Post, the two executives left their posts in the wake of major disagreements over the medical center’s big investment in an Epic EMR.

The Denver Post story reports that former Denver Health CIO Gregory Veltri was on the outs with CEO Arthur Gonzalez from the outset where Epic was concerned. Apparently, Veltri argued from the get-go that the Epic install costs — which he estimated could hit $300 million when the $70 million cost of dumping the center’s current EMR contract and doubling of its IT staff were computed — stood a chance of bankrupting the hospital. (Gonzalez, for his part, claims that the Epic installation is under budget at $170 million, and says that the system should go live in April.)

In another example of Epic-related turnover, the chief information officer at Maine Medical Center in Portland seems to have left his job at least in part due to the financial impact of the hospital’s $160 million Epic investment. Admittedly, the departure of CIO Barry Blumenfeld may also have been related to technical problems with the rollout which slowed hospital collections. This took place back in 2013, but it still seems noteworthy.

The spring of 2013 also saw the departure of Sheila Sanders, the chief information officer for Wake Forest Baptist Medical Center, in the midst of the medical center’s struggles to implement its own Epic system. While Wake Forest Baptist had spent a comparatively modest $13.3 million on direct Epic costs during its second quarter of fiscal 2012-13, the medical center had been socked by delays in revenue resulting to Epic rollout problems, including issues with billing, coding and collections.

Wake Forest Baptist reported taking an $8 million hit that quarter due to “business-cycle disruptions (that) have had a greater-than-anticipated impact on volumes and productivity.” It also reported $26.6 million in lost margin due to reduced volume during go-live and post go-live Epic optimization.

Of course, a botched rollout can mean job insecurity no matter what EMR the hospital has chosen. For example, in May of 2014, Athens Regional Medical Center President and CEO James Thaw was apparently pressured out of office when the facility’s Cerner rollout went poorly. (After weeks of Cerner problems, the hospital’s staff voted 270-0 that they had “no confidence” in the hospital’s leadership. Gulp!) Somehow, Senior Vice President and CIO Gretchen Tegethoff kept her job, but my bet is that it was a close-run thing.

And to be fair, this is obviously a small, selected set of anecdotes about questionable Epic rollouts. They don’t prove that Epic is a CIO job killer or an ineffective EMR. But these stories do highlight the fact that while Epic investments might yield good things, rolling Epic out requires nerves of steel and flawless execution.

A Study on the Impact of ICD-10 on Coding and Revenue Cycle

Posted on January 27, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

Implementing ICD-10 coding has been, in some ways, like learning a new language. We took a specialized task that has been repeatedly performed for over 30 years and turned it on its head with new guidelines, new characters, and new specificity that we have never had before. Many healthcare leaders have been watching for (and possibly expecting) catastrophic effects of the changes to surface after the implementation of ICD-10 such as a reduction in reimbursement and an increase in denials. A recent study commissioned by Primeau Consulting Group surveyed respondents to see how healthcare organizations are doing with ICD-10 and how they are preventing denials.

It’s no surprise that ICD-10 has led to a decrease in coder productivity. In fact, the survey showed that 66% of those surveyed had experienced some negative changes in coder productivity. Some respondents claim somewhere between a 25% to 35% decrease in productivity. I know all HIM leaders want to know if this will be a permanent or temporary loss in productivity and that is yet to be determined. When equating this productivity loss to A/R days, this can have a huge impact on the number of accounts in an unbilled status waiting for coding. Unfortunately, 34% of respondents to the survey have already seen negative impacts on the revenue cycle since ICD-10 was introduced.

In preparation for ICD-10, it was difficult to predict if additional training and education would be needed after the ICD-10 go-live. Some feedback in the survey showed that respondents did not necessarily plan for additional formal ICD-10 training for coders in 2016 but will keep up with the standard continuing education that has always been part of a coder’s job. I think this is still yet to be determined pending the results of coding audits that will show areas for education and documentation improvement.

While ICD-10 has been relatively smooth thus far, HIM leaders are still proceeding with caution and bracing for any potential downsteam impacts that could result from the drastic changes we have undergone. The study revealed that the most commonly perceived risks with ICD-10 in 2016 center on physician documentation and specificity. Again, I believe auditing will be key in determining education for coders as well as physicians.

How has the ICD-10 experience been for you? Are you seeing similar issues or risks?

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Athenahealth Amps Up Drive To Build Inpatient EMR

Posted on January 26, 2016 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.

EMR vendor athenahealth has been driving forward for a while now to build a new hospital inpatient system and fight for the big-ticket customers in acute care. Given the intense competition for the acute care EMR dollar, I’m skeptical that athenahealth can wedge its way into the game. But so far, it looks like the vendor is going about things the right way.

athenahealth already offers the athenaOne suite, which includes an ambulatory EMR, revenue cycle management and patient engagement tools. But it seems the ambitious execs there have also decided to participate in the bare-knuckled fight for hospital bucks being duked out between Cerner, Epic, MEDITECH, McKesson and Allscripts. Considering the billions at stake, these acute care giants won’t be gentle. But as the following details suggest, athenahealth may just have enough going for it to slip into place.

Last year, athenahealth got the ball rolling when it struck a co-development deal with Boston-based Beth Israel Deaconess Medical Center to create a new inpatient system. The two organizations agreed to kick off the development work at Beth Israel’s 58-bed hospital, which is located in the nearby suburb of Needham, Mass.  The deal makes particular sense given that athena corporate is located in another Boston suburb, Watertown.

To supplement its development efforts, athenahealth also picked up small-hospital EMR vendor RazorInsights and Beth Israel’s home-built webOMR EMR. athena has replaced the RazorInsights EMR with a rebuilt version of its ambulatory athenaClinicals EMR, and integrated it with the RI hospital information system, plus several ancillary systems. This hybrid system is being sold to the small-hospital market.

athenahealth has begun converting webOMR into athenaNet in partnership with the small Needham branch of Beth Israel, working with clinicians and technical staffers to better understand the inpatient care environment.

That agreement alone might have gotten the job done, but athena didn’t stop there. Last week, the vendor announced that it would be partnering with the University of Toledo Medical Center to further speed the development of its inpatient EMR. The agreement clearly builds on the vendor’s prior relationship with the University of Toledo Physicians, which picked up the athenaOne suite in late 2014.

The deal with UTMC will do more than give athenahealth another testbed and development site. This agreement with the health system, which is dumping its McKesson Horizon system by 2018, gives athenahealth a real-life win in a substantial setting. What’s more, given that the medical center is being given the chance to build things to its liking, the new acute-care EMR is unlikely to cost as much over the long-term as, say, Epic support and maintenance.

I must admit that I still see athenahealth’s plans as fairly risky. While it has significant resources, the vendor can’t match those of its big competitors. What’s more, it could lose a great deal if it endangers its strong legacy base of ambulatory users. But if any of the established ambulatory HIT firms have a shot at the bigger deals, this one does. I’m eager to see how this turns out.