Category: Matthew Holt

Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site and hosts the #THCBGang and #HealthInTwoPoint00 video shows/podcasts. He was co-founder of the Health 2.0 Conference and now also does advisory work mostly for health tech startups at his consulting firm

Ingenix buys Axolotl (with minor Update)

Ingenix, the arms dealer that’s been supplying all sides in the health care information war for the past decade or so, built itself up by buying lots of little companies in the data analytics space. Now it’s repeating the effort in the Health Information tools space. First it bought Caretracker (actually the company may have had a different name when it bought it, but that’s the name now). It’s a Web-based EMR for smaller practices (a sector with lots of Federal dollars attached). Then it bought Picis, a company that offers software that runs ORs, EDs and other high acuity inpatient sites (another recipient of lots of Medicare dollars).

Today it bought Axolotl, one of the vendors that’s biggest in the emerging (and constantly confusing) Health Information Exchange marketplace. Yet another place that lots of Federal dollars via ONC are going.

You’re probably noticing a pattern by now…

Ingenix itself of course is owned by United Health Group, although its CEO Andy Slavitt will be at pains to tell you that United also just happens to own a health insurer or two, and that Ingenix is not the subsidiary of a health insurer. Of course, Congress doesn’t always agree…

Normally I’d do lots of in-depth analysis about this story, but I’m for now just rushing to for once beat HIStalk to the punch!

UPDATE: Inga at HISTalk won’t truck with my “I beat her” comment and notes that she posted the following tweet before me (even if I got my post up on THCB before her or MrHISTalk posted on HISTalk!)

ngaHIStalk1:09pm via Facebook

Rumor from two good sources: Ingenix/UnitedHealth Group will announce its acquisition of Axolotl after the market…
boltyboy2:56pm via TweetDeck

Ingenix (UHG) getting even more expansive in HIT, buys HIE vendor Axolotl

Beating up on ONC, mostly unjustified

Earlier this week there was a curious little hearing at Pete Stark’s committee. Much of the Q & A—mind you post the announcement of the final meaningful use rules—was (apparently, as I can’t find the transcript) a beating up on the poor folks at ONC for reducing the barriers towards meaningful use. Here’s Jonathan Hare of upstart privacy/identity/network vendor Resilient explaining that things are not tough enough.

While Jonathan is having a bit of fun here (and, oh by the way, he does actually have a solution for the inadequacies of current HIEs which we’ll be showing you more about in the world of Health 2.0), some of this and the other stuff the ONC folks had to deal with was a little tough. They got a fair amount of abuse from the committee.

Continue reading…

Knee Trauma, again

One of my favorite topics is back in the news. Apparently ACL repairs may be unnecessary. Here’s the WSJ Health Blog write up about the NEJM study. Two groups of active young people with torn ACLs were split. Half got immediate ACL repair, half got rehab and later repair if they needed it. Of the second group around 39% needed surgery but when the two groups (surg vs surg when rehab wasn’t enough) were assessed there was no difference.

Mostly this is a big duh! A simple ACL tear doesn’t need fixing unless you are going to go skiing, play soccer, volleyball or some other sport that needs it. I had a left knee simple ACL tear in my early 30s, had it fixed after 6 months wait & rehab and went back to all those sports. (Although I never seriously tested it in a twisting sport before repair).

Then several years later I had both a right knee ACL tear and a few weeks later multiple trauma to my left knee—3 ligament tears and other damage. (Advice to you all; snowboard around the tree not into it). My left knee has never recovered (nor will it) to take part in those twisting sports so I never had the right one fixed (I did get a new ACL & PCL in left knee as I need to be able to walk again!). But the right knee with no ACL is fine for walking, running, biking and even controlled pivoting for snowboarding—where the leg is locked in place vis a vis the other one.

But if I try to twist in a gentle soccer kickabout on my right knee I fall on my ass. So for my earlier ACL repair I suspect that I would have been in the group that needed surgery anyway (the 39%). So if you don’t want to or don’t need to play those sports OR if you do the rehab and are fine, you don’t need a repair, But if you do need to play those sports and rehab alone doesn’t work, then you do.

The question is how many people are getting the ACL repair but never gave rehab a try? Probably quite a few, and for them rehab with the option of surgery is a good idea.

But the real question is how many people are getting ACL repairs when they’re not participants in those sports? Anyone know?

So I’m on TV, unfortunately in piece of crappy reporting

So last month the nice people from KTVU (the local Fox affiliate in SF) came by to interview me and last night it aired. They’d been over at web-based EMR vendor Practice Fusion and had found out about EMRs. Then they came to interview me. I should probably have got the hint when reporter John Fowler kept on asking me about privacy concerns. I spent 20 minutes giving a balanced nuanced view about the advantages and problems of adopting medical records which is not exactly represented by the 6 second soundbite I get.

Unfortunately—despite the producer’s stated desire to use Bay Area people—Texan nut job Deborah Peel gets almost half the piece including almost all the interview content. (Apparently Deven McGraw couldn’t be tracked down? Maybe DC is too far away) And what does Deb Peel say? Well you know what she says…

Continue reading…

Fantastic job: HHS ONC subject matter expert on consumer e-health

Josh Seidman has written from ONC telling us about a fantastic job opportunity. You get to work with the brilliant folks at ONC on fun stuff regarding consumer e-Health. What does that mean? From the posting.

