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Reddit Users Comment on Epic Losing the DoD EHR Contract to Cerner

Posted on August 17, 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.

The reactions to Epic losing the DoD EHR contract to Cerner have been all over the place. Most of them create some simplified view of why Epic beat out Cerner. I personally think that Leidos vs IBM had a lot more to do with the DoD’s decision than Epic vs Cerner. Either way, HIStalk reported that the protest period for the DoD EHR bid has expired and so Cerner is the big EHR winner. Mr. H said that rumors have been that Cerner’s bid was $1 billion less than Epic and Allscripts and so that’s why there was no protest.

Personally, I’ve been most fascinated by the reactions to Cerner beating out Epic in this reddit thread that includes a number of current and former Epic employees. The person who started the thread conveyed many people’s reaction to the selection of Cerner over Epic:

RIP my contracting plans for the next 2+ years :(

No doubt, Cerner consultants are celebrating in the opposite direction along with the 30+ other partners that won the bid with Leidos, Cerner, and Accenture. I previously wrote about how many people will be required in the $4 billion DoD EHR contract.

Here are some of the other interesting reactions in the reddit thread linked above:

I don’t think this is that bad for Epic.
* The government contract likely would have significantly shifted the focus of R&D efforts for the next few years towards features that may not be in the best interest of other Epic customers.
* When the project invariably runs into issues: overbudget, overtime, stability, training, response time, upgrades, etc. Cerner will be on the hook and take the hits in the media. Much of this implementation will be handled by outside consultants so coordination will be a huge challenge for any company.

Reminds me of the post I wrote about a year ago suggesting that losing the DoD bid might be the best thing for Epic.

Some source claim the contract would have been worth $9 billion overall. Just to put that in perspective… For an Epic employee making $200k a year, $9bn would pay your salary for 45 THOUSAND years. For 5,000 employees each making $200k a year, $9bn would pay their salaries for nine years.

(Yes, I know its not that simple… just trying to put $9 billion dollars in some kind of perspective).

Point is, yes, gaining or loosing a contract for that kind of money is a very big deal for ANY company, and impacts the future of that company in a significant way.

I don’t think most of us can comprehend a billion dollars. I know I can’t. However, I agree with the point that losing the DoD EHR contract is a big deal for any company. Even with this other clarification about how much money the EHR vendor will get from the contract:

I saw estimates that the contract would be worth $9 billion over 18 years, and that Cerner was likely to get only 10-20% of it (with most of the money going to Leidos). That means Cerner is getting $50-$100 million per year. This is obviously substantial, but it’s not as impressive as the $9 billion sounds.

I’ll be interested to see if those estimates are accurate. Plus, we’ll see how much the project cost balloons over time.

This Epic employee offered an interesting concern over Epic losing the DoD contract:

As a current Epic employee, I’m more than a little concerned about how much of the current building projects and massive hiring was made under the hope/assumption that we would be awarded this contract. I think this represents a much bigger deal for Epic than what you try to wave off.

Another user offered this comment on why Epic might have lost the deal:

What everyone needs to consider is that Epic is currently working on the build for United States Coast Guard (USCG). 1.The USCG falls under the DoD in terms of rules of engagement to include use of CHCS and PGUI (USCG didn’t transition to ALHTA). 2. The Epic build is consider by most involved on this project as an Epic failure! 3. DoD know about this Epic failure and of course the decision to to choose Epic is based upon this build failure. 4. After five years of this USCG contract Epic is still trying to understand military processes.

However, I think this was the feeling for many and why many are still in shock that Cerner won the contract over Epic:

Wow, I thought Epic had that contract locked up.

Just like I’ve done with ICD-10, I chose not to try and predict what the government will do. So, I wasn’t personally surprised by the DoD picking Cerner over Epic. However, now that Cerner is chosen, I’m interested to see how this affects both companies. The last comment about Epic’s USCG implementation illustrates how challenging working with the government can be. Cerner will definitely be spending time developing some unique software and technology to meet the DoD’s unique needs.

