– Net Health acquires post-acute market analytics platform PointRight to deepen the company’s analytics capabilities, post-acute presence, and support for SNF networks.
Health, a provider of cloud-based software for specialty medical providers
across the continuum of care, today announced that it has acquired PointRight Inc., a leading provider of
analytics and data-driven tools for the post-acute market. The acquisition adds
to Net Health’s expanding investments in analytics capabilities, which include
the recent acquisition of Tissue Analytics in April 2020 and the earlier
acquisition of Focus on Therapeutic Outcomes (FOTO).
Unlock the Power of Advanced Analytics for Post-Acute
Founded in 1995, PointRight provides analytics that shows a 360⁰ view of long-term and post-acute (LTPAC) facility performance and clinical outcomes. Equipped with these insights, LTPAC Provider and Payers can lower rehospitalization rates, improve clinical outcomes, and build and manage high-performing networks. Today, close to 2,400 SNFs use PointRight’s advanced analytics and data-driven decision support tools to further their clinical, financial, and operational objectives.
SNFs use PointRight to improve the accuracy of their reimbursement and regulatory submissions and to enhance overall performance in readmissions, quality, and outcomes, including more accurate and compliant patient assessments, reduced rehospitalization rates, and optimized care transitions.
More recently, health systems, ACOs, payers, and real estate investment trusts (REIT) have relied on PointRight to provide insight into the health of their SNF networks and to identify areas for improvement.
Acquisition Expands Net Health’s
Market Share in Growing Post-Acute Market
acquisition of PointRight expands Net Health’s position and scale in the
growing post-acute market. Additionally, the acquisition will enable Net
Health’s broad roster of hospital clients to better manage their skilled
nursing facility (SNF) networks and support outcomes measurement and performance
improvement in Medicare Advantage and managed Medicaid programs. As part of the
acquisition, Net Health
plans to fully integrate PointRight staff to accelerate the delivery of new
analytics solutions and expand the availability of PointRight to Net Health’s
customers and markets.
“Through PointRight, Net Health will significantly expand how we support SNFs and their health system, accountable care organization (ACO), payer and REIT partners,” said Josh Pickus, Net Health’s Chief Executive Officer. “It also strengthens our growing analytics capabilities by providing insights into post-acute performance, which enables providers and payers to align around value-based care initiatives.”
Financial details of the acquisition
were not disclosed.
Interoperability is a big discussion in health care, with
new regulations requiring interoperability for patient data. Most approaches
follow the typical RESTful API approach that has become the standard method for
data exchange. Yet Health Level Seven (HL7), with its new Fast Healthcare Interoperability
Resources (FHIR) standard for the electronic transfer of health data, is
leading to a rash of implementations that, to date, are not solving core interoperability
Data is still insecure, users can’t govern their own health
records, and the need for multiple APIs for different participants with
different rights (human and machine) in the network is adding unneeded
expenditures to an already burdened healthcare system. The way out is not to
add more middleware, but to upgrade the basic tools of interoperability in a
way that finally brings healthcare
technology into the 21st century.
A Timely Policy
Doctors, hospitals, pharmacists, insurance providers,
outpatient treatment centers, labs and billing companies are just a few of the
parties that comprise the overcomplicated U.S. healthcare system.
In digitizing medical files, as required by the 2009 Health
Information Technology for Economic and Clinical Health (HITECH) Act, providers
have adopted whatever solution was most convenient. This has led to the mess of interoperability
issues that HL7 seeks to remedy with FHIR.
Existing Electronic Medical Records
(EMR) systems do not easily share data. Best case, patients have to sign
off to share data with two incompatible systems. Worst case, information must
be turned into a physical CD or document to follow the patient between
providers. Data security is also notoriously poor. Hackers prioritized the healthcare sector as their main target in 2019; breach
costs exceeded $17.7 billion.
The New Infrastructure Rush
When common formats, by way of FHIR and HL7, provided
standards and solutions to empower global health data interoperability, the
industry erupted into a flurry of activity. Thousands of healthcare databases
are now being draped in virtual construction tarps and surrounded by digital
Building a new, interoperable data ontology for the entire
healthcare system is a massive undertaking. For one, 80% of hospital data is
managed using the cryptic, machine-language HL7 Version 2. Most of the rest
uses the inefficient, dated XML data format. HL7 FHIR promotes the use of more
modern data syntaxes, like JSON and RDF (Turtle).
Secondly, databases have no notion of the new FHIR schema.
Armies of developers must build frameworks and middleware to facilitate interoperability.
This is why Big Tech incumbents including Google Cloud Healthcare, Amazon AWS
and Microsoft for Healthcare are jumping into the fray with their own
The outcome, once HL7’s 22 resources are fully normative, will
be seamless information sharing, electronic notifications, and collaboration
between every player in the giant web of patients, providers, labs, and
middlemen. But it will come at a steep cost in the current traditionally RESTful
API-based manner that is being broadly pursued.
The Problem with APIs
The new scaffolding is expensive, takes data control away
from patients, and is not inherently secure. The number of unique APIs required
to support the access, rights and disparate user base in the healthcare network
are the reason.
Interoperability requires a common syntax and “language” to
enable databases to talk to each other. The average traditional API costs up to
$30,000 to build, plus half that cost to manage annually. That is not to
mention the cost to integrate and secure each API. A small healthcare
organization with only 10 APIs faces costs of $450,000 annually for basic API
When you consider that most big healthcare organizations will
need to connect thousands of APIs, HL7’s interoperability schema really is the
best way forward. The traditional API tooling to manage the interoperability of
the well-framed data structures, however, is the problem.
Moreover, the patient, the rightful owner of their own
health record, still doesn’t have the ability to govern their own data. Because
change only happens in the database itself, the manager of the database, not
the patient, controls the data within.
In the best case, this puts an additional burden on patients
to give explicit permission every time health records move between providers.
In the worst case, a provider sees an entire medical history without a
patient’s consent–your podiatrist seeing your psychiatric records, for
Finally, each API enables one data store to talk to the
next, opening opportunities for bad actors to make changes to databases from
the outside. The firewalls that protect databases and networks are penetrable,
and user profiles are sometimes created outside of the database itself, making
it possible to expose, steal and change data from outside the database.
In that light, HL7 is paving the wrong road with good
intentions. But there is another way.
Semantic Standards and Blockchain to the Rescue
If you eliminate data APIs, secure interoperability, with
data governance fully in the hands of the patient, becomes possible. Healthcare
data silos will be replaced with a dynamic, trusted and shared data network
with privacy and security directly baked in. The solution involves adding
semantic standards for full interoperability, blockchain for data governance
and data-centric security.
Semantic standards, such as RDF formatting and SPARQL
queries, let users quickly and easily gain answers from multiple databases and
other data stores at once. Relational databases, the ones currently in use in healthcare,
are all formatted differently, and need API middleware to talk to one another.
Accurate answers are not guaranteed. Semantic standards, on the other hand,
create a common language between all databases. Instead of untangling the
mismatched definitions and formatting inevitable with relational databases,
doctors’ offices, for example, could easily pull in pertinent patient records,
insurance coverage, and the latest research on diseases.
Patients, for their part, would use blockchain to regain control
of their data. Patients would be able to turn on aspects of their data to
specific caregivers, instead of relinquishing control to database business
managers, as is currently the case. Your podiatrist, in other words, will not
be able to see your psychiatric records unless you choose to share them.
The data ledger, which lives on the blockchain, will contain
instructions as to who can update (writer new records on) the ledger, who can
read it, and who can make changes. All changes are controlled by private-key
encryption that is in the hands of the patient; only those with authorization
can see select histories of health data (or, as in the case of an ER doctor,
entire histories, with permission).
Data security is controlled in the data layer itself,
instead of through middleware such as a firewall. Data can be shared without
API, thanks to those semantic standards, and data are natively embedded with
security in the blockchain. Compliance, governance, security and data
management all become easier. Data cannot be stolen or manipulated by an
outside party, the way it commonly is by healthcare hackers today.
The interoperability conundrum, in other words, is solved.
Fewer APIs means fewer security vulnerabilities; a common, semantic standard
eliminates confusion and minimizes mistakes. Blockchain puts patients in
control of who sees what parts of their health records. Eliminating the need
for API middleware also saves tens of thousands of dollars, at a minimum.
About Brian Platz
Brian is the Co-CEO and Co-Chairman of Fluree, PBC, a decentralized app platform that aims to remodel how business applications are built. Before establishing Fluree, Brian was the co-founder of SilkRoad technology which expanded to over 2,000 customers and 500 employees in 12 international offices.
– Nuance Communications, Inc. launched an AI-powered
patient engagement virtual assistant platform to transform omnichannel digital
experiences for patients.
–Healthcare provider organizations can now deploy
a single, common cloud-based platform to support their entire patient journey
across engagement channels using Nuance’s market-leading Intelligent Engagement
– The launch comes as patients increasingly expect the
same level of engaging experiences from healthcare organizations that they have
with consumer brands.
Communications, Inc., today launched an AI-powered patient
engagement virtual assistant platform to transform voice and digital
experiences across the patient journey. The platform combines Nuance’s decades
of healthcare expertise and its award-winning AI technology trusted by consumer
brands like H&M, Rakuten and Best Buy. It works by integrating and
extending Nuance’s EHR, CRM and Patient Access Center systems to enable
healthcare provider organizations to modernize their “digital front door” and
improve clinical care experiences.
Holistic Approach to Healthcare’s New Digital Front Door
Patients are demanding the same conveniences from healthcare
organizations that they enjoy from major consumer brands. A recent survey reveals that consumers are ready for
digital changes such as telemedicine options (44%), digital forms and
communication (41%), and touchless check-in (37%). What’s more, 68% value a
customized patient experience. In fact, a poor digital health experience caused
more than a quarter of patients to change medical providers in 2020 — up 40
percent from 2019.
“Our new omnichannel Patient Engagement Virtual
Assistant Platform takes a holistic approach to powering healthcare’s new
digital front door, overcoming the shortcomings and inconsistencies of partial
point solutions,” said Peter Durlach, Senior Vice President, Strategy
and New Business Development, Nuance. “By marrying the capabilities of our
healthcare experience and the proven omnichannel customer engagement technology
trusted by Fortune 100 companies worldwide, we can help address the
urgent need of providers and patients alike to transform access to, and
delivery of, care in the modern age of digital medicine.”
– TigerConnect has announced an expansion in their suite
through the acquisition of Critical Alert, a leading provider of
enterprise-grade middleware for hospitals and health systems.
– For the hundreds of thousands of nurses that currently
use TigerConnect, these new capabilities will deliver real-time, contextual
information to their mobile device or desktop to allow them to work smarter,
prioritize responses, and efficiently coordinate care, all within the same
reliable TigerConnect platform they use every day for enterprise messaging.
a care team collaboration solution, today announced the acquisition
of Critical Alert, a Jacksonville,
FL-based leading provider of enterprise-grade middleware for hospitals and
health systems. Critical Alert’s product suite consists of a middleware suite
of products as well as traditional nurse call hardware servicing over 200
hospitals in North America. Financial details of the acquisition were not
Real-Time Care Team Collaboration for Hospitals
Founded in 1983, Cloud-native and mobile-first, Critical
Alert’s middleware solution enables any health system to combine nurse call,
alarm and event management, medical device interoperability, and clinical
workflow analytics. TigerConnect will integrate Critical
Alert’s middleware stack into its platform to power a wide range of alert types
and alarm management enhancements for TigerConnect’s customers. Critical
Alert’s Nurse Call hardware business will continue to operate under its
namesake as a standalone business unit.
When combined with Critical Alert’s middleware, TigerConnect dramatically
enhances the value proposition to nursing, IT leadership, and end-users. This ‘dream
suite’ of capabilities comes at a time when nurse burnout is at a record high
and chronic nurse shortages are severely challenging organizations’ ability to
deliver the best quality care.
“We see the Critical Alert acquisition as highly strategic and
a natural evolution of our already-robust collaboration
platform,” said Brad Brooks, CEO and co-founder of TigerConnect. “For the
hundreds of thousands of nurses that currently use TigerConnect, these new
capabilities will deliver real-time, contextual information to their mobile
device or desktop to allow them to work smarter, prioritize responses, and
efficiently coordinate care, all within the same reliable TigerConnect platform
they use every day for enterprise messaging.”
Joining TigerConnect is Critical Alert CEO John
Elms, who will assume the role as TigerConnect Chief Product Officer,
guiding the integration of the two companies’ technologies and leading the
development of all future product offerings. Wil Lukens, currently VP of Sales
for Critical Alert, will assume the role of General Manager of Critical Alert’s
traditional Nurse Call hardware unit.
“The timing of the deal and the fit of these two companies aligned perfectly,” said John Elms, CEO of Critical Alert. “Two best-in-class, highly complementary solutions coming together to solve some of the chronic challenges—alarm fatigue, response prioritization, resource optimization—that have driven nurse teams to the brink. Together, these unified technologies will make care professionals’ lives easier, not harder, and I couldn’t be more excited to lead the TigerConnect product organization into this next chapter.”
Critical Alert Integration with TigerConnect Plans
TigerConnect’s robust product suite, which includes care
team collaboration (TigerFlow®), on-call scheduling (TigerSchedule®), virtual
care/telemedicine (TigerTouch®), and now virtualized nurse call and
alerts/alarm management (Critical Alert middleware), will help transform
hospitals and healthcare organizations into the real-time health systems of the
Hardware-free Middleware Forms the Foundation
With a shared cloud-native approach, Critical Alert’s
advanced middleware seamlessly fuses TigerConnect’s care team
collaboration with alarm management and event notifications. Deep
enterprise-level integrations with hospital systems enable the centralization
of clinical workflow management and real-time analytics. Integrating these
systems will have a sizable impact on customer organizations’ productivity and
Next Generation Nurse Call
Critical Alert’s nurse call solution brings a modern, badly
needed upgrade to legacy systems, extending both their life and feature-set. A
single mobile- or desktop-enabled user-interface brings vital contextual
information about requests while allowing for centralized answering of nurse
call alerts and management of workflows and assignments. These streamlined
workflows reduce noise and clinical interruptions while improving
Physiological Monitoring – Less Noise, More Signal
The FDA-cleared offering intelligently routes context-rich
alarm notifications from clinical systems to TigerFlow+. An easy-to-use
workflow builder ensures alerts are prioritized accordingly and are routed to
the appropriate caregiver, suppressing unnecessary noise. The filtering,
mobilization, and escalation of alerts pairs with TigerConnect Teams,
allowing for prompt responses in critical situations.
Smart Bed Alarms for Enhanced Patient Safety
Integrations with popular smart bed systems provide remote
monitoring of bed status details, informing nurses whether they should walk or
run to a patient’s room. Staff can review and adjust bed compliance settings
from their mobile device and receive fall prevention notifications if safe-bed
configuration is compromised.
Real-time Location System (RTLS) Measures What Matters
The integration of RTLS with a deployed nurse call
application greatly enhances the data available to clinical leadership. The
combined TigerConnect/Critical Alert offering enables real-time tracking
of staff location (presence) and time spent on tasks, providing deeper insights
into resource planning, workflow effectiveness and ongoing process improvement
Advanced Analytics for Deeper Workflow Insights
A better understanding of patient behavior and workflows
helps reveal areas for optimization that can lead to improved patient care and
staff efficacy. The new combined platform capabilities centralize the
collection and tracking of patient event data and nurse task efficiency,
turning insights into action. Advanced analytics also allow for identifying,
documenting, and benchmarking responsiveness, compliance, resource allocation,
and patient throughput across the health system.
This new integrated functionality is expected to be
available to TigerConnect customers in Q1 of 2021.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
Industry experts state that orphan drugs will be a major trend to watch in the years ahead, accounting for almost 40% of the Food and Drug Administration approvals this year. This market has become more competitive in the past few years, increasing the potential for reduced costs and broader patient accessibility. Currently, these products are often expensive because they target specific conditions and cost on average $147,000 or more per year, making commercialization optimization particularly critical for success.
This is important because personalized medicine has the capacity to detect the onset of disease at its earliest stages, pre-empt the progression of the disease and increase the efficiency of the health care system by improving quality, accessibility, and affordability.
These factors lay the groundwork for specialty pharmaceutical companies that are developing and commercializing personalized drugs for orphan and ultra-orphan diseases to pursue productive collaboration and meaningful partnership with a specialty pharmacy, distribution, and patient management service provider. This relationship offers manufacturers a patient-first model to align with market trends and optimize the opportunity, maximize therapeutic opportunities for personalized medicines, and help to contain costs of specialty pharmacy for orphan and rare disorders. This approach leads to a more precise way of predicting the prognosis of genetic diseases, helping physicians to better determine which medical treatments and procedures will work best for each patient.
Furthermore, and of concern to specialty pharmaceutical providers, is the opportunity to leverage a patient-first strategy in streamlining patient enrollment in clinical trials. This model also maximizes interaction with patients for adherence and compliance, hastens time to commercialization, and provides continuity of care to avoid lapses in therapy — during and after clinical trials through commercialization and beyond for the whole life cycle of a product. Concurrently, the patient-first approach also provides exceptional support to caregivers, healthcare providers, and biopharma partners.
Integrating Data with Human Interaction
When it comes to personalized medicine for the rare orphan market, tailoring IT, technology, and data solutions based upon client needs—and a high-touch approach—can improve patient engagement from clinical trials to commercialization and compliance.
Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for when seeking a specialty pharmacy, distribution, and patient management provider. The key to effective care is to balance technology solutions with methods for addressing human needs and variability.
With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating independently. The continuity across the entire patient journey strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. This focus addresses all variables around collecting data while maintaining frequent communication with patients and their families to ensure compliance and positive outcomes.
As genome science becomes part of the standard of routine care, the vast amount of genetic data will allow the medicine to become more precise and more personal. In fact, the growing understanding of how large sets of genes may contribute to disease helps to identify patients at risk from common diseases like diabetes, heart conditions, and cancer. In turn, this enables doctors to personalize their therapy decisions and allows individuals to better calculate their risks and potentially take pre-emptive action.
What’s more, the increase in other forms of data about individuals—such as molecular information from medical tests, electronic health records, or digital data recorded by sensors—makes it possible to more easily capture a wealth of personal health information, as does the rise of artificial intelligence and cloud computing to analyze this data.
Telehealth in the Age of Pandemics
During the COVID-19 pandemic, and beyond, it has become imperative that any specialty pharmacy, distribution, and patient management provider must offer a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states and expectations for each drug.
A customized telehealth option enables essential discussions for understanding patient needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.
Each touchpoint has a care plan. For instance, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on.
This approach captures relevant information in a standardized way so that every pharmacist and patient is receiving the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the story of the patient journey created for them.
Just as important, patients know that help is a phone call away and trust the information and guidance that pharmacists provide.
About Donovan Quill, President and CEO, Optime Care
Donovan Quill is the President and CEO of Optime Care, a nationally recognized pharmacy, distribution, and patient management organization that creates the trusted path to a fulfilled life for patients with rare and orphan disorders. Donovan entered the world of healthcare after a successful coaching career and teaching at the collegiate level. His personal mission was to help patients who suffer from an orphan disorder that has affected his entire family (Alpha-1 Antitrypsin Deficiency). Donovan became a Patient Advocate for Centric Health Resources and traveled the country raising awareness, improving detection, and providing education to patients and healthcare providers.
Communication problems and inadequate information flow are two of the most common root causes of medical errors. The potential for miscommunication and faulty exchange of information in healthcare is substantial.
Consider: patient information is dispersed among multiple providers and payers along the continuum of care. Electronic Health Records (EHRs) and other clinical systems do not capture patient information or format medical documentation in a standardized manner. In an environment with incompatible systems, the easiest way for healthcare organizations to exchange records is to generate those records in a document format. It is not surprising then that many healthcare organizations are still heavily dependent on traditional, paper-based fax, which adds its own challenges to the process. Fax hardware and communication equipment are often unreliable, resulting in document delivery failures and delays.
As a result, an inadequate information flow can cause problems that impact the availability of essential knowledge needed for prescribing decisions, timely and reliable delivery of test results, and coordination of medical orders. The ensuing administrative and medical errors raise healthcare costs and may lead to poor health outcomes, including patient harm and readmissions.
The reality of mundane, manual processes
Document-based information exchange processes are highly inefficient. Staff often print and copy documents, creating a risk of accidental exposure of protected health information and resulting in needless costs. Moreover, documents – whether printed or stored on a workstation or server – still require manual data entry into EHRs and practice management systems. The tasks are tedious, prone to error, and negatively impact workflow, staff efficiency, physicians, and patients, and may lead to the following:
– Patient record errors, including filing or documenting information in the wrong patient file, and data entry errors;
– Poorly documented or lost test results; and
– Gaps in communication during transitions of care from one healthcare provider or setting to another.
In addition to these areas of concern that threaten patient safety, inbound documents often contain a lot of information on clinical, administrative, and financial matters that aren’t necessarily relevant to an intended recipient. That means a recipient must review all pages of the document and separate needed information from extraneous ones, which can further delay processing and patient transitions of care.
Smarter, faster document processing with AI
Healthcare providers need a document exchange and processing strategy that enables fully digital, secure, and efficient communication among numerous, highly customized EHRs, each with its own workflows and document processing preferences.
Such a strategy needs to include moving away from paper to fully digital documents. Healthcare organizations can accomplish this easily and without the need to overhaul the entire existing health IT infrastructure. The two main ways of transitioning from paper to digital are using digital fax instead of traditional fax and document imaging when documents are simply scanned into the system. In many cases, the resulting document format will be a TIFF image; and while it is not machine-readable, it enables paperless filing of clinical documents to the EHR.
Alternatively, converting the document into a readable format, such as a searchable PDF, will allow the healthcare organization to add value in document processing at every subsequent step. Making the document readable enables automatic identification of the type of document, data extraction, including patient name, medical record, date of birth, and physician name, as well as more effective management of the overall lifecycle of the document.
This step requires the utilization of AI and natural language processing techniques. Automatic extraction of data replaces the human labor required to manually index the information, which streamlines the triaging of documents to correct systems, teams, or recipients.
For example, if a digital document is clearly labeled as a discharge summary for John Harrison, a staff member can process it much easier and faster than when she has to open and read it to understand the type of the document and the identity of the patient. By mostly automating the receiving, reading, classifying, and triaging of medical documentation, providers are able to save time and ensure information is received and processed quickly by the right person, which typically means that the patient can be better served.
The COVID-19 pandemic has only driven home the need for seamless, 100%-digital exchange of patient information. If healthcare administrators depend on the physical fax machine to do their jobs, they won’t be able to work remotely. Most people don’t have fax machines at home, and especially fax machines routed to the hospital’s number, to be able to print information and then manually scan and enter that information into the patient’s health record. A fully digital document processing approach enables agility and flexibility necessary in the modern healthcare environment.
Moreover, recent ransomware attacks in the form of malware embedded into email attachments sent to users in hospitals lead to providers blocking inbound email attachments altogether. That means providers could not access their own patient data, let alone data from other institutions. As a result, emergency patients may have to be taken to other hospitals, and surgeries and other procedures delayed. Cloud-based platforms enable users to securely access patient information outside of the hospital’s network.
Small steps lead to big results
It’s essential from both a patient safety perspective and provider efficiency perspective that the exchange and processing of medical documentation be digitized. The benefits of digital document processing are significant, enabling fluid information exchange among all stakeholders.
By transitioning to fully digital document exchange, providers can significantly streamline administrative and clinical processes. The key to realizing the benefits of this approach is to take the first step by moving away from paper and then build on that by harnessing the power of AI to fully support the daily work of clinicians and administrators. Outbound and inbound documents can be prioritized, addressed, processed, and delivered appropriately, facilitating timely information exchange for processing prescriptions, medical orders, billing, reporting, analytics, research, and much more.
About John Harrison
As Chief Commercial Officer at Concord Technologies, John is responsible for the company’s revenue growth and brand development, ensuring Concord continues to create the right products to meet the needs of its customers. John brings more than 25 years of document communication and automation experience to the team. Prior to joining Concord, John held executive management positions at OpenText, Captaris, and Goaldata, overseeing business operations across multiple continents.
– Service commerce platform EverCommerce acquires Dublin,
OH-based Updox, a healthcare communication platform for in-person and virtual
– The acquisition
expands EverCommerce’s health services portfolio and enables the companies to
further their shared goal of simplifying the business of healthcare and
facilitating the growth of healthcare practices.
Today, EverCommerce, a leading service commerce platform, completed the acquisition of Updox, a Dublin, OH-based complete healthcare communication platform for in-person and virtual care. The company will join EverCommerce’s portfolio of health services companies, enabling it to provide customers with faster access to more products, a broader suite of solutions, and more resources.
The acquisition comes on the heels of a breakout year for
virtual care. Digital health is on track to hit over $12 billion in investments
by the end of 2020 – the largest funding year for the sector yet – and over 60
acquisitions through the end of Q3, including other telehealth breakouts like
Teladoc, which recently completed its acquisition of Livongo in a deal valued
at over $18B.
Deliver the Best in Virtual & In-Person Care
Updox provides next-generation virtual care, patient engagement, and office productivity solutions that enable practices to reduce costs and drive revenue. Based on increasing demand for solutions that seamlessly work together to improve practice efficiency and provide an engaging patient experience, Updox has continuously brought new functionality to market. Additional solutions are planned for 2021.
Updox serves more than 560,000 users across healthcare practices, health systems and pharmacies, and more than 210 million patients. Updox has experienced rapid growth and adoption this year, as healthcare providers sought to quickly implement telehealth and other patient engagement solutions that enabled them to acquire new patients, operate more efficiently, and engage their patients as a result of the COVID-19 pandemic. In fact, Updox facilitated over 3.5 million telehealth visits since March and continues to support more than 15,000 visits per day.
The EverCommerce health services portfolio includes a
diverse mix of solutions including cloud-based medical billing, specialty EHR,
practice management, RCM software, lead generation, marketing solutions and
retention services for healthcare practices. With this acquisition,
EverCommerce will advance its mission to provide end-to-end mission-critical
solutions that enable healthcare practices to accelerate growth, streamline
operations and increase patient retention.
“Now more than ever, healthcare providers need a one-stop-shop to acquire new patients, operate more efficiently and engage their patients. They also need one single place to communicate with patients where they are – on their mobile phones,” said Michael Morgan, president of Updox. “We’re thrilled to join the EverCommerce team, which shares our vision for advancing healthcare. We look forward to accelerating innovative solutions that enable healthcare practices to more effectively market to patients, simplify payments, and effectively interact with patients both in and outside the practice.”
– Philips and BioIntelliSense has been selected by the
U.S. Army Medical Research and Development Command (USAMRDC) to receive nearly $2.8M
from the U.S. Department of Defense (DoD) to validate BioIntelliSense’s
FDA-cleared BioSticker device for the early detection of COVID-19 symptoms.
– Working with the University of Colorado Anschutz
Medical Campus, the clinical study will consist of 2,500 eligible participants
with a recent, known COVID-19 exposure and/or a person experiencing early
Philips and BioIntelliSense,
Inc., a continuous health monitoring and clinical intelligence company, today
announced they have been selected by the U.S. Army Medical Research and
Development Command (USAMRDC) to receive nearly $2.8M from the U.S. Department
of Defense (DoD) through a Medical Technology Enterprise Consortium (MTEC)
award to validate BioIntelliSense’s FDA-cleared BioSticker device for the early
detection of COVID-19
symptoms. The goal of the award is to accelerate the use of wearable
diagnostics for the benefit of military and public health through the early
identification and containment of pre-symptomatic COVID-19 cases.
Medical-Grade Wearable for Early COVID-19 Detection
As millions of individuals have been screened and tested, the emerging research on traditional screening methods is revealing how challenging it is to detect the risk of COVID-19 infections early. Temperature checks have proven to be unreliable and even amplified testing (PCR) has proven to be ineffective in identifying the virus in the early days of infection.
