Wednesday, October 10, 2012

MediNotes to PeakPractice to MyWay to…..?



My sympathies go out to the doctors and their staffs having to endure the Allscripts MyWay sunset.  Many of you started with MediNotes and were moved to PeakPractice then MyWay when both MediNotes and PeakPractice were sunsetted.  I know your pain, I rode that train with you as your implementation consultant and project manager.  You’ve patiently endured through the 2008 sale of Bond Technologies, 2008 sale of Medinotes, 2010 sale of Eclipsys and now apparent imminent sale of Allscripts.  We’ve patiently sat by while each newly constituted company merged cultures, systems, and software platforms.  You’ve waited for them to announce their “go-forward” strategy and software.  You have put vacations on hold, quelled staff revolts, and suffered lost productivity as you have implemented your “free technology uplift” when your existing EMR was sunsetted.

So what next?  If you’re a 1-10 provider medical practice, do you stay with Allscripts or move to another vendor?

Well, that’s a difficult question, and one I don’t think can be answered yet because there are so many other unanswered questions. 

Can a privately-owned Allscripts profitably make and support a competitively priced small-practice EMR and practice management software, when they have shown they can’t do this in the past?  Or do they even want to at this point?  Or do they want to focus on the acute care and large ambulatory care market segments, but feel forced to offer their existing mid-size practice software (Allscripts Professional) to their existing small-practice customers?  What will the future pricing of Allscripts Pro look like for small practices?  Can Allscripts overcome their reputation as being more sales-focused than  development and client support focused? 

That’s lots of questions, and I don’t see any answers yet. 

From where I sit, here’s what I see.  I see an EMR/PM market which had not produced a user interface which has created a devoted following.  No MS Excel, no Word versus WordPerfect debates, no Mac versus PC enthusiasm.  I see regulatory bodies shaping functionality for the EMR/PM platforms.  I see lots of little players in a growing market, but also a market which will see slimmer margins.  I see continued mergers and acquisitions of EMR/PM vendors.  I see more hospitals and health systems subsidizing EMR/PM software for independent medical practices in the hopes of getting their ancillary business such as lab work and radiology.  I see health systems consolidating medical care in their communities.  I see health information exchanges sharing patient information to an increasingly national grid of information networks.  I see the actual EMR/PM software platform becoming less important than the pipes of information that feed it, and those pipes of information will increasingly structure the user interface.

I anticipate medical practices will very likely see their existing EMR/PM vendors be purchased in the coming few years.  And the purchase won’t be for their software, but for their installed customers.  And those customers will also have to endure a “free technology uplift”.

So, I can’t say I have an answer for you at this point.  I think much of it depends on where you’re located and what’s going on in your medical community.  I’m sure most of you have already been approached by other EMR/PM vendors.  If it were me, I’d listen to their pitch, but also remember that any EMR/PM vendor is prone to the same pressures and questions as Medinotes-Eclipsys-Allscripts.

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