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HEALTH2.0/TECH: Athena Health: The History of the First Health 2.0 IPO By Scott Shreeve

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Scott Shreeve writes frequently about Health 2.0, open source and healthcare, topics that as the co-founder of Medsphere, one of the most-closely followed companies in the industry, he is extremely well qualified to write about. If you enjoy this piece, you will probably also enjoy his recent essay "Health 2.0 Business Model: "Payment Dependent on Results."  For more on AthenaHealth have a listen to our podcast interview with always-entertaining CEO Jonathan Bush, one of the real stars of this industry.

        Initial Public Offering (ĭ-nĭsh’əl pŭb’lĭk ô’fər-ĭng) n.

 1. The first sale of stock by a private company to the public.

2. Stock issued typically to raise capital and gain access to public markets.

3. Sale of stock typically handled by underwriters who determine type, quantity, and price of stock sold.

I have previously written on several occasions about one of my all-time favorite companies – Athena Health.
It is appropriate to once again put finger to key to congratulate
Jonathon Bush, Todd Park, Nancy Brown, Ed Park, Jon Hallock, and the
rest of the Athenista’s for their recent IPO (September 20, 2007). It was the largest IPO of 2007 and bodes well for the ongoing wave of investment in healthcare information technology.

I
find the history, growth, and now the prosperity of Athena to be
fascinating. Athena was founded by my fellow IT co-conspirators,
Jonathon Bush and Todd Park, Athena has steadily advanced over the last
decade birthing the "software as a service"
(SaaS) model within healthcare industry. I say "birthing" because I
have watched the labor pains of Athena fairly closely over the last 5
years since first meeting Todd Park in Waterbury, CT on my first ever
presentation with Medsphere. We discussed then, and watched again and again, as Athena began to take a bigger and bigger swipe at the "healthcare hairball".

Continue reading…

TECH/CONSUMERS: Ix Therapy time again!!

Today Indu and I are at the Ix Therapy Conference in Park City, UT. I’m here as a guest of Josh Seidman, Dorothy Jeffress and the crew at the Center for Information Therapy

David Kibbe is up first. His talk is called "Google. Then Gargle." He’s talking about 4 disruptions:

1. EMR, and spread of electronic health records

2. MinuteClinic, and retail medicine from NPs
3. Medical Tourism, drugs and surgery abroad
4. Health2.0

He’s very interested in Microsoft’s HealthVault (although like me he notes that creating a "strong password" for HealthVault is pretty annoying–I also think HealthVault needs a tutorial PDQ too). But nonetheless the option of moving data around easily between multiple entities and providers is pretty disruptive.

JOB POST: Software architect

Phreesia is a
fast growing venture backed start up company looking for an experienced Software Architect.Phreesia is free to physicians in participating practices. The
Phreesia solution includes the leading edge PhreesiaPad™ which adds immediate value to the
physician’s practice by gathering comprehensive intake information and chief
complaints, decreasing the time spent asking basic questions, improving patient
flow and reducing administrative time. Based on the patient’s responses they
are automatically taken to a customized portal with relevant health and
lifestyle information. Phreesia is sponsored by pharmaceutical and healthcare
companies with relevant educational communications to patients at
the point of care.

Continue reading…

TECH: Glen Tullman, Allscripts CEO on HealthVault

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Microsoft’s HealthVault brings lots of partners to the table. And so far it’s announced one major EMR vendor as a partner. That partner is Allscripts and this morning I got to talk with CEO Glen Tullman. Glen explained his take on Microsoft’s business model, why Allscripts is interested in getting involved and also gives a brief update on NEPSI–Allscripts’ online eRx initiative. Here’s the interview.

Are We Willing to Accept a Two-Tier Hospital System? By Maggie Mahar

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Frequent THCB contributor Maggie Mahar returns today with another of her "Inside Baseball" posts on the healthcare industry. Is the recent boom in hospital construction a sign of a healthy and vibrant industry as many prognosticators have argued, or a symptom that something is going very wrong beneath the surface. This piece first appeared at Healthbeat, Maggie’s blog at the Century Foundation.    

Yesterday, I wrote about the hospital-building boom and suggested
that we may not need it—and more to the point, we may not be able to
afford it.

In my description of how hospitals are adding costly amenities like
waterfalls and all-private-rooms in order to woo well-heeled,
well-insured patients, I suggested that the money might be better
invested in computerized medical records or Level I trauma units. (In
some parts of the country, trauma units are spaced so far apart that if
you are in a car accident, there is a real danger that the unit will be
too far away to be of any help.)

Barry Carol responded, agreeing that safety should come first, but
also arguing that the private rooms help prevent infections. As for the
waterfalls, he noted that “while they may make good journalistic copy
as illustrative of frills,” given the high cost of hospital
construction “they probably get lost in the rounding as a cost factor.”
See his comment here.

