Salesforce to make big push into healthcare industry(reuters.com)
reuters.com
Salesforce to make big push into healthcare industry
http://www.reuters.com/article/2014/10/26/us-salesforce-com-health-exclusive-idUSKBN0IF0EA20141026
5 comments
Well, Epic is the #1 EHR in the country (and several others), with something like 30-40% of the market. They will absolutely crush anyone that tries to go head to head with them. One of their top competitors did abour $1.2bn in revenue last year and lost over $300m trying to compete with Epic. Their EHR works well enough, but doctors hate it, and it costs a literal fortune to install and maintain. So who know what will happen in 10 years.
However, my personal opinion as a healthcare software developer is that SalesForce has gravely miscalculated if the intend to produce an EHR/EMR system. Product lock in is on the order of a decade.
However, my personal opinion as a healthcare software developer is that SalesForce has gravely miscalculated if the intend to produce an EHR/EMR system. Product lock in is on the order of a decade.
I took traning like a decade ago to become Epic systems admin. They use Caché database, a hierarchical db. MUMPS and visual basic are a couple of languages they use.
Kaiser permanente is a big customer of Epic. At one point, Kaiser wanted equity in privately held Epic systems, because Kaiser thought it is the market maker for Epic systms. Epic systems did not budge to Kaiser's demands.
Unless salesforce comes with a solid product to compete with Epic, no big hospital would buyt Salesforce product. If I were the decision maker, I would rather go with a product that can be successfully implemented; otherwise, I would end up loosing the job like those bad $1B SAP implementations.
What is the impact of cloud in healthcare EHR. Not much, healthcare is like banks, finance. Lots of regulations like HIPAA, audits, etc.
Yes, Epic and non-epic systems can be interfaces via HL7, which is like XML.
When banks move to cloud, thats when we expect healthcare IT to move to clound. Until then, it is gonna be in the datacenters managed by hospitals.
Kaiser permanente is a big customer of Epic. At one point, Kaiser wanted equity in privately held Epic systems, because Kaiser thought it is the market maker for Epic systms. Epic systems did not budge to Kaiser's demands.
Unless salesforce comes with a solid product to compete with Epic, no big hospital would buyt Salesforce product. If I were the decision maker, I would rather go with a product that can be successfully implemented; otherwise, I would end up loosing the job like those bad $1B SAP implementations.
What is the impact of cloud in healthcare EHR. Not much, healthcare is like banks, finance. Lots of regulations like HIPAA, audits, etc.
Yes, Epic and non-epic systems can be interfaces via HL7, which is like XML.
When banks move to cloud, thats when we expect healthcare IT to move to clound. Until then, it is gonna be in the datacenters managed by hospitals.
>Yes, Epic and non-epic systems can be interfaces via HL7, which is like XML.
Epic has a Restful(ish) system now too. And most of the others have full on JSON APIs now.
Epic has a Restful(ish) system now too. And most of the others have full on JSON APIs now.
You could replace every instance of Epic with Siebel and find hundreds of similar quotes when Salesforce prepared to take out the leader in enterprise CRM.
As a consumer, the EHR space seems ripe for revolution. 5 years from now, they may not be the leader, but I expect they will own a sizable share of the market and introduce a serious competitive threat to existing players.
I would count the following in their favor: 1- Their cloud design makes rollout easy compared to a data-center installed product. 2- Their existing and growing mobile offerings could be a disruptive option for both health care providers and consumers. 3- The AppExchange Marketplace allows a wide spectrum of 3rd parties to easily integrate into the core platform. This has proven to be a very powerful added benefit in other markets (disclosure: I presented on this topic at Dreamforce earlier this month). 4- Low overall cost of adoption. It is very easy to develop custom solutions on Salesforce. I could see some potential customers opting for a small pilot that proves the value of Salesforce over an existing install. 5- A provider still adapting to changes from ACA could use this as an opportunity to make a change. Ideally, Salesforce would have done this a few years ago, but there may still be enough Obamacare disruption to gain traction.
