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4. 2018 low end vendors 4-6


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4. 2018 low end vendors 4-6

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4. 2018 low end vendors 4-6

  1. 1. 2018 HIS Vendor Review Part 4: “Small” HIS Vendors © 2018 by H.I.S. Professionals, LLC, all rights reserved. By Vince Ciotti & Elise Ames HIS Professionals, LLC CPSI HarrisHealth Medhost Cantata
  2. 2. “Small” HIS Vendors • Our HIS vendor review ends with four whose 2017 annual revenue is “only” $300M or less. – The last 3 are privately held or small divisions of much larger parent companies, so we had to estimate their revenue based on past years’ figures. – Most are a “family” of discrete sub- systems as illustrated on the right: • This episode covers their: - Revenue HI$tory over the years - Products & client base by bed size - Recent mergers & acquisitions - A new spin-off from NTT Data (Dell) - Candid assessment of future prospects
  3. 3. Top 10 Compara-chart • To put these last four vendors in perspective, note the huge disparity in $ size (& market share) from HIS market leaders:
  4. 4. • Computer Programs & Systems, Inc (CPSI) – re-branded as Evident in 2016, now back as CPSI, evidently proving something… • Their revenue had dropped 11% in 2015 as part of the post-MU droop, but their acquisition of Healthland proved to be a boon: • CPSI’s revenue increased by 40% in 2016 and 4% last year, reflecting continued strong sales among ≈300 remaining Healthland clients. #7:
  5. 5. The CPSI “Family” • Like most HIS vendors, CPSI branched out into many specialty markets to increase their annual revenue far beyond the core HIS comprised of an EHR, Ancillaries, RCM, & an integrated ERP (only Meditech & HMS also wrote their own ERP!). • CPSI’s family of products/divisions/brands now includes: • First acquired by Healthland in 2013, this major LTC player has brought CPSI into over 2,000 facilities in 47 states. • Known as the “CPSI System” for decades, the new name for their HIS is now “Thrive,” running in over 600 clients. • Leading HIS vendor in the CAH market, acquired for its 400+ client hospitals running on Classic, Centriq, APS and AHN. • Acquired by Healthland in 2015, this Revenue Cycle Management specialist runs BOs for hospitals & SNFs. • CPSI’s “consulting” division, TruBridge offers RCM management services as well as complete IT outsourcing. CPSI Rural ACO Program • CPSI’s partnership with Caravan Health that claim to be running 23 ACOs in 32 states with over 17K physicians.
  6. 6. Below is the rough # of clients on CPSI’s “Thrive” (formerly “The CPSI System”) and Healthland’s Classic, Centriq, APS & AHN systems: Client Base We’re sure the # of clients will continue to shift shift from red to blue!
  7. 7. • Rather than a complex array of products targeted for various sizes of hospitals, CPSI’s HIS sales strategy is relatively simple: CPSI’s HIS Products & Prospects - Sell “Thrive,” period. - And primarily to small hospitals (although they will rarely turn down a large hospital’s RFP…) • According to CPSI’s press release after the acquisition, support the older Healthland “Classic” system has ended, whereas the newer “Centriq” system will be supported for ≈4 more years. • So we’re pretty bullish on CPSI remaining on top of the small hospital market for some time, as their sharp sales team has direct access to the C-suite of hundreds of Healthland clients. • By contrast, Cerner targets Millennium to large & Community Works to small, Epic has All Terrain, Utility & Sonnet for the 3 market sizes, Allscripts’ Sunrise = large & Paragon = small, etc.
  8. 8. • #8 this year is Harris Healthcare, the new name that the N. Harris division of Canadian giant Constellation Software has given their HIT division comprised of many acquired vendors/products. • Constellation/Harris follows an interesting business model of leaving the companies that they acquire as separate financial entities, rather than burying them in the parent firms’ dollars… • Their core HIS product has long roots going back 50 years: - Started as Compucare in 1969 by Sheldon Dorenfest, building an HIS through FM… - Bought by Baxter then sold back, Compucare self-developed the “Affinity” HIS in the 90s. - Then bought by QuadraMed, a major HIM coding firm (Quantim), who later added: - The “CPR” EHR from Misys/Per Se, originally named “UltiCare” by Health Data Sciences. #8: Harris Healthcare
  9. 9. - A leading ERP player, Ormed tried to crossover into the HIS field by acquiring CSS HealthTech in 2014. - Picis is a major player in the Perioperative market (OR, Anesthesia, Recovery Room, etc.). - Their PulseCheck is a leading EDIS product, and they also market a strong ICU/CCU system, as well as medical device dashboards. - An OB/GYN physician practice EMR specialist. Other Harris Healthcare Acquisitions - CSS’ EMR failed to achieve MU2, so Ormed sold to Harris in 2016. - Their full suite of robust & affordable ERP apps (GL, AP, PR, HR, Mat. Man., Cost Acc., EIS, DSS, etc.) runs in over 350 hospitals. - “MetaVision” EMR for hospital ICU & anesthesia.
