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Circle Square | HIT Trends | Page 1
HIT Trends
May 2015
H E A L T H I N F O R M A T I O N T E C H N O L O G Y
Circle Square | HIT Trends | Page 2
The Ups and Downs in HITMay 2015
FHIR is hot. Fast Healthcare Interoperability Resources
(FHIR) is all over the HIT news. iHealthBeat has an Insight
article that helps demystify the emerging application
programming interface (API) standard that promises much
simpler and more flexible integration among apps and EMRs.
Epic and Cerner each have made announcements that highlight
the standard.
IBM Watson Health. Watson led the news last month
with its deals with Apple, Medtronic and J&J and acquisition of
Explorys and Phytel. Its deal-making continues this month with
a report on Watson working with 14 leading oncology centers.
Epic announces it will embed Watson in its decision support
apps and the Japanese postal service will use Watson to inform
a new care management service for the country’s elderly.
Medicare CCM. Medicare’s Chronic Care Management
(CCM) program generates $500 per year per enrolled patient for
physician practices that participate. This month Allscripts
announces a few deals that include its CCM product for small
practices. And CircleLink Health is partnering with
WellTrackONE on an innovative model that couples CCM and
services to provide an annual wellness visit that captures all the
data needed for the care plan and is reimbursed by Medicare.
From the publisher…
HIT and pharma. Pharmaceutical companies partner with
Sutter Health to help design and implement consumer apps that
support specific conditions of interest: Boehringer Ingelheim and
COPD; AstraZeneca and cardiometabolic care. IMS Health, a
Big Data supplier to pharma, buys an analytics company that
will help the industry get insights from its data. And a number of
pharmas are working on projects to accumulate DNA data on
individuals for drug discovery. Trialbee raises capital to assist
pharma in clinical trials.
Accelerate and sense. The technology accelerator
trend continues this month as ONC announces its inaugural
Market R&D Pilot Challenge grant winners and athenahealth
announces new More Disruption Please app companies. And
sensors are in the news. We cover a Forbes article on brain
sensing and a new monthly column in Nature on digital health.
Thanks for reading….
MichaelMichael Lake, Publisher, HIT Trends
Circle Square | HIT Trends | Page 3
ContentsMay 2015
Electronic Health Records
Epic is the usability leader in hospital EMR with room for
improvement
AHRQ report recommends core functions for pediatric EHRs
IBM Watson Health will interoperate with Epic’s decision support
apps
Enterprise EMR update: Allscripts, Cerner, MEDITECH
Health Information Exchange
Fast Healthcare Interoperability Resources (FHIR) gets
momentum
Natural language processing (NLP) can support medication
reconciliation
Surescripts reports continued growth in its network, apps and
partners
Government and HIT
EHR incentives hit $30 billion
AHA and ATA release reports that help demystify telemedicine
issues
ONC awards $300K to six small businesses for digital health pilots
Update on HIT in China
Apple and IBM collaborate with Japan Post for vulnerable elderly
Care Communications
Athenahealth updates on its More Disruption Please accelerator
Brain sensors and digital health innovations in four segments
New series on digital health launches in Nature
CMS wellness and chronic care reimbursements drive innovative
model
Opportunity for mobile health: safety net providers need
resources
HIT innovations of note for life sciences companies
Healthcare Analytics
Most providers who use analytics apps get them from their EMR
vendor
Fourteen cancer centers will deploy IBM Watson Health services
Welltok buys Predilytics, a predictive analytics company
Evolent Health files to go public
Drug manufacturers embrace genomic analytics for drug
development
Ed. Note. Please click the blue arrows to get to specific sections. Also check out the live links to original
source documents by clicking the underlined grey text on the bottom right of each story page.
Circle Square | HIT Trends | Page 4
Epic is the usability leader in hospital EMR with room for improvement
KLAS Research reports that Epic remains the clear
usability leader with consistent progress. See upper
chart at right. Analyst’s note lots of room for improvement.
Cerner is significantly more involved in usability
success than competitors. See lower chart at right.
Customers uniquely attribute their progress in usability most
directly to Cerner’s efforts.
Epic has a big lead in mobile functionality throughout
the enterprise. Almost every Epic customer (88%) reports
using mobile; nearest competitor, Allscripts is half that.
Here are the overall KLAS usability ratings (CPOE,
physician documentation, problem lists and clinical decision
support)
Epic (7.2)
Cerner (6.4)
Allscripts (6.3)
MEDITECH 6.0 (5.9)
Cerner Soarian via Siemens (5.6)
McKesson (5.0)
Source: KLAS Research
May 2015Electronic Health Records
Editorial. KLAS interviewed physician leaders (CMOs, CMIOs, and medical directors at over 100 organizations) about usability of their EMRs.
