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Posts Tagged ‘Carefx’

Over a 1,000 exhibitors, some 30,000+ attendees and I come away from HIMSS, again, thinking is this all there is? Where is the innovation that the Obama administration i.e., Sec. Sebellius and Dr. Blumenthal both touted in their less than inspiring keynotes on Wednesday morn? Maybe I had my blinders on, maybe I was looking in the wrong places but honestly, outside of the expected, we now have an iPad App for that type of innovation where nearly every EHR vendor has an iPad App for the EHR, or will be realeasing such this year, I just didn’t see anything that really caught my attention. But then again, looking over my posts from previous HIMSS (this was my fourth), maybe my expectations need a serious reset and it would be wise of me to read this post next year before I get on the plane to Las Vegas and HIMSS’12.

Prior to HIMSS I participated in a webinar put on by mobihealthnews (BTW, Brian at mobi has a good article on some of those mobile apps being rolled out at HIMSS this year). My role in this webinar was to give an overview of what one might expect at HIMSS’11. Having weathered the last two HIMSS and the major hype in ’09 about Meaningful Use and ’10 when HIEs were all the rage, this year I predicted that the big hype would be around ACOs. Much to my surprise such was not the case.

The reason was quite simple and two fold.

First healthcare CIOs and their staff are going through numerous contortions to get their IT systems in order to meet Stage One Meaningful Use (MU) requirements. Looking ahead their focus is naturally myopic: What do I need to do to meet Stage Two and finally Stage Three MU requirements, requirements that have yet to be published? Then there is this little transition to ICD-10 that some pundits claim is the HIT sector’s own Y2K nightmare (not sure if that means the hype and fear is far greater than reality or what). Either way, CIOs are having a tough enough time just keeping up these demands and filling their ranks with knowledgable staff (one CIO told me he has 53 open positions he’s trying to fill) to even begin thinking about ACOs.

Secondly, there are the vendors who today are not completely sure of what exactly healthcare organizations (HCOs) will need to succeed under the new ACO model of care and bundled payments. In countless meetings I had over the course of my three days at HIMSS I did not meet one vendor that had a clear picture of what they intended to offer the market to help HCOs become successful ACOs. There was unanimous agreement among the vendors I met with that analytics/BI would play a pivotal role, but what those analytics would look like, what types of reports would be produced and for whom, were less than clear. So it looks like we may have to wait another year before the ACO banter begins in earnest at HIMSS.

Some Miscellaneous HIMSS Snippets:

Much to the chagrin of virtually every EHR vendor at HIMSS (still far too many and I just can’t even begin to figure out how they all stay in business) Chuck Friedman of ONC announced in his presentation on Sunday that they are looking into usability testing of EHRs as part of certification process. Spoke to someone from NIST who told me this is a very serious consideration and they are putting in place the necessary pieces to make it happen.

Defense contractor and beltway bandit of NHIN CONNECT fame, Harris Corp. acquired HIE/provider portal vendor Carefx (Carefx was profiled in our recent HIE Market Report) from Carlyle Grp for a relatively modest $155M. I say modest as this was some 2x sales and far less than the spectacular valuations that Axolotl and Medicity received. Could this be a reset of expectations for those other HIE vendors looking to be acquired? Reason for acquisition is likely two-fold: Carefx has a good presence in DoD and this may help Harris land some potentially very lucrative contracts as the DoD and VA look to bring their systems together. Secondly, for some bizarre, and likely highly political reason, Harris won the Florida State HIE contract and now has to go out and pull the pieces together to actually deliver a solution, which frankly they don’t have but Carefx will help them get there..

Kathleen Sebellius needs a new speech writer. David Blumenthal needs more coffee before he hits the stage.

The folks at HIStalk once again provided excellent, albeit slightly self-congratulatory coverage of HIMSS. They also threw one of the better parties that I attended. Thank you HIStalk team.

Had several people, mostly investor types contact me for my opinion of the athenahealth-Microsoft partnership that was announced. Do not see much in the way of opportunities for either party in near-term. It will take a lot of work for anything truly meaningful and profitable to come from this relationship. That being said, did think that the Microsoft-Dell announcement was quite significant and should be watched closely, especially if Microsoft can truly get Amalga down to a productized, easily deployable version for community hospitals that Dell intends to target.

HIMSS and most vendors are still giving lip-service to patient engagement. Rather than seeing a slow rise in discussing how to engage consumers via HIT, this issue is something that few vendors bother mentioning and when they do, it is still with the old message of how to market to consumers with these types of tools rather than engaging consumers/patients as part of the care team. Hell, not even part of the care team, but the damn center of the care team. Not sure when these vendors will get religion on this issue. Maybe they are just following the lead of their customers who have yet to fully realize that in the future, a future where payment will be bundled, that actively engaging consumers in managing their health will be critical. While I have not completely given up hope on this industry to address what is arguably the most challenging issue facing healthcare’s future, I do chide them for not having more vision and frankly guts to take a leadership role and help guide their customers forward.

