Matthew Holt

Matthew Holt
Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site. He is also the co-founder of the Health 2.0 Conference, as well as a Founding Principal of the associated consulting firm Health 2.0 Advisors.

In Search of Intra-Aero-Bili-ty

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Today is the kick-off of the vendor-fest that is HIMSS. Late last week on THCB, ONC director Karen De Salvo and Policy lead Jodi Daniel slammed the EMR vendors for putting up barriers to interoperability. Last year I had my own experience with that topic and I thought it would be timely to write it up. (I’ll also be in the Surescripts booth talking about it at 3.45 Monday)

I want to put this essay in the context of my day job as co-chairman of Health 2.0, where I look at and showcase new technologies in health. We have a three part definition for what we call Health 2.0. First, they must be adaptable technologies in health care, where one technology plugs into another easily using accessible APIs without a lot of rework and data moves between them. Second, we think a lot about the user experience, and over eight years we’ve been seeing tools with better and better user experiences–especially on the phone, iPad, and other screens. Finally, we think about using data to drive decisions and using data from all those devices to change and help us make decisions.

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This is the Cal Pacific Medical Center up in San Francisco. The purple arrow on the left points to the door of the emergency entrance.

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Cal Pacific is at the end of that big red arrow on the next photo. On that map there’s also a blue line which is my effort to add some social commentary. To the top left of that blue line in San Francisco is where the rich people live, and on the bottom right is where the poor people live. Cal Pacific is right in the middle of the rich side of town, and it’s where San Francisco’s yuppies go to have their babies.
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Last year, on August 26, 2014 at about 1 am to be precise, I drove into this entrance rather fast. My wife was next to me and within an hour, we were upstairs and out came Aero. He’s named Aero because his big sister was reading a book about Frankie the Frog who wanted to fly and he was very aerodynamic. So when said, “What should we call your little brother?” She said, “I want to call him Aerodynamic.” We said, “OK, if he comes out fast we’ll call him the aerodynamic flying baby.” So he’s called Aero for short.

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Thus began the Quest for Intra-Aero-Bili-ty –a title I hope will grow on you. The Bili part will become obvious in a paragraph or two.

Something had changed since we had been at Cal Pacific three years earlier for the birth of Coco, our first child.

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If you look carefully at the top of Amanda’s head, there’s now a computer system. Like most big provider systems, Sutter–Cal Pacific’s parent company–has installed Epic and it’s in every room or on a COW (cart on wheels). Essentially we have spent the last few years putting EMRs in all hospitals. This is the result of the $24+ billion the US taxpayer (well, the Chinese taxpayer to be more accurate) has spent since the 2010 rollout of the HITECH act.

Why England is out of the World Cup

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Matthew holt

I don’t often write about Footy any more on THCB, but England is out of the World Cup today, stuffed 4–1 by Germany. So I thought I’d give my opinion, and for the moment I’m dropping my dual nationality and writing as an Englishman!

Why did we lose? Realistically England doesn’t have enough good players because England’s population is too small (50m vs 80m Germans) and—as pointed out in Soccernomics—the working class ethos against middle & upper class kids limits our potential pool of players even more—as England’s working class population is falling relatively as more kids go to college. In general England could improve our football team by changing its economy to match the slums of Argentina’s or Brazil’s but I wouldn’t take that as a fair trade. After all, the US dominates international sport (except its fifth most important sport soccer) because it has a huge urban underclass with a great feeder system (that’s colleges!) to getting them into basketball/American Football/Track etc. And it may well be that with more and more kids from the big urban centers getting into soccer, America can only improve. It’s a decent prediction that the US will win the World Cup in the next 50 years or so. Unlikely that England ever will again.

Accessing & Using APIs from Major EMR Vendors–Some Data at Last!

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Today I’m happy to release some really unique data about a pressing problem–the ability of small tech vendors to access health data contained in the systems of the major EMR vendors. There’ll be much more discussion of this topic at the Health 2.0 Provider Symposium on Sunday, and much more in the Health 2.0 Fall Annual Conference as a whole.

Information blocking, Siloed data. No real inter-operability. Standards that aren’t standards. In the last few years, the clamor about the problems accessing personal health data has grown as the use of electronic medical records (EMRs) increased post the Federally-funded HITECH program. But at Health 2.0 where we focus on newer health tech startups using SMAC (Social/Sensor; Mobile OS; Cloud; Analytics) technologies, the common complaint we’ve heard has been that the legacy–usually client-server based–EMR vendors won’t let the newer vendors integrate with them.

