TTA’s Mid-Winter Update: CVS board boots Bertolini , VA’s exec suite revolves again, a clean look at Digital Health 2019 investing, Outcome Health exec settles, NHS snoozes, more!

 

 

February is here, can Spring be far away? It might be an early one for Mark Bertolini, booted from the board of the company he worked so hard to put together. Ashik Desai of Outcome Health may be looking at a Club Fed ‘vacation’. And James Byrne of the VA got an early furlough from Washington for that Florida holiday. So we can take a Mid-Winter’s nap courtesy of NHS, dream of digital health investments for 2020, and won’t buy into a company paying a $1 million monthly rent.

But do wake up in time for DHACA Day on 18 March! A good reason to be in London….

Considering 2019’s digital health investment picture: leveling off may be a Good Thing (Less froth, more quality)
Outcome Health’s Desai reaches settlement with DOJ, SEC (Another cautionary tale of Young Entrepreneurs Gone Wrong–somewhat like Theranos)
Comings and goings, wins and losses: VA’s revolving door spins again, NHS sleep pods for staff, Aetna’s Bertolini booted, Stanford Med takes over Theranos office

Practice Fusion costs Allscripts another $145 million–and leads a closer look at the boundaries between ethics and revenue. AR contact lenses on the way? Outcome Health’s small fish plead guilty. And in the UK, CQC’s recommendations and DHACA Day in March.

Mojo Vision’s really smart vision correcting/AR contact lenses (A bit of a moonshot)
A Practice Fusion coda: an insider’s perspective on the pressure to ethically breach an ‘objective’ service for revenue (How far is too far?)
Allscripts’ $145 million settlement with DOJ on Practice Fusion’s ‘kickbacks’ on opioid prescribing, other charges (Why PF was so cheap)
Outcome Health analysts plead guilty, cooperate with Federal prosecutors (Trap the small fish…)
Digital triage in health service – CQC’s initial recommendations (Moving towards regulatory clarification)
Calling all digital health entrepreneurs: DHACA Day on 18th March is for you! (NHSX, AI, and more)

Acquisitions and funding raises lead off with Teladoc and InTouch Health, DrChrono, and CareBridge. Where are the hottest startups?–not on either coast. But Proteus continues on the Road to No-teous. Femtech’s hot but unvalidated. And events from Dallas to Dubrovnik!

News roundup: Proteus dissolves with Otsuka, EHRs add 16 min. per patient, DrChrono mobile EHR raises $20M, CareBridge LTSS launches, ‘flyover healthtech’ soars
Femtech’s huge potential global healthcare market–but needs to connect with payers and employers (That Old Validation Again)
Consolidation crunch time in telehealth: Teladoc acquires InTouch Health for $600 million (Enterprise telehealth is the charm)
European Patient Experience and Innovation Congress (EPIC 2020) invites world health tech to Croatia (And beautiful Dubrovnik)
Texas Healthcare Challenge WISH-es on women in February hackathon (Dallas TX) (Health Wildcatters’ latest)

To kick off the New Year, we take a Gimlety view of CES and the state of health tech innovation, Babylon Health’s diagnostics, Germany’s health ID system, and the cratering value of many HIT companies.

News roundup for the New Year: NHS £40m diet on login times, Germany’s ‘cheesy’ health ID security, Livongo and Higi partner, MTBC picks up CareCloud (For a knockdown price)
CES roundup: what happened to the excitement around ‘innovation’, robots, VR, and voice assistants? (A Gimlet Eye view of CES)
Babylon Health criticized by Manchester CCG, cardiac activists in UK, Canada (Scaling and AI problems lead to more)
The CES circus opens its largest tent yet in health tech, AI, 5G, and more (Step right up…)

Our windup for 2019: the ACA mandate was found to be unconstitutional, Babylon Health’s entering the US market in January, Appello acquires Medvivo Careline. Will Outcome Health’s execs dodge Club Fed? And calendar DHACA/HTF’s pitch event on 5 February.