This is a report of progress over the last two years. There is some progress with Epic and Cerner doing best. Scores overal l can still improve.
Circle Square | HIT Trends | Page 5
AHRQ report recommends core functions for pediatric EHRs
Source: AHRQ
May 2015Electronic Health Records
Editorial. There is consensus in the literature that healthcare for children require these eight specific functions to ensure EHRs can provide for
quality care. At the core are a child’s evolving physiology and maturity relative to health conditions. Researchers also find that these functions
will also likely improve healthcare for adults as well.
Efficient recording of vaccine
status, e.g., bar coding.
Clinical decision support:
forecasting and reminders.
Immunization status
assessments.
Format flexibility.
Support pediatric functions
in managing a clinical
subpopulation.
Clinical decision support
reminding clinicians to
assess for ADHD.
Enable default privacy
settings for adolescents.
Hold individual EHR items
as private and transmit
settings with information.
Special consideration for
patient portals and privacy.
Sensitivity to growth norms.
Flexible data formats.
Flexible growth charts.
Subpopulation-specific
growth charts.
Growth monitoring decision
support.
Easy sharing of family
member data and linkages.
Confidentiality updated when
children reach a certain age.
Make parental connections
with children transparent.
Templates appropriate for
well-child and sick visits.
Optimized procedures for
pediatric billing, e.g.,
frequently used lists.
Pre-visit questionnaires.
Age-specific documentation
support tools.
Visit summary: height,
weight, future guidance,
immunization and school
forms and info handouts.
Weight-based dosing
calculations and range-
based alerts.
Automated dose rounding.
Age correction and
adjustments for pre-term
infants.
VACCINESROUTINE HEALTH
MAINTENANCEFAMILY DYNAMICS PRIVACY
PEDS IN VULNERABLE
POPULATIONSMEDICATIONS
DOCUMENTATION AND
BILLING
PEDS NORMS AND
GROWTH CHARTS
Circle Square | HIT Trends | Page 6
IBM Watson Health will interoperate with Epic’s decision support apps
IBM Watson Health will integrate its cloud-based
cognitive computing capabilities of Watson to Epic’s
EHR for clinicians within their workflows.
Providers will share patient data in real-time at get
back the most relevant clinical evidence impacting a
patient’s specific medical situation. Watson can analyze
medical literature and clinical case studies in real-time to present
therapeutic alternatives.
Epic will embed Watson’s functions into its decision
support solutions. Via its open API using HL7 FHIR, an
emerging open high level standard.
Mayo Clinic will be implementing Epic solutions and
is already working with Watson Health on oncology
solutions.
Source: IBM; HL7 FHIR; Watson Health
May 2015Electronic Health Records
Editorial. Here’s a glimpse into the future as Epic and IBM take first steps toward enhancing clinical decision support with most relevant
clinical advice in real-time and within a physician’s workflow. Physicians are likely to see value out of the convenience of the analysis.
Epic is important here because of its scale with 350 customers and 80 million records exchanged in the last year. IBM and Epic are
partners in the bid for the EMR at the Department of Defense due to be announced in June 2015. Interoperability is a central issue in the
selection process.
COLLABORATES WITH
AND
Circle Square | HIT Trends | Page 7
Enterprise EMR update: Allscripts, Cerner, MEDITECH
Source: Allscripts (CCM); (PAS); Cerner; MEDITECH; SMART
May 2015Electronic Health Records
Editorial. The Allscripts CCM program is significant. Expect to see more EHRs sign up practices. Allscripts and MEDITECH had wins in the UK.
The EU is attracting more interest from US enterprise EMR vendors. MEDITECH contracts for its new Web Ambulatory EHR demonstrates positive
momentum in linking the practices into the enterprise. Integration is a key value in the market. The other key value is interoperability. Cerner
announces a partnership with Geisinger and xG Health supporting Fast Healthcare Interoperability Resources (FHIR) and demonstrates how apps
can be integrated. It’s significant that it’s Geisinger and xG Health because they are long term Epic users, implementers and analysts. The DoD
opportunity as well as market-shifting values are driving this interoperability activity.
