In the age of core system replacements, there are a lot of tough decisions that have to be made. Quirk Healthcare lends its expertise of this difficult topic in this weeks Insight.

1. Core
System
Replacements
Wednesday,
August
13,
2014
Disclaimer:
Nothing
that
we
are
sharing
is
intended
as
legally
binding
or
prescrip7ve
advice.
This
presenta7on
is
a
synthesis
of
publically
available
informa7on
and
best
prac7ces.

2. Jonathan
Evere,
I
have
been
around
the
Healthcare
IT
arena
for
over
12
years
Vice
President
of
Business
Development
for
Quirk
Healthcare
Reside
in
Portland,
OR
Quick
IntroducFon

3. Industry
DefiniFon
–
The
act
of
systemaFcally
meeFng
business
goals
through
ensuring
you
have
the
right
technology
in
place,
even
when
meaning
to
replace
exisFng
technology.
My
DefiniFon
–
The
act
of
violently
ripping
out
your
enFre
way
of
life
with
your
pracFce
to
hopefully
make
it
be,er.
FINGERS
CROSSED
☺
Core
System
Replacements

4. This
IS
the
quesFon
(for
the
C-­‐Suite)
To
Change
or
Not
to
Change

5. • AcquisiFons
and
Mergers
• Physician
SaFsfacFon
• Meaningful
Use
Compliance
• Cost
Why
Should
We
Even
Discuss
This?

6. • They
make
business
sense!
– Control
all
facets
of
care
delivery
• Care
delivery
and
business
objecFves
are
changing
– Hospitals
buy
physician
groups
– Hospitals
join
hospital
systems
– Hospital
systems
buy
more
ambulatory
pracFces
– Payers
buy
hospital
systems
– Everyone
is
trying
to
create
a
new
Kaiser
– Look
at
UnitedHealth’s
profits
over
the
past
5
years
AcquisiFons
and
Mergers

7. • But
who
acquired
who?
– Su,er
Health
bought
Mills
Peninsula
– Optum
(United
Health)
bought
Monarch
– Tenet
has
just
acquired
its
80th
hospital
– Cleveland
Clinic
acquired
Ohio
Cancer
Specialists
– Mayo
Clinic
acquired
Queen
of
Peace
Hospital
AcquisiFons
and
Mergers
The
List
is
ENDLESS

8. • Who
acquired
who?
– Cerner
bought
Siemens
– NextGen
bought
Mirth
and
Opus
– Allscripts
bought
Eclipsys
and
MISYS
– PracFce
Fusion
buys
Ringadoc
– AthenaHealth
buys
Epocrates
AcquisiFons
and
Mergers,
Technology
Companies
Too!
The
List
is
ENDLESS

9. • Ask
yourselves
these
quesFons
– First,
what
are
the
goals
of
the
business?
– What
is
the
biggest
benefit
of
switching?
– What
is
the
biggest
loss
of
switching?
– Do
mulFple
systems
make
sense?
– How
much
will
it
cost
to
stay?
– How
much
will
it
cost
to
switch?
– Do
our
physicians
like
the
system
they
use?
What
Do
AcquisiFons
and
Mergers
Mean
for
My
PracFce?

10. Go
ahead,
try
to
make
me
click
another
bu,on
Physician
SaFsfacFon

11. Physician
Complaints
Are
Valid
• But
as
I
said
in
an
InformaFon
Week
arFcle,
they
can
be
controlled
at
home.
• This
is
a
BAD
reason
to
replace
an
EHR.
• You
need
to
evaluate
your
implementaFon
and
encourage
physician
use
of
the
system.
• Do
not
reward
basic
uFlizaFon,
make
it
a
part
of
employment.

12. Ask
yourselves
these
quesFons:
– What
is
the
goal
of
the
business?
– Are
clinicians
just
complaining
loudly?
– What
is
the
biggest
benefit
of
switching?
– What
is
the
biggest
drawback
of
switching?
– How
much
will
it
cost
to
stay?
– How
much
will
it
cost
to
switch?
Should
Physician
Complaints
Make
Us
Consider
a
New
EHR?

13. You
said
this
EHR
would
qualify!
Meaningful
What?

14. • Meaningful
Use
Stage
1
ONC
CerFfied?
– 472
Ambulatory
Systems
• Meaningful
Use
Stage
2
ONC
CerFfied?
– Less
than
half
of
the
original
472
• Meaningful
Use
Stage
3
ONC
CerFfied?
– I
believe
this
will
be
less
than
50
complete
cerFfied
systems
How
Many
CerFfied
EHR
Systems
Exist?

15. • YES!
Then
ask
yourselves
these
quesFons.
– What
systems
are
out
there?
– Can
they
convert
our
legacy
data
with
minimal
cost?
– How
much
will
it
cost
to
switch?
– Are
we
ensuring
physician
saFsfacFon?
– What
if
we
don’t
care
about
Meaningful
Use?
Should
a
Lack
of
MU
CerFficaFon
Make
us
Switch?

16. The
PracFce
Budget
Runs
Out!
It
IS
a
business!
Cost

17. Each
System
Has
a
Cost,
Even
the
Free
Ones!
• Millions
up
front
or
a
percentage
of
claims
for
years
to
come?
• Want
to
host
it
yourself
or
have
someone
else
host
it
in
the
cloud
for
you?
• Do
you
even
want
to
worry
about
hosFng
anything
at
all,
onsite
or
remote?
• All
of
these
topics
have
cost
associated
with
them
and
there
are
too
many
to
list.

18. Ask
yourselves
these
quesFons
– First,
what
are
the
goals
of
the
business?
– What
is
the
biggest
benefit
of
switching?
– What
is
the
biggest
drawback
of
switching?
– How
much
will
it
cost
to
stay?
– How
much
will
it
cost
to
switch?
– Do
our
physicians
like
the
system
they
use?
Should
the
Cost
of
an
EHR
Make
Us
Consider
a
Switch?

19. There
Isn’t
a
Cookie
Cu,er
Answer
• Google
any
EHR
vendor
name
and
the
word
“lawsuit”
and
you
might
have
a
heart
a,ack
• Each
system
you
are
considering
is
developing
to
the
beat
of
the
government,
not
necessarily
to
innovaFon
(though
some
are
trying)
• Each
situaFon
is
unique,
so
make
sure
you
are
considering
the
switch
for
the
right
business
reasons.

20. Q&A
Jonathan
Evere,
Vice
President,
Business
Development
Quirk
Healthcare
h,p://www.quirkhealthcare.com
Jonathan.evere,@quirkhealthcare.com
@jtevere,_hit
h,ps://www.linkedin.com/in/jtevere,