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Bosch’s Telemedicine Shutdown Suggests New Models Are Needed

Posted on June 25, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While many new telehealth plays are rapidly gaining ground, the previous generation may be outliving its usefulness. That may be the message one can take from one giant German conglomerate’s decision to shut down its U.S. telemedicine division.

Robert Bosch GmbH recently announced that it would shut down its U.S. telehealth unit, Robert Bosch Healthcare Systems, which makes business-to-business telemedicine systems. Its offerings include patient interfaces, software and platforms.

You may never have heard of this healthcare company, nor of its massive corporate parent Robert Bosch GmbH, but it’s part of a very large conglomerate with virtually infinite resources.

As it turns out, Bosch is a massive firm which competes with market leaders like GE and Siemens. Robert Bosch GmbH, which has existed since 1886, has more than 350 subsidiaries across about 60 countries and employs about 306,000 people. (I could share more, but I’m sure you get the idea.)

While the failure of one company’s telemedicine strategy doesn’t necessarily mean death for all similar plays, it does suggest that the nimble smaller firms may have more of an advantage than it appears.

Bosch Healthcare was actually way ahead of the market with its offerings, which included remote monitoring tools such as a touch-screen device for home use after hospital discharge and a family of mHealth tools aimed at chronic care management.But they appear to have been held back by proprietary technologies in a market that demands cheap and easy.

Ultimately, the end came when the parent company wasn’t happy with how the telehealth division was performing financially, and decided to cut and run. A statement from the company said that Bosch plans to shift its medical focus to sensor technologies to support improved diagnostics.

It’s hardly surprising that a company Bosch’s size would fail to keep up with the marketplace, given its size. No matter how smart the division’s 125 employees were, they were probably saddled with big company politics which prevented them from making big changes. Not to mention low priced tablets appeared and created a low cost competitor.

The question is, will other large players follow Bosch’s lead? It will be worth noting whether other large companies cede the telehealth market to small and emerging entrants as well. It’s not a no-brainer that this will happen; after all, there’s billions to be made here. But they may actually be wise enough to know when they’re ill-equipped to proceed.

I’ll be particularly interested to see what strategies existing health IT players adopt toward telehealth. It’s unclear how they’ll react to rising consumer and professional interest in telehealth technology, but whatever they do it will probably be worth analyzing.

That being said, with smaller companies out there breaking new ground with next-gen telemedicine apps and tools, they’re probably going to be in the unusual position of playing catch up. And in this case, slow and steady may not win the race.

Medical Device Vendors Will Inevitably Build Wearables

Posted on May 21, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As we’ve reported in the past, hospitals are throwing their weight behind the use of wearables at a growing clip. Perhaps the most recent major deal connecting hospital EMRs with wearables data came late last month, when Cedars-Sinai Medical Center announced that it would be running Apple’s HealthKit platform. Cedars-Sinai, one of many leading hospitals piloting this technology, is building an architecture that will ultimately tie 80,000 patients to its Epic system via HealthKit.

But it’s not just software vendors that are jumping into the wearables data market with both feet. No, as important as the marriage of Epic and HealthKit will be to the future of wearables data, the increasing participation of medical device giants in this market is perhaps even more so.

Sure, when fitness bands and health tracking smartphone apps first came onto the market, they were created by smaller firms with a vision, such as the inventors who scored so impressively when they crowdfunded the Pebble smartwatch.  (As is now legendary, Pebble scooped up more than $20M in Kickstarter funding despite shooting for only $500,000.)

The time is coming rapidly, however, when hospitals and doctors will want medical-grade data from monitoring devices. Fairly or not, I’ve heard many a clinician dismiss the current generation of wearables — smartwatches, health apps and fitness monitoring bands alike — as little more than toys.  In other words, while many hospitals are willing to pilot-test HealthKit and other tools that gather wearables data, eventually that data will have to be gathered by sophisticated tools to meet the clinical demands over the long-term.

Thus, it’s no surprise that medical device manufacturing giants like Philips are positioning themselves to leapfrog over existing wearables makers. Why else would Jeroen Tas, CEO of Philips’ healthcare informatics solutions, make a big point of citing the healthcare benefits of wearables over time?

In a recent interview, Tas told the Times of India that the use of wearables combined with cloud-based monitoring approaches are cutting hospital admissions and care costs sharply. In one case, Tas noted, digital monitoring of heart failure patients by six Dutch hospitals over a four-year period led to a 57% cut in the number of nursing days, 52% decrease in hospital admissions and an average 26% savings in cost of care per patient.

In an effort to foster similar results for other hospitals, Philips is building an open digital platform capable of linking to a wide range of wearables, feeds doctors information on their patients, connects patients, relatives and doctors and enables high-end analytics.  That puts it in competition, to one degree or another, with Microsoft, Qualcomm, Samsung, Google and Apple, just for starters.

But that’s not the fun part.  When things will get really interesting  is when Philips, and fellow giants GE Healthcare and Siemens, start creating devices that doctors and hospitals will see as delivering medical grade data, offering secure data transmission and integrating intelligently with data produced by other hospital medical devices.

While it’s hard to imagine Apple moving in that direction, Siemens must do so, and it will, without a doubt. I look forward to the transformation of the whole wearables “thing” from some high-end experimentation to a firmly-welded approach built by medical device leaders. When Siemens and its colleagues admit that they have to own this market, everything about digital health and remote monitoring will change.

GE Phasing Out Centricity Enterprise, To Some Surprise

Posted on April 22, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Conceding that its competitors have the upper hand, GE is phasing out its Centricity Enterprise product, informing the world in a #HIMSS15 announcement which has gotten little play from our tech media colleagues.  As we’ve argued before, HIMSS is not only a great time to announce big plays, it’s also a great time to bury unpleasant news, and GE seems to have succeeded.

Not surprisingly, employees saw things coming long ago. More than a year ago, for example, a 10-year-plus employee of GE Healthcare called the vendor out on what they saw as low-wattage efforts on company rating site Glassdoor.com. The ex-employee cited a “lack of resources to deliver a good EHR product, [causing] a strong customer base to choose other EHR vendors.”

It’s little wonder that GE is backing out of Centricity Enterprise, which according to a report in MedCity News generated only 5 percent of its EMR revenue, according to Jon Zimmerman, general manager of clinical business solutions. “Is it in the best interest of our customers, shareholders and employees to (be) in a market where competitors are clearly ahead, or should we recognize the situation and go to where the market is going?” Zimmerman told MedCity.

But the fact is, Zimmerman’s comments are somewhat disingenuous. At HIMSS, the company admitted that it had begun the process of dumping Centricity Enterprise three years ago, though it’s not clear how long ago it began to let customers know about its plans. For example, I doubt that Continuum Health Partners CIO Mark Moroses, who as of summer 2013 was moving his organization to the Centricity enterprise EMR, expected to have it phased out less than two years later.

It’s worth wondering why a player with GE’s resources seemingly couldn’t hack the enterprise market. But the problem isn’t new. As far back  as 2011, GE was forced to admit that some of its ambulatory and enterprise customers wouldn’t be able to achieve Meaningful Use with their products. That was probably the beginning of the end for the Enterprise product, which ranked either fifth or sixth in the market recently depending on who you asked. But with Epic alone controlling 15% to 20% of the enterprise EMR market of late, and Cerner hot on its heels, giving up probably was a reasonable response.

The real question is what comes next. If Glassdoor.com posters are any indication, GE Healthcare is prone to frequent strategic changes as management shifts, so who knows what the future holds for its ambulatory Centricity EMR?

At the moment,  it seems that GE is firmly behind its ambulatory product. And that makes sense. After all, physicians are decommissioning their existing EMRs at a frantic rate, and are eager to find substitutes, and that gives GE plenty of sales opportunities. With 70% of physicians unhappy with their EMR, according to a study announced in February of last year, it should be easy pickins.

But given the way GE may have fumbled the ball on the enterprise side, I’d want some proof that leaders there had a long-term commitment to ambulatory care. Practices have a hard enough time finding EMRs that work for them; having to switch for reasons that have nothing to do with them makes no sense.

KLAS Reports Cerner and Epic Combined to Capture More Than 3/4 of New Large Hospital EMR Contracts

Posted on August 28, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This tweet and associated messages are circling all around social media. Here’s the short description of the KLAS report:

HITECH has drastically changed the acute care EMR market. Previous industry mainstays like GE Healthcare and QuadraMed have effectively dropped out. McKesson has promoted their community hospital solution, Paragon, over their former flagship, Horizon. Allscripts, MEDITECH, and Siemens are all racing to recover from past stumbles and regain market share. Since meaningful use became a reality, Cerner and Epic have captured a large majority of new hospital contracts. However, there are still many decisions to be made in coming years and the remaining market is potentially more competitive than in years past.

For those of us following the industry, this isn’t really big news. Cerner and Epic have been battling for the big hospitals for quite a while. In fact, coming out of this year’s HIMSS I was more interested in the battle for small hospitals than large hospitals. Of course, we’ll see how hospital consolidation affects this as well.

What does seem clear and this report confirms is that Epic and Cerner all well positioned in the large hospital EMR market. I predict they’ll dominate until at least the end of meaningful use.

Top Inpatient EHR Vendors – 2013 Black Book Rankings

Posted on February 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I think that most of you know how I feel about the various EHR ranking systems. They all have their issues, but they are another interesting data point in the search for the right EHR. Plus, the EHR ranking trends over time can be interesting. Not to mention, it’s hard not to look at a post that has rankings. It’s almost un-American not to look.

So, I figured I’d post some of the Black Book Rankings over the next week. The following are the Top Ranked EHR Vendors for Inpatient Hospital Systems, Chains and IDN (in alphabetical order).

4MEDICA
ALLSCRIPTS
CPSI
EPIC
GE HEALTHCARE
HCS EMR
HEALTH MANAGEMENT SYSTEMS
HEALTHLAND
INFOMEDIKA
KEANE
MCKESSON
MEDITECH
NEXTGEN
PROGNOSIS HIT
QUADRAMED
SEQUEL
SIEMENS
UNI/CARE
VERSASUITE

Not too many surprises on the list. Was their any Hospital EHR vendor that you think should have made it on this list? I think this list would be more interesting if it just ranked the top 5 Hospital EHR vendors.

HIE and Other Interoperability Solutions for Healthcare

Posted on September 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was participating in a LinkedIn discussion a few months back about HIE solutions. Jeremy Bikman from Katalus Advisors offered this great list of HIE and other interoperability solutions for healthcare:

Orion. Love these guys. Top notch products. Great service. Great UIs and culture too.
dbMotion. Another great firm. Top R&D in Israel. To-die-for partnership with UPMC
Axolotl (United). One of the first to really do HIEs. Good number of clients. Access to a lot of stuff by being owned by a mega-Payer.
Medicity (Aetna). See comments on Axolotl. Bought Novo Innovations which makes them super good at Amb-to-Acute connections. I know several of their execs and they are good honest guys.
Microsoft/GE/Whatever the JV will be called [This commentary is a few months old. I’m sure Jeremy knows it’s called Caradigm now]. They have a few very large and advanced HIEs (WHIE being the foremost of its kind). Remains to be seen what will become of it with so many top leaders leaving.
ICA. John Tempesco from ICA described their offering this way, “With our new approach to HIE deployment, we’ve been experiencing very good success in deploying our CareConnect clinical communication capabilities to enable clinicians in rural settings to attach clinical documentation and have true conversations in a secure environment at very low entry points and high adoption. See more at www.icainformatics.com to review our solution page.”

There are dozens of other vendors that claim to do it (and have one or two psuedo-HIEs here and there) including many of the inpatient and outpatient EMR vendors (Greenway just landed a big chunk of the state of Idaho) but I won’t mention those like Epic that have a great HIE offering (so long as the other orgs in the HIE also have Epic).

I think this is a good way to look at the various vendors and how their customer bases match their company culture as Jeremy pointed out. Are there other HIE solutions that should be on this list?

Microsoft, GE Creating (Me Too?) Platform For Integrating Clinical Apps

Posted on December 9, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Here’s an fun announcement, a bit light on the details but certainly fascinating enough just by virtues of the companies involved. Microsoft and GE’s healthcare IT business have announced that they’re creating an open platform allowing providers and ISVs to create next-gen clinical apps.

Exactly what apps, the announcement doesn’t say, though it hints at fashionable stuff like population health management. (I think that’s corporate-ese for “we’re not sure what we’ve got yet.”)

Clearly, MS and GE are getting wind of efforts by firms like SAP — which has promised to deliver an abstraction layer which can bring myriad data sources into a single happy EMR database.  With the need for integrated health analytics growing stronger by the minute, health IT middleware has never been sexier.

The MS/GE joint venture brings a number of existing properties to the mix, including:

* Microsoft Amalga, an “enterprise health intelligence platform”

* Single sign-on and context management solution Microsoft Vergence

* GE Healthcare eHealth, an HIE platform

* Microsoft expreSSO, an  enterprise single sign-on solution

Perhaps the most interesting item on the list is GE Healthcare Qualibria. Qualibria is a clinical knowledge app GE is developing in partnership with Intermountain Healthcare and Mayo Clinic, both known for being innovative and forward-looking where quality analytics are concerned.

Not surprisingly, GE Healthcare IT will also be developing its own healthcare apps on the platform, which will be designed to connect with a broad cross-section of existing health IT products.

The stated function of the new platform, as stated in the two companies’ press release,  is “helping healthcare organizations and professionals use real-time, systemwide intelligence to improve healthcare quality and the patient experience.”

The real function, at this point, is “don’t let other enterprise IT companies jump ahead in healthcare IT,” I’d say. But clearly something cool could come out of this at some point, particularly from providers like Intermountain and Mayo. So stay tuned.

Data reporting bugs found in GE EMR products

Posted on October 24, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Sure, you’re an IT professional, and you’re not exactly shocked by news that a vendor has found some bugs in its code. (In fact, the more cynical out there probably start to wonder what’s up when they don’t get bug reports.)

That being said, with Meaningful Use at a white heat, this is a particularly bad time for an EMR vendor to find problems with the data reporting functions. Unfortunately for them (and possibly, you) that’s just what GE Healthcare is facing.

Last week, GE Healthcare announced what it termed “inaccuracies” in the reporting functions contained within its Centricity Electronic Medical Record and Centricity Practice Solution products.  The division’s VP and general manager sent out a letter to users last Thursday saying the problems might create flaws in results from SAP’s Crystal Reports or GE’s Medical Quality Improvement Consortium.

While the vendor promises to send out an update that will fix everything by November, right now you’d best not try to attest for MU. Not fun.

Worse, if yo u’ve already attested, GE’s suggesting nicely that you re-run reports for your attestation period and see if you still meet MU standards. Even less fun.

I’m not writing this to wail on GE  — I’m sure execs there are suffering enough  — but to simply give the story a bit more play, as I haven’t seen it tweeted or Facebooked as widely as I’d have expected.

More importantly, perhaps, I though it was worth asking the following. What happens if in the rush to help providers meet MU deadlines, other vendors have made slip ups they haven’t discovered yet? What if other major vendors discover flaws in EMRs that could jeopardize attestations nationwide?

And what do you plan to do, if anything, to make sure you’re not caught unprepared if your vendor has to fess up to serious problems like these?

Hospitals Choosing EMRs/EHRs Based on Integrated Options

Posted on August 5, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For quite some time, hospitals have chosen to patch together existing systems and link them to their new, fancy EMR/EHR system. But lately, EMRs that offer better end-to-end integration are beginning to be hospitals’ first choices, according to research released last month by healthcare vendor research firm KLAS.

As everyone knows, Meaningful Use rules have thrown hospital EMR adoption efforts into high gear over the past couple of years. Just as importantly, MU gave providers an excuse to spend on new, integrated clinical data technology rather than slapping together old clinical systems with spackle and electrical tape.

Not only are the new, integrated systems easier to use — as they make it simpler to review and manage data across the enterprise — they’re also easier to maintain, KLAS notes. Of course, integrated systems created the dreaded vendor lock-in, but these days perhaps that’s a risk hospitals have decided to face.

Recent KLAS data on hospitals with over 200 beds suggests that the Epic juggernaut continues to pick up speed. Apparently, Epic ranked first in new hospital contracts for hospitals in this size range. According to KLAS, Epic is impressing hospitals with its ability to integrate systems, even though, in KLAS’ words, “they lag behind in technology and are not the cheapest solution available.”  (Hey, KLAS said it, not me.)

Another vendor turning up among KLAS’ winners’ list is Cerner, which came in second after Epic. Many of the new Cerner sales were to existing customers who’d previously implemented the big vendor’s system in other facilities, KLAS reports.

Just for the record, other EMR/EHR vendors doing well in the 200+ bed hospital category include Allscripts (Eclipsys), GE Healthcare, McKesson, NEDITECH, QuadraMed and Siemens.

My bet is that the high-ticket EMR spending spree will slow down within a year or so, as hospital IT directors begin to feel, well, rooked by the big-ticket vendors selling jury-rigged, hard-to-use technology. But for the time being, I guess price is, well, not too big an object.