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Smart Home Healthcare Tech Setting Up to Do Great Things

Posted on March 31, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today, I read a report suggesting that technologies allowing frail elderly patients to age in place are really coming into their own. The new study by P & S Market Research is predicting that the global smart home healthcare market will expand at a combined annual growth rate of 38% between now and the year 2022.

This surge in demand, not surprisingly, is emerging as three powerful technical trends — the use of smart home technologies, the rapid emergence of mobile health apps and expanding remote monitoring of patients — converge and enhance each other. The growing use of IoT devices in home healthcare is also in the mix.

The researchers found that fall prevention and detection applications will see the biggest increase in demand between now and 2022. But many other applications combining smart home technology with healthcare IT are likely to catch fire as well, particularly when such applications can help avoid costly nursing home placements for frail older adults, researchers said. And everybody wants to get into the game:

  • According to P&S, important players operating in this market globally include AT&T, ABB Ltd, Siemens AG, Schneider Electric SE, GE, Honeywell Life Care Solutions, Smart Solutions, Essence Group and Koninkllijke Philips N.V.
  • Also, we can’t forget smart home technology players like Nest, and Ecobee will stake out a place in this territory, as well as health monitoring players like Fitbit and consumer tech giants like Apple and Microsoft.
  • Then, of course, it’s a no-brainer for mobile ecosystem behemoths like Samsung to stake out their place in this market as well.
  • What’s more, VC dollars will be poured into startups in this space over the next several years. It seems likely that with $1.1 billion in venture capital funding flowing into mHealth last year, VCs will continue to back mobile health in coming years, and some of it seems likely to creep into this sector.

Now, despite its enthusiasm for this sector, the research firm does note that there are challenges holding this market back from even greater growth. These include the need for large capital investments to play this game, and the reality that some privacy and security issues around smart home healthcare haven’t been resolved yet.

That being said, even a casual glimpse at this market makes it blazingly clear that growth here is good. Off the top of my head, I can think of few trends that could save healthcare system money more effectively than keeping frail elderly folks safe and out of the hospital.

Add to that the fact that when these technologies are smart enough, they could very well spare caregivers a lot of anxiety and preserve older people’s dignity, and you have a great thing in the works. Expect to see a lot of innovation here over the next few years.

Increasing Revenue Through Clinical Connectivity

Posted on August 27, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most of you know, I’ve been working hard to create more content related to revenue in healthcare. My interest in this has grown even more since I had the chance to attend the ANI 2012 conference in Las Vegas where I got the chance to talk to people like Rishi Saurabh from GE Healthcare. It’s amazing how many people (myself included) don’t think that revenue cycle management is sexy since there are so many opportunities in healthcare.

One example of missed healthcare revenue management opportunities has to do with connecting clinical content with the financial data. From my experience, it’s quite rare to see a healthcare institution that does a great job of connecting these two pieces of data. The clinical data is in a silo of its own and it’s only looked at by the clinical people. The financial data is in its own financial data silo and only ever looked at by the financial people.

These silos are a problem and present a really big opportunity for healthcare organizations to increase the revenue of their organization. Although, doing so in an organization is not always easy. It takes great leadership to bridge the two content silos. Plus, you need someone who’s effective at understanding both the clinical and financial point of view. So, it’s not hard to understand why this doesn’t happen more often.

I think the most basic example of what I’m talking about can be seen in the annual checkup. I was talking with a colleague the other day when I told him that I couldn’t remember the last time that I’d been to my doctor. In fact, I honestly don’t even know my doctor’s name (which might beg the question of whether he’s really MY doctor). Why hasn’t my doctor sent me a reminder about the need to do an annual physical exam? Why don’t I have a regular connection with my doctor that helps me to take better care of my health?

I think at least part of the answer to this is that the clinical is not tied to the financial. If the clinical were tied to the financial, then the doctor could provide a care plan for me and my specific health needs. Then, the financial could ensure that I’m following that care plan. Imagine the revenue implications of me visiting the doctor regularly as part of a well defined care plan.

I’m sure that many of you out there are likely skeptical about whether patient reminders will actually change behavior. Certainly in many cases, these reminders will be discarded or ignored. However, a certain percentage of those reminders will be followed. This will mean your patients get better care and your clinic increases their revenue. Plus, maybe we need to take a deeper look at the care plans that we offer patients. If large percentages are ignoring the suggestions, then maybe we need to rethink the plan or how we’re communicating that plan to the patient.

There are certainly plenty of other medical examples where a follow up doctor visit would make sense and improve the health of your patients. In fact, you could get really sophisticated with how you reach out to your patient population.

I believe the key to success of this type of program is to integrate the clinical data with the financial data. It creates tremendous power and amazing opportunities.