25% of EHR Budget Goes to EHR Training…At Least for the DoD EHR

Posted on August 14, 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.

In all of the news surrounding Leidos and Cerner winning the DoD EHR bid, I was really struck by this one piece from Healthcare IT News:

Training. As is often the case in massive software implementations, training eats up a lot of the costs and, in the DoD’s case, “over 25 percent of the contract goes to training users and clinicians,” Miller said.

Think about how much training you can get for $1+ billion. I get that training is not cheap. I also get that the DoD EHR implementation is a massive project, but that’s a lot of money for training. Do you think that most EHR implementations spend 1/4 of their budget on training?

Hopefully people will chime in with their answer to that question in the comments. My experience is that hospitals probably should budget 1/4 of their budget for training, but most don’t get anywhere near that amount. Plus, the EHR training budget often starts much larger and then when the budget overruns start to happen, EHR training is one of the first places they go to cut the budget.

How much EHR training is enough in your experience? Should it be 25% of the budget? I’m not sure how much is needed, but I do know that most organizations don’t purchase enough. Sounds like the DoD might be the exception.

Would Cerner DoD Loss Seal Its Fate As An Also-Ran?

Posted on July 29, 2015 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.

Update: Cerner has been announced as the winner of the DoD EHR Contract.

As everyone knows, Epic has attained a near-unbeatable place in the race for U.S. hospital market share. By one important criterion, Meaningful Use attestations, Epic has the lead hands down, with about 186,000 attestations as of March 2015 compared with 120,331 attestations on Cerner systems.

That being said, Cerner is hardly an insignificant force in the hospital EMR marketplace. It’s a multibillion-dollar powerhouse which still holds a strong #2 position and, if a casual survey of Web and social media commentary is to be believed, has done far less to alienate its customers with high-handed tactics. And while Cerner systems are far from cheap, you don’t regularly see headlines citing a Cerner investment as pivotal in a hospital’s credit rating taking a pratfall. Also, Cerner has the most contracts with MU-eligible hospitals, holding contracts with about 20% of them.

Nonetheless, there’s an event looming which could tip the scales substantially further in Epic’s direction. As many readers know, Epic is part of a team competing for the Department of Defense’s $11B Healthcare Management Systems Modernization contract (Word on the street is that we could hear the winner of the DoD EHR bid this week). I’d argue that if Epic wins this deal, it might have the leverage to push Cerner’s head under water once and for all.  Cerner, too, is fighting for the deal, but if it wins that probably won’t be enough to close the gap with Epic, as it’s harder to play catch up than to zoom ahead in a space you already control.

Now my colleague John argues that winning the DoD contract might actually be bad for Epic. As he sees it, losing the DoD deal wouldn’t do much damage to its reputation, as most hospital leaders would understand that military healthcare bears little resemblance to commercial healthcare delivery. In fact, he contends that if Epic wins the contract, it could be bad for its customers, as the Verona, Wisc.-based giant may be forced to divert significant resources away from hospital projects. His reasoning makes sense.

But losing the DoD contract would almost certainly have a negative impact on Cerner. While Epic might not suffer much of an image loss if it loses the contest, Cerner might. After all, it doesn’t have quite the marquee list of customers that Epic does (such as the Cleveland Clinic, Massachusetts General Hospital, Mayo Clinic and the Johns Hopkins Hospital). And if Cerner’s rep suffers, look out. As a surgeon writing for investor site Seeking Alpha notes, the comparatively low cost of switching TO Cerner can just as easily be used as a reason to switch AWAY FROM Cerner.

What’s more, while Cerner’s acquisition of Siemens’ health IT business — adding the Soarian product to its stable — is likely to help the company differentiate itself further going forward, but that’s going to take a while.  If Cerner loses the DoD bid, the financial and PR hit could dampen the impact of the acquisition.

