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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.

8 Things the Hospital Website of the Future Will Include

Posted on May 15, 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 Wall Street Journal has an article that talks about what the hospital website of the future will look like. In the article, the writer offers these 8 suggestions for what a hospital website will include in the next 10 years:

  1. Real-time patient reviews and observations
  2. Quality ratings
  3. Your protected medical record
  4. Literally see a clinician, right now
  5. Advanced help with medications
  6. Prices
  7. Consumer specials
  8. Food ratings

The only one I’d really argue with is the quality ratings item. I think that measuring quality is a really challenging thing and I’m not sure anyone will do it well enough that hospitals will be publishing those ratings on their website.

What’s more important about this list is that almost every one of them could be implemented in a hospital today. There is nothing on the list is not easily achieved technically. A few of them have some financial challenges like “literally see a clinician, right now”, but many in telemedicine are working on that as well.

If I were to describe these changes, I’d suggest that the shift you see described is one of a website that looks to engage the patient versus today’s hospital website which generally tries to not engage the patient. This will be a welcome shift for patients and a major culture shift for hospitals.

Do Hospital #HIT Leaders Need Business Coaches?

Posted on May 4, 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.

Though they don’t always cop to it, a goodly number of senior business leaders pay very good money — I’ve heard quotes as high as $10,000 a year — for the help of an executive coach. Part high-end consultant, part amateur therapist, executive coaches help VPs and C-suite execs make better decisions by giving them an unvarnished view of their current situation and the inspiration to carry out their most ambitious plans.

This may have something in common with bringing on a partner like, say, Deloitte, but it’s decidedly different. While executive coaches may have worked in a bigshot consulting firm like PwC, their relationship is decidedly with the individual, and a trusted one at that.  The process of executive coaching sounds like a very useful one. (I’ll probably try it someday — when I have $10,000 to spare!)

The thing is, while I could be missing something, I’ve never heard so much as a hint that senior HIT executives are retaining executive coaches. It makes me wonder whether CtOs and VPs of IT still define their job largely by technical skills rather than their capacity for making strategic decisions with hospital- or system-wide implications.

The inescapable reality is that HIT execs have long outgrown supergeek status and are increasingly a key part of their healthcare organization’s future. So if they’re open for growth, HIT leaders may very well want to test out the executive coaching model, particularly in working out the following:

  • ACO development:  While the ACO contracting and development process may be led by other departments, health IT leaders have the power to make or break these agreements by how they support then. A VP of business development may spearhead such efforts, but it’s the health IT exec who will make or break how effectively the ACO handles population health support, risk management, data analytics and more.
  • Managing digital health: I hardly need to remind HIT execs of this, but the most important directives as to how to work with digital health tools aren’t going to come from the CEO down, but from the CIO or VP up. With the healthcare industry just beginning to grasp the value app-laden smartphones and tablets, smart watches, sensor-laden clothing, telemedicine and other rapidly emerging  technologies can bring, it’s the health IT exec who must lead the charge. And that means knowing how to solve critical business problems that extend well beyond IT’s boundaries.
  • EMR transformation: As hard as you’ve worked on implementing and tuning your EMR, it’d be nice to think you could stick a fork in it and consider it done.  But EMRs are having new demands placed on them seemingly every day, including integration of massive volumes of wearables and other patient-generated data; number-crunching and making sense of population health data; connecting revenue cycle management functions with EMRs and much more.  Deciding how to handle this spectrum of issues is the job of a business/tech thinker, not solely an IT guru.

Look, I’m not suggesting that the executive coaching is for everyone, health IT executives included. But I do believe that the right kind of executive coaching relationship could help HIT leaders to make a smoother transition into the even more critical role they are inheriting today. And anything that supports that transition is probably worth a shot.

Will I See Any Hospital CIO’s at CES?

Posted on December 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.

For those not familiar with the International CES conference, it’s held in Las Vegas every year at the beginning of January. CES stands for consumer electronic show and it is a show that literally takes over the city of Las Vegas. It’s so full of tech and geek that they use the entire Las Vegas Convention Center, the entire Sands Convention Center, and all of the conference area of the Westgate (Previously LVH and the Hilton), and all of the conference area in the Aria, and at least a couple days at Mandalay Bay. Long story short, the event is massive! I bet some of the larger vendors spend upwards of a million dollars or more on their booths.

As part of the growth of the show, there’s been a larger and larger digital health section of the show. Plus, that doesn’t really include the massive companies like Samsung that have gotten into health as well but have an enormous booth in another area of the show.

The largest portion of health at CES carries the banner of the Digital Health Summit and mostly includes wearables (check out my previous post on Hospitals and Wearables) and robotics (often tied to Telemedicine). However, I know many technology people come to see where the tech is headed so they can prepare. That’s why I attend the event every year.

To be honest, I’ll be surprised if I see any hospital CIOs at CES. Possibly a few hospital CTOs who are looking at some technology, but that might even be a stretch. What it makes me wonder is where hospital IT executives search to see what’s happening next for technology. Where do you look for innovation and where technology that can benefit your hospital is heading?

Hospitals and Wearables

Posted on September 12, 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.

I’ve been pretty closely following the various wearable options that have been entering the tech marketplace as part of my mobile health coverage. The most recent coverage is of the Apple Watch that was just announced. It’s a fascinating market and one that’s just barely getting started. It includes everything from smartwatches to eyeware (led by Google Glass) to contact lenses to fitness trackers to even your smartphone and more.

