KANSAS CITY – A flurry of mergers and acquisitions in late 2004 could signal the start of a busy year for corporate makeovers in the healthcare IT world.

In the last 45 days of 2004, big players in the industry – including Cerner, Kodak, Misys and Eclipsys – announced major acquisitions, expansion plans and restructurings to take advantage of what Forrester Research analyst Eric Brown calls the emerging "healthcare interstructure."

"Healthcare IT vendors have been working to assemble a complete clinical enterprise portfolio serving everything from small practices to academic medical centers with the promise of easy integration within the healthcare enterprise," Brown recently wrote in his analysis, "Healthcare IT's next big market."

This month, Cerner is scheduled to close its deal to acquire VitalWorks' medical division, a 4100 million deal that gives the Kansas City company immediate access to smaller clinics and practices with practice management, EMR and EDS software.

"This," says Cerner Executive Vice President Paul Black, "is a market share and connectivity play whereby in a very short time we will have a dramatic increase in the number of physicians who are interacting with a Cerner system."

In addition, Cerner has a number of new initiatives under way that should lead to 400 new jobs – many of them engineering positions – at a brand new facility in Kansas City. Black attributed the growth to new departmental initiatives in oncology, cardiology and women's health; the community connectivity effort; and work for the United Kingdom's National Health System.

"We're coming off a successful 2004 and we expect that momentum to continue," said Black. "I'm knocking on wood as I say this, but we see nothing in the near term that's going to make us feel any less bullish about the marketplace in the United States."

Cerner's not alone.

"We've developed a strategy of reach and climb," says Kodak's Todd VanderVen, announcing yet another broadening of the company's healthcare IT group. The division plans to reach more aggressively into boutique areas, while climbing higher with new enterprise capabilities.

VanderVen says Kodak plans to announce a major "5th generation" information technology it has developed with Pacific Rim partner at the 2005 HIMSS show in Dallas next month. Kodak showed bits and pieces of the technology at the 2004 RSNA show in Chicago last November, but VanderVen declined to comment on it other than to predict it would be a "paradigm-changing technology" for healthcare enterprises.

VanderVen said it was too early to make predictions, but said Kodak anticipated "adding jobs and some new organizations" in 2005.

Like Kodak, Misys and Eclipsys are also retooling for growth. Eclipsys recently closed its acquisition of eSys medical Systems, Inc., a Montreal-based radiology information systems vendor. The move permits Eclipsys to offer a tightly integrated PACS/RIS product to extend its presence in radiology.

Misys, meanwhile, announced the merger of two business units focusing on EMRs. The Physician Systems business unit, which provides EMR systems and practice management solutions for small- to medium-sized medical practices, and the Physician Enterprise Systems business unit, which offers similar products for larger medical organizations, are now operating as one entity under the Physician Systems name.

"In the ambulatory space, we definitely see market opportunity, especially around EHR/EMR," said spokesman Mike Truell.