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Not exactly what athenahealth was looking for

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By MATTHEW HOLT

This is not a fun day for athenahealth, and frankly with HIMSS coming up, not a fun time to have such a day. None of this has anything to do with their products or their client services, but late last night the company announced that it’s going to be restating its earnings. You can see a longer discussion on The Street.com but essentially it appears that athenahealth has been amortizing its installation costs over one year whereas they ought to have been doing it over more years. The net result is that they’ll have to restate some earnings and are going to miss the next earnings reporting deadline. The stock is off roughly 12% today.

Athn

What’s been happening is that the new CFO (Timothy Adams) has come in and cleaned house, and not liked what some of the old CFO (Carl Byers who moved to Chile!) had been doing. Long term this clean up is probably good news. The company is still operationally profitable (we assume!), and its business of running the back office and increasingly front offices of doctors using a combination of technology and forklifts/sweat remains a great way of both routinizing their businesses and aggregating data for overall process improvement.

So better to get any financial “irregularities” cleared out now and be more conservative. But while other than the shareholders (and the coming lawsuits) it probably doesn’t matter much, this may per chance slow down Jonathan Bush a touch next week. Or maybe not. We’ll see….

Health 2.0: Beneath the Hype, There’s Cause for Real Hope

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By MICHAEL MILLENSON

Health 2.0 is a trend accompanied by both buzz and buzzwords. That worries some advocates for the poor, under-served and just plain old and sick. Will those groups be left behind in the latest information revolution?

The potential positives of the Web-as-health-care platform for interactive health care services could be seen in two full days of presentations and discussions at a recent meeting in San Francisco, called the Health 2.0 Conference. Still, a certain Silicon Valley sensibility remained: widgets for weight control were much more likely to target the calorie count of cappuccinos than corn dogs.

Yet the real question is not whether Health 2.0 arrives clothed in hype; of course it does. The capitalistic ritual of “new and improved” is similar for software and soapsuds. The important issue is whether the substance of Health 2.0 can help deliver health care services significantly more efficiently and effectively while reducing disparities. Look beneath the hype and you can see it’s already starting to do so.Continue reading…

HIMSS Parties, and a little more

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By Matthew Holt

Next week the health IT world descends on Atlanta which means a lot of chat, lots of meetings and lots of parties. You’ll be seeing the results of my interviews on THCB next week.

But meanwhile more importantly—the party schedule. So far I’m signed up on Monday for the MEDecision party (mostly because it’s in the aquarium), the HISTalkparty (in which you try to spot the mysterious MrHISTalk and Inga) at Max Lagers. I’ll likely be wearing a sash.

For Tuesday night I’ve been asked to give a special shout out to the FierceHealthIT party. Apparently this one will be huge but there’s room for more. It’s at the World of Coca-Cola, and I'm not sure if you have to bring your own rum. Sign up here

Finally, there’s a new party on Tuesday called HITMen which has an interesting group of cats & dogs on its host committee….although probably only worth going after the palavah is over (unless you like sitting through award ceremonies).

Of course there’s a large chance that I’ll miss all of these but there are two sessions I won’t be missing.

Monday at 2pm in room C201 I’ll be one of the bloggers to meet in the Meet the Bloggers session. It’ll be a good chance for me to argue in public with Val Jones.

And Tuesday at 1pm the ever wonderful Jane Sarasohn-Kahn and I will be presenting on Health 2.0 & Participatory Medicine in Georgia Ballroom 1.

This does all assume I can get out of France despite the air traffic controllers strike! Hope to see you in Atlanta.

DNADirect bought by Medco: Consumer genomic counselling goes mainstream?

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By Matthew Holt

Ryan Phelan started DNADirect to expand the power of genetic testing to everyone, using the Web. She’s been ploughing a tough furrow but been making some real progress in the last few years, including getting an investment from Lemhi Ventures and working with Humana to provide genetic testing to its members (and the utilization management going along with it), to go along with their initial DTC approach.

Late last week DNADirect was purchased by Medco. I spoke with Ryan and Robert Epstein, Chief Medical Officer of Medco to get just a taste of what this will mean for the future of DNA testing within Medco.

Here's the interview.

The Point of Health 2.0. Yes There is One

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By MATTHEW HOLT

The (not huge) world of Health 2.0, participatory medicine and ePatients has been fretting itself about a comment Susannah Fox (all hail) elevated into a post called “What’s the Point of Health 2.0”.

Here’s an excerpt from the comment from DarthMed,

The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently. Some (emphasis on some) will do a standard Google search when they receive a new diagnosis at best. Yet these are the folks – often folks with multiple chronic (often preventable) health problems, many overweight, on multiple medications, sometimes social problems – that have the real issue that needs fixing.

So we can all sit and perfect the tools for a few folks that never needed them anyway, or we can recognize that the kinds of solutions required for healthcare in the US today have nothing to do with fancy IT, or prioritization on search engines, and everything to do with low-tech, unsexy approaches toward grass-roots public health. Sorry to be the voice of reality guys.Continue reading…

Todd Park speaks: Free the data!

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By Matthew Holt

Todd Park is definitely one of health care IT’s good guys. Todd was the brains (though not the mouth!) behind athenahealth. After he left athenahealth, he spent a year back in California doing angel investing (Ventana among others) and being a dad. But despite his desire to stay on the west coast, he was dragged into the vortex known as Washington DC, and for the last 5 months he’s been the (first) CTO of HHS. (By the way, he cashed out his investments, and politely turned down my proposal to “care for” his cash while he was being a public servant!)

Todd gave the keynote yesterday at the Health IT Summit for Government Leaders. He describes his job as unlocking HHS’ “inner mojo” in terms of data use and technology innovation. So what are the big deals he sees? These are my notes on his fast talking!

1) HITECH/ARRA is not about for paying for software. Its purpose is to incentivize “meaningful use”. He wants to make sure that people understand that the NHIN (National Health Information Network) is not a thing. It’s a set of policies and services that people can use to make health data work over the Internet. It is NOT a parallel network. And at the end of the day, what’s going to make this work is the private sector — including vendors modifying their products to match these policies.

2) Leveraging the power of HHS data for public good. The amount of data HHS has is “ridiculous”. It has a set of sets of data. Todd is a paid up member of Tim Berners-Lee “free the data” club. They’re adding all kinds of data sets to data.gov including every grant, patent et al licensed/paid for by HHS. Todd calls this “data liberation”. They’re also creating community health maps where data on community health performance can be mashed up with other types of maps (real estate, job listings, et al). In addition, they’re doing “smart targeting” — an attempt to combine findings from different/disparate data sets without waiting to do the big database integration. He’s hoping to use techniques that the intelligence community uses to link, say, emails and bank wires, to similarly track, say, disease outbreaks, drug interactions, etc.

Continue reading…

PharmaSecure using SMS to detect counterfeit drugs

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By Matthew Holt

In developing countries, (and here too) counterfeit drugs are a mega-big problem. Essentially fraudulently labeled drugs in the supply chain are often not what they say they are, with potentially devastating consequences. But there’s no really easy way for companies to monitor their supply chain. We ran into PharmaSecure as they were getting off the ground last year, and yesterday I met CEO Sarah Hine who showed me how their technology allows the consumer to directly connect with the manufacturer using SMS.

A very innovative use of technology and a very interesting brief interview (complete with demo!). They’ve also just raised a $2m series A round.

MS-HUG Awards; let’s see you, Health 2.0 gang!

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By Matthew Holt

Last year I was a judge in the MS-HUG award for the HealthVault applications category. The quantity and standard of the entries was pitiful. I think that a few sales reps rounded up a few entries at the last minute

Given that many if not most Health 2.0 applications now link to HealthVault I really hope that the entries this year are way better. Here’s the blurb but if you are a cool Health 2.0 company linked to HealthVault, please enter. You have a week or so (and no Microsoft is not paying me to write this! In fact I didn’t even get paid to be a judge!)

Nominations are accepted in the following categories: 

Clinical Records – Inpatient
Clinical Records – Ambulatory
HIE and Interoperability
Microsoft HealthVault Applications
The nominations have been open since mid-December and will close on January 22 at 5:00 pm Central Standard Time. All of this year’s awards information is on the Microsoft HUG website at: www.mshug.org/awards.

Welcoming immigrants and robots to fill the nursing shortage

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By DAVID E. WILLIAMS

David E Williams

In a report this week, Nursing crisis looms as baby boomers age, CNN Money repeats a well-known story:   there are unlikely to be enough nurses to take care of people as they age. Nursing schools can’t keep up with the demand and trouble awaits. We’ll face a shortage of 260,000 RNs by 2025, we’re told.

I don’t really believe it’s such a big deal.

There are two good solutions to the problem, and they aren’t mutually exclusive:

  1. Increase the recruitment of nurses from abroad
  2. Substitute technology for laborContinue reading…

Virtual Medicine: The Lever That Just Might Save Independent Practice

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By RICHARD REECE, MD

Reece

Give me a lever long enough, and a prop strong enough, I can single-handedly move the world.

— Archimedes

Independent medical practice in America is in trouble. It is fragmented, with some 900,000 doctors – 300,000 primary care doctors and 600,000 specialists- practicing in disparate settings. These physicians are located in roughly 580, 000 locations. Some are solo, most are in small groups, and many are clustered around 125 academic medical centers, 100 integrated groups, and 5000 community hospitals.

Doctors are not unified – less than 20 percent belong to the AMA. Some 110,000 are members of Sermo – a social networking organization that tends to house dissident physicians. The MGMA is said to represent 300,000 doctors.Continue reading…