1. H.I.S.-tory
by Vince Ciotti
Episode #121:
McKesson
Part 9 = More
M & As
© 2013 by H.I.S. Professionals, LLC, all rights reserved.

2. More Major Mergers
• After last week’s coverage of the McKesson/HBOC meltdown, it’s
nice to pick up the story of how McKesson rebounded from the
1999 lawsuits and scandals to get right back into M & As again.
• Here’s some of their bigger ones over the next few years:
– 2000 = MED-Solution, an RX system developed by Health Care
Systems, Inc, renamed “Pathways Meds Manager.” Like every
other HIS product seems to have been at one time or another,
it was rated by industry consultant KLAS Enterprises as the #1
in terms of performance, value, customer satisfaction, and the
amount of money that they spent over the years buying KLAS’
market research reports. Within days, Pathways Meds
Manager was integrated with other McKesson/HBOC clinical
solutions’ proposals, contracts, PowerPoints, brochures, ads,
and demos. Then over many subsequent years, interfaces
were slowly built between the products themselves…

3. A Picture-Perfect Deal
• Kidding aside, the next deal was a quite a coup in the PACS world:
– 2002 = ALI– In May acquired Vancouver, BC-based ALI
Technologies for $340 million. McKesson now expanded its
flagship Horizon Clinicals, to include data, documents, voice,
and medical images via ALI’smedical image management and
PACS. ALI’shigh-profile client base included such notables as:
• Cedars-Sinai Medical Center
• Johns Hopkins University Hospital
• St. Luke's Episcopal Hospital, and
• Kaiser Permanente.
A good deal for ALI, as McKesson had ≈40
times more sales staff than ALI (500 versus
12) with systems installed in about half of
all U.S. hospitals larger than 200 beds...

4. A Banner Year
• 2007 was a major merger year for McKesson with three big deals:
– 1. Per Se – at “only” $1.8B, this deal may not have been that
big per se, compared to the $14B McKesson spent for HBOC,
but Per Se was a series of acquisitions…, oh well, per se:
• NDC Health's revenue-cycle management business, bought
that same year, gave McKesson an entrée into RCM.
• Previous acquisitions by Per Se over its HIS-tory included:
– Health Data Services
– Rapid Systems
– Atwork
– Medaphis
– Consort
– Medical Consult
– GFS, etc, etc, etc.

5. RH Positive
• 2. Relay Health– Acquired
by McKesson in June of
2007, over the previous 3
decades RH had turned
HIPAA privacy regulations
into the lucrative business
of providing secure
communications between
patients, providers,
pharmacies, payors and
pharmaceutical
manufacturers.
• It’s a shame Target never
knew about them…

6. How Do You Get To Carnegie Hall?
• 3. Practice Partners– I
must confess that even I
get confused with the
differences between
Practice Partner and
Practice Point Plus,
which McKesson
hadacquired earlier, let
alone the recently
announced “integrated”
ambulatory solution for
Paragon!?
• Ah well, practice makes
perfect…

7. Recap of All the Deals
• Anyway, here it is: a visual recap of the biggest HIS vendor that
acquired the most vendors/products over its 50 years of HIS-tory:

8. So?
• So what that McKesson was built from scores of mergers &
acquisitions over the past 50 years? These M & A roots explain
what is easily the most complex product line in HIS-tory, to whit:
AccessHealth
AcuDose-Rx
Advantage Catalog
Alliance Partners
Anesthesia Care
Anesthesia-Rx
ANSOS One-Staff
Application Hosting
Application Services
AR Processing
Asset Management
ANSOS One-Staff
Automation Decision Support
Bar-Code Medication Packaging
Behavioral Coaching
Biometric Identity Management
Brand for Surgery Centers
Business Consulting Services
Business Folder
Business Improvement Services
Capacity Planner
Cardiology Management
CareEnhance Review Manager
Central Fill
ClaimCheck
ClaimsXten
Clear Claim Connection
Clear Coverage
ComplyScan
Computing Solutions
Connect-Rx
Contract Manager
Controlled Substance Ordering
Disease Management Programs
Distribution ExcellenceED
Benchmarks Collaborative
Education and Training
Employed Physician Services
EMR and ePrescribing
Enterprise Content Managementr
Enterprise Image Repository
EnterpriseRx AR
Equipment for Surgery Centers
eShift
eSig CapturePLUS
Expert Help
Fiscal Management
Freight Payment
FrontEdge
Fulfill-Rx
Gift Card Mall
Health & Wellness Programs
Health Buddy Appliance
Health Mart
Healthcare Perf Benchmarks
Healthy Valu$
Homecare
Horizon Blood Bank
Horizon Lab

