HIMSS10 – Sage

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Dr. Eric Fishman speaks to Ken Ernsting, Vice President of Business Development for Sage Healthcare. They discuss Sage’s long history in Health IT. Mr. Ernsting reviews both Sage’s flagship and legacy products. The flagship product is Sage Intergy, an EHR/PM solution. Mr. Ernsting discusses Meaningful Use, and the three major things Sage is doing to ensure its products meet the final criteria. Dr. Fishman and Mr. Ernsting discuss the future of the industry, with the movement towards patient centric technology and connectivity. Sage has recently launched patient portal technology that will integrate with the Intergy EHR system. This is one example of how Sage is thinking forward in regards to meeting stage one criterion for meaningful use.

Category: HIMSS10, Tradeshows
Date: March 23, 2010
Views:14,486 views

Dr. Eric Fishman: This is Dr. Eric Fishman for EHRtv and we're speaking with Ken Ernsting, Vice-President of Business Development for Sage. Ken, I thank you very much for taking the time to speak with me today.

Ken Ernsting: Thank you, Doctor.

Dr. Eric Fishman: I appreciate it. Sage has quite a history. Now, I know Sage is a rather large multi-billion dollar British company that has its roots in the accounting industry and then more recently a few years ago, they purchased what I will call the Medical Manager because I was a medical manager user as an orthopedic surgeon for decades that had become Ambience. If you could tell us a little bit about that history, that would be very helpful.

Ken Ernsting: Actually, Sage Medical Manager started back in the early 80s and it was one of the pioneers in billing. It's the kind of practice management system that folks like you adopted early on.

Dr. Eric Fishman: It was the product to get back then. There weren't any options.

Ken Ernsting: That's right. It was the product to get back then. Over the years, it developed a strong following and as happened in the mid to late 80s, a lot of acquisitions, mergers took place and so Medical Manager combined with a number of other organizations, bought (unintelligible) and distributors and then later on combined with Web MD. That also later on combined with MDI. Later on, there was a divestiture of a couple of components and we subsequently were acquired by Sage.

Dr. Eric Fishman: A number that sticks in my mind it was a $565 million acquisition.

Ken Ernsting: That's correct.

Dr. Eric Fishman: So obviously, Sage has an interest in staying in this industry quite long term.

Ken Ernsting: And it fit very well with their market strategy. They wanted a larger presence in the United States. It's a large multi-billion dollar corporation and they were particularly interested in health care and our size and penetration within the health care environment.

Dr. Eric Fishman: Now, Sage has a number of products which you are maintaining and I compliment you on doing this - maintaining the Medical Manager product line and supporting it, but you also have the Sage Intergy Suite which is a combined EHR, practice management system. If you could briefly go over the various product lines that you have, that would be very helpful.

Ken Ernsting: The Sage Intergy Suite, that's what we call our flagship product. That consists of a number of components, a practice management system, EHR as you mentioned plus a couple of other things that we can talk a little bit later about. On our legacy product side, we of course, have our Medical Manager product. We've got about 6,500 customers still using that product across the country. We also have about 2,500 customers using MedWare and about 2,500 customers using the (verses) PC end products.

Dr. Eric Fishman: How many Intergy EHR users do you have?

Ken Ernsting: Intergy EHR right now is about 1,300 and growing I might add.

Dr. Eric Fishman: And that's a nationwide presence.

Ken Ernsting: That's right. Intergy Suite, which is both the practice management side and Intergy EHR or either of those, is about 2,600 across the country.

Dr. Eric Fishman: And how's that delivered? Is it client server, is it software as a service?

Ken Ernsting: It's delivered primarily in a client server environment. More recently, we introduced Intergy IOD which is --

Dr. Eric Fishman: On demand?

Ken Ernsting: On demand. That's been very popular especially for organizations that are looking to reduce their initial cash outlay.

Dr. Eric Fishman: I find that particularly smaller practices find a solution of that nature appropriate.

Ken Ernsting: That's right and it's good because their entry point, in terms of cost, is fairly low and they pay on a subscription basis so it's a great way for them to acquire the technology.

Dr. Eric Fishman: Now it's 2010, we've all heard about Meaningful Use. What is Sage, as a company, doing to ensure that their users will be able to prove Meaningful Use?

Ken Ernsting: Well, there's three different things that we're doing. First of all, we're informing customers and informing perspective customers - because there's a lot of questions about what does Meaningful Use mean - what concerns they should have, what do they need to do. So we've done a lot of educational emails to our customers. Week before last we had a webinar that attracted over 600 participants. We put that online and we have had since a couple hundred people view that webinar. Out of that webinar, we've gotten over 300 questions about Meaningful Use.

Dr. Eric Fishman: There's an incredible interest in this industry, there's no question about that.

Ken Ernsting: Incredible interest. So the first part has been education. The second part that we're doing is we're saying, number one, we're giving our customers a Meaningful Use guarantee. We're saying that if you buy our Intergy Sage EHR and associated end products, we will guarantee that as the ONC changes their requirements, we will change to make sure that we meet that criteria and if we don't, then we're going to give them credit of up to a year's worth of support. So we felt like it was very important to be very proactive and tell our customers, look, you invest in our technology and we're going to make a commitment investment back to you. The third thing that we're doing is we're trying to put together as many different configurations as we can for our customers that have all different technologies. So we can go to any customer and say, you have this technology of ours and we add this component and this component and this will get you to where you need to be as far as meeting Meaningful Use criteria.

Dr. Eric Fishman: It sounds like you have a number of migration pads. You're not insisting that your customers do anything, but if they care to, you give them that opportunity.