Allscripts launches its chronic care
management (CCM) program with
two customers
CareMore Nevada
CFP Physicians Group, Florida
Four additional independent
practices are implementing ACO
services that likely include CCM
Allscripts expands its Patient
Administration System adoption in
the UK with two customers
East Kent Hospitals University
NHS Foundation Trust
Maidstone and Turnbridge Wells
NHS Trust
MEDITECH signed new agreements
for its Web Ambulatory EHR.
Henry Mayo Newhall Hospital
Good Shepherd Community
Hospital
HMC Hawaii Pacific Oncology
Center
Magnolia Regional Health Center
Galway Clinic, Ireland, is the first
MEDITECH 6.1 EHR customer in
Europe.
Cerner, Geisinger Health System
and xG Health Solutions will use
SMART® on FHIR® to integrate xG
Health’s apps to Cerner’s FHIR-
compliant Millennium EHR.
The first app focuses on graphical
views for managing the
rheumatology encounter.
xG Health expects to launch EnrG |
Rheum Summer 2015 and available
via the Cerner Store.
Circle Square | HIT Trends | Page 8
Fast Healthcare Interoperability Resources (FHIR) gets momentum
FHIR, a new standards framework from HL7, is
getting industry traction. FHIR uses snippets of data to
represent clinical entities so third party apps can just plug-in to
EHRs without custom interfaces.
Argonaut is a coalition of 40 EHR vendors
working on FHIR that include:
Source: iHealthBeat; Argonaut; SMART
May 2015Health Information Exchange
Editorial. The stars are aligning for relatively rapid adoption of FHIR by vendors. Ken Terry, one of the industry’s top journalists, develops this
Insight report for iHealthBeat. He pulls together ideas from David McCallie, Jr., SVP at Cerner, Aneesh Chopra, former US CTO, and Tee
Green, CEO at Greenway. One driver, according to McCallie, is that vendors sense the government is ready to step in. Chopra argues the key
is the consumer; and that the industry will still face resistance to collaboration. Green, although not part of Argonaut, is supporting FHIR.
The FHIR Train is Leaving the Station
athenahealth
Cerner
Epic
GE
McKesson
Meditech
NextGen
Practice Fusion
FHIR is often paired with SMART, a web-based
graphical interface to FHIR designed at Boston
Children’s and Harvard. App developers writing to
SMART on FHIR specs can connect to any supporting EMR.
The 16 data elements in HL7 CCDA, the current
standard, translate into 12 FHIR profiles. FHIR
allows simpler transactions, for example, requesting single
elements as options.
Fast Health Interoperability Resources
Circle Square | HIT Trends | Page 9
Natural language processing (NLP) can support medication reconciliation
A study using patient records from Cincinnati
Children’s Complex Care Center finds promising
results using machine learning and NLP
technologies for medication reconciliation.
Researchers reconciled free-text clinical notes
(unstructured data) and discharge prescription
lists (structured data) using algorithms.
The algorithm did well in medication entity
detection, attribute linkage and medication
matching. See data excepts at right.
While more work is needed to reduce false
negatives and increase recall in identifying some
errors, authors suggest impact when moved to
production will be significant.
Source: BMC
May 2015Health Information Exchange
Editorial. Machine learning and natural language processing are increasingly being utilized to capturing additional values contained in clinical
notes. Here’s an example of how NLP can reach into free-text clinical notes and find medications and compare them against other parts of a
patient’s record to ensure quality. Companies that are working on NLP in healthcare include: Apixio, Clinical Architecture, Clinithink, Health
Fidelity, Hiteks, Nuance, QPID Health, SyTrue and others.
1
2
A medication documented in the
overview note but were missed in
the discharge prescription list
A medication that had inconsistent
amount between the clinical note
and the discharge prescription list
Complex Care Center
Excerpts from the documentation
Circle Square | HIT Trends | Page 10
Surescripts reports continued growth in its network, apps and partners
Network connections.
900,000 healthcare professionals serving
230,000,000 patients
3,300 hospitals and 61,000 pharmacies
700 EHRs and 32 HIEs
Electronic prescribing.
1.2 billion electronic prescriptions; 67% new
56% of total prescribers utilizing
Clinical messaging. 7.4 million messages; 974 hospitals;
160,000 provider addresses.
Medication history. 764 million transactions with 80%-
85% patient data coverage
Electronic prescribing of controlled substances. 1.6
million transactions; 73% pharmacies enabled yet few
providers.
Source: Surescripts (Progress Report); (PDR Collaboration)
May 2015Health Information Exchange
Editorial. Surescripts continues the growth of its network and its applications. The PDR collaboration confirms leadership in prior auth services.
