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McKesson and Infor Go-To-Market Partnership – What Happens Now?

Posted on January 9, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

A couple weeks ago, McKesson and Infor announced a partnership that will have McKesson EIS (Enterprise Information Solutions) offering Infor Cloudsuite as their cloud-based ERP (Enterprise Resource Planning) solution for human resources, supply chain, and financials. What does each party have to gain from this partnership and what does this mean for existing customers of McKesson ERP solutions?

Infor continues to be the dominant player in the ERP space for healthcare providers. Its healthcare applications, previously known as Lawson (and probably always known as Lawson to many of us), have the largest market share with the majority of larger hospitals and healthcare systems. Its closest competitor in the past, Peoplesoft, is now owned by Oracle which is focused on developing and promoting its Fusion product and has released the final version of the Peoplesoft product. Workday, the cloud-only solution that is publicly traded and making significant strives in many industries, has won deals in human resources and financials implementations but lacks a supply chain solution, critical to any integrated ERP deployment. SAP, the largest ERP provider in the world, has a strong presence in healthcare manufacturers but does not provide a supply chain solution well suited for the unique needs of healthcare providers, and therefore has a very small market share.

McKesson, once a strong player in this space, has faded over the years in ERP as they have with EHR solutions. The majority of the McKesson ERP customer base, using the products commonly referred to as Pathways, have been long-time legacy customers. Pathways has not been kept up with modern ERP needs, and it has been many years since I have seen a hospital consider Pathways as a potential solution, but rather it is typically the solution being replaced.

Infor has invested significantly in creating a cloud-based solution, referred to as CloudSuite. However, the existing healthcare customer base typically has an on-premise installation and therefore cloud adoption has been focused on new customers as well as those that are specifically looking to transition away from on-premise. McKesson has not had a cloud offering, therefore it would make sense for them to partner with someone to offer it as an alternative to Pathways.

Infor will gain access to the Mckesson customer base, many of whom are likely considering leaving Pathways for other solutions anyway. In addition, Infor will be able to provide Mckesson’s Strategic Sourcing solution for their customers.

However, it is unclear what that means for Pathways. While McKesson press releases state that CloudSuite is an alternative to Pathways, one has to wonder why Infor would want to expose their solution to someone who is actively selling a competitive solution, and why McKesson would continue to invest in Pathways when it has access to a much more mature and robust solution as a go-forward path for its Pathways customers.

Therefore while it is likely that McKesson will keep Pathways supported and up-to-date with regulatory improvements for the time being, it seems very unlikely that they would continue to enhance it – and inevitable that it will eventually be sunset in favor of transitioning those customers to Infor Cloudsuite. If history is indeed an appropriate predictor of the future, consider that McKesson announced its BetterHealth 2020 plan – in which they announced a focus on Paragon as their EHR but continued support of the older Horizon EHR product. Shortly after that they went back on that commitment and announced they would sunset Horizon in 2018.

Meaningful Use has led to a focus of resources on Electronic Health Records implementations which have led many customers to hold onto their older ERP solutions past their useful life. I suspect that the next two years will see a re-focus to ERP solutions with customers with more modern solutions focusing on upgrades and new feature deployment while customers with older solutions making a change.

Those customers who stayed on Horizon for too long are currently in a rush to implement replacements before the March 2018 sunset date.Customers on Pathways products should likely start the conversation now about their long-term ERP plans and consider if they want to get ahead of any sunset announcement.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Operationalizing Health IT Discoveries

Posted on June 24, 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.

I’ve been talking a lot lately with people about how we take the health IT discoveries made at one hospital and apply them to another hospital. In a recent conversation I had with Jonathan Sheldon from Oracle, he highlighted that “Many organizations don’t care about research, but just want a product that works.”

I agree completely with this comment from Jonathan. While there are some very large healthcare organizations that do a lot of research, there are even more healthcare organizations that just want to see patients in the best way possible. They just want to implement the research that other organizations have done. They just want something that works.

The problem for big companies like Oracle, SAP, Tableau, etc is that they have the technology to scale up many of these health IT discoveries, but they aren’t doing the discovery themselves. In fact, most of them never will dive into the discovery of which healthcare data really matters.

