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Medical Manager History

From MirrorMed

Contents

[edit]

Medical Manager the Enron of Medical Informatics


[edit]

Software from a Cult?

Medical Manager was started in Florida in the 1981 by Mickey Singer a very quirky guy who is into eastern mysticism.( he founded a commune and wrote some books on karma). Singer ultimately made a fortune from Medical Manager, and has a reputation as a philantropist in his community.(1).

The temple that they founded is called the "Temple of the Universe" although little information can be found about it online. Apparently this was not just a friendly, hippie commune, but more of the scary "what are the doing over there" cult-commune. Mikey Singers parter, Richard Gartee is apparently a registered sex offender, at least the picture on the Gartee website and the picture on the florida sex offender website appear to be the same guy. Gartee is the author or co-author of many Medical Manager books.

[edit]

The Golden Years, when the proprietary vendor cared about its customers

Singer started Personalized Programming Inc. which was one of several companies which ultimately formed Medical Manager Inc. Medical Manager Software was the product of Personalized Programming. The original Personalized Programming business model kept Florida as its local territory and franchised the use of the software business to "Medical Manager Dealerships" for the rest of the country. This model took the market by storm. At one time Medical Manager was the most popular practice management system in the United States. 

"The product took over the market and now has the largest installed base of any 
practice management software in the country," Singer related to The Sun in 1999.

In 1987 Medical Manager claimed that it was the first Practice Management system that could perform electronic claims in all 50 states. In 1997 Medical Manager had about 24,000 clinics and 110,000 health practitioners using the system. In 1997 John H. Kang took Medical Manager public. Ultimately John Kang would be indicted. Kang has some information on his role at Medical Manager from his new company Liquidmetal from the Liquidmetal bios... 

John founded the predecessor to Medical Manager, an integrated healthcare automation solution which
addresses the financial, administrative, clinical and practice management needs of healthcare providers.
He guided the growth of the company from a small one-office business in 1995 to a corporation with more 
than 3,000 employees and more than 100 offices nationwide. He took Medical Manager Public in 1997. 
He continued to run the company as president and co-CEO through subsequent mergers and the 
ultimate sale of the company in September 2000.
[edit]

Early Technology

Most of this was taken from a post by DAW on the Medical Manager Users Group

The first released version of Medical Manager was 4.A8. This version was programmed in CBasic on the CP/M operating system. (eventually became Concurrent DOS)

From the post: 

The whole system fit on one 1.2 MB floppy diskette, since that partially-compiled language included 
provision for overlays, which allowed key code to be used repeatedly from various program functions.  
The very first release included all the key features of current releases, and all subsequent releases, 
except the new program, were easily migrated up to the next version.

At version 5.2 approx 25 man years where estimated to be invested in the code.

[edit]

The Dot Com acquisitions

In 1999 Synetic purchased Medical Manager Health Systems,Inc (NyTimes), and called the resulting company Medical Manager. At the time Martin Wygod was the CEO of Synetic. They also purchased Kippgroup, and Point Plastics that year. In 2000 Medical Manager acquired Physician Computer Network This was one of famous stock deals of the Internet Era. Synetic paid a hefty premium on the current stock price of Medical Manager.

A year later a dot-com company, Healtheon/WebMD purchased Medical Manager, Inc. At the time WebMDs main asset was its website, but it had a darling evaluation which drove a stock purchase. (Sounds a lot like the TimeWarner AOL takeover).

Since that time WebMD has fractured and changed its name to Emdeon. I would be glad for someone to take a close look at what happened here. There is some recent shady dealings at WebMD

[edit]

The y2k scandal

In 1997 Medical Manager Inc, released version 9 of Medical Manager, which was y2k compliant. It told its customers using version 8 that they needed to pay at least $2500 to upgrade the software. Users at Medical Manager 7 needed to pay to upgrade twice. Some offices using Medical Manager filed a class action lawsuit, which was ultimately settled by Medical Manager. Medical Manager, conceded to provide a free y2k patch for version 8 and allow version 7 users to upgrade to the patched version 8 for free. Actually upgrading to the y2k compliant Medical Manager 9 still cost money. a good article on what happened. Under the terms of the resolution, Medical Manager Inc. was required to release a patched version of Medical Manager 8, however, they were not required to support it. The corporate office refused to field support calls on the patched version of Medical Manager 8.

[edit]

BridgeIt Fallout

BridgeIt is a product from BridgeIt Solutions. At one time BridgeIt was a product that was resold by Medical Manager, but apparantley they had a falling out. From the Medical Manager Users Group. 

