EMIS exits the Canadian market

On the heels of the Healthscreen management change, there is news that EMIS is leaving the Canadian market.

Although I’m not surprised at the “fragmented market” challenges facing EMR vendors in Canada, I’m a little surprised that EMIS has decided to exit entirely in the next three months. After searching for more details online, the parent company CEO, Mr. Riddell, was quoted by analysts as saying part of the reason for the exit is “We were hoping that there would be a federal accreditation programme in Canada, but that didn’t happen so we had to deal with different rules in every province.

Alan Brookstone at CanadianEMR has an excellent post on the EMIS situation, and according to his post he will be interviewing the former CEO Eric Gombrich in the near future.



5 responses to “EMIS exits the Canadian market

  1. Mark, do you think that the EMIS decision marks the start of vendor consolidation in the Canadian EMR market? There appears to be a lot of turmoil in this market and I am hearing rumblings from several sources that EMR adoption is slowing down.

    What about a national EMR certification / accreditation program? Do you think that we will such a program in the next year or two? There seems to be a growing consensus that we need such a program.


  2. I’m always a little nervous when it comes to making predictions. Invariably you get part, or all of it wrong and that is all you ever tend to hear about. 🙂

    That being said I think that the situation at Healthscreen, EMIS and other situations that I’ve heard about do have one thing in common. All of them are selling into fragmented provincial markets, reducing addressable market opportunity and increasing their COGS; thus reducing their ability to survive in Canada. Some would argue that the current system is a good thing as fewer vendors are better. I would argue that consolidation will happen whether you like it or not, and that a more open market will not only accelerate consolidation but also lead to better products more attractive to late adopters.

    National certification has always been a bit of “pie in the sky” dream to me. Not a bad idea, for the simple fact that it would allow all the vendors to compete on a level national playing field. The smart well run vendors would quickly break from the pack and only a handful of the most innovative and responsive would survive in the end. All you have to do is look at the current EMR vendor landscape in Denmark and New Zealand to see this in action.

    The challenge for a national certification program has always been in the federated model of delivery for healthcare in Canada. Until/unless you can figure out a way to make the feds and provinces all agree (good luck) to coordinate their existing programs then forget it. I would love to see Infoway and the provinces make this happen in a meaningful way, but I’m not sure there is a will or realistic means to do so in a year or two.


  3. The only things that can probably be said for sure is that there will be massive change in the future and that (eventually, possibly very far in the future) things will get better.

    Right now we have a mess of an ehealth/ EMR landscape…. multiple vendors with cumbersome, difficult to set up product, nearly impossible to port data to other systems when the need will inevitably arrive in most cases. The vendors pander to where the money is (meeting provincial standards) rather than catering to the actual users (doctors… should be patients as well but they are almost completely ignored).

    My prediction which, as Mark says about predictions, is a shot in the dark but here goes…. There will be a new vender surface who will provide a totally groundbreaking innovation. This vendor will completely ignore the government subsidies and create a product that delights doctors (and patients who will also use the system). It will be easy to set up and use and although have less features than the behemoth systems of today, it will have 80% of the day to day functionality. This system will organize data such that it is nearly impossible to maroon data if doctors need to migrate out, which will be one of it’s big selling points. Because of it’s simplicity, such a system will be mostly ‘self serve’. Due to all the above features it will be very inexpensive, possibly free if another revenue model could be found to support it.

    If any of you think I’m talking about something I’m aware is in development, I am not. This is my wish list and I think totally doable. I’m just waiting to read about someone who has done it.

  4. I think I’ll reach my likely wrong prediction further out into the future…

    This innovator will build a totally cloud based system, one with open standards and technology.

    This disruptive innovation will blindside all current EMRs, government, and anyone else ‘in the know’. Although quite amazing it will only be initially adopted by few, so it won’t put the EMR industry out of business right away.

    But these early adopters will rave about the ‘product’ and it will spread, spawning similar projects. These other players will develop systems that conform the the standards set by the disrupter. Data will flow naturally through this ‘system’ build from the ground up by users (doctors and patients) and the new vendors…. vendors who will be more missionary than mercenary, though they will do just fine financially. Like Mark Zukerberg they will not be crying poor.

    This evolving system will welcome government and any other players who want to join in on a good thing. Ehealth will be built from the ground up.

    Twenty years from now we’ll all look back and laugh at how in multiple places around Canada and the world we actually thought that such an ecosystem could be built in an enterprise model from the top down and lead by government no less!

    In 1900, there were over 200 car manufacturers. They were all custom jobs. If you asked any one of them where the car industry would go next, they probably would have said, ‘More leather, more wood, fancier….’. And then Henry Ford came along and forever changed the entire auto industry…..production methods…. and prices of cars plummeted. Had the government come along prior to Ford and told the public that they needed to purchase cars and subsidized them, perhaps the Model T would never have been invented. But once it was, it was pretty clear to the average person that they ‘needed’ a car. This led to the development of the suburbs and the world was forever changed.

    I’m not saying that our current situation is entirely analogous to that but there are a lot of similarities.

    Then again, I could be totally wrong.

  5. BTW, I’m interested in communicating with anyone who wants to discuss this further. I’ve got a professional web site, http://www.DoctorMarcus.ca where I will be blogging on the theme of ‘Grassroots healthcare innovation’. I will be blogging regularly on topics concerning how those at the grassroots in healthcare…. doctors, patients, entrepreneurs, healthcare organizations, can have meaningful input into helping innovate/ renovate the healthcare ecosystem.

    I’m interested in the new media, social networking tool, and anything that can empower those who directly impact or are impacted by the healthcare system. Wikis, open source software…. etc. All of these tools are revolutionizing the world outside healthcare from Toronto to Tripoli and beyond. When are these tools going to make a difference on the ground in healthcare? I want to discuss that and hopefully this discussion can lead to real changes…. changes that don’t rely on waiting for the government or any powers-that-be to deliver a solution from the top.

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