Revenue Cycle Management Interview with Rishi Saurabh – GE Healthcare

Posted on July 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most of you know, I had the chance to attend the ANI 2012 conference in Las Vegas that’s put on by HFMA. This conference is a hospital CFO’s home since all of the major players in the healthcare financial management space were in attendance. Around every corner was another Hospital CFO it seemed.

While at the conference, I was able to corner the Global Product Marketing Manager at GE Healthcare, Rishi Saurabh, for a short video interview about revenue cycle management. In the video Rishi provides his insights into the biggest challenges facing hospitals today and also provides some insight into how GE plans to approach these challenges. I hope you enjoy the video:

Are Large EHR Vendors More Likely to Shut Down an EHR Than Small EHR?

Posted on May 9, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most people who have read this blog for a while, you know that I try to bring you raw perspectives on things that a lot of people don’t want to talk about. Plus, I don’t mind arguing the other side of topics in order to provide a more well rounded view of an important topic. One of my main goals is to provide the information necessary for doctors to make great decisions.

I recently got into a lengthy discussion with someone about EHR vendor selection. They suggested that doctors should look to the 5 EHR market leaders in their EHR selection process (I believe he sold one of those EHR market leaders). He made some very good points about the market leaders ability to support all stages of meaningful use, that they have a solid business model that will support doctors for the long term, and that they have the resources to support an EHR software for the long run. He also provided some reasonable cautions around small EHR vendors with skeptical business models that might not be around a few years from now.

Certainly the points he makes have merit and are worthy of consideration. Although, unlike this person, I’m not so ready to throw the rest of the non-top 5 EHR vendors out and I think it’s a mistake for a doctor or practice manager to do so as well.

As I considered on this discussion, I realized that over the past 5-7 years, it’s many of the big EHR vendors that have closed up their EHR software. Possibly even more than the various startup EHR companies. Here are just a few examples of large companies shuttering their EHR: Misys (billion dollar company if I remember right), Epocrates and GE Centricity Advance (one of GE’s suite of EHR). Of course, Misys merged with Allscripts (if you call it a merger since they were going bankrupt), but I know a lot of unhappy Misys users that don’t know what to do now. GE has many other Centricity products as well and seems to have made a smoother transition for their Centricity Advance users. At least that’s within the same company. Epocrates is a large company, but didn’t have many EHR users.

My point of course is that even EHR software from large EHR vendors aren’t safe from possible future issues. In fact, I could make a reasonable case for why a smaller EHR vendor that’s grown in a sustainable way over a long period of time is in a better financial position than a HUGE company with a lot of overhead. Plus, I know personally A LOT of these small EHR vendor CEOs. They love what they’re doing and they’re in this for the long haul.

Now with 600+ EHR vendors out there, I’m certainly not saying that all of them have great business models. I was blown away when I met one at MGMA who had 1 doctor using their system. I hope whoever they sign up second is aware of the situation and is going in with both eyes open. There are certainly risks associated with being the second doctor on an EHR software, but there are also plenty of benefits as well. When you suggest something be changed, there’s a good chance you’ll get that change.

Conclusion
There are good small EHR companies.
There are good large EHR companies.
There are bad small EHR companies.
There are bad large EHR companies.

I guess what I’m saying is that size doesn’t matter in EHR selection. There are much more important factors to consider.

Greenway Medical (GWAY) IPO Suggests Big Opportunities For EMR Vendors

Posted on February 2, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While there’s a number of  large, publicly-traded EMR vendors out there — General Electric (NASDAQ: GE) and Cerner (NASDAQ: CERN) immediately come to mind — to date we haven’t seen many mid-sized or small companies kick off an initial public offering. But one medium-sized EMR/practice management vendor has broken the mold.

Today, Greenway Medical Technologies (NASDAQ: GWAY) took the plunge , pulling in $67 million to fund its operations. While the company had hoped to raise $100 million, its take is nothing to sneeze at. Health IT is a tricky investment, even for pros like yourselves, readers, and institutional investors in particular are a conservative bunch. The fact that they’re spending on a risky business means a lot.

Greenway, whose EMR is bundled with practice management software, had one heck of a ride today, with its stock climbing 30 percent during its first day of trading. The company sold 6.7 million shares at prices below its expected $11 to $13 range, diluting its intake somewhat, but the stock closed at a promising $13 per share.

The Carrollton, Ga.-based vendor has certainly done well in recent times. According to insider Wall Street blog Seeking Alpha, Greenway revenues shot up 55 percent, to $25.7 million, during the last quarter of operations. Operating margins went from negative to a positive 2 percent, which is at least a start.  Its biggest cash generator during the quarter was licensing revenue, which climbed 49 percent.

What’s interesting about this IPO isn’t just the fact that it ended well for Greenway. After all, it did take in less than planned, and the Wall Street crowd justifiably wonders how it will fare in a mind-boggling competitive market.  But it’s worth asking whether Greenway did better because it bundles both an EMR and practice management tools. Did the fact that Greenway wasn’t relying solely on EMR revenue contribute to its growth and financial success?  It would be interesting to find out, as that might help predict whether the bundled model is especially popular with physicians.

