Continuing with our AHIP video series, THCB and Health 2.0 had the chance to catch Sam Muppalla, CSO of Portico Systems. Portico is a supplier of Integrated Provider Management (IPM) solutions for payers. In this video, we get a chance to hear about Portico 9.0 which aims to optimize payer-provider relations and enable robust design, management and reimbursement of provider networks. Muppalla also discusses, Portico’s goal of significantly reducing medical, administrative and IT costs while delivering quality care to patients.
Matthew Holt
SaaS tiptoes into the hospital
As we prepare for the Health 2.0 conference in the Fall and get stuck into demo after demo, it’s interesting to step back and look at the bigger picture. Clearly the cloud/SaaS trend is going beyond the obvious places–consumer tools, online communities and the data utility layer–to those where client-server architecture has been dominant and successful, such as practice management. Carecloud and athenahealth are examples in that environment (and athenahealth offers a lot of services to go with their on-demand software) and of course the SaaS-based EMR space is burgeoning with not only web-native applications like Practice Fusion, Clearpractice and athenaclincals, but also several of the bigger players like GE with Centricity Advance, OptumpInsight’s Caretracker (United) and even eClinicalworks adding SaaS offerings into the mix. Even the AMA is in the game, with its Amagine service offering a fully hosted SaaS version of NextGen, as well as several other tools and packages.
But then we get up to the walls of the “enterprise.” In health care “enterprises” are called hospitals. Every week it appears that HISTalk is reporting that yet another hospital is uninstalling one client-server EMR product and going with another–almost always Epic. But–with the exception of an odd announcement I don’t understand from McKesson–there doesn’t seem yet to be the healthcare equivalent of large enterprises going with a Salesforce.com approach, where core parts of their infrastructure are put in the cloud. And every installation is a separate custom installation, leaving groups of users needing to be literally banded together by consultants to humbly petition the wizards of Madison County to make particular interface changes. (I’m not kidding–there really is at least one consultant putting together such a group of Epic users). Cloud-based systems of course can roll out these changes much more easily, and receive feedback from their users much more quickly.Continue reading…
The bleak state of the (health care) economy
By MATTHEW HOLT
Health care spending increased at 3.9%, its slowest rate for decades in 2010 following a slowdown in 2009. Merill Goozner has the play by play but it’s clear that the numbers are starting to reflect what Jeff Goldsmith said in his keynote at Health 2.0 last year.–even the health care industry can not grow geometrically forever.
But there’s something hiding in these data. Recently I gave an update for a talk that I’d given 15 years before at the Oregon Medical Association. I reviewed the 2010 year forecast I did for IFTF in 1997 and I was struck by how in our scenarios we had overestimated the per capita spend on health care, but underestimated its share of GDP. That meant while overall health spending didn’t grow as fast over the decade as we’d forecast, the economy grew much slower. And of course the big jumps in health care as share of GDP that we saw in 1991-4 and 2007-9 came when the economy tanked
As we enter the 7th year of our lost decade with the stock market starting to predict a double dip recession, and real unemployment in the high teens, we face the prospect of getting to 20% of the GDP going to health care via not a boom in spending brought on by the ACA or a rich economy making rational choices, but by default. Of course these days the loonies in the Tea Party are reminding us of the other meaning of the word default!
Not much fun with Pharma spend online
The other day Mark Bard (formerly of Manhattan Research) came by for a quick chat. Mark’s now running the Digital Health Coalition which is trying to get some voluntary agreement on guidelines as to what Big Pharma can and can’t do on sites that feature user-generated content. Pharma’s still tipping all its consumer advertising into TV when it would be much better off moving the 5% it spends online to 15-20%. But because Pharma’s scared of the FDA, and because–despite holding hearings in the 1990s and in 2010–the FDA is still not close to issuing guidelines, everyone is stuck. I saw Ben Lei who runs eMarketing at Genentech speak at a conference this week and he basically confirmed that they could do much more, but they won’t for now. And it may be that this is getting worse. This has real financial consequences. WebMD missed earnings badly last quarter and lost about 1/3 of its market cap because a bunch of pharma advertising was delayed/put on a longer regulatory review. If you want to dig into this, here’s a link to their earnings call Q&A in which Chairman Marty Wygod himself felt it important enough to come face the music–which is being provided by class action plaintiffs as we speak. In any event, I’m sure that the agencies, the online guys and the pharma marketing types are hoping that Mark can come up with something and soon!
