Anyone who follows WM (owner of Sam’s Club) should have a pretty good idea of what happens when WM lines up a target. They are the single largest retailer in the world and the company has changed the face of retail America and its suppliers (a subject on which I’ll reserve further comment). Because it constitutes such a large portion of America’s economy, the company carries quite a big stick. I’ve read stories of vendors’ dealings with buyers in the great halls of Wal-Mart in Bentonville, Arkansas. What Wal-Mart buyers say they require, the vendor WILL deliver – it’s simply too large a marketplace to ignore or flip off.

And let’s not forget Dell, which is part of the deal and will be supplying the hardware that will be running this show. The deal claims that “cost and complexity” of physician adaptation of an EMR will be mitigated by the Sam’s Club offering.

The blogosphere that follows healthcare technology exploded with its opinions about this deal.

An Odd Couple with Good Intentions at the EMR Software Advice blog is a good description of this marketing marriage.

Furthermore, we do see some very real sales and services challenges arising from this partnership. Simply put: sophisticated, $25,000 EMR systems don’t sell themselves. Get a Wal-Mart “greeter” involved and things could get ugly. Wal-Mart has already stumbled a bit trying to support the relatively complex sale of iPhones. EMRs are a far more complex sale. My mind goes to the horribly awkward image of a brilliant, yet intolerant, cardiologist interrogating a greeter about eCW functionality. The mismatch of intellect and clinical expertise could be incendiary.

Topping off the accuracy of the above statement, WM and eCW haven’t been terribly forthcoming about what price breaks they’re offering or what additional value the buyer gets by going through the Sam’s Club offering.

(Just for kicks and grins, I went to the Sam’s Club web site to see if this had been added as one of the services.  So far, it’s not. But I did get a giggle when I pictured “electronic medical records” listed as a service with credit card processing, web site services, printing and shipping, and commercial insurance. I mean, really – isn’t it just a TAD more complex than that??)

Putting aside my sense of humor and cynicism, I’d have to point out how happy I’ve been with  business services through Costco. I’ve used their business service for payroll and voice mail services, and their personal service for auto purchase. Basically, it’s a matter of using the required format for letting the vendor know you came to them through Costco so you can get the discount. Once you’ve done that, you’re in the hands of the vendor and Costco doesn’t get involved – or I’ve never had a reason to try and involve Costco.

Back in my cynic mode… if the Sam’sClub/eCW deal is going to accomplish what the press release claims, that’s not the way the transaction is going to happen.

In reading the press release, it sounds to me like Sam’s Club plans on facilitating sales and implementation, not just introducing the parties and standing back – which is the way the transactions for services at places like Costco and Wal-Mart currently are handled.

“Cost and complexity have been the primary barriers to EMR adoption,” said James Coffin, vice president of Dell’s Healthcare and Life Sciences business. “Partnering with eClinicalWorks and Sam’s Club, we are addressing both by providing an EMR solution that is easy to purchase, easy to implement and easy to manage so that healthcare providers spend less time on administration and more time serving patients.”

Unless Sam’s Club has facilitators, nothing in this partnership makes any of these processes easier. And if there is a third party injected to facilitate, it would seem to me the cost would go up, not down. Perhaps Sam’s Club is requiring Dell and eCW to step up implementation service? Without more information from any of the parties involved, it’s difficult to say.

Further in my cynicism… I frequently have people contact me, wanting to sell me services to find clients. Here’s the thing, however: my client base isn’t difficult to find. By the same token, eCW’s client base should be pretty easy to find. I’m not quite sure what they get from partnering with WM when it’s so easy to identify potential customers and reach them in the appropriate place for selling an EMR (i.e., their office) and when they’re in the frame of mind to buy what’s being sold (i.e., at work). I’m having a difficult time picturing  someone at a practice meeting snapping their fingers and saying, “EMR – hey, let’s check out Sam’s Club!” Or a doctor detouring from the snack aisle to go check out what Sam’s Club has in the way of EMRs for the office. If you can’t sell an EMR directly to an easily identified client, I’m not quite sure what Sam’s Club is going to do for your product sales.

And what does this say for the current implementation process? It sucks? I had a transcription client buy the eCW EMR and they practically held their hand throughout the entire process, carefully easing the digital recorders out and the laptop computers in. Maybe they don’t provide that level of support to all customers, but if they can’t do it without Sam’s Club, what’s to say they can do it with Sam’s Club?

Chilmark Research also had a bit to say about the deal. They contacted eCW for more information. In a February 11, 2009 post at their blog, they say eClinicalWorks Tight-lipped on Wal-Mart Deal. If I read this blog entry, as well as the NYT article linked there, correctly, Wal-Mart plans on utilizing the EMR in their in-store clinics, which are operated in in partnership with Revolution Health. (Wasn’t Wal-Mart throwing its hat into the home-grown EHR market a couple years ago?) Apparently, part of the plan is to provide eCW with a ready market, while getting a discount for the Wal-Mart branded clinics.

I also found this blog article interesting: The Wal-Mart of EMR.

eClinicalWorks beat out a host of larger EMR players. Why? I’ve heard competitors refer to eClinicalWorks as “the Wal-Mart of EMRs.” This is a compliment, given the company’s success in the small and medium practice group market. A regular Best in KLAS favorite, eClinicalWorks is cheap, easy to use, built natively on the Web, and strong on functionality without laboring under lots of bells and whistles. “Value,” as Wal-Mart shoppers would say.

And what makes it most interesting is the date on the post – April 25, 2006! Who knows – maybe this blog was the catalyst for the deal!

Other blogs on the Wal-Mart (Sam’sClub)/eClinicalWorks EMR:

• Wal-Mart, eClinicalWorks team up to sell e-health systems
• Wal-Mart, eClinicalWorks Deal Exposes Need For EMR Price Transparency
• Walmart and eClinicalWorks: An Odd Couple?
• eClinicalWorks EHR and Wal-Mart – More Details and Information
• WalMart eClinicalWorks Dell Not Quite All There