Today, Microsoft officially announced that it is shutting down operations and sales for Amalga HIS. Amalga HIS was the former Global 2000 EMR that Microsoft acquired roughly two years ago. Global 2000’s claim to fame was being the EMR for the major medical tourism hospital, Bumrungad International, based in Thailand.
I never liked the acquisition of Global 2000 for a few simple reasons:
1) Despite “low adoption of EMR” systems, the EMR market is actually a fairly mature market. Most hospitals have an EMR already and it is not easy to dispace such – much like chipping out concrete. The “adoption problem” rests more with poor implementation and use, at least in the acute care market, which was the sweet spot for Amalga HIS.
2) Though Microsoft claimed that Amalga HIS would only be sold overseas, primarily in APAC, this acquisition put many an EMR company on alert to be careful working with Microsoft for Microsoft may change its mind at some future date and become a competitor in their backyard. This hinders Microsoft’s ability to develop closer partnerships with these vendors, which Microsoft admitted was the case in a call with them earlier today.
3) The EMR market is a very messy, competitive market with far too many vendors. The last thing it needs is another acute care EMR solution, even if it did come from a heavyweight such as Microsoft. Also, one would have thought that Microsoft learned from its previous mis-steps in the Enterprise Resource Planning (ERP) market (very similar in many respects to EMR), where it made several acquisitions, but the return on that investment is less than stellar.
4) The EMR market, being messy, mature, etc., is not a market where one can truly be disruptive. But once that data starts being collected and begins to have some structure, then the application of analytics and reporting to better understand operations and how to ultimately improve them, is a higher order of value that will be of high interest to healthcare organizations, both large and small. This is a disruptive opportunity. Now that we have a major push to drive adoption and use of EMRs/EHRs, that data will increasingly become available for solutions such as Microsoft’s Amalga UIS. Microsoft can now focus its resources on this disruptive opportunity, rather than waste resources on an EHR.
It now appears that Microsoft has come to the same conclusion. Thankfully, Microsoft is not leaving dozens of hospitals in the lurch. Actually, Amalga HIS has only six customers today and those customers will receive support for the next five years. After that they will be on their own, but Microsoft has assured me that they are working with third party vendors and service providers to insure that these customers will receive continued support in the future.
One take away from all of this:
Performing a viability assessment on a potential vendor may not reduce one’s risk. Even a big, viable company such as Microsoft may change its mind on occassion and chose to exit a market.
Will this impact Healthvault and its future?
No Archibald, MSFT’s pull-out of the EMR market will not impact its other HSG initiatives such as HealthVault. Actually it may strengthen MSFT’s HealthVault efforts for EMR vendors may become more willing to work with MSFT in connecting to HealthVault in support of Meainingful Use rules for patient access to their personal health information (PHI).
I work with Amalga. Microsoft’s customer support is horrible and the product itself is NOT worth the price. We find ourselves fixing deficiencies that should have been fixed by Microsoft.
Its very interesting, and in my opinion exciting, to see these EMR companies grow and fend off huge companies like GE and Microsoft. Most industries succumb to the juggernauts once they enter, but with the resiliency of so many EMR companies I think we will see good competition for a long, long time, which only benefits the consumer.
The reason the EMR/EHR market is “messy” and “mature” is because no EMR/EHR has solved the simple issues of making a clinician’s work simpler and more productive. If someone does that it WILL be disruptive.
I am very familiar with Amalga UIS. It is a terrible system. I’ve been working with it for 6 months now, and here is what I’ve learned: 1) its indexing and surrogate ID methodology adds too much overhead to queries 2) its dade filer is WAY too chatty with file io 3) the HL7 parsers are sub-standard (which is sad because I work somewhere that has a cloverleaf license and yet because of politics we have to use a far from acceptable alternative) 4) the console is a joke 5) the ERD (that they give you) is based on HL7. I don’t know if anyone explained this to them, but HL7 is a message format, not a serialization model. Because it is redundant, you end up with lots of redundant unauditable crap in the DB. I could continue, but it is really too sad given how tight budgets are these days.
Dan —
First of all, sorry that you’ve had trouble getting Amalga to work well for you. While we’re seeing great success with the majority of our customers, it is a complex product with a ton of “knobs” to turn, and it can be easy for things to go wrong. The performance issues you note are classic examples of this — DADE and AmalgaID easily support millions of daily messages and queries at a bunch of customers … but if the systems aren’t built and tuned right, they can seem sluggish even at low volumes. Same with the “sample hospital” ERD — the HL7-based tables are a great starting point, but that’s all they’re meant to be — each customer is free (and expected) to customize or replace these tables as appropriate for their situation.
To make sure things *don’t* go wrong, we try hard to ensure that customers have the right support channels to resolve issues before they become a big deal. In addition to formal support channels, our engineers as part of their responsibilities regularly read and respond to issues on our community forums — having that direct line of communication between the product team and customers goes a long way.
We believe we’re on to something with Amalga — a unified data asset supporting a ton of use cases, exposed through a variety of clients and tools. If there are specifics that I can help you resolve, feel free to drop me a note using the contact form at http://familyhealthguy.com. Thanks!
—S
Its amazing thing to know these EMR companies grows and fends off huge companies like GE and Microsoft.