Posts Tagged ‘ICW’

Acquisition fever has set in and they’re dropping like flies, independent HIE vendors that is. Earlier today, Siemens announced its intent to acquire enterprise HIE vendor MobileMD. So in little over a year we have seen IBM snag Initiate, Axolotl fall into the hands of Ingenix/United Health Group (Ingenix is now known as OptumInsight), Medicity tie the knot with Aetna, Harris pick-up Dept of Defense clinician portal darling Carefx and Wellogic, a damsel in distress, being rescued by Alere. Elsevier also announce an intent to acquire dbMotion for a whooping $310M, but nothing came of that other than a substantiation of the rumor that dbMotion was being shopped.

That does not leave many small, independent HIE vendors that have some traction left in the market. Following is our list of such vendors and what might become of them:

4medica: A relative new comer to the HIE market, 4medica will be profiled for the first time in the upcoming HIE Market Trends Report which is scheduled for release in early 2012. 4medica is quite strong on lab information exchange. Future: 4medica still remains under the radar screen as it completes its platform to truly serve all HIE needs. Once that process is complete, the company is likely to gain increasing attention and will be acquired in 18-14 months.

Care Evolution: Privately owned and self-funded, founder has every intent to stay independent. As he has told us on more than one occasion, I’ve already made plenty of money and this is not about cashing out to the highest bidder. Future: Everyone has a price but this company may be one of the last to fall into the arms of another.

Certified Data Systems: Appliance (think small router with embedded HIE functionality) HIE vendor that has close, yet non-exclusive partnership with Cerner. Would not be surprised if they struck a similar deal with Epic as Epic struggles to connect to EHRs outside its system. Future: Fairly new to the HIE market but gaining traction. Will stay independent for next 12-18 months, after that, anyone’s guess.

dbMotion: One company already made a bid, but pulled back, thus pretty clear this company will be acquired, question is how much and we suspect it will be significantly less than what Elsevier was planning to pay. Future: If price is right, could be acquired at anytime.

HealthUnity: Small HIE vendor from the Pacific Northwest that made a big splash when with Microsoft (Amalga UIS) they won the big Chicago HIE contract. Future: With Microsoft cozying up close to Orion, HealthUnity will be looking hard for other partners and/or to be acquired. Will give them 12-18 months as an independent.

ICA: Another small HIE vendor that has had a few wins here and there but will come under increasing pressure from larger, better funded HIEs. Future: Likely to be acquired in next 6-12 months, maybe even earlier.

ICW: InterComponent Ware is a German HIT company and a sizable one at that with over 600 employees. To date, ICW has a very small presence in the US HIE market so an acquisition, if there were one, would have little impact.  Future: Their foreign ownership, size and interests in several health related markets make them an unlikely candidate for acquisition.

InterSystems: Arms dealer to all, InterSystems Cache and Ensemble are widely used in the market and the company has built upon these core technologies to get into HIE market. Future: Fiercely independent and senior team is basically the same since founding this company will remain independent.

Kryptiq: Having signed a strong partnership deal with Surescripts, Kryptiq is unlikely to be interested in any acquisitions talks. Future: Will remain independent for time being and if Surescripts’ Clinical Interoperability solution gains significant traction, Surescripts will likely acquire Kryptiq outright.

Orion Health: New Zealand-based, privately owned with good prospects in markets beyond America’s shores, this company will likely want to stay independent (future IPO) unless of course a very large software company (think IBM, Microsoft, Oracle etc.) gives them an offer they can’t refuse. Future: Will stay independent.

Getting back to the Siemens/MobileMD deal…

While we have not had an opportunity to talk with either Siemens or MobileMD (will provide follow-on update once we do) here are some quick take-aways:

Siemens has chosen to buy. This is unlike other EHR vendors who have either built their own HIE solution (athenahealth, eClinicalWorks, Epic, NextGen) or have partnered with others (Allscripts, Cerner, GE).

Existing partner doesn’t cut it. Siemens has an existing partnership with NextGen for ambulatory but NextGen’s HIE is a closed system. This prevented Siemens from being able to leverage this partnership to serve their client needs, which most often includes a multitude of EHRs in the ambulatory sector to interface with.

Lacked sufficient internal resources. By buying into the market, Siemens has signalled that it does not have the development resources to respond quickly enough to customer demand (not too surprising, Siemens has been struggling in the North American market for sometime). This also signals that they could not find the right partner outside of their NextGen relationship, which is a tad puzzling as we are quite sure they paid a premium for MobileMD.

Paid a premium. We estimated MobileMD sales in 2010 just shy of $8M in our 2011 HIE Market Report. HIE vendors are selling at a premium, even second tier ones such as MobileMD. Assuming industry average growth in 2011 (we peg it at 30%) that would give MobileMD sales of ~$10.5M for 2011. We put the final strike price for MobileMD at $95-110M.

Existing MobileMD customers relived. Unlike the acquisitions of Axolotl and Medicity, which both fell into the hands of payers, MobileMD is going to a fellow HIT vendor which must assuage the fears of more than a few MobileMD customers and prospects. Siemens intends to keep MobileMD whole, bringing on-board MobileMD’s president and founder, again contributing to continuity.

ADDENDUM: Please excuse our lack of posting on industry trends in a more frequent manner. Like many in the healthcare sector, Chilmark Research is struggling to keep up with demand and recruit top-notch resources. We seem to have hit our stride in this market, are receiving countless engagement inquiries and engaging in most of them. All good problems to have, but you dear reader are the one who ultimately suffers from our lack of posts. Thank you for your patience to date and know that we are doing our best to keep you informed with some of the best research and analysis of this critically important and meaningful market.

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Back home from my two day whirlwind tour of HIMSS. Here’s what I have for you from Day Two.