The FDA-cleared BioSticker is an advanced on-body sensor
that allows for effortless continuous monitoring of temperature and vital signs
combined with advanced analytics, enables the BioSticker to identify
statistically meaningful trends and screen for early potential COVID-19
“The medical-grade BioSticker wearable, combined with advanced diagnostic algorithms, may serve as the basis for identifying pre- and very early symptomatic COVID-19 cases, allow for earlier treatment for infected individuals, as well as reduce the spread of the virus to others,” said James Mault, MD, Founder and CEO of BioIntelliSense.
Clinical Trial Details
Working with the University of Colorado Anschutz Medical Campus, the
clinical study will consist of 2,500 eligible participants with a recent, known
COVID-19 exposure and/or a person experiencing early COVID-19 symptoms.
Individuals may learn more about the study eligibility and enroll online
The research will focus on the validation of BioIntelliSense’s BioSticker for
early detection of COVID-like symptoms, as well as assessment of scalability,
reliability, software interface, and user environment testing.
Turning Data into Actionable Insights
While previous studies have shown potential using consumer wearables in relation to COVID-19, this study will leverage BioIntelliSense’s medical-grade wearable, the BioSticker, which enables continuous multi-parameter vital signs monitoring for 30 days and captures data across a broad set of vital signs, physiological biometrics and symptomatic events, including those directly associated with COVID-19. With its integration into Philips’ remote patient monitoring offerings, this is another example of how cloud-based data collection takes place seamlessly, across multiple settings, from the hospital to the home. Allowing data to be turned into actionable insights and care interventions, while providing connected, patient-centered care across the health continuum.
Dr. Vik Bebarta, the Founder and Director of the CU Center for COMBAT Research and Professor of Emergency Medicine on the CU Anschutz Medical Campus added: “The University of Colorado School of Medicine and the CU Center for COMBAT Research in the Department of Emergency Medicine are excited to be a lead in this effort that will change how we care for our service members in garrison and our civilians in our communities. The COMBAT Center aims to solve the DoD’s toughest clinical challenges, and the pandemic is certainly one example. With this progressive solution, we aim to detect COVID in the pre-symptomatic or early symptomatic phase to reduce the spread and initiate early treatment. This trusted military-academic-industry partnership is our strength, as we optimize military readiness and reduce this COVID burden in our community and with frontline healthcare workers.”
– 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.
– BioTelemetry business is expected to deliver double-digit growth and improve its Adjusted EBITA margin to over 20% by 2025; the acquisition will be sales growth and adjusted EBITA margin accretive for Philips in 2021.
announced it has entered in an agreement to acquire BioTelemetry, Inc., a U.S.-based provider
of remote cardiac diagnostics and monitoring for $2.8B ($72 per share), to be
paid in cash upon completion.
USD 72.00 per share, to be paid in cash upon
completion. The board of directors of BioTelemetry has approved the transaction
and recommends the offer to its shareholders. The transaction is expected to be
completed in the first quarter of 2021.
Founded in 1995, BioTelemetry primarily focuses on the diagnosis and monitoring of heart rhythm disorders, representing 85% of its sales. BioTelemetry’s clinically validated offering includes wearable heart monitors (e.g. a mobile cardiac outpatient telemetry patch and extended Holter monitor) that detect and transmit abnormal heart rhythms wirelessly, AI-based data analytics, and services.
With over 30,000 unique
referring physicians per month, BioTelemetry provides services for over one
million patients per year. Additionally, BioTelemetry has a clinical research
business that provides testing services for clinical trials. The total
addressable market is USD 3+ billion, growing high-single-digits driven by an
increasing prevalence of chronic diseases, and the adoption of remote
monitoring and outcome-oriented models.
Acquisition Strengthens Philips’ Cardiac Care Portfolio
The acquisition of BioTelemetry is a strong fit with Philips’ cardiac care portfolio, and its strategy to transform the delivery of care along the health continuum with integrated solutions. The combination of Philips’ leading patient monitoring position in the hospital with BioTelemetry’s leading cardiac diagnostics and monitoring position outside the hospital, will result in a global leader in patient care management solutions for the hospital and the home for cardiac and other patients. Philips’ current portfolio includes real-time patient monitoring, therapeutic devices, telehealth, and informatics. Moreover, Philips has an advanced and secure cloud-based Philips HealthSuite digital platform optimized for the delivery of healthcare across care settings. Every year, Philips’ integrated solutions monitor around 300 million patients in hospitals, as well as around 10 million sleep and respiratory care patients in their own homes.
“The acquisition of BioTelemetry fits perfectly with our strategy to be a leading provider of patient care management solutions for the hospital and the home,” said Frans van Houten, CEO of Royal Philips. “BioTelemetry’s leadership in the large and fast growing ambulatory cardiac diagnostics and monitoring market complements our leading position in the hospital. Leveraging our collective expertise, we will be in an optimal position to improve patient care across care settings for multiple diseases and medical conditions.”
Upon completion of the transaction, BioTelemetry and its
approximately 1,900 employees will become part of Philips’ Connected Care
business segment. The acquisition is projected to be sales growth and adjusted
EBITA margin accretive for Philips in 2021. Philips targets significant
synergies driven by cross-selling opportunities (especially in the U.S.),
geographical expansion, and portfolio innovation synergies, such as Philips’
Health Suite digital platform. Additionally, Philips will drive operational
performance improvements through its proven productivity programs. The
BioTelemetry business is expected to grow double-digits and to improve its
Adjusted EBITA margin to more than 20% by 2025.
– Highmark Health signs six-year strategic partnership agreement
with Google Cloud to transform the health experience for patients and
caregivers through the development of Highmark Health’s new Living Health
– The Living Health model is designed to eliminate
the fragmentation in health care by re-engineering the healthcare delivery
model with a more coordinated, personalized, technology-enabled experience.
Highmark’s Living Health model is designed to eliminate the fragmentation in health care by re-engineering the healthcare delivery model with a more coordinated, personalized, technology-enabled experience. In addition to offering seamless, simpler, and smarter interactions with patients, the Living Health model is designed to free clinicians from time-consuming administrative tasks while providing them with timely data and actionable information about each patient. Living Health is not just focused on improving the patient-clinician relationship, it is about changing the way health care delivery operates.
“The Living Health model is about improving each person’s health and quality of life, every day,” commented Dr. Tony Farah, executive vice president and chief medical and clinical transformation officer of Highmark Health. “The traditional health care system is too fragmented and for the most part reactive. The Living Health model takes the information and preferences that a person provides us, applies the analytics developed with Google Cloud, and creates a proactive, dynamic, and readily accessible health plan and support team that fits an individual’s unique needs.”
Living Health Model
Powered by Google Cloud
Highmark Health will lead the collaboration to build its
Living Health Dynamic Platform on Google Cloud. Key elements of the agreement
– The construction of a highly secure and scalable platform
built on Google Cloud
– The application of Google Cloud’s advanced analytic and
artificial intelligence capabilities to supercharge Highmark Health’s existing
clinical and technology capabilities
– The engagement of a highly skilled professional services
team that will collaborate to drive rapid innovation
– The use of Google Cloud’s healthcare-specific solutions, including the Google Cloud Healthcare API, to enable rapid innovation, interoperability, and a seamless Living Health experience.
Highmark Health will control access and use of its patient
data using rigorous long-standing organizational privacy controls and
governance, which will be enhanced through the creation of a joint Highmark
Health-Google Cloud Data Ethics and Privacy Review Board to ensure that uses of
data are consistent with prescribed ethical principles, guidance, and customer
expectations of privacy.
Why It Matters
The strategic partnership reflects Highmark Health’s vision for a remarkable health experience by moving care and disease management of clinical conditions beyond traditional care settings through an engaging digital experience. By providing the insights needed to enable timely interventions, people will be empowered to proactively manage their health. For example, specific outcomes could include proactive intervention based on timely and individual patient data; digital disease management; easily accessible, personalized health plans; and centralized scheduling and management of care teams.
Economic Impact of Partnership
Approximately 125 new jobs are being created at Highmark Health to support the development of the Living Health Dynamic Platform, specifically in the areas of application development, cloud-based computing architectures, analytics, and user experience design.
– With ICU beds near capacity across the United States,
GE Healthcare announced a strategic partnership with Oregon Health and Science
University (OHSU) that will allow OHSU to oversee and help provide care to ICU
patients across eight hospital sites via a “Virtual ICU” (VICU), using the GE
Healthcare Mural Virtual Care Solution.
– The VICU provides critical care specialists at OHSU
with digital tools to deploy hospital defined care protocols to remotely
identify changes in patient status, respond in real-time, and support local
clinicians caring for patients in their local communities. The VICU will also
extend OHSU’s critical care expertise to patients in rural communities, where
specialists are not otherwise available.
COVID-19 Underscores Shortage of Critical Care
pandemic is highlighting a pre-existing shortage of critical care specialists,
nurses and other clinicians across the United States and around the
world, according to a recent
report from the RAND Corporation. Furthermore, a 100-bed hospital may
have only one intensivist who can care for patients requiring
In response to the critical care shortage and in
collaboration with OHSU, GE Healthcare developed a customized solution of care workflows
that powers the OHSU VICU. The VICU benefits patients by keeping them in their
local communities near family and friends; supports local economies by
maintaining resources, such as ambulances and revenue, in the immediate area;
and improves efficiency by allocating hospital beds, resources and staff for
the most critical patients.
“Through the Virtual ICU, we can supplement the
local expertise in a variety of ways and durations – from a single shift to
several a week – bringing much-needed relief and support to the clinicians on
the ground,” said Senior Vice President and Chief Operating Officer of OHSU
Healthcare Joe E. Ness, M.H.A., R.Ph. “The VICU allows us to execute our vision
of increasing the level of care in community hospitals, allowing
patients across the state of Oregon to receive the care they need
closer to home while reducing unnecessary transfers and optimizing ICU capacity
in the area.”
“I can fully focus on the patient – who may be
physically hundreds of miles away — in real time, by watching vital signs, lab
values, waveforms and other parameters,” said OHSU Associate Professor of
Anesthesiology and Perioperative Medicine and TeleICU Medical Director Marshall
Lee, M.D. “And by enabling audio and visual support in the patient room,
I can virtually visit and collaborate with the local, bedside team.”
Mural will also support the OHSU goal of enhancing the
quality of care throughout the system by providing analytics on
clinical information, such as minutiae ventilation data and metrics on clinical
and operational best practices, including pain, delirium and agitation
management. Data tracked and generated by the VICU translates into metrics –
such as length of stay and average ventilation days per patient —
that hospitals can use to refine operations to support improved patient outcomes
and increased efficiency.
Based on Specific Clinical Workflows
GE Healthcare’s Mural can be customized based on specific
clinical workflows, enabling intensivists and advanced nurses in a central
location to support bedside teams as they care for patients in their
communities. Mural can also support compliance documentation on healthcare
associated infections (HAIs), and prevention measures such as
thromboprophylaxis, stress ulcer prophylaxis and glucose management.
Enabled by Edison, GE Healthcare’s intelligence platform,
Mural can be deployed on-premise via GE Healthcare’s Edge infrastructure or on
the cloud, depending on customer preference and need.
Currently available in the United States, Canada, China,
Korea, U.A.E. and Saudi Arabia, Mural is designed to help reduce the time for
clinical teams to deliver responsive, timely, and compliant care by
digitizing hospital defined protocols, care pathways, and Early
Warning Scores (EWS).
– Microsoft launches a COVID-19 vaccine management platform with partners Accenture and Avanade, EY, and Mazik Global to help government and healthcare customers provide fair and equitable vaccine distribution, administration, and monitoring of vaccine delivery.
– Microsoft Consulting Services (MCS) has deployed
over 230 emergency COVID-19 response missions globally since the pandemic began
in March, including recent engagements to ensure the equitable, secure and
efficient distribution of the COVID-19 vaccine.
With COVID-19 vaccines soon to be available, Microsoft
announced it has launched a COVID-19 vaccine management platform together with
industry partners Accenture, Avandae, EY, and Mazik Global. The COVID-19
vaccine management solutions will enable registration capabilities for patients
and providers, phased scheduling for vaccinations, streamlined reporting, and
management dashboarding with analytics and forecasting.
These offerings are helping public health agencies and
healthcare providers to deliver the COVID-19 vaccine to individuals in an
efficient, equitable and safe manner. The underlying technologies and approach
have been tested and deployed with prior COVID-19 use cases, including contact
tracing, COVID-19 testing, and return to work and return to school programs.
To date, Microsoft
Consulting Services (MCS) has deployed over 230 emergency COVID-19
response missions globally since the pandemic began in March, including recent
engagements to ensure the equitable, secure and efficient distribution of the
COVID-19 vaccine. MCS has developed an offering, the Vaccination Registration
and Administration Solution (VRAS), which advances the capabilities of their
COVID-19 solution portfolio and enables compliant administration of resident
assessment, registration and phased scheduling for vaccine distribution.
Key features of the solutions include:
– tracking and reporting of immunization progress through
secure data exchange that utilizes industry standards, such as Health Level
Seven (HL7), Fast Healthcare Interoperability Resources (FHIR) and open APIs.
– health providers and pharmacies can monitor and report on
the effectiveness of specific vaccine batches, and health administrators can
easily summarize the achievement of vaccine deployment goals in large
Microsoft partners have leveraged the Microsoft cloud to
provide customers with additional offerings to support vaccine management.
These offerings also apply APIs, HL7 and FHIR to enable interoperability and
integration with existing systems of record, artificial intelligence to
generate accurate and geo-specific predictive analytics, and secure
communications using Microsoft Teams.
–EY has partnered with Microsoft for the EY Vaccine
Management Solution to enable patient-provider engagement, supply chain
visibility, and Internet of Things (IoT) real-time monitoring of the vaccines.
Additionally, the EY Vaccine Analytics Solution is an integrated COVID-19 data
and analytics tool supporting stakeholders in understanding population and
geography-specific vaccine uptake.
Mazik Global has created the MazikCare Vaccine Flow that is built on Power Apps and utilizes
pre-built templates to implement scalable solutions to accelerate the mass
distribution of the COVID-19 vaccine. Providers will be able to seek out
specific populations based on at-risk criteria to prioritize distribution.
Patients can self-monitor and have peace of mind to head-off adverse reactions.
– Amazon today announced the launch of Amazon HealthLake,
a new HIPAA-eligible service enables healthcare organizations to store, tag,
index, standardize, query, and apply machine learning to analyze data at
petabyte scale in the cloud.
– Cerner, Ciox Health, Konica Minolta Precision Medicine,
and Orion Health among customers using Amazon HealthLake.
Today at AWS re:Invent, Amazon
Web Services, Inc. (AWS), an Amazon.com company today announced Amazon HealthLake, a
HIPAA-eligible service for healthcare and life sciences organizations. Current
Amazon HealthLake customers include Cerner, Ciox Health, Konica Minolta
Precision Medicine, and Orion Health.
Health data is frequently incomplete and inconsistent, and is often unstructured, with the information contained in clinical notes, laboratory reports, insurance claims, medical images, recorded conversations, and time-series data (for example, heart ECG or brain EEG traces) across disparate formats and systems. Every healthcare provider, payer, and life sciences company is trying to solve the problem of structuring the data because if they do, they can make better patient support decisions, design better clinical trials, and operate more efficiently.
Store, transform, query, and analyze health data in
Amazon HealthLake aggregates an organization’s complete data across various silos and disparate formats into a centralized AWS data lake and automatically normalizes this information using machine learning. The service identifies each piece of clinical information, tags, and indexes events in a timeline view with standardized labels so it can be easily searched, and structures all of the data into the Fast Healthcare Interoperability Resources (FHIR) industry-standard format for a complete view of the health of individual patients and entire populations.
Benefits for Healthcare Organizations
As a result, Amazon HealthLake makes it easier for customers to query, perform analytics, and run machine learning to derive meaningful value from the newly normalized data. Organizations such as healthcare systems, pharmaceutical companies, clinical researchers, health insurers, and more can use Amazon HealthLake to help spot trends and anomalies in health data so they can make much more precise predictions about the progression of the disease, the efficacy of clinical trials, the accuracy of insurance premiums, and many other applications.
How It Works
Amazon HealthLake offers medical providers, health insurers,
and pharmaceutical companies a service that brings together and makes sense of
all their patient data, so healthcare organizations can make more precise
predictions about the health of patients and populations. The new
HIPAA-eligible service enables organizations to store, tag, index, standardize,
query, and apply machine learning to analyze data at petabyte scale in the
Amazon HealthLake allows organizations to easily copy health
data from on-premises systems to a secure data lake in the cloud and normalize
every patient record across disparate formats automatically. Upon ingestion,
Amazon HealthLake uses machine learning trained to understand medical
terminology to identify and tag each piece of clinical information, index
events into a timeline view, and enrich the data with standardized labels
(e.g., medications, conditions, diagnoses, procedures, etc.) so all this
information can be easily searched.
For example, organizations can quickly and accurately find
answers to their questions like, “How has the use of cholesterol-lowering
medications helped our patients with high blood pressure last year?” To do this,
customers can create a list of patients by selecting “High Cholesterol” from a
standard list of medical conditions, “Oral Drugs” from a menu of treatments,
and blood pressure values from the “Blood Pressure” structured field – and then
they can further refine the list by choosing attributes like time frame,
gender, and age. Because Amazon HealthLake also automatically structures all of
a healthcare organization’s data into the FHIR industry format, the information
can be easily and securely shared between health systems and with third-party
applications, enabling providers to collaborate more effectively and allowing
patients unfettered access to their medical information.
“There has been an explosion of digitized health data in recent years with the advent of electronic medical records, but organizations are telling us that unlocking the value from this information using technology like machine learning is still challenging and riddled with barriers,” said Swami Sivasubramanian, Vice President of Amazon Machine Learning for AWS. “With Amazon HealthLake, healthcare organizations can reduce the time it takes to transform health data in the cloud from weeks to minutes so that it can be analyzed securely, even at petabyte scale. This completely reinvents what’s possible with healthcare and brings us that much closer to everyone’s goal of providing patients with more personalized and predictive treatment for individuals and across entire populations.”
PointClickCare announces its intent to acquire Collective Medical to create the
largest combined acute and post-acute care network in North America for $650M.
Collective Medical’s platform connects more than 1,300 hospitals, thousands of
ambulatory practices and long-term post-acute care (LTPAC) providers, as well
as accountable care organizations (ACOs) and every national health plan in the
country, across a 39-state network.
– With the acquisition of Collective Medical, PointClickCare will solidify its position as a high-growth, cloud-based SaaS leader, serving a large, diversified customer base across the acute, ambulatory, post-acute, and payer spectrum.
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, 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 lower cost.
The acquisition follows a partnership, created between the
companies in August 2019, which streamlined the integration of Collective
Medical’s solution for care transitions with PointClickCare’s leading
cloud-based software platform. Hundreds of PointClickCare customers are already
leveraging this connection to the Collective platform to coordinate seamless
care transitions and influence decisions at the point of care.
COVID-19 Underscores Barriers to Care Coordination
Currently, hospitals, ACOs and health plans
lack the data and tools to effectively coordinate with LTPAC providers and
other disparate points of care – an issue spotlighted further by the COVID-19 pandemic.
And despite the healthcare system’s ongoing move to value-based payment
models, barriers to care coordination
persist, especially for seniors and other complex patient populations. Through
this acquisition, the company will be uniquely positioned to address these
PointClickCare supports a network of more than 21,000
skilled nursing facilities, senior living communities and home health agencies.
In the United States, 97 percent of all hospitals discharge patients to skilled
nursing facilities using PointClickCare. Founded in 2005, Collective Medical’s
platform connects more than 1,300 hospitals, thousands of ambulatory practices
and long-term post-acute care (LTPAC) providers, as well as accountable care
organizations (ACOs) and every national health plan in the country, across a
These providers come together via the Collective platform to
support patients suffering from a variety of complex conditions, including
substance use disorder, mental and behavioral health issues, and other care
needs requiring multiple interventions and transitions across disparate care
settings. The combination of PointClickCare and Collective Medical will enable
care to be more seamlessly delivered for the most complex (high-cost,
high-needs) patients, including the rapidly growing aging population.
The acquisition will connect care teams, post-acute
providers, hospitals and health plans with better data about their patients,
ultimately reducing administrative burdens and bringing down the high costs of
complex care. Providers and health plans will be empowered as they work to
solve the complexities around the senior patient population by leveraging
increased information across diagnoses groups and unprecedented access to drive
behavior change at the point of care.
Acquisition Establishes PointClickCare As Leader in Acute and Post-Acute
With the acquisition of Collective Medical, PointClickCare
will solidify its position as a high growth, cloud-based SaaS leader, serving a
large, diversified customer base across the acute, ambulatory, post-acute, and
payer spectrum. As the shift to value-based care fuels growing market demand
for intelligence and collaboration tools, the company will be best positioned
to provide the most fully integrated set of real-time care coordination tools
across the entire continuum of care, powered by the largest network of its kind
in the U.S.
“The healthcare ecosystem is a mix of disconnected providers, systems, plans, processes and data. Healthcare costs and risk are on the rise, while patient care and provider-to-provider coordination are inconsistent. Our mission is to improve the lives of seniors, and we believe the best way to meaningfully advance this goal is by connecting disparate points of care,” says Mike Wessinger, founder and chief executive officer of PointClickCare Technologies. “Collective Medical offers the right fit of people and technology and together we will initiate a new era of data-enriched collaboration across the continuum that radically transforms how data and people are empowered to liberate health.”
The acquisition is subject to receiving regulatory
approvals, including from The Committee on Foreign Investment in the United
States (CFIUS), and other customary closing conditions, and is expected to be
completed by the end of December 2020.
– Today, MEDITECH announced MEDITECH Cloud Platform—a
suite of solutions available to healthcare organizations of all sizes that
further extend the possibilities of the Expanse EHR.
– This offering includes: Expanse NOW, High Availability
SnapShot, and Virtual Care solutions, all created to work naturally in the
cloud, and available through a subscription model.
introduced MEDITECH Cloud Platform—a suite of solutions available to healthcare
organizations of all sizes that further extend the possibilities of the Expanse Electronic Health Record
(EHR). Multiple MEDITECH Cloud
Platform solutions are built on Google Cloud, enabling healthcare organizations
to further personalize their EHR in a way that is secure, reliable, and easy to
Subscription-Based Cloud Model
Healthcare organizations can select one or a combination of
the solutions from MEDITECH Cloud Platform. The flexibility of the subscription
model enables a quick setup as well as the ability to add solutions as needed.
Additionally, the cloud combined with the subscription model provides
opportunities to add solutions in the future.
Expanse NOW is a mobility app that empowers
physicians to manage everyday tasks and coordinate care on their smartphone
device. Integrated with Expanse, tasks and messages can flow between workload
and the app in real time.
High Availability SnapShot provides healthcare
organizations with immediate access to key patient data in the event of
unexpected or planned downtime. Patient information such as medications,
allergies, orders, and more is backed up securely and accessible via
Virtual Care gives new and existing patients access
to urgent virtual care on demand through the healthcare organization’s website,
as well as the ability to schedule virtual visit appointments. New patients who
request Virtual Care are automatically enrolled in the Patient Portal,
connecting them to the organization and in turn, enabling organizations to grow
Leveraging Google Cloud’s Capabilities
The Expanse NOW and High Availability SnapShot solutions
leverage Google Cloud’s core capabilities including compute and storage (as
well as their healthcare-specific data, analytics, security, and identity
management solutions) alongside existing on-prem solutions to provide high
availability and continuity of care in a secure and scalable service. They can
be easily accessible to critical care staff to improve healthcare continuity
across MEDITECH-powered healthcare organizations.
For more information about the MEDITECH Cloud platform,
The COVID-19 pandemic has shed light on the shortcomings of today’s hospital and healthcare IT infrastructure, with many healthcare organizations quickly adopting the latest and greatest technology to support remote operations. However, in the scramble to adapt, many IT leaders did not ensure that the acquired technology integrated well with legacy systems – resulting in underused components and wasted costs. As we enter into a new era in healthcare, it is paramount that these organizations adopt technologies that support overall digital transformation and are fiscally responsible. The IT acquisition journey has taken us from focusing on the speed of components to the speed of the cloud, but we must work to innovate further. To adopt infrastructure that works at the speed of the business, healthcare IT providers must evaluate legacy IT acquisition efforts, the current models, and how they can evolve in the future.
The historic view of acquiring healthcare IT has been to move at the speed of the components. This lifecycle management approach was born out of the perception that acquiring new IT systems were too expensive for the return on investment. The focus was on the management of equipment, licenses, and contracts, causing IT leaders to spend the majority of their time patching and updating existing systems. The inability to predict a system’s capacity for computing, storage, and data meant less time spent on security, which left health systems vulnerable to outside threats.
Today’s Operating Model
Today, the focus has shifted to ensuring IT infrastructure moves at the speed of the cloud. Many hospitals and healthcare organizations have adopted an on-premise cloud and consolidated their licenses, equipment, and contracts to streamline service and reduce maintenance interruptions. This allows IT departments to proactively manage infrastructure capacity while also gaining security hardened systems. The technology management approach provides application-based cost management for healthcare organizations that require a variety of different needs, adjusting the perception of IT to that of service providers. Healthcare organizations that embrace this model are able to move and house their applications based on need, rather than pre-existing equipment constraints, which was unattainable before.
The Future of IT Acquisition
Looking ahead, there is no doubt that hospitals and healthcare organizations need to continue to evolve to maintain seamless operations. With COVID-19 highlighting infrastructure vulnerabilities, it is paramount that IT adjusts for increased technology, network traffic, and security weaknesses. Healthcare organizations that are working through issues with tools, cloud skills, and other obstacles that impede hybrid cloud adoption believe these problems will soon be resolved. With that in mind, it is likely that within the next decade there will be aggressive hybrid cloud adoption across the healthcare industry.
Additionally, in response to shifting priorities, subscription and consumption-based service models are growing in popularity because of their ability to flex up or down to optimize costs and efficiencies. In the future, healthcare organizations must move at the speed of the business as well as meeting community needs, like COVID-19 data reporting and analytics.
Instead of investing in legacy solutions that have proven difficult to manage, healthcare organizations looking to adjust their IT infrastructure can consider adopting numerous “as-a-service” models. For organizations that have specific software, application management, and full system infrastructure needs, Software-as-a-service (SaaS), Platform-as-a-service (PaaS), and Infrastructure-as-a-service (IaaS) are top considerations. Some organizations may only need access to software for a set number of users, rather than full support for the entire system, pointing them to subscription-based software instead of the as-a-service options. Conversely, consumption-based software models are growing in popularity.
Organizations that prefer to pay for applications or devices based on actual usage of the product may prefer this model because it often implies the user pays a certain amount in advance and then draws down against the pre-payment based on their use (“consumption”) of the application. This option allows systems to better budget from the onset, rather than determining costs as the year progresses.
Historically, projects and supporting product offerings are based on yearly budget and funding allotments. That is until the product offerings changed. Software subscriptions, software-as-a-service (anything-as-a-service), and consumption-based services are dramatically impacting the way that IT is purchased, which helps reduce costs.
When looking at healthcare IT spending more broadly, organizations allocate millions of dollars each year, even though they often have mixed experiences in the success of implementations. Since companies usually pay based on project implementation milestones, there are rarely performance clauses. With this in mind, organizations need to hold vendors accountable for successful implementations and first-year operations. In the future, many healthcare organizations will pursue shared risk cost models as they allow the provider to develop system improvements while mitigating costs for the organization.
The COVID-19 pandemic has forever changed how health systems assess and acquire IT infrastructure. With unprecedented amounts of network traffic, telehealth needs, and sensitive patient data, organizations need to prioritize IT planning and acquisition to avoid procurement delays and exorbitant costs. As 2021 budgets are being determined, hospital decision-makers should consider adopting subscription and consumption-based models to help them the best support and protect their data and meet the demands of tomorrow.
About Cheryl Rodenfels
Cheryl Rodenfels is the Healthcare Strategist for Nutanix. She is a seasoned technology executive, responsible for improving customer success and experience across the entire portfolio of Nutanix products and services. Cheryl’s responsibilities include developing the healthcare practice at Nutanix by identifying market opportunities, creating industry-specific training and documentation, enabling sales, and improving technology adoption and solution delivery. Cheryl can be found on LinkedIn.
Healthcare leaders attempting to regain some of the revenue lost during the COVID-19 shutdowns now face a formidable challenge. The American Hospital Association estimates that U.S. hospitals and health systems lost $202.6 billion in just the four months from March 1 through June 30—roughly $50.7 billion per month.
Many variables feed into the overall financial impact for individual healthcare organizations, of course—including geographic location, local ordinances, specialty designations, and speed of service resumption. Regardless, every health system has experienced revenue shortfalls caused by disruptions to their service pipeline. The question now is how to generate enough additional revenue to cover some of those losses without incurring additional operating expenses.
We may be able to take practical inspiration from an unlikely source: the hospitality industry. By solving for something one healthcare organization calls “the motel problem,” health systems can increase workflow efficiency, staff satisfaction, clinic volume, and revenue.
The Motel Problem
Accurately assigning exam rooms with enough flexibility to accommodate continuously changing provider and patient schedules remains a perennial challenge for health systems. In fact, during a recent Porter Research study of 100 executive leaders, roughly two-thirds indicated their health systems lack visibility into exam room utilization.
The leaders of one academic medical center’s 65-physician neurology clinic began referring to this capacity challenge as “the motel problem.” How do motels consistently keep their rooms full of paying customers?. In contrast, their own exam rooms often appeared full on the scheduling spreadsheet but actually sat empty. Staff afraid of accidentally double-booking the space would then let those rooms sit idle.
Despite increasing the administrative time devoted to room management, underutilization in the neurology clinic caused rising patient wait times, lowered physician satisfaction, and decreased revenue. If the Porter Research survey is any indication, this situation is not unique. Approximately 72 percent of the survey’s respondents felt their room utilization rates were significantly subpar. Most said their organizations ran at about 20 points below the 80-89 percent utilization level they deemed optimal.
As the neurology department leadership mused about “the motel problem,” they looked at the similarities between motel and healthcare room management needs. Motels must match each guest to a room with the right accommodations (e.g., two doubles versus one king-sized bed) on the right dates. Health systems must take that same workflow one step further by matching the right patient and the right provider to a properly equipped exam room at the right time. In both cases, empty rooms mean lost revenue. Utilization is key.
Consequently, they came to believe that they needed a system that optimized room capacity with much of the same visibility and flexibility as a hotel or motel reservation system. That would require bringing together data about room availability, room attributes, provider schedules and patient needs—and making the resulting intelligence accessible through real-time displays.
A meaningful solution
When it comes to capacity management within a health system, the real complexity lies with provider and patient schedules. The physical space is always there; it’s the “people” part of the equation that’s fluid. What happens when Dr. Johnson suddenly falls ill, for example? Or Dr. Smith needs to attend a last-minute meeting? Or when patient Mrs. Brown reschedules her appointment?
Clinics typically rely on relatively static spreadsheets or siloed software to track room utilization. But these tools aren’t designed to make such real-time adjustments, especially at the enterprise level—which means the exam rooms assigned to an absent Dr. Johnson or Dr. Smith likely remain empty even as patients wait to be seen by other providers.
On the other hand, an organization’s scheduling system is aware when a provider calls in sick, heads to a meeting, or arrives at the clinic early. With a cloud-based scheduling platform, organizations can achieve near real-time visibility into provider availability across the enterprise.
Consider, then, what can happen when room management software is layered on top of an enterprise scheduling platform. Providers’ movements are then connected to exam room status. The entire organization gains transparency into how providers’ availability affects room availability. That allows staff to quickly and easily move providers into unused rooms and call patients in for appointments faster. Plus, by “tagging” various room attributes—like whether it’s equipped with oxygen or an ENT chair, for instance—such platforms ensure that the proper clinical accommodations are available when providers and patients need them.
Such real-time visualization of room availability can have a substantial impact on health system revenue. One regional health system, for example, calculated that underutilization in its orthopedic clinic costs at least $2,000 per provider per day in lost revenue.
Another large health system quantified the effect from a different perspective. It contemplated how maximizing capacity would enable increased patient throughput without investing in additional space or staff. With that in mind, the organization determined that every one percent increase in utilization results in an annual operational savings of $140,000.
At the neurology clinic, solving “the motel problem” by implementing a solution to standardize capacity generated both revenue growth and increased provider satisfaction. The organization has captured revenue previously missed through underutilization and has recognized that revenue scales directly proportional to volume.
To that end, gaining visibility into capacity has helped the clinic achieve a 7.4 percent increase in patient visits and a 4.7 percent increase in-clinic session volume. As important, providers now trust that the right exam rooms will be ready for them when needed—just like a reservation at a high-end hotel.
About Rich Miller
Rich Miller is the Chief Strategy Officer of QGenda, a healthcare workforce management provider, enabling organizations to optimize capacity across the enterprise. Leading physician groups, hospitals, academic medical centers, and enterprise health systems use QGenda to optimize their workforce which allows them to provide the best possible patient care.
– Google Cloud launches Healthcare Interoperability
Readiness Program to help healthcare organizations achieve healthcare data interoperability.
Google Cloud launched the Google Cloud Healthcare Interoperability Readiness
Program, helping organizations achieve data interoperability in advance of
upcoming HHS deadlines and to enable future innovation. Alongside partners like Bain, BCG, Deloitte, HCL,
KPMG, SADA, and more, the Healthcare Interoperability
Readiness Program will help healthcare organizations understand the current status
of their data and where it resides, map out a path to standardization and
integration, and make use of data in a secure, reliable, compliant manner.
Google Cloud Interoperability Readiness Program
This program provides a comprehensive set of
services for interoperability, including:
– HealthAPIx Accelerator provides
the jumpstart for the interoperability implementation efforts. With best
practices, pre-built templates and lessons learned from our customer and
partner implementations, it offers a blueprint for healthcare stakeholders and
app developers to build FHIR API-based digital experiences.
– Apigee API Management provides the underpinning and enables a security and governance layer to deliver, manage, secure and scale APIs; consume and publish FHIR-ready APIs for partners and developers; build robust API analytics, and accelerate the rollout of digital solutions.
– Google Cloud Healthcare API enables
secure methods (including de-identification) for ingesting, transforming,
harmonizing, and storing your data in the latest FHIR formats, as well as HL7v2
and DICOM, and serves as a secondary longitudinal data store to streamline data
sharing, application development, and analytics with BigQuery.
– Interoperability toolkit that includes solution architectures, implementation guides, sandboxes, and other resources to help accelerate interoperability adoption and streamline compliance with standards such as FHIR R4.
COVID-19 Pandemic Underscores Drive to Accelerate
“With COVID-19 underscoring the importance of even more data sharing and flexibility, the next few years promise to accelerate data interoperability and the adoption of open standards even further—ideally ushering in new and meaningful partnerships across the care continuum, new avenues for business growth, and new pathways for patient-centered innovation,” stated in the announcement blog post.
Each year, Adverse Drug Events (ADE) account for nearly 700,000 emergency department visits and 100,000 hospitalizations in the US alone. Nearly 5 percent of hospitalized patients experience an ADE, making them one of the most common types of inpatient errors. What’s more, many of these instances are hard to discover because they are never reported. In fact, the median under-reporting rate in one meta-analysis of 37 studies was 94 percent. This is especially problematic given the negative consequences, which include significant pain, suffering, and premature death.
While healthcare providers and pharmaceutical companies conduct clinical trials to discover adverse reactions before selling their products, they are typically limited in numbers. This makes post-market drug safety monitoring essential to help discover ADE after the drugs are in use in medical settings. Fortunately, the advent of electronic health records (EHR) and natural language processing (NLP) solutions have made it possible to more effectively and accurately detect these prevalent adverse events, decreasing their likelihood and reducing their impact.
Not only is this important for patient safety, but also from a business standpoint. Pharmaceutical companies are legally required to report adverse events – whether they find out about them from patient phone calls, social media, sales conversations with doctors, reports from hospitals, or any other channel. As you can imagine, this would be a very manual and tedious task without the computing power of NLP – and likely an unintentionally inaccurate one, too.
The numbers reflect the importance of automated NLP technology, too: the global NLP in healthcare and life sciences market size is forecasted to grow from $1.5 billion in 2020 to $3.7 billion by 2025, more than doubling in the next five years. The adoption of prevalent cloud-based NLP solutions is a major growth factor here. In fact, 77 percent of respondents from a recent NLP survey indicated that they use at least one of the four major NLP cloud providers, Google is the most used. But, despite their popularity, respondents cited cost and accuracy as key challenges faced when using cloud-based solutions for NLP.
It goes without saying that accuracy is vital when it comes to matters as significant as predicting adverse reactions to medications, and data scientists agree. The same survey found that more than 40 percent of all respondents cited accuracy as the most important criteria they use to evaluate NLP solutions, and a quarter of respondents cited accuracy as the main criteria they used when evaluating NLP cloud services. Accuracy for domain-specific NLP problems (like healthcare) is a challenge for cloud providers, who only provide pre-trained models with limited training and tuning capabilities. This presents some big challenges for users for several reasons.
Human language very contexts- and domain-specific, making it especially painful when a model is trained for general uses of words but does not understand how to recognize or disambiguate terms-of-art for a specific domain. In this case, speech-to-text services for video transcripts from a DevOps conference might identify the word “doctor” for the name “Docker,” which degrades the accuracy of the technology. Such errors may be acceptable when applying AI to marketing or online gaming, but not for detecting ADEs.
In contrast, models have to be trained on medical terms and understand grammatical concepts, such as negation and conjunction. Take, for example, a patient saying, “I feel a bit drowsy with some blurred vision, but am having no gastric problems.” To be effective, models have to be able to relate the adverse events to the patient and specific medication that caused the aforementioned symptoms. This can be tricky because as the previous example sentence illustrates, the medication is not mentioned, so the model needs to correctly infer it from the paragraphs around it.
This gets even more complex, given the need for collecting ADE-related terms from various resources that are not composed in a structured manner. This could include a tweet, news story, transcripts or CRM notes of calls between a doctor and a pharmaceutical sales representative, or clinical trial reports. Mining large volumes of data from these sources have the power to expose serious or unknown consequences that can help detect these reactions. While there’s no one-size-fits-all solution for this, new enhancements in NLP capabilities are helping to improve this significantly.
Advances in areas such as Named Entity Recognition (NER) and Classification, specifically, are making it easier to achieve more timely and accurate results. ADE NER models enable data scientists to extract ADE and drug entities from a given text, and ADE classifiers are trained to automatically decide if a given sentence is, in fact, a description of an ADE. The combination of NER and classifier and the availability of pre-trained clinical pipeline for ADE tasks in NLP libraries can save users from building such models and pipelines from scratch, and put them into production immediately.
In some cases, the technology is pre-trained with tuned Clinical BioBERT embeddings, the most effective contextual language model in the clinical domain today. This makes these models more accurate than ever – improving on the latest state-of-the-art research results on standard benchmarks. ADE NER models can be trained on different embeddings, enabling users to customize the system based on the desired tradeoff between available compute power and accuracy. Solutions like this are now available in hundreds of pre-trained pipelines for multiple languages, enabling a global impact.
As we patiently await a vaccine for the deadly Coronavirus, there have been few times in history in which understanding drug reactions are more vital to global health than now. Using NLP to help monitor reactions to drug events is an effective way to identify and act on adverse reactions earlier, save healthcare organizations money, and ultimately make our healthcare system safer for patients and practitioners.
About David Talby
David Talby, Ph.D., MBA, is the CTO of John Snow Labs. He has spent his career making AI, big data, and data science solve real-world problems in healthcare, life science, and related fields. John Snow Labs is an award-winning AI and NLP company, accelerating progress in data science by providing state-of-the-art models, data, and platforms. Founded in 2015, it helps healthcare and life science companies build, deploy, and operate AI products and services.
CVS Health Corporation names Neela Montgomery Executive Vice President and President of CVS Pharmacy/Retail, effective November 30, 2020. Montgomery will oversee the company’s 10,000 pharmacies across the United States. Montgomery, currently a Board Partner at venture capital firm Greycroft, most recently served as chief executive officer of furniture retailer Crate & Barrel and has nearly 20 years of global retail experience.
The Cleveland Clinic and Amwell joint venture appoint Egbert van Acht as Executive Vice Chairman to the Board of Directors and Frank McGillin as CEO. Formed one year ago as a first-of-its-kind company to provide broad access to comprehensive, high-acuity care via telehealth, the company has made great progress scaling digital care through its MyConsult® offering. With an initial focus on clinical second opinions, the organization also offers health information and diagnosis on more than 2,000 different types of conditions including cancer, cardiac, and neuroscience issues.
Healthcare industry veteran Dana Gelb Safran, Sc.D. has joined Well Health Inc. as Senior Vice President, Value-Based Care, and Population Health. In her new role, Dr. Safran will expand WELL’s uses to improve healthcare quality, outcomes, and affordability through partnerships with payers and Accountable Care Organization (ACO) providers.
Talkdesk®, Inc., the cloud contact center for innovative enterprises appoints Cory Haynes to lead Talkdesk’s strategy for the financial service industry and Greg Miller to lead the strategy for healthcare and life sciences. Haynes and Miller are key members of the Talkdesk industries team led by Andrew Flynn, senior vice president of industries strategy for Talkdesk.
Imprivata appoints Mark McArdle to Senior Vice President of Products and Design. Mr. McArdle has more than two decades of experience in software development, Software-as-a-Service (Saas), in Cybersecurity, and advanced products for the enterprise, SMB, and consumer markets.
Eden Health names Jack Stoddard as executive chairman of its board of directors. Formerly serving in COO roles for Accolade and Haven, Stoddard brings two decades of healthcare innovation and operating experience to the board position, providing leadership, wisdom, and counsel during a time of monumental growth and adoption for the company.
Augmedix names Saurav Chatterjee Chief Technology Officer. Prior to joining Augmedix, he most recently served as Vice President of Engineering at Lumiata, Inc., where he led the engineering team that built a leading AI platform, focusing specifically on transforming, cleaning, enriching, featurizing, and visualizing healthcare data, and on building, deploying and operationalizing machine learning and deep-learning models at scale.
Tridiuum, the nation’s premier provider of digital behavioral health solutions names Philip Vecchiolli has joined the company as Chief Growth and Strategy Officer. Vecchiolli, who brings over 30 years of experience to the new role, has a successful track record of leading business development for large and mid-size healthcare companies.
Connect America appoints Janet Dillione as its new chief executive officer (CEO). Prior to joining Connect America, Dillione worked in the healthcare information services industry as CEO of Bernoulli Enterprise, Inc., GM of Nuance Healthcare, and CEO of Siemens Healthcare IT.
Health Catalyst, Inc. announces that current Chief Financial Officer Patrick Nelli has been named President, effective January 1, 2021. Following Nelli’s promotion to the President role, Health Catalyst has named Bryan Hunt, current Senior Vice President of Financial Planning & Analysis, Chief Financial Officer, also effective January 1, 2021.
Two additional promotions, also effective January 1, 2021, include Jason Alger, Senior Vice President of Finance, to Chief Accounting Officer, and Adam Brown, Senior Vice President of Investor Relations, to Senior Vice President of Investor Relations and Financial Planning & Analysis.
Apervita hires health IT veteran Rick Howard as Chief Product Officer. In his role, Rick will oversee product vision, innovation, design, and delivery of Apervita’s digital platform, which enables digital quality measurement, clinical intelligence, as well as value-based contract monitoring and performance measurement.
Conversion Labs, Inc. appoints Roberto Simon to its board of directors and as the chair of its audit committee. Following his appointment, the board now has eight members, with six serving as independent directors. Mr. Simon currently serves as CFO of WEX (NYSE: WEX), a $6+ billion fintech services provider.
PRA Health Sciences, Inc. appoints senior FDA official Isaac Rodriguez-Chavez, Ph.D., MHS, MS, as Senior Vice President, Scientific and Clinical Affairs. He will lead the company’s Global Center of Excellence for Decentralized Clinical Trial (DCT) Strategy. Dr. Rodriguez-Chavez’s responsibilities will involve the continued growth and development of PRA’s industry-leading decentralized clinical trial strategy, regulatory framework creation, and clinical trial modernization.
Proprio appoints three global thought leaders to its Medical Advisory Board. Dr. Sigurd Berven, Orthopedic Surgeon and Professor at the University of California, San Francisco, Dr. Charles Fisher, Professor and Head of the Combined Neurosurgical & Orthopedic Spine Program at Vancouver General Hospital and the University of British Columbia, and Dr. Ziya Gokaslan, Professor and Chair of the Department of Neurosurgery at Brown University and Neurosurgeon-in-Chief at Rhode Island Hospital and The Miriam Hospital will apply their globally respected surgical and research expertise to the development of the Proprio navigation platform.
Kaiser Permanente names Andrew Bindman, MD Executive Vice President and Chief Medical Officer. In this role, Dr. Bindman will collaborate with clinical and operational leaders throughout the enterprise to help lead the organization’s efforts to continue improving the high-quality care provided to members and patients throughout Kaiser Permanente. Dr. Bindman will report directly to Kaiser Permanente chairman and CEO Greg A. Adams.
Greenway names Dr. Michael Blackman Chief Medical Officer at Greenway. Dr. Blackman will further support the company’s ambulatory care customers, ensuring providers are equipped with the solutions and services they need to improve patient outcomes and succeed in value-based care.
Suki expands its leadership team with six key hires to support the company’s rapid commercial growth. Tracy Rentz, formerly Vice President of Implementation at Evolent Health, joins Suki as the Vice President of Customer Success and Operations to lead all customer operations, with a particular focus around deploying new Suki customers. Brian Duffy brings over 20 years of sales experience to Suki, joining the team as Director of Sales-East, after having most recently served as Regional Director at Qventus, Inc. Brent Jarkowski will also join Suki’s sales team this November as the Director of Sales-West, bringing over 15 years of experience in strategic relationship management. Brent joins Suki after serving as Senior Client Development Director at Kyyrus. Together, Brian and Brent will head the company’s efforts in building new partnerships across the country. And Josh Margulies, who previously served as the Director of Integrated Brand Marketing for the Jacksonville Jaguars, will serve as Suki’s new Senior Director of Field Marketing.
– Microsoft launches a dedicated HealthTech Startup Program and partners with startup incubator Social Alpha to accelerate the growth of healthtech startups in India.
– Selected startups into the program will benefit from
focused healthcare industry teams, co-innovation and collaboration, and
Microsoft AI for healthcare.
Today, Microsoft has announced the launch of a
startup program to drive healthcare innovation in India. India faces an
increasing number of healthcare challenges with a lack of infrastructure,
uneven doctor to patient ratio, and an increase in demand for healthcare
services. The program is designed
to help startups
scale with advanced technology and joint go-to-market support.
Startup Program Approach
Spread across three tiers,
the program offers a range of benefits:
– All startups: Qualified Seed to Series C startups can boost
their business with Azure benefits (including free credits), unlimited
technical support and go-to-market resources with support for Azure Marketplace
startups: Startups with
enterprise-ready solutions can scale quickly with joint go-to-market
strategies, technical support and new sales opportunities with Microsoft’s
– Co-build startups: Startups that are looking to create healthcare solutions have access to Microsoft Cloud for Healthcare, the first industry-specific cloud that brings together trusted and integrated capabilities to enrich patient engagement and connects teams for improved collaboration, decision-making, and operational efficiencies
Being forced by the global pandemic to rethink how healthcare services across the world operate, startups in this industry are reimagining solutions for some of the most pressing healthcare challenges. Technology innovation with advanced data and analytics capabilities is a critical enabler as we build trusted and reliable solutions at scale. The Microsoft for Healthtech Startups program deepens our focus on specific industries and is aimed to accelerate the growth journeys of startups with the best tech enablement and business resources,” said Sangeeta Bavi, Director – Startup Ecosystem, Microsoft India.
Partnership with Startup Incubator Social Alpha
In addition to the healthtech program launch, Microsoft is also collaborating with startup incubator Social Alpha to accelerate the growth of participating startups. To date, Social Alpha has supported over 20 healthtech startups working across devices, diagnostics, treatment, access and quality/UX.
The collaboration with Social Alpha will provide healthtech
startups programmatic support through product innovation labs, sandbox pilots
and structured incubation initiatives that offer knowledge services, bootcamps
and masterclass sessions with mentors as well as tech and industry experts.
As the startups accelerate, they receive access to
go-to-market resources, ecosystem networking, angel networks and investor
forums. Social Alpha supports entrepreneurs and innovators that enable social,
economic and environmental change through their ‘lab to market’ journey by
building access to technology and business incubation initiatives.
– Nuance announced that it’s planning to sell
two sections of its healthcare business – Health Information Management (HIM)
and Electronic Health Record (EHR) Go-Live Services – to a new independent
company, called DeliverHealth, in early 2021.
– Nuance will be a minority shareholder of DeliverHealth
and continue to provide its technology to the company.
The HIM Transcription business includes both Nuance Transcription Services (NTS) and the eScription technology platform. The transaction is expected to be completed in early 2021. As part of the self-off, Nuance will be a minority shareholder of DeliverHealth and will continue to provide its technology to the company. DeliverHealth plans to build on HIM, transcription, technology and EHR services already in place while expanding into intelligent, technology-enabled revenue cycle automation and clinical documentation improvement services within the EHR’s workflow in 2021. DeliverHealth will include both Nuance Transcription Services (NTS) and the eScription technology platform. Financial details of the transaction were not disclosed.
Sell-Off Accelerate Growth as Conversational AI Market
demonstrates Nuance’s continuing execution to focus R&D investments in the
healthcare and enterprise markets – where the company has substantial
competitive advantages and opportunities for growth and value creation. In
2019, for example, Nuance sold its document imaging business to Kofax and
spun-off its automotive business into Cerence, Inc., an independent,
Nuance’s goal with the sale is to enable:
– Existing customers with continued service quality, newly
expanded offerings, and enhancements from DeliverHealth in close collaboration
– Nuance to focus its innovation and market resources as a
pure-play conversational AI market leader while providing continuity of EHR
Go-Live Services and HIM Transcription businesses to existing and new customers
– DeliverHealth to leverage a leading position in healthcare
professional and technology-enabled services, expand global market share,
advance growth plans for the EHR Go-Live and Optimization Services, and provide
enhanced HIM technology and services to a worldwide market in partnership with
Nuance’s growth and market leadership in healthcare are
driven by the accelerating adoption and development of its core cloud-based AI
solutions, including the Nuance® Dragon® Ambient eXperience™ (Nuance DAX™)
ambient clinical intelligence (ACI) solution, Nuance Dragon Medical One, Nuance
CDE One, and its array of diagnostic imaging solutions such as PowerScribe One™
“The dramatic acceleration in the digital transformation of healthcare continues as organizations deploy the power of conversational AI and deeply integrated cloud-based solutions at scale to address physician burnout, expand patient access, and improve system efficiencies and the revenue cycle,” said Mark Benjamin, CEO of Nuance. “With this strategic transaction, we’re aligning our resources to increase our market and technical leadership position in high-growth, high-impact areas that help our customers in a transformative way to improve patient care and operational performance. At the same time, we’re enabling the medical transcription and EHR Go-Live Services businesses to reach their full potential as a separate, focused company benefiting from the enhanced investment and operational experience of AHP and Aeries and technology support from Nuance.”
– Nuance Communications, Inc. and one of the country’s
largest health systems, Providence, announced a strategic collaboration,
supported by Microsoft, dedicated to creating better patient experiences and ease
– The collaboration centers around Providence harnessing
Nuance’s AI-powered solutions to securely and automatically capture
– As part of the expanded partnership, Nuance and
Providence will jointly innovate to create technologies that improve health
system efficiency by reducing digital friction.
Nuance® Communications, Inc. and Providence, one of the largest health systems in the
country, today announced a strategic collaboration to improve both the patient
and caregiver experience. As part of this collaboration, Providence will
build on the long-term relationship with Nuance to deploy Nuance’s cloud
solutions across its 51-hospital, seven-state system. Together, Providence and
Nuance will also develop integrated clinical intelligence and enhanced revenue cycle
Enhancing the Clinician-Patient Experience
In partnership with Nuance, Providence will focus on the clinician-patient experience by harnessing a comprehensive voice-enabled platform that through patient consent uses ambient sensing technology to securely and privately listen to clinician-patient conversations while offering workflow and knowledge automation to complement the electronic health record (EHR). This technology is key to enabling physicians to focus on patient care and spend less time on the increasing administrative tasks that contribute to physician dissatisfaction and burnout.
“Our partnership with Nuance is helping Providence make it easier for our doctors and nurses to do the hard work of documenting the cutting-edge care they provide day in and day out,” said Amy Compton-Phillips, M.D., executive vice president and chief clinical officer at Providence. “The tools we’re developing let our caregivers focus on their patients instead of their keyboards, and that will go a long way in bringing joy back to practicing medicine.”
Providence to Expand Deployment of Nuance Dragon Medical
To further improve healthcare experiences for both providers
and patients, Providence will build on its deployment of Nuance Dragon
Medical One with the Dragon Ambient eXperience (DAX). Innovated by Nuance and
Microsoft, Nuance DAX combines Nuance’s conversational AI technology with
Microsoft Azure to securely capture and contextualize every word of the patient
encounter – automatically documenting patient care without taking the
physician’s attention off the patient.
Providence and Nuance to Jointly Create Digital Health
As part of the expanded partnership, Nuance and Providence
will jointly innovate to create technologies that improve health system
efficiency by reducing digital friction. This journey will begin with the
deployment of CDE One for Clinical Documentation Integrity workflow management,
Computer-Assisted Physician Documentation (CAPD), and Surgical CAPD, which
focus on accurate clinician documentation of patient care. Providence will also
adopt Nuance’s cloud-based PowerScribe One radiology reporting solution to
achieve new levels of efficiency, accuracy, quality, and performance.
Why It Matters
By removing manual note-taking, Providence enables deeper
patient engagement and reduces burdensome paperwork for its clinicians. In
addition to better patient outcomes and provider experiences, this
collaboration also serves as a model for the deep partnerships needed to
Interoperability in healthcare is a national disgrace. After more than three decades of effort, billions of dollars in incentives and investments, State and Federal regulations, and tens of thousands of articles and studies on making all of this work — we are only slightly better off than we were in 2000.
Decades of failed promises and dozens of technical, organizational, behavioral, financial, regulatory, privacy, and business barriers have prevented significant progress and the costs are enormous. The Institute of Medicine and other groups put the national financial impact somewhere between tens and hundreds of billions of dollars annually. Without pervasive and interoperable secure communications, healthcare is missing the productivity gains that every other industry achieved during their internet, mobile, and cloud revolutions.
The Human Toll — On Both Patients and Clinicians
Too many families have a story to tell about the dismay or disaster wrought by missing or incomplete paper medical records, or frustration by the lack of communications between their healthcare providers. In an era where we carry around more computing power in our pockets than what sent Americans to the moon, it is mystifying that we can’t get our doctors digitally communicating.
I am one of the many doctors who are outraged that the promised benefits of Electronic Medical Records (EHRs) and Health Information Exchanges (HIEs) don’t help me understand what the previous doctor did for our mutual patient. These costly systems still often require that I get the ‘bullet’ from another doctor the same way as my mentors did in the 1970s.
This digital friction also has a profoundly negative impact on medical research, clinical trials, analytics, AI, precision medicine, and the rest of health science. The scanned PDF of a fax of a patient’s EKG and a phone call may be enough for me to get the pre-op done, but faxes and phone calls can’t drive computers, predictive engines, multivariate analysis, public health surveillance programs, or real-time alerting needed to truly enable care.
Solving the Surround
Many companies and government initiatives have attempted to solve specific components of interoperability, but this has only led to a piecemeal approach that has thus far been overwhelmed by market forces. Healthcare interoperability needs an innovation strategy that I call “Solving the Surround.” It is one of the least understood and most potent strategies to succeed at disruptive innovation at scale in complex markets.
“Solving the Surround” is about understanding and addressing multiple market barriers in unison. To explain the concept, let’s consider the most recent disruption of the music industry — the success of Apple’s iPod.
The iPod itself did not win the market and drive industry disruption because it was from Apple or due to its great design. Other behemoths like Microsoft and Philips, with huge budgets and marketing machines, built powerful MP3 players without market impact. Apple succeeded because they also ‘solved the surround’ — they identified and addressed numerous other barriers to overcome mass adoption.
Among other contributions, they:
– Made software available for both the PC and Mac
– Delivered an easy (and legal) way for users to “rip” their old CD collection and use the possession of music on a fixed medium that proved legal “ownership”
– Built an online store with a massive library of music
– Allowed users to purchase individual tracks
– Created new artist packaging, distribution, licensing, and payment models
– Addressed legalities and multiple licensing issues
– Designed a way to synchronize and backup music across devices
In other words, Apple broke down most of these barriers all at once to enable the broad adoption of both their device and platform. By “Solving the Surround,” Apple was the one to successfully disrupt the music industry (and make way for their iPhone).
The Revolution that Missed Healthcare
Disruption doesn’t happen in a vacuum. The market needs to be “ready” to replace the old way of doing things or accept a much better model. In the iPod case, the market first required the internet, online payment systems, pervasive home computers, and much more. What Apple did to make the iPod successful wasn’t to build all of the things required for the market to be ready, but they identified and conquered the “surround problems” within their control to accelerate and disrupt the otherwise-ready market.
Together, the PC, internet, and mobile revolutions led to the most significant workforce productivity expansion since WWII. Productivity in nearly all industries soared. The biggest exception was in the healthcare sector, which did not participate in that productivity revolution or did not realize the same rapid improvements. The cost of healthcare continued its inexorable rise, while prices (in constant dollars) leveled off or declined in most other sectors. Healthcare mostly followed IT-centric, local, customized models.
Solving the Surround for Healthcare Interoperability
‘Solving the Surround’ in healthcare means tackling many convoluted and complex challenges.
Here are the nine things that we need to conquer:
1. Simplicity — All of the basics of every other successful technology disruptor are needed for Health communications and Interoperability. Nothing succeeds at a disruption unless it is perceived by the users to be simple, natural, intuitive, and comfortable; very few behavioral or process changes should be required for user adoption.
Simplicity must not be limited to the doctor, nurse, or clerical users. It must extend to the technical implementation of the disruptive system. Ideally, the new would seamlessly complement current systems without a heavy lift. By implication, this means that the disruptive system would embrace technologies, workflows, protocols, and practices that are already in place.
2. Ubiquity — For anything to work at scale, it must also be ubiquitous — meaning it works for all potential players across the US (or global) marketplace. Interoperability means communicating with ease with other systems. Healthcare’s next interoperability disruptor must work for all healthcare staff, organizations, and practices, regardless of their level of technological sophistication. It must tie together systems and vendors who naturally avoid collaboration today, or we are setting ourselves up for failure.
3. Privacy & Security — Healthcare demands best-in-class privacy and security. Compliance with government regulations or industry standards is not enough. Any new disruptive, interoperable communications system should address the needs of different use cases, markets, and users. It must dynamically provide the right user permissions and access and adapt as new needs arise. This rigor protects both patients from unnecessary or illegal sharing of their health records and healthcare organizations in meeting privacy requirements and complying with state and federal laws.
4. Directory — It’s impossible to imagine ubiquitous national communications without a directory. It is a crucial component for a new disruptive system to connect existing technologies and disparate people, organizations, workflows, and use cases. This directory should maintain current locations, personnel, process knowledge, workflows, technologies, keys, addresses, protocols, and individual and organizational preferences. It must be comprehensive at a national level and learn and improve with each communication and incorporate each new user’s preferences at both ends of any communication. Above all, it must be complete and reliable — nothing less than a sub-1% failure rate.
5. Delivery — Via the directory, we know to whom (or to what location) we want to send a notification, message, fetch request or record, but how will it get there? With literally hundreds of different EHR products in use and as many interoperability challenges, it is clear that a disruptive national solution must accommodate multiple technologies depending on sender and recipient capabilities. Until now, the only delivery “technology” that has ensured reliable delivery rates is the mighty fax machine.
With the potential of a large hospital at one end and a remote single-doctor practice at the other, it would be unreasonable to take a one size fits all approach. The system should also serve as a useful “middleman” to help different parties move to the model (in much the same way that ripping CDs or iTunes gave a helping hand to new MP3 owners). Such a delivery “middleman” should automatically adapt communications to each end of the communication’s technology capabilities, needs, and preferences..
6. Embracing Push — To be honest, I think we got complacent in healthcare about how we designed our technologies. Most interoperability attempts are “fetch” oriented, relying on someone pulling data from a big repository such as an EHR portal or an HIE. Then we set up triggers (such as ADTs) to tell someone to get it. These have not worked at scale in 30+ years of trying. Among other reasons, it has been common for even hospitals to be reluctant to participate fully, fearing a competitive disadvantage if they make data available for all of their patients.
My vision for a disruptive and innovative interoperability system reduces the current reliance on fetch. Why not enable reliable, proactive pushing of the right information in a timely fashion on a patient-by-patient basis? The ideal system would be driven by push, but include fetch when needed. Leverage the excellent deployment of the Direct Trust protocol already in place, supplement it with a directory and delivery service, add a new digital “middleman,” and complement it with an excellent fetch capability to fill in any gaps and enable bi-directional flows.
7. Patient Records and Messages — We need both data sharing and messaging in the same system, so we can embrace and effortlessly enable both clinical summaries and notes. There must be no practical limits on the size or types of files that can easily be shared. We need to help people solve problems together and drive everyday workflows. These are all variations of the same problem, and the disruptor needs to solve it all.
8. Compliance — The disruptor must also be compliant with a range of security, privacy, identity, interoperability, data type, API, and many other standards and work within several national data sharing frameworks. Compliance is often showcased through government and vendor certification programs. These programs are designed to ensure that users will be able to meet requirements under incentive programs such as those from CMS/ONC (e.g., Promoting Interoperability) or the forthcoming CMS “Final Rule” Condition of Participation (CoP/PEN), and others. We also must enable incentive programs based on the transition to value-based and quality-based care and other risk-based models.
9. On-Ramp — The iPod has become the mobile phone. We may use one device initially for phone or email, but soon come to love navigation, music, or collaboration tools. As we adopt more features, we see how it adds value we never envisioned before — perhaps because we never dreamed it was possible. The healthcare communications disruptor will deliver an “On-Ramp” that works at both a personal and organizational scale. Organizations need to start with a simple, driving use case, get early and definitive success, then use the same platform to expand to more and more use cases and values — and delight in each of them.
So here we are, decades past the PC revolution, with a combination of industry standards, regulations, clinician and consumer demand, and even tens of billions in EHR incentives. Still, we have neither a ‘killer app’ nor ubiquitous medical communications. As a result, we don’t have the efficiency nor ease-of-use benefits from our EHRs, nor do we have repeatable examples of improved quality or lower errors — and definitively, no evidence for lower costs.
I am confident that we don’t have a market readiness problem. We have more than ample electricity, distributed computing platforms, ubiquitous broadband communications, and consumer and clinician demand. We have robust security, legal, privacy, compliance, data format, interoperability, and related standards to move forward. So, I contend that our biggest innovation inhibitor is our collective misunderstanding about “Solving the Surround.”
Once we do that, we will unleash market disruption and transform healthcare for the next generation of patient care.
About Peter S. Tippett
Dr. Peter Tippett is a physician, scientist, business leader, and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
He was a member of the President’s Information Technology Advisory Committee (PITAC) under G.W. Bush, and served with both the Clinton Health Matters and NIH Precision Medicine initiatives. Throughout his career, Tippett has been recognized with numerous awards and recognitions — including E&Y Entrepreneur of the Year, the U.S. Chamber of Commerce “Leadership in Health Care Award”, and was named one of the 25 most influential CTOs by InfoWorld.
Tippett is board certified in internal medicine and has decades of experience in the ER. As a scientist, he created the first synthetic immunoglobulin in the lab of Nobel Laureate Bruce Merrifield at Rockefeller University.
KLAS recently issued a Spotlight on Zoom for healthcare. KLAS Spotlights are first looks at new and emerging technology. Everyone knows Zoom, but how well does the solution perform for healthcare organizations looking to handle the immediate demands created by COVID-19 as well as develop long-term strategic initiatives? In this Spotlight, KLAS examines the early outcomes and satisfaction of some of Zoom’s healthcare customers.
Zoom Key Strengths & Challenges for Healthcare
– Works as promoted
– Clients see value
in the solution
– Quick implementations, easy initial setup
– Phone/web support less responsive due to extreme growth
– Lacks some bells and whistles other telemedicine products
– Security is a concern for some
KLAS outlines four key points to ponder for healthcare
organizations considering Zoom:
1. The Solution’s Long-Term Viability in Healthcare
In order to remain competitive in healthcare, Zoom will need
to improve the solution’s integration with EHRs and medical devices and also
make it easier for patients to connect to a telehealth session.
2. Impacts and Tradeoffs of the Underlying Technology
Zoom recently adopted Oracle Cloud and also maintains the
use of AWS and Azure cloud services. The mobile apps are developed in Java
(Android) and Swift (iOS). The Zoom environment accommodates both failover and
load-balancing services to support effective and reliable service response
Governance is a key factor in driving success with both
telehealth and teleconference capabilities. Guidance for how these capabilities
will be used internally and externally will need to be established.
4. Telehealth vs. Teleconference
Healthcare organizations require both telehealth and teleconference capabilities to effectively communicate with their staff and patients. Zoom must improve its enterprise application integration and medical device connectivity to compete in the exploding telehealth market.
– Apstar Pharma acquires the assets of respiratory health company Cohero Health to expands its digital portfolio with a focus on respiratory disease management.
– Cohero Health develops digital tools and technologies to improve respiratory care, reduce avoidable costs, and optimize medication utilization.
AptarGroup, Inc., a global leader in consumer dispensing, active packaging, drug delivery solutions, and services, announces that it has acquired all operating assets and the proprietary portfolio of Cohero Health, Inc. (“Cohero Health”), a digital therapeutics company transforming respiratory disease management for asthma and chronic obstructive pulmonary disorder (COPD). Financial details of the acquisition were not disclosed.
Start breathing smarter
Founded in 2013, New York-based Cohero Health develops innovative digital tools and technologies to improve respiratory care, reduce avoidable costs, and optimize medication utilization. With this transaction, Aptar Pharma acquires Cohero Health’s turnkey digital health platform and device assets including:
· BreatheSmart Connect digital health platform – care coordination and HIPAA-compliant SaaS cloud service which captures and securely stores data from Cohero Health’s devices and BreatheSmart® software for remote monitoring and patient communications to help manage patient therapy;
· BreatheSmart® App – designed for patient habit creating and behavior change, driving appropriate medication utilization. Provides real-time tracking of medication adherence and lung function, along with reminders, educational materials, and symptom/trigger recording;
HeroTracker® Sensors – Bluetooth enabled medication smart inhaler sensors
designed for both control and rescue medications. Attaches to respiratory
medications to automatically record time and date of doses taken
· mSpirometer™ and cSpirometer™lung function diagnostic sensors – enable comprehensive pulmonary lung function testing in a handheld wireless device.
Acquisition Expands Aptar’s Digital Portfolio
“Cohero Health further strengthens and expands Aptar’s digital portfolio, in this case, with a focus in respiratory disease management,” commented Sai Shankar, Aptar Pharma’s Vice President, Global Digital Healthcare Systems. “Aptar has made previous investments in digital respiratory company Sonmol in China and digital health company Navia Life Care in India. With this strategic bolt on, Aptar now has global capabilities to deploy digital respiratory health, utilizing either the Cohero or Aptar device portfolio/platform. The investment will also facilitate Aptar’s ability to provide diagnostic solutions in respiratory and a significant number of other disease categories.”
– Cardiac patients and their cardiologists are
experiencing a high number of false positives with remote patient monitoring
devices as a result of signal artifact providing inaccurate data, which can
lead to many complications—other than medical, such as unnecessary tests and
increased medical costs.
– Ambulatory cardiac monitoring provider InfoBionic has devised a way to decrease false positives and increase efficiency.
Remote cardiac monitoring’s false positives—especially on atrial fibrillation (Afib)—hurt everyone, from the patient to the boss who will have to go without an employee when he or she has to go in for unnecessary tests. An estimated 12.1 million people in the United States will have Afib by 2030; Afib increases the risk of stroke, heart failure, and death, and is one of the few cardiac conditions that continue to rise.(1) “We must give the clinician more effective diagnoses, while at the same time increasing confidence in our healthcare technology systems with respect to the accuracy of the same patient data,” expressed Stuart Long, CEO of InfoBionic, a provider of ambulatory cardiac monitoring services.
Impact of Remote
Patient Monitoring on Afib
Afib is a “fluttering feeling that can point to a quivering heart muscle, a notable skipped beat as the mark of a palpitation, and a racing heart rate that sparks other discomforts.” (2) With the rise of remote patient monitoring (RPM) as an effective and economical modality to treat and monitor patients, false positives continue to rise to generate a lack of confidence in the accurate clinical data captured through RPM. False positives can overwhelm the clinician and result in the increased use of resources and downstream costs, and false negatives could have detrimental clinical consequences.(3)
Without a reliable RPM supported by powerful AI solutions, healthcare payers experience higher costs. Heart disease takes an economic toll, as well, costing the nation’s healthcare system $214 billion per year and consuming $138 billion in lost productivity on the job. (4) The cascading effect of false positives run the gamut of the human experience—from the physical and emotional health of the patient to the added out-of-pocket expenses of unnecessary and avoidable tests.
The increased risks of hospital readmissions at a time when healthcare systems are overtaxed and understaffed adds another factor of what could have been an unneeded situation. “InfoBionic AI has all but eliminated the need for physicians to deal with false positives. In fact, 100% of Atrial Fibrillation events longer than 30 seconds are detected accurately (true positive) by InfoBionic’s AI system(6),” said Long.
leveraging cloud computing with continuous arrhythmia monitoring to create a
reliable platform with accurate data collection, an ambulatory cardiac monitor,
such as the MoMe® Kardia device, optimizes AI solutions,
allowing for consistency in the treatment. Integrated sensor measures have been
shown to predict heart failure and might have the potential to
empower patients to participate in their own care.(5) Offering
24-hour monitoring through RPM technology that reduces false positives leads to
the patient becoming more comfortable with the RPM service, which increases the
likelihood the patient will adopt the practice of self-care well into the
future. Cardiac patients with pulmonary or electrolyte problems may need
continuous cardiac monitoring to screen for arrhythmias.
“A primary feature of our MoMe® Kardia is its ability to leverage technology in a way that makes physicians feel more confident via analysis precision that verifies detected cardiac episodes through the algorithm,” said Long. Another distinct advantage is the ability to provide 6 lead analysis instead of the 1 or 2 leads provided by other systems. This affords the physician a much better view of each heartbeat, thereby increasing physician confidence in the accuracy of diagnosis.
provides valuable clinical statistics that guide treatment with the best
patient outcomes. As the leading provider to collect every heartbeat and
transmit it to the cloud in near real time, explains Long, InfoBionic’s AI
algorithms are informed by over 15 million hours of electrocardiogram (ECG)
collected from the entire patient population. With full disclosure transmission
that allows AI algorithms to run on powerful servers in the cloud, the system
utilizes much more intensive processing than could be accomplished on other
patient-worn devices. Multiple patented algorithms are run concurrently on the
ECG stream, each with superior performance on a variety of clinical conditions.
With its share price falling from more than $66 to less than $24, September was a tumultuous month for Nanox.
On August 25th, the medical imaging start-up closed its initial public offering, having raised $190m from the sale of 10,555,556 ordinary shares at a price of $18 each. Money poured in as investors were sold on Nanox’s cold cathode x-ray source and the subsequent reduction in costs that it would enable, as well as the vendor’s pay-per-scan pricing model that would let the company access new, untapped markets.
A week later the shares were being traded for almost double their opening amount, and by the 11th of September, they had reached a peak of $66.67. This meteoric rise soon came to an end though, as activist short-seller Andrew Left of Citron Research published a report comparing the Israeli start-up to disgraced medical testing firm Theranos and asserted that the company’s shares were worthless.
Other commentators added to Left’s criticism, causing investors to abandon the stock. Class action lawsuits followed, with legal firms hoping to defend shareholders against the imaging company’s alleged fabrication of commercial agreements and of misleading investors.
Nanox defended itself against the Citron attack, insisting that the allegations in the report are ‘completely without merit’, but the extra scrutiny and threat of legal repercussions have left the share price continuing to plummet, falling to $23.52 at month’s end.
– New business and payment models could capture demand from new customers in untapped and emerging markets
– Vendors should be reactive. A successful launch of Nanox’s X-ray system could channel more focus and resources on the portfolio of low-end X-ray systems
– Once established, recurring services are hard to displace
– However, brand loyalty and hard-earned reputations aren’t easily forgotten
– Potential for disruptive technology to expand access to medical imaging and provide affordable X-ray digital solutions, delivering a significant and rapid overall market expansion
– New customer bases could have less expertise and a lack of trained professionals – ease of use becomes a critical feature
– Where X-ray system price is a battleground, and a fundamental factor driving purchasing decisions, Nanox’s proposed ecosystem offers revenue-generating opportunities
The Signify View
Assessing the viability and long-term potential of any business is a dangerous game, doubly so if it depends on a closely guarded game-changing technological innovation as is the case with Nanox. Fortunes are won and lost on a daily basis by investors, speculators, and gamblers trying to get in on the ground floor of the next ground-breaking company after being convinced by slick presentations and thorough prospectuses.
There is likely merit in some of the arguments being put forward by those on either side of the Nanox debate. For example, the lack of peer-reviewed journal articles about new technology is questionable. But, the skepticism around the feasibility of Nanox’s technology seems to ignore that research into cold-cathode x-ray generation, the cornerstone of Nanox’s offering has been ongoing for numerous years, and isn’t as out of the blue as the naysayers may suggest.
Regardless of these and other specifics in the ongoing fracas between short-sellers, Nanox, investors, and lawyers, all of whom have their own agendas, the voracity with which the stocks were initially purchased shows the keen appetite investors have for a company that would bring disruption to the X-ray systems market.
When delving into Signify Research’s data on this market, it is easy to see why. Across many developed and mature regions, the market has become relatively stable. It is one of replacement and renewal rather than selling to new customers and increasing the accessibility of X-ray imaging. Developed markets do continue to drive growth for X-ray manufacturers to some extent, particularly as a result of digitalization and favored reimbursement for digital X-ray imaging. However, by and large, the market remains broadly flat, with a CAGR of just 2.7% forecast for the period 2018-2023.
Figure 1: While there are some growth areas, the X-ray market as a whole is very stable
Nanox has strong ambitions to outperform this underwhelming outlook by utilizing its unique and more affordable technology to offer a relatively feature-rich system, dubbed the Arc, at a far lower price than existing digital X-ray systems. Competing on price is only one part of the equation, however.
After all, there are countries where, despite their economies of scale, the multi-national market leaders in medical imaging are unable to compete with domestic manufacturers, which are able to produce X-ray systems locally, with lower overheads, and no importation costs. Globally, there are also a large number of smaller imaging vendors, which have limited, yet low-cost offerings at the value end of the market, with this increased competition driving down average selling prices.
To differentiate itself further, Nanox also plans to launch with a completely new business model. Instead of traditional transactional sales, which see providers simply purchase and pay the full cost of the imaging system in one installment, use the system for the entire shelf life of the product and then replace with an equivalent model, Nanox plans to retain ownership of its machines, but charge providers to use them on a pay-per-scan basis.
There are some regions and some situations where legislation and other factors make this model unfeasible, so Nanox will also make its products available to purchase outright, as well as licensing its technology to other firms. However, the start-up’s focus is on offering medical imaging as a service.
The company says that this shift from a CapEx to a managed service approach means that instead of competing with established vendors over market share, it will be able to expand the total market, enabling access to imaging systems in settings where they have been hitherto absent, with urgent care units, outpatient clinics, and nursing homes being suggested as targets.
According to the Nanox investor’s prospectus, current contracts already secured (although the legitimacy of these deals is one of the issues raised by the short-sellers) feature a $40 per scan cost, of which Nanox receives $14 – although the exact figure varies depending on regional economics. The contracts feature a minimum service fee equivalent to seven scans a day, although the target is somewhat higher, with each machine expected to be used to produce 20 scans a day, for 23 days a month.
If Nanox’s order book is as valid as the company insists, and it already has deals for 5,150 units in place, each system will consequently be bringing in a minimum of $27,048 dollars per year for a minimum total revenue of $139m. If the systems are used 20 times a day as Nanox hopes, that means almost $400m in sticky recurring revenues annually. To put that in perspective, one of the market leaders for X-ray imaging systems in 2018 was Siemens Healthineers, which turned over almost $2.8bn across its general radiography, fluoroscopy, mammography, mobile, angiography, and CT imaging divisions.
With an order book that is, on the face of it, this healthy, there have been questions as to why Nanox went public at all, but the listing may be required for this business model to work. The Israeli vendor says that the vast majority of the investment will be sunk into producing the Nanox scanners, and the associated manufacturing capacity. This is necessary because unlike other imaging companies selling systems on a CapEx basis, Nanox will receive nothing for delivering scanners to customers. Revenue is generated later as the systems are used.
This means that the company is effectively fronting the initial cost of the systems, so needs to get as many units installed and being used as quickly as possible to recoup its initial costs. Unlike other vendors, it cannot rely on sales of a first tranche to fund the second and so on, in its new managed service model, it is better to mass produce everything at once.
Open to exposure
There is, however, nothing to stop other, established players from switching to a similar model. This should be of concern to Nanox, after all, Siemens Healthineers or GE Healthcare already have the manufacturing capacity and capital ready to offer products in a similar way.
And of course, Nanox, shouldn’t underestimate the difficulty of disrupting a long-established market. Despite ample funding and solid products, other companies are still struggling to make an impact in other markets. For example, Butterfly Network, a vendor offering an affordable handheld ultrasound solution, has a valuation of over $1 billion and has received more than $350m in funding.
In 2019, the company turned over $28m, enough to make it the market leader in the nascent handheld category, but in a global ultrasound market worth almost $7bn, at present, it is little more than a drop in the ocean.
Nanox hopes that its own new business model would be disruptive by opening up the market to a far greater range of customers than are currently served. A nursing home, for example, might not be able or willing to allocate the cost of a CT machine from a single year’s budget, but spreading that cost as the scanner is used, and particularly if that cost is passed on to patients at a time of use, on-site imaging suddenly becomes a far more feasible proposition.
What’s more, if a company was able to increase its product’s user base there is a strong possibility for upselling additional services, software, and tools. These could be things like AI modules that increase workflow efficiency, or, especially pertinent given the pricing model could allow machines to be installed in new settings that lack on-site expertise, tools that aid clinical decision making.
Beyond that, there is also ample scope for an imaging vendor to entice a customer into its ecosystem with a scanner that has no cost at the point of delivery, before getting it to commit to its own PACS and other IT systems. Being able to fully exploit these new customers relies, in the first instance, on being able to get a foot in the door. That is why an imaging service model could be so beneficial, even if the returns on the scans themselves aren’t especially lucrative.
While adopting a new business model and securing revenue from add-ons and upselling would help established vendors countenance the price differential Nanox proposes, if we are to take the start-up at its word, addressing its feature set might be another matter entirely.
As well as just providing imaging hardware, Nanox is offering a service that, at face value, is more complete. The Arc automatically uploads all imaging data to its cloud SaaS platform. This platform would initially use AI systems to ‘provide first response and decision assistive information’ before radiologists could provide final diagnoses that could then be shared with hospitals in real-time.
Figure 2: With teleradiology read volumes increasing, it makes sense that the necessary hardware comes baked into the Arc
There is currently limited information available about the exact nature of the so-called Nanox.CLOUD and its integration with the Arc, although several assumptions can be made:
– Firstly, although built-in connectivity is being touted as a feature with clinical benefits, its inclusion is as likely to be a necessity as a design choice, given that Nanox presumably needs to be able to communicate with the systems in order to find out scan volumes and bill accordingly. Or, more drastically, render the system inoperable if people don’t keep up with payments.
– Another assumption that can be made is that the full suite of tools wouldn’t be included in the basic pay-per-scan fee. Signify’s Teleradiology World – 2020 report found that in 2020, the average revenue per read for a teleradiology platform is, in North America for example, $24.40. As such, teleradiology services would only be able to be offered at an additional cost, creating another revenue stream for Nanox.
– Another sticking point could also be Nanox’s promise to enable the integration of its cloud into existing medical systems, via APIs. While well and good in theory, the competitiveness, complexity, and proprietary nature of many medical imaging workflows, combined with the fact that many vendors have absolutely no incentive to make integration easy for the newcomer, mean that in practice, it is likely to either be a prohibitively expensive, or frustratingly limited offering. This is one area where established vendors, which already offer comprehensive medical imaging packages, have a distinct advantage.
Back down to Earth
The short positions promoted by commentators including Citron Research and Muddy Waters Research postulate that the Nanox.ARC scanner isn’t real. There are some legitimate questions, but running through their papers is also an attitude that Nanox’s claims are simply implausible, whether that is because it has an R&D budget a fraction of the size of GE, or because anonymous radiologists unrelated to the company haven’t seen anything like it before.
It is worth remembering, though, that these short sellers will benefit financially if Nanox slumps. Nanox conversely, is obviously financially incentivized to promote its technology and its potential, and it wouldn’t be the first company, to promote the limited fruits of its start-up labor in a flattering light.
As so often happens in these he said, she said situations, the truth could well lie somewhere between the two extremes. Even in this instance, even if Nanox fails to deliver on some of its more impressive promises, the fact is, it has suggested bringing a whole new customer base into play and laid out a strategy for selling to them.
With that being the case, for a big vendor the issue of whether Nanox is legitimate almost becomes moot, their focus should be what these other customers require, how to get these customers into their product ecosystems, and what add-on products, and additional services they can feasibly sell them at a later date.
If nothing else, the entire Nanox furor shows that to achieve growth in mature markets, a vendor’s innovation needs to extend beyond its products.
About Alan Stoddart
Alan Stoddart is the Editor at Signify Research, a UK-based market research firm focusing on health IT, digital health, and medical imaging. Alan joined Signify Research in 2020, using his editorial expertise to lead on the company’s insight and analysis services.
announced their Series A round (combined seed and Series A) of $12.9M led by
Sante Ventures and new innovation VC, Intuitive Ventures.
– KēlaHealth, is a surgical intelligence engine that
applies a dynamic cycle of patient-specific predictions, stratified
interventions, and outcomes tracking to reduce surgical complications
– KēlaHealth is the first investment for Intuitive
Ventures, a new innovation fund spun out of Intuitive Surgical, Inc.
a San Francisco, CA-based surgical intelligence platform that applies a dynamic
cycle of patient-specific predictions, stratified interventions, and outcomes
tracking to reduce surgical complications, today announced the closing of
a $2.9 million Seed financing and milestone-based $10 million Series
A financing led by Santé Ventures and Intuitive Ventures, and inclusive of grant
funding from the National Science Foundation Small Business Innovation Research
(SBIR) Program. These funds will accelerate the expansion of the KēlaHealth
platform to hospitals and surgical partners across the United States. KēlaHealth
is the first investment for Intuitive Ventures, a new innovation fund spun out
of Intuitive Surgical, Inc.