In order to solve this, I’ve seen all of these organizations working on some sort of partnership between IT companies and healthcare research organizations. The IT company provides the technology and the commercialization of the product and the healthcare research organization provides the research knowledge on the most effective techniques.

While this all sounds very simple and logical, it’s actually much harder in practice. Taking your customer and turning them into a partner is much harder than it looks. Most healthcare organizations know how to be customers. It takes a unique healthcare organization to be an effective partner. However, this is exactly what we have to do if we want to operationalize the health IT discoveries these research organizations make.

We’re going to have to make this a reality. There’s no way that one organization can discover everything they need to discover. Healthcare is too complex as it is today. Plus, we’re just getting started with things like genomic medicine and health sensors which is going to make healthcare at least an order of magnitude more complex.

On Premise versus Cloud Analytics

Posted on December 7, 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.

We’ve long been hearing those people talk about the cloud. Most famously, Jonathan Bush has been beating the drum of the power of the cloud and how the cloud EHR vendors are going to take down their dinosaur client server counterparts. In the hospital world that has yet to happen for EHR software, but the cloud has still become a major part of every healthcare IT organization.

When we look at our personal lives, we all have data stored in the cloud. The cloud is a major part of most of our lives. I know I try to store nothing locally and run pretty much my entire business and personal life in the cloud. I had to recently replace my cell phone. Turns out that the change didn’t matter at all since everything I did was in the cloud. I literally didn’t even know the number of my cell phone. I just got the new phone, logged into the cloud and everything started to sync up (I did have to log in to a bunch of apps). It was beautiful.

In the latest movements towards the cloud, I’ve seen a lot of people talking about healthcare analytics heading to the cloud. It begs the question, “Will the cloud win out in the healthcare analytics space?

I think the biggest naysayers to cloud analytics are those who say that they aren’t planning to move all their data to the cloud and they’re not comfortable with all their EHR data in the cloud so they don’t see how cloud analytics will work for them. (Side Note: I always love how we claim privacy and security when we don’t want to do something, but we don’t actually do something to ensure the privacy and security of our data.)

No doubt opinions like this will slow the adoption of cloud analytics. Most vendors I know are going to offer either option for the forseeable future. However, there are some new technologies which leave your data in place, but can leverage the cloud to access the data as needed. I first saw this with SAP, but there are probably others that are doing it too. I think technologies like this will change many people’s view of using the cloud to handle their analytics.

On a much larger scale, I don’t think health care will have a choice but to use the cloud. I don’t see every health care organization building their own private cloud in order to do all of the genomic medicine which is starting to come. I don’t see every health care organization getting the benchmarking and “grand rounds” style of data that analytics providers can provide across disparate organizations. I don’t see most organizations being able to afford to build their own analytics engine on site.

I could keep going on, but the way health care analytics is going I’m not sure that hospitals will have any choice but to embrace cloud analytics. I know this leaves many hospital CIOs uncomfortable. However, burying your head in the sand and acting like it’s not going to happen won’t make you more comfortable. Denial isn’t a good strategy. The best way to be comfortable with it and ensure that healthcare analytics clouds are safe, private and secure is for hospital organizations to make a real investment of time into what’s going on.

What do you think? Is the future of analytics at hospitals going to be in the cloud?

Do Your Board Meetings Use PowerPoint or Real-time Analytics Dashboards?

Posted on October 23, 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.

This week I had a chance to attend the SAP TechEd event in Las Vegas. I met with a number of healthcare people at the event and so I’ll be covering the SAP Hana platform and their new Cloud Analytics offerings in future posts. Turns out that SAP has a pretty compelling story for those of us in healthcare. More on that later.

During the SAP TechEd keynote, they did a demo of an SAP board meeting and during the board meeting they didn’t use any powerpoint charts, but instead dove directly into the SAP business dashboards. Such a simple concept, but a really good one.

How often have you been in a meeting and the data their showing is out dated? I know it’s happened to me. It’s a problem for me as a blogger as well. Whenever I build something for my potential advertisers, the document is immediately in need of updating. I’ve actually started exploring a real time view into the analytics to solve that problem for my advertisers. That’s essentially what a real time dashboard is like for a healthcare organization.