As for those who’d seek to imitate Greenway, they may have a chance if they move soon. Seeking Alpha editors think HITECH will still pump enough money into the EMR market to make these companies a reasonable investment. And given how many doctors and hospitals are still struggling to put EMRs in place, I have to agree.  In fact, given that an amazing number of hospitals and medical practices junk their first EMR, there may be a whole second wave of opportunity within three to five years.

All told, if the market’s response to a smallish IPO is any indication, you can expect a bunch of other EMR players to follow in its footsteps.  I’m thinking it will be companies in the $100m to $200m range, as they’re small enough to need capital (much cheaper capital than banks offer these days!) and nimble enough to benefit from the cash influx. Stay tuned and in coming months, I’ll tell you which other EMR and HIT companies I’m betting will climb onto the launch pad.

Microsoft and GE Announce Healthcare Joint Venture

Posted on December 12, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

I got suckered into article-hopping on TechCrunch reading Dave Chase’s opinion piece on Microsoft’s recent joint venture with GE Healthcare, only Chase’s headline reads “Microsoft Ends Another Vertical Market Dalliance—This Time In Healthcare”. Two hours later, here I am with the post I should have written right away.

Regarding the joint venture, here’s what the Microsoft spin machine put out, and here’s the original New York Times blogpost that first broke the news.

To summarize: Microsoft and GE will be joining forces in a healthcare joint venture, if and when the deal gets regulatory approval. Some of Microsoft’s healthcare projects like Amalga, Vergence, and expreSSO will now form part of the joint venture. The new company has not been named, but there are plans to hire 750 people, sourced from Microsoft, GE and elsewhere.

– HealthVault still remains with Microsoft.

I’m not a Microsoft fan by any standards but I’m not so sure it’s a bad idea for Microsoft to want to join forces with GE, and keep HealthVault inhouse. And I’m also not sure I’d term the process an end to Microsoft’s healthcare plans. It seems more of a shift in gears. However, Chase, who worked with Microsoft for 12 years, believes it is a sign of an exit given Microsoft’s old exit patterns. (Chase’s list of all the verticals Microsoft has exited from makes for interesting reading. Did you know Expedia used to be a Microsoft company? Me neither.) Posting in the discussion following the Tech Crunch article, Chase also insinuates that there have been layoffs among Amalga employees, though he doesn’t give any numbers.

The NYT post states that the aim for the new company is to provide a Windows like platform which developers can then use to create healthcare related apps and services on. It also rightly points out that EMR vendors like Epic and Cerner are not going to be falling head over heels building products for the new platform.

One of the most trenchant comments (to me at least) on the NYT post comes from a commenter called Manuel Albarracin:

“Also, beyond Epic or Cerner, there will be others who will resist change along these lines, for this resistance comes not only from (legitimately) wanting to protect market positions and commercial interests; it also comes from a subtle but entrenched (and not so legitimate) mentality to reinvent the wheel at every healthcare organization, to ‘control things our way’, thus creating ‘walled-gardens’ in each of them.”

Which is probably what Microsoft has in mind – to provide the framework that the apps are built on. If the Windows experience is anything to go by, we should be in for an interesting ride.

Who Will Police EMRs and EHRs?

Posted on November 7, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Amid all the dog-bites-man type health IT news, here are some not-so-positive EMR/EHR stories that have been reported:

– An EMR in Lifespan hospital group gave incorrect prescriptions to some 2000 patients. The article in the Providence Journal says that

The hospitals have placed calls to nearly all the affected patients, although not all have called back, Cooper said. Most patients reached had already obtained the correct medication because the error was noticed by someone at the hospital, or a pharmacist or doctor outside, she said. So far, Cooper said, there is no evidence that any- one was harmed.

Thank goodness for that.

– Incorrectly calculated MU thresholds (GE Centricity). I’m not going to rehash the story, but you can check out Neil Versel’s article in InformationWeek, the spirited discussion on my previous EMR and EHR blog post and John’s EMR and HIPAA blog post.

It might be just be my skewed viewpoint, but GE Centricity related issues are nowhere on par with people being prescribed the wrong prescription. In one case, a few practices may not be able to demonstrate Meaningful Use. Wrong medication could actually be life-threatening to you. So if I had to rank my problems, I’d rather be short by 44K than worry about my EMR inadvertently killing my patients off.

What we need is a governing body, similar to the National Transportation Safety Board, to police EMRs, says Paul Cerrato in a recent InformationWeek Healthcare article.

Cerrato writes:

“An NTSB-like organization for EHRs would at the very least provide a reporting mechanism to keep track of incidents and life-threatening consequences of misusing e-records. More importantly, it could police vendors and healthcare providers who repeatedly ignore these dangers.”

