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#HIMSS18: AT&T Incubating Digital Health Startups

Posted on March 9, 2018 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.

In recent times, some tech giants have started to think small. For example, companies like Microsoft and Google have been developing startup incubator programs capable of finding new niches, especially in AI. They’re also greedily eyeing healthcare; even Amazon has a hush-hush health IT working group in place.

This approach makes tremendous sense So much so that I’m surprised we haven’t heard more about it before. Even if it tries to foster an entrepreneurial culture, the sheer weight of a colossal bureaucracy is likely to crush most new ideas, and even if it doesn’t, very large companies are seldom agile enough to execute on these ideas quickly enough.

Given these experiments at Amazon, Microsoft, Google and other massive tech firms, I wasn’t surprised to learn that AT&T is taking a similar approach. At HIMSS18, I spoke with Judi Manis, regional vice president of business development and strategic relations at the company, about how it’s working with startups to commercialize new ideas in healthcare.

According to Manis, the telecom giant is focusing – unsurprisingly – on connected health solutions. In partnership with the sprawling Texas Medical Center, AT&T has created the Foundry for Connected Health. TMC also has a foot in the incubator business, its TMC Innovation Institute.

Working together, TMC and AT&T scour the world for startups generating innovative ideas in healthcare. They generally select 12 to 15 startups to participate in the program.

When they come on, TMC offers the founders a curriculum designed to help them thrive, including lessons on accounting, legal issues and how to pitch venture capitalists. AT&T, of course, offers startups all of the conductivity they could ever wish for, including mobile, terrestrial and land-based networks.

Once they find a viable idea, AT&T and TMC move at lightning speed. “The Foundry allows us to talk to companies of all sizes and bring the technology from discussion to pilot in weeks,” Manis says.

Though there may be some I don’t know about, I haven’t encountered any startup incubator partnerships between tech giants and hospitals.

However, it’s not surprising to see it happen. As readers may know, many sharp hospital organizations have already begun creating internal incubators and developing programs that seek out and reward employees that come up with innovative ideas. Maybe this is just the next phase in the process of digital health’s maturation process.

Supercharged Wearables Are On The Horizon

Posted on January 3, 2018 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.

Over the last several years, the healthcare industry has been engaged in a rollicking debate over the value of patient-generated health data. Critics say that it’s too soon to decide whether such tools can really add value to medical care, while fans suggest it’s high time to make use of this information.

That’s all fine, but to me, this discussion no longer matters. We are past the question of whether consumer wearables data helps clinicians, which, in their current state, are under-regulated and underpowered. We’re moving on to profoundly more-capable devices that will make the current generation look like toys.

Today, tech giants are working on next-generation devices which will perform more sophisticated tracking and solve more targeted problems. Clinicians, take note of the following news items, which come from The New York Times:

  • Amazon recently invested in Grail, a cancer-detection start-up which raised more than $900 million
  • Apple acquired Beddit, which makes sleep-tracking technology
  • Alphabet acquired Senosis Health, which develops apps that use smartphone sensors to monitor health signals

And the action isn’t limited to acquisitions — tech giants are also getting serious about creating their own products internally. For example, Alphabet’s research unit, Verily Life Sciences, is developing new tools to collect and analyze health data.

Recently, it introduced a health research device, the Verily Study Watch, which has sensors that can collect data on heart rate, gait and skin temperature. That might not be so exciting on its own, but the associated research program is intriguing.

Verily is using the watch to conduct a study called Project Baseline. The study will follow about 10,000 volunteers, who will also be asked to use sleep sensors at night, and also agreed to blood, genetic and mental health tests. Verily will use data analytics and machine learning to gather a more-detailed picture of how cancer progresses.

I could go on, but I’m sure you get the point. We are not looking at your father’s wearables anymore — we’re looking at devices that can change how disease is detected and perhaps even treated dramatically.

Sure, the Fitbits of the world aren’t likely to go away, and some organizations will remain interested in integrating such data into the big data stores. But given what the tech giants are doing, the first generation of plain-vanilla devices will soon end up in the junk heap of medical history.

The Future of Small Medical Practices

Posted on December 27, 2017 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.

One of the questions I get most often relates to the future of small practices in healthcare. I’ve heard a lot of people make really great arguments for why small medical practices have an extremely challenging future in healthcare. We’ve all heard stories of large healthcare organizations eating up small medical practices left and right.

For the longest time, I’ve argued that this is all just part of a cycle of doctors selling to hospitals and then doctors hating life as an employed doctor and so they return to running their own practice. This cycle seems to be playing out and most doctors still hate being employees. However, there are a lot of other forces at play that makes it harder for doctors to go out and start their own independent medical practice again.

As I look at the biggest healthcare trends, none of them point to a brighter future for the small, independent medical practice. In fact, most of them make it even harder for small medical practices to survive.

For example, the shift to value based reimbursement is something that should be a great thing for small medical practices that have been known to provide the highest quality, personalized care. While this is true, must of value based reimbursement is as much about understanding and applying the data to a population in order to improve the overall health. How many small practices are going to be capable to do this type of data analysis?