Significantly slower on Tuesday, though it did pick up later in the afternoon. So was everyone out playing golf or hanging out by the pool before the rain set in, or were they at one of the educational sessions? Hard to tell, but there sure were a lot vendors just sitting around not even trying to look busy.


Had a good briefing with Microsoft. Couple of quick stats for you:

  • Over 4,700 downloads of the HealthVault SDK to date.
  • Have some 100 signed partners that intend to provide a personal health application leveraging HealthVault. Big focus in 2008 is getting these providers live. Sure hope so as so called demos in exhibit area were weak.

As a follow-up to yesterday’s announcement on the $3M Be Well Fund that Microsoft is sponsoring, Microsoft is putting some pretty tight guidelines on it. First, they are really looking to fund innovative ideas coming out of academia and other non-profits such as health advocacy groups. Second, proposals have to be in by May 9th, awards announced July 1st and product ready for demo in October. Will be extremely interesting to see what this produces.

And just in case someone did not see the PR, Microsoft had a HUGE one page ad announcing the Be Well Fund in both yesterday’s and today’s WSJ. Prime spots as well.

I’ll provide a longer post addressing the Microsoft briefing later this week.


In just another example of HIMSS’s seeming indifference to patients as consumers, went to the HIMSS session (sponsored by the HIMSS PHR sub-committee), Personal Health Records: An Industry Update from Various Perspectives. It was awful. Information presented was superficial and dated and seeing as only one person presented, hardly from various perspectives. Really a shame as there was quite a large audience (over 200) in attendance who deserved better than this for their time spent.

Hey HIMSS, take a look at the aforementioned Microsoft ad wherein Microsoft states, and I quote, “..innovative health applications that accelerate connections between consumers (my emphasis) and physicians and the information they need to make informed decisions.” and get a clue. This is where the train is headed so get on board or be left at the station.

More RelayHealth

Yesterday, I mentioned the physician centric PHR company RelayHealth (parent McKesson). Went back there for continuing discussion with their VP of Consumer Solutions, Ken Tarkoff who informed me that they have nearly 1M consumers using this PHR. That may very well put RelayHealth at the top, in terms of users, and ahead of the likes of WebMD. It is a compelling solution, though not sure how RelayHealth customer Aetna will combine it with their own ActiveHealth Management PHR solution.


Learned more about ICW and their LifeSensor PHR. Interesting company that has seen success in Europe, but despite being in the US for a few years now, as seen very little traction. They did win Memorial Hospital in Rhode Island late last year, and another small hospital on the West coast – so maybe they are finally getting serious, we’ll have to wait and see.

Seeing as ICW has had such little success with LifeSensor in the States, I wrote them off. After visiting their booth and getting an initial briefing, my judgment may have been hasty. Quick review:

  • Their motto Don’t reject, connect. Big into promoting interoperability and announced the eHealth Foundation with founding partners Sun and Agfa. Was told that several others intend to join. Might one of them be Siemens?
  • ICW has over 650 employees worldwide.
  • They have established numerous partnerships many of which are with medical device suppliers for device connectivity to automatically populate one’s PHR.
  • Multi-lingual capability (English, German, French, Russian and Bulgarian).
  • Deep domain expertise in the use of Smartcards. Great platform for a “911 card” but little adoption in US. If that changes, (don’t hold your breadth) ICW is well positioned.
  • They offer their SDK to anyone interested in developing apps for the LifeSensor platform and have established an ICW Developers’ Network, (IDN) to support such development efforts. For the IDN, ICW hosts an annual developers conference to share best practices, learn about ICW’s product roadmap, etc. and hosts an online forum for continuing interaction.

Despite all of this, I still have some reservations about ICW as they have yet to prove themselves here in the States and this market is not getting easier to enter, particularly with Google now joining the ranks of PHR providers. ICW is staffing up operations in the US and indeed they could begin making a mark, but their execution in the field will need to be near perfect. Certainly a company worth watching and tracking as they do have quite a nice solution with some distinct differentiation.

Coolest Demo of the Day

Last but not least on the cool technology front was getting a demo of the MiCard from founder and president Tracy Evans. MiCard is this little credit card sized storage device (1GB) with a small screen that one can scroll through. MiCard has partnered with PHR provider NoMoreClipboard who together will sell this prepackaged solution at your local pharmacy or online for ~$130. BTW, NoMoreClipboard – nice PHR solution, too bad their marketing doesn’t quite match-up. Regardless, another PHR vendor worth watching closely, interesting technology under the hood.

Here’s how it works. Consumer gets a subscription to the online NoMoreClipboard where they can create a PHR and simply download information (emergency info or everything) through the mini USB port into MiCard. Once on MiCard, information is in read-only mode and one can quickly scroll through the record with simply up/down arrows on MiCard.

Great idea for emergency situations as it provides PHR info, without allowing direct access to one’s online PHR. And unlike the common USB solutions of today, EMTs and doctors don’t have to take the risk of pluging a USB into their network to see critical information. It is all easily accessible and viewable on MiCard. In addition to direct to consumer sales via pharamcies and the like, Tracy stated that physician practices are also buying MiCard to give to their customers for free as an added value service.

Busiest Booth

Google continues to attract quite a crowd, which can either be a boom or a bust to their neighbors.  Boom for it brings foot traffic.  Bust for it is difficult for someone to even get past the Google crowd and to your booth.  Pretty savvy on Google’s part to go with a small booth.  Having a bustling crowd always attracts attention from afar with passers by wondering, hmm, wondering what’s happening down that aisle – think I’ll go take a look, which of curse just brings more on-lookers.

Lesson Learned

Lastly, number one lesson learned, stay for at least three days as there is no way to sufficiently see everything at HIMSS in any less than that.

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