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The long awaited, dare I say anticipated HIE Market Report is now complete and ready for purchase. This report, arguably the most comprehensive report yet published on this rapidly evolving market (116pgs, 21 vendors profiled, 0ver 25 tables and figures) will provide the reader with a detailed portrait of today’s HIE Market, its leading vendors, and the capabilities that they bring to market. Here’s the HIE Report’s Table of Contents (warning PDF).

The report is the culmination of interviews with countless HIE stakeholders, from State and regional officials, to healthcare CIOs, consultants and of course the HIE vendors as well. Combining these interviews with our own methodology for secondary research, the report comes presents a number of findings including:

  • A definitive classification schema of current HIE vendors that will clarify what appears at first glance as a very convoluted market.
  • The transition that is occurring as vendors move from SaaS to PaaS models and its future impact on the market.
  • The clear differences and similarity of needs of Enterprise and Public HIEs.
  • An HIE Maturity Model that will help adopters of this technology better understand the transitions that will be needed as their platform matures over time.
  • Comprehensive profiles on 21 leading HIE vendors including rankings on a number of HIE attributes as well as market presence.

If you are involved in any aspect of the HIE market, you would do your company a favor by purchasing this report. Really, it is that good.

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In Monday’s post, Chilmark reflected upon a piece that Peter Hudson, co-founder of Healthagen, the developers of mHealth app iTriage wrote for mobihealthnews. In that article, Peter talked about the utility of an mHealth-based PHR (iTriage recently launched such capabilities), but in our post, we countered that today, it is still far too difficult for a consumer to pull together their personal health information (PHI) to create a truly longitudinal record. This will likely stunt the efforts of companies such as Healthagen who are trying to offer consumers a PHR – the hassle factor is still far too great to overcome.

Now we will look at the red hot space of Health Information Exchanges (HIEs).

As local, regional or even statewide aggregators and distributors of health data to facilitate care coordination, HIEs have the potential to play a pivotal role in helping a consumer create and manage their PHI. Now that does not mean that the HIE has to offer the consumer a PHR per se, but what an HIE may be able to do is offer the consumer an ability to have a portal view into their PHI that resides within the context of a given HIE. Better yet, why not have as a condition of receiving some of that federal largesse of $564M for state HIE programs that these HIEs support “Blue Button” functionality allowing a consumer to readily download or export their PHI to wherever the consumer desires.

Ah, but we digress.

The purpose of this post is to extract a couple of data points from our forthcoming HIE report as they pertain to consumer engagement. Unfortunately, it is not a pretty picture.

As part of our market survey of twenty HIE vendors, we asked them a number of questions with regards to what consumer-centric capabilities did their HIE solution support. Fully eighty percent of those interviewed had either modest (15%) or weak (65%) consumer offerings.

The following table provides a brief snapshot of those HIE vendors that have what Chilmark considers strong consumer engagement tools. Two of those vendors, Kryptiq and MEDSEEK are somewhat difficult to classify as an HIE in the traditional sense, thus you will not find them running under the covers at your local RHIO. Microsoft is still new to the HIE market with one HIE live in Milwaukee and another in D.C.. While Microsoft’s platform offers these HIEs the potential for bi-directional communication with HealthVault, that capability, to the best of our knowledge has not been tested at either of these HIEs. Also, it is important to note that the Microsoft HIE solution offers little with regards to support for transactional processes (appointment scheduling, Rx refill, eVisit, etc.). RelayHealth is the remaining HIE vendor that actually has some of the more robust consumer tools in the market (they received fairly high ratings in our previous iPHR Market Report), so this is not too much of a surprise.

Now it is not necessarily the fault of laggard HIE vendors that today, their solutions offer weak consumer tools. Frankly, the market has not asked for them. Even as recently as last year when the various HIT policy committees were meeting in Washington to set policies for the HITECH Act and the funding to come, the committee on HIEs, in one of their seminal meetings, completely ignored the consumer role in an HIE. Shameful.

But this will change in due time. MEDecision and Carefx are building out their consumer-facing capabilities and we are sure others will add consumer functionality in time, most likely via partnerships or an occassional acquisition as market is moving too fast for an internal build-out. in the meantime, those vendors that have this capability bring to market competitive differentiation.

While this is all well and good, another development is also taking place, NHIN Direct – something that Microsoft’s chief architect, Sean Nolan mentioned in his comment to our Monday post. What role might a secure, lightweight communication system play within the broader context of HIEs, aggregated PHI, consumer access and potentially control of their PHI? A lot of questions to ponder that we will be looking into further over the next few days

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