The last news roundup for 2019: ACA mandate unconstitutional, more $ for health research, PartnersHealthcare rebrands, Hackensack Meridian pays ransom, breaches>heart attack deaths, telepsychiatry merger, more (Bidding farewell to ’19, and a happy, healthy New Year to our Readers)
Babylon Health to enter US market with two large strategic partners: report (What $550 million will do)
Calling all pitchers! Join us at Baker Botts on 5th February for a great evening (DHACA/HTF London pitch event)
Appello acquires Medvivo Careline telecare in second major move this year (UK)
Outcome Health founders Shah, Agarwal plead not guilty in Federal court
(Dodging the Club Fed Outcome will take years)

Barely two weeks to Christmas, but a blue one for Proteus Digital Health employees and six former Outcome Health execs. HHS leadership mixes it up in public, malware bites Hackensack, but it’s lovely in Leeds–and if you have a new job.

News roundup: Proteus may be no-teous, DOJ leads on Google-Fitbit, HHS’ mud fight, Leeds leading in health tech, malware miseries, comings and goings (Proteus runs out of road for 300, DOJ looking at Fitbit acquisition, HHS execs no lika each other, malware 2020, and it’s Leeds leading)
“There were practices going on there that were wrong”: Outcome Health’s Desai pleads guilty, cooperates with DOJ. (One pleads guilty, three not guilty, with the major players pleading on Monday)


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A Practice Fusion coda: an insider’s perspective on the pressure to ethically breach an ‘objective’ service for revenue

From both sides: an insider at Practice Fusion, then a regulator at ONC. Mentioned briefly in POLITICO Morning eHealth is a blog posting from a former ONC (Office of the National Coordinator, HHS) official, Jacob Reider, MD, about Practice Fusion. Before he was Deputy National Coordinator of Health IT, he was CMIO of Practice Fusion circa 2009-11. His blog has some interesting insights on even ten years ago, how aggressive pharmaceutical companies were in wanting to ‘bend’ (Editor’s term) clinical decision support (CDS) in the EHR to promote a drug category, and in a young, growing, and revenue-hungry company, the temptation for ‘growth’ teams to do so. Fast forward a few years, and Dr. Reider is working to write the certification requirements for EHRs and the evidence (via citations) for CDS. His conversations with the then-CEO, Ryan Howard, about the ethics of their advertising model and their rationale illustrate the conflict between ethics and revenue–as in right up to the line and looking over. While this is familiar to any media observer–after all, why buy advertising if not to change behavior?–when decisions are being guided by an EHR, the CDS shouldn’t be rigged, visibly or invisibly. Dr. Reider places the crossing of the line after Mr. Howard’s departure with a new pharma-minded team. The evidence in the CDS lies in the citations funded by–pharma and biomed companies. The inevitable result: Allscripts, now the owner, settling for $145 million with the DOJ and having ‘kickbacks’ attached to their business. Dr. Reider is now CEO of the Alliance for Better Health in Albany, NY. Docnotes: When sponsored CDS is a crime

This is hardly the first instance of the blurring of boundaries between ethics and revenue. All those paying to get their genetic history from 23andme or Ancestry.com ought to consider that they may also be signing on to have their information used by a medtech company for research. It may be stripped of PII and ‘de-identified’, but there are ways of cross-referencing some of that information. Why else would GSK own 50 percent of the company? [29 Aug 19, 31 Oct 15

Allscripts’ $145 million settlement with DOJ on Practice Fusion’s ‘kickbacks’ on opioid prescribing, other charges

The US Department of Justice announced on 27 February that it reached a $145 million settlement with Practice Fusion on what DOJ termed “kickbacks from a major opioid company in exchange for utilizing its EHR software to influence physician prescribing of opioid pain medications”. Allscripts, which now owns Practice Fusion, will be paying out penalties of $25.4 million in criminal fines, $113.4 million to the Federal Government, and up to $5.2 million to individual states, as well as forfeiting criminal proceeds of nearly $1 million from the ‘kickback’. The specific charges relate to two felony charges related to the Anti-Kickback Statute (AKS) and for conspiring with its opioid company client to violate the AKS.

The opioid company is widely believed to be Purdue Pharmaceutical, manufacturers of Oxycontin, according to HISTalk. The high dudgeon generated in the DOJ press release is related to opioid prescriptions and physician usage which are and remain highly controversial. Apparently, Purdue wasn’t the only pharma company that benefited from this type of influence.