Certainly there are times when you might want to consider specific point in time images, but most of the time it’s much more powerful to have the real time data of what’s happening in your organization.

The other reason a BI dashboard is so much better than a static image on a powerpoint is that if and when you have questions about the data you can literally drill down into the data and get the answers to your questions. I can’t remember how many times I’ve been in a meeting where someone has asked a question about a chart and the response is “I’ll have to look into it.” Real-time analytics dashboards mean that you can look into it right then, get the answer and move the agenda forward.

How do you handle this in your organization? Do you pull up the real time stats at your board meetings and other management meetings? Or do you still go through a bunch of powerpoint slides with charts and graphs of what people want to show you?

The Place of EHR in the Hospital IT Ecosystem

Posted on August 20, 2014 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’ve been thinking a lot about EHR software and the part it plays in the hospital IT ecosystem. The $36 billion of EHR stimulus money has shined a big light on EHR software. No doubt the EHR incentive money has increased EHR adoption, but at what cost. I wonder if the EHR incentive money has caused many hospital IT teams to place undue emphasis on the EHR software.

The reality of a hospital IT ecosystem is that they usually have hundreds of healthcare IT systems in their organization. The EHR is just one of those systems. In fact, it might not even be the largest system. Their ERP system (usually Peoplesoft or SAP in large hospitals) could be larger. However, try being system #90 at a hospital. Do you think the IT people at a large hospital system are paying much attention to what’s happening to that system? Not only are they distracted chasing the EHR incentive money, but even without that incentive there are 89 other systems in front of it.

I’m reminded of this Healthcare CIO Mindmap that I posted previously. It’s a great image of the amazing complexity that a healthcare CIO is facing. Each of the branches on that mindmap represent one or more IT systems that have to be managed by an organization. That’s a complex and challenging task.

I guess my message here is that while the EHR is extremely important to an organization, don’t lose track of all the other healthcare IT systems you support. They won’t likely be noticed in the short term, but transgressing these smaller health IT systems will create organizational debt that will be hard to overcome in the future.

Business Intelligence And The Smart EMR

Posted on July 26, 2013 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 new study by KLAS suggests that while providers are giving thought to business intelligence needs, they still haven’t honed in on favored vendors that they see as holding a leading position in healthcare. That may be, I’d suggest, because the industry is still waiting on EMRs that can offer the BI functionality they really need.

To look at the issue of BI in healthcare, KLAS interviewed execs at more than 70 hospitals and delivery systems with 200 or more beds.

When asked which BI vendors will stand out in the healthcare industry, 41 percent of respondents replied that they weren’t sure, according to a story in Health Data Management.

Of the other 59 percent who chose a vendor, IBM, SAP, Microsoft and Oracle came up as leaders in enterprise BI applications — but none of the above got more than 12 percent of the vote, HDM notes.

Vendors that did get a nod as standing out in healthcare-specific BI included Explorys, Health Catalyst, McKesson and Humedica (Optum). IBM and Microsoft were also singled out for healthcare use, but respondents noted that their products came with high price tags.

Meanwhile, QlikTech and Tableau Software were noted for their usability and data visualization tools though lacking in full BI toolsets, according to HDM.

While these stats are somewhat interesting on their own, they sidestep a very important issue:  when will EMRs evolve from transaction-based to intelligence-based systems?  After all, an intelligence-based EMR can do more to improve healthcare in context than freestanding BI systems.

As my colleague John Lynn notes, EMRs will ultimately need to leverage big data and support smart processes, becoming what he likes to call the “Smart EMR.”  These systems will integrate business intelligence natively rather than requiring a whole separate infrastructure to gather insights from the tsunami of patient data being generated today.

The reality, unfortunately, is that we’re a fairly long way away from having such Smart EMRs in place. Readers, how long to you think it will take before such a next-gen EMR hits the market?  And who do you think will be the first to market with such a system?

