Author Archives: markd73

eHealth Ontario is read the riot act

Not sure where I stand on this issue. The current management of the agency continues to pay for the sins of the past. Doesn’t seem terribly fair, but this is all about political perception.



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.


Where is the vendor consolidation wave in Canadian Healthcare IT?

I feel like I’ve been sitting around waiting for this to happen forever. When I was working as an analyst, I was once asked by one of my favourite vendors (you know who you are) “when is the consolidation going to start in the EMR market? “ Being the genius that I am I predicted in the next 12-18 months…this was in 2007. Ummm not exactly a home run.

This got me thinking lately, not just about EMR market consolidation, but the whole Canadian Healthcare IT market. I’ve always had an abiding interest in all things merger and acquisition, and on the surface the Canadian healthcare IT market seems ripe for consolidation. For the sake of this post, I am going to assume that consolidation is good and inevitable thing. You may agree or not as you see fit.

Many CIOs and others on the provider side would be just as happy dealing with a smaller number of large vendors than hundreds of smaller guys. Combine this with a highly fragmented geographic distribution of vendors and market share and the big guys “should” be buying companies left and right.

I think there are a number of systemic issues that are preventing this from happening.

1)      The most logical buyers (the big companies) are largely branch plants of US or International companies, and they have to compete with the head office for acquisition resources. I know who would get the first crack at resources if I was running one of these companies, the US market. Why by Vendor A in Canada that sells into a small market, when you can buy the same kind of company and sell your stuff into a market 10 times bigger. Simple math wins every time.

2)      The Canadian market has hundreds of small companies, with most selling into highly regional markets. Many of these small companies have limited access to capital, a record of building things themselves and an unrealistic view of the dollar value of some of their targets.  This makes for reluctant buyers or unrealistic ones, not a good situation if you are looking at consolidation.

3)      In terms of the EMR market, have the provincial certification programs actually slowed down market consolidation? Given that it did happen, then it is pure speculation as to the alternatives, but I love speculation.

  • Would the market have consolidated already if all vendors were equal with no certification? Perhaps. I think one of the big reasons there is less activity is that with a 70% discount to switch vendors, it makes it awfully hard to buy another EMR for their user base.
  • Would the market have consolidated already if there had been a single national certification program created years ago? Again I would say perhaps. It would be easier to source acquisition capital to do a national play than to do 4 or 5 regional plays. This would also be more attractive to the big players who are only interested in selling nationally with their other stuff.

I wonder what those who have done a recent acquisition think about my logic? Did I get it right or am I missing something?


Why did Intel pay so much for McAfee?

I have been puzzling over this deal for the last day or so. For those who have been at the cottage and not reading the news, Intel is paying a 60% premium for McAfee…yes you read that right McAfee.

Many of the articles on the subject are asking why would Intel want to buy McAfee. Intel is a hardware guy and McAfee sells software. Good question, and I’m sure it has a lot to do with a change in direction for Intel as they see baked in security at the hardware level as the next “big thing” in the mobile market. I’m  not sure I buy into the logic, but for arguments sack lets say that this is a genius move. My question is why did they pay a 60% premium on closing price? Typically companies pay a premium to make it too expensive for rivals to trump their initial bid. This keeps a bidding war at bay…smart business move. I’m just not sure anyone else was as interested in buying them as Intel, and the premium was unnecessary. The other issue that has me scratching my head is why buy when you can partner on this stuff? I must be missing something.

I know this blog is supposed to be about healthcare IT, so I would ask the readers if they think buying mobile hardware with Anti-Virus baked in would affect their decision on which hardware to buy?


Spending priorities

I have been spending the last few days thinking about the relatively meager amount of money the Feds, and to some extent the Provinces, have historically allocated to eHealth technologies. I’ve always wondered why these governments, who say that runaway healthcare spending is one of their top priorities, spend on average between 1%-3% of operating healthcare budgets on eHealth. This spending level doesn’t seem to change much regardless of the flavor of the political parties in power.

When a federal government is willing to spend $16B on fighter jets, but only around $2B on Infoway I have to start wondering about priorities. Is eHealth just to hard a concept to sell to the Canadian public, or is it something else?


Self-service optometry…there is an app for that

Leave it to the folks at MIT. They have created an Android App for turning a Google Nexus One into a cheap mobile platform for creating eyeglass prescriptions. The authors of the article claim that they can take what is a $50 procedure, and with the addition of a $2 eyepiece, create prescriptions for the majority of people. Even when you add the cost of the Google phone (north of $500 US), it makes for a potential business “mobile optometry without the optometrist” business.

What does it have to do with the Canadian healthcare market you ask? My answer is that I’m not sure, but it shows that mobile technology is going to disrupt traditional service delivery models in healthcare, whether we like it or not.


Off to the show

Mike and I are attending the eHealth show in Vancouver for the next few days. We will try and live update from the show when time permits. It will be great to see all of my friends and peers in the industry.

I am looking forward to discussing what we learned (good and bad) from the show.