Its 6.5B transactions is more than AmEx (6B) or PayPal (4.2B).
PDR provides drug information, prescriber
communications and behavior-based patient and
consumer health information.
Surescripts brings its network and CompletEPA
product; PDR brings an extensive library of EPA
forms.
Features of the Surescripts CompletEPA service:
Prior authorizations automatically routed to health
plan
Real-time health plan responses delivered to the
EHR
Forms auto-populated with patient demographics
Only relevant questions required
Fully electronic (no faxes or portals)
EHR integration
2014 National Progress Report
highlights 6.5 billion transactions
Surescripts and PDR collaborate on an
electronic prior authorization platform
Circle Square | HIT Trends | Page 11
EHR incentives hit $30 billion
Source: CMS; Healthcare IT News
May 2015Government and HIT
Editorial. CMS has paid out more than $30 billion in EHR incentive payments to hospitals and providers who have attested to meaningful use as
of March 2015. Epic accounts for 186,000 of total meaningful use attestations; Cerner has120,331; Allscripts with 99,091 to date.
Meaningful Use Attestations by Vendor
Meaningful Use Attestations by Year
Meaningful Use Incentives Paid Total
Num
ber
of A
ttesta
tions
Num
ber
of A
ttesta
tions
2011 2012 2013 2014
400K
300K
200K
100K
0
Circle Square | HIT Trends | Page 12
AHA and ATA release reports that help demystify telemedicine issues
Source: AHA Report; ATA Report; Modern Healthcare
May 2015Government and HIT
Editorial. The AHA report was authored by two attorneys from EBG Law (16 pages). The ATA report is 98 pages and includes an extensive
reference section. Both include easy to understand maps showing state by state issues and are linked lower right. Additionally this month, AL
and MN joined the Federation of State Medical Board’s interstate compact creating a quorum to facilitate physician licensing across state lines.
AHA released a report that focuses on the legal and
regulatory challenges in telehealth for providers in
these areas:
Coverage and payment
Health professional licensure
Credentialing and privileging
Online prescribing
Medical malpractice and professional liability
insurance
Privacy and security
Fraud and abuse
Some federal and state laws and regs are also aimed
at giving more flexibility and access to telehealth via
Medicare and Medicaid programs.
ATA released a report that focuses on the policy
landscape of 50 states with 50 different telemedicine
policies and answers these two questions:
How does my state compare regarding policies that
promote telemedicine adoption?
What should my state do to improve policies that promote
telemedicine adoption?
It uses a 13 variable analysis to grade each state:
States with top grades include: ME, VT, VA, DC, TN, NM
States with failing grades include: CT and RI
The analysis of each state includes: Payer parity, Medicaid
service coverage and conditions of payment; and innovative
payment or service delivery models.
Realizing the Promise of
Telehealth: Understanding Legal
and Regulatory Challenges
Fifty State Telemedicine Gap
Analysis: Coverage and
Reimbursement
Circle Square | HIT Trends | Page 13
ONC awards $300K to six small businesses for digital health pilots
Tracks patients and visualizes critical
tasks to be completed by providers
The pilot with Lowell General Hospital will test
CoordinationBox’s efficacy in coordinating
care and engaging patients during surgical
episodes.
My Care Communicator engages
patients in diverse populations
MHP Salud will pilot the solution in the Texas
Rio Grande Valley to enhance the impact of
its Community Health Worker programming in
the areas of diabetes prevention and
breastfeeding.
CareTRx simplifies asthma and COPD
management via remote monitoring
Boston Children’s Hospital will evaluate the
effectiveness of CareTRx on asthma self-
management among urban school children
compared to traditional self-management
practices.
Optima4BP provides personalized Rx
recommendations for hypertension
The pilot with UCSF Cardiology will evaluate
the efficacy of Optima4BP in improving care
coordination for patients with uncontrolled
hypertension.
Personalized analytics for physiology
data compared to a baseline
The pilot with Henry Ford Health System will
evaluate physIQ’s platform’s ability to reduce
hospital readmissions for heart failure and
COPD patients.
Connects senior populations to
preventive and care management
The pilot with Dominican Sisters Family Health
Service will test STATS’ efficacy in increasing
access to primary and secondary prevention
services.
Source: HealthIT Buzz
May 2015Government and HIT
Editorial. ONC announces its inaugural Market R&D Pilot Challenge grant winners. Each will test new HIT apps in healthcare settings in collaboration
with their provider organization partners, beginning in August. The focus is on improving consumer engagement and care coordination. ONC reviewed
78 host-innovator applications to the challenge. Health 2.0 facilitated the process. Note: more information about each company is linked to the logos.
