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HIEs in the Public Interest

July 29, 2010 by John

The Health Information Exchange (HIE) market is the Wild West right now.  Vendors are telling us that they are seeing an unprecedented level of activity both for private and public HIEs.  Private HIEs are being set-up by large and small healthcare organizations to more tightly align affiliated physicians to a hospital or IDN to drive referrals and longer term, better manage transitions in care in anticipation of payment reform.  Public HIEs are those state driven initiatives that have blossomed with the $560M+ of federal funding via the HITECH Act.

But this mad rush is creating some problems.

While the private HIEs seem to have their act together in putting together their Request for Proposals (RFPs), such is not the case for the state-driven initiatives.  Rather then formulating a long-term strategy for the HIE by performing a needs assessment for their state, setting priorities and laying out a phased, multi-year strategy to get there, far too many states are trying to “boil the ocean” with RFPs that list every imaginable capability that will all magically go live within a couple of years of contract reward.  Now it is hard to say who is at fault for these RFPs, is it the state or the consultants they have contracted with that formulated these lofty, unreachable goals, but this is a very real problem and unfortunately, the feds are providing extremely little guidance to the states on best practices.

While the above is more of a short-term concern, longer-term we may have a bigger problem on our hands.  The proliferation of private HIEs, coupled with state-driven initiatives with very little in the way of standards for data governance, sharing and use (this includes consent both within a state and across state lines) has the very real potential to create a ungodly, virtually intractable mess that will be impossible to manage.

So maybe it is time to rethink what we are doing before we get to far down this road.

What if we were to say, as a country, that much like Eisenhower did during his presidency to establish the Interstate Highway system, we made the decision that it is the public interest to lay down the network for an “interstate” system for the secure electronic transport of health information?  And rather than be cheap about it as we have done in the past dedicating only modest funding (e.g., NHIN CONNECT), let’s really make the investment necessary to make this work.

Yes, it won’t be cheap, but think of the alternative – 50 states, countless regions all with their own HIE.  Yes, states are required under HITECH to work collaboratively with neighboring states, but this will not lead to enough consistency to create a truly networked nation for the delivery of quality healthcare for all US citizens.

It is indeed time to take a stand for much like Eisenhower’s Interstate system, which I had the pleasure to enjoy as I traveled cross-country this week from Boston to my beloved mountains of Colorado, such an interstate system for the delivery of health information at the point of care will be something all citizens will benefit from. And taking a cue from the image above, rather than a “Symbol of Freedom” it would become a Symbol of Health.

Posted in HIE, consumer health, policy | Tagged , , | 1 Comment »

Microsoft Pulls Plug on Amalga HIS

July 22, 2010 by John

Today, Microsoft officially announced that it is shutting down operations and sales for Amalga HIS.  Amalga HIS was the former Global 2000 EMR that Microsoft acquired roughly two years ago. Global 2000′s claim to fame was being the EMR for the major medical tourism hospital, Bumrungad International, based in Thailand.

I never liked the acquisition of Global 2000 for a few simple reasons:

1) Despite “low adoption of EMR” systems, the EMR market is actually a fairly mature market.  Most hospitals have an EMR already and it is not easy to dispace such – much like chipping out concrete. The “adoption problem” rests more with poor implementation and use, at least in the acute care market, which was the sweet spot for Amalga HIS.

2) Though Microsoft claimed that Amalga HIS would only be sold overseas, primarily in APAC, this acquisition put many an EMR company on alert to be careful working with Microsoft for Microsoft may change its mind at some future date and become a competitor in their backyard.  This hinders Microsoft’s ability to develop closer partnerships with these vendors, which Microsoft admitted was the case in a call with them earlier today.

3) The EMR market is a very messy, competitive market with far too many vendors.  The last thing it needs is another acute care EMR solution, even if it did come from a heavyweight such as Microsoft.  Also, one would have thought that Microsoft learned from its previous mis-steps in the Enterprise Resource Planning (ERP) market (very similar in many respects to EMR), where it made several acquisitions, but the return on that investment is less than stellar.

4) The EMR market, being messy, mature, etc., is not a market where one can truly be disruptive.  But once that data starts being collected and begins to have some structure, then the application of analytics and reporting to better understand operations and how to ultimately improve them, is a higher order of value that will be of high interest to healthcare organizations, both large and small. This is a disruptive opportunity. Now that we have a major push to drive adoption and use of EMRs/EHRs, that data will increasingly become available for solutions such as Microsoft’s Amalga UIS.  Microsoft can now focus its resources on this disruptive opportunity, rather than waste resources on an EHR.

It now appears that Microsoft has come to the same conclusion.  Thankfully, Microsoft is not leaving dozens of hospitals in the lurch.  Actually, Amalga HIS has only six customers today and those customers will receive support for the next five years.  After that they will be on their own, but Microsoft has assured me that they are working with third party vendors and service providers to insure that these customers will receive continued support in the future.

One take away from all of this:
Performing a viability assessment on a potential vendor may not reduce one’s risk. Even a big, viable company such as Microsoft may change its mind on occassion and chose to exit a market.

Posted in EHR, EMR, Microsoft | 5 Comments »

Telecom’s Tepid Plays in HIE Market

July 20, 2010 by John

The telecom industry makes its money delivering bits and bytes. Therefore, it is not too surprising that the two major players here in the US, AT&T and Verizon are placing some bets in the healthcare sector.  Primary among those bets are enabling telehealth (both have been perennial sponsors of the Partners Connected for Health Symposium), providing communication services to large IDNs and more recently making a play in the still emerging Health Information Exchange (HIE) market.

AT&T has Healthcare Community Online (HCO) as their primary HIE solution, which they often take to market with partner Covisint.  The lighthouse customer for these two is the Tennessee HIE, CareSpark.  Despite AT&T’s claims to have a viable and competitive HIE solution, we have never heard anyone mention them, either within the context of an RFP, a competitive bake-off, mentioned as a competitor by other HIE vendors, etc.  Nothing. Nada.  It’s as if they don’t exist, and frankly, maybe they don’t in the HIE market. (Chilmark did not discount Covisint and there will be a detailed profile of this HIE vendor in our forthcoming report.)

Is Verizon doing anything more substantial in the HIE market?

Late last week, Verizon announced its own HIE product suite.  Let’s be polite, the press release didn’t have us in a panic wanting to call Verizon and immediately get a briefing.  Heck, writing this post several days after the release went out may give you another hint as to our level of interest and excitement.

What’s the problem?

1) Putting “Cloud” in the title of the press release.  Boring, and honestly not at all new as virtually all the leading HIE vendors having been providing cloud-based HIE solutions for years.

2) More importantly, Verizon’s chosen partners, MEDfx, MedVirginia and Oracle.  First MEDfx is but one of the countless and like its brethren, nameless, little HIT vendors out there in the market trying to survive, offering a wide range of solutions from EMR to PM, to HIE etc.  A mish-mash of products with little market traction.. Our bet is that 5 years from now, they’ll be gone.  One would have thought that with its size, brand and clout, Verizon would have been able to do better than this for an app partner. Second, picking a client as a partner? There may be some small value to that but to make that a key part of your announcement message, not so good and a clear sign of weakness.  Besides, it looks like what is really going on here is that MedVirginia is simply replacing its existing HIE vendor, Wellogic, an HIE vendor who, if field reports are correct, is on its last legs.  OK, we’ll give Verizon credit for partnering with Oracle for Oracle’s Master Patient Index solution, if it is indeed the one that Oracle built and not the poorer substitute built by one of Oracle’s most recent acquisition, Sun Microsystems.

It just puzzle’s us that these two very large companies, with clear established brands in the market are making such tepid plays in the HIE market.  They certainly have the resources to do something far bigger, say acquire one of the leading HIE vendors that has an established presence, good customer list and build from there.  In some of our more recent discussions with those assessing and looking to purchase an HIE solution, the issue of vendor viability is always a topic of discussion.  A large company like one of these telecoms could clearly remove that issue from discussion.