In this Editor’s analysis, ‘kickbacks’ is a legalism to prosecute under the AKC what marketers would term a sponsorship deal. Practice Fusion was from inception advertiser supported. What is different here from pop-up screen adverts is that Practice Fusion created sponsorship packages in which not only advertising was featured, but also clinical support decision (CDS) alerts were created, aimed at increasing prescription sales of companies’ products. In addition, Practice Fusion allowed companies to participate in the design of the CDS software. These sponsorships took place between 2014 and 2019. None of this is unusual in AdLand in general, but in pharma and healthcare which play by far stricter rules about marketing programs, this goes against the expectation (and regulation) that an EHR is unbiased.

Allscripts had ‘leaked’ this back in August on their Q2 investor call. Buried in the DOJ release after the opioid ire is the settlement of Practice Fusion’s violations of Office of the National Coordinator for Health Information Technology (ONC) regulations concerning the voluntary health IT certification program, and the Centers for Medicare & Medicaid Services (CMS) regulations around EHR incentive programs, presumably Meaningful Use certifications and payments. This was the origin of the earlier announcement of a $145 million settlement on Allscripts’ Q2 2019 investor call, which in retrospect strikes this Editor as a nice try at minimizing far more serious charges. [TTA 14 August] CDS favoring opioid prescription is far more disturbing.  

It does seem that Allscripts bought itself a bargain basement of trouble with Practice Fusion. Mobihealthnews, TechCrunch

News roundup for the New Year: NHS £40m diet on login times, Germany’s ‘cheesy’ health ID security, Livongo and Higi partner, MTBC picks up CareCloud

NHS investing £40 million to cut health service login times, £4.5 million on digital assists for independent living. Announced by secretary Matt Hancock, the objective is to move to reduce the time to log in over the 15 systems NHS clinicians and staff may have to use with a patient. The test of a single sign-on system at Alder Hey hospital in Liverpool reduced it from 105 seconds to 10. The Department of Health and Social Care is also providing £4.5m to local authorities to fund digital programs aimed at aiding independent living for recipients of adult social care. Guardian

Germany’s health data network security is ‘swiss cheesy’. Germany’s physicians are in the process of being networked into the national health system through an electronic doctor’s card and practice ID card which identify and sign them in. Similarly, patients will have their own chipped ID card. A special research project by NDR, Der Spiegel, and  IT security experts belonging to the Chaos Computer Club (CCC), found that they could send all three to a cheese monger’s shop in Lüneburg. Looks like their security has a few ‘holes’ in it. Tagesschau.de

Livongo’s diabetes/chronic condition management platform and health kiosk Higi are partnering in 500 retail pharmacies in Michigan for a Livongo-branded health screening and tracking program, using Higi’s measurement, tracking, and Livongo’s wellness programs. Mobihealthnews

CareCloud acquired by MTBC for $17 million cash and about $41 million in total consideration such as warrants and perpetual preferred stock. Both companies are in similar businesses related to medical practice management, EHR integration, and patient communications. It reflects the deep falloff of value in the absurdly overcrowded field of EHR and practice management businesses since Meaningful Use wound up: Allscripts’ acquisition of Practice Fusion for $100 million in January 2018 [TTA 14 Aug 19] and reduced prospects for other HIT players such as Athenahealth, Watson Health and Waystar [TTA 25 Apr 19]. Total investment in CareCloud was north of $150 million in ten funding rounds (Crunchbase) which makes the price a knockdown for the investors like Norwest, Intel Capital, First Data and PNC. Seeking Alpha, MTBC release, commentary on HISTalk.

Allscripts reaches deal with DOJ on Practice Fusion in compliance settlement for $145 million

EHR giant Allscripts settled with the US Department of Justice on compliance charges made against Practice Fusion. Allscripts acquired Practice Fusion, a free/low-cost EHR targeted to primary care practices, in January 2018. A year earlier, Practice Fusion had received an inquiry from the US Attorney’s Office for the District of Vermont examining the company’s compliance with the EHR certification program. According to Fierce Healthcare, after Allscripts acquired Practice Fusion, the inquiry expanded…and expanded…to include additional certification and Anti-Kickback statute charges. Since then, Allscripts has rebranded the EHR as Veradigm.

The announcement was made during their 2019 Q2 results investor call. Their president claimed the $145 million settlement, at this point an agreement in principle with DOJ, is in line with other EHR-DOJ settlements. 

