I thought Gen. Colin Powell’s speech at HIMSS was fantastic, funny, moving, intelligent, wonderful and hopeful. Lots of other people were cheerleading him too. However, what else I thought you can see over at Modern Healthcare.
Above the Fold
HEALTH PLANS: Guess who said this?
"Health insurers are committed to improving health care choices for small businesses and bringing costs under control for all Americans,"
A woman who’ll say anything in absolute opposition to the facts, so long as it makes her patrons look better. Don’t you think she’d make a good next attorney-general?
PODCAST/TECH: Glen Tullman, CEO Allscripts interview–What’s the future for eRx and EHR?
This is the transcript of my HIMSS interview with Glen Tullman, the CEO of Allscripts. it includes some comments from Jim Morrow, an MD from Georgia who is HIMSS doc of the year too. The original audio podcast is here.
Matthew Holt: …It’s Matthew Holt with The Health Care Blog. It’s another of my HIMMS podcasts, and this one’s really exciting. I have not only Glen Tullman, who is the CEO of Allscripts, which is one of the dominant players in the EMR market for ambulatory care, and moving to other areas, but I also have Jim Morrow who is a doc from…Where in Georgia, Jim?
Jim Morrow: From Cumming Georgia, North Fulton Family Medicine.
Matthew: Ah. From a medium‑sized practice, a family medicine practice in Georgia. He is an Allscripts user. Jim isn’t going to be prepared for this, but we brought him here anyway. Anyway. Good morning, Glen.
Glen Tullman: Good morning. It’s good to be here.
Matthew: We do this thing‑‑as my listeners are now familiar with‑‑with the mike, so it will fade in and out because it’s not very professional. [laughs]. Anyway, first off Glen, you’ve been CEO of Allscripts since what? 1997, 1998, something like that?
Glen: I’ve been with Allscripts for nine years now.
Matthew: Right, so ’98. And you had the joy of being the head of a public company, which went from a stock price of what, seventy‑eight or seventy‑nine in 2000, to two, or three, or something in 2002? And yet, you’re still there. I can’t think of any other health care CEO who’s gone through that experience. Luckily the stock has been at more than two these days. So how did it feel in those dark days…
Glen: Well, we’ve been…I’m fortunate, this is the third public company that I’ve run, two in health care, one in the property and casualty insurance business. We were the beneficiaries of the Internet "craze", if you will and the stock price ran up. I continued to tell our people that we hadn’t accomplished our mission, but the market put a high valuation on us and the stock ran up to $89. Then it actually came down.Our investors were fortunate that someone called us "the last man standing." It came down slower than most Internet stocks that collapsed; because we had a real business and a real vision. And I think, today we’ve continued over the years to execute on the vision, to build the infrastructure that you see working today. The stock market seems to be rewarding us for it.
Matthew: Well, you guys made what, nine million bucks last year in profit? What are you scheduled for this year?
Glen: Well, I’d like to talk about what we’re accomplishing. I think the accomplishment is that the product is working for physicians. We have over 30, 000 physicians today, over 400 hospitals. When you do things right, when you deliver for your customers, the end result is profitability. So we’re seeing a nice growth in our profitability. The analysts have put a number of different numbers on what we’ll look like next year.I think another key point I’d make is: We are actually reinvesting in software development, and other processes, more money than anyone else in the ambulatory sector. So we’re able to provide a great return on products that are well priced. And also invest in the market. Things like the NEPSI initiative, which is a 30 million dollar investment for us over five years.
Matthew: Let’s move on to NEPSI.
TECH: Interesting employment agreement
There’s a certain fast growing practice management company with a very outspoken CEO, who has a very famous last name. I poked fun about their sorority-crowd employees at HIMSS. But I didn’t know the type of scrutiny that they’d have had to come through. Look at this as part of their employment application agreement:
I understand that the Company reserves the right to require me to submit to a drug test at any time and also reserves the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by applicable law. I authorize the Company to investigate my driving record, my criminal record (Federal, state and local, as well as any record of health care fraud and abuse or other offenses retained by the OIG or other regulatory agencies), and my credit history, and I understand that an investigative consumer report may be prepared whereby information is obtained through personal interviews with neighbors, friends, and others with whom I am acquainted. This inquiry would include information as to my character, general reputation, personal characteristics, and mode of living. (THCB emphasis added) I understand I have the right to make written request within a reasonable period of time to receive additional information about the nature and scope of this investigation.
Well they wouldn’t give me a job! Nor basically anyone else in San Francisco. Then it hit me; what a tradition said company is joining. There’s Henry Ford who sent his minions out to investigate his employees behavior, and then more recently someone else equally outspoken and equally paranoid also started a pretty big health care IT firm and put lots of conditions on his employees behavior too. So I suspect this pretty much guarantees AthenaHealth’s success…..
CONUSMERS/HEALTH PLANS: ‘Consumer-Driven Guy’ Charged With Embezzling Millions in HSA Funds
Fraud and embezzlement by someone pushing HSAs? Who could possibly have imagined that type of character would be attracted to the business?
PODCAST/TECH: Bryan Dieter , CEO of Purkinjie–EMR for the masses?
Here’s the transcript of my interview with Bryan Dieter from Purkinjie, who have a new EMR/practice management product for the smaller physician market. The only thing that I didn’t notice but did get picked up by one of my savvy commenters when the audio podcast was put up, was that Purkinjie’s Chairman is John Doerr’s brother! That’ll be relevant as you read on.
Matthew Holt: OK, the podcasts are coming thick and fast now. Matthew Holt again from The Health Care Blog" and one of my last podcasts from the HIMSS floor is with Bryan Dieter who is the CEO of Purkinje. Bryan, good morning.