Maybe it is just a case of it’s not in their DNA.  Telecoms sell simple services that can be leverage across multiple markets.  Delving into the healthcare sector with an HIE play requires more than just a communication network, it requires secure messaging, deep domain knowledge of healthcare workflow and best practices and it requires a level of software expertise that is foreign to these companies.  No, it is Chilmark’s belief that announcements such as this simply cloud-up what is already a pretty murky market.

Our bottom-line advice to those assessing HIE solutions in this murky market:

1) Look to a vendor that has a proven track record, with good references from those you respect.

2) Seek a vendor (and not just their service partners) who has domain expertise and truly understands what is trying to be accomplished within the context of an HIE.  Look closely at their workflow templates as these will give you some idea as to how well they understand the business.

3) Delve deeply to understand a vendor’s true compettive differentiators.

4) Look closely at their list of partners, both software and service, and talk to the vendors customers about how well these partners’ solutions are integrated into the entire solution suite.

And dear readers, if you have a few suggestions of your own, please add them to the list in the comment section below.

Posted in EHR, EMR, HIE, HIT, RHIO | Tagged , , | Leave a Comment »

Meaningful Use Perspectives & Resources

July 15, 2010 by John

Everyone seems to have an opinion, or at least has written something, about the final Meaningful Use (MU) Rules that were released on July 13th.  Of the multitude of posts and articles out there on the net, there the top three to get you started are:

1) ONC Chief, David Blumenthal’s article in the New England Journal of Medicine that was published on the same day wherein Blumenthal provides a clear abstract of the rules (the actual rules are 864 pgs in length and not a bad read if you have the time) in a easy to read and understand format.

2) Next, head over to the Dell website for a post by their own Dr. Kevin Fickenscher who gives an excellent background on the broader HITECH Act, the origination of the MU rules as well as taking a look at companion rules for Certification of EHRs and the new Privacy & Security rules that were also recently released.

3) Last, but certainly not least is a visit to John Halamka’s site where he provides a freely available, with no need to provide attribution, deck of slides that gives the big picture view of the final MU rules.

With such great resources out on the net, we at Chilmark Research see little need to write an in-depth review of these rules. That being said, we will provide some quick points of analysis.

1) Clearly, HHS listened to the market and the 2,000 comments it received and has relaxed the final MU rules significantly.  If any provider or hospital is still complaining, well they may be the type to complain no matter what.  These rules, while still challenging for some, are certainly doable.  Time to stop talking and get down to work.

2) Thankfully, probably to the chagrin of payers, the requirements to conduct administrative functions (eligibility checking and claims processing) from within the EHR has been removed.  This has always been a fairly silly requirement as today, much of this process is already done electronically through the Patient Management (PM) system. So no need to duplicate it within the EHR, besides which it would have been tough for many an EHR company to build out this functionality in such a relatively short timeframe.

3) The consumer engagement sections of the MU rules also saw some relaxation, but it was reasonable.  What may prove more interesting here is the new requirement within the certification rules for EHRs that they provide health education resources for consumers within the context of their platform.  This may prove to be a real money maker for the likes of health content providers such as A.D.A.M, Healthwise, WebMD, among others.

4) While understandable that there was some pull-back on health information exchange as we saw in the draft MU rules, we were quite surprised that it was completely eliminated in the final rules for Stage 1.  HHS claims that this was done due to the lack of maturity in the HIE market.  Well, yes and no.  There indeed may not be a lot of multi-stakeholder, publicly-led HIEs today that are actively exchanging data, whether regional or state level, but there is a robust market for private HIEs.  It is unfortunate that HHS pulled back on this one for “information sharing for care coordination” was one of the primary precepts of the original HITECH legislation.  Sure, will likely see something within Stage 2, but that does not get clinicians familiar with the concept today.

5) What really caught us by surprise is a reference in the MU rules (pg 39 to be exact) wherein HHS states that they will not discuss the future direction of Stage 3 at all.  Nothing. Nada.  Does this portend a complete pull-back from Stage 3?  Hard to say, but it is clear that HHS wants to see how well Stages 1 & 2 go over in the market before it makes any further demands on providers and the EHR vendors that serve them.

6) Along with the release of MU rules, HHS also released the final rules for EHR certification.  While having not delved into these deeply, yet, the whole concept of “certification” is fraught with challenges, primary among them, technology lock-in.  It is here where Chilmark believes we will see the greatest challenges to indeed create an environment that fosters innovation, providing clinicians with tools they will readily wish to use while at the same time providing some level of certification. Frankly, we do not believe it can be done. Congress really wrapped an albatross around the neck of HHS when they wrote that into the legislation.

What were they thinking?

Posted in EHR, EMR, HIE, Privacy, Security, consumer health, policy, standards | Tagged , , , | 2 Comments »

Meaningful Use Rules Drop Today

July 13, 2010 by John

Nearly a year after the HIT Policy Committee’s meaningful use recommendations were approved by ONC chief Dr. David Blumenthal, an extensive comment period that solicited some 2,200 comments, the final Stage One meaningful use rules will be released today at 10:00am.  Details for today’s conference call are:

WHAT: CMS and ONC will host a press briefing to announce the final rules on Meaningful Use and Standards and Certification under the HITECH Act’s Electronic Health Records (EHR) incentive program.
WHO: Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services
Donald Berwick, M.D, Administrator, Center for Medicare & Medicaid Services
David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
Regina Benjamin, M.D., M.B.A., Surgeon General
WHEN: Tuesday, July 13, 2010
10:00 a.m. EDT
WHERE: Great Hall, Hubert H. Humphrey Building
200 Independence Avenue, S.W.,
Washington, D.C. 20201
Dial In: Call in: 800-857-6748
Verbal Passcode: HHS

A Couple of Thoughts on the Pending Release
A significant amount of effort by many a talented and dedicated individual has gone into providing the initial policy framework and ultimately the final language for these rules.  Hats-off to them for their service for what they may have done is defined much of the future core elements of healthcare IT systems in the decade to come.  Granted, this is only Stage One rules, we have only an inkling of an idea as to what to expect in Stages 2 & 3, but there is no doubt in our minds that these rules will have an impact on the HIT market, more broader technology adoption and use in healthcare and even more broadly, a fundamental change in healthcare delivery and the role of the citizen/patient.

While these rules will have a noticeable impact, we are less confident that they will have a lasting impact for two primary reasons:

  1. It remains to be seen just how many physicians will take the bait (incentives) to buy a “certified EHR” and jump through all the hoops to demonstrate their meaningful use of said EHR.  Yes, $44k may seem like a lot initially, but when you start digging a little deeper into what the total cost of ownership is for an EHR and the number of hoops you must jump through to get that incentive payment, that attractive $44k starts looking less attractive in a hurry.
  2. Looming on the horizon, just beyond the street noise that is meaningful use and the HITECH Act, is a far larger change agent, the Healthcare Reform Bill that was passed into law earlier this year.  Tucked into that legislation are a number of significant changes, primary among them, payment reform via CMS’s Innovation Center.  Following the old adage, “follow the money,” we at Chilmark foresee a restructuring of the healthcare delivery system that will necessitate the adoption of IT not for the aforementioned “meaningful use” but to more efficiently and effectively run operations.  (Over in the radiology world, an article on Aunt Minnie clearly directs radiologist to start thinking efficiency.) This is what organizations both large and small, and not just radiologists, need to be thinking about as meaningful use, in retrospect, may be seen as more of a distraction than anything else.


Posted in CMS, EHR, EMR, HIT, consumer health, policy, standards | Tagged , , , | Leave a Comment »

Buried Under HIE Pile

July 8, 2010 by John

As frequent visitors to this site know, Chilmark Research is putting together a report on the HIE market.  Report was moving along nicely, that is until the one I had hired to help me with it, was recruited by a client of Chilmark’s into a full-time position. While I am truly happy for him, it does put me in a bind as I now must take the lead in getting this report completed.

Therefore, do not be disillusioned at the lack of posts and/or the depth of analysis provided.  It is simply one of those cases where priorities must be set and right now, that priority is the forthcoming HIE Report.

A couple of quick tidbits from initial findings:

There is no agreed upon pricing structure in the HIE market.  Wide mix of pricing models from subscription to straight licensing and plenty in-between.

Most HIE vendors are focused on the basics of moving lab data with some order management and even referral management thrown-in.  Higher order functionality such as clinical decision support, care/case management and business intelligence/reporting are still immature.