As a consumer, the EHR space seems ripe for revolution. 5 years from now, they may not be the leader, but I expect they will own a sizable share of the market and introduce a serious competitive threat to existing players.
I would count the following in their favor: 1- Their cloud design makes rollout easy compared to a data-center installed product. 2- Their existing and growing mobile offerings could be a disruptive option for both health care providers and consumers. 3- The AppExchange Marketplace allows a wide spectrum of 3rd parties to easily integrate into the core platform. This has proven to be a very powerful added benefit in other markets (disclosure: I presented on this topic at Dreamforce earlier this month). 4- Low overall cost of adoption. It is very easy to develop custom solutions on Salesforce. I could see some potential customers opting for a small pilot that proves the value of Salesforce over an existing install. 5- A provider still adapting to changes from ACA could use this as an opportunity to make a change. Ideally, Salesforce would have done this a few years ago, but there may still be enough Obamacare disruption to gain traction.
As someone who writes for one of the big EHRs, writing a CRM is like generating a Rails CRUD template app, throwing out an open beta, then convincing some people to try it out. Writing EHR is like then having to do the same then white box test it with unit tests and integration tests, black box test it, UI automation test it, meet ridiculous amounts of regulations like defects per amount of code and auditing requirements about design and meetings for every code change, getting certifications, deploying it to half a dozen test environments before it hits production, live test runs at clients who are all trying to competitors as well, and absolutely massive amounts of bureaucracy in place for handling incidents and remediation and all the legal mumbo jumbo and required response times that go with them, then finally maybe getting someone to use it for real. Writing medical software is a nightmare and difficult to enter into.
Yea, very similar to rolling out Salesforce in financial services...
fwiw Salesforce announced Merrill Lynch as their biggest customer in 2007 and have added a few more since then.
http://www.zdnet.com/blog/btl/why-salesforce-coms-merrill-ly...
http://www.computerworlduk.com/news/cloud-computing/2049/mer...
http://www.zdnet.com/blog/btl/why-salesforce-coms-merrill-ly...
http://www.computerworlduk.com/news/cloud-computing/2049/mer...
While that all may be true, Healthcare is a completely different space. Importantly Epic is years ahead on meaningful use requirements, and they seem to have a seat at the table so to speak deciding what those requirements might be.
They also have lock in, once you're an Epic hospital, it might bankrupt you trying to switch. The training costs, testing equipment interfaces, building new data interfaces, HL7 engines, and on and on.
Additionally, if you try to switch to a 2nd or 3rd EMR in 10 years the doctors will riot.
AND... if some you new EMR should ever be implicated in killing someone, well you're done.
They also have lock in, once you're an Epic hospital, it might bankrupt you trying to switch. The training costs, testing equipment interfaces, building new data interfaces, HL7 engines, and on and on.
Additionally, if you try to switch to a 2nd or 3rd EMR in 10 years the doctors will riot.
AND... if some you new EMR should ever be implicated in killing someone, well you're done.
What'll happen in 10 years?
I've used salesforce as a development platform before, and still do not understand the hype that surrounds it within enterprise. I found that it actually slowed down development, costs where sky high and constantly worrying about rate limits and working around the system.
The only people who seemed happy was the salesforce sales guy and management who got the pitch from them.
The only people who seemed happy was the salesforce sales guy and management who got the pitch from them.
Very typical for enterprise software. The managers who make the purchasing decisions are not the people who have to use or administer the software.
If it makes you feel any better, we went with SugarCRM instead of Salesforce, and the primary non-financial reason was exactly this: my team actively pushed against having to create interfaces to and program against Salesforce.
I am a daily end user of Salesforce, though I'm not in health.
It is a terrible platform. Either this stuff is really hard to get right, or Salesforce suck.
I think Salesforce caught the "cloud bubble" at exactly the right time, it was all hype with very little substance. However that led to sales, and now to ongoing bookings because customers are locked in.
For anyone seriously using Salesforce, leaving it would be have more to do with business politics and finance than any sort of technical merit.
