Always keen to chat about health IT so thanks for the opportunity. (I only check HC on the odd occasion as one poster has certainly ‘impacted’ its usefulness…)
Re. the FHIR standards – yeah I wouldn’t think achieving the standard directly helps the SP. (I doubt many investors would know or care about it.) It’s a ‘brag’ you can use to help sell your product. (And, in fairness, various customers do care especially when their digital strategy envisions them reaching a particular HIMSS standard; they’re going to want a product that can support that.)
What about EPR’s were you comparing specifically? Like what were the performance measures used? Or, as you said, was the comparison that competitors were winning in target trusts and ALC wasn’t (which, in itself, rightly raises questions)?
Absolutely agreed – a problem for ALC is that it lacks a clear-cut competitive advantage. From my experience it has several ‘strengths’ over its competitors e.g. the IP of its data analytics; it’s far more useful to the clinician in the moment as opposed to say Altera Sunrise (painful user interface, glitchy and that eventually produces clinical issues e.g. https://amp.abc.net.au/article/104028618). But Epic is the market leader re. users loving it. (Nervecentre talks a good game about being user-friendly but I’ve seldom met a clinician who agreed.)
Another strength for ALC is that prospective customers have a greater ability to extract a specific Miya feature and integrate it into their existing infrastructure. (Think the Cerner-Miya Flow integration at East Lancashire, or the Sunrise-Flow integration at Bolton.) Again this skill isn’t unique to ALC (e.g. Nervecentre and System C hold their own); nonetheless ALC is very ‘nimble’ in acute setting deployments. (That edge wears off if you scrutinise their background development processes; think how long it took to make the SL PAS cloud deployable.) Anyway, customer’s ability to ‘precisely’ select and integrate a Miya function also makes ALC’s offering more competitive in terms of price…which has the downside for shareholders of meaning ALC gets paid less*. One could argue ‘sticky customers’ are another strength but they’re equally an obstacle when they’re not your customer lol.
Ultimately, all these benefits can be replicated or rivalled by others so I don’t want to oversell them. (The EPR market is just beyond saturated...Rio, Civica Paris, Nervecentre, Altera, System C, Intersystms, Dedalus, Cerner, EPIC, bespoke solutions like WebV etc. etc. ALC’s ability to pivot to the flow, virtual care and/or similar market segments is possibly its ultimate advantage.) Our competitors have continued to make sales as (some) have their own strengths (looking at you Epic and Birmingham’s bespoke PICS). But other rivals don’t have a strong value propositions and that’s where market opportunities exist e.g. the roughly 14 or so trusts still using Lorenzo, or NCIC replacing both Rio and Emis EPRs with Miya Precision.
*One place where I suspect ALC is at a disadvantage is its billing power. Take our relationship with Dartford as an example. We’re a key partner, we’ve invested in, and strengthened that relationship over several years (and that it is excellent). But for all that effort, look at the bottom line impact as reflected in the per annum TCV:
