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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.

Cerner Offers Voluntary Separation Packages

Posted on February 24, 2015 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.

The Kansas City Star is reporting that Cerner is offering employers whose combination of years of service and age total 65 have been offered voluntary separation packages. Here’s an excerpt from the article:

Cerner spokesman Dan Smith said the one-time offer reflects the “deep bench of complementary talent” because of the Siemens acquisition and doesn’t affect Cerner’s continued hiring or its future growth plans.

“This is a truly voluntary program for all of our U.S. associates,” Smith said. “There is no pre-determined outcome and no number to hit. It provides eligible associates who might be ready to make a change the chance to decide to stay or pursue a different option and get benefits not normally associated with voluntary departures.”

With any large acquisition like the one Cerner did of Siemens, there has to be a lot of duplicate functions and they have to look at how to trim back the number of employees. So, this shouldn’t come as any surprise. In fact, I think the fact that they’re currently doing a voluntary separation package might mean that they aren’t looking to slim down the company as much as you’d think. Some investors might think that’s a bad plan since every company the size or Cerner or Siemens (let alone the combined company) could likely fire 10% of the workforce and improve their company’s profitability. Although, it could also be a sign of how much growth Cerner is experiencing.

Personally, I’ll be watching to see if they announce some other layoffs. It will be a surprise to me if they don’t announce some involuntary layoffs. Either way, this is a normal part of an acquisition like this.

It does make me wonder how many of these older professionals that accept the voluntary separation packages will end up at the wide variety of EHR consulting companies out there. You have to think that would be a pretty sweet deal for them.

Cerner Completes Acquisition of Siemens Health Services

Posted on February 2, 2015 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.

As we first wrote about back in August 2014, Cerner Has Acquired Siemens and today the acquisition is complete. Here’s a quote from Neal Patterson, Cerner Chairman CEO and Co-Founder, about the acquisition:

“By combining client bases, investments in R&D and associates, we are in a great position to lead clients through one of the most dynamic eras in health care,” said Neal Patterson, Cerner chairman, CEO and co-founder. “Cerner remains focused on key development areas including population health, physician experience, open platforms, revenue cycle and mobility. We see these as critical areas of investment to ensure providers can meet growing regulatory demands and control costs, while continuing to improve quality of care.”

This note on Cerner revenue and client base was quite interesting: “Cerner expects revenue in 2015 to be approximately $4.8 billion to $5 billion, with a client base spanning more than 30 countries across more than 18,000 facilities.” For those keeping track at home, the purchase price for the acquisition was $1.3 billion plus working capital adjustments.

We wrote previously about John Glaser staying on at Cerner. Cerner has committed to supporting and advancing the Soarian platform for at least the next decade. Although, that’s not a surprise since it will probably take a decade for the Soarian licenses to come up for renewal so they can move them to the Cerner platform.

Give it 3-4 years and you’ll see why Soarian is not likely to be a long term option for organizations. It’s expensive to support 1 platform, let alone two. Cerner will be doing the minimum necessary on Soarian and integrating new revenue streams into it. Otherwise, I can’t imagine they’ll do anything great with it.

The next couple years are going to get really interesting as the two heavyweights battle it out: Cerner and Epic. Although, I thought Neal’s areas of interest for Cerner were interesting: population health, physician experience, open platforms, revenue cycle and mobility. I’d love to sit down with him and talk about what they’re really doing in these areas. Especially around open platforms.

John Glaser to Stay on as Senior VP of Cerner Upon Close of Acquisition

Posted on November 19, 2014 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.

In case you’re living under a rock (or more affectionately, you’re too busy working to follow the inside baseball of EHR company acquisition), Cerner is set to acquire Siemens in late winter or early spring pending all the needed approvals for companies this size. Watching the merging of these two companies is going to be very interesting indeed.

Neil Versel just reported that John Glaser, current CEO of Siemens Health Services, has announced that upon close of acquisition he’ll be joining the Cerner team as a Senior VP. I also love that John Glaser made this announcement on the Cerner blog.

I think this is a big deal since I believe John Glaser is at the point in his career that he could do just about anything (or nothing) if that’s what he desired. The few times I’ve interacted with John Glaser, he was sincerely interested in moving healthcare forward through the use of advanced IT. I imagine that’s what’s motivating him to stay with Cerner. No doubt, Cerner is sitting on a huge opportunity.

In John Glaser’s blog post, he provided an interesting insight into Neal Patterson’s comments at the Cerner user conference:

In his CHC keynote address, Cerner CEO Neal Patterson did a masterful job of conveying Cerner’s commitment to patient-centered care. Before he spoke, a patient and her nurse were introduced with explanation that the woman’s life was saved by a Cerner sepsis alerting system. Neal then shared the incredible challenges he and his wife have faced in her battle with cancer because of limited interoperability.

Neal’s keynote was very personal – about how we can make a loved one’s care journey easier by ensuring that all records – every detail – are available electronically and accurately wherever the patient receives care. It was the case for interoperability but also the case for making a patient’s life easier and the care better.

It’s hard for me to say how much of this was theatrics, but I’m glad they are at least talking the right talk. I really do hope that Neal’s personal experience will drive interoperability forward. Neil Versel suggested that interoperability would be John Glaser’s focus at Cerner. I hope he’s successful.

While at CHIME, I talked with Judy Faulkner, CEO of Epic, and we talked briefly about interoperability. At one point in our conversation I asked Judy, “Do you know the opportunity that you have available to you?” She looked at me with a bit of a blank stare (admittedly we were both getting our lunch). I then said, “You are big enough and have enough clout that you (Epic) could set the standard for interoperability and the masses would follow.” I’m not sure she’s processed this opportunity, but it’s a huge one that they have yet to capitalize on for the benefit of healthcare as we know it.

The same opportunity is available for Cerner as well. I really hope that both companies embrace open data, open APIs, and interoperability in a big way. Both have stated their interest in these areas, but I’d like to see a little less talk…a lot more action. They’re both well positioned to be able to make interoperability a reality. They just need to understand what that really means and go to work on it.

I’m hopeful that both companies are making progress on this. Having John Glaser focused on it should help that as well. The key will be that both companies have to realize that interoperability is what’s best for healthcare in general and in the end that will be what’s best for their customers as well.

Cerner’s Siemens Acquisition and the Impact on the DoD Bid

Posted on August 7, 2014 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.

One topic I didn’t address in my post covering the $1.3 billion Siemen’s acquisition by Cerner is how this will impact the $11+ billion DoD bid. There’s a lot of discussion about what this acquisition will do. Let me pull out my crystal ball and give you my thoughts.

I personally think that this acquisition will have very little impact on which cluster of companies will win the DoD EHR contract. Some might say that Cerner gains some advantage by having some of the Siemens capabilities on board. Others could argue that Cerner will be distracted with the Siemens acquisition and so they wouldn’t be able to focus on such a large EHR contract. While both of things have some truth, I really don’t think they’ll factor into the DoD decision making.

It seems the consensus out there is people expect Epic to win the DoD contract. If that happens, the Siemens acquisition could become even more interesting for Cerner. It’s a very likely reality that whoever gets the DoD contract will lose some potential clients due to concerns about capacity. If Epic or Cerner get the DoD contract, then it’s possible that these capacity concerns will move them down a notch in people’s EHR selection process. This is a situation where Cerner will benefit from having connections to all of these Soarian customers. As I posted previously, it might be best for Epic not to win the DoD contract.

Are there other ways that Cerner’s acquisition of Siemens impacts the DoD EHR bid?

EHR Consolidation Continues as Cerner Acquires Siemens Soarian

Posted on August 5, 2014 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.

The big news that had been rumored for a while was that Cerner was going to acquire the Siemens Health Services product line including Soarian. The rumor became reality as the acquisition was announced today. You can see the investor slide deck they published here. Most notably, Cerner has committed to supporting the Siemens Soarian product line for a decade:

Following the acquisition, support for Siemens Health Services core platforms will remain in place. Current implementations will continue, and Cerner plans to support and advance the Soarian platform for at least the next decade.