Consider it a final payment on the knockdown price ($100 million) Allscripts paid for Practice Fusion.

Their Q2 bookings were $276 million, up 31% from the prior-year period, but revenue at $445 million was lower than expectations. 

News roundup: First Stop, GlobalMed, American Well, Avizia, Medicity, Health Catalyst, Allscripts, Welbeing, BenevolentAI

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”125″ /]Announcements and acquisitions have been multiplying–here’s what’s most interesting.

In companies we’ve recently written about:

Our recent Contributor Bruce Judson, now with corporate telemedicine provider First Stop Health, wrote us enroute to the Government Finance Officials Association conference in St. Louis that FSH achieved triple-digit top-line revenue growth and also achieved an average utilization rate of 52 percent. The formal announcement was made earlier this week at the HLTH conference in Las Vegas (release), where another one of our Contributors, Sarianne Gruber, is attending for Answers Media Company.

GlobalMed, a prior contributor to Perspectives, is offering a lower cost telemedicine alternative to practices with a flat fee starting at $799 per month for three years. Startup costs remain at about $5,000. The starting kit includes a cart, a total exam camera, stethoscope and vitals linked to the organization’s network, and a nurse license. Additional compatible equipment is available at extra cost. We know that a number of comparable telemedicine cart-based kits run upwards of $8,000. It is one of the first public acknowledgments this Editor has seen (but has known for years) that high cost is a major impediment for implementing both telehealth and telemedicine in practices. Health Data Management.

In other news:

Telemedicine and telehealth consolidation continues with American Well’s acquisition of hospital-based telemed/workflow systems provider Avizia. Avizia has a product line of telemedicine carts and workflow software for 40 different specialties, including telestroke and telebehavioral health. The acquisition price was not disclosed. Prior investors in this 2013 Cisco spinoff include Northwell Health, NY-Presbyterian, HealthQuest, and other providers in seven rounds totaling over $23 million. Healthcare IT News

A further sign of consolidation, this time in the crowded health information business, is the Medicity acquisition by Health Catalyst. Health Catalyst is primarily a data analytics and warehousing company while Medicity focuses more on data interoperability and patient engagement for practices, health systems, and HIEs. Medicity was purchased by Aetna in 2011 with much fanfare for $500 million as one of its ‘Emerging Businesses’, rebranded as Healthagen in 2013 [TTA 28 Feb 14] which never quite took off. Out of that unit, what remains are Active Health Solutions and Aetna Accountable Care Solutions, a payer-driven value-based care management company. The amount of the sale was not disclosed but is expected to close in 90 days. Health Catalyst’s CEO Brent Dover served as president of Medicity up to 2013, and both companies are located in Salt Lake City. What is interesting about this sale is that CVS, which is buying Aetna, has no comparable in-house technology. It’s a probable shedding of peripheral or money-losing businesses prior to sale.  HISTalk, MedCityNews

Allscripts continues on its acquisition binge with patient communication and engagement platform HealthGrid. HealthGrid is a mobile app platform that delivers care and education materials traditionally distributed from practices to patients via paper. In January, Allscripts bought practice EHR Practice Fusion for $100 million (a loss to investors) and earlier McKesson’s HIT business for $185 million. It’s a noticeable shift to value-added care tools for this formerly EHR-centric company. Mobihealthnews. 

In UK news:

Welbeing has won Norwich City Council’s Norwich Community Alarm Service (NCAS). It provides a 24-hour, year-round monitoring and response service for over 6,500 adults who are vulnerable or at risk in this part of East Anglia. The press release is on UK Telehealthcare‘s news page. 

BenevolentAI, a UK company using artificial intelligence for drug development, raised $115 million in new funding, mostly from undisclosed investors in the United States, according to Mobihealthnews, for a total funding of over $200 million. The company uses AI to reduce drug discovery time and risk. It does not do its own drug discovery but sells the intellectual property discovered by their AI algorithms, claiming to cut drug development timelines by four years and improve efficiencies by 60 percent compared to pharma industry averages.

