Sunday, June 22, 2014

$100 million Epic install dampens Lifespan Rhode Island Healthcare's credit

Lifespan Rhode Island Healthcare System's Siemens EHR was apparently causing thousands of electronically-generated prescriptions to become scrambled, as I posted in Nov. 2011 here:

Due to this "glitch" - and other factors, I surmise - they switched to Epic.

Here are the current results:

$100 million Epic install dampens Lifespan's credit

By Bob Herman

Posted: June 6, 2014 - 5:45 pm ET

A multimillion-dollar electronic health-record system installation is eroding the cash flow, and bond rating, of Rhode Island's largest health system.

Moody's Investors Service downgraded the rating of Lifespan, Providence, R.I., to Baa2—only two notches away from junk-level status. The ratings agency also gave the system, which operates four acute-care hospitals and one children's hospital, a negative outlook.

... At the heart of the downgrade is Lifespan's new health IT system. In March 2013, Lifespan chose to implement an Epic platform, a system spokeswoman said. Lifespan expects to go live with Epic's EHR by the spring of 2015. Moody's analysts noted the investment will cost $35 million this year and $100 million total over the next several years.

This has slammed Lifespan's operating performance, Moody's analysts wrote. Lifespan is projecting a 2.8% operating cash flow margin for fiscal 2014, which is far below the Baa2 median of 8.8%. The operating margin is predicted to hover around -1.7%. And it's not likely to get better soon—executives told Moody's they don't expect to post improved results until 2016.

“The thin performance provides little cushion during a period of increased capital spending and the installation of a new IT system with short-term implementation risks that could disrupt cash flow,” the report said

They're a year from going "live" and they've already damaged their financials.  (This does not account for the losses from abandoning an older system.)

$100 million is not an unusual cost for a commercial EHR, as I noted elsewhere, e.g.,  An entire hospital or large hospital wing can be built with that much money...not to mention the hiring of quite a lot of human health information management professionals.

Hospital executives have bought the "EHRs will save massive amounts of money, eliminate medical errors, and heal the sick" marketing hype hook, line and sinker (as opposed to the more sober "improve healthcare somewhat when implemented expertly").  They are so eager to have this unregulated technology, NOW, that they will place their organizations - and patients - into jeopardy to get it. (As to patient risk, see and its hyperlinks).

I find this phenomenon stunning, and even more so the cognitive dissonance and refusal to believe the actual evidence when the starry-eyed predictions of Cybernetic Medical Nirvana just don't come true.

-- SS


Anonymous said...

Not to worry, they will upcode everything to make up for the shortfall.

Anonymous said...

I'm sure that $100 million is an understatement, and that the computers caregivers are accessing the EMR on are running Windows XP still.

Steve Lucas said...

Every year the business community publishes a list of psychopaths and at the top we see CEO’s, lawyers, and salespeople. This group has no sympathy and do not care about their customers or even employees.

The second rising concept in business is that everyone will get a bailout. This leads the psychopaths to use the logical fallacy that it is ok to destroy a business since the government will come to the rescue.

The reality here is that we as taxpayers have now become the financial backers of this type of business model to the tune of billions of dollars, billions of dollars that could have been used for hands on medical care.

There is a complete and total false economy that is the EMR debacle since government bailouts are in fact taxpayer bailouts and tax money is not the highest and best use of a limited resource. Politicians will tell you all they need to do is take more, but in this taking they are stifling investment and innovation. Money sent to the public coffers is money not being used by a company to improve its operation, higher new employees, or innovate.

Billions spent, more billions planned, no improvement in care, show me the economic gain.

Steve Lucas