Of course, it’s one thing to suggest this in a press release. It’s another thing to actually do it in practice. However, it was smart of them to announce this approach to allay the fears of Soarian customers. If enough Soarian customers move over to Cerner, then you can be sure the announcement to sunset Soarian will happen. That’s a feature of EHR acquisition and consolidation. It’s just too expensive, especially in this regulatory environment, to maintain two code bases which perform the same functions.

These stats about the combined organizations are quite interesting:

  • 20,000 associates in more than 30 countries
  • 18,000 client facilities, including some of the largest health care organizations in their respective countries
  • $4.5 billion of annual revenue
  • $650 million of annual R&D investment

The last one is interesting given yesterday’s post on R&D companies. However, I think one of the key numbers there is the associates in 30 countries. Siemens Health Services has approximately 5,000 client facilities in over 40 countries including a strong presence in Germany, Sweden, Austria, Spain, Norway, and the Netherlands. You can be sure that a large part of this acquisition by Cerner is being able to go after the global market. There’s a huge opportunity in many countries that haven’t had billions of dollars falsely stimulating the market.

What I found particularly interesting on the investor call about the deal was Siemens efforts to take care of their existing customers. I’d describe it as finding a soft landing for their customers. You can understand why this is important. Many of those Soarian customers are still Siemens customers in other parts of the business like radiology. Siemens no doubt didn’t want to kill their other business by selling Siemens Health Services.

We’ll see what comes of the Siemens and Cerner $100 million innovation budget. If you look at the wording it says stuff like up to $100 million budget. Plus, these two companies are going to have to work together on some projects regardless. Cerner needs the data Siemens has and Siemens will need to get the data into Cerner. Will anything beyond that really occur, I’m not as optimistic.

I did find Neil Patterson’s comments on the post-Meaningful Use era interesting. I’d love to explore more of what he sees in that future. One person described it as a move from documenting the care given to a patient to technology that drives the care given a patient.

I’m not sure hospital execs should be that excited about this acquisition. It takes out another competitor from keeping EHR vendors honest. This really is getting down to a two horse race between Cerner and Epic and I think this acquisition will put Cerner just ahead of Epic in market share.

I liked this tweet from Hospital CIO Will Weider about the acquisition:

More of the Siemens Healthcare Back Story

Posted on July 10, 2014 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.

One of the things I love about blogging is the comments that I receive. Many of them come in the comments of the blog, but just as many get emailed to me privately in response to my posts being emailed to readers. Every once in a while I want to share the emails I receive with the readers (Note: You can now subscribe to all of the Healthcare Scene emails in one place). This is one such response that I got in response to my post about Siemens Selling its Health IT business.

I remember the good ol’ days of being a 25+ year SMS Unity customer. Siemens who had recently purchased SMS told us that Unity would be going away. They showed us Soarian (which at the time was not actually built) and said that they would move us there for free. Of course, since it didn’t yet exist we would have to transition to Invision first for about a year. That would also be free. However, they would have to expense us for professional fees which they estimated to be in excess of $1,000,000. This is how we became a Meditech customer.

This kind of back story is what makes healthcare IT so interesting and so challenging. Many who want to enter the healthcare space forget about all this history and they usually fail. The very best hospital health IT companies that I know usually do an amazing job pairing new innovations and technologies together with someone who understands and has been part of this history. Pairing the two together is a powerful combination.

Siemens to Sell Hospital IT Business?

Posted on July 9, 2014 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 is some interesting news for the hospital health IT world:

Siemens (SIE) AG is exploring a sale of its hospital database and information-technology unit to focus on energy and industrial businesses, according to two people familiar with the plans.

The German engineering company is evaluating options for the business, and no final decision has yet been made, said the people, who asked not to be identified because the considerations are private. The unit could be valued at more than 1 billion euros ($1.4 billion), said one of the people.

Siemens Chief Executive Officer Joe Kaeser is seeking to focus Siemens around “electrification, automation and digitalization” and has already sold off $2.3 billion euros since late 2012. It seems like Siemens healthcare product line fits great with the digitalization focus, so there’s likely more to the story. My guess is the Siemens healthcare business hasn’t been doing well (Thank you Cerner and Epic) and so he’s looking to get out while there’s still some value in the business.