Updated–Rounding up this week’s news: VA budget, Shulkin’s troubles, ATA’s new CEO, Allscripts’ wheeling-dealing, Roche buys Flatiron, Nokia out of health?, NHS Carillioning?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]Here’s our roundup for the week of 12 February:

VA wins on the budget, but the Secretary’s in a spot of bother. Updated. Last week started off as a good week for Secretary Shulkin with a White House budget proposal that increased their $83.1 billion budget by 11.7 percent, including $1.2 billion for Year 1 of the Cerner EHR implementation in addition to the agency’s $4.2 billion IT budget which includes $204 million to modernize VistA and other VA legacy IT systems in the interim. While the Cerner contract went on hold in December while record-sharing is clarified, the freeze is expected to be lifted within a month. POLITICO  Where the trouble started for Dr. Shulkin was in the findings of a spending audit by the VA’s Inspector General’s Office of an official European trip to Copenhagen and London which included unreimbursed travel by Mrs. Shulkin and free tickets to Wimbledon, at least partly justified by a doctored email. This has led to the early retirement of the VA Chief of Staff Vivieca Wright Simpson and also an investigation of hacking into Wright Simpson’s email. It also appears that some political appointees in the VA are being investigated for misconduct. CNBC, FierceHealthcare.

Updated: POLITICO doesn’t feel the love for Dr. Shulkin in today’s Morning eHealth, linking to articles about the supposed ‘internal war’ at the VA, with veterans’ groups, with the Trump Administration, and within the VA. It’s the usual governmental infighting which within the 16 Feb article is being whipped by POLITICO and co-author ProPublica to a fevered pitch. Dr. Shulkin comes across as doctor/tech geek who underestimated the politicization of and challenges within an agency with the mission to care for our veterans. It’s also an agency having a hard time facing the current demands of a dispersed, younger and demanding veteran group plus aging, bureaucratic infrastructure. As usual the ‘privatization’ issue is being flogged as an either/or choice whereas a blend may serve veterans so much better.

Digital health entrepreneur named CEO of the American Telemedicine Association. A first for ATA is a chief from the health tech area who is also one of the all-too-rare executive women in the field. Ann Mond Johnson, who will be starting on 5 March, was previously head of Zest Health, board chair and advisor to Chicago start-up ConnectedHealth (now part of Connecture), and had sold her first start-up company Subimo to WebMD in 2006. She began her career in healthcare data and information with The Sachs Group (now part of Truven/IBM Watson). Ms. Johnson replaces founding CEO Jonathan Linkous, who remained for 24 years before resigning last August and is now a consultant. ATA release, mHealth Intelligence. ATA relocated in January from Washington DC to nearby Arlington Virginia. And a reminder that ATA2018 is 29 April – 1 May in Chicago and open for registration.

Allscripts’ ‘Such a Deal’! Following up on Allscripts’ acquisitions of Practice Fusion for $100 million (a loss to investors) and earlier McKesson’s HIT business for $185 million [TTA 9 Jan], it hasn’t quite paid for itself, but came very close with the sale of McKesson’s OneContent, a healthcare document-management system, for a tidy $260 million. Net price: $25 million. Their CEO is some horse trader! Some of the savings will undoubtedly go to remedying the cyberattack in January that affected two data centers in North Carolina, shutting down EHR and billing applications for approximately 1,500 physician practices, which have launched a class action lawsuit. FierceHealthcare 

Flatiron Health acquired by Roche. (more…)

EHR action: Allscripts acquires Practice Fusion, expands footprint in small/ambulatory practices

A significant EHR acquisition kicks off an action-packed week. Announced today by leading EHR Allscripts is their acquisition for $100 million of independent practice EHR Practice Fusion. Allscripts, which has been usually in the top five US EHRs (Kalorama April 2017 survey), vastly expanded its hospital market share with August’s acquisition of #2 McKesson‘s health IT business and with this would be ranked just behind EHR leader Cerner. In acute care settings, Epic and Cerner dominate with 25 percent of the market each with Allscripts/McKesson far behind #3 Meditech (KLAS April 2017). 

Practice Fusion, one of the pioneers in the small practice/ambulatory EHR starting with a basic free, ad-paid model in 2005, has 30,000 ambulatory sites serving about 5 million patients each month. In the Allscripts view, they will now be able to offer “last mile” reach to the under-served clinicians in small and individual practices” and close gaps in care. Allscripts President Rick Poulton noted in the statement that “We believe this transaction will directly benefit Practice Fusion clients, who will now have access to Allscripts solutions and services. We look forward to welcoming Practice Fusion team members to our family.” which leads one to believe that the Practice Fusion name will be sunsetted. Allscripts release and Healthcare IT News

From being the leader in small practice EHRs, Practice Fusion found the last few years difficult as competition expanded into their segment, from eClinical Works, drchrono, athenahealth, and NextGen to small practice packages from Epic and Cerner.