Self-tracking gets hip: Withings & more
We’ve been watching self tracking at Health 2.0 for a little while, as it emerges from the world of the Quantified Self geeks to becoming a more mainstream set of shiny consumer gadgets. Today’s NY Times takes a look at just a few of the shiniest including Fitbit and the French company Withings. It has a Wi-Fi scale that sends your weight to the cloud and a beautiful (really!) blood pressure cuff that attaches to your iPhone-both of which I’ve been test driving and like. Also although the NY Times author Farhad Manjoo doesn’t seem to care–despite the fact he obviously has a young kid–a Withings baby monitor is on the way to market too. Many other players aren’t in this article, including sleep monitor Zeo, exerciser tracker BodyMedia and emerging data utility layer platform RunKeeper. But you won’t be surprised to hear that all four and more will be at the forthcoming Health 2.0 Conference on Sept 25-7
As if we needed further proof…
This weekend tells us three things. One, American government is beyond broken. In this completely artificial debate, a minority opinion that after all represents a minority of the opinions of a party that only controls one third of the government dictates the terms of the deficit reduction compromise. A compromise that is pure fantasy anyway. Two, no one in DC gives a shit about the economy and particularly no one cares the lowest 30% of Americans who are un- or marginally employed or relying on support from society. We heard nary a peep even from any Democrats about them as we insanely cut spending in the middle of a recession. It’s 1937 all over again. Third, health care is for sure a government business, according to Wall Street, with the stocks of most major insurers and hospitals off 5-10% this morning on fears of cuts in Medicare.
West Shell, CEO, Healthline
I recently had a chance to talk with West Shell, Chairman and CEO of Healthline, who will appear onstage at the Health 2.0 Conference this Fall during our session, In Conversation with Three CEOs. While Healthline has always been known as a powerhouse search and content site, they are expanding to provide new tools and services keep up with the growing needs of users as technology in the healthcare space evolves (check out their Human Body Maps!).
As West mentions below, providers and payers are doing different things which is changing Healthline’s market and their offerings. They’re also working with the large amounts of data being released to help users make more informed decisions regarding their health. Check out the interview to hear West discuss even more Healthline updates, and where they’re headed in the future.
AHIP Video Series: Healthcare Productivity Automation
Check out the first in our AHIP video series featuring Healthcare Productivity Automation (HPA). HPA is a technology company specializing in business process and automation services using their cloud-based robotic service, Health Mason. Novin speaks about this product and how he sees cloud-based robotics transforming the healthcare space.
EHR Tweetjam for Xerox 1pm EST Today
Today from 1:00 – 1:30 p.m EST (10-10.30 am PST) we’re hosting a TweetJam for our friends over at Xerox (FD-Yes they are paying us). We’ll be discussing the results from their recent survey on Electronic Health Records and invite you to join in on the conversation. Never heard of a TweetJam before? It’s simply a time to gather on Twitter around a particular topic and learn from each other. Anyone can ask, or answer, a question. All you have to do is login to Twitter, follow the Twitter handles @THCBStaff and @ServicesatXerox and use hashtag #EHRJam to participate in the discussion. We hope to see you there!
What’s the next way PBMs will make money?
Yesterday Medco offered itself up to smaller competitor Express Scripts, creating an entity with more than 50% of the PBM market. PBMs originated as specialized claims processors that supposedly were able to reduce drug costs. But in the 1990s drug costs soared. Somehow PBMs didn’t lose employer clients, further confirming that employers are dumb about how they buy health care. Most employers didn’t understand that PBMs made much of their profits on rebates they were paid by drug companies to keep particular drugs on formulary. Almost none of that money went back to the employer. After that game ended, PBMs replaced almost all those profits by making huge margins on generics until Walmart showed that it could make a profit by charging only $4 a fill. Now it looks like extracting a bigger piece of the pie from pharmacies and charging more to employers may be the only game left for PBMs. And that’s probably the driver behind the merger.