Learning Ecosystem to Improve Surgical Care Outcomes
Founded by Bora Chang, MD, with a goal of harnessing machine
learning algorithms to reduce patient surgical complications and improve
outcomes. KēlaHealth uses advanced artificial intelligence techniques to
deliver a cloud-based software-as-a-service solution to healthcare providers,
surgeons, and hospital systems.
In the U.S., 51 million surgeries are performed annually, with an average complication rate of 15 percent. This results in millions of patients suffering harm and loss after a procedure. Tragically, half of these complications are known to be avoidable and contribute to $77 billion in wasted healthcare costs each year
KēlaHealth helps to prevent these avoidable complications
while enhancing surgical care by delivering stratified patient risk scoring.
The company’s state-of-the-art platform uses machine learning algorithms to
match individual risk levels with graduated pathways of care that align with
the unique needs of each surgical patient.
These personalized efforts bring surgery into a new era of
precision medicine: with KēlaHealth, surgeons can match the right patient with
the right procedure with the right precautions at the right time, leading to
improved patient outcomes and significant hospital savings.
To date, KēlaHealth’s hospital partners have applied the
company’s AI-powered platform in colorectal, vascular, cardiac, and orthopedics
The company has participated in highly selective accelerator
programs such as Cedars-Sinai Techstars Accelerator, Healthbox Studio, and Plug
Dr. Chang, CEO of KēlaHealth added: “Our vision is to apply the lessons learned from millions of previous surgeries for the benefit of every patient undergoing a procedure. Patients and their families, clinicians, and hospitals deserve the assurance that the risks of any surgery will be safely navigated by surgical teams with the best information available to them at every point in the surgical journey. We are thrilled to have a stellar group of surgeons, hospital centers, investors, and advisors working with us to realize the opportunity of precision surgery.”
– Human API, the consumer-controlled health data platform
announced it has closed a Series C round of $20M+ this week.
– Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers.
– The platform harnesses a machine learning-powered data pipeline
that structures health data into a consistent format, making it easier for
medical researchers and scientists to use actionable data more quickly and
efficiently while ensuring that patients remain in full control of who their
personal data is being shared with.
Human API, a San
Mateo, CA-based company empowering consumers to connect and share electronic
health data with companies they trust, announced today that it has raised over
$20 million in Series C funding. The round includes participation from Samsung
Ventures, CNO Financial Group, Allianz Life Ventures, and Moneta VC, as well as
from existing investors BlueRun Ventures, SCOR Life and Health Ventures, and
Guardian Life Insurance Company.
The capital will be used to scale new products and services
that enable new product design, granular risk stratification, optimize clinical
trial recruitment, support population health management, automate patient
monitoring, and digitize chronic disease management.
The Next Generation of Health Data Exchange
Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers. The platform
harnesses a machine learning-powered data pipeline that structures health data
into a consistent format, making it easier for medical researchers and
scientists to use actionable data more quickly and efficiently while ensuring
that patients remain in full control of who their personal data is being shared
However, going one step further than just solving the data
portability issue, the Human API platform offers users various options to make
their data actionable, such as:
– Sharing their information with specific researchers who can put it to good use
– Enlisting to take part in medical trials or pharma trials
– Speeding up insurance processes to less than 24 hours
– Taking part in wellness programs provided by their employers.
“By facilitating these transactions,” explains Sean Duffy,
Co-Founder & CEO at Omada Health, “Human API is bringing into being a new
consumer health ecosystem driven by consumer-centric health apps and services.”
Appoints New Chief Commercial Officer
To drive forward this period of growth, Human API has
brought on Richard Dufty as Chief Commercial Officer. Having spearheaded
AppDirect’s growth from early stage startup to Unicorn status in just 4 years,
and having led Symantec’s $1B US Consumer and Cloud business, Dufty brings
extensive experience launching and growing software ecosystems.
– Clinical trials technology company Medidata has
acquired the digital biomarker business of MC10.
– MC10’s offerings will bring novel clinical analytics
and biosensor capabilities to Medidata’s existing technology solutions,
enhancing Medidata’s capabilities to integrate data from wearable sensors –
including clinical grade metrics – in clinical trials.
– With this acquisition, Medidata’s integrated offering
will help provide life sciences companies and device developers with greater
understanding of diseases, transformational therapies, and novel endpoints.
a Dassault Systèmes company, the global leader in creating end-to-end solutions
to support the entire clinical development process, acquired
the digital biomarker business of MC10. MC10’s offerings will bring novel
clinical analytics and biosensor capabilities to Medidata’s existing Patient Cloud solutions
in ePRO (patient-reported outcomes), eCOA (clinical outcome assessments), and
biomarker discovery. This will enhance Medidata’s capabilities of integrating data from wearable
sensors – including clinical grade metrics – to help
customers successfully virtualize clinical trials.
MC10 is a Lexington, MA-based privately held
company focused on improving human health through digital solutions. The
company combines conformal BioStamp sensors with clinical analytics to unlock
novel insights from physiological data collected from the home or in clinical
settings. The company flagship product, BioStamp nPoint, is intended for the
clinical research community.
Why It Matters
Remote, patient-centered technologies have become
an essential part of clinical research, especially in the age of COVID-19; the
physical restrictions placed on patients and clinical sites caused by the
pandemic can interfere with launching a clinical study and carrying it to
completion. Wearable sensors are used in about 15 percent of studies, and the
use of sensors is expected to grow to approximately 70 percent by 2025.*
Medidata leads the industry in building and integrating new technologies to revolutionize clinical research in pursuit of patient-centric therapy development. MC10’s focus on clinical-grade data capture and novel digital biomarker development represents an important next chapter – advancing the understanding of disease progression and treatment effect in the home.
“Medidata is excited to add the pioneering work at MC10 to our ongoing efforts in building a new platform for ingestion and analytics across a wide array of mobile sensors,” said Anthony Costello, senior vice president, Mobile Health, Medidata. “Incorporating remote biometric data capture and analysis that includes the MC10 nPoint Biostamp, alongside other leading mobile devices, will further strengthen the Medidata platform and help propel the digital transformation of life sciences.”
Acquisition Builds Integrated Offering
An integrated Medidata offering will provide research companies and device developers new and innovative ways to collect, normalize, and analyze data in pursuit of new therapy development. This enhanced capability will also create a closer connection between patients and the ecosystem of trailblazing researchers, practitioners, and life science companies committed to deepening a shared understanding of the disease, transformational therapies, and novel endpoints.
“Medidata is an exceptional fit for MC10. Our combined expertise will help customers and partners take a more data-driven approach to bringing targeted therapies to patients,” said Ben Schlatka, co-founder and CEO, MC10. “We are looking forward to moving ahead together, accelerating the development and deployment of new innovative offerings for our customers and ultimately transforming therapy development to improve the lives of patients.”
– Nuance Communications, Inc. announced the Kettering
Health Network has selected ED Guidance for Nuance Dragon Medical Advisor.
– This AI-powered computer-assisted physician
documentation (CAPD) solution will help reduce physicians’ administrative
burden while lowering the risk of adverse safety events, missing diagnoses, and
malpractice litigation – priorities for all physicians, especially in the ED
where the nature of care presents special challenges and risks.
Kettering Health is deploying ED Guidance for Nuance Dragon
Medical Advisor to improve patient safety, alleviate the administrative burden
on clinicians, and reduce the risk of missing diagnoses by:
– Extending the Nuance CAPD solution to physicians in its 12
full-service emergency centers through its existing use of the Nuance Dragon
Medical One HITRUST CSF-certified conversational AI platform for documenting
care in the electronic health record (EHR).
– Empowering physicians with integrated real-time,
evidence-based emergency medical guidance from The Sullivan Group.
– Supporting best-practices-based clinical decision-making
and accurate documentation of the severity of illness and acuity of each
patient at the point of care within clinician’s standard EHR workflows.
– Using Nuance conversational AI to automatically identify
and add critical details that may impact patient treatment in real-time.
Sullivan Group Outcomes/Results
The Sullivan Group’s content has been shown to decrease the
occurrence of adverse safety events and reduce diagnosis-related malpractice
claims by up to 70 percent, and with the integration into Nuance Dragon Medical
Advisor, this guidance can be delivered in real-time while the patient is still
in the ED. ED Guidance for Nuance Dragon Medical Advisor also provides powerful
analytics for assessing ED performance and improving care quality and financial
“We see Nuance Dragon Medical One and Dragon Medical Advisor as essential tools that help physicians use the EHR efficiently for delivering high-quality patient care,” said Dr. Charles Watson, DO, Chief Medical Information Officer at Kettering Health. “Patient safety and reducing the administrative burdens of documentation and compliance are priorities for all physicians, especially in the ED, where the nature of care presents special challenges and risks. The ability to add those tools and data analytics via the cloud will help us align our clinical and compliance practices with diagnostic drivers more quickly and accurately.”
– Cohere Health partners with health insurer Humana to modernize
the prior authorization process for musculoskeletal treatment across 12 states.
– In addition, the company has closed an additional $10M
in funding led by Flare Capital Partners and Define Venture, bringing the
company’s total funding to $20M.
Health insurer Humana has signed an agreement with healthcare collaboration company Cohere Health to improve the prior authorization process for musculoskeletal treatment across 12 states, starting Jan. 1, 2021. Cohere aligns physicians, patients, and health plans on a patient’s optimal healthcare experience—enabling access to higher quality care while at the same time minimizing administrative burden and siloed decision-making.
The partnership leverages CohereNext Platform’s prior authorization capability which grants authorizations across an entire episode of care, in effect pre-authorizing a complete treatment regimen from the initial diagnosis to treatment plan selection, and, ultimately, to the patient’s return to good health. Cohere’s approach aims to expedite evidence-based treatment plans to improve the healthcare experience for doctors and patients alike.
Humana to Leverage CohereNext Platform to Streamline
As part of the partnership, Humana will employ the CohereNext Platform to streamline prior authorizations in musculoskeletal treatment in Alabama, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia. The platform will initially serve approximately 2 million members and more than 3,500 physician practices.
This partnership supports Humana’s vision to reimagine and modernize processes for prior authorization by reducing approval times and improving the delivery of care, all while preserving important benefits such as safety, predictability, and cost containment.
Cohere’s solution will initially focus on prior
authorization; the company is developing additional use cases such as
value-based contract performance, improving physician and patient engagement,
and optimizing health plan clinical programs. By facilitating physician and
health plan collaboration, Cohere’s technology will help accelerate the
evolution to value-based care models.
“Through this strategic initiative and collaboration with Cohere Health, Humana is building on its commitment to reduce the complexity and friction of prior authorization for our physicians and members,” said William Shrank, MD, MSHS, Chief Medical Officer, Humana and Board Member, Cohere Health. “Cohere’s solution was co-designed with physicians and represents a major leap forward in improved physician experience and the adoption of evidence-based medicine.”
Cohere Health Closes Additional $10 Million in Funding to
Accelerate Delivery of Patient Journey Platform
In addition, the company announced it closed an additional
$10 million in funding led by Flare
Capital Partners and Define Ventures,
bringing the company’s total funding to $20 million. The funding will be used
to enhance the company’s scalable CohereNext® platform that is built on
next-generation cloud and data technologies and provides interoperability to
existing healthcare infrastructure as well as the emerging digital health
Series A extension comes just two months after Cohere Health’s initial $10 million Series
A funding, which was also led by Flare
Capital Partners with Define Ventures contributing as an investor and partner,
as well as participation from a leading national strategic partner.
The CohereNext Platform improves the physician experience
and quality by:
– Authorizations that begin with diagnoses and not billing
– Facilitating and auto-approving evidence-based treatment plans
– Delivering a peer review process with a true peer
specialist or sub-specialist
– Sharing quality performance relative to peers for specific
care paths and patient cohorts
– Providing tools, data and technology that optimizes
“The tragedy of COVID-19 has reinforced that the basic infrastructure supporting healthcare innovation is fundamentally broken. The shift from fee-for-service to value-based-care requires enabling interoperable capabilities to facilitate care around the interests of patients, and as a result, Cohere Health continues to rapidly grow and attract additional investments,” said Siva Namasivayam, CEO and founder of Cohere Health. “The additional funding will enable us to expand the CohereNext platform to impact more failure points across patient journeys so that physicians can deliver better outcomes and we can continue building our team, which has grown by more than 95 people this year.”
Helping Physicians Document Care During Virtual Visits
The cloud-based technology allows VA physicians to use their voices to capture and document patient stories securely, accurately, and more efficiently during virtual visits conducted by phone and the widely deployed VA Video Connect platform. Nuance Dragon Medical One is the leading medical speech recognition solution today used by over 550,000 physicians. Compatible with the VA CPRS and Cerner Millennium, it is a key productivity component in EHR solutions throughout the Federal Government, including Veterans Affairs and the Military Health System. Because the VA first standardized on Nuance cloud-based Dragon Medical solutions system-wide in 2014, physicians could readily adopt the added capabilities and mobile flexibility of Dragon Medical One for telehealth services.
“Helping frontline clinicians at the VA and other major health systems has been our highest priority since the pandemic began,” said Diana Nole, executive vice president and general manager of healthcare, Nuance. “The combination of our cloud-based platforms, organizational agility and deep experience working with the VA health system made it possible for us to act quickly and deliver the technology solutions needed to protect and assist physicians treating patients remotely. While our strong sense of mission and purpose in serving critical healthcare organizations and businesses already is very clear, it becomes amplified knowing that our technology solutions are playing a role in caring for our nation’s Veterans.”
– HP launches patient-first print technologies to help healthcare
workers stay safe and spend more time caring for patients.
– Innovations co-developed with healthcare professionals
include industry’s first sterilizable printers, exclusive EMR-compliant
workflow solutions, and services to improve patient safety and privacy.
Today, HP Inc.
officially launched new print solutions for the healthcare industry. Based on
deep customer insights and co-developed with healthcare providers, associations
and partners, HP Healthcare Print Solutions address the most pressing issues
facing the healthcare industry today including patient wellness and safety,
care coordination, mobility, privacy and security.
Reducing the Risk of Virus Transmission and Healthcare-Associated Infections
HP’s new Healthcare Edition MFP keyboards and touch-enabled
control panels are designed to be disinfected regularly, withstanding up to
10,000X industry-standard germicidal wipes, helping to reduce the risk of
health-care associated infections (HAIs) and viral pathogen transmission.
HP has further enhanced the disinfection capabilities of high-touch areas of
the printer with removable covers/drapes that can be sterilized daily in an
autoclave up to 134 ºC. HP is also collaborating with Clorox Healthcare to
offer a guide detailing infection prevention best practices and other
In order to enhance support of infection prevention
policies, HP has also broadened disinfection capabilities of HP Personal System
devices to include HP Engage Go3 and HP Elite products such as HP EliteDesks,
HP EliteOne (display panel only), ZBook Mobile Workstations and Z Series
Desktop Workstations, HP Elite and Z Displays (Z, S, E and P series, Display
Panel Only) and HP Education Notebooks (keyboards only) .
The U.S. Centers for
Disease Control (CDC) estimates that healthcare-associated infections
(HAIs) are responsible for 1.7
million infections and 99,000 associated deaths each year. Infections and
viruses add further strains to healthcare organizations’ ability to provide
safe, quality care to patients. Influenza alone accounts for an US$11B economic
annual burden. Studies show commonly used technologies, like printers and
mobile devices, are often highly contaminated with pathogenic bacteria and
viral pathogens. Most IT and IoT devices were not designed to be regularly
cleaned by hospital-grade disinfectant wipes. Repeated use has shown to damage
the integrity of the plastic and, ultimately, the device itself.
Minimizing Contact with Common Points of Transmission
HP’s unique global Managed Print Services (MPS) program with
Zebra Technologies provides the HP Advance mobile app on Zebra’s TC52-HC
handheld touch computer to enable care providers to minimize contact with
common points of infection transmission at the point of care. Providers can
walk up to any HP Healthcare Edition MFP, authenticate with the TC52-HC mobile
computer and release critical patient documents without having to touch the
Reducing the Risk of Electromagnetic Interference (EMI)
Patient and clinical worker mobile and IoT devices add to a
very congested radio spectrum that can interfere via electromagnetic
interference (EMI) with life-saving medical devices. The new HP Health
Solutions portfolio of IoT hand-held devices and IoT print devices are EN/IEC
60601-1-2 certified for EMI safety. The EN/IEC 60601-1-2 certification
ensures these devices can be used within the patient sphere and shared patient
areas without risk of EMI to sensitive patients and surrounding medical
Helping Ensure Positive Patient ID
Patient identification errors are common and can lead to
serious reportable events that harm not only the patient’s health, but also the
clinical standing of the healthcare facility where such an error occurred. Together,
HP and Zebra solutions empower clinicians to better manage positive patient
identification through integrated color patient ID wristbands, trackable
specimen labels printed on-demand with Radio Frequency Identification (RFID)
location services and point of care identification solutions for patients.
Digitizing Processes for Faster, More Efficient Care
HP Healthcare Edition MFPs include the HP Workpath Biscom for Healthcare app fully integrated
with EPIC and Cerner. This
enables the entire clinical team to digitally transmit and receive patient
information and high-resolution color imaging like MRIs or directly input data
into the electronic
medical record (EMR) system right from an app on the printer. As a
result, care providers can make timely critical decisions to improve the
experience of patients and the entire care team and give back face time with
68% of physician respondents reported feeling burned out at
the moment, largely because of paperwork, regulatory demands and electronic
health record (EHR) documentation. Important pieces of healthcare data can fall
through the cracks, frustrating patients who don’t understand why a specialist
can’t see last week’s diagnostic test result or why they were not offered a
diabetic-friendly hospital menu while staying as an inpatient, for
Protecting Patient Privacy and Security
As the implementation of technology advances, so too are the
security threats against healthcare systems. To help healthcare
organizations defend against emerging threats, HP provides the world’s most
secure PCs16 and printing solutions to protect patient privacy and sensitive
information. The new Healthcare portfolio also offers Basic Print Cloud
Services delivered through a service, HP Print Security Advisory Services and
HP Security Manager that provides patient data protection to all HP devices,
with the added protection of PrintSecure on Zebra wristband printers.
HP Healthcare Print Solutions are now available for direct
MPS customers in North America with plans to roll out across Europe and Asia in
The coronavirus pandemic accelerated telemedicine exponentially as patients and doctors switched from in-person visits to remote consultations. Health providers rapidly scaled virtual offerings in March and April and traffic volumes soared to unprecedented levels, with practices “seeing 50 to 175 times the number of patients by telehealth than before the outbreak,” according to McKinsey. By early August, the U.S. Department of Health and Human Services expanded the list of allowable telehealth services in Medicare and there was an executive order supporting permanent telehealth provisions for rural areas.
But the surge in telemedicine adoption comes with a host of cybersecurity risks and regulatory compliance requirements unique to the healthcare sector.
As telemedicine traffic increases, so does the volume of hacking attempts. Recent cybersecurity news indicates healthcare organizations are top targets for cyberattacks and “providers remain the most compromised segment of the healthcare sector, accounting for nearly 75 percent of reported breaches.” The consequences are chilling: “The average cost of a healthcare data breach is $7.13 million globally and $8.6 million in the United States.
Further, whenever patient information is involved, HIPAA compliance is required. While HHS temporarily suspended pursuing HIPAA penalties on providers for “good faith provision of telehealth during the COVID-19 nationwide public health emergency,” such permissiveness will not last.
Luckily, most telemedicine providers can utilize managed services and cloud infrastructure to keep pace. Here are some best practices to meet IT compliance and cybersecurity demands for telemedicine.
Telemedicine Compliance Best Practices
Compliance should be viewed as a real-time process that drives security. Telemedicine tools and technology should therefore reflect significant expertise with all healthcare regulations (HIPAA, HITRUST, HITECH), with compliance functions permeating processes. Recommended compliance best practices include:
1. Automate Remediation
Healthcare applications cannot offer high reliability if every potential compliance problem is remediated manually; there’s just too much that can go wrong and never enough staff to address it when needed. The solution is to automate everything that can be automated, and rely on people to handle exceptions or potential violations that don’t impact reliability. Cloud-based services can integrate AI and operational intelligence to automatically remediate anomalies when possible, present recommendations to operations staff for cases that cannot be resolved automatically, and present clear choices such as:
· Do Nothing: Take no action, delete ticket after [x number of days]
· Fix Now: Implement the recommended actions immediately
· Schedule: Perform the recommended actions during the next maintenance window
This approach speeds resolution and decreases service disruptions, and improves the reliability of telemedicine delivery. The automated response also plays a critical role in security (which will be discussed shortly).
2. Perform Formal Risk Assessments
Understanding the risk level and specific risk issues are critical components for an effective compliance plan. Many providers of healthcare services underestimate their level of risk, in part because it is difficult to quantify. The HHS has published guidance in its Quantitative Risk Management for Healthcare Cybersecurity, which offers insight. There are also cloud solutions that can aid the process. Cloud services providers such as Amazon Web Services (AWS), Microsoft Azure, and Google Cloud offer automated security assessment services that help improve the security and compliance of applications deployed on their cloud hosting platforms. They can generally assess applications for exposure, vulnerabilities, and deviations from best practices. A good inspection service should highlight network configurations that allow for potentially malicious access, and produces a detailed list of findings prioritized by level of severity.
3. Reduce Attack Surface
To provide secure access to sensitive information, hybrid architectures supporting telemedicine applications need a virtual private network (VPN) gateway between on-premises and cloud resources. However, developers, test engineers, remote employees, and others who need access to cloud-based protected health information (PHI) may bypass a VPN gateway by either cracking open the cloud firewall to allow direct unencrypted internet traffic or using peering connections. To prevent such potential exposures, secure desktop-as-a-service (DaaS) solutions provide an elegant way to allow cloud-based access to PHI without exposing connections or records. A DaaS is generally deployed within a VPC providing each user with access to persistent, encrypted cloud storage volumes using an encryption key management service. No user data is stored on the local device, which reduces overall risk surface area without impeding development capability.
Telemedicine Security Best Practices
While the full scope of cybersecurity strategies is beyond the scope of this article, here are three best practices that telemedicine providers can use bolster their security profile:
1. Deploy Proactive Network Security
Modern cyber threats have become steadily more sophisticated in evading traditional security measures and more devastating once they penetrate network perimeters. For that reason, telemedicine providers need a highly proactive, multilayered approach to prevent malware-based outages, theft of intellectual property, and exfiltration of protected health information (PHI).
A combination of network anti-malware, application control, and intrusion prevention systems (IPS) is recommended. Such proactive solutions are generally bundled in managed cloud services that should automatically detect suspicious system changes in real-time, isolate and quarantine affected resources, and prevent the spread of exploits by locking down any server whose configuration differs from the installed settings.
2. Encrypt Data Storage
Data encryption is the last line of cyber-defense for PHI and other critical information. Even if an attacker can penetrate the perimeter and proactive network security and exfiltrate data from the provider, those data are useless to the hacker if encrypted. It’s good practice to encrypt all web and application servers running on cloud instances using a unique master key from a key management service when creating volumes.
Encryption operations generally occur on the servers that host cloud database (DB) instances, ensuring the security of both data-at-rest and data-in-transit between an instance and its block storage. For additional protection, you can also opt to encrypt DB instances at rest, underlying storage for DB instances, its automated backups, and read replicas.
3. Harden Operating Systems
Both Microsoft Windows Server and Linux are ubiquitous operating systems in telemedicine. They are also both attractive targets for cybercriminals because they provide complex capabilities, frequently remediate vulnerabilities, and are so common (increasing attackers’ chances of finding an unpatched system). Hackers use OS-based techniques such as remote code execution and elevation of privilege to take advantage of unpatched operating system vulnerabilities. Hardened images of Windows Server and Linux virtual machines (VMs) should be used, employing default configurations recommended by the Center for Internet Security (CIS). Such hardened images make gaining OS administrative extremely difficult, and coordinate well with proactive security bundles described earlier.
While these best practices are targeted primarily at telemedicine companies, they can also be applied to a wide range of healthcare providers and organizations delivering vital services in the face of 2020’s dramatic swings in demand.
About Gerry Miller
Gerry Miller is the founder and chief executive officer at Cloudticity. He is a successful serial entrepreneur and healthcare fanatic. From starting his first company in elementary school to selling his successful technology consulting firm in 1998, Gerry has always marched to his own drummer, producing a series of successes. Gerry’s first major company was The Clarity Group, a Boston-based Internet technology firm he founded in 1992. Gerry presided over seven years of 100% aggregate annual growth and sold the company in 1998 when it had reached $10MM in revenue.
He was recruited by Microsoft to become their Central US Chief Technology Officer, eventually taking over a global business unit and growing its revenue from $20MM to over $100MM in less than three years. Gerry then joined ePrize as Chief Operating Officer, where he grew sales 38% to nearly $70MM while improving operating efficiency, quality, and both client and employee satisfaction. Gerry founded Cloudticity in 2011 with a passion for helping healthcare organizations radically reshape the industry by unlocking the full potential of the cloud.
Twenty years ago, technology consultants started advising CIOs to build less. That’s when the movement towards Commercial Off the Shelf (COTS) began.
Today, there are many shops, especially those in small and medium-sized organizations, with few programmers who build new applications from scratch.
Yes, they have programmers who configure, script, and integrate various applications but very little is built. For the provider community, we have a habit of either sourcing our needs from our Electronic Health Records (EHR) application vendor or buying a “best of breed” application from a niche vendor.
Moving to Software as a Service (SaaS) has even reduced the dread of upgrades. No doubt buying commercial software has enabled all of us to have access to better solutions and in some cases, may have reduced the ongoing run rate. Still, it means technology costs have gone up and a lot of our technology goals have not been achieved.
For example, interoperability remains a point to point problem. ONC and CMS are still pushing to remove barriers to interoperability and have mandated data exchange with penalties.
CIOs are struggling with the realities of constraint budgets where new programs are starving while dollars go to pay maintenance, integration costs associated with prior purchases (e.g. tech debt).
Then, in a year of the normal pull-and-tug between maintaining current and delivering new systems, COVID-19 arrived and our planning fell short. Technology teams were challenged as never before. They suddenly needed to:
– Enable teams to work from home – even teams who have never worked remotely.
– Stand up telehealth solutions in days – not months.
– Find a good external data source with statistics to integrate and then discover a newer, better source days later.
– Provide real-time updates on the availability of hospital rooms to leadership.
– Provide rapidly evolving guidance to patients on admissions changes, new requirements for entrance to facilities reduced access to admitted patients.
– Be a trusted, consistent source of guidance to reduce the spread of the disease.
This was all new, unplanned work. Work that took resources from other budget areas and other teams. Work that didn’t always meet our aim for better patient care or patient experience.
For example, we saw some providers advertising the availability of telehealth services but requiring a patient to call their primary care doctor to schedule instead of requesting an appointment online. Then due to staff shortages, the patient would land in voice mail, further delaying access to care.
Patients needing tests have been told to get an order from their physician. The truth is telehealth isn’t integrated and isn’t part of our daily processes.
The story here is the emergence of an unsung hero you can’t find on the nightly news: our IT Teams. We need to arm this group of heroes with better tools. Tools where delivery of new programs, updates to existing processes and integrating new data from external sources can be done in days, not months.
Did your clients link to external data sources such as John Hopkins? Did they need to enable test sources from new partners? Did they need to build new mobile applications to integrate workstations in parking lots and third-party locations?
New approach – Low-Code
Today’s challenges require a new approach that is “low-code.” Low-code is shorthand for an application development environment that is primarily visual and uses simple declarative statements to create applications. The primary goal of low-code is to accelerate program delivery.
