Why Don’t Vendors Partner to Build Interoperable Systems Before Mandates Force them To?

In a recent conversation with Steve Ferguson, vice president of Hello Health, he described how the company is identifying new revenue sources for practices while working to engage patients. Even though the company’s business model is one that sets it apart and helps it rival other free EHRs, like Practice Fusion, I left the conversation with him wondering why more venodrs weren’t trying the same thing as Hello Health: trying something no one in the market is trying to see, if by change, a little innovation helps pump some life into the HIT market.

Along the same lines, myself and thousands of others in HIT have wondered why systems are not interoperable and, for the most part, operate in silos that are unable to communicate with competing systems.

Certainly, there’s a case to be made for vendors protecting their footprints, and for growing them. In doing so, they like to keep their secrets close; it’s the a business environment after all and despite the number of conversations taking place by their PR folks, improving patient health outcomes comes in only second (or third) to making money.

However, let’s move closer to my point. Given the recent rumors that Cerner and McKesson are working on a joint agreement to enable cross-vendor, national health information exchange, I’m wondering: Why don’t other vendors partner now and begin to build interoperable systems.

According to the rumors, the deal, if completed, could shift the entire interoperable landscape for hospitals, physicians and patients. It would position Cerner, which has more EHR users, and McKesson, which has a strong HIE product in RelayHealth with a loyal user base, to take on Epic Systems, a leading EHR vendor.

An announcement is expected at HIMSS13.

Here’s why this is important news: Interoperability mandates are coming. Like most things, it’s really just a matter of time. Systems will be forced to communicate with other, competing systems. They should already. It’s actually a bit shocking that given the levels of reporting required of care givers, the push for access to information through initiatives like Blue Button and patient’s access to information through mobile technology that there’s not more openness in the market.

The Cerner/McKesson news is incredibly refreshing and worth a look. Two major competitors may be realizing that by partnering they’ll be better able to take on each company’s biggest competitor: Epic.

Imagine connected systems exchanging data. The thought alone would be marketable across several sectors of the healthcare landscape and the move worthy of reams of coverage, which would lead to great brand awareness for each and the change to do what all EHR companies aim for: To create thought leaders; to stand out; to set the market on its heels.

If nothing else the partner vendors would stand ahead of the pack when future interoperability mandates are enacted and will be seen as experts in the exchange game. Tongue and cheek aside, the idea really is a good one and with no one currently doing it, it’s a great opportunity for a couple of HIT companies to actually move change forward and create an environment where information can be easily exchanged across practices, across specialties and across  borders.

Then, perhaps, we’ll see a real commitment to improved patient health outcomes rather than them simply trying to improve bottom lines.

If an EHR Company’s Business Model Can Be Beautiful, Hello Health May Be Hard to Turn Away From

Can a business model be beautiful? Yes, it can, according to Hello Health’s Steve Ferguson, vice president of marketing.

The business model, and the way things get done, at Hello Health are what set it apart from other electronic health records in the market place, Ferguson said.

Hello Health was built from the ground up and launched by the private company Myca in 2008. It made its meaningful use certified EHR available in 2011. The Hello Health system includes everything needed to run a small practice, the area of the ambulatory market in which the company focuses.

Originally designed for single doc practices, the system now scales up, with practices of as many as 10 physicians using it.

At its most basic, Hello Health is a web-based EHR and patient health record, and it’s free to for qualified physicians to use. A qualified practice is typically one with 1,500 active patients on its panel. Unlike Practice Fusion, another well-known free cloud-based electronic health record, it’s not powered by ads, but instead is a revenue source for practices as monthly access subscriptions can be sold to practices’ patients, allowing the patient to access the system’s patient portal, where their personal information is kept.

The patient subscription model allows patients to schedule appointments, view lab results, communicate with their physicians through the HIPAA-compliant portal and, in some cases, view their complete record including visit notes.

Steven Ferguson
Steve Ferguson, vice president of marketing at Hello Health

Those patients that don’t subscribe are still allowed limited access to the portal, but they can’t access all of the information available to them. Cost of monthly subscriptions range between $3 and $10, Ferguson said, but the average is closer to $5.

The annual revenue earned through patient subscriptions is $10,000 per practice, he said, with 30 percent of patients, on average, signing up in each of the practices Hello Health serves. In some cases, more than 50 percent of a practice’s patients have signed up for access to their health information.

Currently, the typical age of a Hello Health subscribing patient is 57 years old and has at least on chronic condition. The “indestructible” 30-something is less likely to subscribe to access to the portal, said Ferguson.

In some cases, patients are able to skip a practice visit or an in-office consult because of their prescription to Hello Health, Ferguson said, and practices are okay with it because they can still bill for the visit.

It’s a simple model, and with the number of portals currently available and the likelihood that access to them will increase alongside meaningful use stage 2, it’s a wonder why other vendors are not creating similar strategies.

“Companies are so in grained in the license model, and on paper it may seem easy to change, but it’s tough to change a business model,” Ferguson said.

Among another key difference between Hello Health and competitor systems is that it doesn’t charge for training and allows as much training as is needed so practice employees are comfortable using the system and are able to educate patients about the value of subscribing to the patient portal.

“Practices really have a partner in Hello Health,” he said. “We take extra time to implement and train employees so they can educate patients to use the systems and better understand the benefits of it.”

Ferguson said Hello Health is experiencing explosive growth, though, would not confirm the number of practices using the system nor the number of patient subscribers because the company is private. However, it is currently available in 27 states, with concentrations of users in New York, New Jersey, Texas, California, Georgia and Florida.

The value proposition to physicians is Hello Health’s business model and the fact that it is a revenue driver.

“Our differentiator is our business model,” Ferguson said. “Everyone tries to sell to the physicians, but most physicians are forced to push back because they can’t afford another bill.”

The fact that the system is free to implement and offers unlimited training is also a plus, he said.