Mercom Capital Group, a global communications and consulting firm, releases a new report depicting VC funding and mergers and acquisitions activity in the healthcare IT third quarter 2014. According to the report, venture capital funding in the sector came to $956 million raised in 212 deals globally, a decline of 46 percent in terms of dollars compared to the massive $1.8 billion in 161 deals raised in Q2 2014, a rare quarter. Q3 2014 was still the second highest quarter for VC funding since 2010, though, and total VC funding year-to-date is $3.6 billion.
The quarter was dominated by more than 100 funding deals of less than $2 million. There were 252 investors that participated in the quarter including angels, VCs, private equity and corporate VCs. The quarter also included 12 accelerators/incubators.
“Healthcare IT saw another big fundraising quarter in Q3 with almost $1 billion raised. Companies from countries outside of the United States, accounted for a record 21 percent share of the funding. While consumer-centric companies attracted the majority of the funding this quarter, M&A has been a different story with the majority of the deals involving practice-focused companies,” said Raj Prabhu, CEO and co-founder of Mercom Capital Group.
Consumer-focused technologies received 65 percent of all VC investments, with $623 million in 140 deals compared to $678 million in 100 deals in Q2 2014. Areas that received the most funding under this category were mobile health with $345 million in 82 deals followed by telehealth, which had its best quarter, with $101 million in 16 deals; personal health with $85 million in 24 deals; social with $70 million in three deals; and scheduling, rating and shopping with $23 million in 15 deals.
Practice-centric companies received $333 million in 72 deals in the third quarter of 2014, compared to $1.1 billion in 61 deals in Q2. Under this category, the areas that received the most funding were revenue cycle management with $75 million in eight deals, and data analytics with $71 million in 19 deals.
The top five VC funding deals in Q3 2014 were the $70 million raise by DXY (Ting Ting Group), an online healthcare community for medical institutions and healthcare providers in China, from Tencent Holdings Limited, a provider of comprehensive internet services in China, followed by the $52 million raise by Proteus Digital Health, a developer of products and services integrating medicines with ingestible sensors, wearable sensors, mobile and cloud computing.
The Centers for Medicare & Medicaid Services (CMS) announces the availability of a new initiative for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. The new ACO Investment Model is designed to bring these efforts to to rural and underserved areas by providing up to $114 million in upfront investments to up to 75 ACOs across the country.
The ACO Investment Model will give Medicare Accountable Care Organizations more flexibility in setting quality and financial goals, while giving them greater accountability for delivering quality care efficiently, said CMS administrator Marilyn Tavenner.
“We are working with these organizations to make necessary investments that encourage doctors, hospitals and other health care providers to work together to better coordinate care and keep people healthy,” Tavennaer said.
Through its Innovation Center, CMS will provide up front investments in infrastructure and redesigned care process to help eligible ACOs continue to provide higher quality care. This will help increase the number of beneficiaries – regardless of geographic location – that can benefit from lower costs and improved health care through Medicare ACOs.
Guest post by Tom S. Lee, Ph.D., CEO & Founder, SA Ignite.
If the few years since the onset of meaningful use haven’t been proof enough, the speed and unpredictability of regulatory change in the last five months has cemented our field’s status as truly not-for-the-feint-of-heart.
Yesteryear’s glacial rate of change in healthcare IT regulation is nowhere to be seen. May 2014 brought both a CMS reset of the ICD-10 transition deadline to October 1, 2015, and a proposed meaningful use rule to enable the use of 2011 edition certified EHR technology (CEHRT) to meet compliance in 2014. The summer then ended with the August 29th finalization of the 2014 meaningful use final rule, the ensuing disappointment that the mandated start of Stage 2 was not delayed and then the swift Congressional response in the form of the September 15th proposed Flex-IT Act to introduce quarterly meaningful use reporting for 2015; enough to spin heads more than once around.
What’s happened in the field since the publication of the final rule among provider organizations bring the phrase “threading the needle” to mind. To further illustrate, we have culled some sample issues from our client base of more than 8,000 providers, across more than 15 EHR brands, and representing numerous combinations of meaningful use stage, payment year and program. These issues, none of which yet have universal and clean solutions, span three areas for provider organizations as seen in the field: 1) properly adhering to the requirements of the final rule, 2) working within the constraints of what EHR vendors can deliver per the final rule’s timeline, and 3) redirecting or pausing organizational momentum for change on short notice.
