A single deal in another country, if it's large enough, can deliver enough cash flow to bring U.S. operations stability and enough capital to be a buyer when the inevitable shake-out comes.
For now the name of the game is in addressing Wall Street, in telling stories that create the appearance of momentum and bring the public investments needed to execute the strategy.
Bob Lorsch of MMR Information Systems (above) is one player I have mentioned here before. His company signed a distribution deal in China late last year. Now he has renamed his company, to MMR Global, and at his annual meeting showed just how anxious he is for headlines with this bon mot:
Google Health is a name you're familiar with. We link to them, and we now understand they are phasing out of the personal health record market because they have not made it work.
Lorsch claimed MMR helped push them out. In fact, if Google Health is going away, it's because Google never seriously invested in learning the space. I didn't lead with this because Lorsch's claim is, for now, unsubstantiated speculation. But we'll follow up.
UPDATE: I reached a Google spokesman this afternoon who denied that Google Health is going away. Google's chief health strategist was just in Washington recently showing off new features, he noted. And they gave away nifty new tape measures at HIMSS.
Another outfit that wants to be a Wall Street playa is Merge Healthcare. I wrote about them during HIMSS, when they were buying Amicas. Now they are following MMR into the export market, signing a distribution deal for their image-viewing software, eFilm Workstation, with a Brazilian company.
As the health IT market moves forward it's important to note that the same trends and needs evidenced here exist worldwide. The stimulus gave American players capital, but if they can deploy that profitably elsewhere they may be players here down the road.