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Wednesday, February 20, 2013

Allscripts to Close 12 Offices and One Warehouse–Tough to Compete in Complex World Today With Other Medical Records System Who’s Development & Code Were All Done In-House Over the Years…

I probably go back in this business too far, before there was an Allscripts EHR and when it was only an e-prescribing program.  The company grew by acquiring other companies and Mysis imagewas the acquisition that put the company into the medical records business with the first system sold called MyWay.  If you have kept up on some of the news you have probably read that the original EMR is not an ONC certified system and that Allscripts has offered free upgrades to those still using the original program.  There are other vendors who are offering a free transfer of the records if they convert to their medical records system.  Back in 2008 the link below will give you a few more details as the two companies merged and Allscripts was the decided marketing name.  I used to compete with the original Misys system, back in the very early days. 

Misys seals deal on Allscripts purchase


Along came the acquisition of Eclipsys in 2010 and CVS began switching clients to the Allscripts e-prescribing program and they stopped marketing the iScribe product which was basically the original e-prescribing software.   

Misys Sells Allscripts Shares to Enable Eclipsys Merger – Medical Records

Then there was the licensing agreement with Pegasus with a long legal battle that was eventually settled with part of the offerings from Allscripts coming from other technologies.  Allscripts bought a company that was a customer of Pegasus and claimed they had a license for the related bar coding technology.  After the financial crisis in 2008 the company was hit hard and found a larger credit line in 2009 with JP Morgan and went through a stock repurchase.  They partnered with companies such as Quicken Health Bill pay to market getting faster payments from patients.  They also partnered with Cardinal Health to be a reseller of their EHR products.  In 2008 the Lehman bankruptcy had an effect and delayed the Misys-Allscripts deal as well. Back in 2008 they were also part of a group called NEPSI to where they offered a free basic version of their e-prescribing program and integrated it with the now defunct Google Health.  In 2008 the company also sold their marketing subsidiary, Physician’s Interactive. 


 

Allscripts in Legal Battle With Pegasus Imaging Over Bar Coding Software – David and Goliath At Battle

iMedica was the software that Allscripts paid $5 Million for and rebranded to the name Mysis in 2007.  Mysis is actually located in London and after the crisis of 2008 also received help from HSBC bank. 

So there’s a little history from what I have covered here and as you can see there was quite a bit of buying up technologies and consolidating here for a few years which meant hiring a lot of software engineers to make it work and function.  If you look at Cerner and Epic by comparison, they built all their own software in house and there is something to be said for that as you do have control and know the history and don’t open up code modules to find some unexpected surprises.  That is a comment you hear from folks like me who have to look at what has been built and what clean up needs to be done and what engineering is needed.   

I do have to say the company marketed well and for a long time rolled the code and made it work until we had the Eclipsys merger and now the game of integration was growing to a much imagecomplex mode and this is where the trouble came with promising shareholders a date for release and it was not completed.  As when you dig in with anything like this, you find plenty of things to repair, modify and rewrite so it all caught up.  Sales were projected and based on this time element too.  I read all the time about clients not getting their software when promised and it’s late, so just expect that if you want it to work correctly and be debugged properly before it is finally compiled. 

Eclipsys and Microsoft To Integrate Sunrise Enterprise Suite With Amalga Unified Intelligence System


I did a little speculation myself about where Allscripts might end up and though the Caradigm group could have been a place since they market Microsoft Amalga and are a new combined company formed by GE and Microsoft.  The Allscripts programs use Microsoft technologies for their build and Amalga itself doesn’t have an in-house EHR to test and work with, so again just my thoughts on that topic. 

Allscripts States They Are Considering Sale to Third Party–Follow the Code Technologies To Think About Caradigm As An Educated Speculation Being A Potential Match

So where is the future from here?  I think that’s a question we are all asking including Allscripts themselves as they go through their reconstruction mode here.  I think one thing that all should learn from this is the lesson on how complex software is today and it’s not likeimage the old days with combining code and we all work with platforms today anywhere to where we are dependent on code written outside our immediate control, so get used to it.  I said the same thing not too long ago trying to break it through HHS’s head as well as the news came out to rush. If you don’t have the “walk and chew code” mentality and knowledge at the top in organizations and in government  today this is what you get, as I sometimes call it, “waiting for the Algorithm Fairy” to come in and fix everything.

Speed Up Rate of Change in Health IT?–“Short Order Code Kitchen Burned Down a Few Years Ago and There Was No Fire Sale”..IT Infrastructure Chance and Revisions Takes a Lot of ”Code”, “Time” and “ Most Importantly Money”


Short of chaining up developers to computers and waterboarding the code out of them (grin) you don’t have a choice on setting deadlines, so the more folks as consumers and in business that can grasp  and realize how complex things are today, we will see less uneducated perceptions as such making the news.  The company is filing lawsuits but I don’t think that’s the way to go over sour grapes here.  Again when Epic was chosen you have some very smart CIOs out there who have to make sound decisions and have a system that will work, otherwise their jobs on are on the line.  If one was a CIO where’s the stability and reliability and sure it costs money as well.  As the old saying goes you get what you pay for.  With the lawsuit filed they became on of my Attack of the Killer Algorithms” posts back in May of 2012 as it was all about not enough time to get those new algorithms up and going and they bit back with teeth. 

Class Action Lawsuit Filed Against Allscripts For Misleading Investors With Merging Data Systems–Too Much Code and Not Enough Time – Attack of the Killer Algorithms Chapter 30


I don’t know what kind of technology background Mr. Tullman had but from how this has all developed, I seem to think he’s also one who never wrote a stick of code and that makes a difference, so compare him to CEO Judy at Epic who wrote the original software at Epic.  All say they have a high priced product but they also had some high expenses and major code to write when they secured Kaiser and everyone else who purchased after that fact benefitted, so there was some recovery of cost with new engineering with the EMR modules in their system.

Allscripts Sues NYC Health and Hospital System Over Contract Award to Epic - EHR Vendor Playing the Same Game as Health Insurance Companies With Lawsuits

I try to do my best to bring the reality of what has to occur versus what is maybe shown more as OMG material in the media at times.  Reality works better for me and I think it works better for others if they understand too.  There’s a lot of unknowns and better leaders we have with some software engineering knowledge the better we can be.  It is what it is and some of the wild perceptions that float around out there make for bad decisions when you don’t go to the core, and the public and others don’t understand either.  I call a lot of this “Algo Duping” as you are sold and told something that conflicts from the laws of math and code that just isn’t there sometimes. 


So now time will tell on how the reorganization goes and with a former officer from Cerner who has a background with a company that has built their technologies in house he’s got a lot of work ahead of him with not only the engineering of the software but also with the public opinions and shareholders.  Cutting costs with closing offices sounds like the natural first move and we’ll see where it goes from there.  I think some work is needed to also begin to attract any private equity folks too. No algorithm fairies but just a lot of hard work and restructuring needed.  They did create an API to where anyone so inclined to work with the “cash for code” model to grab a small dollar carrot can help them.   Not much incentive for developers to do this today as they need to put food on the table too, and you have GE and Verizon for example doing the same, saves money but again doesn’t do much for the average developer unless someone who already has a job wants a little extra cash.  I wonder sometimes if big companies when offering “carrots” to write code for them, thinks of the other side being a human needing to make a living too.  BD

Allscripts Ousts CEO Glen Tullman and Lee Shapiro, President, Appoints Board Member To Take Over


Earlier Tuesday, the company disclosed some restructuring and cost-cutting efforts, including plans to close 12 offices and one warehouse. The company also is making changes to its corporate operating structure in an effort to trim product-development costs.

"Our fourth quarter and 2012 financial results did not meet our expectations," Mr. Black said. Following the conclusion of Allscripts' strategic review last year, Mr. Black said he has been engaged with clients and team members.

http://online.wsj.com/article/BT-CO-20130219-715523.html

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