9. But Wait, There’s More:
Imaging Link Engine
Industry Leadership
Infrastructure Services
In-Office Dispensing
Intelligent Coding
InterQual Behavioral Health
InterQual Care Planning
InterQual Clinical Evidence
InterQual Content Customization
InterQual Coordinated Care
InterQual Behavioral Health
InterQual Learning Source
InterQual Level of Care Criteria
InterQual Molecular Diagnostics
InterQual Online
InterQual Specialty Rx Criteria
InterQual Transparency
InterQual View
InterRater Reliability Suite
InvestiClaim
IT Help Desk Services
IVRxLab Order Management
LoyaltyScript
Lynx Mobile
Lynx TotalView
Lytec and Lytec MD
Managed Services
MAX Impact
McKesson 340B Manager
McKesson Advantage Catalog
McKesson Anesthesia Care
McKesson Biometric Identity
McKesson Business Folder
McKesson Capacity Planner
McKesson Cardiology
McKesson Content Manager
McKesson Image Repository
McKesson Fiscal Management
McKesson Home Healthcare
McKesson Hospice
McKesson Intelligent Coding
McKesson Mobile Manager
McKesson OneStop Generics
McKesson Patient Folder
McKesson Performance Analytics
McKesson Pharm Optimization
McKesson Point of Use Supply
McKesson Population Manager
McKesson Practice Care
McKesson Practice Focus
McKesson Practice Plus
McKesson Preferred Rewards
McKesson Quality Monitor
McKesson Radiology
McKesson Revenue Management
McKesson Risk Manager
McKesson ScanManager
McKesson Strategic Supply
McKesson Study Share
McKesson Supply Chain
McKesson Surgical Manager
McKesson Telehealth Advisor
McKesson Time and Attendance
McKesson Unsaleable Returns
McKesson VITAL Business Insight
MedCarousel
Medical Imaging Workflow
Medication Safety Cabinet
Medisoft
MedShelf-Rx
Molecular Diagnostics
Money Management
My Care Plus
NarcStation
National Consumer Outreach
OneStop Generics
Onmark
OR Benchmarks Collaborative
OTC Consumer Products

10. And Finally:
PACMED
Paragon
Pathways Healthcare Scheduling
Patient Assistance Programs
Patient Folder
Deficiency Completion
Patient Satisfaction Surveys
Performance Analytics
Performance Visibility
Pharmaceutical Distribution
Pharmacy Decor and Fixtures
Pharmacy Engagement Programs
Pharmacy Management Solutions
Pharmacy Optimization Services
PharmacyRx Hardware
PharmacyRx Suite
Pharmaserv
Physician Resources and Info
Plasma and Biologics Distribution
PlayMaker CRM
Point of Sale
Point of Use Supply
Point-of-Sale for Pharmacy Rx
Population Manager
McKesson Practice Care
McKesson Practice Choice
McKesson Practice Complete
Practice Focus
Practice Man. Technologies
Practice Partner
Prefer Rx
McKesson Preferred Rewards
Prescriber-Pharmacist Interface
Pricing Services
Printing Services
Priority ExpressProcessing
Services
Professional Certification
PROmanager-Rx
Provider Manager
Purchasing Tools
Quality Monitor
Radiology
Reimbursement Manager
Reprocessing Services
Retail Expansion
Retail Independent Pharmacy
Revenue Cycle Management
Review Manager Enterprise
Risk Evaluation and Mitigation
Risk Manager
ROBOT-Rx
RxPak
ScanManager
Secure Data Protection
ServiceFirst Customer Relations
SIM plus
SKY Unit Dose Packaging
Specialty Distribution
Strategic Outsourcing
Study Share
Sunmark Private Brand
Supply Chain Management
Surgery Center Educational
Surgical Manager
Surgical Scope Repair
Technology and Integration
Telehealth Advisor
Third-Party Contracting
Time and Attendance
Training and Education Services
TrialScript
Unsaleable Returns Program
VIP Gold
VITAL Business Insight
VITAL Consumer Portal
Web Reporting for ANSOS
Wellness Programs
World-Class Logistics
Your Pharmacy Online Website

11. Interesting Questions
• Over 200 different products! Makes one wonder:
– How much would it cost to buy all of them?
• Say, an IDN a with hospital, physician practice,
home health care, retail pharmacy, etc?
– How long would it take a the Atlanta HQ to prepare
a proposal and contract to buy all 200 products?
• How many pages printed on paper for signing?
– How long does it take to train a new sales rep in all
of these products’ many features & prices?
• How many reps does it take to sell them?
• And when I joined SMS in 1969, I thought their SHAS
system was complicated with 5 distinct products:
– Census, Billing, AR, GL and Cost Allocation…