Meditech continues to hold the largest EMR market share in Canada, but it is losing customers — mostly to Epic, which has seen a rapid rise in popularity, a new KLAS report shows. The report delves into market share data and customer satisfaction insights to assess EMR vendors’ positions in the Canadian market.
Electronic medical records (EMRs) are widely expected to serve as a cornerstone technology that drives the delivery of modern patient care.
But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.
The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.
Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.
This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs.
To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.
Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:
1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk.
The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.
2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.
Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.
It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:
– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?
– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?
– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?
The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.
But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.
About Assaf Halevy
Assaf Halevy is the founder and CEO of 2bPrecise, LLC, leading an international team dedicated to bridging the final mile between the science of genomics and making that data useful at the point of care. He joined Allscripts as senior vice president of products and business development in 2013 when the company acquired Israel-based dbMotion. An initial inventor and co-founder of dbMotion, Halevy helped develop the leading clinical integration and population health management platforms in the industry today.
With 13 patents pending in the areas of actionable clinical integration, interoperability, and precision medicine, Halevy leverages his industry expertise by evaluating strategic alliances and partnerships for U.S. and international markets. Halevy was invited to participate in several U.S. government activities and contribute to an HHS privacy committee task force. In 2016, he was part of a small selective group of executives invited to the White House by Vice President Joe Biden to discuss the future of interoperability.
The combination of Teladoc Health and Livongo creates a
global leader in consumer-centered virtual care. The combined company is
positioned to execute quantified opportunities to drive revenue synergies of
$100 million by the end of the second year following the close, reaching $500
million on a run-rate basis by 2025.
Price: $18.5B in value based on each share of Livongo
will be exchanged for 0.5920x shares of Teladoc Health plus cash consideration
of $11.33 for each Livongo share.
Siemens Healthineers Acquires Varian Medical
On August 2nd, Siemens Healthineers acquired
Varian Medical for $16.4B, with the deal expected to close in 2021. Varian is a
global specialist in the field of cancer care, providing solutions especially
in radiation oncology and related software, including technologies such as
artificial intelligence, machine learning and data analysis. In fiscal year 2019,
the company generated $3.2 billion in revenues with an adjusted operating
margin of about 17%. The company currently has about 10,000 employees
Price: $16.4 billion in an all-cash transaction.
Gainwell to Acquire HMS for $3.4B in Cash
Veritas Capital (“Veritas”)-backed Gainwell Technologies (“Gainwell”),
a leading provider of solutions that are vital to the administration and
operations of health and human services programs, today announced that they
have entered into a definitive agreement whereby Gainwell will acquire HMS, a technology, analytics and engagement
solutions provider helping organizations reduce costs and improve health
Price: $3.4 billion in cash.
Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B
Philips acquires BioTelemetry, a U.S. provider of remote
cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion). With $439M in
revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients
remotely; its portfolio includes wearable heart monitors, AI-based data
analytics, and services.
Price: $2.8B ($72 per share), to be paid in cash upon
Hims & Hers Merges with Oaktree Acquisition Corp to Go Public on NYSE
Telehealth company Hims & Hers and Oaktree Acquisition Corp., a special purpose acquisition company (SPAC) merge to go public on the New York Stock Exchange (NYSE) under the symbol “HIMS.” The merger will enable further investment in growth and new product categories that will accelerate Hims & Hers’ plan to become the digital front door to the healthcare system
Price: The business combination values the combined
company at an enterprise value of approximately $1.6 billion and is expected to
deliver up to $280 million of cash to the combined company through the
contribution of up to $205 million of cash.
SPAC Merges with 2 Telehealth Companies to Form Public
Digital Health Company in $1.35B Deal
Blank check acquisition company GigCapital2 agreed to merge with Cloudbreak Health, LLC, a unified telemedicine and video medical interpretation solutions provider, and UpHealth Holdings, Inc., one of the largest national and international digital healthcare providers to form a combined digital health company.
Price: The merger deal is worth $1.35 billion, including
WellSky Acquires CarePort Health from Allscripts for
WellSky, global health, and community care technology company, announced today that it has entered into a definitive agreement with Allscripts to acquire CarePort Health (“CarePort”), a Boston, MA-based care coordination software company that connects acute and post-acute providers and payers.
Price: $1.35 billion represents a multiple of greater
than 13 times CarePort’s revenue over the trailing 12 months, and approximately
21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12 months.
Waystar Acquires Medicare RCM Company eSolutions
On September 13th, revenue cycle management
provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue
cycle management, workflow automation, and data analytics tools. The
acquisition creates the first unified healthcare payments platform with both
commercial and government payer connectivity, resulting in greater value for
Price: $1.3 billion valuation
Radiology Partners Acquires MEDNAX Radiology Solutions
Radiology Partners (RP), a radiology practice in the U.S., announced a definitive agreement to acquire MEDNAX Radiology Solutions, a division of MEDNAX, Inc. for an enterprise value of approximately $885 million. The acquisition is expected to add more than 800 radiologists to RP’s existing practice of 1,600 radiologists. MEDNAX Radiology Solutions consists of more than 300 onsite radiologists, who primarily serve patients in Connecticut, Florida, Nevada, Tennessee, and Texas, and more than 500 teleradiologists, who serve patients in all 50 states.
PointClickCare Acquires Collective Medical
PointClickCare Technologies, a leader in senior care technology with a network of more than 21,000 skilled nursing facilities, senior living communities, and home health agencies, today announced its intent to acquire Collective Medical, a Salt Lake City, a UT-based leading network-enabled platform for real-time cross-continuum care coordination for $650M. Together, PointClickCare and Collective Medical will provide diverse care teams across the continuum of acute, ambulatory, and post-acute care with point-of-care access to deep, real-time patient insights at any stage of a patient’s healthcare journey, enabling better decision making and improved clinical outcomes at a lower cost.
Teladoc Health Acquires Virtual Care Platform InTouch
Teladoc Health acquires InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems for $600M. The acquisition establishes Teladoc Health as the only virtual care provider covering the full range of acuity – from critical to chronic to everyday care – through a single solution across all sites of care including home, pharmacy, retail, physician office, ambulance, and more.
Price: $600M consisting of approximately $150 million
in cash and $450 million of Teladoc Health common stock.
AMN Healthcare Acquires VRI Provider Stratus Video
AMN Healthcare Services, Inc. acquires Stratus Video, a leading provider of video remote language interpretation services for the healthcare industry. The acquisition will help AMN Healthcare expand in the virtual workforce, patient care arena, and quality medical interpretation services delivered through a secure communications platform.
CarepathRx Acquires Pharmacy Operations of Chartwell from
CarepathRx, a leader in pharmacy and medication management
solutions for vulnerable and chronically ill patients, announced today a
partnership with UPMC’s Chartwell subsidiary that will expand patient access to
innovative specialty pharmacy and home infusion services. Under the $400M
landmark agreement, CarepathRx will acquire the
management services organization responsible for the operational and strategic
management of Chartwell while UPMC becomes a strategic investor in CarepathRx.
Cerner to Acquire Health Division of Kantar for $375M in
Cerner announces it will acquire Kantar Health, a leading
data, analytics, and real-world evidence and commercial research consultancy
serving the life science and health care industry.
This acquisition is expected to allow Cerner’s Learning
Health Network client consortium and health systems with more opportunities to
directly engage with life sciences for funded research studies. The acquisition
is expected to close during the first half of 2021.
Cerner Sells Off Parts of Healthcare IT Business in
Germany and Spain
Cerner sells off parts of healthcare IT business in Germany and Spain to Germany company CompuGroup Medical, reflecting the company-wide transformation focused on improved operating efficiencies, enhanced client focus, a refined growth strategy, and a sharpened approach to portfolio management.
Price: EUR 225 million ($247.5M USD)
CompuGroup Medical Acquires eMDs for $240M
CompuGroup Medical (CGM) acquires eMDs, Inc. (eMDs), a
leading provider of healthcare IT with a focus on doctors’ practices in the US,
reaching an attractive size in the biggest healthcare market worldwide. With
this acquisition, the US subsidiary of CGM significantly broadens its position
and will become the top 4 providers in the market for Ambulatory Information
Systems in the US.
Price: $240M (equal to approx. EUR 203 million)
Change Healthcare Buys Back Pharmacy Network
back pharmacy unit eRx Network
(“eRx”), a leading provider of comprehensive, innovative, and secure
data-driven solutions for pharmacies. eRx generated approximately $67M in
annual revenue for the twelve-month period ended February 29, 2020. The
transaction supports Change Healthcare’s commitment to focus on and invest in
core aspects of the business to fuel long-term growth and advance innovation.
Price: $212.9M plus cash on the balance sheet.
Walmart Acquires Medication Management Platform CareZone
Walmart acquires CareZone, a San Francisco, CA-based smartphone
service for managing chronic health conditions for reportedly $200M. By
working with a network of pharmacy partners, CareZone’s concierge services
assist consumers in getting their prescription medications organized and
delivered to their doorstep, making pharmacies more accessible to individuals
and families who may be homebound or reside in rural locations.