It should be noted that Practice Fusion in 12 years went through 13 funding rounds, raising almost $158 million from a long list of VC luminaries such as Kleiner Perkins, Artis Ventures, Founders Fund, and Qualcomm Ventures (Crunchbase). However, it disappointed its investors and Wall Street, which expected two years ago a $1.5 billion IPO. The $100 million from Allscripts is all cash and the price is “subject to adjustment for working capital and net debt”–an exit which was surely not the sugarplum in the eyes of its 2014 and prior  investors. CNBC

‘VC tourism’ in Health Tech Land is over (updated)

The ‘silly money’ is packing its bags and taking the next flight from the Coast. An exceedingly tart take out of Fast Company confirms what your Editors have noticed in Rock Health and other year-end reports. Funding for digital health may have surpassed $4.2 billion in 2015, but it barely eked over 2014’s total of $2.3 billion despite rising geometrically since 2011 [TTA 16 Dec 15, revised by Rock Health since then]. Since then, we’ve had the Trouble Every Day of ‘unicorns’ (overreaching) Theranos and (ludicrously) Zenefits [TTA 17 Feb]; EHR Practice Fusion stalled out and cutting 25 percent of its staff, hoping to be acquired by athenahealth–or anyone (Healthcare Dive); shaky Fitbit shares [TTA 20 Feb]. Perhaps the high point was last year’s ‘Corvette Summer’ with yet another big round to a company yet to fulfill its promise, ZocDoc [TTA 15 Aug 15]. Even Castlight Health with decent revenue (still at a loss) has been dubbed an ‘absolute horror show’ when it comes to its share prices, if you were foolish enough to buy it at or near its IPO.

Fortunately a large dose of sanity may prevail among VCs with a sobering realization–no different than five or ten years ago–that investment has to be strategic and far longer than the usual 18 month-and-out time frame. Too many companies have systems which work the same niche–you don’t need 50 companies doing these things: data analytics for care management, patient engagement platforms, med reminders or diabetes management. [We’ve already noted the ‘sameness’ in companies getting funded in 2015, almost as if investors were seeking reassurance in similarity, a sure sign of a coming fail–TTA 30 Dec 15.]

Developers must fill a need–uniquely. And have a superb business plan, squeeze the nickels till they squeak and forget about the party culture. Investors: Dumb Money For Digital Health Will Vanish As Quickly As It Came In

 

If Silicon Valley were a rose, it would be wilting

Does this signal a new ‘trough of disillusionment’? The lead in this story is one of the major practice EHRs in the US–Practice Fusion. From a high valuation in 2013 of $635 million as a healthcare darling (free to doctors, ad supported), it burned through $4 million cash per month while revenue missed targets by 10 percent, chased after rainbows such as telemedicine, overhired, overperked and overpartied in the office. Now with a quarter of their staff pink-slipped, a new CEO is trying to bail them out. Most of the other examples aren’t healthcare, but huge deals by VCs are slowing, companies are discounting the price of their shares, taking on debt to not dilute shares, laying off employees and subletting their space. Adding to this is the glut in wearables and a slowdown in demand for single-purpose devices, leading to a 20 percent loss today in value in shares of Fitbit (MarketWatch). Like the ‘oil patch’ in the upper Midwest, the San Francisco area is feeling the chill that never really left the rest of the country. And ‘unicorns’ may become an endangered species. Wall Street Journal

Integrating inexpensive lab testing, imaging to EHR–and vice versa

In the Dr Eric Topol patient-driven world, personal lab testing would be walk in, keep retail hours and not even need a doctor’s order. That is the model for Theranos, a well-funded low cost blood testing company operating 43 centers in California, Arizona (no doctor order needed) and one Pennsylvania Walgreens. Their latest alliance is with EHR physician practice giant Practice Fusion, which claims about 112,000 doctors actively using its cloud-based, ad supported platform, claims to be the fastest growing US EHR with at present 100 million patient records. The Theranos reporting app, which also connects patients with doctors who can help interpret the results (MD Connect) integrates with other EHRs (though not listed) and now the results will also show in their Practice Fusion patient record. Practice Fusion is also integrating imaging center RadNet‘s results.