If you extrapolate this further, it’s hard to imagine a future healthcare system that’s not built on the back of data. If that’s the case, he who holds the data holds the power. It’s worth asking if even the hospitals and health systems will be large enough to have the data they need on their patients. Or will even the largest hospitals and health systems need to work with massive companies like Google and Amazon who are currently collecting data at rates that no hospital could even consider?

This is a scary and exciting future that is a topic for another post. However, from a small practice perspective, this could be a good thing. If large corporations like Google and Amazon have the data needed to improve healthcare, then it’s possible that those corporations will enable small practices to survive. It could level the playing field for small practices that are trying to compete with large health systems.

What’s certain is that every healthcare organization is going to have to move beyond just the EHR. Sure, the EHR will be a requirement for every medical practice, but I believe it will only be the start. For small and large medical practices to survive, they’re going to have to start exploring what other technology they can implement to provide a better patient experience. The good thing is that small practices can be nimble and implement new technology quickly and without as much bureaucracy. The hard part is that they have to do so with a smaller budget.

What do you think about the future of small medical practices? Will they survive? Should we be making efforts to make sure they survive?

Will 2018 Be The Year Of The Health IT/Non-Health-IT Merger?

Posted on December 1, 2017 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.

Within the last several days, the news broke that Amazon Web Services would probably be doing some sort of far-reaching cloud deal with Cerner. Given that AWS is a nearly $20 billion cloud organization, and Cerner one of the largest health IT players in the game, a lot could happen here.

My guess, not that it’s any leap of imaginative genius, is that if the currently-rumored deal between the two partners works, Amazon will make a serious bid to buy out Cerner as a whole. Given the massive profits potentially at stake in health IT, the idea of such an acquisition seems credible to me, at least if Cerner’s stockholders approve. After all, isn’t Amazon the company that just did a multibillion-dollar buyout of Whole Foods to fuel its growing (but still relatively small-scale) efforts in food retailing?

Not only is this particular deal interesting, I think it may portend some major structural changes in the health IT business as a whole. Specifically, I think we’re reaching a point where there will be a lot of pressure on companies with adequate cash and compatible goals to target HIT organizations, particularly if they need to scale up quickly and don’t have much internal knowledge on the subject.

And there’s no question that as healthcare settles into being a digital business, a range of digital businesses outside of healthcare will see that as an opportunity to step into such an important market. After all, how could they not want to be part of any organization that’s competing effectively in an industry that consumes a double-digit portion of the US GDP?

Over this period, many small internal workgroups outside healthcare will be transformed into scouting units seeking the next big digital healthcare deal. At the same time, these divisions will start forming quiet alliances strategic to their business, not only with giants like Cerner and Epic but also well-positioned startups in hot areas such as, say, blockchain security or supply chain management. (How could an ERP vendor not wonder how a healthcare supply chain management company running over blockchain could enhance their business?)

Then, of course, there are the more obvious moves which will bring a new critical mass of health IT customers, knowledge and talent to companies with a giant market presence already, such as Apple and Samsung.

Such M&A efforts won’t be optional. As Microsoft’s experience has proven in the past, and Amazon has apparently found more recently, you can’t just storm into the enterprise healthcare world and demand your cut, no matter how big a player you are. Getting there will take a well-finessed, mutually-fruitful agreement, if not an acquisition, even for a mega-company like Google/Alphabet.

Now, can I tell you which companies will be executing on such deals next year? I have a few theories, but no specific intelligence to share that you couldn’t pick up on your own by skimming industry headlines. But I do stand by my prediction that by the end of 2018, we’ll have seen a few spectacular deals between HIT vendors and digital companies outside the industry that will have a major influence for years to come.

Amazon Attacking Health IT Opportunities

Posted on August 17, 2017 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.

Getting a footing in the health IT industry is more challenging than it looks. After all, even tech giants like Microsoft, Apple, and Google haven’t managed to take over despite their evident interest in the field.

Apparently, that hasn’t daunted Amazon. The retail giant has pulled together a secret team dedicated to exploring new healthcare technology opportunities, according to a CNBC report. And unlike other companies attacking the space from outside, Amazon has a history of sliding its way into unexpected markets successfully.

According to CNBC the new team, which is named 1492, is working to find an easier way to extract data from EMRs as well as push data into them. In doing so, Amazon is going up against a very wide field of competitors ranging from small startups to the healthcare arms of giant tech vendors and consulting firms.

What distinguishes Amazon’s approach from its competitors is that the online retailer hopes to aggregate that data and make it available to consumers and their doctors, sources told CNBC. The story doesn’t say whether Amazon plans to sell this data, and I don’t know what’s legal and what isn’t here, but my bet is that if it can, Amazon will pitch the data to pharmaceutical companies. And where there’s a will there’s a way.