Verisk Acquires MSP Compliance Provider Franco Signor
Verisk, a data
analytics provider, announced today that it has acquired Franco Signor, a Medicare Secondary Payer
(MSP) service provider to America’s largest insurance carriers and employers.
As part of the acquisition, Franco Signor will become part of Verisk’s Claims
Partners business, a leading provider of MSP compliance and other analytic
claim services. Claims Partners and Franco Signor will be combining forces to
provide the single best resource for Medicare compliance.
Rubicon Technology Partners Acquires Central Logic
Private equity firm Rubicon Technology Partners acquires
Central Logic, a provider of patient orchestration and tools to accelerate
access to care for healthcare organizations. Rubicon will be aggressively driving Central Logic’s
growth with additional cash investments into the business, with a focus
on product innovation, sales expansion, delivery and customer support, and
the pursuit of acquisition opportunities.
Price: $110M – $125 million, according to sources
Telehealth and virtual care are not brand-new phenomena suddenly cobbled together as a rapid response to the onset of the COVID-19 pandemic, but the average US patient could be forgiven for thinking that it is. Indeed, virtual visits to care providers and remote patient monitoring have been available for quite some time, delivering two key benefits:
– Providing a platform to address cost-efficiencies and accessibility to quality healthcare for the populace at large
– Playing a key role in managing a growing population of chronically ill seniors.
Prior to 2020, however, the rules of reimbursement and implementation for associated telehealth services were difficult to navigate, wildly differing at the state and federal level with a host of regulations further complicating matters. Federal reimbursement policies are centered on Medicare, via the Centers for Medicare and Medicaid Services (CMS) – the single largest payer for seniors and chronically ill patients. Additionally, compliance with the Health Insurance Portability and Accountability Act (HIPAA) dictated rigorous standards for direct and monitoring communications between care providers and patients. Complicating matters further, US states offered a patchwork of individual telehealth laws dictating separate Medicaid policies.
The result was a lack of clarity of how healthcare providers could overcome regulatory and financial reimbursement barriers to implement effective telehealth programs as well as a lack of parity in coverage services and payments for patients. To address this at the federal level, CMS released new guidance in 2020 to relax reimbursement restrictions for providers. Now, we’re at the cusp of a new era of telemedicine where providers could widely offer:
– Virtual office visits that address traditionally in-person services such as primary care, behavioral health, and specialty care (e.g. pulmonary or cardiac health rehabilitation)
– On-demand virtual urgent care to address pressing concerns and urgently needed consultations
– Virtual broader home health services such as remote patient monitoring, outpatient disease management, and various forms of therapy (e.g. physical, speech)
– Tech-enabled home medication administration helping patients receive injectable or consumable medication via monitored self-administration
This is all, of course, dependent upon the mobile technology (e.g. tablets, wearables, etc.) and associated services that telehealth providers will rely upon to make these services happen at parity and scale for their patients. Even more importantly, virtual care programs being scaled up to cover a larger percentage of patients will fall apart if providers don’t have the resources to offer robust support and maintenance options for these devices and services. Quality of virtual care is highly dependent on persistent device and service availability and dependability.
Whether providers have already begun purchasing the mobile devices needed or are still struggling with the choice of what devices and services they need and/or can afford, however, they now face a different quandary: How to stand up these virtual care services at scale in a sustainable way that works within current budget resources and doesn’t pass on ballooning costs to your patients?
One way to make complex mobile technology deployments financially manageable is opting for a mobile device as a service (mDaaS) model which allows you to shift from a CapEx-based spending model to an OpEx spending model for purchasing hardware and allows telehealth providers to bundle or roll up a range of devices, accessories, services, maintenance and support into a single, predictable monthly per-device price. With mobile device technology rapidly evolving, telemedicine providers will need the operational agility to pivot to different solutions and quick technology refreshes as the need arises.
When done with the right third-party partner, it offers the additional advantages of outsourcing end-to-end support and lifecycle management to highly trained agents, who can free up precious IT resources. Most importantly, it creates a level of control over technology and spend that makes standing up virtual care programs convenient and stress-free.
There are many options to consider when expanding telemedicine services rapidly to larger patient bases, whether during disruptive events such as the COVID-19 pandemic or in the years to come. The key to making these services sustainable is finding a financing model that will free up internal resources, offer greater spending flexibility, and offer end-to-end support for your healthcare mobile technology ecosystem.
About Don Godbee Senior Mobile Solutions Architect at Stratix
Don brings a unique perspective to mobility in the Healthcare Vertical with over 25 years of consulting and delivery of critical solutions. Don has delivered various solutions from OEM integration of sensors in medical devices to mobile point of care solutions and services with major EHR software solution providers such as Epic, Cerner, GE Healthcare, Allscripts, and McKesson.
What You Should Know:
– DAS Health Ventures acquires healthcare
and managed IT company Randall Technology Services (RandallTech).
– This acquisition adds Allscripts® PM
and EHR solutions to the DAS portfolio of supported products, and DAS Health
has now added additional staff in Texas that will create opportunities for
greater regional support of its entire solutions portfolio.
DAS Health Ventures, Inc., an industry leader in health IT and management, announced today it completed the acquisition of Randall Technology Services, LLC (RandallTech) healthcare and managed IT company based in Amarillo, TX. As part of DAS’ growth strategy, this most recent expansion further strengthens its position in the US healthcare technology space.
Acquisition Enhances DAS Health Market Reach
DAS Health actively serves more than 1,800 clients, and
nearly 3,500 clinicians and 20,000 users nationwide, with offices in Florida,
Nevada, New Hampshire and Texas, and a significant employee presence in 14 key
states. This acquisition adds Allscripts® PM and EHR solutions to the DAS
portfolio of supported products, and DAS Health has now added additional staff
in Texas that will create opportunities for greater regional support of its
entire solutions portfolio.
Increased Support for Existing RandallTech Clients
Randall Technology’s clients will gain an increased depth of support, and a substantially improved value proposition, as DAS Health’s award-winning offerings are robust, including managed IT / MSP services, practice management, and EHR software sales, training, support and hosting, revenue cycle management (RCM), security risk assessments (SRA), cybersecurity, MIPS/MACRA reporting & consulting, mental & behavioral health screenings, chronic care management, telemedicine, and other value-based and patient engagement solutions.
Financial details of the acquisition were not disclosed.
What You Should Know:
– New KLAS report finds acute and ambulatory care EMR
vendors Cerner, Epic and NextGen are best at making outside patient data usable
for clinicians (data from outside the clinician’s health system).
– KLAS report examines adoption and usability among advanced
users of the main acute and ambulatory care EMR vendors.
The national interoperability networks of Carequality and CommonWell Health Alliance have become some of the primary means by which patient records are shared between healthcare organizations in the US. Despite progress in delivering interoperability, the number of providers connected to these plug-and-play networks, and the usability of the shared data varies significantly depending on the EMR in use. The KLAS report, Interoperability 2020 (Acute/Ambulatory) examines adoption and usability among advanced users of the main acute and ambulatory care EMR vendors.
Epic, NextGen, Cerner Best at Making Outside Patient Data
The report reveals Cerner, Epic and NextGen are the best
acute/ambulatory EMR vendors at making outside patient data
usable for clinicians (data from outside the clinician’s health system). Epic
continued to enhance the end-user experience with its Happy Together solution delivering
the most natural integration of outside data into the clinician workflow,
including the recent addition of basic lab trending.
KLAS named NextGen as the only ambulatory specific EMR vendor
to provide a strong usability experience for all interoperability workflows,
while Cerner customers validated its strong capabilities for accessing and
incorporating a wide variety of outside data into the patient record.
Duplicate PAMI Data a Growing Problem
Customers of both Cerner and Epic say the next step is for
the vendors to reduce the duplication of problems, allergies, medications, and
NextGen Healthcare is the only vendor whose customers report
significant improvement in this area. The NextGen EMR is able to filter out duplicate
medications, even for inexact matches (e.g., Tylenol vs. acetaminophen). While
other solutions may be capable of flagging duplicate information and removing
some of it, customers say the process is often still very manual.
Other key findings of the report include:
– athenahealth and Epic continue to lead in overall
adoption, with nearly all customers connected to CommonWell Health Alliance
– Cerner has been encouraging customers to adopt the
CommonWell connection for some time, and over the past 18 months, the number of
customers live has doubled, meaning a majority of clients are now connected.
– NextGen Healthcare has also continued to advocate for the adoption of Carequality among its customer base.
– eClinicalWorks customers have been actively connecting;
their usability experience remains similar to what it was in the past.
– Since early 2019, many organizations have implemented Expanse, but the adoption of CommonWell among MEDITECH customers has increased only slightly (from two customers to eleven).