Circle Square | HIT Trends | Page 14
Update on HIT in China
Alibaba is rolling out a three-hour delivery service for
healthcare goods in five cities growing to nineteen this
year. It works through five pharmacy chains that sell on Alibaba’s
Tmall.com website
The Ji Su Da service (fast delivery) links consumers to the closest
of 1500 drugstores
Cainiao is the logistics partner that picks up and delivers the order
It is piloting a mobile service for prescriptions: Customers upload a photo of their prescription and get price bids
from nearby retail pharmacies
They pay through Alibaba’s mobile payment system, AliPay, and
the medication is delivered to their door
Tencent invested $70M into China’s largest medical
website (Dingxiangyuan) and $100M into appointment
scheduling in hospitals (Guahaowang).
Baidu also provides appointment scheduling. It provides
mobile health monitoring, analyzing and advising to consumers in
Beijing.
Source: The Diplomat; Reuters; Want China Times
May 2015Government and HIT
Editorial. Alibaba is 24% owned by Yahoo and 36% owned by Softbank. Its recent market moves are an attempt to disrupt the prescription
market which is dominated by hospitals. The mobile digital health segment is predicted to hit $2B in 2017 growing at 70% a year.
Circle Square | HIT Trends | Page 15
Apple and IBM collaborate with Japan Post for vulnerable elderly
Japan Post Holdings is deploying IBM’s data
analytics technology and Apple’s devices to
improve care for elderly Japanese as the
population ages. JP Holdings is Japan’s state-owned
financial and postal services organization.
Japan Post provides a service to visit the
elderly on behalf of family members.
Apple will provide its devices to collect
information on senior citizens that will be
analyzed by IBM Watson Health analytics
services.
Japan Post will develop the software to run on
the Apple iPads and will begin testing with
1000 citizens in October 2015. The program will
also support shopping and other health care functions.
Source: Japan Times; JP Holdings
May 2015Government and HIT
Editorial. Japan Post is positioning for an IPO later this year. It’s wanting to leverage its vast network of post offices for other business uses to
generate additional revenue streams. Apple is looking to sell more iPads as sales slump. And IBM is aggressively pursuing opportunities to
generate revenue from its large Watson Health investment. Japan has one of the world’s eldest populations. It will lead the way for many
modern economies where eldercare is moving higher on national agendas.
CEOs at Apple, Japan Post, IBM (left to
right) make the announcement
Circle Square | HIT Trends | Page 16
Athenahealth updates on its More Disruption Please accelerator
Source: athenahealth; MobiHealth
May 2015Care Communications
Connects clinical teams and their
patients between visits
Patients can upload photos and videos.
Care teams collaboratively tag patient records
and get alerts when patients enter new info.
Company management with significant tech
user experience design expertise.
Stores personal health info for retrieval
in an emergency using QR codes
Founded in 2011 with funding from Kleiner.
Available in Northern California in 2012.
After entering medical info, consumers are
mailed Lifesquare stickers that may be
scanned by emergency personnel.
Small physician practice customer
marketing platform
Helps small practices acquire patients,
manage online reputation, communicate with
patients and measure practice performance.
Company reports a 78% rise in search engine
rankings and a 5X ROI for customers.
Announcing new companies in San Francisco
Update on existing companies in Boston
Smart Scheduling product predicts
patient no-shows and late cancels
Machine learning and predictive advises of
potential for scheduling issues.
In use in hospitals (Martin’s Point) and got
seed funding from Rock Health.
Tracks physician credentials and
automates verification for providers
Founded in 2013 with seed funding from
Blueprint Health.
Other investors include Primary Venture
Partners, Bovary Capital and Tigerlabs.
Connects primary care providers to
remote specialists for e-consults
Clinician requests specialist input; assigned
specialist shares e-consult within hours.
Investors include Blueprint Health and Center
for Primary Care at Harvard.
Editorial. Companies get seed funding, free office space, mentorship and access to athenahealth’s network of 64,000 providers. Athenahealth will open
a new MDP location in Austin. It looks for companies who have a product that is ready to scale via access to its provider customers. Click on the logos
for more information about each company.
Circle Square | HIT Trends | Page 17
Brain sensors and digital health innovations in four segments
Source: Forbes; Note: click the logos for more info about each company
May 2015Care Communications
Memory Support is currently one of the most popular
segments. Lumosity, which specializes in brain training
the participants with interactive games on one’s desktop
or smart device, is a good example. These types of
products are collaborative and fun methods to track and
compare scores of recall and other cognitive skill games.
