Government // Leadership
10:43 PM
Anthony Guerra
Anthony Guerra
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Guerra On Healthcare: Upset Customers Can Be Good

As a private company immune from the pressures of quarterly results, Meditech can focus on the long term and chart a course that ensures its customers will be as happy tomorrow as they might be today.

I had repeatedly heard stories about the extended wait times for the company's software -- wait times that were as true for existing customers desperate for upgrades as newly signed clients desperate for delivery. I thought to myself, "Man, that company must be in some serious trouble. There's no way those customers and prospects are going to sit around and miss HITECH deadlines because their vendor can't it together."

I thought that for a long time, that is until I interviewed the President and COO (soon to be CEO) of that company last week. The executive is Howard Messing, and the company is perhaps the most important one in healthcare IT -- Meditech. What Messing said taught me a lot about running a company (I currently run my own), serving customers, and resisting the temptation to grab easy money today at the cost of unhappy clients tomorrow.

To his credit, Messing didn't shy away from the software wait times one bit, explaining that the simple fact was demand currently outstripped capacity. He said that some of the upgrades in question were major ones, and required heavy lifting of both the client and his organization. Messing emphasized that Meditech was not about to make promises it couldn’t keep, it would not set customers up for dissatisfaction down the road.

"If we lose business because we can't meet a particular customer's need for dates, so be it," he said.

So in the purest spirit of customer service, Meditech is telling some customers it can't serve them, at least not right away. The company, he says, is in it for the long term and must chart a course that ensures customers will be as happy tomorrow as they might be today.

Though Messing admitted turning down cold hard cash wasn't easy, he explained Meditech only had the ability to chart that course because it was private, and not subject to shareholder demands that this quarter beat last, and that any quarter beat the expectations of the Street.

Of the major acute EMR vendors -- those I call the Big 7 -- only two are private: Meditech and Epic. Both are still run by folks who have invested their whole lives in the business, and both are outstanding organizations with generally happy customer bases. Is it possible for one of the other five -- GE Healthcare IT, Siemens Healthcare, Cerner, Eclipsys or McKesson Provider Technologies -- to make their customers just as happy, to provide software that is every bit as dynamic? Of course. But it is still a fact that those publicly held organizations must consider the quarter as much, if not more, than the decade.

The interesting thing is hospital/vendor relations -- especially in the core clinical area -- can literally be measured in decades, at least in five year increments. So which type of vendor best matches up with the time horizon of its customers? While Meditech and Epic can more easily focus on the long term, it will be the willingness of the others to fight for it that will determine their survival. And that fight will fall to the CEO, or whomever the head executive in question happens to be. This is where leadership matters, where the human being who holds that role can have a concrete and dramatic effect.

Public company CEOs with the nerve to stand before their boards and shareholders and exclaim "If we lose business because we can’t meet a particular customer's need for dates, so be it," will have a chance of winning the future, because there is a direct correlation between grabbing too much easy money today and losing tomorrow.

Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at

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