– Allscripts was a founding member of CommonWell in 2013 but
never connected. After multiple delays and a shift to Carequality, they
connected their first customer (via dbMotion) in the second half of 2020.
What You Should Know:
– Health technology leader WellSky has agreed to acquire
CarePort Health to power coordinated care transitions for acute and post-acute
care patients for $1.35B.
– By providing end-to-end visibility across the
continuum, WellSky and CarePort can improve outcomes, lower costs, and increase
WellSky, a global health, and community care technology company, announced today that it has entered into a definitive agreement with Allscripts to acquire CarePort Health (“CarePort”), a Boston, MA-based care coordination software company that connects acute and post-acute providers and payers.
The agreed sale price of $1.35 billion represents a multiple
of greater than 13 times CarePort’s revenue over the trailing 12 months, and
approximately 21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12
months. CarePort is included in Allscripts Data, Analytics and Care Coordination
reporting segment and represents approximately 6% of Allscripts consolidated
revenues. Reference should be made to the Allscripts quarterly earnings reports
and supplemental financial data for a reconciliation of non-GAAP Adjusted
EBITDA. William Blair and J.P. Morgan Securities, LLC acted as financial
advisors to Allscripts in connection with the sale of CarePort.
Acquisition Enhances Care Coordination Across Acute,
As part of the acquisition, WellSky and CarePort will facilitate effective patient care transitions across the continuum — driving better outcomes for patients, providers, and payers. With the addition of CarePort, WellSky is uniquely positioned to manage the acute care discharge process, track patients across post-acute care settings, apply patient and population-level analytics, and support EMR-based care protocols.
CarePort’s EHR-agnostic suite of solutions connects the
discharge process with post-discharge care coordination — allowing providers
and payers to track and manage patients throughout their care journey. By
providing end-to-end visibility across the continuum, WellSky and CarePort can
improve outcomes, lower costs, and increase patient satisfaction.
“As part of the WellSky team, we will be able to accelerate our mission to connect providers across the continuum. Both of our organizations are aligned in our dedication to proactively bridging gaps in care. Together, we have the technology, analytics, and network to ensure that patients receive seamless care,” said Dr. Lissy Hu, CEO of CarePort. “Joining WellSky means that we can increase vital connections between acute, post-acute, and community care providers to make a meaningful difference in the lives of more patients in more places.”
With WellSky’s deep experience in post-acute care and
CarePort’s suite of care coordination solutions, this combination is a natural
fit. CarePort clients will gain access to a broader network of post-acute
providers and can leverage WellSky’s powerful predictive analytics suite, and
leading value-based care technologies. This combination of capabilities will
enable health systems, payers, and post-acute providers to more effectively
collaborate in a data-driven way and enhance patient outcomes.
“Together with CarePort, WellSky will establish new, meaningful connections between historically disparate settings of care. We have the exciting opportunity to bring care coordination to more providers in service of delivering more informed, personalized care,” said Bill Miller, CEO of WellSky. “Through this agreement, we’re ensuring our clients have the intelligent technology they need to do right by their patients, collaborate with payers, and succeed in value-based care models. It’s WellSky’s mission to realize care’s potential, and this moves us that much closer to achieving it.”
Today, Apple announced
the Health Records feature within the Health app is now available for users in
the UK and Canada to securely view and store their medical records right on
their iPhone, with their privacy protected at all times. Oxford University
Hospitals and Women’s College Hospital has been selected the first healthcare
institutions in the UK and Canada to make this feature available to their
How Health Records Works
Health Records creates a direct connection between medical
institutions and a patient’s iPhone, allowing users to see a central view of
their allergies, conditions, immunizations, lab results, medications,
procedures, and vitals across multiple institutions, and to be notified when
their data is updated. Apple utilizes a direct, encrypted connection between
the user’s iPhone and the healthcare organization to protect patient’s privacy.
All Health Records data is encrypted on device and protected
with the user’s iPhone passcode, Touch ID, or Face ID. Apple worked closely
with Cerner, Epic, Allscripts, and InterSystems to enable the FHIR (Fast
Healthcare Interoperability Resources) standards-based integration with the
Health app for their UK and Canadian customers.
To date, over 500 institutions currently support Health
Records on iPhone, listing more than 11,000 care locations. Previously,
patients’ medical records were held in multiple locations, requiring patients
to log in to each healthcare provider’s website to piece together their health
The Health Records feature in the Health app is available to
patients of the medical institutions listed below.
– Oxford University Hospitals NHS Foundation Trust – Oxford,
– Milton Keynes University Hospital NHS Foundation Trust –
Milton Keynes, UK
– Women’s College Hospital – Toronto, Ontario
– St. Joseph’s Healthcare Hamilton – Hamilton, Ontario
– Mackenzie Health – Richmond Hill, Ontario
What You Should Know:
– How the top US acute EHR vendors, namely Cerner, Epic, Allscripts, and MEDITECH (+85% share of US acute market in terms of revenues), have progressed on international expansion.
As highlighted below, there is a significant variance amongst the big four in terms of revenue and share of business outside the US. Cerner has by far the highest revenue at more than $650M in 2019, representing 12% of its business. Whilst MEDITECH has considerably lower revenue than Cerner, its international revenue is broadly similar to a share of its total revenue.
By contrast, Allscripts and MEDITECH each has international business that is comparable in terms of revenues, but as a share of overall revenues, international is much less important for Allscripts.
Allscripts’ international revenue was lower than Epic, Cerner, and Meditech in 2018, however, its growth in 2019 enabled it to overtake MEDITECH and become the third largest of the four vendors in 2019.
Cerner’s international revenues fell marginally as a proportion of its total business in 2019 (11.5%, down from 11.9% in 2018), although revenues grew in absolute terms by 3%. This growth was aided by success in Europe, particularly in the UK and Nordics where it won new contracts. Cerner’s overall revenue suffered a 3% decline in 1H 2020 (versus 1H 2019). Despite the impact of COVID-19, its international business witnessed marginal revenue growth (+1%) and rose as a share of its overall business (11.9%) during this period.
Cerner received a significant boost to its international business in 2015 when it acquired Siemens’ EHR business. This provided it with a broad footprint of deployments in DACH (Germany, Austria, Switzerland), Benelux, France, Norway, and Spain. Since this acquisition, the challenge for Cerner had been to migrate the customer base to Millennium. However, this has not happened to date, particularly in Germany and Spain.
Tough market conditions, especially in Germany which already had a highly competitive acute EHR market, was another factor impacting the market growth. The above challenges faced by Cerner were key drivers behind the deal to sell parts of Cerner’s Healthcare IT portfolio in Germany and Spain to CompuGroup Medical (CGM). Cerner will continue to maintain a presence in Spain and German acute markets via its i.s.h.med solution (originally contracted to SAP/Siemens), which was not included in the CGM agreement. i.s.h.med has also provided Cerner a footprint in several other European, African, and Asian countries such as Russia and South Africa.
In other European countries where Cerner has a Millennium footprint it has had more success, and the additional product support and development costs have been less.
Cerner has a substantial UK presence, in part owing to its legacy relationship with BT and the subsequent contracts given out under the largely failed NPfIT program. These customers do use Millennium and the company has grown this business in recent years. To date, Cerner has an installed base of 26 trusts in the UK, up from 22 in 2019, and has had success upscaling these contracts to include products such as HealtheIntent. It has also grown the number of acute trusts served. For example, in 2018 it won contracts with The Countess of Chester Hospital National Health Service Foundation Trust, previously using MEDITECH, and Sandwell and West Birmingham Hospitals. In 1Q 2020, Cerner was selected by two NHS Foundations Trusts (Ashford and St Peter’s Hospital and Royal Surrey) to implement a shared Millennium EHR system, which should support a more coordinated care approach between the two organizations.
Elsewhere in Europe, Cerner expanded its Nordic business recently with large contracts in Region Skäne and Västra Götalandsregionen (both in Sweden) during 2018 and 2019. Cerner was chosen as the preferred EMR supplier for Central Finland (four of 19 sote-areas) and will have the opportunity to expand the contract to other surrounding regions in the mid-long term. However, it lost its Norwegian footprint to Epic when it chose not to bid when the Helse Midt-Norge (Central region) contract was renewed in 2019.
The company has also seen success in the Middle East, particularly in the UAE, Qatar, and Saudi Arabia. However, growth has been more subdued over recent years. In the UAE, it has large contracts with the Ministry of Health and Prevention (MOHAP) and Abu Dhabi department of health (HAAD). Whilst Cerner already has a significant footprint in Saudi, e.g. King Faisal Hospital, the country is still relatively untapped in terms of deployment of digital solutions and offers Cerner a good future growth opportunity.
In Asia Cerner has been successful in Australia, winning state/territory-wide EHR contracts in both Queensland and New South Wales (the only vendor to win two state/territory-wide contracts), and also had success in other states/territories where procurement is decentralized. Cerner was aiming to add a third centralized Australian contract to its customer base, namely ACT Health (Capital Territory), but was unsuccessful in a head-to-head with Epic, which was selected as the chosen partner in July 2020. Cerner aims to push its PHM solution (HealtheIntent) through its existing state-level contracts where it already has a presence with Millennium.