Because Barry had raised a number of good points, and because the
hospital boom is such a large and crucial subject, I decided to return
to it today while responding to his comment.

Continue reading…

TECH: Microsoft Healthvault

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Microsoft released its new Health Vault system this morning. You can read lots about it all over the Internet (NY Times article here).

Briefly the Health Vault allows you to save searches and information you’ve collected on the Internet, also data from devices like blood glucose meters and peak flow meters, and finally the ability to store data from various places (e.g. PHR companies, EMRs etc). I’ll be checking in with some of those partners later in the week.

Microsoft swore blind to me that this has been vetted by the privacy crowd (including the more, ahem, extreme among them) and that all this data will be totally portable to other storage applications.

The money will come from people using search, not from (as Peter Neupert said at Health2.0) putting a toll between patient and doctor.

So with Intuit already making noises, Dossia possibly back on track, Microsoft launching, and Google still working on something similar, the games really are beginning. I’ll be back to comment later.

The Perpetual Health Care Crisis By Jeff Goldsmith

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I began teaching health policy almost thirty years ago with Odin Anderson at the University of Chicago
Graduate School of Business. Like me, Odin was a sociologist, and one
of his hobbies was tracking the sociology of our nation’s “healthcare
crisis”.  He found that the health care “crisis” waxed and
waned (as measured by press mentions and journal articles), but never
disappeared.   It had been going on for twenty years by then,
so I guess we’ve now been in “crisis” for fifty years.  The
American health care “crisis” is not acute illness – rather it is
like a chronic disease which flares up periodically, accompanied by
fresh prophecies of impending doom and calls for someone on a white
horse to fix the problem.

From 1970 to 1993, health costs
roughly doubled as a percentage of GDP. All the way along, prophets
of doom  forecast that the country would simply fall apart when
health costs exceeded 8%, then 10%, etc. .  Our economy somehow
continued growing and innovating, and the health system  got steadily
more capable at managing our illnesses the entire time. No-one 
I know would trade our present, very expensive health system for the
cheaper one we had in 1965 or 1980. 

Then, during the mid- 1990’s,
a remarkable thing happened.  For the first time since people began
tracking the statistic, health costs remained dead flat as a % of GDP
for eight years in a row.  It is remarkable how little attention
this flattening got from the “crisis” mongers.  When we finally
get this year’s spending numbers from the CMS Actuary, my forecast
is thathHealth costs will have been flat as a percentage of GDP for
the past five years if you include 2007.  Five years isn’t “momentary”,
as Brian Klepper characterized this latest pause.

Continue reading…

Bogle on the Financial Sector’s Threat to Democracy – Brian Klepper

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Some years back I was mortified to realize that it would be all-but-impossible to fix health care without first fixing America’s patronage system, that puts virtually all policy up for sale to the highest bidder. In 2006, American corporations spent $2.5 billion lobbying Congress, nearly $5 million per Senator and Congressional representative. More than $350 million of that figure came from the health care sector, and half of that ($180 million) came came from the drug, device and supply industries. All this information is handily cataloged at the excellent site, www.opensecrets.org.

A couple weeks ago I published a letter in the New York Times – yes, I was astounded too – arguing that we won’t have health care reform until the leaders of the non-health care business community come together and roll over the health care industry.

Now, the always astute Greg Pawelski brought my attention to a superb Bill Moyers presentation, describing a parallel problem. America’s financial sector leverages its strength to take huge amounts of capital out of the system, without providing much in the way of value. The message is delivered by John Bogle, who created The Vanguard Group. Here’s the background:John Bogle, 77, created The Vanguard Group, Inc., in 1974, which today
is one of the two largest mutual fund organizations in the world, and
was was the first index mutual fund. He retired as Chairman and Chief
Executive Officer of the fund in 1996, yet remained Senior Chairman
until 2000.

Bogle explains the broader implications of The Carlyle Group’s buyout of Manor Care Nursing Homes. More and more, Wall Street is taking control of corporations, making Main Street pay the price, and making health care less attainable. The financial sector – banks, money managers, insurance companies, and certainly annuity providers – takes $560 billion a year out of society. They all subtract value from the economy.

Read Mr. Bogle’s recent article in DAEDALUS, "Democracy in Corporate America."

Take the time to watch this worthwhile piece and possibly to read Mr. Bogle’s lucid article. All the stuff we talk about on this and related sites are moot unless we understand and ultimately address these deep cancers on our system.

Keen Observations Department – Klepper

"Managed care plans earn higher margins today than they ever have before, and operate at lower medical loss ratios than at any time in their history….There are a lot of reasons for this, like enrollment growth, new products and acquisitions, but the bottom line is that isn’t exactly a sympathy-inducing state of affairs."

CIBC World Markets analyst Carl McDonald tells AIS’s Health Plan Week

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