Net-net, I doubt that Cerner is going to lie down and play dead under any circumstances, nor should it. Epic may have a substantial advantage but there’s certainly room for Cerner to keep trucking. Still, if Cerner loses the DoD bid it could have a big impact on its business. Now is the time for Cerner to reassure current and potential customers that it’s not planning to scale back if Epic wins.

Erlanger Health System Takes A Chance On $100M Epic Plunge

Posted on May 11, 2015 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.

The seemingly eternal struggle between EMR giants Cerner and Epic Systems has ended in another win for Epic, which was the final choice of Chattanooga, TN-based Erlanger Health System. The health system’s CEO, Kevin Spiegel, who said that Cerner had been its other finalist, announced last week that Erlanger would spend about $100 million over 10 years for the Epic installation.

Erlanger, a four-facility public hospital system with about 800 total beds, is an academic medical system and serves as a campus of the University of Tennessee College of Medicine. The system also partners with UT to operate the UT Erlanger Physicians Group, a 170-member multispecialty practice.

The health system, which fell in financial trouble in 2012, only recently saved itself and positioned itself for the massive Epic investment. It closed out FY 2014 with $618M in total operating revenue and $18M in operating income.

Erlanger’s turnaround is all well and good. But that being said, these numbers suggest that Erlanger is making something of a gamble by agreeing to an approximately $10M a year health IT investment. After all, the health system itself concedes that its return to financial health came in large part due to $20 million in new Medicare and Medicaid funding from CMS, along with new funding from the state’s Public Hospital Supplemental Payment Pool. And politically-obtained funds can disappear with the stroke of a pen.

The risky nature of Erlanger’s investment seems even more apparent when you consider that the system has an aggressive building plan in place, including a new orthopedic center, a $68M expansion of one of its hospitals, a 100,00 square foot children’s & women’s ambulatory center and a new health sciences center. Particularly given that Erlanger just completed its turnaround last year, does it make sense to squeeze in Epic payments alongside of such a large capital investment in infrastructure?

What’s more, the health system has a bond rating to rehabilitate. Faced with financial hardships in 2013, its bond rating was downgraded by Moody’s to a Baa2 and the system’s outlook was rated “negative.” By 2014, Erlanger’s had managed to boost the Moody’s outlook to “stable,” in part due to the influx of state and federal funds obtained by Erlanger execs, but the Baa2 rating on its $148.4 million in bond debt stayed in place.

While I imagine the hospital will realize a return on its Epic spending at some point, it’s hard to see it happening quickly.  In fact, I’d guess that it’ll be years before Erlanger’s Epic install will be mature enough to be evaluated for ROI, given the level of effort it takes to build a mature install.

In the meantime, Erlanger leaders may be left wondering, from time to time at least, whether they really can afford their expensive new EMR.

GE Phasing Out Centricity Enterprise, To Some Surprise

Posted on April 22, 2015 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.

Conceding that its competitors have the upper hand, GE is phasing out its Centricity Enterprise product, informing the world in a #HIMSS15 announcement which has gotten little play from our tech media colleagues.  As we’ve argued before, HIMSS is not only a great time to announce big plays, it’s also a great time to bury unpleasant news, and GE seems to have succeeded.

Not surprisingly, employees saw things coming long ago. More than a year ago, for example, a 10-year-plus employee of GE Healthcare called the vendor out on what they saw as low-wattage efforts on company rating site Glassdoor.com. The ex-employee cited a “lack of resources to deliver a good EHR product, [causing] a strong customer base to choose other EHR vendors.”

It’s little wonder that GE is backing out of Centricity Enterprise, which according to a report in MedCity News generated only 5 percent of its EMR revenue, according to Jon Zimmerman, general manager of clinical business solutions. “Is it in the best interest of our customers, shareholders and employees to (be) in a market where competitors are clearly ahead, or should we recognize the situation and go to where the market is going?” Zimmerman told MedCity.

