After five decades in the HIS/EMR world I have seen this movie to many times. Even played an active part in a few. It NEVER ends well. A real Greek tragedy. When OH gets close to finishing the project they will need to charge big bucks for the new system, Larry is running a for profit public company - right? Then 50% of remaining clients will say it's time to leave, and there is only one place to go. In the end unless they can really come up with something truly unique that clients 'must have to survive' versus the 'we now have a marginally better mouse trap' it will be a long slow death march.
EMRs in health systems is a replacement market and the big money is in a virgin market or replacing Epic, and I do not see that happening. Even if you only classify Epic as an 'adequate' system with no doubt some shortcomings no health facility will want to go thru the pain and cost of installing a new product unless there is some major benefit that addresses major real pain points. Good luck Larry, you'll need it.
Hoping Oracle is Listening... - 1 month ago
From what I understand, they are going to be replacing the front-end UI, but leaving the backend data model mostly the same. Their current release is for primary care only, which is a relatively simply workflow compared to specialty care or acute. Keeping the backend the same should greatly increase their chances for technical success. However, from recent conversations, Oracle still likely under-estimates both the legacy 3rd party workflows/apps that are integrated with PowerChart (particularly for acute care) today and how difficult it will be to to get clients to switch over from their much more complex inpatient care systems - especially if Oracle isn't willing to be flexible and accommodate those older systems. The downstream breakage and change management would suddenly make a complex-UI update near impossible - especially for the larger, older customers. While Oracle has a strong carrot with their new AI/voice-first UX, if Oracle makes the barriers or risks too high, clients will look for vendor alternatives... not a good outcome for Oracle given their recent trends.
It's All Good - 1 month ago
I've been the PM for a "super EHR" that was going to replace all of the company's legacy products at Medical Manager/WebMD/Emdeon/Sage/Greenway and at Allscripts. Collectively I've been responsible for 5 new EHRs that withered on the vine because:
a) no one could figure out a way to convince existing customers to move to a new platform without putting the entire installed base of the legacy product in play to buy a new system. We even tried PAYING people to convert. No one bit. And by the way, it costs an EHR vendor a FORTUNE to convert customers from decades-old software, complete with customization.
b) any project that extended into a new fiscal year required renegotiating and re-justifying the project budget in subsequent years. Some of my projects made it through year 2. None made it to year 3.
c) in the revolving door of senior management of EHR companies, seldom were the decision-makers who approved the new super-EHR still the decision makers in subsequent fiscal years. New execs = new agenda. To new execs, old agenda = boondoggle.
Honestly, why doesn't Oracle just sell Cerner now, rather than wait a few years until it's worth pennies on the dollar. Allscripts acquisition of Paragon, etc is the case study. HBOC to McKessson to Allscripts to Harris. Who knows how many customers are still left using Paragon, but there can't be many....
Bill Spooner - 1 month ago
I suggest that Oracle time its releases for April 1 and October 31 - April Fools and Trick or Treat !
After five decades in the HIS/EMR world I have seen this movie to many times. Even played an active part in a few. It NEVER ends well. A real Greek tragedy. When OH gets close to finishing the project they will need to charge big bucks for the new system, Larry is running a for profit public company - right? Then 50% of remaining clients will say it's time to leave, and there is only one place to go. In the end unless they can really come up with something truly unique that clients 'must have to survive' versus the 'we now have a marginally better mouse trap' it will be a long slow death march.
EMRs in health systems is a replacement market and the big money is in a virgin market or replacing Epic, and I do not see that happening. Even if you only classify Epic as an 'adequate' system with no doubt some shortcomings no health facility will want to go thru the pain and cost of installing a new product unless there is some major benefit that addresses major real pain points. Good luck Larry, you'll need it.
From what I understand, they are going to be replacing the front-end UI, but leaving the backend data model mostly the same. Their current release is for primary care only, which is a relatively simply workflow compared to specialty care or acute. Keeping the backend the same should greatly increase their chances for technical success. However, from recent conversations, Oracle still likely under-estimates both the legacy 3rd party workflows/apps that are integrated with PowerChart (particularly for acute care) today and how difficult it will be to to get clients to switch over from their much more complex inpatient care systems - especially if Oracle isn't willing to be flexible and accommodate those older systems. The downstream breakage and change management would suddenly make a complex-UI update near impossible - especially for the larger, older customers. While Oracle has a strong carrot with their new AI/voice-first UX, if Oracle makes the barriers or risks too high, clients will look for vendor alternatives... not a good outcome for Oracle given their recent trends.
I've been the PM for a "super EHR" that was going to replace all of the company's legacy products at Medical Manager/WebMD/Emdeon/Sage/Greenway and at Allscripts. Collectively I've been responsible for 5 new EHRs that withered on the vine because:
a) no one could figure out a way to convince existing customers to move to a new platform without putting the entire installed base of the legacy product in play to buy a new system. We even tried PAYING people to convert. No one bit. And by the way, it costs an EHR vendor a FORTUNE to convert customers from decades-old software, complete with customization.
b) any project that extended into a new fiscal year required renegotiating and re-justifying the project budget in subsequent years. Some of my projects made it through year 2. None made it to year 3.
c) in the revolving door of senior management of EHR companies, seldom were the decision-makers who approved the new super-EHR still the decision makers in subsequent fiscal years. New execs = new agenda. To new execs, old agenda = boondoggle.
Honestly, why doesn't Oracle just sell Cerner now, rather than wait a few years until it's worth pennies on the dollar. Allscripts acquisition of Paragon, etc is the case study. HBOC to McKessson to Allscripts to Harris. Who knows how many customers are still left using Paragon, but there can't be many....
I suggest that Oracle time its releases for April 1 and October 31 - April Fools and Trick or Treat !