The Disorder Support segment is also significant in
healthcare as EEG feedback can be used to control
prosthetics or move a wheelchair with brain-computer
interfaces. Researchers at University of Houston are
building bionic hands for amputees that are controlled by
brain signals.
Healthcare is one of the most promising areas for brain
wearables. Companies offer devices that assist in
monitoring EEG waves to assess individual emotional
states and assist in changing them. Thync is a good
example. It uses neuro-signaling to either stimulate or
calm the brain without the use of drugs.
Environment Interaction is one of the more futuristic
segments and EMOTIVE is a good example. It has
products that can be used in a variety of scenarios from
controlling a video game to monitoring performance
such as anxiety, focus or stress levels. Tasks are
completed using EEG waves and facial expressions.
Circle Square | HIT Trends | Page 18
New series on digital health launches in Nature
Continuous and remote monitoring. Tracking and analysis of data gathered longitudinally
reveals new patterns of markers that open up new lines of
investigation for researchers
Continuous monitoring and prevention tools mediated
through digital devices blurring lines between diagnosis and
monitoring encouraging earlier interventions.
Examples cited include AliveCor (ECG), Kinsa
(thermometer) and Sanofi’s iBGStar (glucose monitor)
The digital phenotype. Digital biomarkers, when combined with personal omics
enables more comprehensive disease modeling
Alzheimer’s research is an example where digital tools
broaden the biometric profile and ability to detect disease
An example is Ginger.io which captures data about a user’s
phone usage detecting signs of depression
Remote disease management. Omada Health digital
programs are guided by online coaches encouraging compliance;
Propeller Health uses a sensor attached to an inhaler to guide use;
Empatica monitors brain activity to help manage epileptic seizures.
Source: Nature; PureTech
May 2015Care Communications
Editorial. Executives at PureTech, a healthcare innovations company, have launched a monthly column at Nature covering digital health. We are
including excepts and summaries from three themes from its inaugural article and will check back in occasionally to keep our readers up to date.
Physiological data types and
companies marketing
wearable sensors
Three themes from the inaugural article
Circle Square | HIT Trends | Page 19
CMS wellness and chronic care reimbursements drive innovative model
Source: CircleLink Health; WellTrackONE
May 2015Care Communications
Editorial. This idea is likely to get market attention. The combined reimbursements of around $700 per patient per year should be enough to
provide incentives to physician practices with high Medicare populations and a return to service providers. One added benefi t to this approach
is that it generates enough data in the wellness visit to drive a care plan. WellTrackONE clinicians provide the wellness visits in the physician’s
offices. CircleLink has experience in care management for disadvantaged populations via mobile phones.
Annual Wellness Visit and
Chronic Care Management
CircleLink Health and WellTrackONE are launching an
integrated solution for providers to support new
Medicare reimbursement opportunities.
The service integrates annual wellness visits (AWV)
and chronic care management (CCM) services for a
practice’s Medicare population. AWV: $125-$200 per patient per year
CCM: $500 per patient per year
Patient assessment data collected at the wellness visit
drives a personalized care plan that is monitored
continuously for gaps and alerts.
CircleLink Health has been providing chronic care
management services through mobile phones since
2010. Customers have included Johns Hopkins, Tulane, Montefiore,
Henry Ford, Emory, University of Maryland, Vanderbilt and UPMC.
WellTrackONE provides the initial and follow-up
wellness visits that feed the CCM services.
Circle Square | HIT Trends | Page 20
Opportunity for mobile health: safety net providers need resources
The Commonwealth Fund survey (2013), focused on
the desire for, current use of, and barriers to cell phone
apps in clinical care in underserved areas.
Most want to use mobile for patient engagement for
chronic and preventive care and wellness programs,
but most are focused on appointment reminders. See
charts above.
Source: Commonwealth Fund
May 2015Care Communications
Editorial. EMR adoption in the safety net has been closing the technology gap in recent reports, but not yet in the use of mobile and cell phones in
particular for patient engagement. Texting and other mobile apps are proving to be impactful for health and likely would del iver a good return to
state health agencies and other payers. While EMR vendors have some capabilities in this area, perhaps niche companies focused on mobile and
cellular applications also have a role to play. By satisfying this segment, vendors have a path to international applications of the service as well.
