Tag: "health IT"

Obama’s Former Health IT Czar Raises $35 Million for New Venture

FMBow-tied and charismatic, Dr. Farzad Mostashari, who led the Office of the National Coordinator of Health IT (ONC) from April 2009 to October 2013, has raised a total of $35 million from leading venture capitalists for his new business, Aledade. Aledade’s senior management includes veterans of athenaHealth and Practice Fusion, both firms which I admire for their entrepreneurship and relative (although not perfect) independence from government.

Like those firms, Aledade will provide its Electronic Health Records to independently practicing physicians. Aledade claims its uniqueness lies in an EHR that will ensure doctors’ win the Accountable Care Organization game. At NCPA, we think that ACOs are unlikely to succeed. Nevertheless, if anyone can pull this off, Dr. Mostashari and his team have got a pretty good edge (in my humble opinion).

Electronic Health Records: Physicians, Hospitals “Literally Terrified” of Next Stage

In a hearing on Meaningful Use Stage 3, interoperability and patient access to data, Sen. Lamar Alexander (R-Tenn.) cut right to the heart of the problem.

“To put it bluntly, physicians and hospitals have said to me that they are literally terrified of the next implementation stage … because of the complexity and because of the fines that will be levied,” he said. (Katie Dvorak, FierceHealthIT, June 10, 2015)

Well, okay, but let us recall that these doctors and hospitals were happy to take the almost $30 billion of taxpayers’ money the government handed them to install the Electronic Health Records subject to these regulations

88 Percent of Nurses Use Smartphones at Work

Patients and providers alike use mobile technology. New data from market intelligence provider InCrowd indicates that the majority of nurses, 93 percent, own smartphones.

Of these nurses, 88 percent use their smartphones’ apps on the job. Though smartphones are becoming integrated into the daily nursing workflow, the majority of nurses are absorbing the costs themselves. Approximately 87 percent of nurses reported their employers do not cover any costs related to smartphone use.

Less than 1 percent of nurses indicated that smartphone use was prohibited on the job. (Carrie Pallardy, Becker’s Hospital Review, June 3, 2015)

I’m all in favor of information technology, but might this not pose a risk to privacy? I had understood most hospitals had very strict policies on BYOD (Bring Your Own Device).

Successful Health IT Deals Are Obamacare Agnostic

(A version of this Health Alert was published by Forbes.)

Obamacare has definitely benefitted the health sector. My Forbes colleague Zina Moukheiber makes the case the Affordable Care Act (Obamacare) and the HITECH Act of 2009 (which channeled 30 billion taxpayer dollars into Electronic Health Records) deserve the credit (or blame) for the explosion of health information technology investments. That is undoubtedly true for traditional Electronic Health Record (EHR) providers like Cerner or Epic, which were boosted by the HITECH Act. In addition, the recently signed Medicare “doc fix” will likely ensure they continue raking in money for a while, because the law increases the EHR burden on physicians.

However, other successful new health IT ventures have prospects quite independent of Obamacare’s risky future. Rather, they appear robust in the face of a wide range of possible futures for U.S. health reform. Because health care is so dependent on government, it is not surprising that adoption of effective IT in health care has lagged behind other sectors, where suppliers have to rely on customers — not government — for revenue. Nevertheless, even a sector so politically protected from disruption as U.S. health care must eventually give way to change. Three examples show this change can come from different directions, despite Obamacare’s straightjacket.

Electronic Health Records: Not Just An American Problem

A few years ago, this blog discussed the failure of government-dictated Electronic Health Records (EHRs) in the United Kingdom.

In Australia, the Liberal-National coalition government has decided to scrap the nation’s Electronic Health Record, blaming the previous Labour government for the current one’s failings. Unfortunately, the government plans to replace it with a new one, instead of leaving well enough alone:

The Abbott Government will deliver a rebooted personalised myHealth Record system for patients and doctors that will trial an opt-out, rather than opt-in, option as part of a $485 million budget rescue package to salvage Labor’s failed attempts to develop a national electronic medical records system.

Opt-out rather than opt-in? Doesn’t that sound kind of like a mandate? It’s an odd choice for a government that espouses free-market principles.

Malpractice By Electronic Health Record

Arthur Allen of Politico exposes yet another reason for doctors to fear Electronic Health Records: Their errors lead to lawsuits:

Medical errors that can be traced to the automation of the U.S. health care system are increasingly an issue in medical malpractice lawsuits.