Bryan Dieter: Good morning.
Matthew: Don’t be too fussy about the mike, I’ll just wave it around and put it in your face and you’ll talk and it works fine. So Purkinje is the result of a merger that happened a couple years back. Can you talk a bit about what you do and what the components were of that merger and what parts of the IT space you play in?
Bryan: Sure. The merger took place in February of 2004. A company that was founded in St. Louis called Wellinx acquired Purkinje in Canada and we adopted their name as a result of that acquisition. The products that Wellinx offered was primarily an e‑prescribe application, diagnosis driven, into which we incorporated evidence based information for helping the physicians with prescribing decisions. Purkinje, in Canada, as you may be aware, has a pretty large footprint across the country. Some of the customers there include the Canadian Department of Defense. There are a couple of province wide initiatives and community health centers rolling out their EMR product, their e‑prescribing application is being deployed across Quebec and we have a pretty large presence in Ontario as well. The application there is primarily an EMR; it was one of the first to market in the early 90s. They’ve had tens of millions of dollars invested in their clinical knowledge base and we were interested in the product for that reason. What we are in the process of doing now is melding the capabilities of the application from Canada with the United States along with a native browser‑based application that we’ve recently completed the development and just made the announcement of it being in general availability here in the states.
HEALTH PLANS: UnitedHealth keeps gobbling
United is buying Sierra Health Services, a regional HMO in Nevada for $2.6 billion. Sierra is a more traditional HMO than most of the health plans United’s bought in recent years (Golden Rule et al). The price is a modest 15% increase over Sierra’s current stock price, which last month was hit by the rather interesting news that it was taking a bath on its new Part D plan—mostly because a certain other plan (hint: it’s one of united’s big competitors) was shunting its sick people onto Sierra’s plan.
TECH: Silverlink–Automating Outreach
I had an interesting chat with Stan Nowak, CEO of Silverlink. Being a mere dumb blogger I’d never actually heard of Silverlink, but they are going great guns. They have 80 people, they’re growing at 80% run rate and they raised $14m in VC about a year ago. Their business is making automated phone calls for health plans and PBMs. And these aren’t your ordinary automated calls. They’re recorded by professional voice types, they have multiple scripts that people can use a “Press 1 to hear again, press 2 to learn more about this disease, 3 to get to a nurse” approach to navigate around, and they can record data back. They’ve started in mostly informational type calls, e.g. PBMs use them to remind people to refill prescriptions. Then they moved on to helping Part D recipients understand their choices. They now do HRAs on the phone, and now they’re putting a package together for full disease management—starting with diabetes—including communicating Healthwise material over the phone.
As you might expect they claim a 5 to 1 cost advantage over having humans make the same calls, and they believe that they’re not eliminating outbound calling staff, but rather both extending the reach of DM to the at risk population (who the call center nurses don’t have time to call) and minimizing their work. (Stan said that is was surprising how many companies have nurses calling wrong numbers!). They claim really high response rates (up to 80% depending on the type of call).
I’ll have a longer conversation with Stan on THCB soon, but the automated outbound calling play is very interesting—given that lots of people still don’t use the web.
THCB JOB MARKET
The latest posts on the THCB job board:
JOB POST: Systems Administrator
JOB POST: Ultimate Super Hero of UI Designers
JOB POST: Passionate about changing health care? – Clinical Informatics
PODCAST/TECH: John Capobianco, President of Medecision “making the unknown known”
Here’s the transcript from interview with John Capobianco from Medecision talking mostly about the “payer-based health records” they’re developing with several big health plan customers, and distributing to providers. The audio podcast is here.
Matthew Holt: Matthew Holt with The Health Care Blog, still at HIMSS. Now I’m meeting with John Capobianco, who is the President of MEDecision, and also with Tracey Costello, who is the VP of marketing. So welcome to you both, hi John.
John Capobianco: Hi.
Matthew: Hi, Tracey.
Tracey Costello: Hello.
Matthew: John, tell us a bit about MEDecision. As some of the readers of the blog know, I’ve had folks from ActiveHealth Management and Click4Care do podcasts. I was thinking about the whole space around payers and data, and analyzing what’s going on in that world is something that probably most of our readers don’t know that much about. So give me a brief overview of what you guys do, where you fit in the space generally, and how you compare yourself to those guys, or other competitors.
John: Hi, Matt. I’d be happy to do that, Matt. MEDecision started about 18 years ago creating a solution to a mission statement that was put forth. That was: how to improve the relationship amongst payers, patients, and providers. We started out going after the payer community because it was not only where the money is, but where the data is, to create clinical records for patients. If you want to improve the outcome, you want to improve the health of patients, what you have to do is to get health information exchange to actually work.By spending the first 18 years going after providing the right information for care managers, for utilization in case and disease management, we figured out how to analyze and gather the data together that was inherent within the only currently available digital systems in the industry that have a lot of data. That’s from the payer’s claims data. We also then created the workflow applications for the case disease utilization mangers. We’ve now recently added the clinical overlays for both utilization as well as case and disease conditions, and what the best practices and processes are around that. Then just a few years ago we started to create the communication vehicles from those inside the walls of the payer to the outside, to the provider communities.About a year ago now, we entered into what we think is probably the most important phase of that. That is, above and beyond the great work we’ve now been able to do with authorizations and referrals and extensions as communication vehicles, we’re actually now starting to take what we call the patient clinical summary. That summarized view of this patient and all their conditions and move it out to the point of care.With several of our clients now, we are not only populating the personal health records, or personal health management systems that they choose, but we’re also providing that data out to either their provider portals or through the standard vehicles we put in place to do authorizations and referrals. Delivering that patient clinical summary right to the provider at the point of care.
