Stimulus effect is anybody's guess at this point

Nobody knows for sure how this whole stimulus business is going to shake out, but that hasn't stopped prognosticators from prognosticating or pundits from...punditing?

On Monday, Allscripts-Misys Healthcare Solutions reported strong earnings for its second fiscal quarter. Its revenue of $94 million was 16 percent better the year-ago period, but below analysts' estimates. So, naturally, Allscripts stock dipped by more than 6 percent. Investors also dumped shares of Cerner, Athenahealth and Quality Systems, the parent company of NextGen Healthcare Information Systems, leading one news service to wonder if this was a "final buying opportunity" for EMR stocks, because it looks like many physician practices will defer their purchases until 2011.

The fact that the recently released proposal for the EMR incentive program would only require doctors to demonstrate meaningful use for 90 consecutive days in 2011 to get the full year's Medicare bonus of $18,000 may be the cause for this perceived delay. "It won't be a wholesale slamming of the breaks [sic] that some bears think, but with [Monday's] bookings number, Allscripts has showed that the bar will be a little bit lower," market analyst Leo Carpio is quoted as saying in The Street.

If only it were that easy to be confident in his forecast. The previous Friday, Jan. 8, Healthcare IT News reported that EMR sales were off to a "great start" in 2010 thanks to the stimulus, citing a Piper Jaffray research report. "We continue to believe that mega-deals will continue as hospitals seek to capture first-mover advantage and HHS' finalization of stimulus criteria will act as a catalyst for stand-alone physician/group practices to jump into the deal foray," Piper Jaffray health IT analyst Sean Wieland wrote.

An unscientific survey of my email inbox seems to favor Wieland. Normally, I'd put EMR contract "wins" in the Also Noted section of this newsletter. This week, I had too many to fit in that section, but here's a quick rundown:

- Jordan Valley Community Health Center, Springfield, Mo., signed a deal for a NextGen EMR, practice management software, a patient portal and a Quality Systems electronic dental record.

- Medsphere Systems entered into a series of partnerships to promote adoption of the company's OpenVista EMR.

- Allscripts inked a contract with Catholic Health Initiatives to provide EMR systems to the organization's 1,050 employed physicians and offer the software to more than 7,200 affiliated doctors.

- QuadraMed and e-MDs will supply EMRs to physicians affiliated with University Medical Center at Princeton in New Jersey.

- Bronx Lebanon Hospital Center in New York City completed a "big-bang" rollout of an Eclipsys Sunrise Enterprise system. 

And there are more. Still, some consultants I've heard from the last few weeks tell me their business is way down. Perhaps that's a symptom of the traditional December slowdown, or a sign that interest is cooling, or simply the result of an overall spending freeze at many healthcare organizations. Whatever, I'm getting a lot of mixed signals about the impact of the stimulus, at least so far. - Neil

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