They say "when one door closes, another one opens."
But when it comes to an EHR vendor shutting its doors, the popular expression doesn't bring immediate relief to a panic-stricken practice. Unfortunately, it's a reality that all practice managers must consider.
Over the past two and a half years since CMS launched its "meaningful use" EHR incentive program, several small and large EHR vendors announced acquisitions, plans to consolidate, or plans to shut down completely.
"There are anywhere from 800 to 1,100 certified products out there, and everyone is expecting in the next five years, you're going to see, for a variety of reasons, forces that are going to drive consolidation of healthcare and health IT," says Scott Monteith, a psychiatrist turned healthcare consultant who specializes in risk management. "You're going to see a lot of vendors not being successful, [and] a drying up of venture capital. You're going to see the vast majority of products falling by the wayside, and a vast number of acquisitions."
Jeff Wasserman, vice president of strategy and executive leadership services at consulting firm Culbert Healthcare Solutions, agrees.
"What's happening right now in the market is there's tremendous impetus for practices, hospitals, and healthcare systems to implement practice management systems and EHRs because of the federal dollars available," he says. "Some vendors are getting overwhelmed … [and] are finding a hard time keeping up with the demand."
Here's how to read between the lines and figure out what it means when your vendor is closing its doors, winding down its EHR or other technology operations, or being acquired — and how to prepare for the worst.
When a vendor closes its doors, it can mean one of a few things.
In the best-case scenario, one vendor is acquired by another, but everything — from templates to support to upgrade pace — stays the same. Thus, the process is practically transparent to the user.
Other times, when a vendor is acquired, everything changes — and that can be a good thing or a bad thing for a practice, depending on how much staff and physician users liked the old EHR and the nature of the changes. If the shift means a greater level of support from IT liaisons, that's great. But if it means higher prices for upgrades, that's not so great.
In the case of an acquisition, "there are two things that can happen," says Amy Jennings, a strategy consultant at Culbert. "The larger vendor can maintain customer support, or the larger vendor can't provide those services and decides to sunset those parts."
But perhaps the worst thing that can happen is if a vendor shuts down completely with little warning, leaving practices in the dark about what to do next.
"The worst that happens is a company that is acquired and shuts down," says physician Jonathan Bertman, CEO of Amazing Charts, an EHR vendor recently acquired by Pri-Med. "That stops the support."
Monteith says retrieving data from old systems is sometimes a major issue as well.
"God forbid if you find yourself in a medical malpractice case, the expectation is you will present your documentation," says Monteith. "And if you can't present your documentation, you don't have a case. Documentation is a central element of any case. Without notes, you are nearly indefensible."