Now to keep you busy, a couple of reports worth a scan/quick read are:

A Health Approach – Technology for Personalized, Preventative Healthcare: This report from the Europe (ICT Research) gives an overview of several technology initiatives in Europe.  While the report is not terribly focused (covers all forms of health technology) it does give one a sense of how those across the pond are thinking about personalized healthcare and where they are currently placing some bets with their research Euros.

Consumer Use of Computerized Applications to Address Health and Health Care Needs: This report was published last year by the US Dept of Health and Human Services.  Quite a comprehensive report and a good primer for those who are just beginning down this path.  For those who are more knowledgeable on the subject, the bibliography is the best I’ve seen on the subject.  Someone worked very hard on this report and it shows.

In closing, fear not, Chilmark Research continues to keep its ears to the ground and if anything earth-shattering (or at least HIT shattering) breaks, we will discussing it here, e.g. the drop of Meaningful Use rules, though frankly, those rules are getting far more attention than they deserve, same for certification of EHRs.  But we will discuss that in greater depth within a future post.

Oh, one last thing: the picture accompanying this post is a photo I took on the beach here in Chilmark MA. Basically, I like to take those nice rounded beach stones, balance them in odd ways and take a photo.  One of these days I may actually print and frame one of these pictures, but for now, they make nice wallpaper for the laptop.

Posted in HIE | Leave a Comment »

Where is the Consumer in Vendors’ HIE Solutions?

June 30, 2010 by John

In Monday’s post, Chilmark reflected upon a piece that Peter Hudson, co-founder of Healthagen, the developers of mHealth app iTriage wrote for mobihealthnews. In that article, Peter talked about the utility of an mHealth-based PHR (iTriage recently launched such capabilities), but in our post, we countered that today, it is still far too difficult for a consumer to pull together their personal health information (PHI) to create a truly longitudinal record. This will likely stunt the efforts of companies such as Healthagen who are trying to offer consumers a PHR – the hassle factor is still far too great to overcome.

Now we will look at the red hot space of Health Information Exchanges (HIEs).

As local, regional or even statewide aggregators and distributors of health data to facilitate care coordination, HIEs have the potential to play a pivotal role in helping a consumer create and manage their PHI. Now that does not mean that the HIE has to offer the consumer a PHR per se, but what an HIE may be able to do is offer the consumer an ability to have a portal view into their PHI that resides within the context of a given HIE. Better yet, why not have as a condition of receiving some of that federal largesse of $564M for state HIE programs that these HIEs support “Blue Button” functionality allowing a consumer to readily download or export their PHI to wherever the consumer desires.

Ah, but we digress.

The purpose of this post is to extract a couple of data points from our forthcoming HIE report as they pertain to consumer engagement. Unfortunately, it is not a pretty picture.

As part of our market survey of twenty HIE vendors, we asked them a number of questions with regards to what consumer-centric capabilities did their HIE solution support. Fully eighty percent of those interviewed had either modest (15%) or weak (65%) consumer offerings.

The following table provides a brief snapshot of those HIE vendors that have what Chilmark considers strong consumer engagement tools. Two of those vendors, Kryptiq and MEDSEEK are somewhat difficult to classify as an HIE in the traditional sense, thus you will not find them running under the covers at your local RHIO. Microsoft is still new to the HIE market with one HIE live in Milwaukee and another in D.C.. While Microsoft’s platform offers these HIEs the potential for bi-directional communication with HealthVault, that capability, to the best of our knowledge has not been tested at either of these HIEs. Also, it is important to note that the Microsoft HIE solution offers little with regards to support for transactional processes (appointment scheduling, Rx refill, eVisit, etc.). RelayHealth is the remaining HIE vendor that actually has some of the more robust consumer tools in the market (they received fairly high ratings in our previous iPHR Market Report), so this is not too much of a surprise.

Now it is not necessarily the fault of laggard HIE vendors that today, their solutions offer weak consumer tools. Frankly, the market has not asked for them. Even as recently as last year when the various HIT policy committees were meeting in Washington to set policies for the HITECH Act and the funding to come, the committee on HIEs, in one of their seminal meetings, completely ignored the consumer role in an HIE. Shameful.