First, BridgeIt Solutions terminated their agreement with Medical Manager in 1998 due to the 
incompetence MedicalManager showed in implementing BridgeIt.  Customer satisfaction is our primary goal, 
and Medical Manager was not on the same page.  We even offer a 30-day money back guarantee.  
Second, in most cases no additional hardware or software is required to implement BridgeIt.  
Third, any Medical Manager user I have ever spoken with about their “Report Generator” says 
it is very cumbersome to use, and limited in the solutions it provides.  We provide information 
solutions for thousands of providers using Medical Manager, and would recommend anyone 
looking for a comprehensive data management, reporting, and decision support solution to 
take a look at these videos.
http://www.BridgeItSolutions.com/Videos.htm
Dwight Williams
CEO
BridgeIt Solutions

BridgeIt is proprietary software

[edit]

Lee Data Systems

In 1998 Medical Manager acquired Lee Data Systems. Apparently, (need reference) Lee Data Systems wrote the Medical Manager Collections Module

[edit]

The Dealership Scandal

Medical Manager Inc. used its IPO to fund a buyout of the Medical Manager Dealerships that made it successful.

WebMD decided that it was going to start to buy back the Medical Manager franchisees. These buybacks were often brutal, generally if you were big, they bought you out and if you were small they just sent you a letter which said that they were taking your customers. As it turns out you had a much better chance of being acquired if you were willing to participate in a Medical Manager kickback scheme that was later investigated by the SEC. The FBI later 10 Medical Manager executives for fraud. In the first quarter result of 2008 for HLTH, the following information was buried: 


Also included in discontinued operations is a $1 million net charge 
from an increase in the estimate of HLTH's indemnification obligation 
for defense costs for nine former officers and directors of HLTH's former 
subsidiary Emdeon Practice Services, Inc. who were indicted in connection 
with the previously disclosed investigation by the United States Attorney 
for the District of South Carolina, which was almost fully offset by 
proceeds from settlements with two of the insurance companies related to this matter.
[edit]

Practices Abandoned

From a software perspective the change in the support was startling. Customers who had previously been taken care of by very enthusiastic medical manager dealerships now found that the mother ship did not return phone calls quickly and rarely actually helped them with their problems. Then came the kicker! Medical Manager was discontinued by WebMD in favor of a new product called Intergy. WebMD stopped supporting medical billing formats for Medical Manager, which became a huge problem when HIPAA mandated a change from NSF to X12 837p 4010a. Practices were forced to upgrade to the tune of tens of thousands of dollars.

[edit]

Sold Again

At a recent HIMSS, Emdeon announced that it is trying to get rid of Medical Manager. This has now apparently gone through. Sage has agreed to purchase Medical Manager for $565 million in cash. Sage is a UK based company.

Here is another story on the sale to Sage

A story about the purchase from the UK

You can also read the Sage press release on the subject I wonder what the following means?? 

There are also opportunities to raise operating margins through the 
application of Sage’s customer base marketing and support expertise, 
and through administrative synergies.

Gainesville article which details the sale and gives updates on the trial. Mickey Singer has resigned according to this.

Emdeon CFO to run Sage healthcare div. Emdeon CFO and Practice Services CEO Andrew Corbin will be leaving to become the CEO of the healthcare division at SAGE. Update! Andrew Corbin has resigned from Sage in a surprise move.

commentary on the SAGE purchase from Forrester Another article

[edit]

The GPL Solution

Now there are thousands of abandoned Medical Manager users who like Medical Manager, but cannot use it anymore. They are wondering "What can we do to prevent this from happening again". The answer if GPL software. If Medical Manager had been licensed under the GPL then WebMD would have never been able to force anything on their customers. The purpose of the GPL is to make you as much the owner of the software as the vendor. If the vendor does something you do not like you can fire them and hire someone else to support the software. You can read more about this at GPLMedicine.org.


mm2mm is a project sponsored by SynSeer to migrate Medical Manager installations to MirrorMed an EHR and Practice Management system that is available under the GPL. By using MirrorMed you can guarantee that your vendor will always respect you, because you can fire that vendor.

[edit]

Proprietary Solutions

This is a list of solutions that claim to have support for the Medical Manager database. Feel free to add your software here. Please note which of the mm2mm goals (EHR add-on, medical billing add-on, reporting tool, migration tool) you can match with your proprietary solution.

By reputation the best third-party proprietary reporting tool for Medical Manager is BridgeIt. This is a reporting tool and could probably serve as a migration tool.

Alex Chigos wrote in to mention that X-Med has script to migrate from Medical Manager to X-Med, X-Med is a proprietary product that runs on Linux.

Jack Goldstein, M.D. wrote to me to mention that his company automationmed which allows one to access Medical Manager data via ODBC connection. He claims this is more powerful than BridgeIT.

[edit]

Sources

sources: article on IPO with good background info

article on the y2k settlement

mentions y2k problems with an example Medical Manager customer

Matthew Holt had some dealings with WebMD and a summary of the history

article from a law site discussing the money laundering

CFO.com article about the kickback scheme Note: I attempted to verify the facts in this article with Emdeon. I sent a Letter to Emdeon with no result so far. I will keep you updated.

Note: "Medical Manager" is a trademark currently held by Sage. At one time your could read about that here

article about an executive that left Medical Manager

article on migrating data automatically from Medical Manager

If you have any information regarding Medical Manager history, either technical or otherwise, please contact me here Fred Trotter

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