Home Forums Discussions General Discussion Food for thought - Integrated EHR

Interesting article on integrated EHRs.

Some of the points are very salient as AC tries to grow and integrate other functions beyond its original intent.

http://www.physicianspractice.com/p...rme=1&ts=04102011&printable=true

Great article. I would like to see AC stay a stand along and not try to integrate the PM. There are a lot of choices out there, albeit none of them perfect, there is a choice. If PM and AC is inevitable, I hope there will still remain a choice

Hi Donna and Vicki,

Interesting link. I agree completely with the premise that government regs will mess up anything and everything!

Beyond this, not sure if I agree completely. To continue the automotive example, do we want to buy a car, or buy an engine from vendor 1, a transmission from vendor 2, and so forth? And then have the engine not really work right with the transmission? I fear that even "perfect" component systems may not integrate properly.

So a totally functional integrated system that is adequate may be superior to superb components that do not integrate well.

Gene

I don't know. A transmission HAS to connect to the car to work. Some standalone products don't.

Sure, I would love to have an integrated product, but I found the Imported Items to be deficient, so we designed our own product that integrates only with AC's demographics.

Especially in the beginning, I found that AC's immunization process was severely lacking, so we designed VIPER, which even now, is much faster and accurate than AC's.

There is no label printing in AC, so we designed a program for making lab and address labels using a DYMO printer connected to the demographics of AC.

Just food for thought.

In 1996, I bought a brand-new Ram Air Trans Am. I tell you now, I loved that car. That car was a part of me. It was a totally integrated solution for a young male in his early to mid-twenties.

But there were about four things I hated about that car. Gas mileage, blind spots, T-tops that required constant maintenance to prevent leaking, etc.

During that time-frame, I also worked part time at a machine shop that made parts for hot-rod cars. Most of these cars were totally custom-built from the ground up. Chevy frame, Ford Motor, Jaguar transmission, you name it, they did it. However, the amount of work that went into putting these cars together was pretty serious.

Either work hard to have a custom solution that does EXACTLY what you want, or buy an integrated solution and live with the shortcomings.

How's that for choice.

JamesNT

I was most impressed by the fact you were in your early twenties in 1996

How about getting the integrated solution and arranging for someone like James to keep doing the maintenance (we could call it "fixing the bugs"), hopefully sooner rather than later. We could pay him an annual fee to keep the integrated solution working. Oh hey, that sounds like how AC is supposed to work!

This article made me think about the development course AC has taken. It would seem that AC could have focused its efforts on improving the existing EHR, fixing the requests of longtime users, rather than re-inventing the wheel with PM. Why not team up with an existing PM program to make a great partnership with AC rather than spreading AC resources too thin? A good example of a component system is UpDox which interfaces well with AC, and satisfies many AC users with its fax and document management solution (which was also missing from AC). And, Bert's software are also components that work well for his needs without being integrated.

Donna,

This was also suggested to Jon several years ago.

I wouldn't assume that Jon didn't consider things like partnerships and acquisitions before they were mentioned here. Actually, I'd assume he did consider them and investigated them, but couldn't find a partner whose software he liked and who 'saw eye-to-eye" with him. It acutally seems typical for the industry. Even OfficeAlly came out with its own EMR. Dont be surprized if EZClaims releases one. Though it does seem like Jon could have found someone to partner with temporarily until he had resources to develop his own PM/Billing Mgmt. There are alot of vendors out there with products targeted at managing athe "medical office revenue cycle."

It really comes down to what products/service Jon sees his company as providing, and obtaining financing and other resources to do it properly. Obviously it was intially that he supplied an (inexpensive, etc.)EMR and that was it. If he defines AC as supplying "software to help run small medical practices" you have a broader, though admittedly more clumsy, definition. Once you change that definition, you can think about what is needed to provide that broader product/service in a different light. I wonder how Jon is defining AC. If it is as an EMR vendor, but "we'll try to do this PM thing since people want it" then Bert's fears may be realized.

A few years ago I was actually expecting AC to announce the acquisition of a small billing company. It just seemed to me the natural thing to do.

Oops. This is not what I meant. I meant that I expected them to acquire a small billing software company. Similar to EZClaims, only smaller. Or maybe not smaller. But I didn't mean that they'd actually acquire MTBC or something similar.

Wayne,


Two things on that:

1. You may actually be recommending AC create a partnership with a another company and then betray them. Furthermore, after the "betrayal" AC would still have all those clients out there who had signed up with the third party PM partner. AC would still have to support all of them, and the transfers between Amazing Charts and the third party PM. Most of them would not be interested in moving to yet another PM as that would incur training costs and so forth.

2. I'm not sure I would want to do business with such a company.


When most companies buy a PM or EMR rival or make such an aquisition, they are not looking to get the software, they are looking to get the customer list. The customer list of a PM company may not be in AC's best interests. There would be three types of clients AC would have to support:

1. Clients who have the PM but not the EMR (most of these would be inherited). This would also include clients who may be billing centers, not doctor offices.

2. Clients who have both the PM and the EMR. This would be the ideal situation, but the smallest one upfront. This client list would have to grow.

3. Clients who have only the EMR and may not be interested in the PM.

Clients 1 and 3 would be the most common scenarios for a long time, possibly forever. With the approach AC is taking, they have only clients 2 and 3 to worry about. And client 2 would be a lot easier to grow with an integrated PM.

JamesNT

Donna,

The reason AC may have actually decided AGAINST teaming up with a PM is because most of them suck so much. They are also expensive. It would be difficult to maintain such a relationshiop long term. Here is a list of possible problems:

1. Clients want to know why the EMR is only $2k per provider but the PM is around $5k.

2. Coordination between the PM tech-support and AC tech-support.

3. The "blame game." Something goes wrong and the PM tech-support guy blames AC, but the AC tech-support guy blames the PM. Do not write this one off. I have seen partnerships between companies in different industries, and this problem is VERY real.

4. People who buy the PM because AC recommends it only to not like it so they blame AC.

5. The PM vendor being upset sometimes because people buy AC but not the PM.

This list could easily go on. Food for thought.

JamesNT

James, growth by acquisition is a time-honored strategy. There are risks involved. You didn't outline any new ones, but the ones you did outline are valid. There is also risk involved in deciding to fully develop the product with your current (or slightly expanded) resources. And obviously you can hire some people with experince in the new area. I've seen acquisitions to get the customer base, and also to get the technology and/or product base. Since AC had not yet started on this product, it would make sense to consider acquiring one if they found one they thought was appropriate. And they would get the customer base too. Nothing wrong with them later developing an new product to replace it if they wish and porting the customers to it. Same with working closely with a billing s/w vendor. Just because they later develop their own product doesnt mean they have to sever ties. It just gives the customers a choice. And if the other company's management had half a brain, they would be planning for this eventuality anyway.

EZ is expected to roll something out in January 2012