One Step Forward, Two Steps Back

mHealth12Be careful what you wish for sure did apply to this year’s mHealth Summit, which was held last week in Washington D.C. Of the some 4,000 in attendance, I was one of the 10% or was it even 1% of those present that have attended all four events in succession. It is with that perspective that I came away from this year’s mHealth Summit more disappointed than ever.

At previous mHealth Summits, I often bemoaned the lack of organization of the conference, the often bizarre exhibitors one would find (couple of years back one exhibitor, and I kid you not, was marketing herbal aphrodisiacs) and basic necessities one would find at virtually any event, breaks with coffee, maybe a snack here and there. This disorganized, but charming event was mHealth Alliance Summits of years past. (more…)

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Telecom’s Tepid Plays in HIE Market

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 was the now belly-up SharedHealth in the state of Tennessee. 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.

Coming to a Cell Near You – TxtMed

Today’s Wall Street Journal (WSJ) has a fairly long article, by their standards, (section D, pg 1) on the use of cellphone text messaging to deliver health related information. Unfortunately, the article tries to cover too much ground going from texting for sex education info for teens in California to reminders for an appointment at your local spa to dieting and medication management.

Being hit with such a slew of possibilities left me wondering, “OK, now what?” Sure this looks interesting, but is there anyone doing it in a systematic fashion that can point to clinically and statistically relevant results? Based on the article it appears that no such study exists today but I am sure there is someone out there putting a proposal together for AHRQ funding to look at this issue.

But maybe we really don’t need such a study as it seems so intuitively obvious, particularly for the Generation Y-types out there, who text incessantly. For that generation, and maybe my own, who are slowly adopting text as a form of communication, this may be an ideal solution as it is fairly secure, can be automated, messages are short, and the message is delivered wherever you are, as long as you have your cellphone.

Now imagine this…

You have an online personal health record (PHR), but this PHR goes a step further than what we have today as this PHR offers a service, say for some nominal fee, whereby you can request a text message sent to your cellphone alerting you on any number of health related topics. Text messages could range from alerting you of an upcoming appointment (no more calls from the doctor’s office), to a text telling you that the latest lab results are now available, to alerts for taking various medications at defined intervals, or maybe even information about a loved one for which you are the primary caregiver. In that last example, you certainly wouldn’t want a text message saying your mother just fell and broke her hip, but there is plenty of other information that you may wish to receive. All of these text notices are user defined, thus inherently relevant and could go a long way in making PHRs more relevant and sticky for the consumer.

I have yet to come across a PHR vendor offering such a service, but this makes such good sense, that there maybe something out there among the plethora of PHR solutions, I just don’t know about it yet. Appears, at least from the article, that the WSJ didn’t find any either as none of the examples provided were from a PHR vendor. One thing I do know, however, is that Verizon Wireless, Sprint and AT&T were all at the recent Connected for Health symposium and it is only a matter of time before they start positioning their services for txtmed.