  • Forge alliances with consumer organizations, technology and care delivery innovators and consumer advocates to further the consumer e-health agenda.
  • Develop consumer oriented strategies across the Office of the National Coordinator for Health Information Technology (ONC).
  • Serve as Project Officer providing project management oversight for contracts, including designing, developing and coordinating project management plans for policy initiatives in conjunction with the Division Director and the Office of Policy and Planning Director.

We’ve been very impressed by everything we’ve seen about ONC’s commitment to patient communication—not least the “sneaking-in” to the meaningful use requirements in Phase 1 of patient education materials (what Don Kemper calls Christmas in July). I can’t think of a more fascinating job for anyone who cares about online health.

So if you’re interested here’s the link to apply

Interview: Blumenthal talks meaningful use

Absolutely hot off the recorder, here’s my interview with David Blumenthal, the Obama administration’s National Coordinator for Health IT.

David and I discuss patient communication, why the percentages of certain criteria were reduced, and how to get the two Reginas on Oprah. Well, he didn’t have many ideas about that! …

David Blumenthal on Meaningful Use, 13 July 2010

Meaningful use, and cats & dogs

More than a year or so of squabbling is (sort of) over and today HHS announced its criteria for the first phase of meaningful use. Essentially the 25 criteria for qualifying for “meaningful use” (in other words who qualifies for the money) have been changed to 15 with a further 5 from a menu of 10. The details are here, and it looks like most of the percentages needed to qualify have been relaxed but not eliminated. The Dogs have clearly had a minor victory in that there are patient communication requirements in both the mandatory and optional criteria.

The most impressive part of the announcement (you can see it here) which included HHS Sec Sebelius, CMS head Berwick (not wearing his Che Guevara T Shirt) & ONC Director Blumenthal, was the two Reginas. First, Surgeon General Regina Benjamin explained how thrice her clinic was destroyed by nature, and how the second time she realized that while she had thought she couldn’t afford electronic records for her patients, she then realized that she couldn’t afford not to have them.

The other Regina was our friend Regina Holiday who made (to me) a surprise appearance and told the 73 Cents story in a heartfelt and powerful way. She’s really become the poster child for why access to health data matters to ordinary people, and we need to get her from the world of webinars, Health 2.0 Conferences and HHS announcements onto Oprah and the 6 O’Clock News right now.

And I’ll be suggesting that when I interview David Blumenthal in a little under 30 minutes.

And here's the 3mins audio of Regina Holiday at MU announcement

Wellcare, yes there’s more even without(?) Regi

A few weeks back we welcomed John Goodman as a contributor at THCB. His first column was more than a tad critical of me for impugning the ethics of Harvard Business School Prof Regina Herzlinger. Herzlinger, you may recall made a boatload of money off her position on the board of directors of Wellcare. Wellcare was operating a Medicaid and Medicare HMO in Florida, while basically using that not-too-sacred trust as an excuse to defraud the taxpayer.

Due to the demands of reality cutting into my work-life, my blow-by-blow analysis of Wellcare’s bad behavior has waned a little, but here I instead commend to you the consistently great work of Roy Poses over at Health Care Renewal. Earlier this month Roy took a look at the latest chapter in the tawdry tale. I encourage you to read his article for the full tale, but essentially even despite the settling of the criminal and civil charges for theft of around $46m, there’s a brand new set of charges from the same period—this time theft is alleged of up to $600 million. This new set of allegations were collected by (FBI informant & Wellcare financial analyst) Sean Hellein who wore a wire for more than a year, and probably stands to make a packet in the qui tam suit.

And not that I’d further besmirch the reputation of Prof. Herzlinger, but the time period all this happened was while she was still on the board, and none of these were given as her expressed reasons for leaving. Then it struck me, is Regi in on the qui tam suit too? That would be the way to make serious money out of her insider knowledge.

Bizarre PR pitch of the year so far

I get emails from PR companies all the time pimping this or that client, but they don’t get a lot stranger than this one. (I‘ve hidden the names to protect the guilty):

Subject: Top 3 Reasons Why Health Insurers Are On Your Side…

Hi Matthew,

Health plans are typically portrayed as the evil empire, bent on raising premiums and squeezing every shred of patience out of their members. But, what if I told you that in reality, that isn’t the case?

Here are the top 3 reasons why your health plan really is in your corner and why it is in their best interest to keep you healthy:

1. The healthier you are, the more profitable it is for your insurance provider. Therefore they should go out of their way to keep you healthy with preventative care recommendations.

2. Your health insurer is in a position to get you access to the providers and specialists you want, when you want them. A plan biggest differentiator and selling point is its provider network. It benefits both the plan and the member to have the most skilled, sought after providers a part of the network.

3. Health plans have a 360 degree view of every member’s care. Unlike individual healthcare professionals, plans know every touch point their members have with providers and can make care recommendations.

How about a story that looks at why plans get a bad rap, and actions they are taking that are in their members’ best interests that aren’t typically publicized?

I can put you in touch with REDACTED of HEALTH IT VENDOR who can elaborate on the top 3 reasons and discuss steps that plans are taking to improve the flow of information between plans and providers and plans and members leading to more efficient and effective care.

What do you think?


I thought that the careful THCB reader might come up with some interesting analysis about whether health plans are actually doing what this PR maven thinks they’re doing. And I’m sure one or two other THCB readers may not be convinced that insurers are “on your side”


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