Cerrato goes on to say there are only 120 EHR-specific problems reported to the FDA over the last 18 years. That figure, if correct, to me shows:

  • EMR users don’t know how/where they can report EMR related errors or don’t expect any action to be taken – this certainly is credible, because from all quarters, it seems as if the focus is just to get the healthcare field into electronic data capture, not on whether the experience delivers any tangible and useful benefits
  • Maybe they’re willing to give EMRs a pass assuming the healthcare IT to be in infancy
  • They’re too overwhelmed with the EMRs’ capabilities/inabilities to really see what’s going on

For a national database of EMR problems to be truly relevant, here’s the information I would look for, on problems I’m facing:

  • How critical was the error? How many people did it affect, and in what ways – medically, financially?
  • How was it handled?
  • How common is it – are there others who’ve faced similar problems?
  • If the problem was not sorted, what raps on the fingers did the vendors face?

Read the article here.

iPad Adoption Slow in Healthcare

Posted on March 24, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At least that’s the case that was made in this blog post on the Software Advice website. The post is a few months old which is centuries in the tech world, but I have to disagree with them on their take that EMR vendors are slow to move their products to the iPad platform. In fact, I mentioned in their comments that I think every single EMR vendor has an iPad strategy.

They do get it right that doctors are adopting the iPad at a really dramatic pace. Here’s my reasons why it’s been so popular:
1. Battery life that lasts a full shift
2. 3G and Wireless Connectivity
3. Intuitive interface
4. $500 price point

We’re still waiting on some enterprise features that it seems like the Blackberry Playbook is trying to implement for healthcare. However, I’m pretty sure they’ll get there in time or someone will create an app that will create those features anyway.

Back to the iPad, the article only states 2 companies that have an iPad EMR offering. There are many more than that. I’ve seen some from Practice Fusion, GE, and VitalHealth to just name a few.

What I haven’t yet seen is how well doctors like the use of their EMR iPad interface. Is it really that usable for a doctor doing his rounds? Does it work well for clinical documentation? Is it a nice compliment to a desktop environment?

Sadly, I still can’t give my first hand account of using an EMR on an iPad. I got my refund from HIMSS since despite all the free iPad giveaways I came home without one. Oh well, the iPad 2 is out now and it would have been a shame to only won a first generation iPad. I’m told by Christmas there may even be an iPad 3, but I digress.

What might even be more interesting than EMR use on an iPad is the other creative ways that people are using iPads in healthcare. For example, I’ve heard of people using an iPad as a check in device for their clinics. There’s something cool about handing over an iPad instead of a clipboard for your patients to fill out their paperwork. I’m sure some patients would hate it, but I for one would be much happier feeling out the stack of paperwork electronically.

A Good Question: What Would Epic Be Worth, And Does It Matter?

Posted on March 19, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Few would argue that Epic is one of the two or three most visible enterprise EMR vendors on the market today. There’s little doubt that these days, Epic is shortlisted when hospitals plan an EMR rollout, alongside of giants like GE and Cerner.

It’s hard to imagine that Epic isn’t in a sweet financial position, practically stuffing warehouses full of the revenue they’re generating in this pivotal period of HIT history. (For a sense of the scale involved, bear in mind that Kaiser Permanente’s reportedly $4 billion to $6 billion EMR rollout was an Epic installation.)

That being said, we really don’t know. Why? Well, while Cerner and GE and McKesson are public companies, Epic remains privately held. Looked at another way, health systems that sink half a billion dollars over five years to implement Epic know far less about its financial situation than they would about Cerner’s.

So, maybe I’m wandering out on a limb here, but if I were a big health system, wouldn’t it be a little bit concerning not to know some details on how robust the company’s financial picture is? Does it really make sense, despite its strong reputation and impressive customer list, to spend a staggering sum on Epic without some third-party analysis of its prospects?

After all, when you spend the kind of money health systems are spending, that vendor becomes an incredibly important partner. But if the vendor’s not open to Wall Street scrutiny , it might get away with fibbing about its ability to deliver.

Mind you, I’m not saying that health systems that go with Epic — or any other privately-held vendor — are behaving irresponsibly. It’s just that in this climate, more information can’t hurt.

P.S.: I began thinking about this when I saw a question (posted on Quora.com) asking what Epic would be worth if it went public. Could the poster know something we don’t?

EMR by the Numbers Video

Posted on September 3, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I find it interesting that I was sent another EMR YouTube video. No doubt YouTube can be a great tool for getting the word out, but so far the views on EMR videos are pretty low. However, I must admit that this video by GE Healthcare is much more interesting than the previous meaningful use video I posted. Plus, they focus on physicians number 1 concern: productivity and reimbursement. Take a look for yourself.