There is an interesting post on HIStalk with some history on Picis, IDX and how Picis has worked with the IDX and other large health care IT vendors.  IDX and Picis have been working together for quite some time (mid 90's?).  Picis has done very tight integration with IDX Care Cast, Eclipsys CPOE, and McKession Pathways scheduling and materials management systems, in an effort to secure their “best of breed” position for ICU and perioperative applications.  For it's part, IDX has gained a competitive advantage over Cerner, Epic, Eclipsys and other enterprise vendors by offering Picis applications to their customers.  Their largest joint customer is the Mayo Clinic, with 180 operating rooms, 130 PACU beds and 350 ICU beds.  I wonder how many of those ICU beds are filled with patients who need monitoring but don't need the high level of care provided by the one to one nurse/patient ratios in an ICU.