But this will change in due time. MEDecision and Carefx are building out their consumer-facing capabilities and we are sure others will add consumer functionality in time, most likely via partnerships or an occassional acquisition as market is moving too fast for an internal build-out. in the meantime, those vendors that have this capability bring to market competitive differentiation.

While this is all well and good, another development is also taking place, NHIN Direct – something that Microsoft’s chief architect, Sean Nolan mentioned in his comment to our Monday post. What role might a secure, lightweight communication system play within the broader context of HIEs, aggregated PHI, consumer access and potentially control of their PHI? A lot of questions to ponder that we will be looking into further over the next few days

Posted in HIE, PHR, consumer health, eRx, policy | Tagged , , , , , , , , | 6 Comments »

Consumer Challenge: Creating a Longitudinal Record

June 28, 2010 by John

A very good eZine on all things mobile health, is mobihealthnews.  Brian and his partner Joe have done an excellent job of following many of the developing trends in this sector and occasionally, will have a guest author a column.  On Friday, one of  the co-founders of the iPhone app, iTriage, Peter Hudson, wrote a column on Personal Health Records (PHRs) and mHealth. (FYI, iTriage is arguably, one of the more successful consumer-facing healthcare iPhone apps – they are actually making a living at it, more than we can say for most iPhone app developers). The article caught our attention instantly with this lead-off paragraph:

Personal health records (PHRs) represent a great opportunity for healthcare consumers to take control of their healthcare data and help deliver many meaningful solutions for managing their health. The problem with the current landscape of solutions is that data is not flowing quickly from healthcare systems into central repositories. When this data is available, it is not being delivered to the healthcare consumer in a meaningful way: It’s not easy-to-use, mobile, easily shared, or present with them when they need it.

While Chilmark applauds iTriage and Peter for continuing to extend the functionality of their platform to now address consumers’ mobile access to their PHR, in this case Google Health (Note: iTriage is also working to have similar connectivity to HealthVault), Peter has not addressed the real issue here, how do we, as a society, create the systems necessary that will allow a consumer to easily aggregate their health data to create a truly longitudinal record that they can securely tap via their iTriage app, or some other mechanism, regardless of location, when needed.

And therein lies the rub – those systems do not exist. We are dealing with point-to-point access, point-to-point data retrieval, a complicated, convoluted process that frankly most consumers will not bother with.

Ever the optimist, Chilmark firmly believes there may be a solution tucked within the billions that will be spent to digitize the healthcare sector: The Health Information Exchange (HIE).

In the second of this two part post, Chilmark will look more closely at the HIE market, vendors therein and their efforts, or lack thereof to provide consumer engagement tools that may ultimately allow consumers to create a longitudinal record of their health or the health of a loved one.  Stay tuned.

Posted in Google Health, HIT, HealthVault, PHR, consumer health, mHealth | 7 Comments »

Going Stealth, MSFT Brings HealthVault to UK

June 22, 2010 by John

Today, Microsoft, via a blog post by its UK leader John Coulthard, announced the launch of HealthVault in the United Kingdom. Yesterday, Chilmark received a briefing from Microsoft’s Director of International Development, Mark Johnston who provided us the back-story on this launch and how this launch is different from Microsoft’s previous international forays in Canada and Germany.

HealthVault UK is initially a very limited subset of capabilities focusing more on the MSN Wellness Center (or is it Centre for UK).  Two reasons for this: First, as the National Health Service (NHS) is Microsoft’s largest enterprise customer worldwide (yes, larger than say the US federal government) and Microsoft certainly does not wish to directly compete against NHS’s own citizen-facing personal health platform, Healthspace. Secondly, Microsoft has been working closely with Nuffield Health, a private health & wellness organization in the UK who will be its first customer.  Nuffield, which has ~150 facilities across the UK, both fitness centers, clinics and private hospitals, advocates a whole health model and is looking to the HealthVault platform, its wellness features and ability to take in biometric data as core to its strategy of providing customers a value-added service.

