April 17, 2006

Medical records project has breakaway winner

Christopher Rowland
Software produced by a start-up company in Westborough has emerged as the overwhelming favorite among doctors participating in a $50 million electronic medical records experiment in three Massachusetts communities.

The privately held company eClinicalWorks was favored over much bigger players in the electronic medical records marketplace, including GE Healthcare, Allscripts, and NextGen, in what amounted to a ‘‘beauty contest” that is being watched by medical technology wonks nationwide.

Each of the vendors was screened and preapproved last year by the Massachusetts eHealth Collaborative, a nonprofit organization that is coordinating the pilot project.
Next, each of the software vendors made presentations to groups of physicians in the three pilot communities -- Newburyport, North Adams, and Brockton -- in an effort to win the business.

Now doctors have made their selections and the first practices are getting wired. The president of eClinicalWorks, Girish Kumar Navani, said in an interview last week that eClinicalWorks software was selected by 170 out of 180 doctor’s offices in the three communities.

Navani credited its success to the company’s start-up culture and its modern, Web-based software, developed in 1998 and 1999. ‘‘We think a lot faster, we move a lot faster, and people cannot compete with our speed and agility,” he said.

For the participating doctors, numbering about 450 in all three communities, price did not enter the equation. The bills are being paid by the Blue Cross and Blue Shield of
Massachusetts Foundation, which launched the $50 million project to encourage adoption of electronic records. Computerized systems can make healthcare more efficient and help doctors and insurance companies measure performance.

‘‘It’s fair to say we didn’t have any expectation that a lot of practices would go to a single system,” said Micky Tripathi, chief executive of the eHealth Collaborative. ‘‘That was somewhat unexpected.”

Neither the collaborative nor any of its competitors offered an explanation as to why more physicians chose the eClinicalWorks system. But GE Healthcare executives said their programs are geared for medium- to large-scale practices with dozens of doctors.
Many of the practices in the eHealth Collaborative are small practices.

‘‘People make the best choice on their circumstances and their need,” said Blair Butterfield, senior director of government initiatives for GE Healthcare integrated IT solutions. NextGen and Allscripts did not respond to requests for comment.

Dr. George Papanicolaou, who is part of a two-doctor family practice in Rowley, near Newburyport, said he wanted a system that would make his office staff work faster, that would alert him when patients are due for mammograms and other tests, and allow him to make sure prescriptions are matched with the right patients. He said he tried out several competitors and decided that eClinicalWorks is the fastest and simplest and required the least technical support.

‘‘Changing the system and customizing it for my practice did not require any high-end support,” he said. ‘‘If you’re a small practice, you need something that doesn’t require a lot of infrastructure support.”

Navani is a software developer who studied at Boston University and worked for
Teradyne Inc. and Fidelity Investments before breaking out on his own with a group of partners, including relatives and friends, in 1999. EClinicalWorks booked $25 million in sales in 2005 and is aiming for $40 million in 2006, Navani said. The company employs about 250 people at its Westborough offices.

The company has its systems in about 2,000 doctors’ offices nationwide, with 5,500 practicing physicians, which compares to about 25,000 offices for Allscripts and 20,000 offices for GE Healthcare.

Its software costs $10,000 for the first doctor in a practice and $5,000 for every other physician. Training costs $500 a day. Using those numbers, a 10-doctor practice can get wired and trained for $65,000, assuming 20 days of training, Navani said. A single doctor would pay $12,500, assuming four to five days of training, he said.

The bulk of eClinicalWorks’ clients are in California, Texas, and Florida, Navani said. Massachusetts is not among its biggest states. ‘‘We do not have a home-field advantage,” he said.

The company is shooting for sales of $100 million by 2009, but it has no plans to go public, Navani said. He said he likes the business model of his former employer.

‘‘If Fidelity can stay private, why can’t we?” he said.