WEDNESDAY, WEDNESDAY,August August1,1,2012 2012
Six Nations to get new Electronic Medical Record system By Stephanie Dearing SIX NATIONS
It’s official – Six Nations has signed a three year agreement with Nightingale Informatix Corporation. The contract represents the largest Nightingale has landed with any First Nation health care provider. The agreement will cost Six Nations $635,000 and will replace an existing, electronic medical record (EMR) system that Six Nations’ Health Director says does not meet the needs of her employees. In a written statement Six Nations Health Services Director Ruby Miller said she expects the new system will provide her staff with “flexibility, customization to the Six Nations community health needs and reporting needs, user friendly data collection, and a commitment to a strong responsive working relationship.” Reached by telephone, Doug Watts, Vice President of Development for Nightingale said the system, Nightingale On Demand, is a “cloudbased system” that allows ease of use similar to on-line banking. “All they have to do is log into to it and we manage all the technology side of things related to the EMR.” “I think that we bring a level of flexibility and willingness to work with them on other items that might be
important to them that I don’t think that they felt they were receiving from their first vendor,” said Watts. “We have a lot of capabilities that will allow First Nations to manage different community programs that are focused on groups as opposed to individual services they are providing to a patient, and so that allows them to track objectives and outcomes for that group versus just track the information related to individual patients,” said Watts. When bringing the potential relationship forward to Elected Council’s Human Services Committee in early July, Miller said Nightingale had been chosen following a tendering process. She elaborated in writing, saying of the 13 EMR providers authorized by the province, three submitted proposals to Six Nations, and after a vetting process, Nightingale was selected. While discussing Nightingale at the Human Services Committee, Miller advised the Committee Six Nations Finance Director Gary Phillips had some concerns about Nightingale’s financial situation. She said Phillips had “met a couple of times now with the Nightingale Corporation and talked about some of the financial issues that he had identified,” but she did not specify the issues of concern. Phillips, who was present
at the Committee meeting on July 4 said much the same thing. He told the Committee Nightingale “spoke to” his concerns about the company’s financial situation, but did not elaborate what those concerns were, only that he was satisfied with the direction being taken by Nightingale. But the auditor for Nightingale stated in financial statements for the company released just one week before Six Nations and Nightingale signed the agreement, “The Company has sustained losses from operations and, until recently, negative cash flows from operations, for many years.” The auditor, PriceWaterhouseCoopers, cautioned the company’s cash flow was in a bit of a delicate situation. The statements show Nightingale has a cumulative shareholder deficit of over $35 million. Nightingale posted a net loss of $1.2 million for the financial year just ended. Watts said, “If you look back at our track record ... you’ll find highlighted within our financial records that over the past nine or ten quarters, two-and-a-half-years, we’ve actually been running what’s called positive EBITAS (a measurement of your earnings before interest, tax, depreciation and amortization).” “It says that we are essen-
tially working on a positive cash flow basis now and that, from a financial perspective, that is what the investment community and the community at large is really looking for,” said Watts. While Miller and Phillips would not say why they were concerned about Nightingale’s financials, Miller did say meetings with Nightingale had eased those concerns. “After the initial postponement,” she wrote, “on selecting a provider the Director of Finance spoke with the CEO and CFO regarding the financial viability of Nightingale. They provided a presentation previously given to the financial community that included a large contract win with AOHC [Association of Ontario Health Care Centres] valued at $9.0 million which occurred after the year ended March 31, 2012 financial results.” “Nightingale’s large contract win of AOHC and the acquisition of Medrium [medical practice management software] were influences on the decision,” said Miller. She also said Nightingale’s “financial statements do indicate continued improvement in cost control.” When asked about the deficit, Miller stated, “software companies normally take years to become profitable.” Nightingale’s Chief Ex-
ecutive Officer, Sam Chabib, said Nightingale has seen growth in profits. The deficit is “what we call retained deficits, from the onset of the company, which is fairly typical to young technology companies that have a heavy investment in research and development and growth or acquisitions, which we have, we have about five acquisitions.” “I think the measure the market looks at for technology companies is EBITAS,” said Chabib. “We just closed our 14th consecutive quarter of positive EBITAS, which is a major achievement for a company in our space, and that has instigated a couple of research analysts ... to initiate coverage to our business. “It’s been a fairly healthy growth story, a Canadian story,” said Chabib. EBITAS measures non-cash accounting entries, he said. He explained the $1.2 million loss posted for the company’s last fiscal year as a “tax loss,” and said, “If you look at our financials you’ll see that we actually generated $1.2 million of positive earnings this past year, $1.9 million before. As I mentioned, it’s been 14 consecutive quarters of positive earnings before non-tax items.” Nightingale made first place on the Deloitte Technology Fast 50 list in 2008, “and we made the list every
single year since then,” said Chabib. Nightingale placed 50 on the 2011 list. Nightingale just celebrated its tenth anniversary. The company is publicly traded on the Toronto Stock Exchange, which Watts said is “not that common a practice for Canadian EMR companies.” He said Nightingale wants to “continue to grow and expand, to continue to provide expanded capabilities and services to all of our customers,” and going public allows Nightingale to raise money. “Risk is all about balance and it often is a relative thing,” said Watts. “I guess I would argue that it’s riskier to stay as a privately held company and not have access to the finances and the capital that you require in order to make the types of investments that you need to make in order to be successful.” Miller said Elected Council was provided with the same financial information she and Phillips were given, spanning 2007 to 2011. Nightingale will not only convert the existing system into the new system, it will also provide training and support for Six Nations staff. The new medical records system is expected to be in operation by the beginning of 2013. It is anticipated that 150 health care providers in Six Nations will use the system.
a number of Ontario citizens and at least one environmental group. Given Enbridge has sustained two separate accidental oil releases over the past two months, it appears concerns about the potential for a spill appear have more than just a little validity. The Polaris Institute, an organization that works to enable citizen movements, compiled Enbridge's spill reports from 1999 to 2008. The company had 610 spills during those nine years, releasing 21 million litres of oil and petroleum into the environment. This past June, an Enbridge pipeline failure resulted in a small oil spill in Alberta. A larger spill took place on July 29 when Line 19 failed in Wisconsin. Enbridge is still cleaning up one of its biggest spills, which saw thousands of barrels of oil released into Michigan's Kalamazoo River in 2010.
While HDI had raised valid concerns, whether
the organization could have swayed the National Ener-
gy Board decision on Line 9, we'll never know. Accord-
ing to the National Energy Continued on page 17
Enbridge gets green light to reverse pipeline flow of Line 9 Enbridge has secured approval from the National Energy Board to reverse the flow of a 35 year old pipeline that presently carries petroleum from Montreal to Sarnia. Line 9 crosses the Grand River between Cambridge and Paris. The Haudenosaunee Development Institute (HDI) was the only Six Nations organization to object to the plan last year, submitting a letter outlining concerns about the pipeline's potential impact on the land, water, as well as the rights and interests of the Haudenosaunee and the lack of consultation with HDI. HDI's concerns about health and safety issues in the event of an accidental spill were shared by many others, including the Aamjiwnaang First Nation, Oneida Nation of the Thames, and Chippewas of the Thames,
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By Stephanie Dearing ALBERTA
If you would like to learn some tips and gain some knowledge on how to talk to your teens or tweens about sexual health, self-respect, and relationships, then come join us for “The Talk”. When: August 15 2012, 6:30 pm in the Gane Yohs Boardroom We will have refreshments, snacks and prizes
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