This is surely a goal for every healthcare technology team. As enterprise clients embrace low-code, they can ensure readiness by putting these building blocks in place so clients can realize the promised value:
– Authentication Management through APIs (OAuth)
– Standardized access through APIs
– Management and Monitoring
In preparation for the adoption of a low-code application platform (LCAP), it is essential to assess the adoption of authentication best practices.
The technology landscape now spans on-prem, private cloud, and public cloud solutions requiring a standardized, tokenized approach to authentication. Without this, security processes will inevitably fall short of the CISO’s goals or will require additional manpower to monitor and maintain.
OAuth is the building block
Given the number of vendors, environments, and the velocity of human interactions (non-employee clinicians, temporary resources of all types, patients, etc.), OAuth is the building block for scalable secure authentication. OAuth is a delegated authentication framework that replaces the need to send credentials in program calls (APIs).
It has been required by CMS for the interoperability rule as a foundation for data sharing. If you haven’t, invest in a centralized identity management system and move to use OAuth to authenticate service and access requests. Standardizing authentication is foundational. Do it before selecting a low-code vendor.
LCAP platforms deliver a variety of methods to access data from other applications. Typical integration patterns include files, database calls (ODBC, JDBC, etc.), and scripting.
Now is the time to adopt API-First and design thinking. Stop building point-to-point integrations – the velocity of LCAP will result in a proliferation of connection methods if interfaces are not standardized.
Using APIs – fast delivery
Using APIs will enable faster delivery and better performance. Providing a set of standardized interfaces that meet the needs of consumers (a fundamental goal of API-First) will reduce test time, production breakage, and upgrade complexity. Don’t wait.
Doing APIs right requires a culture shift – slapping an API on an enterprise application is not the goal. Delivering APIs that drive consumption and adoption by citizen developers and go-to-market programs will power user experiences that truly do more with less.
Management and monitoring
Last but not least is the management and monitoring of your new agile applications, especially the application interactions with your core enterprise applications and external integrations. We have all seen it, a new program or upgrade is delivered, and performance slows to a crawl.
Monitoring and metering access (limited access to X number of calls per time period) is essential to proactively prevent coding errors and shield your client from bad actors. Knowing who is accessing what, and how the load varies, is necessary to achieve the goals of delivery velocity and efficient use of resources.
API Management vendor leaders include policy engines, management, and embedded analytics in their gateways to protect and scale service integrations.
Better, faster, cheaper is our mantra (once again, some of us mutter under our breaths). Adopting low-code will accelerate delivery and help us meet the demands of the new normal.
LCAP demands standardized authentication, application program interfaces (APIs), and secure, monitoring gateways to accelerate adoption while protecting and securing enterprise resources.
About Ruby Raley
Ruby Raley is VP of Healthcare and Life Sciences at Axway. Axway empowers customers to compete and thrive in dynamic marketplaces using hybrid integration solutions to better connect their people, systems, businesses, and digital ecosystems. More than 11,000 organizations in 100 countries rely on Axway to solve their data integration challenges.
– physIQ has been selected by the National Institute of Health (NIH) to develop an innovative AI-based COVID-19 digital biomarker solution to address the COVID-19 pandemic.
– Early detection of COVID-19 decompensation in patients
is complicated by infrequent and non-specific clinical data. The first-in-kind
tool will collect and analyzes continuous physiologic data could provide early
clinical indicators of COVID-19 decompensation.
Today, high-risk COVID-19
patients and their providers are finding out too late that in the disease
continuum they are getting sicker and need urgent care. The new early warning
system under development could allow providers to intervene sooner when a
COVID-19 patient is clinically surveilled from home and begins to worsen.
Rather than relying on point measurements, such as temperature and SpO2, that
are known to be lagging or insensitive indicators of COVID-19 decompensation,
continuous multi-parameter vital signs will be used to establish a targeted
biomarker for COVID-19.
Despite the technological advances and attention paid to COVID-19, the healthcare community is still monitoring patient vitals the very same way as we did in the 1800s,” said Steven Steinhubl MD, Director of Digital Medicine at Scripps Translational Science Institute (STSI) and a physIQ advisor. “With the advances in digital technology, AI and wearable biosensors, we can deliver personalized medicine remotely giving caregivers new tools to proactively address this pandemic. For that reason alone, this decision by the NIH has the potential to have a monumental impact on our healthcare system and how we manage COVID-19 patients.”
COVID-19 Decompensation Index (CDI) Digital Biomarker Development
PhysIQ will develop and validate a CDI algorithm that builds off existing wearable biosensor-derived analytics generated by physIQ’s pinpointIQTM end-to-end cloud platform for continuous monitoring of physiology. The data will be gathered through a clinical study of COVID-19 positive patients in collaboration with the University of Illinois Hospital and Health Sciences System (UI Health) and build upon work already in-place for monitoring COVID-19 patients convalescing at home.
In the development phase of this project, physIQ and its clinical partner will monitor participants who are confirmed COVID-19 positive, whether recovering at home or following discharge from the hospital. During the validation phase, physIQ will evaluate lead time to event statistics, decompensation severity assessments, and the ability for CDI to predict decompensation severity.
“The application of the CDI may provide a universal indicator of decompensation,” said Karen Larimer PhD, ACNP-BC, study PI and physIQ’s Director of Clinical Development. “Application of this technology could detect COVID-19 decompensation and prevent hospitalization or morbidity events in both scenarios.”
The study is designed to capture data from a large, diverse
population to investigate CDI performance differences among subgroups based on
sex/gender and racial/ethnic characteristics. This project will not only enable
the development and validation of the CDI, it will also collect rich clinical
data correlative with outcomes and symptomology related to COVID-19 infection.
This index will build on physIQ’s prior FDA-cleared, AI-based multivariate change index (MCI) that has amassed more than 1.5 million hours of physiologic data, supporting the development of this targeted digital biomarker for COVID-19. This will enable new research and further insight into using digital health to advance the public health response.
Care and Amwell® announced an expanded partnership, allowing
the companies to develop new integrations to enhance virtual care offerings for
– By pairing Tyto Care’s TytoHome device and platform
with Amwell’s platform, the two companies will together provide patients
and providers with augmented virtual care experiences and
broadly enrich the capabilities and satisfaction with healthcare organizations’
virtual care applications.
provider Amwell, today
announced it is expanding its partnership with Tyto Care, the
healthcare industry’s first all-in-one modular device and examination platform
for AI-powered, on-demand, remote medical exams. Together the companies will
introduce exclusive integrations and newly designed workflows and tools to
enhance the ability for providers using the Amwell platform to examine and
diagnose patients virtually. Additionally, Amwell will become a reseller of Tyto Care’s
Tyto Care Background
Tyto Care seamlessly connects people to clinicians to provide
the best virtual home examination and diagnosis solutions. Its solutions are
designed to enable a comprehensive medical exam from any location and include a
hand-held, all-in-one tool for examining the heart, lungs, skin, ears, throat,
abdomen, and body temperature; a complete telehealth platform for sharing exam
data, conducting live video exams, and scheduling visits; a cloud-based data
repository with analytics; and built-in guidance technology and machine
learning algorithms to ensure accuracy and ease of use for patients and
insights for healthcare providers.
Conduct Exams and Diagnoses
By pairing the TytoHome handheld examination
device – which enables on-demand examinations of the heart, lungs, abdomen,
skin, throat, ears, heart rate, and body temperature – with Amwell’s telehealth
platform, providers can guide patients through
virtual health examinations and together gain real-time insight into a
patient’s health data and status directly in the visit. For patients and
providers, this will augment the virtual care experience and more broadly
enrich the capabilities and overall satisfaction associated with healthcare
organizations’ virtual care applications. This enriched workflow will be available to
thousands of Amwell hospitals, health systems, health plans
and employer clients who collectively serve millions of patients.
“As COVID-19 wages on and more patients and providers adopt telehealth, it’s critical that we accelerate the depth of care that can be provided in the home – to keep patients and providers safe,” said Roy Schoenberg, President and Co-CEO, Amwell. “Our latest integration with Tyto Care will allow providers to clinically come closer than ever before to patients during telehealth encounters, allowing them to see, interact, examine and deliver care in ways that growingly resemble in-person care.”
Offering More Holistic Care for Patients
“Our longstanding partnership with Amwell exemplifies our shared goal of providing deeply integrated telehealth solutions that put health in the hands of consumers, creating a more impactful and seamless healthcare experience for both patients and providers,” said Dedi Gilad, CEO and Co-Founder, Tyto Care. “The integration with TytoHome will enable Amwell to offer more holistic care for patients, especially for urgent and primary care needs, as well as help to enable better adherence to treatment plans. We look forward to continuing our work together as we realize the full potential of clinic-quality, at-home care in this new era of telehealth.”
– Anthem extends the use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users.
– doc.ai’s product offerings are deployed on its cloud-agnostic and zero-trust infrastructure that lets clients like Anthem launch products faster and at lower costs.
Anthem, today announced it is extending its partnership with doc.ai, an enterprise AI platform accelerating digital transformation in healthcare to power its digital health offerings. The expanded relationship extends Anthem’s use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users. Payors, pharma, and providers license doc.ai’s enterprise AI platform that unlocks the value of health data.
Most recently, Anthem licensed Passport, doc.ai’s privacy-first COVID-19 evaluation tool for a safer entry to the workplace, and Serenity, a guided mental health chat companion that helps manage anxiety and depression. In addition, doc.ai’s technology has streamlined Anthem’s ability to create an ecosystem of developers. doc.ai’s product offerings are deployed on its cloud-agnostic and zero-trust infrastructure that lets clients like Anthem launch products faster and at lower costs.
Appoints New CEO and Chief Scientific Officer
In addition to the expanded relationship with Anthem, doc.ai
has announced key executive leadership appointments: Sam De Brouwer, co-founder
has been named its new CEO; Walter De Brouwer, co-founder takes on the newly
created role of Chief Scientific Officer. Dr. Nirav R. Shah, MD, MPH has been
appointed as its first Chief Medical Officer.
Sam De Brouwer, co-founder, and previous Chief Operating Officer has taken on the role of Chief Executive Officer, with a focus on scaling its enterprise offerings. Co-founder Walter De Brouwer has transitioned from CEO to the new role of Chief Scientific Officer where he will focus on vision and will lead research, innovation, and engineering efforts for the company. As doc.ai’s first Chief Medical Officer, Dr. Nirav R. Shah, MD, MPH will lead the clinical focus and medical research of the platform company. These new appointments will join doc.ai’s leadership team alongside current CTO Akshay Sharma and CFO Greg Kovacic.
“What doc.ai has accomplished in a remarkably short period of time is impressive, and I’m excited to join such a talented team,” said Dr. Shah. “Doc.ai has brought cutting-edge technologies to the market that will help break down many of the silos in healthcare, and will ultimately increase the pace of innovation and create pathways to better health outcomes.”
Dr. Shah is a Senior Scholar at the Clinical Excellence Research Center, Stanford University School of Medicine. His expertise spans across the health industry as a member of the HHS Secretary’s Advisory Committee, a Senior Fellow of the Institute for Healthcare Improvement (IHI), and as an independent director for public and private companies and foundations.
He served as Senior Vice President and Chief Operating Officer for clinical operations at Kaiser Permanente in Southern California, where he oversaw the region’s health plan and hospital quality while ensuring effective use of technology, data, and analytics to produce better patient health outcomes. In addition, he served as Commissioner of the New York State Department of Health, where he was responsible for public health insurance programs covering more than five million New Yorkers and led public health surveillance and prevention initiatives.
– 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.
– Nuance advances conversational AI with Dragon Medical virtual
assistant for Hey Epic! virtual assistant in Epic Hyperspace.
– Building upon Nuance’s Dragon Medical solution already
used by more than 550,000 physicians, this integration with Hey Epic! enables
clinicians to conversationally navigate the EHR, search for information, place
orders, and seamlessly switch hands-free between voice assistant and dictation.
Virtual assistant technology is viewed as essential to
enable clinicians to complete administrative and clinical tasks more
efficiently and easily during in-person and virtual visits – to improve both
physician and patient experiences before, during, and after each encounter.
The Nuance virtual assistant technology for Hey Epic! in Hyperspace is
available through Dragon Medical One, Nuance’s leading cloud-based solution for
To date, nearly 80,000 physicians and nurses using Epic have
licensed access to Nuance virtual assistant technology in Epic Haiku and Epic
Rover mobile apps to conversationally navigate the EHR more efficiently, while
conveniently retrieving information such as schedules, patient information,
laboratory results, medication lists and visit summaries.
“I have been using Nuance virtual assistant technology with Hey Epic! in the Haiku mobile application to quickly navigate the EHR, access and dictate clinical notes, and complete other tasks simply by using my voice. This saves time that can be dedicated to patients instead of searching through documentation. Now, having access to this technology in Hyperspace will further our ability to gain situational awareness and access to accurate, timely information that helps us treat the patient to the best of our ability in the moment,” said Dr. Patrick Guffey, CMIO, Children’s Hospital Colorado.
– Today Vocera Communications acquires EASE Applications,
a provider of a secure communication platform and mobile application that
delivers updates, messages to patients’ loved ones, during surgeries and at
– The Orlando-based EASE offers a cloud-based service
that is built to improve the patient experience by enabling friends and family
members to receive timely updates about the progress of loved ones in the
hospitals. Care team members can send a patient’s loved ones HIPAA-compliant
texts, photos, and video updates putting them at ease and saving valuable time.
Inc., a provider of clinical communication and workflow solutions,
today announced that it has acquired EASE (Electronic Access to Surgical
Events), based in Orlando, FL. EASE offers a cloud-based communication
platform and mobile application built to improve the patient
experience by enabling friends and family members to receive timely updates
about the progress of their loved one in the hospital. The EASE app
enables nurses and other care team members to send HIPAA-compliant texts,
photos, and video updates to patients’ loved ones, putting them at ease and
saving valuable time.
Patients can add friends and family members to their distribution list; and with a simple tap, caregivers can keep them informed and ease their concerns. Messages, pictures, and videos sent disappear 60 seconds after being viewed, and nothing is saved on the mobile device, providing an additional layer of security and privacy. The application also provides secure two-way video conferencing between patients’ families and care teams. Additionally, EASE enables care team members to customize in-app surveys, offering a quick way to track and improve patient engagement and satisfaction in real-time, and giving feedback and support for the caregivers.
Return on Investment
With more than 1.6 million sent messages, the EASE
application has demonstrated improved patient and family satisfaction and
reduced the number of phone calls from loved ones to the hospital. In one study
with approximately 2,500 family members, 98% said that EASE reduced their
anxiety, and 81% reported that the availability of EASE would influence their
choice of hospital. Additionally, patient satisfaction scores increased by an
average of 6% for patients who used EASE compared to patients who did not use
Issuance of Restricted Stock Units
As part of the onboarding process, Vocera will issue
restricted stock units totaling approximately 60,000 shares of Vocera common
stock to approximately eleven employees of EASE. These restricted stock units
will vest over three years after the closing and will be made from an
inducement plan adopted by the company’s board of directors pursuant to the
inducement exemption provided under the NYSE listing rules.
– Change Healthcare acquires Nucleus.io to create the first of its kind end-to-end, cloud-native Enterprise Imaging to integrate Change Healthcare’s next-generation medical imaging platform.
– The acquisition will accelerate Change Healthcare’s
timeline to implement a complete cloud-based, end-to-end Enterprise Imaging
solution with customers by leveraging the 7,500+ organizations Nucleus.io
Change Healthcare (Nasdaq: CHNG) today announced the acquisition of Nucleus.io, a leader in the development of advanced, fully enabled, cloud-native imaging, and workflow technology. Nucleus.io’s state-of-the-art, cloud-native imaging technology, including a zero-footprint diagnostic viewer with patented streaming technology, workflow, and image sharing solutions, completes Change Healthcare’s next-generation medical imaging platform.
Medical Image Exchange Solution
Nucleus.io ingests, stores, routes, and provides lightning-fast access – from just about anywhere – to all medical images regardless of file size. Nucleus.io’s market-leading medical image exchange solution is utilized by over 7,500 organizations across the U.S., with approximately 150 new organizations onboarding each month. Their advanced, fully enabled, cloud-native imaging technology includes a zero-footprint diagnostic viewer with patented streaming technology, workflow, and image sharing solutions, and more.
“We began our journey eight years ago with the goal of improving patient care by using the power of the web to make medical imaging instantly accessible to patients, providers, and hospitals,” said Dr. Vishal Verma, chief executive officer, NucleusHealth. “Change Healthcare was the clear choice when searching for an organization to deliver our technology to the world. We couldn’t be happier about the opportunity to have Change Healthcare bring our unified vision to light.”
Today’s acquisition supports Change Healthcare’s commitment
to focus on and invest in core aspects of the business to fuel long-term growth
and advance innovation. This will accelerate Change Healthcare’s timeline to
implement a complete cloud-based, end-to-end Enterprise Imaging solution with
customers. Nucleus.io expands Change Healthcare’s addressable market by
leveraging the over 7,500 organizations Nucleus.io currently serves.
Change Healthcare’s Enterprise Imaging Network (EIN) is the
first of its kind, fully managed, cloud-native platform. The foundations of the
platform, including its Archive and Analytics applications, have been
successfully delivered to the market as a cloud-native solution. The
combination of both companies’ technologies and experienced teams will enable
physicians to read, diagnose, and collaborate from anywhere, reduce IT
complexities, and leverage data and Artificial Intelligence (AI) to improve
Why It Matters
“Now more than ever, customers are seeking ways to lower cost, reduce complexity, protect their patient data, and deliver the best care possible. Our next-generation Enterprise Imaging Network platform helps meet those needs in ways not previously possible and delivers exceptional value to our customers,” said Tracy Byers, senior vice president and general manager, Enterprise Imaging, Change Healthcare. “This transaction will accelerate the realization of our vision and the innovation our industry has been waiting for.”
Financial terms of the acquisition were not disclosed.
The amount of data generated by the healthcare industry is staggering—and constantly increasing. Healthcare data encompasses the personal information of patients, doctors, nurses, and administrators. It includes diagnostic information, test results, ultrasound images, x-ray images, and of course insurance and financial information. With so much sensitive patient information there for the taking, it comes as little surprise that the healthcare industry—perhaps more than any other sector—has become a primary target for cyberattacks. Now, more than ever, it is critical that healthcare organizations take decisive action to protect their data.
There has been no shortage of major (and notably costly) data breaches in recent years. The Equifax breach, for example, affected nearly half of all Americans. Last year’s Facebook breach was also headline news, thanks in large part to the number of users affected. Then there was a lesser-known yet costly LifeLabs breach—the largest in Canadian history—affecting more than 15 million people and prompting a lawsuit seeking north of $1 billion in damages for failure to adequately protect data.
Healthcare data heists yield a premium, making them particularly attractive to hackers. The Center for Internet Security (CIS) notes that the “average cost of a data breach incurred by a non-healthcare related agency, per stolen record, is $158,” compared with $355 for healthcare records.
Though large, the LifeLabs incident isn’t even close to the largest healthcare data breach in history. That dubious honor goes to Anthem, which suffered a breach in 2015 that resulted in nearly 80 million compromised records. Although Anthem was able to reach a settlement with the victims for the relatively paltry sum of $115 million, both the standards for data protection and the expected remediation for failure have changed considerably in the five years since the attack.
Regulations Raise the Stakes for Security
As the regulatory environment surrounding data breaches of all types grows more strict, hospitals and insurers have found themselves in the crosshairs of an increasingly brazen and sophisticated set of attackers. Part of the reason for this targeting stems from the relative value of healthcare records. There is a reason why “HIPAA” is an acronym known to most Americans, while other data protection laws are not.
Personal Health Information (PHI) tends to be more valuable than standard Personally Identifiable Information (PII) in large part due to its static nature. Patients can change a compromised credit card number or social security number, but not their medical history—and scammers prepared to exploit that history may render victims more vulnerable to certain types of fraud.
New regulations are further raising the stakes for compliance. Although the California Consumer Privacy Act (CCPA) is not specifically targeted at healthcare organizations, the sector represents potentially one of the most vulnerable industries under the new law. If an organization is found to be in violation of CCPA, they have 30 days to rectify the situation or be subject to a fine of up to $7,500 per record exposed.
To put this in context: if CCPA were adopted nationwide, the LifeLabs breach that affected 15 million individuals would potentially be subject to a fine of $112.5 billion. That $1 billion lawsuits that LifeLabs is facing might sound like a lot, but under CCPA, it might mean getting off easy. This should underscore the necessity of protecting data of any kind today—let alone healthcare records.
Ecosystems Span Email to Equipment
With the healthcare industry becoming an increasingly popular target and the penalties for breaches growing steeper, it’s important to consider that every endpoint, from desktops to devices, present attack paths for hackers. Measures as simple as stronger email security can make a big difference: in 2018 alone, Business Email Compromise (BEC) attacks resulted in more than $1.2 billion in victim losses. Spear phishing attacks, which are carried out using social engineering techniques to convince the target to relay confidential personal or financial information to what they believe is a legitimate recipient, represent an increasingly common method for attackers to gain access to user credentials or even directly obtain PII or PHI. Securing email with S/MIME (Secure/Multipurpose Internet Mail Extensions), which authenticates the sender of an email, enables employees not only to digitally sign and encrypt email communications but also to detect whether an email received has been authenticated or should not be trusted or opened.
Digital certificates are an essential part of protecting medical devices. Because they can be incorporated during the manufacturing process, these certificates allow device identity and integrity to be established from the moment they are first powered on. They also eliminate the potential for device spoofing, which protects against the possibility of counterfeit devices connecting to the network. These certificates serve as an effective proof point for savvy healthcare organizations. When vetting device suppliers and manufacturers, asking about their approach to device identity is essential. By learning to trust only manufacturers with a responsible approach to authentication, healthcare organizations can help protect one of the areas most susceptible to costly breaches.
Medical equipment itself has also become more vulnerable. Today’s diagnostic devices are rarely standalone—most are connected to the internet, and anything connected to the internet can potentially be compromised. In fact, this compromise could occur before devices even leave the factory, potentially undermining even the most secure networks and leading medical device manufacturers to consider security starting at the assembly line; the point where device identity measures and digital certificate authentication become critical. Technologies such as secure boot can protect the integrity of a device or piece of software from the first time it is powered on. Similarly, embedded firewall and secure remote update technologies help ensure that software updates are authenticated before installation and that any communication with unauthorized devices stops before harm can be done.
Moving Forward with New Security Strategies
Today, health insurers, hospitals, and other patient care organizations must manage a truly massive amount of data. It is simply a fact of life. That data comes in many forms, and it can be valuable to cyber attackers for a multitude of reasons. At its core, this data is the healthcare industry’s most valuable asset—one that it must protect at all costs.
Vulnerabilities can take many forms, from a human error to compromised devices. And while no solution can shield every possible form of attack, data and IT security administrators (and even OEMs) can take concrete steps to protect their organizations, patients, or chipsets against common attack vectors and better comply with today’s strict data protection regulations. Yes, the cloud has introduced new vulnerabilities, but it also has helped enable new security strategies and solutions that ensure every application, cell phone, server, or other connected “thing” has an authenticated digital identity. The stakes are simply too high, and hackers have become too savvy, to rely on yesterday’s security status quo.
Senior Fellow Tim Callan contributes to the company’s standards and practices effort, industry relations, product roadmap, and go-to-market strategy. Tim has more than twenty years’ experience as a strategic marketing and product leader for successful B2B software and SaaS companies, with fifteen years’ experience in the SSL and PKI technology spaces.
– Cerner launches a new Command Center dashboard to help organizations visualize and optimize operations in a centralized location by leveraging real-time data and predictive analytics to provide situational awareness and decision support during COVID-19.
– Powered by AI and predictive models, helps organizations align patient needs, staffing, and resources to improve care and operational efficiency.
Healthcare IT leader Cerner recently launched a new tool to help organizations visualize and optimize operations in a centralized location by leveraging real-time data and predictive analytics to provide situational awareness and decision support. The Cerner Command Center dashboard, powered by AI and predictive models, helps organizations align patient needs, staffing, and resources to improve care and operational efficiency.
Helping Provider Manage Operational Efficiency During COVID-19
The need for healthcare systems to have situational awareness has never been greater. To help organizations manage operational efficiency during COVID-19, Cerner offered and is offering rapid deployment of the Cerner Command Center dashboard. The Cerner Command Center culminates people, processes, and technology into a single physical space to execute collaborative decision-making and workflows supporting the improvement of patient throughput. This approach focuses on patients — aligning the patient with the appropriate caregiver, in the right place, at the right time. The Cerner Command Center centralizes operational solutions that provide situational awareness and trigger the team to take immediate action when needed.
features of the Cerner Command Center include:
data and predictive analytics to provide health systems clear line of sight
into critical resources such as available beds or equipment in order to respond
to patient needs and plan for the next.
– visualize key clinical and operational metrics in a centralized location, aligning throughput, staffing, and resources to optimize operations and drive action.
– standardized and near real-time dashboard that is accessible to the right staff at the right time can be used for making important operational decisions that can help facilitate the delivery of quality care to patients, support transformational change, and predictable operational excellence.
Deployment at Northern Light Health
Northern Light Health in Maine was the first health
system to deploy the Cerner Command Center dashboard, as
part of its COVID-19 response. The ability to capture and display real-time
data and analytics has been vital for Northern Light Health to effectively
address managing bed capacity and care activities during this health
crisis. With a cloud-based machine learning ecosystem, Cerner used
3 years of historical data from Northern Light Health to go beyond the current
and predict operational needs in the near future.
– Revenue cycle management provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue cycle management, workflow automation, and data analytics tools at a $1.3B valuation.
– The acquisition will create the first unified
healthcare payments platform with both commercial and government payer
connectivity, resulting in greater value for providers.
Waystar, a provider of healthcare payments software, today
announced a definitive agreement to acquire Francisco Partners-backed eSolutions, a revenue cycle
technology company with unique Medicare-specific solutions at a $1.3B valuation,
according to sources close to the deal. In bringing these two industry leaders
together, Waystar will be the first technology to unite both commercial and
government payers onto a single payments platform. The transaction is expected
to close later this year, subject to customary conditions and approvals.
Founded in 1999, eSolutions’ technology maximizes revenue
collection, accelerates cash flow, and reduces administrative burden across
numerous sites of care. The company has over 6,000 payer connections and
maintains a powerful and growing data set of billions of transactions. In addition
to hospitals and ambulatory providers, eSolutions has deep expertise in serving
the post-acute market across the entire revenue cycle, including skilled
nursing, senior living facilities, home care, hospice, federally qualified
healthcare centers (FQHCs), and durable medical equipment providers. eSolutions
is backed by Francisco Partners.
“eSolutions is thrilled to be joining forces with Waystar, a company like ours that relentlessly focuses on delivering exceptional customer service,” said Gerry McCarthy, Chief Executive Officer of eSolutions. “The combination of our technology platforms and data solves a major pain point in revenue cycle management to drive stronger results for our clients, partners, and for healthcare.”
Medicare has become the largest payer in the United
States and as baby boomers age, the mix of insurance coverage is
increasingly shifting to Medicare. Historically, providers have had to leverage
two different systems – one to handle commercial claims, and another to handle
Medicare. For healthcare providers, leveraging a single, end-to-end platform to
manage both private and government payments solves a major pain point and
creates significant efficiencies, freeing up time to deliver care.
“Together, Waystar and eSolutions will deliver unprecedented innovation to the industry, helping healthcare organizations accelerate revenue collection while reducing administrative expenses and repetitive tasks,” said Matthew Hawkins, Chief Executive Officer and board member of Waystar. “Uniting our companies’ data sets will further power Waystar Hubble, our artificial intelligence solution, providing access to even greater insights and value for our clients. We have long-admired eSolutions for its unique Medicare-specific revenue cycle capabilities, which are a perfect complement to the Waystar platform. We are excited to move forward as one team.”
