By David Shaywitz, MD

While the evolution of the digital health ecosystem has seemed at times almost painfully contrived, it now appears to have reached the point where it requires but a few sprinkles of magic fairy dust to be truly alive.

The basic idea behind digital health is pretty clear: we can (and must) do health better, and technology should be able to help,

There’s also an ever-increasing amount of support for early-stage innovators in this space. A remarkably large number of digital health incubators have sprung up around the country, as Lisa Suennen captured with characteristic verve in a recent Venture Valkyrie post.

On top of this, a slew of corporate VCs have now emerged – many from payors, but some from communication companies, and even a few from big pharmas such as Merck – all keen to invest strategically in the digital health space.

Deliberately, many of these large corporations also represent likely buyers for the products or services that will be produced, so it really does seem like an example of the savvy external sourcing of innovation.

So we’re good, then – right?

Well, not so fast.

It turns out that many high profile VCs continue to eschew this space, other than perhaps an occasional investment or two. The reason? As one extremely well-regarded VC – with extensive healthcare experience – told me yesterday, “I haven’t seen a viable business model yet.”

Translation: how do you make (serious) money here? Where’s the revenue?

Continue reading “Digital Health: Almost a Real, Live Business”

By John Irvine

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Who am I? Why am I here?  Does it really matter anyway?  Bestselling business author and corporate historian Jim Collins(“From Good to Great”, “Built to Last: Successful Habits of Visionary Companies ”) has made a career by asking executives unused to such introspective philosophical questions to stop and think about the fundamental assumptions at work in their businesses.  Collins has found that the most successful companies (think Google, Apple, Microsoft, probably notFacebook) learn to ask the key questions that keep them focused on what they’re supposed to be doing and teach them to avoid making the mistakes that cause lesser, more mortal companies to trip up over their own feet.  Not long ago THCB was on hand to catch Collins and bestselling author (“Getting Things Done”) David Allen speak at an exclusive invitation-only healthcare forum hosted by the Denver-based Breakaway group. In this interview, Breakaway group CEO Charles Fred talks with THCB founder Matthew Holt about his organization’s innovative and very successful approach to teaching healthcare professionals to work with new technologies.

By Dave Chase

Health system CEOs would be well advised to study what newspaper industry leaders did (or perhaps more appropriately, didn’t do) when faced with a dramatic industry change. Turn back the clock 15 years and the following dynamics were present:

• Newspaper leaders knew full well that dramatic change was underway and even made some tactical investments. However they didn’t fundamentally rethink their model.
• Newspapers were comfortable as monopoly or oligopoly businesses allowing for plodding decisions. Their IT infrastructure mirrored the plodding pace with expensive and rigid technology architectures.
• Newspaper companies bought up other newspaper chains and took on huge debt.
• Owning printing presses was a de facto barrier to entry allowing newspapers unfettered dominance.
• Depending on one’s perspective, it was the best of times or the worst of times to be a leader of local media enterprise.

Before they knew it, owning massive capital assets and the accompanying crushing debt became unsustainable. The capital barrier to entry transformed into a boat anchor while nimble competition dismissed as ankle-biters created a death-by-a-thousand-paper-cuts dynamic. Competitively, newspaper companies worried only about other media companies or even Microsoft, but their undoing was driven by a combination of craigslist, monster.com, cars.com, eBay, and countless other marketing substitutes for their advertisers. In addition, there were easier ways to get news than newspapers. Generally, the newspaper’s digital groups were either marginalized or unbearably shackled so that the encumbered digital leaders left to join more aggressive competitors. The enabling technology to reinvent local media didn’t come from legacy IT vendors who’d long sold to newspaper companies, but from “no name” technologies such as WordPress, Drupal and the like.

