IDX Systems

» see idx.com as it lived, on the wayback machine

~ the obituary ~

The company was incorporated in Vermont on 2 June 1969, a date its own last annual report was still printing in 2005. Robert Hoehl and Richard Tarrant started it to do the paperwork that doctors' offices could not do themselves: payroll and insurance claims, run on a service bureau basis for physician practices around Burlington. It went through at least two earlier names before settling on IDX Systems Corporation, and the renaming chain is one of those details that survives only on Wikipedia with nothing behind it.

What turned a Vermont bureau into a national vendor was the practice management system. Flowcast handled scheduling and registration and the whole miserable business of getting an American physician group paid by a dozen insurers with a dozen rule sets. IDX went public in November 1995, closing its offering on the 22nd at $18 a share for 4,604,500 shares and net proceeds of just over $76 million, and traded on Nasdaq as IDXC. By 2004 revenue was $520.7 million, up from $348.2 million two years earlier, with 2,409 people on the payroll.

General Electric signed the merger agreement on 23 September 2005 and announced it six days later: $44 a share in cash, about $1.2 billion net of IDX's cash on hand. The press release counted roughly 150,000 physicians using IDX systems at more than 3,400 customer sites, including over 850 group practices and around 370 integrated delivery networks covering more than 500 hospitals. The ending is in the filing index rather than in any announcement. On 4 January 2006, at 17:03, IDX filed a Form 15-12G to deregister its stock, reporting one holder of record. That is what a company looks like when it has been fully absorbed.

~ the case file ~

~ what the hospitals ran ~

I have never touched this category from the inside, and almost nobody has. Hospital and practice software is the most consequential software most people will never see a screen of. It decides whether your appointment exists and whether your record follows you between departments, and you only notice it when it is wrong. The only version of it I have personally used is the Turkish state's central appointment system, from the patient end, which tells you nothing about the thing itself.

IDX's hospital side came from outside. It acquired PHAMIS of Seattle in 1997, at 0.73 IDX shares for each PHAMIS share, and with it the LastWord enterprise clinical system, which IDX later rebuilt and renamed Carecast. The 2004 annual report describes Carecast as building on twenty-five years of LastWord development, which is a vendor admitting in print that its flagship clinical product was somebody else's long-lived codebase. The trademark list that year runs Flowcast, Groupcast, Carecast, Imagecast, LastWord, IDXtend and Web Framework. GE put the Centricity name over all of it. Flowcast became Centricity Business and Carecast became Centricity Enterprise, and by March 2006, barely two months after the Form 15, GE's own press material was already writing "formerly known as IDX Flowcast".

~ the london job ~

The strangest line in the 2004 report is the geography. United Kingdom revenue was $83.9 million that year, 16.1 percent of the total, against $3.4 million the year before. A Vermont practice-management company had suddenly become a significant British government contractor, because Carecast had been picked as the clinical system for London under the NHS National Programme for IT, with IDX working as a subcontractor to BT as the local service provider.

University College London Hospitals was the proving ground. It had been set to deploy LastWord and switched to Carecast instead, which turned a deployment into a development project to anglicize an American product. Trust-wide go-live slipped by three weeks and happened in June 2005. The program it belonged to became one of the most expensive public IT failures in British history, though the usual accounts spread the blame across several vendors and several systems, and I have not found a source that pins any of it specifically on Carecast.

~ the senate run ~

Richard Tarrant had been chairman of IDX and sold his stake into the GE deal. In October 2005, the month after the merger was announced, he declared as a Republican candidate for Vermont's open United States Senate seat, and largely funded the campaign himself. His opponent was Bernie Sanders. On 7 November 2006 Sanders took 171,638 votes to Tarrant's 84,924, a margin of better than thirty points, and Sanders has been in the Senate ever since.

So the company was gone in January and its former chairman was beaten two to one in November. The billing engine went on running in hospitals under a General Electric brand, and was later sold on again into other hands. idx.com no longer resolves.

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