But the fact is, Zimmerman’s comments are somewhat disingenuous. At HIMSS, the company admitted that it had begun the process of dumping Centricity Enterprise three years ago, though it’s not clear how long ago it began to let customers know about its plans. For example, I doubt that Continuum Health Partners CIO Mark Moroses, who as of summer 2013 was moving his organization to the Centricity enterprise EMR, expected to have it phased out less than two years later.

It’s worth wondering why a player with GE’s resources seemingly couldn’t hack the enterprise market. But the problem isn’t new. As far back  as 2011, GE was forced to admit that some of its ambulatory and enterprise customers wouldn’t be able to achieve Meaningful Use with their products. That was probably the beginning of the end for the Enterprise product, which ranked either fifth or sixth in the market recently depending on who you asked. But with Epic alone controlling 15% to 20% of the enterprise EMR market of late, and Cerner hot on its heels, giving up probably was a reasonable response.

The real question is what comes next. If Glassdoor.com posters are any indication, GE Healthcare is prone to frequent strategic changes as management shifts, so who knows what the future holds for its ambulatory Centricity EMR?

At the moment,  it seems that GE is firmly behind its ambulatory product. And that makes sense. After all, physicians are decommissioning their existing EMRs at a frantic rate, and are eager to find substitutes, and that gives GE plenty of sales opportunities. With 70% of physicians unhappy with their EMR, according to a study announced in February of last year, it should be easy pickins.

But given the way GE may have fumbled the ball on the enterprise side, I’d want some proof that leaders there had a long-term commitment to ambulatory care. Practices have a hard enough time finding EMRs that work for them; having to switch for reasons that have nothing to do with them makes no sense.

No Cloud Based Hospital EHR of Note…Yet?

Posted on April 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.

Scott Mace offered this interesting intro to his article “Cloud Adoption Gains Traction” in Health Leaders Magazine:

While no cloud-based electronic health record software of note for hospitals has yet to emerge on the scene, cloud-based ambulatory EHRs continue to gain traction, storage remains a strong cloud option, and intriguing new analytics options are tapping the versatility of cloud technology.

A look at hospital EHR market share and the main EHR companies (Epic, Cerner, MEDITECH, etc) are not cloud based EHR systems. Sure, some of them might have their client server installs hosted in the cloud, but that’s not a true single database EHR cloud.

What’s fascinating to me is why cloud EHR hasn’t taken off in hospitals like it’s taken off in the rest of the world (even ambulatory EHR as the article notes). It’s worth noting that athenahealth is working on a cloud based hospital EHR. However, there still at least a couple years out from even being in the conversation when a hospital considers selecting an EHR. The small SaaS Hospital EHR vendors don’t even make a dent in the market share.

Here’s why I think cloud EHR hasn’t taken off in hospitals:

Early Adopters – Many hospitals adopted some form of EHR really early on. They made the investment before cloud was really a decent option to consider (ie. before high speed internet was ubiquitous). Now they’re stuck with a legacy investment and they’re still paying off that investment

Switching Costs are High – Switching EHR in the ambulatory world is hard. Doing so in a hospital is infinitely more difficult. If I’m a CIO at a hospital, do I want to put my organization through that process? It takes a really visionary CIO and a supportive CEO to make the change.

No Great SaaS Hospital Alternatives – Once hospitals decided they needed one all in one system, that narrowed the number of EHR options to very few. We still have yet to see a SaaS software expand their offerings to cover the full gamut of software that’s required by a hospital. For example, even Epic which has been around forever (and is not a cloud EHR for the record), still gets complaints from hospitals about their lab software. Now apply that to 100 departments in a hospital and SaaS software just hasn’t been able to provide the full suite of software a hospital requires.

Fear – I think most hospitals are still afraid of the cloud. There are plenty of reasons why they should be less afraid of cloud than their current set up, but there’s still very much fear surrounding cloud. Somehow having the servers in my data center, on site where I can touch them and feel them makes me feel more safe. Reality or not, this fear has prevented most hospitals from even considering a cloud based EHR. I think they’re starting to get past it since every hospital now has something in the cloud, but that wasn’t true even 5 years ago in many organizations.

