Is there life outside HITECH?

With all the talk on Meaningful Use, I am left sometimes to wonder what happens to all the other systems that are not ARRA linked? The biggest and most brutal to think about is your patient accounting and patient management system. Like it says in Les Miserables, “At the end of the day, you're another day older.” These systems, many written in the 70s, continue to perform well but they're not getting any younger. The pressure behind this dam is building, and the question comes to us often, “When will it actually make sense to move off this dinosaur?”

Well, in many cases, this dinosaur has legs. One CIO commented, “We need to replace our system, but our A/R days are in the low 40s, and I don't see us getting any better with a new system. How do I make a reasonable argument to the CFO for a new system, until this one just dies?” Much like my 1982 Honda Accord, that is bound to happen at some point…but when?

With ICD-10 and the impending pressures of accountable care, it may be that this dam will actually break, but likely not for a few years. And what then? Are the new patient accounting systems ready?

• Siemens Soarian has the most progress of best of suite systems, getting over the hump with some large medical centers installed and about 15 organizations live.
• McKesson has a handful of sites on their new Horizon ERM (one doing billing) and a huge client base of Star, Healthquest and Series customers waiting.
• GE and QuadraMed continue to have a fairly loyal group of customers, but not many are buying.
• Meditech, Epic and McKesson Paragon work well for enterprise buyers while Cerner ProFit is getting closer to reality for select Cerner customers, with a few large customers stepping to the plate.
• Eclipsys is updating their Sunrise Financials to integrate with Sunrise Clinical Manager, and the new access management is confirmed live.

Most of these new systems are literally years behind where they were expected to be, and with the risk-averse nature of healthcare organizations when it comes to billing, maybe ARRA was a good thing. These systems may actually be tested and true by the time the dam breaks. With news this week that both McKesson and GE are putting their clinical and financial teams under the same business unit, let's see if that speeds up either of them bringing proven solutions to market. What is the safe answer today? For many it is wait and see.