The Same Fate of ERP Software Will Happen with Hospital EHR Software

Posted on March 12, 2012 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’ve often thought of the challenge associated with selling an EHR or other related enterprise software to a large hospital. As I think about this purchase process it’s made me wonder why any hospital would change out that software. I’ve often said that Epic’s approximately $1 billion contract with Kaiser (along with a number of other similar contracts) is one reason that Epic is going to be in the healthcare IT business for a long time to come.

In fact, these contracts and the process of change in hospitals has often led me to feel like change in the hospitals is almost impossible.

The amazing thing is that the same arguments could be made for ERP software in large companies. I know some people don’t like the comparison, but I think there are a lot of really interesting similarities.

In fact, I was reading through this somewhat older article which talks with Aneel Bhusri and Dave Duffield who founded PeopleSoft which was taken in a hostile takeover by Oracle and Larry Ellison. Turns out that Aneel and Dave decided to start another company a few months after the takeover of PeopleSoft. As he describes it, “we had a lot of fun so should we start another one?”

Aneel offers this insight that they found with their new Workday software as it tries and competes with the larger Oracle and SAP ERP software systems:

The big vendors are vulnerable because they require big expensive upgrades. Workday doesn’t go into startups — it’s selling to big companies that have HR and financial software in place. But companies have to update this software periodically, and the traditional vendors like Oracle and SAP make it hard and expensive to upgrade. That’s when startups like Workday jump in.

Can you see the Hospital EHR fate the same as what’s mentioned above?

Sure, the other big hospital EHR vendors will continue doing business much like Oracle and SAP are doing in the ERP world. However, there is a great opportunity for the people that have the right connections and knowledge of the hospital world to do a startup hospital EHR company that steps in and gains some market share.

I will admit that it’s going to take a gutsy hospital CIO to make this happen, but you can be sure that it will happen. Many of these hospital CIO will be rewarded handsomely for the choice as well.

A Taste of This Week’s mHealth Summit Event

Posted on December 5, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

This week, we’ll be at the mHealth Summit in DC, which should offer quite a deep dive into the emerging and critically important world of mobile health technology.  I suspect we’ll all learn something new at the event, whose keynote speakers include HHS Secretary Kathleen Sebelius, Verizon Wireless COO John Stratton and FCC Chairman Julius Genachowski.

Once in a while,  you get to attend an event which is happening at just the right time and drawing just the right people.  As I see it, this is just such a moment. Not only are EMRs and other health IT migrating to mobile devices in increasing numbers, mobile apps are working their way into mainstream use, and we’ve even seen a few mHealth apps approved for use by the FDA.

As an editor covering the show, I’ve got a lovely ringside view of the event, and I’ve been getting fascinating e-mail from vendors for weeks. A few items that caught my eye include the following:

*  Vendor BoxTone is pitching its Enterprise Mobility Management platform, designed to help IT departments provision, manage and support mobile devices and apps. I suspect hospitals aren’t paying enough to corporate level management of mobile devices yet, and if so, now is certainly the time.

* Dr. Peter Tippett, CMIO with Verizon Connected Healthcare Solutions, is co-presenting on mobility innovation in healthcare. And Verizon press  are promising to provide new healthcare mobility use cases for disease management and outline best practices for integrating identity and access management techniques into mobility strategies. I hope to hear first hand what Dr. Tippett and his colleagues have to say.

*The Continua Health Alliance is offering some interesting lectures, including one on the future of wearable mHealth apps, devices and sensors. I’ve always been surprised that these technologies aren’t more widely deployed already, but maybe I’ll learn on Tuesday at the lecture.  I’m also interested to hear what Continua folks have to say about standards in mHealth are shaking out — seems like a conversation worth having, no?

* SAP will be talking about its recently-launched mobile EMR app and its mHealth strategy generally. I’m eager to see how SAP’s existing strategy plays in this arena, which calls for fleetness of foot rather than having armies of developers at your command. Can a giant like SAP compete with nimble little mHealth app shops?  Trust me, I’ll ask.

So, folks, no mere blog item could cover the explosion of mHealth activity gearing up in DC this week, so I’ll leave you with these tidbits. I think this is going to be an exciting show.