I’m sure there are other reasons you can offer in the comments. Of course, Scott Mace’s article linked above goes into a number of the benefits of a cloud EHR. However, that’s not yet a realistic option for hospitals. I’m sure one day it will be.

RNs are Choosing Where to Work Based on Hospital EHR

Posted on February 27, 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.

I came across this tweet and it made me stop and realize how important the selection and more important the implementation of your EHR will be for your organization. In many areas there’s already a nurse shortage, so it would become even more of an issue if your hospital comes to be known as the hospital with the cumbersome EHR.

Here’s some insight into the survey results from the article linked above:

79% of job seeking registered nurses reported that the reputation of the hospital’s EHR system is a top three consideration in their choice of where they will work. Nurses in the 22 largest metropolitan statistical areas are most satisfied with the usability of Cerner, McKesson, NextGen and Epic Systems. Those EHRs receiving the lowest satisfaction scores by nurses include Meditech, Allscripts, eClinicalWorks and HCare.

The article did also quote someone as saying that a well done EHR implementation can be a recruiting benefit. So, like most things it’s a double edge sword. A great EHR can be a benefit to you when recruiting nurses to your organization, but a poorly done, complex EHR could drive nurses away.

I’m pretty sure this side affect wasn’t discussed when evaluating how to implement the EHR and what kind of resources to commit to ensuring a successful and well done EHR implementation. They’re paying the price now.

Department of Defense (DOD) and Open Source EHR

Posted on February 25, 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.

I was intrigued by a report by the Center for New American Security that was covered in this article on HealthcareDive. In the report, they make a good case for why the Department of Defense (DOD) should select an open source EHR solution as opposed to a commercial solution. Here’s an excerpt from the article:

“I think the commercial systems are very good at what they do,” Ondra said. However, “they are not ideally designed for efficiency and enhancement of care delivery, and I think the DOD can do better with an open source system both in the near-term, and more importantly in the long-term, because of the type of innovation and creativity that can more quickly come into these systems.”

Reports like this make a pretty good case for open source. Plus, I love that it also pointed out that commercial EHR vendors were built on the back of the fee for service model which doesn’t matter to the DOD. It was also interesting to think about the DOD’s selection of an open source EHR system as an investment in other hospitals since the money they spend on an open source EHR could help to catalyze the ongoing development of a free open source EHR solution.

While these arguments make a lot of sense, it seems that the DOD has decided not to go with an open source EHR solution and instead is opting for a commercial alternative. In this article (Thanks Paul) the DOD has narrowed the list of contenders for the $11 Billion DOD EHR contract (DHMSM) to just: CSC/HP/Allscripts, Leidos/Accenture/Cerner, and IBM/Epic who “fall within the competitive range.” They reported that PwC/Google/GDIT/DSS/Medsphere and Intersystems did not fall within the competitive range.

I’ll be interested to hear Medsphere’s take on this since every report I’ve ever read has Medsphere and their open source Vista solution as much less expensive than the commercial alternatives (Epic, Cerner, Eclipsys). So, I can’t imagine that the Medsphere bid was so much more than the others. Unless the consultants are charging through the nose for it. Or maybe the open source Vista option wasn’t “in the competitive range” because it was too cheap. Wouldn’t that be hilarious to consider. Hopefully the government isn’t that stupid, but…

I don’t claim to have any clue on how these $11 billion government contract bids work. I’m just a casual observer from the sideline. It seems like 3 companies remain in the ring. I guess the Google juice wasn’t enough for the PwC/Medsphere bid.

Cerner Offers Voluntary Separation Packages

Posted on February 24, 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.

The Kansas City Star is reporting that Cerner is offering employers whose combination of years of service and age total 65 have been offered voluntary separation packages. Here’s an excerpt from the article:

Cerner spokesman Dan Smith said the one-time offer reflects the “deep bench of complementary talent” because of the Siemens acquisition and doesn’t affect Cerner’s continued hiring or its future growth plans.