Most of Cerner’s non-US business in the Americas is in Canada where approximately 100 hospitals are estimated to be using its solution. Here it faces competition from the other leading US vendors such as MEDITECH, Epic, Allscripts, and also local vendor Telus.
In summary, Cerner has broadly made a success of its international business. It tops the market share table in several of its international geographies and it has done this while broadly maintaining the margins achieved with its US business. However, Cerner’s divestiture of the legacy Siemens business in Germany/Spain, and withdrawal from Norway (Central region), will reduce the size of its European business. Cerner also faces an increasing threat from EMEA competitor Dedalus, whose recent acquisitions of Agfa Health’s EHR and integrated care business, and DXC’s healthcare provider business (deal to close in March 2021), could impact Cerner’s position as acute EHR market leader in EMEA moving forwards.
Allscripts’ international revenues witnessed a substantial rise in real terms (up by 34% versus 2018) and as a share of overall business in 2019. This was partly due to a strong performance in the UK with existing customer sales, and new contract wins in New Zealand, Qatar, Philippines, and Saudi Arabia. The impact of COVID-19 on Allscripts’ total revenues was comparatively significant (versus Cerner and MEDITECH), with declines of 9% and 6% respectively in 2Q 2020 and 1H 2020. It is estimated that these declines predominantly impacted North American revenues, whereas international revenues suffered to a lesser extent.
Canada had historically been its largest market outside the US accounting for just under a third of its non-US business, however, its share fell by six percentage points from 2018 to 23% in 2019, largely owing to the growth of its business in the UK and Australia, which are estimated to now be broadly similar in size to Canada.
In Canada, it is a top-five player, but lagging someway behind MEDITECH, Cerner, and Epic in terms of hospital installations. Allscripts continues to steadily grow its Canadian business with a focus on selling added functionality/upgrades to long-standing customers in three provinces (Manitoba, Saskatchewan, and New Brunswick). It aims to expand its Canadian coverage by securing the contract with Nova Scotia province in 2H 2020.
Success in EMEA was mainly driven by wins in the UK, which included two Sunrise clinical wrap contracts along with several added-value solutions for existing client systems. In May 2019, Gloucestershire Hospitals NHS Foundation Trust selected Allscripts to provide a clinical wrap around InterSystems’ PAS. This was rolled out to the entire Trusts’ inpatient wards in March 2020 and represented the fifth clinical wrap around another vendor’s PAS in the UK. In the UK it serves 18 acute trusts (only Cerner, DXC, and SystemC are estimated to serve more).
Much of the company’s UK footprint was built from its acquisition of Oasis Medical Solutions six years ago. However, it has slowly built on this foundation adding new acute trust customers and upgrading many from the legacy Oasis PAS solution to Sunrise and other Allscripts’ solutions such as dbMotion – although perhaps at a slower rate than hoped. Besides the UK and Italy (where it has one Sunrise contract) Allscripts does not have immediate plans for Sunrise expansion in mainland Europe. However, countries that are attempting to implement integrated data-sharing programs (e.g. France, Germany, and Italy), offer Allscripts potential markets for its dbMotion solution.
Allscripts also achieved growth in the Middle East, fuelled by a contract win in March 2020 with Qatar’s Alfardan Medical / Northwestern Medicine for Sunrise. Allscripts has been working on opportunities across Saudi Arabia, UAE, Oman, Qatar, and Kuwait, with different strategies for each country. For example, Oman has a relatively low level of digital healthcare maturity and is being targeted with EMR solutions, whereas relatively mature health markets (e.g. UAE and Qatar) are being targeted with PHM/dbMotion.
Its entry into the Oceania market was also largely via acquisition (Core Medical Solutions in 2016). Core Medical Solutions was a leading player in the smaller hospital and private hospital markets in Australia. Allscripts has added to this legacy with a state-wide Sunrise EHR contract in South Australia (although deployment has not been without its challenges). Sunrise has been implemented in Royal Adelaide Hospital, South Australia Health and Medical Research Center, University of Adelaide, and the University of South Australia.
In 4Q 2019 Allscripts added South Australia’s largest regional hospital network, Mt Gambier, to its coverage. It also had success selling its Sunrise solution outside of this state-wide contract (e.g. Gippsland Health Alliance in Victoria in 2018) and in 2019 its footprint expanded into New Zealand.
In terms of its broader Asian strategy, the company recently split its Asian business into two sub-businesses, ASEAN and ANZ, indicating it sees opportunities beyond its existing Singapore footprint in South East Asia. This has been supported by 2019 wins in the Philippines. In less digitally mature countries, the BOSSNet EHR solution it obtained via the Core Medical Solutions acquisition offers a potential route to offering a more entry-level EHR solution compared to Sunrise.
At just 4.0% of revenues in 2019, international remains a relatively niche business for Allscripts. To some extent the company needs to decide where it wants to take this business. Relying on organic growth in the regions it currently serves is unlikely to move the dial far from this 4.0% figure over the next five years. A significant change is likely only via acquisition, something the company has not shied from in the past. However, should it focus on cementing its position in existing markets or expansion into new? Given it is not a top-two vendor in any of its current geographies outside the US, acquisition to cement its position in existing markets would make more sense than further expansion into new geographies.
Historically, there have been two major points of entry into new geography for EHR vendors; either through a partnership to gain expertise and ‘localize’ a solution or through the acquisition of a local vendor (as with Cerner and Allscripts earlier). Both have their challenges, with partnerships often being slow to progress and acquisition resulting in the long-term support, and in some instances a significant burden of a legacy solution (e.g. Cerner is still supporting several legacy Siemens EHR solutions nearly six years after announcing its acquisition plans and most of Allscripts’ UK customers are not using Sunrise).
Examples where vendors have taken on large regional projects without sufficient ‘localization’, have often resulted in projects not meeting expectations and negatively affecting both vendors and providers alike. To some extent, Epic has suffered from this with several of its non-US deployments, in particular in the UK (e.g. Cambridge University Hospitals in 2015) and more recently in Denmark (regional contracts in the Zealand region and Capital Region) and Finland (regional contract in the Apotti Region).
Epic has not made acquisitions to enter its international markets and in all these examples EHR implementations have not met expectations and have either had to be scaled back, delayed, or required a significant amount of remedial action. The main criticism is often not enough ‘localization’ before deployment. That said Epic has had success elsewhere internationally, with less controversy surrounding its deployments in DACH, Netherlands, Middle East, and Singapore. In Canada, it is estimated to be the market leader in terms of revenues and second only to MEDITECH in terms of hospital deployments.
Epic has increased its focus on international expansion in recent years with incremental increases in revenue. However, it needs to improve on implementation/execution or future opportunities may be limited. The fact it was the only vendor to hit the preselection criteria in Norway for the Helse Midt-Norge contract which it won in 1Q 2019 (replacing Cerner) suggests that progress has perhaps been made on this front.
Historically Epic has struggled to win any Australian state/territory-wide deployments where Cerner, Allscripts, and InterSystems have been successful. However, Epic strengthened its position by winning its first state contract in July 2020 – a $151m deal for the Australian Capital Territory (ACT Health). This was also significant due to it being the first time the Capital Territory had centralized contracting.
At 12% of 2019 revenue, MEDITECH had the highest proportion of non-US sales of all the vendors analyzed in this insight. However, the overwhelming majority of this was from Canada, where it is estimated to be the market leader in terms of the number of hospital installations (although in terms of revenues it is smaller than Epic, Cerner, and Allscripts). Of approximately $60M in non-US sales in 2019, nearly $50M is estimated to have been from Canada. Non-US revenue share was down marginally from 13% in 2018 and in absolute revenues (-7%) due to a fall in Canadian revenues (-8%), whereas revenue from other international markets was marginally up (+1%).
In early 2018 MEDITECH announced the release of its cloud-based EHR, Expanse. MEDITECH has since been rolling out its cloud-based EHR to new customers and replacing its legacy hosted Magic solution for existing customers. This will ease some of the costs and time associated with implementing the solution, which should make it more competitive. In addition, the data hosted on the cloud will make it easier to drive interoperability through a Health Information Exchange, further increasing its attractiveness for provider networks.
Implementation delays caused by COVID-19 contributed toward MEDITECH’s total revenue declining by 3% in 2Q 2020 (versus 2Q 2019). However, a strong international performance in 1Q 2020 (estimated revenue up by c.25%) was driven by new Expanse installations in Canada (including Ontario Mental Health Hospital), leading to 1H 2020 revenues rising by almost 10% (versus 1H 2019).