As I think about the wearable marketplace, I was thinking about how these wearables will apply in the hospital setting. I’d divide wearables impact on hospitals into two main categories: enterprise wearables and consumer (patient) wearables.

Enterprise Wearables
In the enterprise wearables space, I think we’ve seen the most traction with Google Glass. There are a whole plethora of eyeware computing companies that are using Google Glass in enterprise applications in hospitals. I’d say that most of the solutions revolve around telemedicine like applications, but we also see a few that are starting to integrate with other outside data and displaying that to the doctor. We’ve also seen a few applications where Google Glass has been used to document something for the patient. I’m interested to see how these technologies evolve over time. The tests of all of these things are so early that it’s hard to say if they are must have features for every hospital organization.

I have yet to see an enterprise smartwatch implementation. I expect that the first implementation will likely be in the healthcare communication space. One challenge in hospitals is definitely around hospital communication. Access to various messages on your watch could make accessing them easier. I’m not so bullish on this idea because it’s not that much easier than just pulling out your smart phone.

In the enterprise wearables world, what does seem clear to me is that these applications will have to integrate with the legacy systems. There are a few implementations (ie. Telemedicine applications) where this isn’t completely necessary, but the applications will have limited benefit to a hospital without a great integration with the other hospital systems.

Patient Wearables
I’m much more bullish on the various patient wearables. Many of these wearables were designed for consumers, so it makes sense that they would work well for consumers. Take for example, a smart watch. What a perfect way to track a diabetic and remind them of appropriate treatment. I’ve seen this done with smartphones and that’s pretty smooth, but a watch is even easier. Done right, it can be made so easy, even my mother could do it (no offense to my mother, but she’s not very technical). I love that type of monitoring and tracking that could be done with patients and hopefully reduce hospital readmissions and ensure care plans are followed. I haven’t seen anyone doing it yet, so maybe that’s an opportunity waiting for you.

I’m less excited about eyeware computing with patients. There might be some edge cases, but I haven’t seen or heard of any great patient focused applications with Google Glass. If you know of some, I’d love to hear of any.

Those are a few of my thoughts on wearables in the hospital. I’m sure there are plenty of implementations and technologies I’m missing. It’s a rapidly changing area. I’d love to hear your thoughts on what’s happening with wearables in hospitals or things you think could or should happen with them.

ICUs Can Improve Survival, Speed Discharges Using Telehealth

Posted on December 10, 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.

ICUs can boost patient survival rates and speed ICU and hospital discharge rates if they use tele-ICU technologies, a study published  in CHEST Journal concludes, according to a report in iHealthBeat.

The study involved researching the impact of tele-ICU technologies in 56 ICUs that were part of 32 hospitals and 19 health systems, tracking them over a five-year period, according to iHealthBeat. The project, which was led by Craig Lilly, director of UMass Memorial Medical Center’s eICU Program, involved more than 110,000 patients.

The hospitals involved in the study used the Phillips Healthcare eICU technology, a comprehensive set-up which included bidirectional audio and video equipment, population management tools and real-time and retrospective reporting tools.

The study looked at how ICU doctors created treatments based on best practices, and responded to patient alerts and alarms, iHealthBeat notes.

Researchers found that patients who received care in hospitals using telemedicine were 26 percent more likely to survive in the ICU than patients in units that didn’t use tele-ICU technologies. It also found that patients were 16 percent more likely to survive their hospitalization than their counterparts who didn’t receive tele-ICU services.

What’s more, researchers found that patients in ICUs using telemedicine saw 20 percent faster discharges in the ICU and 15 percent faster hospital discharges.

This research strongly suggests that tele-ICU is maturing, and should be taken seriously as part of a hospital’s treatment arsenal.  In fact, your hospital might want to take a look at a new set of best practices created by the New England Healthcare Institute designed to make tele-ICU more scalable and accessible to hospitals.

Ultimately, the ideal is to connect telemedicine — and other remote sources of data — to hospital EMRs, allowing a new level of collaboration between far-flung clinicians. But in the mean time, it seems that tele-ICU can offer great benefits even if it creates a data silo for the time being.

Remote Patient Monitoring Going Mainstream

Posted on January 31, 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.

This week I read a piece of news which suggests to me that we’re seeing a turning point in the use of remote monitoring technology to manage patients.  It looks like AT&T is taking a major public position in support of remote monitoring via the cloud, via a partnership with a  hot new startup that just raised funding, according to a report in mobihealthews.

According to the mobile health news publication, cloud-based patient monitoring company Intuitive Health just got a $3.4 million investment in what appears to be the company’s first public round of investment.

Intuitive, which completed a pilot with health system Texas Health Resources and AT&T last year, offers cloud-based remote monitoring software which can interface with any device.

The pilot involved monitoring CHF patients remotely for 90 days using wireless pulse oximeters, blood pressure cuffs and weight scales, plus tablets and apps feeding the data to the  patients’ EMR records. During the pilot, THR reduced hospital readmissions for chronic heart failure patients by 27 percent, mobihealthnews reports.

According to a press release from AT&T, Intuitive’s software has since become a key component in the telecom giant’s own SaaS patient monitoring product.

Remote monitoring has been a hot topic of discussion and an emerging approach for several years, but hasn’t found an established place in day-to-day care for most institutions.  With AT&T and Intuitive offering a device-agnostic model, however, I believe they will give a boost to the use of remote monitoring generally.

Personally, I’ve been cheering for remote monitoring to succeed for some time; after all, given how mobile-device-oriented people are anyway, it just makes sense to leverage those capabilities to improve their health.  I hope this represents a turning point for this type of technology and that we see news of more successful pilots this year.