“This is a truly voluntary program for all of our U.S. associates,” Smith said. “There is no pre-determined outcome and no number to hit. It provides eligible associates who might be ready to make a change the chance to decide to stay or pursue a different option and get benefits not normally associated with voluntary departures.”

With any large acquisition like the one Cerner did of Siemens, there has to be a lot of duplicate functions and they have to look at how to trim back the number of employees. So, this shouldn’t come as any surprise. In fact, I think the fact that they’re currently doing a voluntary separation package might mean that they aren’t looking to slim down the company as much as you’d think. Some investors might think that’s a bad plan since every company the size or Cerner or Siemens (let alone the combined company) could likely fire 10% of the workforce and improve their company’s profitability. Although, it could also be a sign of how much growth Cerner is experiencing.

Personally, I’ll be watching to see if they announce some other layoffs. It will be a surprise to me if they don’t announce some involuntary layoffs. Either way, this is a normal part of an acquisition like this.

It does make me wonder how many of these older professionals that accept the voluntary separation packages will end up at the wide variety of EHR consulting companies out there. You have to think that would be a pretty sweet deal for them.

Will Cerner Let Mayo Clinic Move to Epic Easily?

Posted on February 9, 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.

As most regular readers know, we don’t try to get into the rat race of breaking news on things like EHR selection, the latest meaningful use, or whatever else might be time sensitive healthcare news. Sure, every once in a while we’ll report something we haven’t seen or heard other places, but we’re more interested in the macro trends and the broader insight of what various announcements mean. We don’t want to report on something happening, but instead want to tell you why something that happened is important.

A great example of this is Mayo Clinic’s decision to go with Epic and leave behind Cerner, GE, and other systems. There’s a good interview with Mayo Clinic CEO, Cris Ross, that talks about Mayo’s decision to go with Epic. As he says in the interview, GE Centricity wasn’t part of their future plans, and so they were really deciding between Epic and Cerner. Sad to see that Vista wasn’t even part of their consideration (at least it seems).

Based on Cris Ross’ comments, he commented that he liked Epic’s revenue cycle management and patient engagement options better than Cerner. Although, my guess is that they liked Epic’s ambulatory better than Cerner as well since they were going away from GE Centricity. Cris Ross’s double speak is interesting though:

As we looked at what met our needs, across all of our practices, around revenue cycle and our interests around patient engagement and so on, although it was a difficult choice, in the end it was a pretty clear choice that Epic was a better fit.

Either it was a difficult choice or it was a pretty clear choice. I think what Cris Ross is really saying is that they’d already decided to go with Epic and so it was a clear choice for them, but I better at least throw a dog bone to Cerner and say it was a hard choice. Reminds me of the judges on the voice that have to choose between two of their artists. You know the producers told them to make it sound like it’s a hard choice even if it’s an easy one.

Turns out in Mayo’s case they probably need to act like it was a really hard choice and be kind to Cerner. Mayo has been a Cerner customer for a long time and the last thing they want to do is to anger Cerner. Cerner still holds a lot of Mayo’s data that Mayo will want to get out of the Cerner system as part of the move to Epic.

I’ll be interested to watch this transition. Will Cerner be nice and let Mayo and their EHR data go easily? Same for GE Centricity. I’ve heard of hundreds of EHR switches and many of them have a really challenging time getting their data from their previous EHR vendor. Some choose to make it expensive. Others choose to not cooperate at all. Given Mayo’s stature and the switch from Pepsi to Coke (Cerner to Epic, but I’m not sure which is Pepsi and which is Coke), I’ll be interested to see if Cerner lets them go without any issues.

I can’t recall many moves between Epic and Cerner and vice versa. Although, we can be sure that this is a preview of coming attractions. It will be interesting to see how each company handles these types of switches. What they do now will likely lay the groundwork for future EHR switching.