Approximately 2% of MEDITECH’s business comes from outside North America, a trend that has remained relatively unchanged for several years. As with Epic, Cerner and Allscripts, a significant proportion of its non-American business is in other English-speaking countries, such as the UK/Ireland (22 customers in the UK and 3 in Ireland – mainly public/private sector hospitals), South Africa (24 hospitals) and Australia (72 private hospitals). In the UK it is a second-tier vendor providing EHR solutions to a small number of NHS trusts (low double-digit). Despite a concerted push into the UK, with the acquisition of Centennial (its UK distributor and system integrator) and the official formation of MEDITECH UK in 2018, the number of trusts served decreased with Cerner taking Chester NHS Trust from MEDITECH in 2018.
The company has had considerable success in Africa, selling solutions in 12 countries including Botswana, Namibia, South Africa, Kenya, Nigeria, and Uganda. In September 2019, it partnered with Aga Khan University for a new 2020 deployment of Expanse in South African and Kenya, and subsequent deployment in Pakistan. Contracts in Kuwait and the UAE result in the whole MEA region accounting for a sizable share of its non-North American business.
MEDITECH’s international business mirrors its US business to some extent. It has one of the largest installed bases of hospitals worldwide, but predominantly small hospitals, and often in countries where spend per bed is low; it is also typically not upselling beyond core EHR, meaning that its international revenues, particularly when Canada is excluded, remain small.
In Signify Research’s latest global EHR analysis, it was estimated that the US accounted for nearly two-thirds of global EHR sales in 2019, so for these four vendors it must remain the key priority. However, the US is forecast to be one of the slowest growing EHR markets over the next five years as it approaches saturation, particularly for core-EHR products in the acute market. Further, the acute market in the US has now broadly consolidated around these four vendors meaning opportunities for gains in share through replacement is increasingly rare – the long tail has gone.
The geographic expansion offers a potential avenue to drive growth. However, it is not easy and there are plenty of pitfalls. Localizing solutions, acquiring local vendors, displacing local incumbents, aligning products to match government requirements and projects, and putting in place local implementation, project management, and support teams all require significant time and investment. Because of this, the global market remains highly fragmented and market share change is slow. However, for the big four discussed in this insight, ignoring the international opportunity will significantly limit long-term growth; so despite slow and sometimes painful progress, we expect it to remain a priority.
About Arun Gill, Senior Analyst at Signify View
Arun Gil is a Senior Market Analyst at Signify Research, a UK-based market research firm focusing on health IT, digital health, and medical imaging. Arun joined Signify Research in 2019 as part of the Digital Health team focusing on EHR/EMR, integrated care technology, and telehealth. He brings with him 10 years’ experience as a Senior Market Analyst covering the consumer tech and imaging industry with Futuresource Consulting and NetGrowth Consultants.
What You Should Know:
– New Chilmark Research report on revenue integrity
in healthcare reveals a transitional market making strides to address the new
burdens of modern care economics.
– The ongoing COVID-19 public health emergency underscores
the imperative need for automation and reduced administrative costs even
has and continues to be one of the most difficult challenges in healthcare.
These issues manifest in the claims process of submission, appeal, and
remittance, but the causes are found much earlier in clinical workflows. Rather
than think of these as separate issues, they should all be considered under a
broader category of revenue integrity. The latest report from Chilmark Research,
Revenue Integrity in Healthcare: Solutions Driving Payment Performance,
reveals a market in flux as new technologies are applied to old problems,
increasingly complicated by contracts that include performance and reporting
Modern Revenue Integrity Solutions Can Improve Financial
New software and platforms can accelerate, automate, and
improve the accuracy of these activities. Automated outreach, demographic and
eligibility checking, computer-assisted coding, natural-language processing,
and more traditional revenue cycle platforms.
These tools are offered by:
– Electronic Health Records (EHRs)
– Independent Platforms
– Best-of-Breed Solutions from outside the Revenue Integrity
space, but with powerful tools to address payment needs
These activities are essential for healthcare enterprises of
all sizes, scopes, and specialties. They are needed whether the organization is
primarily concerned with fee-for-service (FFS) reimbursement or value-based care (VBC).
The ongoing COVID-19 public health emergency has made the need for automation
and reduced administrative costs even clearer. With appointment volumes
dropping, provider organizations are faced with the need for reliable, accurate
payments for their care activities more than ever. These solutions are equally
valuable for traditional provider care and for modern virtual care solutions
“Accounting and revenue cycle work can never fix these issues. They need to be addressed where they occur and prevented from showing up in revenue cycle in the first place. One mistake in patient registration that was easy to fix can cause millions in complicated denials down the road.”– Lead Analyst Alex Lennox-Miller
Each type of solution (EHR, Platform, Best of Breed) is
evaluated based on how they address the needs of provider enterprises. The
report reviews the current state of the market, the maturity of solutions, and
the strengths and weaknesses of each solution type. While the current market is
valued at more than $20 billion, projections within the report show its
expected growth to nearly $35 billion in the next five years. The report shows
which segments of this market can expect annual growth rates exceeding 10% and
which will slow to under 2.5%.
Profile of Leading Revenue Integrity Vendors
In addition to the categorical analyses, this report includes 13 profiles of major and promising vendors: 3M, Allscripts, athenahealth, Cerner, Change Healthcare, Hayes|MDAudit, Medicomp Systems, Optum, PatientMatters, RevSpring, Sift, and ZOLL. Each profile includes an assessment of the vendor’s strengths and challenges, detailed descriptions and evaluations of the product capabilities and market execution, and rankings across 24 categories.
Managers and directors of healthcare organizations looking
for ways to address revenue cycle issues, lower clean claims rates, or improve
strategic revenue projections will appreciate the report’s clear breakdown of
vendor offerings and the impacts on their clinical and non-clinical staff.
Payers, including self-insured employers, and other organizations interested in
the total cost of care will find the market overview and product evaluations of
great value, helping them understand the tools and challenges their partner
organizations will be using.
What You Should Know:
– Bridge Connector raises $25.5 million in Series B funding to advance interoperability layer for healthcare organizations as demand for integrated health data intensifies during COVID-19 pandemic.
– The investment will support the growth of Destinations,
the company’s new integration-platform-as-a-service (iPaaS) that connects
health data systems using use-case-based interoperability blueprints to speed
integrations with major vendors.
a Nashville, TN-based interoperability company changing the way health care
communicates, today announced it has raised $25.5 million in Series B funding led
by Axioma Ventures. The round was also joined by all existing investors,
including veteran investor Jeff Vinick, and brings Bridge Connector’s total
funding to over $45 million.
COVID-19 Underscores Growing Demand for Integrated Health
The last decade has seen an explosion of digital health platforms and the U.S. health care system has taken incremental steps toward achieving interoperability between them. In March, the Department of Health and Human Services (HHS) issued new rules that force formerly closed vendor solutions to become interoperable.
However, the COVID-19 pandemic has exposed the urgent need for data liquidity as healthcare providers across the country have struggled to share essential patient information and provide comprehensive care via remote delivery methods such as telehealth. In the face of the pandemic’s disproportionate effect on minority communities, the industry has also recognized the critically important role that social determinants of health — the environments in which we are born, live and work — play in our overall well-being and the need to make this information available to health care providers.
A True Interoperability Layer for Healthcare
Founded in 2017, Bridge Connector provides a suite of vendor-agnostic integration solutions and a full-service delivery model, helping health care vendors, providers, and payers more easily share data between disparate systems, such as electronic health records (EHRs) or patient engagement solutions. The company’s technology is designed to democratize health care by allowing organizations of any size to equitably connect data systems and empower care teams with the most accurate patient data in real-time. Unlike other health care interoperability vendors, Bridge Connector’s unique approach does not lock customers into a forced data model or proprietary APIs, instead of employing a vendor-agnostic integration layer that works across data models without the need for standardization.
The investment will further support the company’s increasing
market share in healthcare interoperability and growth of Destinations, a new
integration-platform-as-a-service (iPaaS) that connects health data systems
using use-case-based interoperability blueprints to speed integrations with
Recent Integrations with Key HIT Stakeholders
The new funding comes shortly after Bridge Connector finalized various collaborations with some of the most influential stakeholders in health IT, including Epic, Allscripts, and Salesforce, as well as other system integrators such as MuleSoft. Those collaborations represent calculated steps toward creating a centralized hub of integration solutions for all data platforms that any health care provider or payer can access. The average hospital today uses approximately 16 disparate electronic health records platforms that limit data sharing within the walls of a single hospital, let alone between separate hospitals.
– Healthcare Growth Partners’ (HGP) summary of Health IT/digital health mergers & acquisition (M&A) activity, and public company performance during the month of July 2020.
While a pandemic ravages the country, technology valuations are soaring. The Nasdaq hit an all-time high during the month of July, sailing through the 10,000 mark to post YTD gains of nearly 20%, representing a 56% increase off the low water mark on March 23. More notably, the Nasdaq has outperformed the S&P 500 (including the lift the S&P has received from FANMAG stocks – Facebook, Amazon, Netflix, Microsoft, Apple, Google) by nearly 20% YTD.