In addition to looking at data management opportunities, 1492 members are scouting out ways of repurposing Amazon’s existing technology for use in healthcare. As another article notes, some healthcare organizations have already begun experimenting with delivering routine medical information and even coaching surgeons on safety protocols using Amazon voice-based assistant Alexa.  The new group, for its part, will be looking for healthcare applications for existing Amazon products like the Echo and Dash Wand.

The 1492 group is also preparing to build a telemedicine platform. Your first thought might be that the industry doesn’t need another telemedicine platform, and generally speaking, you would probably be right.  But if Amazon can get its healthcare IT bona fides in order, and manages to attract enough doctors to its platform, it could be in a strong position to market those services to consumers.

Make no mistake: We should take Amazon’s health IT effort seriously. At first glance, healthcare may seem like an odd arena for a company best known for selling frying pans and socks and discount beauty supplies. But Amazon has expanded its focus many times over the years and has typically done better than people expected. It may do so this time as well.

By the way, the retailer is apparently still hiring people for the 1492 initiative. I doubt it’s easy to find the hiring manager in question, but if I were you I’d inquire. These jobs could pose some interesting challenges.

ZocDoc’s Company Culture – What’s Been Your Experience?

Posted on August 17, 2015 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.

Company culture has been in the tech news lately after this lengthy article looking at Amazon’s company culture. However, in the healthcare IT world, I was more interested in this recent article by Business Insider looking at ZocDoc’s company culture. The article paints a brutal picture of a “frat house” mentality together with sexism and drugs. Not a pretty picture and it pains me to even read stories like this. However, this part of the article really stuck out for me:

On the sales floor at ZocDoc, employees say there’s a phrase used over and over again: “churn and burn.” Former employees say this phrase indicates the competitive, often stressful nature of work in ZocDoc’s sales division.

“They are full steam ahead,” one former salesperson told Business Insider. “They have this arrogance in the company where the human capital is of zero value.”

A former employee at ZocDoc told Business Insider that employee turnover at the company is high. The company recruits and brings in batches of new employees regularly because so many end up leaving or quitting, the employee alleges.

I definitely know very little about ZocDoc’s company culture. I do know that they raised a lot of money, very quickly. That puts a lot of pressure on your company. First, you have to hire a lot of people over a very short period of time. That doesn’t leave much time to develop a quality company culture. Second, when you raise that much money, you face enormous pressure to scale the company and deliver results. That’s not an excuse for bad behavior (assuming the Business Insider report is accurate), but it could explain how their company culture got out of control.

Company culture aside, their description of their sales organization mimics what I’ve heard from a number of doctors about ZocDoc. I’ve only ever met one doctor who liked ZocDoc. That doctor felt that he got patients he wouldn’t have otherwise gotten and so it was worth it. Every other doctor I’ve talked to said that ZocDoc charged way too much for new patient referrals and so they didn’t use them.

Outside of doctors’ views on ZocDoc’s pricing model, some doctors told me how aggressive the ZocDoc sales people were with them. They’d tell me about being contacted all the time by their sales people. I remember one practice manager telling me that they would never do business with ZocDoc since they hated their sales approach. The practice manager didn’t talk about the ZocDoc product or service at all. The sales person had ruined ZocDoc with that practice.

After hearing so many practices talk about ZocDoc over the years, it resonated with me when the former salesperson described the “arrogance in the company.” That’s the impression I’d been given by the many practices I’d talk to myself. I’m sure the $97.9 million they’d raised in funding (and reports said they’re raising another $152 million) helped perpetuate that culture.

What’s been your experience working with ZocDoc? I’d love to hear from more doctors and practice managers.

Could Amazon or Facebook Build A Better EMR?

Posted on February 18, 2011 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.

As we all know, few EMRs are a breeze to use.  In fact, many have such awkward, counterintuitive UIs that they ought to be thrown back into the pond.

On the other hand, superstar consumer apps like Facebook and Amazon have hooked people by the millions with intuitive, logical interface designs that simply addict users.  (And let’s not forget Apple, whose gift for consumer design has vaulted it from has-been to trend setter for the world.)

One CIO, Dale Sanders of the Cayman Island Health Authority, has taken these  examples and run with them, making what seems like a very strong argument in favor of the these giants’ approach:

In Facebook, we have a perfect framework for longitudinal documentation, collaboration, messaging, and scheduling between a patient and members of their entire care team, including family and friends.

We also have a framework for easily integrating data from other sources to enhance the value to the patient’s healthcare – there’s no equivalent of HL7 interchange going on in Facebook.  It references data located in other sources and systems. Can you imagine Facebook surviving if it required itself to house all the data that it presents?  Facebook takes great advantage of referencing and pointing to data in the source systems.

In Amazon, we have a perfect and familiar metaphor for ordering tests and procedures; tracking them; assessing their costs; rating them and seeing how other clinicians rated those orderables and referrals; and adjusting orders based on the behaviors and ratings of other clinicians, etc.

What makes his thoughts more interesting is that he actually marks up screenshots of key Amazon and Facebook pages, commenting directly on aspects he thinks EMR vendors could adopt.  It’s a thought-provoking exercise:  I recommend you check it out.