6th Waystar Acquisition Since 2018
Waystar has integrated several other transformational
technologies onto its single instance cloud-based platform since uniting
Navicure and ZirMed in 2017. This marks Waystar’s sixth acquisition in the last
couple years, as the company rapidly expands within the space (not including
their own $2.3B acquisition by two private equity firms last year).
Recent acquisitions include Recondo, a patient estimation and prior authorization
technology, PARO, a presumptive charity scoring solution, UPMC’s Ovation, a claims monitoring tool, and Connance, leveraging predictive analytics to offer agency
manager, advanced propensity to pay (AP2P), and presumptive charity. Waystar is
backed by EQT, Canada Pension Plan Investment Board, and Bain Capital.
The coronavirus pandemic has affected every aspect of our lives, from how we work to how we get our health care. The crisis has put the creativity of many small businesses to the test after being forced to move operations online once social distancing became the norm. As economies reopen, many aspects of our life that changed in response to the virus will likely return to the way they were.
However, we have the opportunity to emerge stronger from this crisis if the salient shortcomings from our economic system are addressed. Regarding health care, the virus has exposed deep flaws in the way services are provided and has shown us how businesses and people can be better prepared when the next pandemic hits.
1. The way companies insure their workers will change
One trend we will likely see occurring is the decentralization of healthcare. Before the pandemic, there had been growing signs of American businesses becoming tired of a rigged system where costs to keep employees insured often spiraled out of control. One example of this dissatisfaction was the partnership between Amazon, JP Morgan, and Berkshire Hathaway, who more than 2 years ago announced the formation of their own joint venture to provide healthcare coverage to their employees.
The pandemic is going to introduce a long term change in healthcare and especially the relationship between companies and healthcare providers. More companies will make the switch to self-funded insurance and assume the healthcare expenses of their employees while being reimbursed for claims that exceed a certain amount through stop-loss insurance. Businesses will also start to hire their own physicians to offer services to their employees directly to reduce their dependence on the healthcare system.
Given our early struggle to increase our virus testing capabilities, companies may take steps to avoid waiting for the federal or local governments to step in during a pandemic. Businesses may start partnering with local labs to design their own diagnostic tools and serological tests which would allow them to react more quickly and successfully to an outbreak. Businesses will value knowing which of their employees have been exposed, how many might be immune, and which might be more susceptible to infection based on parameters such as BMI or blood pressure readings.
2. Businesses and people will take charge of their own health
Although the United States spends close to 20% of its GDP on healthcare, diseases that put people at higher risk for severe COVID-19 illness, including obesity, diabetes, and heart disease, are still prevalent in the population.
This crisis exposed the need for businesses to help employees maintain a healthy lifestyle in order to protect themselves and their jobs. Businesses may start promoting behaviors proven to strengthen the immune system and improve overall health, including taking active breaks at work to increase physical activity or encouraging healthy eating by offering healthy food choices. Companies may also start to offer testing equipment in office locations to help employees keep track of their health. Businesses may start investing in mini-physiology lab stations that include equipment to measure blood pressure, lung function, and heart health. They may also invest in blood tests that measure important biomarkers that allow employees to make better health choices that reduce their risk of disease.
3. Telehealth solutions will become widely available
The pandemic has amplified the need for a technology-driven transformation of healthcare. Companies can invest in built-in telemedicine capabilities so that employees have an easy way to get online care when they need it. The regulatory barriers that have delayed widespread use of telehealth should start to disappear. Hospitals can benefit from offering these services and implementing them now will better equip them for future crises. Doctors can remotely provide care to vulnerable patients so they don’t have to be exposed by going to a hospital, and physicians and nurses who have to quarantine themselves can still see patients through telehealth means so that hospitals don’t have to face staff shortages when they believe they might have been exposed.
4. Artificial Intelligence will change everything
The use of AI in healthcare will combine with the trends described above to completely disrupt healthcare, especially in terms of corporate wellness. Skyrocketing costs and disillusionment with the governmental response to COVID-19 will convince organizations of all sizes to take more direct responsibility for the health and wellness of their employees. Cloud-based systems can aggregate everything from electronic medical records to whole-genome sequences. Fitness trackers and other inexpensive devices can add real-time physiologic data that can be tracked over time.
All this data would be overwhelming for human physicians, but it’s perfect for AI-based systems. For example, an AI can continuously calculate the probabilities of dozens of diseases for each employee and generate automatic recommendations when a probability exceeds a certain threshold. Such systems can also give employees personalized advice to help them reduce such probabilities and return to a healthy state. The advice can range from lifestyle changes (nutrition, exercise, etc.) to supplements or further testing. These AI-based systems will grow in sophistication over time to rival – and even exceed – the capabilities of human physicians.
The American healthcare system was clearly dysfunctional even before COVID-19. However, the pandemic has put the flaws into sharp relief and will almost certainly push companies and other organizations to seek better solutions. Those solutions will leverage many recent developments including:
Cloud platforms with nearly limitless storage and compute capacity
Engaging mobile apps
Direct-to-consumer molecular and genetic testing
Fitness trackers and other medical devices
Together, these trends will usher in lasting change that will transform the healthcare landscape for all businesses.
About Dr. Don Brown
Don is a serial software entrepreneur (founder of 4 companies), life-long learner (4 degrees: a bachelor’s in physics, a master’s in computer science + biotechnology and an MD) and philanthropist (donated $30 million for the establishment of the Brown Immunotherapy Center at the Indiana University School of Medicine). Prior to LifeOmic, Don founded Software Artistry which became the first software company in Indiana ever to go public and was later acquired by IBM for $200 million. Don then founded and served as CEO of Interactive Intelligence which went public and was acquired by Genesys Telecommunications Laboratories in 2016 for $1.4 billion.
If you’ve been to a big-brand grocery or department store recently, you probably noticed some form of healthcare outlet – or maybe you didn’t. These in-store pharmacies and clinics have become so omnipresent, right there next to the diapers, dog food, and green beans, that unless you use them, you may not notice them at all.
This convergence of healthcare and retail has been happening for a few years and represents one of the fastest-growing corners of the healthcare market. In fact, retail health is growing at 10% each year – twice as fast as conventional healthcare.
The shared spaces are the latest and most obvious ways healthcare providers have emulated their retail counterparts. Just as retailers moved on from the 1980s mall archetype toward a more individualized, customer-friendly model, so too are healthcare providers – perhaps grudgingly. A large, decentralized healthcare system is more complicated than similar retail models, but patient expectations and other drivers are pushing the change. As a result, today’s hospitals increasingly are foregoing the traditional, centralized architecture in favor of distributed points of care – separate or offsite surgical, imaging and testing facilities are the norm for the modern health system.
The goal is the same whether it’s a hospital or a hardware store – improve and enhance the customer experience. Today’s hospitals are changing their models to make using their services easier, faster and, if not more enjoyable, certainly less irritating. Healthcare customers may not have the universe of options available to retail customers, but they do have options, including the easiest option of all – staying home.
Of course, this shift is about more than convenience. Because of the wave of healthcare consolidations across the country, rural America is increasingly underserved when it comes to healthcare. In those areas, these clinics offer an opportunity to receive expert care from medical professionals in other parts of the country through advanced applications and technologies. We also can’t ignore the affordability angle for patients. To some extent, productizing care and being able to access existing infrastructure in other, larger facilities, drives down cost in the overall system.
The Technology of Customer Experience
Of course, there is more to customer experience than physical accessibility. Retailers are leading the way in implementing technology to improve their customer interactions, and it’s about more than just e-commerce. You see it in everything from streamlined checkout and smart shelves to mobile coupons tailored to customer history.
The deployment of 5G networks will enable even more advanced, customer-friendly applications, something retailers and healthcare providers understand well. For that reason, they are exploring creative ways not just to leverage 5G services, but to partner with telecommunications providers to reach their shared customers.
The thinking is simple and sound: The ultra-low latency capabilities of 5G will enable innovations in all sorts of areas, including for the purposes of this conversation, intelligent retail and healthcare and telemedicine. In order for centrally located medical experts to access, read, and diagnose patients in remote clinic settings, often exchanging high-resolution medical imaging and other diagnostic information, low latency and high bandwidth are required. That’s where 5G comes in.
However, these networks require much denser networks with powerful computing that doesn’t yet exist across today’s networks. For users to take advantage of 5G’s many anticipated benefits, the network must be pervasive, and existing 4G LTE networks aren’t there yet.
That doesn’t mean providers aren’t trying. In fact, they clearly see an opportunity. Before COVID-19, Verizon estimated half the country would have access to 5G by the end of 2020, and in March the company announced an additional $500 million investment in its own 5G network. Our own industry survey conducted with 451 Research found that 86% of operators expect to be delivering 5G services by 2021. The projections are aggressive for good reason: IHS Markit expects 5G to generate some $12.3 trillion in annual revenue by 2035.
Meeting those timelines requires upgrades at existing cell sites but also fast, widespread deployment of new sites. Finding available real estate for that many new deployments – especially in the densely populated areas at the front of the line for 5G service – isn’t easy.
Enter the retail industry. Large retailers are in the business of reaching as much of the population as they can, and many of them already have a footprint that is the envy of cellular providers. The nation’s largest retail chain has 4,500 stores, and about 90% of the U.S. population lives within 10 miles of one of them. We look at that and see fast, easy, one-stop shopping. Telco providers see rooftops crying out for 5G equipment, with the potential to accelerate network densification and gain instant access to the vast majority of the U.S. population.
There is an opportunity emerging here for a symbiotic relationship between retailers, healthcare providers, and telecom operators to form a high-tech, customer-friendly hub for shopping and healthcare services. Let’s look at the possibilities from the perspectives of each party.
Telcos: It’s All About the Footprint
As always with network deployments, activity around 5G will follow demand, and demand follows the population. That means urban environments are likely to be first in the queue, and real estate in most cities is at a premium. Every rooftop and light pole are potential homes for 5G towers or equipment, a reality that has been the subject of considerable discussion – only recently moving toward a clear resolution.
Retailers already know the math, and most stores are placed strategically in proximity to as many consumers as possible. This is fertile ground for telcos, simplifying right-of-way negotiations and deployment times and ensuring significant network penetration. They also have ready-made customers in the retailers and healthcare providers occupying the buildings that support their towers.
Retail: Powering the Customer Experience
Customer experience has become a great differentiator in the retail space, as retailers evolve to meet the expectations of the Amazon generation. The last two years have been marked by growth in distribution centers and in the allocation of data center space supporting online retail and distribution.
Enabling the online shopping experience and bringing all the simplicity of online shopping to in-store customers are the threads that connect today’s most successful retail organizations. The tools and tactics making the in-store part of that possible include sensor and customer tracking, demand analytics, 360o customer learning, and artificial intelligence deployed in interactive customer environments that leverage the Internet of Things in new and creative ways.
These applications are only as effective as the networks upon which they exist and operate and 5G is simply far superior to our current 4G networks. The increase in bandwidth will enable speeds up to 100 times faster than 4G, eliminating the slow or dropped service common in highly populated environments – such as crowded department stores.
A retailer with a 5G antenna on the roof providing pristine service for all of its in-store technologies and large swaths of customers faces few limits in its deployment and adoption of advanced technologies.
Healthcare: Expanding With Confidence
The goal of retail healthcare is to make many common health services more accessible, and it’s working. There are more than 2,700 Convenient Care clinics (CCCs) in the U.S., and those clinics have received more than 40 million patient visits. Today’s consumers can buy a gallon of milk, pick up a prescription from the pharmacy, and get a flu shot in a single stop.
While these retailers and healthcare providers increasingly are sharing physical space and many of the same motivations – improving customer experience chief among them – there are some important differences. Protecting customer data certainly is a priority for retail stores – and a challenge, considering estimates that 80-90% of those who log in to a retailer’s e-commerce site are hackers using stolen data – but patient privacy may in fact be even more sensitive.
With that in mind, the security enhancements offered with 5G can harden existing retail healthcare networks and potentially open the door to even more patient services in those CCC settings. 5G has anti-tracking and spoofing features, including more encrypted data, to reduce the amount of raw data being transmitted and help protect against hackers. 5G relies more on software and cloud support than 4G, which enables better monitoring, and 5G networks can be sliced into smaller, virtual networks with security tailored for various devices and applications.
Those kinds of advanced security features may eliminate some lingering reservations among healthcare providers reluctant to dive fully into retail healthcare and embolden the more aggressive to expand their offerings. The increased bandwidth of 5G makes it easier to share and access not only sensitive files but also larger patient records, such as high-definition images and even videos from patient procedures. With no technological or security restrictions, it’s not a stretch to envision a world where anything short of surgery could happen in a CCC.
The Opportunity of Integration
There are plenty of arguments for this three-way marriage of convenience, but the full potential of this telco-retail-healthcare convergence will only be realized if the parties collaborate. There may be benefits for all parties in spite of siloed planning, but they’re also will be opportunities lost.
Retailers and healthcare providers who work closely with telcos can build offerings that take advantage of the on-site 5G capabilities, and telcos can gain not just rooftop real estate, but enthusiastic customers itching to stretch their data plans.
Of course, maximizing the partnership may mean new investments in IT systems and infrastructure. For example, you wouldn’t want to build the industry’s most robust customer experience program and then cross your fingers every time a storm threatened utility power. When you lean heavily into IT-enabled smart retail, power protection becomes paramount.
Similarly, retail healthcare centers, or CCCs, may seize the opportunity to expand their offerings and collect and/or transmit more sensitive patient data, but the enhanced security capabilities of 5G networks only go so far. Employees switching between external networks – to find an address for an insurance provider, for example – and more sensitive internal networks with private patient information will want to protect that sensitive information with secure KVM switches.
These types of investments can be managed separately or more efficiently as a single, integrated system. Mobile edge computing (MEC) is an increasingly common model for 5G-enabled computing hubs, and it brings the power and planning of an integrated, modular data center to these types of network edge locations.
MEC deployments can be housed inside or out, preserving valuable space in the store. They can be configured to support AC power-reliant IT systems as well as the DC power plants and equipment common to 5G sites. As with all modular solutions, they can be configured to meet the needs of a specific site and deployed in a matter of days. MEC systems also provide low-latency local computing when even 5G isn’t fast or secure enough for the user; most commercial transactions in these types of settings would be handled with local computing.
The key to optimizing these retail-healthcare-telco hubs is early communication between all parties and proactive planning to ensure the 5G capabilities are fully realized. A failure to communicate will result in squandered opportunities for everyone.
The Final Word
Eventually, all of this will happen with or without coordination between the interested parties. Retailers are going to continue to test the limits of technology to better serve their customers and give them more enjoyable experiences in their stores. Health systems are going to continue to decentralize their facilities and find ways to be closer to their patients and provide better interactions and outcomes. And telcos are going to find homes for their 5G antennas and expand their networks to deliver 5G services to both their subscribers and enterprises. There is an opportunity now, however, while all of these things are happening simultaneously, to do it all better, faster, and more efficiently while meeting the needs of all parties and their customers.
About Mitzi Amon, Director of Healthcare Marketing at Vertiv
Amon is the Director of Healthcare Marketing at Vertiv, where she has more than 20 years of experience in helping customers in healthcare, industrial and commercial environments optimize their operations. From researching the latest trends in the market to understanding the challenges faced by leading healthcare providers, payers, and vendors, Amon’s goal is to inspire conversations and build a collaborative environment where ideas are shared and solutions are created to help the industry stay ahead of what’s next.
– DreaMed Diabetes, the developer of personalized,
AI-based diabetes management solutions, will participate in a clinical study,
led by Jaeb Center for Health Research Foundation, to evaluate the efficacy of virtual
treatment for diabetes patients. The research is funded by a $5 million grant
from The Leona M. and Harry B. Helmsley Charitable Trust.
– DreaMed uses AI-powered technology to seamlessly treat
patients remotely with its virtual diabetes management service by providing
personalized recommendations on insulin dosage for people with type 1 diabetes.
– As part of Helmsley’s research, the study will
determine if the virtual clinic model improves clinical and psychological
outcomes for people with diabetes. DreaMed, together with Aetna and Cecilia
Health, will provide a multi-faceted platform to fully evaluate the
effectiveness of virtual clinics using DreaMed’s technology.
DreaMed Diabetes Ltd., the developer of personalized, AI-based diabetes management solutions, announces it will be serving as a subcontractor on a $5,025,099 grant from The Leona M. and Harry B. Helmsley Charitable Trust to the Jaeb Center for Health Research Foundation. DreaMed’s technology will include a comprehensive data system that can pull information from CGM, SMBG, insulin pumps, and connected insulin pens. It will visualize this information for the healthcare provider and for the participants through web and mobile applications as well as operate decision support algorithms to optimize insulin treatment plans for people with type 1/type 2 on insulin pumps or multiple daily injections therapy.
Growing Need for Virtual Diabetes Care
Due to the sheer size of the United States, many people with
diabetes lack the necessary medical support required, particularly access to
endocrinologists who provide them with critical guidance and information. This
includes the overseeing of continuous glucose monitoring (CGM), insulin-dosing
support, and pertinent mental health support. The lack of support alongside
today’s social distancing guidelines has encouraged a host of remote medical
initiatives, many of which aim to provide people with diabetes a comprehensive
virtual solution. While virtual solutions have proved exciting, questions
remain as to whether virtual care, including CGM, provides better outcomes than
Jaeb Center’s Pilot Study
In January 2019, the Jaeb Center’s pilot study assessed
whether CGM could be successfully introduced outside of a clinic over a
three-month period. The results found participants using CGM received
personalized support, enabling them to improve their glycemic outcomes and
quality of life. While the study proved invaluable, there was a need for a
larger study that truly evaluates the efficacy of remote diabetes care, which
will be accomplished within the scope of this new grant from the Helmsley
Charitable Trust to the Jaeb Center.
New Study Explores the Efficacy of Virtual Diabetes Care
The new study represents a more rigorous model for analyzing
virtual diabetes management, because it will evaluate CGM use over time,
glycemic- and participant-reported outcomes, healthcare utilization and cost,
the use of decision support tools, and the impact of mental health support.
Jaeb will evaluate the efficacy of a virtual specialty
clinic model for improving clinical and psycho-social outcomes for people with
diabetes. This evaluation will include 300 patients who don’t currently utilize
CGM, with type 1 and type 2 diabetes nationwide over the course of a six-month
period. To integrate the virtual management of insulin dosage, the initiative
will utilize the DreaMed Advisor Platform, which gives providers a way to view
and manage recommendations.
For the first time, DreaMed Advisor’s state-of-the-art
cloud-based technology will provide, in this study, personalized
recommendations on insulin dosage for people with type 1 or type 2 diabetes
treated with insulin pumps or multiple daily injections. The investigational
version of DreaMed Advisor will also manage the virtual presentation of
data derived from CGM, glucometers, insulin pumps, and connected insulin
pens. Furthermore, the platform supports virtual communications of new
treatment plans as well as a virtual clinic team, which provides behavioral
health coaching to help participants address certain diabetes-related
“We are thrilled to be involved in Jaeb’s VDiSC study,” says Eran Agmon, Chief Product Officer of DreaMed Diabetes. “Virtual care is the future of medicine, and the technology is ripe for deployment in diabetes. We are confident in the model and proud that our technology is providing the support necessary to enable its implementation”
– 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.
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.
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:
– Redox adds data on demand and single sign-on access
features to its cloud interoperability platform to help to simplify the process
of developing software for healthcare.
– Both new features are now available to all customers on
the Redox platform.
Inc., a Madison, WI-based interoperability platform for healthcare data
exchange, unveiled Data on Demand, which enables software developers to query
any electronic health
record (EHR) or healthcare data source via the Redox API. Powered by a
FHIR-conformant data storage architecture, Data on Demand is pre-built
integration infrastructure designed to simplify and normalize the integration
experience and reduce the technical burden of consuming hundreds or thousands
of messages per day. In addition, the company has added Single Sign-on that allows applications using Redox to make
it easier for providers to launch their products from within their EHR in an
efficient manner. Both features are available to all customers on the Redox
Data on Demand and Single Sign-on Simplify the Process of
Redox continues to expand the integration capabilities
healthcare software developers can access through a single API with these new
Data on Demand converts traditional HL7 feeds into a
data store that application developers can query on demand. This provides a
consistent integration experience that works with both the push- and API-based
integrations provided by EHR companies. Regardless of how data is provided by
the EHR, Redox customers can more easily manage the volume of messages and
logic needed to update information, allowing them to focus on getting the data
that they want, when they want it. No other integration vendor can turn HL7
feeds into reusable queries.
Single Sign-On (SSO) allows customers to improve the
provider’s experience with their products by sharing login credentials and
pertinent patient or visit context along with patient data that they’ve
collected. This allows applications on the Redox network to securely connect to
other applications and share the login context for a user. Customers trust Redox
to verify that the SSO request is valid, and Redox normalizes and pulls the
information to launch the application.
“Redox continues to develop the robust integration
capabilities software developers need to navigate the fragmented world of data
exchange and interoperability in healthcare,” said Niko Skievaski, co-founder
and president, Redox. “The Redox API is transforming the way healthcare
organizations access and share data. Our company’s ultimate goal is to enable
the frictionless adoption of technology in healthcare, and we’re making great
strides as the interoperability standard and one-stop-shop for our customers.”
– Today, Talis Biomedical Corporation announced it has
been awarded a $25M contract from the National Institutes of Health (NIH) as
part of Phase 2 of its Rapid Acceleration of Diagnostics (RADx) initiative as
well as another $100 million in additional financing.
– The new funding will be used to scale manufacturing for
the launch of the Talis One™ diagnostic platform that provides rapid and highly
accurate detection of COVID-19 at points-of-care in 30 minutes or less.
– The Talis One System is a fast, easy-to-use, solution
that brings testing out of the lab and to the point of care. The technology
provides healthcare professionals with an entire clinical lab in the palm of
their hand and is intended for use in non-laboratory settings, such as
physicians’ offices, urgent care clinics, elder care/assisted living
facilities, cancer treatment and dialysis centers, and potentially the
Talis Biomedical Corporation,
a company dedicated to developing high-performance point-of-care diagnostic
tests for infectious diseases, today announced that it has secured a $25
million contract from the National Institutes of Health (NIH) for Phase 2
of its Rapid Acceleration of Diagnostics (RADx) initiative. Additionally, the
company has completed an additional financing of $100 million to scale
manufacturing for the launch of the Talis One™ diagnostic platform, which
provides rapid and highly accurate detection of COVID-19 at the
Accurate Point of Care COVID-19 Testing
Today, patients are
often forced to endure days of waiting for lab results. As a result, doctors may initiate unnecessary
isolation or empirical treatment based on incomplete information. This approach
is costly and can be harmful to patients. With COVID-19 cases
on the rise in many areas across the country, there is a tremendous need for
access to testing, especially in vulnerable populations where the spread of
COVID-19 infection can be devastating. The Talis One System is a molecular diagnostic
platform developed to enable rapid, highly accurate point-of-care testing for
infectious diseases such as COVID-19.
Talis One COVID-19 Assays
The Talis One assays are based on a proprietary, highly
optimized nucleic acid isothermal amplification chemistry to achieve
exceptional test performance much faster than traditional PCR. The system is
designed for use in non-laboratory settings, such as physicians’ offices,
urgent care clinics, elder care/assisted living facilities, cancer treatment
and dialysis centers, and potentially the workplace.
COVID-19 is the first infectious disease that the Talis One
System will support. Future infectious disease indications may include assays
for other respiratory infections, such as influenza, as well as sexually
transmitted infections (STIs) and other infections impacting women’s health.
The Talis One instrument can be managed remotely and sends test results to a
cloud database for secure transmission, storage and review. Results are
available in 30 minutes or less.
“We are extremely proud that the NIH selected Talis,
out of a field of 600 applicants, to be among the first teams to move to the
final phase of the RADx initiative. This important funding will accelerate the
commercialization of our Talis One System for the detection of COVID-19.
Additionally, we are pleased to have the continued support of our investors,
who share our excitement about the significant impact the Talis One System can
deliver as a fast and reliable diagnostic testing platform for life-threatening
and life-altering infectious diseases,” said Brian Coe, Co-Founder and
Chief Executive Officer of Talis.
“In response to the significant need for rapid, highly
accurate testing solutions to help combat the pandemic, we were able to utilize
our Talis One System, which we have been developing for clinical use in women’s
health, to quickly develop an assay for SARS-CoV-2, the novel coronavirus that
causes COVID-19. We are particularly focused on serving vulnerable populations,
such as those in elder care facilities or patients with impaired immune
systems. With the support of the NIH RADx program and proceeds from the new
financing, we are confident that we will be able to accelerate our goal of
making rapid diagnostic testing widely available,” added Coe.
The Talis One COVID-19 assay project is supported by the
RADx program and has been funded in whole or in part with Federal funds from
the National Institute of Biomedical Imaging and Bioengineering, National
Institutes of Health, Department of Health and Human Services, under Contract
– To help meet the needs of ambulatory care practitioners in a post-COVID environment, Greenway Health, a leading health information technology, and services provider, today announced a new strategic partnership with Amazon Web Services (AWS).
– Leveraging AWS cloud services, Greenway is developing a
new cloud-based, data services platform, Greenway Insights, that creates new
data insights and healthcare interventions to advance the breadth of Greenway’s
products and services.
Greenway Health, a leading health information technology, and services provider, today announced a new agreement with Amazon Web Services (AWS), Inc. The agreement will promote collaboration in the healthcare industry with the primary goal of developing transformative healthcare products that will further meet the needs of ambulatory care practices in a post-COVID-19 world.
Insights Build on AWS
will develop a new cloud-based, data services platform, Greenway InsightsTM, on AWS that creates new data insights and healthcare
interventions to advance the breadth of Greenway’s products and services.
Greenway Insights will leverage AWS cloud services, giving Greenway engineering
teams direct access to a robust set of data analytics and machine learning
capabilities, such as Amazon SageMaker and Amazon Comprehend Medical, that will
enable product innovation to occur at an accelerated pace.
Initially, Greenway will leverage the platform to deliver a
regulatory analytics solution to help customers meet the evolving reporting
requirements of quality payment programs and value-based care
initiatives. The solution will enable practices to receive data insights in
real time, increasing practice performance and positively impacting patient
“Technology is key to improving patient care and health outcomes. This collaboration via our Digital Innovation Program to deliver the Greenway Insights data and analytics platform will bring needed solutions to the market quickly,” said Paul Zimmerman, Worldwide Head, Private Equity at AWS. “Our team is currently working with three Vista portfolio companies on innovative solutions, and we are particularly proud of our work with Greenway. The project is operating on a rapid implementation timeline, and we have already seen initial success and proof of concept. We are looking forward to a continued collaboration in developing solutions that streamline workflows and improve the way healthcare providers care for their patients.”
– Cerner expands its AI collaboration with Nuance to
provide joint customers with more advanced natural language virtual assistant
technology to navigate electronic health records (EHRs) using just
their voice, giving clinicians more time to spend with patients and less time
with a computer.
– As part of the expanded collaboration, Nuance will
offer Cerner deeply embedded virtual assistant technology that
delivers sophisticated conversational dialogues and skills to automate
high-value clinical tasks inside Cerner Millennium, such as chart
search, navigation, intelligent computerized physician order entry (CPOE), and
Communications, Inc. today announced that it has expanded its
long-standing AI collaboration with Cerner
to include the integration of Nuance’s virtual assistant technology into
the Cerner Millennium® electronic health record
(EHR). Building upon the existing integration between Nuance’s Dragon®
Medical platform and Cerner Millennium, joint clients can utilize
Nuance’s advanced natural language virtual assistant technology to navigate the
EHR using just their voice, giving clinicians more time to spend with their
patients and less time with their computer.