At HGP, we focus on private company transactions, but there is a close connection between public company and private company valuations. While the intuitive reaction is to feel that companies should be discounted due to COVID’s business disruption and associated economic hardships facing the country, the data and the markets tell a different story.
While technology is undoubtedly hot right now given the thesis that adoption and value will increase during these virtual times, the other more important factor lifting public markets is interest rates. According to July 19 research from Goldman Sachs,
“Importantly, it is the very low level of interest rates that justifies current valuations. The S&P 500 is within 4% of the all-time high it reached on February 19th, yet since that time the level of S&P 500 earnings expected in 2021 has been pushed forward to 2022. The decline in interest rates bridges that gap.”
Additionally, Goldman Sachs analysts also estimate that equities will deliver an annual return of 6% over the next 10-years, lower than the long-term return of 8%. Future value has been priced into present value, and returns are diminished because the relative return over interest rates is what ultimately matters, not the absolute return. In short, equity valuations are high because interest rates are low.
What happens in public equities usually finds its way into private equity. To note, multiple large private health IT companies including WellSky, QGenda, and Edifecs, have achieved 20x+ EBITDA transactions based on this same phenomenon. From the perspective of HGP, this should also translate to higher valuations for private companies at the lower end of the market. As investors across all asset classes experience reduced returns requirements due to low interest rates, present values increase across both investment and M&A transactions.
As with everything in the COVID environment, it is difficult to make predictions with certainty. Because the stimulus has caused US debt as a percentage of GDP to explode, there is an extremely strong motivation to keep long-term interest rates low. For this reason, we believe interest rates will remain low for the foreseeable future. Time will tell whether this is sustainable, but early indications are positive.
Noteworthy News Headlines
- A $10.2 million “sole source” contract to run a centralized Covid-19 database for the Trump administration drew sharp criticism from congressional Democrats, who demanded that the federal Centers for Disease Control and Prevention be reinstated as the primary repository of coronavirus data. The contract drew scant public attention when it was awarded in April to TeleTracking Technologies, a Pittsburgh company whose core business is helping hospitals manage the flow of patients. But it drew scrutiny after the administration ordered hospitals, beginning on Wednesday, to report coronavirus information, including bed availability, to the new database, housed at the Department of Health and Human Services in Washington, instead of to the C.D.C.
- With the CDC sidelines, some states lose access to timely COVID-19 hospital data. Just as the number of people hospitalized for COVID-19 approaches new highs in some parts of the country, hospital data in Kansas and Missouri is suddenly incomplete or missing. Earlier this week, the Trump administration directed hospitals to change how they report data to the federal government and how that data will be made available. Missouri Hospital Association spokesperson Dave Dillon called the move “a major disruption.”
- Hospital giant ACA makes $822 million profit off CARES Act stimulus money. HCA’s biggest profit driver and boost to surviving the pandemic and the influx of Covid-19 patients in the second quarter came from the federal government. In HCA’s second quarter, the government stimulus passed by Congress and signed into law by President Donald Trump turned into a windfall as of the end of the second quarter.
- Hims Inc, a U.S. online provider of mens’ healthcare and consumer products ranging from hair loss treatments to Viagra, is exploring going public through a merger with a blank-check acquisition company that could value it at more than $1 billion, according to people familiar with the matter.
- HIMSS pushes back 2021 conference to August. HIMSS canceled its 2020 global health conference in March just days before it was slated to start due to concerns about COVID-19. HIMSS officials are planning a press conference Friday to offer more details about the HIMSS21 conference.
Noteworthy M&A transactions during the month include:
- Workflow optimization software vendor HealthFinch was acquired by Health Catalyst for $40mm.
- Sarnova completed simultaneous acquisition and merger of R1 EMS and Digitech.
- Payment integrity vendor The Burgess Group acquired by HealthEdge Software.
- Ciox acquired biomedical NLP vendor, Medal, to support its clinical data research initiatives.
- Allscripts divests EPSi to Roper for $365mm, equaling 7.5x and 18.5x TTM revenue and EBITDA, respectively.
Noteworthy Buyout transactions during the month include:
- HealthEZ, a vendor of TPA plans, was acquired by Abry Partners.
- As part of a broader wave of blank check go-public transactions, MultiPlan will join the public markets as part of Churchill Capital Corp III.
- Also as part of a wave of private equity club deals, WellSky partially recapped with TPG and Leonard Greenin a rumored $3B transaction valuing the company at 20x EBITDA.
- Edifecs partnered with TA Associates and Francisco Partners in another club deal valuing the company at a rumored $1.4B (excluding $400mm earnout) at over 8x revenue and 18x EBITDA.
- Madison Dearborn announced a $410mm take private of insurance technology vendor Benefytt.
- Nuvem Health, a provider of pharmacy claims software, was acquired by Parthenon Capital.
Noteworthy Investments during the month include:
- Doctor on Demand, a telemedicine vendor, raised $75mm led by General Atlantic.
- Truepill, an on-demand pharmacy, raised $25mm from investors including Optum Ventures.
- VillageMD, a primary care provider, took a $275mm investment from Walgreens and others.
- Medly Pharmacy, an online pharmacy, received a $100mm investment led by Volition and Greycroft.
- Forcura, a vendor of post-acute software, received a growth investment from Accel-KKR.
- Preventice, a developer of mobile health applications, received a $137mm Series B with a host of strategic investors.
- Ro (fka Roman), a cloud consumer pharmacy, received a $200mm investment valuing the company at $1.5B.
- Sema4, a big data genomics company, raised $121mm led by BlackRock valuing the company at $1B.
- Heal, a physician house call company, raised $100mm from Humana.
- Tempo, developer of smart at-home fitness platforms, raised $60mm.
Public Company Performance
HGP tracks stock indices for publicly traded health IT companies within four different sectors – Health IT, Payers, Healthcare Services, and Health IT & Payer Services. Notably, primary care provider Oak Street Health filed for an IPO, offering 15.6 million shares at a target price of $21/ share. The chart below summarizes the performance of these sectors compared to the S&P 500 for the month of July:
The following table includes summary statistics on the four sectors tracked by HGP for July 2020:
About Healthcare Growth Partners (HGP)
Healthcare Growth Partners (HGP) is a Houston, TX-based Investment Banking & Strategic Advisory firm exclusively focused on the transformational Health IT market. The firm provides Sell-Side Advisory, Buy-Side Advisory, Capital Advisory, and Pre-Transaction Growth Strategy services, functioning as the exclusive investment banking advisor to over 100 health IT transactions representing over $2 billion in value since 2007.
What You Should Know:
– The latest Chilmark Research report examines how data-oriented APIs are contributing to development and integration efforts across healthcare from the perspective of the developer.
– Reeling from the impact of the COVID-19 pandemic and
seeking more effective ways to implement new functionality, healthcare
enterprises of all kinds are looking to alternatives for prevailing development
and integration practices.
from the data scattered across healthcare communities was once a tantalizing
opportunity. After COVID-19,
it is an existential necessity. Chilmark
Research’s latest Market Trends Report, Open APIs in Healthcare: The Future of Data Integration, captures a market whose approach to data access and
integration will be changing substantially in the coming years and introduces a
subvertical within healthcare
IT that anticipates a 16% CAGR through 2025.
APIs Are Still New in Healthcare
Outside healthcare, the ascendance of
data access and integration facilitated by application programming interfaces
(APIs) is the culmination of decades of technology evolution and implementation
lessons with distributed applications. Across the SaaS landscape in particular,
APIs have become the preferred method for accessing data and conducting
transactions across applications and organizations. Developers recognize and
appreciate the value of loosely coupling their applications and data, wherever
each is located.
Inside healthcare, many enterprises are
hesitant on the topic of APIs, seeing them as too big a leap from established,
successful software practices. But they also recognize that eliminating the
need for hard-coded interfaces that must be re-implemented every time an
application or its underlying data changes will deliver higher programmer
productivity and more-responsive applications.
Traditional Integration Methods Fall
Conventional development and
integration approaches proved cumbersome and slow in efforts to contribute to
understanding or responding to the current health crisis. Unlocking more value
from the data scattered across healthcare communities is — post-COVID-19 —
a critical element in clinical and
“Enterprises across healthcare were already wrestling with challenging market forces and government mandates,” says Brian Murphy, the report’s lead author and analyst. “Open APIs will play a central role for providers, payers, or any healthcare enterprises that intend to better utilize their data and pursue development efforts that make them — and the broader healthcare community — more responsive and adaptable to the demands of a post-pandemic healthcare system.”
Developers Require Accessible Data
Developers find data wherever they can from among a large
and confusing mix of data holders and associated vendors. This report
identifies the sources where different kinds of health-related data are most
likely to be API-accessible. It shows how APIs are already contributing to
development and integration efforts across healthcare and estimates the much
larger potential of widespread adoption.