Continue reading “The Creative Destruction of the News Business and Other Weird Stories”

By JOHN MOORE

Today, GE and Microsoft announced a joint venture (JV) that will lead to the formation of a new company (NewCo) targeting the clinical healthcare market sector. The NewCo will be located near Microsoft HQ in Redmond, WA, start with roughly 700 employees and combine the remaining Microsoft clinical products, Amalga UIS and the former Sentillion products Vergence and expreSSO with GE’s eHealth and Qualibria suite. NewCo’s new CEO will be GE’s Michael Simpson, who has been heading up the combined Qualibria-eHealth group since earlier this year after a re-org at GE. Along with this announcement, Microsoft’s Health Solutions Group (HSG) leader, Peter Neupert stated that he’ll be retiring.

Combine the above announcement with Microsoft’s long anticipated sale of Amalga HIS, which went to Orion Health in October, and you are left with Microsoft completely pulling out of the clinical market. Sure, they’ll claim to be still in healthcare by directly selling their horizontal products (e.g., SharePoint, MS Office, various server products, etc.) into this sector and having a stake in this JV, but it is also exceedingly clear that Microsoft will no longer have any direct involvement in this market, that will be left to GE. That being said, Microsoft did state that they’ll hang onto HealthVault, but even here, that is more likely a by-product of no one wanting to take on HealthVault rather than Microsoft’s strong desire to continue to try and build a viable, revenue generating entity out of it. Do not be too surprised if, in a year’s time, HealthVault falls to the wayside much like Google Health did this year.

Continue reading “Microsoft Bows Out of the Clinical Market”

By David Harlow

Microsoft and GE Healthcare announced a joint venture yesterday (as-yet unnamed), trumpeted as bringing together the best of both companies’ offerings in the health care provider market. (More from the NY Times.) Late in the day, I spoke with Brandon Savage, Chief Medical Officer at GE Healthcare, and Nate McLemore, General Manager of Microsoft Health Solutions Group.  They had a great deal to say about the companies’ shared vision of the use of platform technology to enable care teams to deliver the right decision at the right time, noting that their core products complement each other rather than overlap.

The centerpiece of the collaboration will be an amalgamation (so to speak) of the two companies’ strengths around Amalga (the Microsoft product) and Qualibria (the GE product). Brandon and Nate described the challenges facing these products thus: Qualibria needs to be able to pull in data from multiple sources better (Microsoft can help), and Amalga needs to be able to share best practices across sites better (GE can help).

Put another way (to quote John Moore at Chilmark Research), Amalga is “more a toolset than a product.” McLemore acknowledged that provider organizations need to make a substantial investment in customization in order to realize benefits from using Amalga, and noted that one of the keys to the synergy with GE is that GE can build the applications needed to unlock the value from Amalga for customers who can’t or won’t do it themselves.  While there have been some providers that have walked away from Amalga, there are some notable success stories (e.g. New York Presbyterian’s dramatic reduction in DVT thanks to information extracted and interventions facilitated by Amalga’s analytical tools).  (We should note that there a number of products that carry or have carried the Amalga brand; one of them, Amalga HIS, was sold to Orion Health in a deal that should close soon.)

Continue reading “Microsoft GE Healthcare Joint Venture – A Sign of Weakness or Strength?”

By MARGALIT GUR-ARIE

Health care is in the process of getting itself computerized. Fashionably late to the party, health care is making a big entrance into the information age, because health care is well positioned to become a big player in the ongoing Big Data game. In case you haven’t noticed computerized health care, which used to be the realm of obscure and mostly small companies, is now attracting interest from household names such as IBM, Google, AT&T, Verizon and Microsoft, just to name a few. The amount and quality of Big Data that health care can bring to the table is tremendous and it complements the business activities of many large technology players. We all know about paper charts currently being transformed via electronic medical records to computerized data, but what exactly is Big Data? Is it lots and lots of data? Yes, but that’s not all it is. Continue reading “The Rise of Big Data”

By JOHN MOORE

Microsoft’s Health Solutions Group (HSG), which has straddled the fence with consumer-facing (HealthVault) and corporate-facing (Amalga), is increasingly moving to the corporate side of the fence. Not that surprising considering that the consumer market continues to struggle (Google Health is in virtual mothball state, consumer adoption of HealthVault is nothing to write home about) and that HSG has now moved out of R&D and is now under the business solutions group, Dynamics. At the end of the day, HSG head Peter Neupert has to show that he can deliver the goods and Amalga is the horse he’s betting on (Note: Sentillion is there as well, but think of Sentillion as the gate-keeper to accessing Amalga).