Some of the doctors, attorneys and health IT experts involved in the litigation fear that safety and data integrity problems could undercut the benefits of electronic health records unless HHS and Congress address them aggressively.

“This is kind of like the car industry in Detroit in 1965,” says physician Michael Victoroff, a liability expert and a critic of the federal program encouraging providers to adopt EHRs. “We’re making gigantic, horrendous, unsafe machines with no seat belts, and they are selling like hot cakes.

Readers of this blog know why they are selling despite their serious flaws: The government has thrown almost $30 billion at hospitals and physicians to cause them to buy them.

Electronic Health Records Don’t Help Stroke Victims; And More Bad News

electronic-medical-recordNew research on over half a million stroke victims admitted to hospitals from 2007 to 2010 shows that there was no difference in quality of care for those admitted to hospitals with EHRs and those without:

The new study “is a wake-up call that we should heed,” writes Dr. John Windle, chief of cardiology at University of Nebraska Medical Center, in an accompanying commentary. Windle said electronic health records haven’t been proven to improve quality of health care, the health of large groups of people, or efficiency.

“An [electronic health record’s] first priority must be support of clinical care, not documentation for billing and reimbursement,” Windle said. (Randy Dotinga, HealthDay)

Zenefits Raises $500 Million More To Reinvent Small-Biz Health Benefits

Most of us buy small-business health benefits the way our grandparents did when they ran the hardware store. It’s a business in dire need of reinventing. Zenefits looks like the company to do it. The company that was one of the top venture deals in health care last year is looking to repeat, raising $500 million at a $4.5 billion valuation:

This is Zenefits’ third funding round in less than a year and a half. The company raised $15 million in its Series A last January, then added $66 million in an June Series B round that valued it at more than $500 million.

Zenefits offers a cloud-based software-as-a-service human resources platform for small businesses that tries to be an all-in-one solution for compliance, onboarding, payroll, health insurance, and other employee benefits. The key is that the software is free to businesses; Zenefits makes its money as a broker of services, for example earning a fee from health insurers who register new businesses through Zenefits. (Brian Solomon, Forbes)

Top VC Backed-Health Tech Companies

PitchBook has compiled a roster of 2015’s top venture-capital financed health technology companies.

The three largest valuations are Modernizing Medicine, valued at $316 million, which provides an electronic medical assistant; WellTok, valued at $216 million, which provides personalized guidance on healthy behaviors; and Crosschx, valued at $64 million, which sans patients’ fingers to create a unique, secure identifier.

Pitchbook has also listed the three biggest deals so far this year:

Pitchbook2

Why Don’t You Own Your Own Health Data?

David Brailer, MD, was the first head of the Office of the National Coordinator of Health Information Technology (ONC), appointed by President George W. Bush. Today, he is a venture capitalist.

In today’s Wall Street Journal, Dr. Brailer notes that a law passed in 1996 governs our access to health information. Clearly, it needs updating:

This brave new digital world has one huge risk: You don’t own your health information. In 1996 the U.S. passed a law called HIPAA (Health Insurance Portability and Accountability Act) requiring hospitals, physicians, labs, pharmacies and other “covered entities” as well as the health plans and their “business associates” (for example, an information-technology vendor) to protect how your data is stored and released. But not without delays, often for months. You can’t force a covered entity to give your data to someone you choose, and you can’t stop them from giving it to someone they choose. Health apps? Most aren’t covered by HIPAA at all, and can do whatever they want with your information.

It is a fascinating indictment by someone with unique expertise in the field. Dr. Brailer is demanding a substantial rewrite to current law. He is also deflating ONC’s assertions that it is succeeding in granting patients ownership of our health data.

I participated in a meeting in September 2013, in which Dr. Brailer’s charismatic and enthusiastic successor, Dr. Farzad Mostashari, repeatedly announced that he and his colleagues had (gulp) “created” – not even “discovered” or “defined” – a “new right” for patients to access our data. The notion that government agencies “create” rights should obviously be anathema in the United States.

However, another major obstacle to solving the problem Dr. Brailer identifies is that health insurers control most of our health spending. They also want to control our data. As long as this is the case, we patients will struggle to own our health data in any meaningful senses.

Only when patients directly control payment to providers will providers respect patients’ ownership of our own health data.