This report includes detailed profiles on 20 public and
private organizations and their offerings, including 1upHealth, 4Medica,
Allscripts, Apple, Athenahealth, Availity, Blue Button 2.0, Cerner, Change
Healthcare, Datica, Epic, Human API, Meditech, NextGen, NCPDP, Particle Health,
The Sequoia Project, Redox, Surescripts, and Validic.
For more information about the
report, visit https://www.chilmarkresearch.com/chilmark_report/open-apis-in-healthcare-the-future-of-data-integration/
What You Should Know:
– According to a recent KLAS report, Allscripts and
eClinicalWorks EMRs are not a good fit for pediatric practices, while Greenway
Intergy is improving.
– PCC, athenahealth, and Office Practicum EMRs named best suited for pediatric offices.
Despite their unique needs, many ambulatory pediatric
offices are expected to “make do” with generalized EMR templates and charting.
From growth charts, to well-child visits, to immunization tracking, to registry
integration, pediatric offices often find their EMR doesn’t meet their
needs. KLAS’ latest report, “Pediatric
Ambulatory EMR 2020: Best EMR Performers in Pediatric Settings”
examines which EMR vendors best ensure pediatric provider success by providing
an outstanding EMR and tailored service. Note that this report is focused on
ambulatory-focused vendors, including pediatric-specific EMR vendors.
Allscripts and eClinicalWorks EMRs Not a Good Fit for
Pediatric Practices; Greenway Intergy Making Improvements
While Allscripts’ EMR is highly customizable and can be
tailored for use in pediatric settings, customers report that in order to make
the solution work for their needs, KLAS reports customers have to dedicate
large investments of time and resources (e.g., hire an IT team to run and
customize the EMR) for customization/optimizations. These investments are not
always communicated to pediatric practices during the sales process, leading to
mixed results and expectations around Allscripts’ pediatric functionality. In addition,
customers cited issues with Allscripts’ support is often subpar or nonexistent.
Although KLAS conducted a limited number of interviews with eClinicalWorks
customers, they cited a negative view of the EMR’s quality, saying it does not
meet the needs of pediatric practices and does not come with necessary
pediatric-specific content or workflows. Multiple respondents also complain
about bugs, crashes, and problematic upgrades that introduce new problems
without bringing substantive fixes. Historically, Greenway Health customers
have felt the solution falls short in aspects like ease of use and needed
functionality; however, a number of interviewed customers feel the vendor is
making more of an effort to listen to customers’ problems and deliver requested
PCC, athenahealth, and Office Practicum EMRs Best Suited
KLAS reports PCC (one of two pediatric-specific vendors in
this report) stands out with the highest overall score and the most consistent
customer satisfaction. They have a proven history of and reputation for
supporting customers and delivering the pediatric-specific technology needed to
successfully run an ambulatory pediatric practice.
KLAS reported athenahealth’s EMR also performs well in
pediatric settings; more than 90% of pediatric customers are satisfied with the
solution and its pediatric specific functionality. Additionally, customers of
Office Practicum (the other pediatric-specific EMR vendor) are generally
satisfied with the functionality they receive and feel it helps make their
practices successful. Recent issues with nickel-and-diming and buggy updates
have caused some frustration for a number of interviewed customers.
For more information about the KLAS report, visit https://klasresearch.com/report/pediatric-ambulatory-emr-2020/1378
What You Should Know:
– Allscripts and Microsoft sign a five-year partnership extension to support Allscripts’ cloud-based Sunrise electronic health record and drive co-innovation.
– The alliance will enable Allscripts to harness the power of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams, and Power BI, creating a more seamless and highly productive user experience.
Today Allscripts and
Microsoft Corp. announced the
extension of their long-standing strategic alliance to enable the expanded
development and delivery of cloud-based health IT solutions.
The five-year extension will support Allscripts’ cloud-based Sunrise electronic health record
(EHR), making Microsoft the cloud provider for the solution and opening up
co-innovation opportunities to help transform healthcare with smarter, more
scalable technology. The alliance will enable Allscripts to harness the power
of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams
and Power BI, creating a more seamless and highly productive user experience.
Partnership Impact for Cloud-based Sunrise EHR
Sunrise is an integrated EHR that connects all aspects of
care, including acute, ambulatory, surgical, pharmacy, radiology and laboratory
services including an integrated revenue cycle and patient administration
system. Cloud-based Sunrise will offer many added benefits beyond the
on-premise version that will improve organizational effectiveness, solution
interoperability, clinician ease of use and an improved patient experience.
Client benefits include a subscription model delivering faster implementations
and lower annual upgrade costs, helping organizations leverage the software
without increasing burdens on their internal IT resources.
The cloud-based Sunrise solution will provide enhanced
security, scalability and flexibility, as well as the opportunity to add new
capabilities quickly as business needs and the cloud evolve. The cloud-based
solution will also include expanded analytics and insights functionality that
can quickly engage with the Internet of Things. Finally, the cloud-based
Sunrise solution will include a marketplace that enables healthcare apps and
third parties to easily integrate with a hospital EHR. Allscripts clients will
begin to see these updates by the end of 2020.
Why It Matters
“The COVID-19 pandemic will forever change how healthcare is
delivered, and provider organizations around the world must ensure they are
powered by innovative, interoperable, comprehensive and lower-cost IT solutions
that meet the demands of our new normal,” said Allscripts chief executive
officer Paul Black. “Healthcare delivery is no longer defined by location —
providers need to have the capability to reach patients where they are to truly
deliver the care they require. Cloud solutions, mobile options, telehealth
functionality — these are the foundational tools for not just the future of
healthcare, but the present. Collaborating with Microsoft, the leader in the
public cloud sector, we will efficiently deliver the tools caregivers need to
improve the clinical outcomes of their patients and operational performance of
March 17, 2020, may well be remembered as the day the telemedicine revolution finally took off. Telemedicine and Telehealth‘s adoption, fast-tracked by Coronavirus/COVID, will create profound changes in how healthcare services are provided — while also spawning new healthcare marketing opportunities.
Earlier last month, in the interest of public safety, the federal government largely removed two huge and long-standing barriers to telemedicine adoption by easing reimbursement and HIPAA restrictions. Many private pay health plans followed suit. These changes open the door to exciting new ways to better serve patients today and to bolster, grow and sustain medical practices, medical offices, hospitals, and healthcare networks in the future.
Changes in healthcare and medical services delivery commenced almost instantly. For example, right around this time, we spoke with one of our multi-location oncology clients about our marketing teams‘ recommended changes to their marketing plans due to COVID-19. These discussions evolved to focus on their need to help cancer patients both safely and remotely, and their uncertainties regarding HIPAA. The new rules now allow the use of simple, practical, patient-friendly solutions like Apple FaceTime and Zoom, to communicate with homebound patients. True to their purpose, these new government proclamations have opened the door to safer, better, and more convenient care for cancer patients.
Our healthcare clients are not alone:
“With the coronavirus pandemic turning doctors’ offices into no-go zones, family physicians are now doing many of their consultations online or by telephone,” The New York Times reports. “In a matter of days, a revolution in telemedicine has arrived at the doorsteps of primary care doctors in the U.S. and in Europe. The virtual doctor visits, at first a matter of safety, are now a centerpiece of family doctors’ plans to treat everyday illnesses. We’re basically witnessing ten years of change in one week.”
Until now, operational challenges, internal politics, resistance from doctors, state law limitations, and HIPAA and reimbursement-related fears had stymied larger healthcare systems from embracing telemedicine. Due to COVID-19, these same players suddenly found ways to do the previously unimaginable – adopt telemedicine at scale in a matter of weeks.
According to Harvard Business Review, “Prior to this crisis, many major health care systems had begun to develop telemedicine services, and some, including Intermountain Healthcare in Utah, have been quite active in this regard. That said, nationwide use of telemedicine had been limited. John Brownstein, chief healthcare innovation officer of Boston Children’s Hospital, noted that his medical institution was doing more telemedicine visits during any given day in late March that it had during the entire previous year.”
During a recent webinar (COVID-19: Up to the Minute Learnings from Industry Experts on the Front Lines of the Coronavirus Pandemic), Ed Rafalski, Ph.D., Chief Strategy and Marketing Officer of BayCare Health said, “Necessity is the mother of innovation and invention here at Baycare. I have been trying to get the organization to get more providers stood up on our telehealth platform, and a crisis made it happen. So the good news is we’re adding capacity and getting providers trained that up until this point were either unwilling, or afraid, or too busy seeing patients. And so what’s happened is because people are canceling elective business, doctors have free time. So they’re saying, ‘Well heck, I’ll go ahead and get trained on telehealth.’ So we’re building our capacity exponentially, which is good news.”
Consumer and Doctor Acceptance of Telehealth: What Does the Data Shows?
With social and physical distancing, telemedicine has gained a greater consumer and provider appeal virtually overnight. Telemedicine is a new marketing opportunity, and now is the time to take full advantage of this shift. It’s likely to be a permanent change.
For their part, many consumers have been ripe for change for some time.
