A recent article on Behavioral.net highlighted the news of Cerner Corporation acquiring Anasazi software. The article certainly sparked opinions from our readers on LinkedIn. Angela Jones, who works in AVP Database Services at Hathaway Systems, compared this to last year when Netsmart acquired Sequest Technologies. She thinks the acquisition of Anasazi makes sense and says, “I think health care reform will be the driving force behind a few more mergers/acquisitions going forward.”
Roger Larson, an independent healthcare consultant says, “Direct service providers have been merging or being taken over for years.” Having two experiences of his own with this, he says it is not surprising that it’s happening in related industries.
Harriet D. Markell seems to think that this should have happened earlier than it did. “I have been surprised… for a long time that the bigger health IT systems weren’t integrating into behavioral health,” she says. She continues by saying that she thinks this opens the door for integration.
Mary Cotch, MBA, says that the acquisition “appears to be a good move for Cerner to keep up with Netsmart.” She offers some of her opinions saying, “EHR marketplace for BH needs better options for companies of various sizes but particularly in the medium size organizations. EPIC is too big and other players are too small. Now if the market analysts would take a deeper look at these companies it could benefit those BH organizations during their search and assessments for EHRs.”
Disagreeing with Cotch, Michael Johnson, Assistant Director at Fresno County Department of Behavioral Health, says, “Aside from the fact that the former COO of Cerner is now the CEO of Netsmart, I doubt that Cerner spends a moment concerning itself about keeping up with Netsmart. The owner of Cerner would curl up in the fetal position if they only earned what Netsmart earns per year. I only say this to make a point. I've always been surprised at how most of us view our industry. We are completely in the information business, but we rarely view it through that lens.”
He continues, “The reason that many of the big software players in healthcare have not been interested in BH is two-fold. One, there are virtually no standards in our business and so every implementation is a custom job, which translates into Very Expensive – which leads to the second point. Even though we have very high demands and expectations of our vendors, we resist spending money on technology. There is no way we would take software off the shelf and install it in our agency and start using it. And that variability makes us so hard to work with. But we also really feel that we have very little money to spend on expensive software and the right staff to manage it. And so with weak IT departments (compared to hospitals) and high and idiosyncratic demands we have not been attractive to the big vendors.”
“This purchase is clearly a response to integration needs and it will be interesting to see what happens. I hope that having big players in this space will push the states to reduce some of the silly billing and reporting requirements they push on us,” Johnson finishes.
Kathy Krypel agrees with Johnson and wanted to make it clear that “every BH EHR implementation requires a LOT of customization.”
She explains that “the type of providers vary dramatically (LMFT, LADC, LISCW, etc) from place to place - and the diagnostic tools used (GAD-7, Beck, PHQ 9, etc) varies also. Because of this, there is no one EHR, big or small, that can ever fit 'out of the box'. Add to that the fact that ICD9 (soon to be 10) and DSM IV (soon to be DSM 5) diagnostic codes do not match, and you have another recipe for customization.”
Madan Moudgal, founder of Trignon Health, springs off of Kathy’s comment and says, “Software design can address a lot of the variability that is mentioned in Kathy's note above. With the right software design, you can configure a single software platform to address the unique needs of different types of providers with their own diagnostic tools. Also, DSM vs. ICD can be normalized with mapping tools. The key challenge I see is getting BH professionals to define a structure for how they approach their evaluation and diagnosis.”
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