Desired areas for patient engagement Current area of interventions using cell phones
Mobile Health and Patient Engagement in the Safety Net:
A Survey of Community Health Centers and Clinics
Just 27% used mobile in care delivery. And most of these
(62%) get the functions from their EMR vendor.
There are barriers to overcome. Two most cited:
Lack of external funding
Limited human and technical resources to support the
implementation
Circle Square | HIT Trends | Page 21
HIT innovations of note for life sciences companies
Source: Sutter; IMS; Trialbee
May 2015Care Communications
Editorial. Sutter Health in Northern California has been a pioneer in HIT. It has been deploying Epic throughout the enterprise. I expect we’ll see
more life sciences company partner with health systems around specific conditions of interest looking for condition-specific innovations in digital
health to complement respective drug therapies. IMS Health makes a smart acquisition that should benefit its life sciences clients. Dataline’s
visual analytics will add value to its offering for RWE analytics. And Swedish Trialbee gets investment to expand its services in Europe and rollout
in the US.
Boeringer Ingelheim and Sutter
Health collaborate on a five-year
project to test the impact on care
beginning with COPD.
Tablet or kiosk-based data
collection by patient during every
encounter
Visually display clinical and
patient reported data for
communications and shared
decision making
Sutter and AstraZeneca will
collaborate on a three-year project to
leverage new technology for
cardiometabolic care.
Trialbee raises $5M series A round
by Industrifonden and Briban Invest. Total capital raised since 2010 founding is
$8.4M.
Trialbee provides a patient-centered
cloud-based platform for recruiting
patients to clinical trials. There are
11K industry sponsored clinical trials
recruiting patients; 80% will fail to meet
targets due to recruitment challenges.
The company is a 2015 Red Herring
Europe Top 100 company.
IMS Health has acquired Dataline
Software, a UK-based healthcare
analytics solution provider.
Dataline enables new features in
IMS Evidence 360™ real-world
evidence platform.
Dataline patented algorithm
enhances search of EMR
datasets
Dataline resources improve the
platform’s clinical trial research
and operations applications
Dataline visualization enhance
usability of insights
Circle Square | HIT Trends | Page 22
Most providers who use analytics apps get them from their EMR vendor
HIMSS Analytics released a few data points
from its provider survey on clinical and
business intelligence solutions.
Adoption of these solutions by healthcare
organizations increased from 46% to 52%, up
17% in two years.
Of the 52% who have adopted solutions, 54%
report using their EHR for analytics.
Of those that haven’t yet adopted, 51%
remain unsure about future plans to invest in
clinical and business intelligence tools.
The healthcare organizations’ focus has
changed from accountable care to population
health over the last two years.
HIMSS Analytics reviewed their internal data
and polled 189 healthcare organization execs.
Source: iHealthBeat; HIMSS Analytics
May 2015Healthcare Analytics
Editorial. This analysis maps to the findings of other industry analysts who are assessing healthcare analytics. There’s been modest growth
over the last couple of years, but healthcare organizations use of these technologies remains relatively immature. In a recent KLAS Research
report on the segment, it found three active segments: cross industry (Oracle, Qlik), large EMR (Epic, Cerner) and healthcare niche (Health
Catalyst, Advisory Board).
HIMSS Analytics maturity model for analytics use
Circle Square | HIT Trends | Page 23
Fourteen cancer centers will deploy IBM Watson Health services
Cancer centers will apply Watson's cognitive capabilities
to translate DNA insights to personalize treatment
options in minutes.
Watson Genomic Analytics services aid clinicians
evaluate a specific patient’s case by presenting relevant
drug options alongside literature references.
The work is applicable to all types of cancer. Including:
lymphoma, melanoma, pancreatic, ovarian, brain, lung, breast and
colorectal cancer.
Here are the cancer centers with more expected later
this year:
Source: IBM; Watson Health
May 2015Healthcare Analytics
Editorial. It’s the speed of Watson analysis that makes this
viable in the workflow. Clinicians can use the results of the
analysis in personalizing cancer treatments, particularly when
patients are unresponsive to the standard protocols. The
genomic analysis technology looks for variations in the full
human genome and presents best evidence from the literature
and associated drug therapies for clinician evaluation.
Ann & Robert H Lurie
Children’s Hospital of
Chicago
BC Cancer Agency
City of Hope
Cleveland Clinic
Duke Cancer Institute
Fred & Pamela Buffett
Cancer Center in Omaha,
Nebraska
McDonnell Genome Institute
at Washington University in
St. Louis
New York Genome Center
Sanford Health
University of Kansas Cancer
Center
University of North Carolina
Lineberger Cancer Center
University of Southern
California Center for Applied
Molecular Medicine
University of Washington
Medical Center
Yale Cancer Center
Circle Square | HIT Trends | Page 24
Welltok buys Predilytics, a predictive analytics company
Welltok, a wellness and condition management company
serving large employers and health plans, acquired
Predilytics, a healthcare analytics company.