As far back as 2015, PricewaterhouseCoopers Health Research Institute found that fully 80% of consumers said they’d be open to looking beyond traditional visits for care, and 60% said they were willing to consider virtual doctor visits.
By 2019, American Well’s Telehealth Index: 2019 Consumer Survey, found 66% of consumers were willing to use telehealth, and 8% had tried it. As you might expect, attitudes toward telehealth varied by age. 74% of 18-34-year-olds and 72% of 35-44-year-olds said they were willing to use it, while 52% of seniors (65+) said they were open to telehealth. Of those who had used telemedicine, 54% were Millennials.
Speaking of Millennials, remember they were born into a tech-rich world. Millennials number over 75 million and 40 percent say telemedicine is an extremely or very important option. It’s in their digital DNA to expect and demand immediacy and convenience. What’s more, computers, laptops, mobile devices, and smartphones are ubiquitous, and virtually everyone is equipped for instant audio/video conferencing.
In response to COVID, Sykes TeleHealth Services just completed a survey to understand changing consumer perceptions and behaviors regarding telehealth in our new era. Interestingly, almost 42% of people initially screened were still not even aware of telemedicine, which disqualified them from taking the survey. Of the 2000 respondents (58% of the total) of people who ARE aware of telehealth:
- When asked if their health insurance provider covers telemedicine, 52% said yes, 10% said no, and 35% weren’t sure.
- When asked, “Have you ever considered trying a telehealth appointment?” 20% said they had already completed a telehealth appointment, 40% had considered it, but not yet made an appointment, 37% said they would consider it, and 3% said they wouldn’t consider it.
- Importantly, people who try telehealth become satisfied enough to do it again. Of those who had tried a telehealth appointment, 59% said they’d already had more than one appointment, 37% said they’d consider scheduling another appointment, while 4% said they would not consider another appointment.
- Most importantly, COVID-19 promises to be a game-changer. 73% of respondents said they’d be willing to use telehealth if they showed symptoms of COVID-19, while 60% said COVID-19 had increased their willingness to try telehealth in the future.
Meanwhile, even before COVID-19, physicians predicted a growing acceptance of telehealth. American Well’s 2019 Physician Survey reported that 69% of physicians were willing to have a video visit. The top reasons cited were increased access for patients, flexible work-life balance, to attract and retain patients, to improve outcomes, and to be on the leading edge of medicine.
What’s more, 22% of surveyed physicians said they had already used telehealth to see patients, a 340% increase from 2015 when only 5% had tried it. These doctors reported benefits, including increased access to care, more efficient use of time, reduced costs, high-quality communications with patients, and enhanced relationships with patients.
To make the data come alive for you, let me share two personal stories.
Last year, our family was enjoying Spring Break at our (currently closed) Airbnb vacation rental in Palm Springs. My daughter woke us up, worried about a bug bite with a growing ring around the site of the bite. Rather than taking a chance and spending time at unknown urgent care, we opened my laptop and requested a quick telemedicine conference. Presto, within mere minutes – and for less than I would have paid at the urgent care – our daughter’s minor-but-annoying irritation was solved. She was relieved, and we all sat down to enjoy a family morning with pancakes. Anecdote #2: Days after I alerted him to the new HIPAA and reimbursement changes, my primary care physician sent me an email proudly announcing, “Hey… I’ve now got telemedicine available.” Evidently, he now appreciates the opportunity that is knocking.
The Marketing Opportunity
The coronavirus outbreak has been a tumultuous experience and a worldwide tragedy. At least we can take some solace that our nation’s healthcare system will almost inevitably improve as a result. Telemedicine specifically offers the promise of better care and, at the same time, provides a unique marketing opportunity.
As we’ve seen, the barriers to telemedicine adoption are disappearing rapidly. Regulations and reimbursement are improving. Meanwhile, most doctors and patients who have tried telemedicine continue to use it.
provide a fresh (and often new) service line for hospital CEOs, medical practice administrators, doctors, nurse practitioners, behavioral health professionals, and other healthcare providers.
Potential benefits to your organization include:
- Greater patient satisfaction
- Exceptional convenience
- Patient retention
- Operational efficiency, and
- Increased revenues
Many consumers have long been enthusiastic about the convenience of telemedicine. Changes on the provider side—partly due to the COVID-19 Nationwide Public Health Emergency—include:
- Telemedicine reimbursement is more universally available, including many, if not most, private insurance plans
- Some virtual doctor visits pay at the same rate as regular in-person visits
- Our government has relaxed HIPAA have restrictions in favor of the greater good because of the COVID emergency
- Medicare Part B provides for billing for non-face-to-face communications
- The learning curve has become flat; providers and patients are familiar with communications technology (Zoom, Google Meet, FaceTime, etc.)
- Patients and healthcare providers have computer equipment and use two-way communications nearly universally
- Professional organizations, such as the American College of Physicians, encourage virtual visits, whenever appropriate, to limit potential coronavirus exposure
Here are some of the telemedicine marketing strategies to consider:
- Email your patients to inform them that you now offer telemedicine. Reinforce the message with in-office signage and staff/provider conversations with patients
- Feature your telemedicine option on your website
- Promote a new level of convenience with universal consumer appeal
- Promote telemedicine through your SEO/organic and paid social media
- Start a paid search campaign that targets patients in your area who are already looking for a telemedicine provider
- Present telemedicine as an offer, such as a telemedicine screening
- It can also act as a gateway channel for an online second opinion
- A low-cost, low-risk introductory channel for elective care
- Telemedicine is an easy and natural initial gateway for urgent care
- Offer telemedicine services through doctors, nurse practitioners, clinical psychologists, and many others
- Remote patient monitoring, compliance, and follow-up
- A telemedicine connection can be available at partner locations. (For example, generalists could provide telemedicine access to allied specialists when appropriate.)
In some medical marketplaces, your new telehealth marketing program coulds be a competitive advantage. In other areas, telemedicine is rapidly becoming “table stakes.”
Remember, whether you choose to embrace telemedicine or not, you are already competing with local providers AND well-funded telehealth service providers like Teladoc.
What are Some Telemedicine Options?
People still need healthcare, and healthcare still needs patients. Right now, the various telemedicine formats are an attractive and safe way to connect with new and existing patients. Some platforms also easily facilitate group meetings or collaboration among multiple participants, partners, or internal staff.
And, it’s now relatively easy to open a telemedicine window across the service spectrum. Health systems, medical practices, hospitals, urgent care centers, and other healthcare providers all can adopt telemedicine to benefit their community. For the most part, telemedicine platforms are scalable and can serve large multi-location providers, hospitals, and service line departments, as well as individual doctors and practices.
Right now, during the COVID-19 epidemic, smaller providers are necessarily relying on simple, ad hoc technologies like FaceTime, Zoom, or Skype.
Just in case creating a telemedicine program is entirely new for you, or if you’re rolling it out as a more substantial part of your services, here is an unordered sampling of some of the telemedical services you might consider:
DOXY.ME – A simple, free, and secure telemedicine solution with unlimited message, voice, and video connections. It also has paid tiers with additional features. Doxy.me integrates with Electronic Health Records (EHR) or Practice Management software.
ALLSCRIPTS – Now offers telemedicine integration for health systems and practices to its EHR and practice management software offerings.
EVISIT – Claims an industry leadership position a virtual care provider favored by health systems, hospitals, clinics, and physician groups in the US.
AMC HEALTH – Provides various comprehensive services, including patient personalization and remote monitoring and tracking of patient devices. AMC Health includes clinical trial and research options.
SIMPLEVISIT – Manages telemedicine programs with HIPAA-compliant video visits compatible over Skype, FaceTime, or other communications platforms.
MEND – Described as full-featured and easy to use telemedicine suite. Mend includes voice and video calling, plus appointment reminders, online forms, and appointment self-scheduling.
MEDICI – A secure platform to connect doctors with patients using text, audio, and video. HIPAA compliant provides for billing, chat translate, and other features.
UPDOX – A secure, simple, HIPAA-compliant telemedicine tool. “During the COVID-19 crisis, telehealth is a critical channel for physicians to care for patients while minimizing risk to themselves and others and protecting the community.”
SPRUCE HEALTH – Describes itself as a powerful tool for patients, healthcare providers, and other partners in health to connect and communicate.
Remember, telemedicine and telehealth capabilities represent a significant marketing opportunity. The social distancing demands, plus the broad audience appeal and accessibility, will fundamentally change how patients are seen now and for the foreseeable future.
For Additional Reference:
Note, while the terms are often used interchangeably by the public and even some of the sources cited in this post, technically speaking, TELEMEDICINE refers to remotely providing healthcare services, typically using a secure audio/video platform between provider and patient. Telemedicine is a subset of the larger TELEHEALTH, which also includes online medical education, training, administrative meetings, group sessions, and the like.
Related Telemedicine, Telehealth & COVID/Coronavirus disease links available on the pages of Healthcare Success:
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