Unlike Canada and Germany, where partners Telus and Siemens respectively will take HealthVault to market, in the UK Microsoft is going direct and will offer the HealthVault platform to prospects (healthcare facilities, fitness centers, long term care, etc.) on a common subscriber access license (SAL) model.  With an SAL, Microsoft provides the base HealthVault “utility service,” and based on the client’s needs will build the ecosystem of apps on top of HealthVault, from third party ISVs as well as ones from Microsoft (e.g. MSN wellness widgets). Subscription costs scale, decreasing with a corresponding increase in number of subscribers.  A client, such as Nuffield, then offers HealthVault to their customers.  WebMD use a similar model for selling their platform to payers such as WellPoint or employers such as EMC or IBM here in the US.

As with instances of HealthVault in Canada and Germany, the UK HealthVault service will be fully hosted within the country and be in compliance with all local laws for privacy and security.  Microsoft has teamed up with the UK Cloud IT services provider, Attenda to provide hosting services.

Since Microsoft is already going direct in its sales strategy for Amalga and Sentillion in the UK, longer term, one can envision them also deploying a strategy similar to that at New York Presbyterian combining Amalga, HealthVault and the bridging solution SharePoint, which they have now offer as HealthVault Community Connect.

Assessment:
Clearly, there are those in industry that see the need for deeper consumer/citizen engagement in managing their health and are willing to take a a risk. Microsoft, Telus and Siemens are all huge companies with massive resources at their disposal to use patient money to build out these personal health platforms (PHP). But what we have not seen is a corresponding response from the market (consumers) that they are ready and willing nor, as in the case of the Telus release and this one in the UK, have we seen a ground swell of third party ISVs clamoring to get on-board and develop novel applications to serve the citizens of these countries.

To some extent it is a “chicken n’egg” scenario wherein ISVs may be reluctant to build to the HealthVault platform until they see some tangible traffic, which at least here in the US has seen a rise upward, but still sits at a paltry 7%. Not exactly a vibrant market. Chilmark dinged the Telus health space roll-out for its lack of an ecosystem.  Likewise, we have to ding Microsoft for its own efforts in the UK where honestly, this launch is extremely modest in scope, having no third party apps, just those simple widgets that were developed for the MSN Health & Wellness site.  Not exactly pushing the envelop.

But to their credit, Microsoft is putting their money where their mouth is investing for the long-term. If that investment pays off (i.e., consumers get on-board), Microsoft will have a substantial lead in the global market that will be near impossible for others to replicate.

Posted in HealthVault, Microsoft, PHP, PHR, consumer health, policy | Tagged , | 2 Comments »

Ramping Up for MU Rules, CMS Launches New Site

June 21, 2010 by John

Today, the Center for Medicare and Medicaid Services (CMS) launched a new site that is basically an everything you wanted to know about meaningful use, ARRA, the HITECH Act, certified EHRs, etc., but were afraid to ask.  This is a reasonable attempt by CMS to get as much information online, in one location, that addresses most of the nuances of the HITECH Act and its incentive programs for physician and hospital adoption of EHRs.  Unfortunately, like most government websites, or at least those that seem to emanate from HHS, it is a drab site that presents information in a way that your mid-90′s era web designer would be proud of.  (Note: inside sources state the problem rests with a chief web design honcho at HHS who is stuck on that old model much to the displeasure of others – oh well, that’s government.)

Needless to say, the site does provide a wealth of information, though you may have to dig to find what is most important to you.  The site may also become prone to being dated, so be careful and double check other sources for more current info.  For example, the section on certification of EHRs stated that certification rules will be released in “late spring/early summer” – well they are already out, having been released on June 18th.  Hopefully, HHS, CMS and ONC can work more closely going forward to insure that information on this new, and what may become an important site, is truly current.

In launching this site, CMS is trying to get ahead of the curve and likely onslaught of requests for information once the final meaningful use rules are released. While this website states that these rules will be released, again, “in late spring/early summer,” we are now placing our bets that these rules will be released at 4:55pm on July 3rd, unless of course someone in the administration decides to postpone such an announcement until the opportune moment comes along to generate some positive press for what is currently an embattled administration.

Posted in EHR, EMR, policy | Tagged , , , , | 4 Comments »

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