Untitled Document

March 10, 2008

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1. Cerner's Legacy: Taking Yet Another Epic Beating

Facts and Background

Legacy Health System (OR) announced Friday, February 29 that it would scrap plans to use Cerner applications in its five hospitals, switching instead to those from Epic Systems.

Opinion

Legacy signed with Cerner in 2003, so progress must have been unimpressive to dump them for Epic after just five years and the creation of a much-ballyhooed digital hospital (Legacy Salmon Creek Hospital). Is there anything left for Epic to rub Cerner's nose in?

Musings

New Legacy CIO Dick Gibson was behind the switch. He'd better be right for leading an about-face of that magnitude, otherwise, this first CIO job for him may be his last.
Legacy said Epic would cost just $10 million over several years. Unless Epic gave it away just to annoy Neal Patterson, which isn't like Judy Faulkner, that is highly unlikely.
Are the wheels coming off Cerner? The stock's at a 52-week low, analysts aren't optimistic, CEO Neal Patterson missed both HIMSS and the company's last earnings call, and Epic is beating it like a drum in big-ticket hospital sales.
Cerner has a lot of non-clinical systems irons in the fire (international sales, medication dispensing cabinets, and genomic applications) but those aren't ready to pump earnings. This might be another opportunity for Neal to utter those famous e-mailed words: "tick, tock" since he'd better make something happen quickly to keep investors from losing patience (see: Allscripts).
Just two years ago, Legacy's people were touting Cerner at the Cerner Health Conference. Now that they're kicking Cerner out, it might be a good reminder that what users say at conferences doesn't always reflect high-level reality.

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2. Is That Your iPhone In Your Pocket Or Are You Just Glad To See Me, Doctor?

Facts and Background

Apple announced Thursday that a June update for its iPhone will allow connection with Microsoft Exchange. Also announced were a new software development kit for third party developers and the formation of a $100 million venture capital fund for startup developers of iPhone applications.

Opinion

We had Microsoft vs. Google, now add Apple vs. RIM to the mix as they get ready to duke it out for mobile enterprise superiority, which will no doubt include physicians and other healthcare workers.

Musings

Medical content provider Epocrates was one of five companies Steve Jobs highlighted at the announcement, the others being pretty good company to keep (Salesforce.com, AOL, EA, and Sega).
The $100 million fund will encourage many startups, although healthcare wasn't specifically targeted in the discussion of desirable markets.
IT folks are never big fans of stubbornly cultish Apple users or anyone using mobile devices and expecting application or data access, but they might as well put a placeholder in next year's budget. It's too late to stop it now.
Expect every vendor to be demonstrating their wares on iPhones at HIMSS09, even when such usage is clearly gratuitous.

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3. Midland Memorial Hits EMR Nirvana With a Small-Boothed Vendor

Facts and Background

Medsphere Systems Corporation announced Tuesday that its OpenVista customer, Midland Memorial Hospital of Midland, TX, had been certified as one of 11 Stage 6 EMR hospitals by HIMSS Analytics, the highest level recognized so far.

Opinion

Midland Memorial beats all the hoity-toity hospitals spending dozens of millions by using an open source system that's claimed to cost 80% less than everybody else spends (probably at least 95% less than Epic's customers), much like the notable accomplishments of VistA's developers, the VA.

Musings

Are hospital CEOs and CIOs so convinced that Cerner, Epic, McKesson, and Eclipsys will deliver improved patient outcomes that they'll pay 5x the price?
Midland beat 99.99% of hospitals and doesn't even have a CIO.
If it weren't for slick salesmanship, CIO prestige, and visions of "partnerships" that never develop, who could outsell a competing product that costs 80% less?
Citizens Memorial Hospital, a MEDITECH shop, is also among the Elite 11.
It is absolutely, positively not what electronic toys you have, but how you use them when it comes to improving patient care. Luckily for the high-priced vendors, the HIT market is frequently irrational when making purchasing decisions.

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