If you’re a Siemens healthcare customer, you probably welcome this change as well. Hopefully a sale will infuse the company and the product with a new energy that will produce some better results for their customers. Maybe I’m talking to the wrong people, but those I’ve met on Sorian are basically ho-hum about the product. No doubt it will be interesting to watch.

KLAS: Epic Losing Ground To Cerner

Posted on September 6, 2013 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.

At this point in the EMR buying cycle, one would figure that the market for new hospital EMR purchases is pretty saturated, especially among larger hospitals with the capital to invest in big health IT projects. But according to a recent blog entry from KLAS, that’s not exactly the case.

In his blog item, KLAS researcher Colin Buckley notes that his firm has been watching clinical IT vendor wins and losses at 200+ bed hospitals for 10 years.  During that period — and especially post- Meaningful Use — KLAS has seen a growing number of new hospital EMR contracts.

By this point, after lots of EMR buying, and some switching out technology for second and third-choice EMRs, one might think that over-200-bed hospitals had settled on a platform that they could live with through Meaningful  Use Stage 3. Actually, not quite, Buckley says.

In fact, KLAS data shows that there are more hospitals running legacy EMRs, homegrown EMRs or no EMR at all than those who have bought a currently-marketed solution sometime in the past four years. And it’s likely these hospitals will be choosing a new EMR from the current vendor marketplace within the new few years, KLAS projects.

As sales increase in the 200+ bed hospital segment, market forces are shifting to favor new vendors. What’s particularly noteworthy about this is that the research firm has seen the ratio of Epic-to-Cerner wins shrink from 5-to-1 in 2010 to 2-to-1 in 2012.

According to KLAS, the hospitals that are likely to be out buying new EMRs look different than those which have already bought and implemented the EMR they’ll use for the next several years. “They are smaller and more cost conscious than the large hospital IDNs that have given Epic a lion’s share of wins year after year,” Buckley writes.

With Cerner and Epic busy eating each other’s lunch, Allscripts, MEDITECH, McKesson and Siemens are moving ahead as quickly as possible to roll out integrated ancillary and ambulatory solutions, Buckley notes. In other words, the competition for both ambulatory and hospital EMRs is far from played out.

Despite all of this activity, we are clearly in a late stage of the EMR market as a whole, or as my colleague John Lynn puts it, “the Golden Age of EHR adoption is over.” But if KLAS is right, there’s still some very healthy bucks to be made selling to laggard mid-sized hospitals. Let’s see if vendors used to serving hospital giants can adapt in time.

EMR Vendors Need To Get Their Act Together

Posted on March 22, 2013 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.

For quite some time now, EMR vendors have gotten away with selling products that aren’t very usable and may even pose safety risks. But that’s the price enterprise EMR buyers have been willing to pay to jump in and automate. Very soon, though, vendors may be held to a higher standard, a new report from KLAS.

KLAS recently held a bake-off comparing Allscripts, Cerner, Epic, McKesson’s Paragon, Meditech 6 and Siemens’ Soarian EMRs head to head where it comes to usability and efficiency, SearchHealthIT reports. The study looked at how the products worked for individual users, and then looked at how they meet organizational quality of care demands.

Some of the EMRs  — and I wish SearchHealthIT had told us which ones — took a full month for physicians to learn. In some cases, physicians who were willing to take that month ended up with a richer experience than those which were easy and quick to learn, while in other cases, the darned thing still wasn’t usable.  Of course, those with long learning curves and unimpressive features suffered from low physician adoption, the  publication notes.

This is all interesting enough, but what grabbed me about the story was a provider quote from an end user, supplied by KLAS:

“As suggested by the new 2014 certification standards, vendors should take more responsibility for both the usability and safety of their products. These responsibilities shouldn’t be the sole purview of healthcare organizations and providers like they have been until now.”

Could it be that providers have finally gotten to the point where they’re no longer going to put up with unusable products and bring the hammer down even on giants like the big-shouldered group listed above?  After all, so far providers have swallowed hard and accepted a lot of ugly technology.

Maybe Meaningful Use demands are finally giving health organizations the backbone they need to stand up to Jabba the Hutt vendors?