  10. 10. • QuadraMed’s revenue figures were public for over 20 years, so here’s a chart of how they grew handsomely during the ‘90s when hospitals were buying like crazy for Y2K, then dipped when they sold their huge Quantim HIM coding to Nuance in 2012. • Parent Constellation has revenues in the billions, but we have to estimate Harris’s HIT revenue, which probably increased in 2017 due to the acquisitions of Ormed, Picis, digiChart, iMDsoft, etc. • Plus acquiring NextGen’s Opus/Sphere gave them prospects for Affinity RCM, QCPR EHR, etc. Harris/QuadraMed HI$-tory Y2K Quantim Sale Recent M&As
  11. 11. Harris Healthcare Prognosis • Their business model of having each acquired firm run as an independent company is wise for short-term success: execs will manage each business to hit good numbers every year. • However, the acquisitions of so many products all written in different programming languages, data bases & OS, will be a tougher sale to CIOs who generally prefer integrated solutions with a minimum of time & money-consuming interfaces. Sort of like one-stop shopping but multiple check-out carts… • Short term, they should do well selling to the NextGen HIS clients and specialty niches like Picis’ OR and EDIS. In the long term, it will be challenging for them to compete with more integrated vendors like Meditech & CPSI…
  12. 12. • #9 this year is MedHost, originally founded way back in 1984 as Health Management Systems. HMS was later acquired by VC firm Primus in 2007, who formed HealthTech Holdings as the parent company, and then merged them with MedHost in 2010. - HMS grew rapidly by selling to small and mid-sized hospitals, and specialized in serving hospital chains also based near Nashville, like Community Health Systems, with about 200 hospitals in 29 states. • Their forte for these chains was an ERP designed to pool cash payments from many hospitals into one central account, while centralizing AP, purchasing & materials as well – slick stuff! - MedHost was a long-term leader in the EDIS field, and with a slick interface to HMS, they can now handle the many hospital admissions from ERs very well. #9:
  13. 13. • Being privately held, we’ve had to estimate their revenue during these many years of acquisitions and mergers; the shrinking size of some chains like CHS reduced past years revenue, but strong HIS & EDIS sales last year brought them back up to ≈$175M: • Medhost now offers a hosting, and claim 13 2017 sales: Allegiance, Curae Health, Everest Rehab, Springhill… Medhost/HMS HI$-tory HMS Medhost
  14. 14. • Medhost has a client base of over a thousand US clients as well as ≈20 international (Caribbean), among four main product lines: – HIS = the HMS full suite of apps: EHR, RCM, Access, HIM, ERP and ancillaries that used to be known as Monitor in ≈600 sites – EDIS = Medhost’s very functional ER system in ≈400 sites – Long Term Care & Behavioral Health = ≈500 non-acute sites Medhost Client Base
  15. 15. • Starting as Keane decades ago, bought by Caritor, then NTT Data, who spun off the HIS division as Cantata with the proven HIS known as “Optimum,” with the full array of systems: - Full clinical suite: EHR, CPOE, LIS, RIS, RX, etc. - Robust revenue cycle (formerly PatCom), with a long track record going back to PHS in the 80s. - Solid ERP suite from ORMED, who sold them rights to their system which is now owned by Harris… • NTT Data acquired consulting giant Dell for $3B last year, so had to spin off this HIS division to keep their consulting objective. Cantata is a lot smaller but now focused primarily on HIS with: - ≈245 FTEs, including many veterans… - ≈200 clients on the Optimum HIS... - ≈1,700 non-acute clients on NetSolutions #10:
  16. 16. • Bit of a revenue roller coaster ride since Keane sold to Caritor in 2007, who then sold to NTT Data in 2010. Like so many vendors, NTT offered many services beyond pure IT, so Cantata’s 2017 HIS revenue is starting out much lower than last year’s estimate: Cantata Revenue HIS-tory (Y2K) Caritor NTT Data Keane C a n t a t a
  17. 17. • Here’s the final table of HIS vendors product by hospital bed size: Products by Bed Size
  18. 18. Recap • This episode ends our review of the Top 10 HIS vendors for 2018, based on their FY2017 annual revenue. Biggest news this year: – MIA: • McKesson joins Siemens as former #1 vendors with decades of HIStory and billions in revenue, now gone. – Re-packaging: • Epic now has 3 varieties: All Terrain, Utility and Sonata. – New Names: • NTT Data bought Dell and spun off Cantata • Thanks to HIStalk for taking so much of their valuable blog space with our annual ramblings. In case you have any questions, comments, or you’re as confused as we are about any of this: - 505.466.4958 413.329.6925