COVID-19 Underscores Importance of Addressing Physician
The expanded Nuance-Cerner relationship is driven by the healthcare industry’s need to mitigate what the World Medical Association is calling a “pandemic of physician burnout” with 51 percent of physicians reporting frequent or constant feelings of burnout. This is caused by a staggering administrative workload of electronic paperwork to document patient care and to meet requirements for insurance coverage, financial reimbursement, and medicolegal liability protection.
Research shows that more than 80 percent of physicians believe virtual assistants in health care can reduce the burden on care teams and improve the patient experience. Nuance’s virtual assistant technology helps physicians rapidly accomplish tasks and communicate more naturally while allowing them to use specialized medical terminology across a range of devices and applications with high accuracy.
Virtual Assistant Platform Integration Benefits
Nuance’s deeply embedded virtual assistant technology delivers sophisticated conversational dialogues and skills that automate high-value clinical tasks inside Cerner Millennium, such as chart search, navigation, intelligent computerized physician order entry (CPOE), and scheduling. Nuance technology’s high accuracy rates, rich set of voice-activated skills and ability to understand the user’s intent in context provides higher levels of workflow automation, and more efficient and complete documentation of patient care. Additionally, Nuance’s pre-built, HIPAA-compliant natural language understanding models and cloud platform will support Cerner to deploy the solution quickly and easily to joint clients.
“Together with Cerner, we’re bringing the next level of conversational AI directly to our joint clients with the goals of improving patient experiences, combating clinician burnout, and reducing costs,” said Joe Petro, CTO, Nuance. “Building on our Dragon Medical platform, already used by over 550,000 physicians in the U.S. alone, our new virtual assistant technology will help deliver solutions that automate time-consuming tasks, eliminate inefficiencies, and bring clinical intelligence and better decision-support to clinicians at the point of care.”
Select joint Cerner and Nuance clients can expect
to start deploying this integrated virtual assistant technology late this
– Cerner announced a new offering, CommunityWorks
Foundations aimed at reducing costs and speeding up the implementation process
for Rural and Critical Access Hospitals.
– This much-needed offering caters to small rural healthcare providers, who often face challenges such as geographic isolation, workforce shortages, educational disparities, and diminishing resources that can make it harder to deliver high-quality care.
– Rural hospitals serve about 20% of all Americans, and
Cerner is committed to providing technology and services to help individuals in
all communities get access to quality comprehensive healthcare.
today announced a new tailored cloud-based technology offering, CommunityWorks Foundations, created to help
Critical Access Hospitals across the U.S. reduce financial burdens. This new
technology, geared toward smaller and rural hospitals, offers a fixed-fee
payment structure with no up-front capital spend to help reduce costs and
lengthy implementation processes.
Rapid Cloud-based Deployment
CommunityWorks Foundations, a cloud-based
version of the Cerner Millennium® electronic health record
(EHR), is designed to expedite implementation with a six-month kick-off to
go-live timeline and will make it easier for small hospitals to better serve their
As with all hospitals deploying CommunityWorks, those using CommunityWorks Foundations will also leverage Cerner’s solutions and services designed to help improve clinical and business outcomes, the patient and provider experience and satisfaction while reducing physician burnout. CommunityWorks clients have seen success, with more than 70% of new clients beating baseline accounts receivable by 180 days post-implementation. These hospitals averaged a 5.5% improvement in this area.
Why It Matters
Healthcare providers in small communities often face challenges such as geographic isolation, workforce shortages, educational disparities, and diminishing resources that can make it harder to deliver high-quality care. The National Rural Health Association found COVID-19 has exacerbated these trends, with significant financial impact on these specialty hospitals – half of which were operating at a financial loss prior to the pandemic. Rural hospitals serve about 20% of all Americans, and Cerner is committed to providing technology and services to help individuals in all communities get access to quality comprehensive health care.
“Working with this segment of clients for more than a decade, we have evolved this cloud-based model to meet the various challenges community and rural health care organizations face,” said Mitchell Clark, president, CommunityWorks, Cerner. “CommunityWorks Foundations is the next evolution based on what we’ve learned from our more than 200 rural and critical access clients and the broader industry. It is built to help reduce financial barriers and better support communities that sometimes face challenges accessing the most innovative health care technology.”
With the successful early adoption of CommunityWorks Foundations
at organizations like Macon
Community Hospital, Cerner continues to demonstrate value to clients.
Johnson County Hospital (JCH), an 18-bed Critical Access Hospital with two
clinics located in southeast Nebraska, recently signed for CommunityWorks Foundations.
Hospital leaders cite cost, ease of implementation and vendor support as top
drivers behind the switch to Cerner.
Healthcare IT consultants’ work involving health records may expose them – and their provider and payer clients – to regulatory, legal, financial, and reputational risk. These risks are potentially higher in the COVID-19 era, with many of their employees working from home and accessing sensitive records and networks from remote locations. According to the US Department of Homeland Security (DHS), there is a heightened risk of phishing, SMS phishing and other attacks using COVID-19 themes, and increased attacks on newly deployed remote access and teleworking infrastructure. Managing these risks requires a clear understanding of what a consultant’s potential exposures are, adopting best practices for mitigating risk, and considering appropriate insurance coverage to cover potential liabilities.
How big is your risk?
Too often, cyber risk analysis is conducted with simplistic estimation methods based on broad assumptions. These methods may not tell the full story and may leave an organization uninformed about its true exposure. In my practice, we can use sophisticated scenario analysis to estimate cyber exposure – efficiently defining cyber event scenarios and estimate resulting losses using cost models tailored to specific impacts. Calculating the risk environment related to COVID-19 is part of this analysis.
Consultants and other vendors who have access to personal health information are organizations typically considered “covered entities” under HIPAA. As such, the consultants are “business associates” under HIPAA and subject to HIPAA requirements and penalties. These consultants may also be subject to claims and legal actions by affected patients who believe their personal health information privacy has been violated.
Because of the value of health records and the size of many of the clients, the average claim for a security or privacy breach can average $3.4 million for larger healthcare organizations, according to NetDiligence. Consultants are also subject to the risk of claims and legal actions from their provider or payor clients for damages arising from data breaches and other cybersecurity incidents, interruption of service, and other problems. And whatever the merits of these claims, the cost of defending can be very high.
Best practices for risk management
Best practices for risk management in the COVID-19 era start with employee education and ongoing communication. Focus on safeguarding personal health information, following your organization’s data security policies, proper management of emails that may include malware/ransomware, protecting mobile devices and sensitive paper documents in transit, and other measures. In an era of mass telecommuting, it means enhancing security controls around Security Application Gateway or VPN to access corporate systems and ensure multifactor authentication, where applicable. It also includes following best practices for virtual meetings, including the National Institute of Standards and Technology (NIST) Virtual Meetings Best Practices.
An updated, regularly tested and reviewed, business continuity and incident response plan is essential – with copies of the plan available offline and off-site. This plan should include the contact information for incident response vendors who have been approved by your cyber insurance carrier(s). The incidence response plan should, at a minimum, follow HHS guidance.
How much insurance do you need?
It’s a good idea to evaluate your insurance needs at least once a year, and perhaps more often if your business is rapidly changing. Some organizations acquire insurance early on in their company history, just enough to meet the requirements of clients, lenders, investors, and other interested parties. As time goes on, there may be inefficiencies where you’re paying too much for some coverages, or not scaling up coverage for the current size of your business and the potential exposures. Also, coverage should specifically meet the nature and size of current threats. For example, ransomware demands have increased 33% on average to $111,605 from Q4 2019 to Q1 2020 according to a recent Coveware report. A regular review, coupled with accurate risk assessment, will help you determine appropriate coverages.
Review your cyber liability insurance policy to ensure how it will respond to security/privacy infiltrations within a remote desktop employee environment. Most updated policy forms affirmatively cover unauthorized access into the organization’s network/system/environment when the software is managed by the insured organization, such as via a mobile device manager (MDM). However, each policy differs in coverage. Remind employees to report suspected activity or infiltrations of their home network to their IT/information security team in accordance with your incident response plan and cyber liability policy.
With the expanded use of technology, such as cloud utilization and EMRs, the healthcare industry is more interconnected and dependent on service providers more than ever before. The impact of the pandemic further stresses this reality and can cause implications that can pose numerous liabilities around the confidentiality, integrity, and accessibility of the data within your organization. Reviewing your vendor contracts and audit procedures of such critical vendors can be valuable in maintaining supply chain resiliency and limiting legal and incident response costs when security or privacy incidents occur. Cyber insurance may be an afterthought within some organizations. However, it is a crucial response mechanism that should be known and tested with various simulations to understand the adequacy of coverage and limits.
Disclosure: This article is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency LLC shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as actuarial, accounting, tax or legal advice, for which you should consult your own professional advisers.
– HealthEdge Software announces the acquisition of The Burgess
Group, LLC (“Burgess”), an innovative payment integrity software company
focused on improving healthcare payment operations for an undisclosed sum.
– The strategic acquisition will boost Health Edge’s position in
the payment integrity market and extends best-in-class claims processing to
include software-driven payment integrity
– Burgess’ product, Burgess
Source®, is the first solution to natively bring together claim payment
automation with business intelligence and enables a unified approach to ensure
HealthEdge Software, Inc.® (“HealthEdge”), a provider of the industry’s leading integrated financial, administrative and clinical platform for health insurers, today announced the acquisition of The Burgess Group, LLC (“Burgess”), an Alexandria, VA-based payment integrity software company focused on improving healthcare payment operations through technology. Financial details of the acquisition were not disclosed. TripleTree, LLC served as financial advisor and Debevoise & Plimpton LLP was legal advisor to HealthEdge and Blackstone. Seabrook Partners, LLC served as financial advisor and Vedder Price was legal advisor to Burgess.
Patient Accountability Platform
Founded in 1997, Burgess operates at the intersection
of healthcare, finance and technology. The company helps leading American
health insurers and ACOs set a new standard: Payment Accountability. The
company’s cloud-based platform, Burgess Source, is the only solution that
natively brings together up-to-date regulatory data, claims pricing and
editing, and real-time analytics tools. This unified approach allows clients to
make payments with total confidence, and make business decisions with real
Strategic Fit for HealthEdge to Power Next-Generation
“The acquisition of Burgess is a great strategic fit for HealthEdge to enter the large, high-growth market of payment integrity, helping address the estimated $1 trillion in wasteful spending in the U.S. healthcare system. This partnership will extend HealthEdge’s best-in-class claims processing to include software-driven payment integrity, actioned before a claim is paid, delivering significant value to health plans beyond what is available in the market today,” said Ram Jagannath, Global Head of Healthcare for Blackstone Growth and Chairman of HealthEdge. “We are excited to invest further in HealthEdge to continue building a market-leading software platform for health insurers.”
mission-critical next-generation Core Administrative Processing Systems
solutions to healthcare payors, enabling them to administer benefits, configure
plans, manage providers, and enroll participants seamlessly and efficiently.
The company’s products offer a modern, simple user interface, greater
flexibility, and a cloud-compliant solution well suited to the increasingly
complex and data-rich healthcare environment.
HealthEdge’s acquisition of Burgess follows the acquisition of a
majority stake in HealthEdge by funds managed by Blackstone (“Blackstone”) in
– BJC HealthCare has signed an agreement with patient payment platform
Patientco to offer a seamless patient financial experience, helping patients navigate their medical expenses and pay their bills.
– Patientco’s platform provides patients with a single
billing statement outlining their outstanding balance and will help BJC streamline its payment process by reducing the number
of bills associated with one visit as well as offering digital billing options
via email or text.
BJC HealthCare, a leading health system with 15
hospitals and multiple community health locations in the greater St. Louis,
southern Illinois and mid-Missouri regions has signed an agreement with Patientco to deploy its next-generation patient payment technology platform across
the enterprise. BJC sought an improved, more consistent financial experience
for patients and Patientco will provide BJC with a seamless suite of
patient-friendly billing communication and payment tools.
Billing & Payment Experience
enable BJC to provide patients a single billing statement
outlining their entire patient balance, streamlining the process and reducing
multiple bills associated with one visit. Patients can also opt to
receive digital billing communication via email or text instead of receiving a
mailed paper statement. Patients will then be able to pay their bills
using their preferred device, at any time of day or night, regardless of
business hours through an integrated patient payment portal. To address
affordability concerns for patients, BJC will also support
online, self-service enrollment in flexible payment options, like payment
Together, these features will help patients easily understand, manage, and pay their medical bills. Additionally, Patientco’s technology directly integrates with the health information system (HIS), which supports a better experience for both BJC patients and team members. The BJC revenue management department will also have access to other cloud-based features from Patientco, including:
Digital mailroom for automated check and correspondence
Interactive chat to answer patient inquiries
Staff payment processing integrated within the HIS
Multi-PM/HIS auto posting
Real-time payment reporting
User audit reporting
Historical performance reporting
“We understand that medical financial burdens can cause added stress for patients,” said Cole Elmer, BJC Vice President of Revenue Management. “Our goal is to provide an improved payment system that simplifies the billing experience and offers more convenience and additional options for patients.”
– Microsoft released the public preview of Azure IoT
Connector for FHIR (Fast Healthcare Interoperability Resources), the latest
update to the Microsoft Cloud for Healthcare.
– The Azure IoT Connector for FHIR makes it easy for
health developers to set up a pipeline to manage protected health information
(PHI) from IoT devices and enable care teams to view patient data in context
with clinical records in FHIR.
This week, Microsoft released the preview of Azure
IoT Connector for FHIR—a fully managed feature of the Azure API for FHIR.
The connector empowers health teams with the technology for a scalable
end-to-end pipeline to ingest, transform, and manage Protected Health
Information (PHI) data from devices using the security of FHIR APIs.
and remote monitoring. It’s long been talked about in the delivery of
healthcare, and while some areas of health have created targeted use cases in
the last few years, the availability of scalable telehealth platforms that can
span multiple devices and schemas has been a barrier. Yet in a matter of
months, COVID-19 has accelerated the discussion. There is an urgent need for
care teams to find secure and scalable ways to deliver remote monitoring
platforms and to extend their services to patients in the home environment.
Unlike other services that can use generic video services
and data transfer in virtual settings, telehealth visits and remote monitoring
in healthcare require data pipelines that can securely manage Protected Health
Information (PHI). To be truly effective, they must also be designed for
interoperability with existing health software like electronic medical record
platforms. When it comes to remote monitoring scenarios, privacy, security, and
trusted data exchanges are must-haves. Microsoft is actively investing in
FHIR-based health technology like the Azure IoT Connector for FHIR to ensure
health customers have an ecosystem they trust.
Azure IoT Connector for FHIR Key Features
With the Azure IoT Connector for FHIR available as a feature
on Microsoft’s cloud-based FHIR service, it’s now quick and easy for health
developers to set up an ingestion pipeline, designed for security to manage PHI
from IoT devices. The Azure IoT Connector for FHIR focuses on biometric data at
the ingestion layer, which means it can connect at the device-to-cloud or cloud-to-cloud
workstreams. Health data can be sent to Event Hub, Azure IoT Hub, or Azure IoT
Central, and is converted to FHIR resources, which enables care teams to view
patient data captured from IoT devices in context with clinical records in
Key features of the Azure IoT Connector for FHIR include:
– Conversion of biometric data (such as blood glucose, heart
rate, or pulse ox) from connected devices into FHIR resources.
– Scalability and real-time data processing.
– Seamless integration with Azure IoT solutions and Azure
– Role-based Access Control (RBAC) allows for managing
access to device data at scale in Azure API for FHIR.
– Audit log tracking for data flow.
– Helps with compliance in the cloud: ISO 27001:2013 certified supports HIPAA and GDPR, and built on the HITRUST certified Azure platform.
Microsoft customers are already ushering in the next generation of healthcare
Some of the healthcare organizations who are embracing the technology include:
– Humana will accelerate remote monitoring programs for
patients living with chronic conditions at its senior-focused primary care
subsidiary, Conviva Care Centers.
– Sensoria is enabling secure data exchange from its Motus
Smart remote patient monitoring device, allowing clinicians to see real-time
data and proactively reach out to patients to manage care.
– Centene is managing personal biometric data and will
explore near-real-time monitoring and alerting as part of its overall priority
on improving the health of its members.
– 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
– Health Catalyst announces an agreement to acquire
clinical workflow optimization solution healthfinch using a mix of stock and
– As part of the acquisition, healthfinch will be a new
application suite category called EMR Embedded Insights and its refills, care
gaps closure, and visit planning applications will continue to be available in
their original configuration.
Catalyst, Inc., a provider of data and analytics technology and services to
healthcare organizations, today announced that it has entered into a definitive
agreement to acquire healthfinch, Inc., a Madison,
Wisconsin-based company that provides a workflow integration engine delivering
insights and analytics into EMR workflows to
automate physicians’ ability to close patient care gaps in real-time. Health
Catalyst expects to fund the transaction using a mix of stock and cash.
Clinical Workflow Optimization
Founded in 2011, healthfinch has developed the healthcare
industry’s most trusted, most used clinical workflow optimization solution,
Charlie. Charlie’s unique combination of EMR-integrated technology and protocol
content streamlines key workflows such as prescription renewal processing,
visit planning, and care gap closure. With Charlie, health systems are able to
deliver a better, safer patient experience, while also achieving lower rates of
provider and staff burnout, increased care gap closure, improved quality
metrics, and significant time and cost savings for providers and clinical
Integration with Health
Catalyst Analytics Application Portfolio
The healthfinch acquisition, which will allow Health
Catalyst’s customers to enhance clinical workflows in the EMR, further
strengthens the Health Catalyst Population Health portfolio, which was
bolstered by the Able Health acquisition in February 2020 and Care
Management Suite launch earlier this month.
Within the Health Catalyst analytics application portfolio,
healthfinch will be a new application suite category called EMR Embedded
Insights and its refills, care gaps closure, and visit planning applications will
continue to be available in their original configuration. Additionally, the
healthfinch technology will augment workflows across Health Catalyst’s product
portfolio, with data and insights powered by Health Catalyst’s cloud-based Data
Operating System (DOS™), a healthcare-specific, open, flexible, and scalable
data platform that provides customers with a single comprehensive environment
to integrate and organize data.
healthfinch’s industry-leading capabilities are already in demand from Health Catalyst customers and prospects across multiple product areas including quality measures, care management, population health, patient safety, and others. Providing these capabilities will bring even greater value to Health Catalyst customers by making the critical insights and analytics from the DOS platform actionable within clinical workflows – providing more effective care for patients and saving time for both doctors and staff through automation so they can work at the top of their license.
“We are thrilled to benefit from healthfinch’s decades of collective experience gained from working with customers across the United States that are using a variety of different EMRs. And we also find deeply compelling the strong mission and cultural alignment with our respected healthfinch teammates. We are excited to have the healthfinch leadership team and their talented colleagues join Health Catalyst, and we are grateful for the tremendous insights, knowledge and perspectives they bring, which will accelerate the achievement of our mission to be the catalyst for massive, measurable, data-informed healthcare improvement,” said Health Catalyst CEO Dan Burton.
Burton added, “This acquisition highlights Health Catalyst’s ability to integrate and scale software applications on top of our DOS platform. The healthfinch technology will easily serve up actionable insights, derived from DOS and other Health Catalyst analytics applications into the EMR, at the point of care.”
– Philips integrates the BioIntelliSense FDA-cleared
BioSticker™ sensor as part of its remote patient monitoring solutions for
patients outside the hospital.
– Multi-parameter sensors aid monitoring across multiple chronic conditions with medical-grade vital signs for physicians to remotely track core symptoms, including COVID-19.
– Healthcare Highways is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S.
Philips, today announced it has formed a strategic collaboration with BioIntelliSense, a continuous health monitoring, and clinical intelligence company, to integrate its BioSticker™ medical device into Philips’ remote patient monitoring (RPM) offering to help monitor at-risk patients from the hospital into the home. With the addition of multi-parameter sensors, Philips’ solutions can enhance how clinicians monitor patient populations living with chronic conditions – including diabetes, cancer, congestive heart failure and more – in their homes with passive monitoring of key vital signs, physiological biometrics, and symptomatic events via a discreet wearable patch for monitoring up to 30 days.
COVID-19 Pandemic Underscores Need for Remote Patient Monitoring
Remote patient monitoring and telehealth-enabled clinical programs offer care teams a sustainable and scalable way to manage patient populations with chronic or complex conditions at home and plays a key role in supporting care for COVID-19 patients who do not require hospitalization. By regularly transmitting patient data that can provide critical insights into a patient’s condition, the collaboration will empower care teams in the U.S. with a more holistic patient view and the ability to intervene earlier before adverse events occur. With single-use sensors and patient-owned technology supporting remote monitoring, care teams can also help reduce the need for clinicians and patients to interact in person.
“With more patients interacting with their doctors from home and more hospitals developing strategies to virtually engage with their patients, remote patient monitoring is now, more than ever, an essential tool,” said Roy Jakobs, Chief Business Leader Connected Care, member of the Executive Committee at Royal Philips. “Building on Philips’ global leadership in patient monitoring, which includes an extensive suite of advanced monitoring solutions, platforms, and sensors, this is the latest example of our capability to allow more seamless, cloud-based data collection across multiple settings from the home to the hospital and back into the home. Patient data, coupled with our clinically differentiated and leading AI-powered technology, quantifies the data into relevant actionable insights to help detect deterioration trends and support care interventions – all while outside the walls of the hospital.”
Wireless, Secure Data Transfer of Key Vital Signs
BioSticker is a single-use, FDA-cleared 510k class II wearable medical device
to enable at-home continuous passive monitoring with minute level data across a
broad set of vital signs, physiological biometrics and symptomatic events (skin
temperature, resting heart rate, resting respiratory rate, body position,
activity levels, cough frequency) on a single device for thirty-days. Symptoms,
including those directly associated with COVID-19 such as temperature and
respiratory rate, can be remotely monitored in confirmed cases of Coronavirus
and also for those patients not sick enough to be hospitalized, or those
suspected of having COVID-19.
addition to COVID-19, the BioSticker device will help transform the way
clinicians monitor and manage patients living with chronic conditions from the
sensors are the natural next phase for remote monitoring, especially at a time
when more patients are engaging with their physicians from home,” said James
Mault, MD, Founder and Chief Executive Officer of BioIntelliSense. “Clinicians
need medical grade monitoring and algorithmic clinical insights for COVID-19
exposure, symptoms and management. Accelerated by the COVID-19 crisis, the
practice of medicine has been irreversibly enlightened as to the safety and
efficacy of virtual care. Philips is a demonstrated leader in remote patient
monitoring, and we look forward to BioIntelliSense’s technology playing
an integral role in simplifying and enhancing outcomes for patients and their
Healthcare Highways first to leverage BioSticker as a part of
Philips’ RPM solutions
Healthcare Highways, a provider of health plans, high-performance provider networks, pharmacy benefit management, population health management, and benefit plan administration, is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S. Out of the seven programs that will be deployed with Healthcare Highways, one will focus specifically on monitoring patients with COVID-19. The remaining six will focus on conditions across the acuity spectrum, including patients with congestive heart failure, hypertension, diabetes, total joint replacement, cancer and asthma. The program will help Healthcare Highways improve insights to patient health status across its provider network.
“Healthcare Highways was built on the idea of delivering measurable value and access to quality care to our members. We work in partnership with our providers to innovate on the care model, and look at Remote Patient Monitoring as the next frontier of how providers will connect with patients,” said Creagh Milford, DO, MPH, Chief Medical Officer of Healthcare Highways and Chief Executive Officer of HighCare Health. “COVID-19 has underscored the need for proactive care management. Resources are strained and by integrating an RPM program with biosensor technology, we’ll be able to drive further value for our unique member base, providers and employers to establish a new way of care delivery.”
Healthcare facilities and their sprawling campuses can be overwhelming and challenging to navigate. In fact, facilities lose close to $800 million a year due to missed hospital appointments, and many physicians blame a significant portion of this lost revenue on the problems patients have navigating these facilities.
Figuring out where to park and finding the correct office can be stressful and negatively impact the patient’s experience. Making matters worse, most hospital staff members work in the same unit day in and day out. If a patient approaches them with a question regarding directions, they may not be able to provide an answer or will spend valuable time searching for one. When patients get lost, they tend to arrive late for their appointment, which can back up schedules and create costly inefficiencies for facilities.
Digital wayfinding can help ease this burden on busy staff while improving the patient experience. Visitors also benefit from feeling at ease, knowing they can quickly locate their loved ones. Implementing a wayfinding solution enables healthcare organizations to automate turn-by-turn directions and highlighted routes, making it easy for patients and visitors to find their desired location.
Hospital Wayfinding Mechanics
Most hospital wayfinding systems utilize Bluetooth Low Energy (BLE) technology found in smartphones, which allows for seamless connectivity and lets patients and visitors view the hospital map on their device and navigate in real-time. To deploy this application successfully, all buildings and outdoor areas of the facility must first be mapped.
Once a facility’s maps are finalized, they are uploaded to a Content Management System (CMS) with correlating data such as pathways, routes, and points of interest (POIs). If desired, facility administrators can easily access the cloud-based CMS to create, update and manage maps, points of interest, and pathway routing. Advanced analytics such as real-time occupancy, the volume of visits, historical routing and heatmaps, dwell times, space utilization rates, and web usage data are available for in-depth reporting. This information can help your facility better prepare for the future and ensure your patients receive the care they need.
Locating infrastructure, including BLE beacons, are easily installed to provide indoor location data to the application layer. For more precise coverage and use case expansion, facilities can leverage other Real-Time Location System components using a combination of technologies such as Wi-Fi, Second Generation Infrared, Low Frequency, and BLE. Combining a wayfinding solution with other location services investments reduces IT burden, enhances patient and staff satisfaction, and improves ROI. A future-proof solution can continue to add immense value to healthcare facilities for years to come.
Hospital Wayfinding and Patient Experience
The most advanced indoor wayfinding applications offer many features, including interactive hospital directories, pathway management, informative POIs, navigation from home, geofencing, and location sharing. They can trigger appointment reminders, GPS driving directions to the facility, and turn-by-turn directions once a patient has arrived. Various routes are provided to patients, visitors, and staff who can select filters such as ADA compliance or minimized outdoor travel time in poor weather conditions. These routes are customizable and can also be modified for construction routes, new additions, staff-only and visitor access, and even pathways that avoid specific areas, like COVID-19 units, to support infection control.
The mobile application can contain keyword smart search and can also share helpful details such as contact information, hours of operation, images, videos, descriptions, and URLs. While at the facility, patients and visitors can share their indoor location via text and email. When it is time to leave, they can use the save my parking feature to locate their parked car. In the case of an emergency, the application can direct patients where to go to receive urgent assistance to avoid wasting precious minutes.
Other technologies such as Electronic Medical Records (EMR)/Electronic Health Records (EHR) and Real-Time Location Systems are easily integrated with the wayfinding solution to improve patient experience and make healthcare workers’ shifts easier. Patients can access personalized appointment information such as care plans, questionnaires, and check-in capabilities through the app. In-app access to leading EMR/EHR systems allow users to launch navigation directly from appointment reminder texts or notifications as well as search for a physician.
Staff members can utilize the solution to quickly search for and locate available equipment, such as wheelchairs. Additional integrations include visibility to ER and urgent care wait times, transportation services, scheduling systems, and more. Multiple delivery options, including mobile applications, touchscreen digital kiosk displays, and web browsers, are also available.
One day soon, healthcare facilities will be entirely revolutionized by IoT technologies including wayfinding applications. Digital wayfinding solutions are the first application to provide seamless connectivity of indoor and outdoor environments with navigation and routing from home, across campuses, between buildings, and to parking areas. By investing in wayfinding, healthcare facilities can design a better patient experience, improve operational efficiency, and save valuable resources.
About Christoper Thompson
Christopher Thompson is the Director of Patient Experience at CenTrak, a leading provider of location and sensing technology for the healthcare industry. Thompson has a master’s degree in nursing and more than 20 years of experience improving hospital workflow and operations.