Welltok provides its CaféWell services to a million people
on behalf of 20 customers including: IBM, Aetna, Centura Health,
Cigna, Colorado, Coventry, Community Health Plan of WA, BCBS,
UnitedHealthcare.
Welltok’s CaféWell Health Optimization Platform includes:
CaféWell Core builds a personal health itinerary
CaféWell Rewards for incentives
CaféWell Connect integrates dozens of health devices and apps
CaféWell Concierge personalizes via IBM Watson
Predilytics, founded in 2011, uses its big data approach to
identify who is most likely to respond to offers and services.
It had raised $20 million in venture funds from Qualcomm, Google and
Flybridge.
Predilytics has curated and analyzed data for 250 million
consumers using 1,600 different variables.
Source: Welltok; Forbes
May 2015Healthcare Analytics
Editorial. Welltok makes an important acquisition that brings unique predictive analytics about consumer behavior to its platform. It competes
with Keas, Limeade and Rally Health (UnitedHealthcare). It has raised over $90 million to date and has pioneered the IBM Watson work.
ACQUIRES
Circle Square | HIT Trends | Page 25
Evolent Health files to go public
Evolent Health has filed to raise $100-$150 million in
public funds via an Initial Public Offering of stock. Evolent was formed in 2011 by UPMC Health Plan and The Advisory
Board and has previously raised $124 million.
Evolent provides technology and services that enable
providers to transition to value-based payment models. Strategy and performance consulting; population health technology
(Identifi); clinical and operational capabilities; go-to-market strategy.
It reports 10 long-term contracts with customers, four of
which make up 76% of its 2014 revenues of $100M:
Indiana University Health (25%)
WakeMed Health and Hospitals (21%)
Piedmont WellStar Health Plan (16%)
Premier Health Partners (14%)
Senior management from UPMC and The Advisory
Board lead the company. Currently 836 employees.
The company estimates the market at $10B growing to
$46B by 2020, based on health insurance spending.
Source: S1; Evolent Health
May 2015Healthcare Analytics
Editorial. There’s been an uptick in health technology IPOs and filings in a favorable stock market. While there’s some risk here, as a lways, to
investors because it’s an early adopter market so far for Evolent services, I like the thinking that it’s going to take a lot of resources to compete.
It’s possible to get a consumer-centric app going with a few million dollars; not so with enterprise platforms. It will also take technology plus
expertise in healthcare operations. Evolent brings both.
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM S-1
REGISTRATION STATEMENT
UNDER
THE SECURITIES ACT OF 1933
Evolent Health, Inc.(Exact Name of Registrant as Specified in Its Charter)
Circle Square | HIT Trends | Page 26
Drug manufacturers embrace genomic analytics for drug development
Pharma companies are building up repositories of
human DNA to shorten the time to develop drugs. Researchers use the data to identify rare genetic mutations.
The cost of the genetic sequencing has dropped by
more than 10X in five years to $1,500.
Regeneron partnered with Geisinger last year to sequence
partial genomes of 250,000 volunteers
Pfizer, Roche and Biogen are conducting similar projects for
new drugs and predicting side effects
US 2016 federal budget asks for funds to build a
genetics database of a million volunteers.
Other efforts include:
Amgen bought Decode Genetics (2012) in part for its genetic
database of 2,600 Icelanders
Genentech partnered with Genomic Medicine on a large
sequencing project
23andMe inked deals with Pfizer and Genentech for access
to its patient data for Lupus and Parkinson’s respectively.
Biogen formed a $30 million research alliance with Columbia
University’s sequencing center
Source: Reuters
May 2015Healthcare Analytics
Editorial. Reuters reports this uptick in DNA analytics by pharma is driven by lower costs, but also by successful research. Regeneron says
they learned a lot about treatments for high cholesterol. Pfizer has had success in the approach for lung cancer treatment and Vertex for cystic
fibrosis. Amgen has had success in understanding more about Alzheimer’s, diabetes and atrial fibrillation. Regeneron is also working on
genetic implications of obesity in children
Circle Square | HIT Trends | Page 27
HIT Trends © 2015 Circle Square Inc.Michael Lake | Publisher | www.circlesquareinc.com
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