Ken Ernsting: Yes, that's right. There's two things we're trying to do. First of all, we're trying to make it simple because it's very confusing. The second thing we're trying to do is make sure they understand what they need to do and what it's going to cost them. We're coming up with a couple of things that are very attractive in terms of Meaningful Use products that are specifically for that like the analytics products. The other thing that we're doing is we're putting together very attractive financial bundles and very attractive financing along with it. Again, the whole idea is to make it as easy as possible for them to take advantage of the stimulus money.

Dr. Eric Fishman: What do you envision is going to be happening in the coming year or two in this industry?

Ken Ernsting: Well, I think that interoperability, connectivity to other applications, I think obviously, EHR is going to be a big portion of it. I think that more and more practices want to communicate with their patients through electronic means. I think more and more patients want to be able to communicate with their physicians.

Dr. Eric Fishman: So is there a patient portal?

Ken Ernsting: There's a patient portal.

Dr. Eric Fishman: Do you find that the physicians use that frequently? It's a pet concern of mine that surprises me that what should be such a cost savings method for physicians is under utilized to be quite honest.

Ken Ernsting: I think part of it is it's a brand new technology.

Dr. Eric Fishman: In this industry, but patients use it everywhere.

Ken Ernsting: I know. I think more and more are adopting it. We've sold several hundred patient portal systems to our customers.

Dr. Eric Fishman: Good. I would love to hear now or some point in time in the future about the physician's experiences in how they're actually being utilized by the patients.

Ken Ernsting: Everything that we've heard is that not only do the physicians and the practices love it but the patients love it because they can book appointments, they can renew prescriptions, they can do all kinds of things online. Doesn't matter whether it's three in the morning, seven in the morning. They don't have to try to get hold of the practice; the practice is not burdened with phone calls and everything else so it's a beautiful thing. It's also, by the way, part of Meaningful Use stage one criteria.

Dr. Eric Fishman: Of course. They need to connect with the patients.

Ken Ernsting: That's right. Electronically.

Dr. Eric Fishman: And so we've all heard about the RECs, the regional extension centers. In fact, they've been funded with $350 million of the money that will be coming in just the past couple of weeks. What is Sage's position as it relates to the RECs?

Ken Ernsting: Well, we're working with the RECs closely. We want to help them understand our significant market penetration that we have. The RECs basically have a mandate to sign up and get as many practices in their area as they possibly can an EHR.

Dr. Eric Fishman: Right.

Ken Ernsting: So when we come in, we come in there with not only talking about the strength of our product but we come in there talking about how many customers we have in the local area that we can bring into play in their physical area.

Dr. Eric Fishman: And we all hear stories about companies saying you can buy our EMR today and be implemented in 24 hours. In my humble opinion, that's not reality. I think in general the implementation cycle is shortening nationwide as physicians realize that it is a difficult process and moreover, the vendors realize that they need to stop up to the plate and make it easier for physicians. So if you can discuss the implementation process to us that'd be helpful.

Ken Ernsting: Sure. I agree with you 100 percent, Doctor, because I've read some of the things that you've written on it and I think the biggest challenge is implementation of an EHR. There's a couple of reasons for that. I attended the HIE summit in Washington D.C a couple of weeks ago and I attended two different symposiums and listened to three physicians talking about how the first thing that has to happen prior to implementation of the EHR is the practice has to look at its work flow and make work flow changes to adopt to the EHR environment because it is very different. We taught for years, and as a computer technology company, we've always tried adapt our systems to work the way the physician likes to work. We've done a lot of that but we can't do it all. So I think the change management has to come, I think many think the change management has to come before the implementation of the EHR. The interesting thing is some of them move very quickly and are very successful. Those circumstances where that happens is when the practice has designated somebody as a clinical champion.

Dr. Eric Fishman: Absolutely.

Ken Ernsting: They make the call, they make the decision, they get consensus and they say here's what we're going to do before.

Dr. Eric Fishman: Let's talk about the change management for just a few more moments. Do you have a team that comes into the office and analyzes their current existing work flow and makes recommendations about what work flow changes will be necessary and what options there are?

Ken Ernsting: Well, there's a couple of things that we can do. First of all, as a part of our training process, we help to do a little bit of that on the front end but we also have a consulting group that is working with the larger organizations in change management work flow to go in and do a work flow assessment, make some recommendations. So we have the consulting group that also goes in there pre-implementation and does some of that work to make sure that they're ready for a full and successful implementation.

Dr. Eric Fishman: Good. Now let's talk, Ken, if we could a few moments about the target market. What physicians, what type of specialties, what size market is the sweet spot.

Ken Ernsting: Well, the sweet spot for us is in the 1 to 26 provider area. We have a lot of very large organizations that have as many as 200 or 300 practices but in terms of the most installations that we have it's in the 1 to 26.

Dr. Eric Fishman: Any particular specialty?

Ken Ernsting: Specialties of course, primary care, pediatrics, internal medicine. We're also very strong in orthopedic practices, cardiologists…

Dr. Eric Fishman: I used to do that.

Ken Ernsting: There you go. I hate to name them because you hate to leave anybody out.

Dr. Eric Fishman: You hate to exclude them so other than possibly oncology or things of that nature that most general purpose if you will or EHRs don't touch, you cover the gamut.

Ken Ernsting: That's right.

Dr. Eric Fishman: Well, Ken, it's been a pleasure chatting with you.

Ken Ernsting: Thank you, appreciate it.

Dr. Eric Fishman: I thank you very much. This is Dr. Eric Fishman with EHRtv. We've been speaking with Ken Ernsting, Vice-President of Business Development for Sage HealthCare. Thank you.

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