HIStalk
Lots of Misys news to report as announcements are made in
London:
- The so-called Diagnostic Information Business, i.e.
Sunquest, is being sold to Vista Equity Partners for $382 million. That
includes pharmacy, lab, and radiology systems.
- The Misys CPR hospital clinical system is being sold to
QuadraMed for $33 million.
- Rumors are that Misys will introduce an open source,
EMR-related product (along with other open source products in its
banking divisions).
- Vista will try to market Misys EMR as part of the deal.
- Both new owners have agreed to support the Misys Connect
strategy.
- UK rules require Misys shareholders to approve the
transaction.
Thoughts
- From QuadraMed's announcement of the CPR purchase, it
appears that Quadramed's motivation was known weaknesses in its own
Affinity clinical offferings, particularly for larger hospitals:
integration and CPOE.
- Misys bought CPR from Per-Se (as Patient1) for $30 million
in mid-2003 and spent a lot of money ($20 million?) tinkering with its
technology underpinnings. So, QuadraMed gets an even better fire-sale
price than Misys got originally, although with a few more layers of
accumulated tarnish. It's now nearly 20 years old with few
installations.
- Misys CPR was once a great product, but it has languished
for many years under two unfocused owners.
- Current KLAS rankings: CPR # 6, but notably one notch ahead
of Cerner Millennium and two above GE Centricity Enterprise (Affinity
had much higher numbers, but too few installs.) Lab: a strong #2 (good
job, Sunquest.) Pharmacy: mid-pack, but too few customers to score
officially. Radiology: #3 of a four-horse race, but once again the
last-placer was Cerner. In other words, if you believe KLAS, QuadraMed
gets an instantly competitive clinical product line for $33 million.
- QuadraMed CEO Keith Hagen is familiar with both products:
before becoming CEO, he was with QuadraMed and left for Misys (although
he was involved in their transaction services, not software).
- One rumor is that the old Sunquest name will be revived. I
like that idea.
- Misys took on 200 Per-Se employees when it bought CPR. I
can't imagine very many are left. Ramping up staff isn't something
QuadraMed has done a lot of, so that will be a challenge (as will
trying to move the office from Tucson if that's part of the plan -
QuadraMed struggled with that in moving everyone to Reston a few years
back.)
- Vista is the same private equity company that bought
Surgical Information Systems in February 2006.
Reader Comments
"Affinity was not
designed for larger, multi-facility organizations and lacked technical
infrastructure to support needed enhancements. Their interfaced,
acquired pharmacy product was never going to work. CPR has an excellent
integrated pharmacy system and an OK lab solution. Much deeper nursing
and CPOE capability. However, CPR is hard to install and most of the
knowledgable staff are long gone. It needs to be configured for
out-of-the-box installation."
"I need some help, as
a business-ignorant techie. Misys just sold of PLX (Pharm,
Lab, Xray) to an investment firm. CPR is probably going to
QuadraMed based on another rumor. What I don't get is
this: Verne keeps telling us that Hospital Systems is
making money and keeping areas like Physician Systems (that
he said is bleeding) afloat. Why sell off the very unit that
is keeping the other units afloat? I just don't get it." Misys Myopia is an interesting
phenomenon caused by bringing over a bunch of Medic people who never
bought into the inpatient thing and just assumed their gravy train had
endless track in front of it. The old, unprofitable product line wasn't
Sunquest or CPR, it was the ambulatory business, but they couldn't see
that. The cash cow has been sold for a low price to try to plug a few
of many lifeboat holes. While this strategy isn't a bad idea, they need
to show far more brilliance and vision in trying to save the only
remaining business than they did deciding to sell this one off.
Mr. HIStalk's Cheap Seat,
Hastily Thought Out Conclusions
- CPR was always a better product than the market
acknowledged. The problem was the incompetent vendors selling,
installing, and supporting it (Health Data Sciences, then
Medaphis/Per-Se, then Misys). Several years ago, when I last looked
side by side (casually) at all the available products (except Epic), I
ranked it #1. Very nice user interface, great for physicians and nurses.
- Affinity Clinicals are pretty good and, despite technology
criticisms (MUMPS and Cache', not much different than the original CPR
technology). Epic is obviously a poster child to prove it's sellable
despite the nuts and bolts. Still, QuadraMed's purchase of Australia's
Detente Systems never really worked out - nobody does real integration
via that route and McKesson is much better at convincing a gullible
market to the contrary than QuadraMed ever was.
- QuadraMed paid $4 million for Detente in 2004. It paid $14
million to get Tempus Software the same year, a much better investment.
- Affinity Clinicals are best suited for small- to mid-sized
hospitals, while CPR's few customers seemed to indicate a big-hospital
preference. Keith Hagen's video statement about the announcement
clearly says they'll offer both products. That's been tough for those
who've tried it before - trying to merge cultures, technology, and
sales is a lot harder than just hanging a new name on it.
- I don't know how many good clinical product people are left
at QuadraMed since Affinity Clinicals were doing pretty much nothing.
Ditto CPR. Who'll be involved? It had better be folks with clinical
backgrounds who can come up to speed quickly.
- Misys management seemed almost openly contemptuous
of the Diagnostic Information Business, but the sales
announcement painted a far rosier picture, with margins of nearly 30%.
Need proof they didn't get it? How about this from the press release: "The Diagnostic Systems
business has been run largely as a stand-alone operation, and therefore
will experience minimal impact in day-to-day operations."
In other words, Misys was adding no value whatsoever and, most
probably, actually hampering that division from succeeding due
to its own corporate- and division-level bungling. And even
then, it was bringing home big profit margins.
- Misys is selling the former Sunquest for slightly less than
it paid: $404 million in 2001. Not much value-added there.
- Misys Connect never amounted to much and will be
irrelevantly straddled across three companies. The only remaining
assets of Misys Healthcare, i.e. the physician systems, will have to
make it on their own with fierce competition. Divesting the other
businesses will let them focus on trying to salvage that struggling
product line.
- Misys finally acknowledges that, grand proclamations about
its vision aside, it lacked the execution and vision to play in the
hospital market. It's first and foremost a banking software company
that happens to own a troubled physician practice software division
hanging on for the ride. It has finally gotten ride of one of its two
unaligned albatrosses.
- QuadraMed has had its share of rough rides, too: wildly
faulty acquisitions, survival without vision under Larry English, the
slow and painful demise of Affinity, and what looked like a wise
retrenchment into the company's only strength: the HIM product and
service market. Will the market accept their re-emergence into acute
care clinical systems?
- The industry needs another strong clinical systems player,
with the odds going down by the minute that a GE-retooled
Carecast will be it.
- Tucson employees of Misys, as Gerald Ford said, your long
national
nightmare is over. Your were already an abused step-child, so it can't
get much worse. The announcements proved what everyone suspected: Misys
Healthcare didn't respect its only successful product lines and the
people producing them.
Post Your Thoughts on
HIStalk Discussion
Since I have to work for a living on Monday, I won't necessarily be
able to post HIStalk updates as any news breaks and to get your
comments online quickly.
Post
here! You can bet that Misys, QuadraMed, Vista, investment
analysts, and everybody else in the industry wants to know what you
think.