It is a terrible platform. Either this stuff is really hard to get right, or Salesforce suck.
I think Salesforce caught the "cloud bubble" at exactly the right time, it was all hype with very little substance. However that led to sales, and now to ongoing bookings because customers are locked in.
For anyone seriously using Salesforce, leaving it would be have more to do with business politics and finance than any sort of technical merit.
"With its new approach, Salesforce may have a tricky time convincing dominant health record vendors like Epic Systems and Cerner Corp to share information. Their cooperation would be vital in serving some major customers."
The only way Salesforce or anyone else will usurp entrenched players like Epic, Allscripts, Cerner, etc. is if they can provide an equal or better product (not that difficult) that ALSO is open in bidirectional programmatic data access. Open access to EMR housed data is the next revolution in health care as all current health data is locked in data silos. Open data is the only real differentiator in the space. That said, it doesn't seem like Salesforce is entering the market with an EMR. They seem to be providing ancillary services like secure messaging.
Here are some of my thoughts on health data integration:
http://siculars.posthaven.com/health-data-integration-regula...
The only way Salesforce or anyone else will usurp entrenched players like Epic, Allscripts, Cerner, etc. is if they can provide an equal or better product (not that difficult) that ALSO is open in bidirectional programmatic data access. Open access to EMR housed data is the next revolution in health care as all current health data is locked in data silos. Open data is the only real differentiator in the space. That said, it doesn't seem like Salesforce is entering the market with an EMR. They seem to be providing ancillary services like secure messaging.
Here are some of my thoughts on health data integration:
http://siculars.posthaven.com/health-data-integration-regula...
Working for a fortune 20 health care company, one of the top 5 ehr among other fields.
We are in the process of switching to sales force over ms dynamics for a new crm and document management system.
Suprised to see them enter this space. Its growingly dominated by epic and other big players.
We are in the process of switching to sales force over ms dynamics for a new crm and document management system.
Suprised to see them enter this space. Its growingly dominated by epic and other big players.
>Suprised to see them enter this space. Its growingly dominated by epic and other big players.
It's still vulnerable IF they can push a solid product that looks modern and offers many of the things that existing products offer, but that will require a pipeline of product managers and docs/nurses who already know the landscape because chances are, picking up developers already in this field will get you more of the same quality the industry has to offer.
Okay, not TOTALLY their fault. Programmers != designers necessarily, and designers are sometimes have their hands tied legally, but 2k line functions? Ugh.
As an anecdote, optometry could also use better software (from my optometrist).
It's still vulnerable IF they can push a solid product that looks modern and offers many of the things that existing products offer, but that will require a pipeline of product managers and docs/nurses who already know the landscape because chances are, picking up developers already in this field will get you more of the same quality the industry has to offer.
Okay, not TOTALLY their fault. Programmers != designers necessarily, and designers are sometimes have their hands tied legally, but 2k line functions? Ugh.
As an anecdote, optometry could also use better software (from my optometrist).
Health care is the last field I'd be targeting for the next couple of years. There is going to be a lot of churn as the longer-tail provisions of obamacare take effect, and as they are changed and/or repealed by future administration(s).
Anytime I visit the doctor, they always have Epic up on the computer. Granted, I know I'm living in the city where it's made, but it's used across the country. I even had a friend who moved out West and planned on just finding a random job, and it ended up being Epic to help install the software at health clinics in Washington.
I don't know their full stack of offerings, but I used some of their treatment billing software when I worked at a health care insurance company during my college summer vacation. It worked just fine, but certainly had an old software feel to it. I don't know if they offer any cloud offerings right now (their website sure doesn't make me think they do), but if they do I find it hard to imagine it's anywhere near as powerful as something that Salesforce could offer right out of the gate. I work with Salesforce every day where I work now and I have to admit it's very well done, although they certainly fall short in some areas.
I don't particularly care about Salesforce or Epic so long as my data is safe, but I'm interested to see how it plays out since it impacts my community.