Yet Amalga has gone through its share of birthing pains with some in the industry beginning to question its value.

Amalga has suffered from two significant problems, both inter-related. The first is that Amalga is an extremely powerful set of data aggregation and analytical tools, but it is more of a toolset then a product and this leads to long implementation time-frames and subsequently an inability to extract value quickly (ROI for Amalga is measured in years). For example, in 2009 Golden Living signed on to adopt Amalga and HealthVault. At last week’s Connected Health Conference, (CHC) Golden Living presented some remarkable results of how they are transforming long-term care through the use of Amalga. But in their presentation, Golden Living also stated that they knew full well when signing on to Amalga that this was going to be a multi-year effort and their implementation team has been given 5 years to put Amalga in place. Five years to fully implement a software solution is a very long-time and similar to the installs of the largest EHR systems. Unfortunately, many early Amalga customers did not have the foresight of Golden Living. In recent conversations with Microsoft, Chilmark has been told that significant resources are now being dedicated to improving time to value for Amalga. We’ll have to wait and see as the CHC sessions we attended on Amalga and HealthVault Community Connect, did not make this readily apparent. Continue reading “Microsoft HSG Bets Future on Amalga”

By JONATHAN BUSH 

I’m watching ads during the ballgame (I watched the kick-off and the ads—the rest, not so much) and who should be declaring itself a “cloud solution” but Microsoft?!

See the ads here and here, in case you don’t own a TV or computer or newspaper.

OK, I’ve gotta admit my gut reaction was: Microsoft in the cloud? Seriously? But my next thought was…YES! FINALLY! I’m watching evolution unfold before my very eyes, and it’s oh so comforting to see others walking upright on two feet, using modern tools, and cooking their food.

What am I talking about? Well, let me explain. Gather round kids for a quick tour of the museum of ancient computing history. There will be time for a bathroom break later.

Here in the lobby is a giant diorama like you see in other ancient history museums. (For a larger version, click here.) Continue reading “Welcome to the Cloud Clan”

By ALEX EPSTEIN

When I first heard about Augmented Reality, I thought – this is really cool. Let me try and augment mine.

And I had a vision that included Scarlett Johannson (just kidding, sweetheart) and a home totally free of weekend honey-do’s and totally full of perfectly happy, compliant teenage children.

Hell, if I am going to augment reality… I might as well go for it.

How naive.

Imagine this – in the not too distant future a wearable device will display a seamless series of  “helpful” tags on top of what you are actually seeing, so as to make your viewsing more effective.

Maybe you are part of surgical team involved in a complicated intervention, and your technology is superimposing real-time CT scans over your actual view of the operating field, hopefully improving outcomes. O0ps, that is happening now! The tags, and decision support, which will make things even mo betta will happen later.

Or say you are 18 and a Marine trying to repair a complicated hunk of your war machine (or maybe just a flat tire) in the desert or the jungle – special goggles will augment your reality with a layer of digital information that shows you how to fix your stuff in real time.

Continue reading “Augmenting My Reality”

By JOHN HALAMKA, MD

In previous blog posts, I’ve mentioned an idea deserves its own dedicated post.

Over the weekend, I keynoted the eClinicalWorks National User’s Conference in Florida. One of the attendees emailed me the following question:

“I have a number of questions regarding certain types of patient-level data that might cause us problems in the future of HIE. No one, to date, has been able to answer these and I thought I might ask you.

The first, and easiest, is how we we going to handle the following situation:

1) I am seen in Boston as a child and my mother says that I am allergic to Penicillin (or pick your drug of choice). The nurse-practitioner asks a few questions of my mother, who isn’t terribly forthcoming with information but insists that I am allergic. While he/she has reservations, they record it as an allergy in their eclinicalworks EMR. It goes to the Massachusetts HIE.

Continue reading “The Electronic Medical Home”