Since the late 2000s, Practice Fusion has historically been the game changer in cost (one of the first in the cloud) and in catering to smaller practices. They are good at managing their hype, but as Neil Versel points out, there’s been a CEO ‘change-lobsters-and-dance’, there are questions about revenue and their awaited IPO seems far away, especially given the recent market upset. Hospital EHRs Cerner, Epic and NextGen now all have lower-cost practice versions that integrate with hospital versions. An American College of Physicians (ACP) 2014 survey identified that Practice Fusion is third (and tied with others) among most used practice EHRs behind Epic and eClinical Works, though strongest in solo practices. On the polar opposite of Mr Versel’s skeptical article is this breathless Forbes piece which confuses partnerships with acquisitions. Perhaps self-made billionaire Theranos CEO Elizabeth Holmes may decide to buy Practice Fusion!

Unicorns to Series A–health tech funding gained in (perhaps) the nick of time

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/08/1107_unicorn_head_mask_inuse.jpg” thumb_width=”150″ /]Money, money everywhere–unicorns get the headlines, but the companies are still (largely) small

Up until early August, this Editor would have assumed that our Readers would look at this funding roundup as a bracing windup to a largely positive eight months and a veritable Corvette Summer for healthcare technology funding. We may have to give back the keys a little sooner than we imagined. Will the dropping market affect digital health as 2008-9 did–‘out of gas’ for years? Or will it barely affect our motoring onward? Despite the Dow Jones average hitting an 18 month low today, we hope it’s closer to the latter than the former. though the new and big entrant to digital health investing is the country most affected, China.

Our roundup of the August Action includes ZocDoc, Fitbit, Alphabet, PillPack, Owlet and more, along with a few comments:

**ZocDoc, a NYC-based online medical care appointment service that matches patients with doctors by location and schedule, had the most sensational round with last week’s Series D funding of $130 million, giving it a valuation of $1.8 bn. It took over a year after the filing (June 2014) and was led by two foreign funds (London-based Atomico and Edinburgh-based Baillie Gifford) with additional funding from Founders Fund, which previously participated in raises of $95 million.

Though it claims 60 percent coverage in the US  and ‘millions of users’ (numbers which have been quoted for some years), ZocDoc won’t disclose profitability nor volume–metrics that would be part of any IPO.

Direction? Points given for deciphering this windy statement (quoted from Mobihealthnews): (more…)

Encouraging signs of change

A couple of recent articles have given me hope, after a really depressing session at my local surgery today for an NHS Health Check.  It began when I spotted two adjacent notices in the waiting room, the first encouraging patients to access the surgery’s online facilities, and the second banning the use of mobile devices. It descended further when after producing the form I’d been asked to complete about height, weight, alcohol consumption, family history of disease etc., I was asked every question all over. When I protested, I was told that as most patients don’t fill in the form, or forget it, they ask patients anyway. (Discretion suggested it probably wasn’t the right time to suggest that perhaps that was why people don’t fill in forms…)

However the first article, by Zahid Latif, who heads up healthcare for the Technology Strategy Board, indicates a restlessness with the current use of patient data that appeals to me.  He goes on to explain how the projects in the TSB’s dallas programme (more…)

AliveCor links with Practice Fusion

Breathlessly noted in today’s mHealth blogosphere is AliveCor’s partnership announcement with EHR giant Practice Fusion to integrate their patient-generated ECG information. According to the release, the 100,000 physician base of Practice Fusion will have the option to import AliveCor ECG data into patient records. This is a major breakthrough for AliveCor, which just gained FDA over-the-counter clearance for its snap-on case [TTA 11 Feb]. The AliveECG app also enables physicians to obtain an expert review of the ECG data, annotate and electronically transfer this data into the EHR within seconds. Is this the confirmation that AliveCor is the ‘product of the year’ as the Forbes article puts it? Or just an indicator where mHealth with clinical quality could be going?  (Let’s see if other EHRs like Athenahealth join the trend.) Release