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Rolling with the changes


By Joseph Goedert, News Editor July 2007
Hospital information systems vendor Healthcare Management Systems Inc. has had the same overriding market strategy since its formation in 1984. "Our proposition from the beginning was an integrated product for the small hospital market," says Thomas Stephenson, president and COO.

That's why about 80% of HMS' sales include its complete line of clinical, financial/administrative and ancillary information systems. And the strategy has been successful enough to enable the privately held Nashville, Tenn.-based company to be profitable nearly from the beginning, although there have been some years where it broke even, Stephenson says. In 2006, profit rose 29% as revenue increased 15%, he says. The company has more than 500 hospital clients across the nation, most with less than 200 beds.

But market forces compel changes in corporate strategy. In recent years, HMS' customers have been looking for more functionality in clinical systems. The company and its rivals-primarily Computer Programs and Systems Inc., Dairyland Healthcare Solutions, McKesson Corp. and Medical Information Technology Inc.-have had a lot of work to do. "We've put a significant amount of work into development in the past two or three years," Stephenson says.

HMS has added electronic signature functionality and medical image viewing to its physician Web portal, rolled out enhanced clinical documentation, and improved workflow and integration between the nurse documentation and medication applications, he says. Another improvement, expected to roll out in late summer, will enable the routing of scanned documents to the physician portal for review and electronic signature.

By the end of this year, HMS will enable clients to transmit data from medical devices to the electronic health record, using interfaces developed by Capsule Technologies, Paris. Clients have requested this capability, Stephenson says, but the costs of interfaces from device manufacturers had proven prohibitive.

A new industry force is affecting hospital information systems vendors, including HMS.

The Certification Commission for Healthcare Information Technology this summer will launch its first certification program for inpatient electronic health records.

Stephenson says the desire to become certified "certainly caused us to accelerate our development plans."

For example, improved links between laboratory and medication applications, enabling physicians when prescribing to check laboratory results against ordered medications for possible complications, are expected to roll out this summer instead of next year.

Further, HMS accelerated enhancements to some security and audit functions to meet CCHIT criteria.

HMS' goal is to earn certification for its EHR in the first round of the CCHIT inpatient program.

"Obviously, we want to be in there and if so, I think we'll have an advantage," Stephenson says. "But certainly by the second round, you want to be certified."

Filling The Gaps

HMS and its rivals that target the smaller hospital market offer similar suites of products, Stephenson acknowledges. Each vendor is strong in some areas and lagging in others. "We're better with nurse documentation, physician portal and financial reporting," he asserts.

On several fronts, HMS is working to strengthen its applications. The company expects, for instance, an enhanced home health product in 12 to 18 months.

Another weak area was resolved last year when the company partnered with MediNotes Corp., West Des Moines, Iowa, to offer ambulatory practice management and electronic records software interfaced with the hospital systems.

In most cases, hospitals are buying the ambulatory software for owned clinics, but Stephenson believes the Internal Revenue Service's recent ruling on hospital information technology donations could present some new business opportunities. He isn't aware of hospitals that were ready to start a donation program pending a favorable IRS decision, "but I'm sure they are out there."

Another area of opportunity is remotely hosted software services, which HMS has offered for seven years. Interest is rising as smaller hospitals and start-up long-term care facilities adopt advanced clinical applications requiring upgraded hardware, Stephenson says. "We've seen a real upswing in the past year of ASP services."

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