With support from California Health Care Foundation, earlier this year (2016) Health 2.0 surveyed over 100 small health tech companies to ask their experiences integrating with specific EMR vendors.

The key message: The complaint is true: it’s hard for smaller health tech companies to integrate their solutions with big EMR vendors. Most EMR vendors don’t make it easy. But it’s a false picture to say that it’s all the EMR vendors’ fault, and it’s also true that there is great variety not only between the major EMR vendors but also in the experience of different smaller tech companies dealing with the same EMR vendor. All the data is in the embedded slide set below, with much more commentary below the fold.

David Delaney, SAP: Democratizing Data Science

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SAP is a giant of ERP but over a decade or so has been layering both new acquisitions in analytics (Business Objects, Success Factors) and developing the Hana “cloudfirst” data platform. They’re actually a quiet giant in health care, in part because of a partnership with Epic. But the next step is providing what they’re calling a “democratization of data analytics” allowing line managers & clinicians to really understand what’s happening at the coal face of care delivery. It’s a complex space, but one David Delaney, Chief Medical Officer at SAP, explains in this interview from HIMSS17

Omar Hussein, CEO Imprivata

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This is the first of a series of interviews I’m doing at the behemoth HIMSS conference. They will hopefully give you a quick overview of the companies, and give you a sense of where the system is going.

First up, grabbed in the corridor is a quick interview with Omar Hussain, CEO of widely used data security company Imprivata. (They incidentally had a rocking party last night, and in case you were wondering this interview was filmed before not at the party!)

Big community hospital CEO pay-out. Normal, criminal, both?

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Salinas is a poor-ish rural California town down Highway 101 from Silicon Valley, and the financial contrast between the two is similar to that between Beverly Hills  and Bell, a California city where officials’ salaries sparked national outrage and then arrests. Now it turns out that the CEO of the local Salinas community hospital got a $4m retirement pay-out and a $150,000 a year pension and managed to stay on in his job for another two years at $668,000 a year and when he retired last week he got another payment of nearly $900,000. Can we expect the same in the Salinas case as in Bell? I doubt it because that would expose to the world that there are thousands of community hospitals all over America paying their CEOs the same kind of money–ignoring the $1 million + salaries most AMCs dole out.  Can running a 300 bed hospital really be that difficult?

Interview with Rasu Shrestha, CIO at UPMC

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More about Health 2.0 Rasu Shrestha, CIO at the University of Pittsburg Medical Center, will be joining me on stage this afternoon in our Provider Symposium (on his birthday) and again on Tuesday, September 27th for our Information Blocking, APIs & App Stores: The State of Play in Data Access session. Below is the interview I had with him a couple of weeks ago about how a huge medical center like UPMC deals with the innovation side of the house. Not too late to sign up and come to Health 2.0 and come hear what else Rasu has to say!

Indu & Matthew talk Health 2.0 with Lisa & Dave

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One of the most insightful and funniest writers in health care is recovering VC Lisa Suennen. With trusty sidekick Dave Shaywitz, she’s been doing Tech Tonics, one of these newly trendy (again) podcasts. And Sunday at Health 2.0 they interviewed my partner Indu Subaiya, and me. Want to know a little more aobut the backstory of Health 2.0? Listen in!

Bridget Duffy: Improving the patient experience

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Bridget Duffy, the CMO of communications tech company Vocera & head of its Experience Innovation Network, is a national leader in the patient experience movement. And we all agree there are lots of improvements needed in the experience for both patients and front line clinicians. Anyone following the story about the death of my friend Jess Jacobs last year knows that there are problems a plenty in how patients are treated (pun intended). Bridget talked with me at HIMSS17 about how well we’ve done and how far we have to go.

Philips — Interview with Carla Kriwet

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Now I’ve got them uploaded and semi edited I’ll be running the interviews I did at the HIMSS conference earlier this month. They will hopefully give you a quick overview of the companies, and give you a sense of where the system is going.

Today is an interview with Carla Kriwet, CEO of Patient Care and Monitoring Solutions at Philips. The Dutch electronics giant has a huge footprint in the hospital and big ambitions outside it.