Regarding the first consideration, note that the final rule requires that an organization attest that it is “not able to fully implement” 2014 Edition technology because of “delays in 2014 Edition CEHRT availability.” Although the rule outlines what does not meet this eligibility test, provider organizations have a persistent question about what documentation and conditions are sufficient to satisfy the test.
Wellframe delivers a mobile experience featuring a secure two-way communication channel to connect patients with care providers. The company also offers a mobile data collection system that is, cloud-hosted and scalable to any number of users. Wellframe’s artificial intelligence engine for health state modeling, prediction and dynamic clinical protocol optimization uses data from a patient’s interaction with the care plans to optimize the system, and the company has developed a lightweight cloud-hosted care management EHR that has been successfully integrated into clinical workflows.
Wellframe’s mobile platform for care management and patient engagement extends therapeutic relationships to promote patient adherence and improve financial outcomes for health plans and systems.
Wellframe enables organizations to extend the reach of their existing care management services, while providing a higher quality of care to members and improving patient outcomes. Wellframe’s intelligent system engages high-risk patients and creates a personalized patient experience, which is delivered in a simple daily health check-list via mobile technology.
Wellframe has demonstrated success working with the health system’s most socially and medically complex —and costly— patients. These are the individuals for whom payers and providers most desperately need additional insights. The insights gleaned from the Wellframe platform enable clinicians and care managers to better manage their patients’ health and keep them engaged in their care. Wellframe amplifies rather than replaces therapeutic relationships and is re-engineering an antiquated market by using mobile technology to put a care manager in every patient’s pocket.
The Wellframe founding team is comprised of individuals with a diverse set of skills and whose backgrounds include clinical medicine, public health, systems engineering, data science and consumer engagement. By leveraging their different areas of expertise, the founding team was able to identify a gap in the way care is delivered in the US.
The CEO, Jacob Sattelmair, who is an epidemiologist by training, was focused on using technology to engage people around managing their own health. The chief medical officer, Dr. Trishan Panch, who is a primary care physician and a lecturer at MIT, had been focused on using technology to reengineer care delivery and lower cost settings. Vinnie Ramesh and Archit Bhise are both MIT-trained computer scientists who were researching new ways to utilize low cost technology to improve access to healthcare.
Utilizing and merging their diverse backgrounds, the team developed the idea behind Wellframe: An effective solution to re-engineer care delivery.
The Affordable Care Act supports healthcare providers in reducing costs and improving efficiency while delivering quality care. Accountable care organizations (ACOs) achieve these goals by enabling physicians, hospitals and other healthcare providers to create networks and share responsibility to deliver care to Medicare and other patients.
At the heart of the ACO model are three core principles:
ACOs are provider-led organizations with a strong primary care base, and collective responsibility for quality and per capita costs.
ACO payments are linked to improvements in quality that also reduce costs.
Performance measures that support improvement are sophisticated and reliable, and demonstrate that savings are achieved through improvements in care.
Joining an ACO is voluntary, but the federal government encourages participation to reduce unnecessary or duplicated services, prevent errors and keep patients healthier. When providers successfully coordinate services to meet a long list of quality measures, they become eligible for bonuses.
The Current Environmment
Medicare offers several ACO programs, including the Medicare Shared Savings Program, the Advance Payment ACO Model and the Pioneer ACO Model, but many other public and private models exist. Some are sponsored by physicians groups, while nonprofit organizations, hospital systems and health insurers sponsor others. The Pioneer Model was designed for early adopters of coordinated care, and is no longer accepting new members.
To date, more than 600 public and private ACOs have formed; in 2012, the first year of the program, they generated $87.6 million in gross savings. Government support is spurring considerable growth, and ACOs could well become the dominant model in healthcare.
Guest post by Anil Jain, MD, FACP, senior vice president and chief medical officer, Explorys, and consulting staff, Department of Internal Medicine, Cleveland Clinic.
Despite advances in medical education, the proliferation of medical journals and the speed of light retrieval of information on the Internet, the lag time between when researchers identify life-saving clinical interventions and when they are put into practice ranges from 10 to 25 years, averaging 17 years. This lag time between the discovery at the “bench” and its practice at the “bedside” is even more startling when you consider the impact of care at the “bedside” to the “bottom-line.” This “bottom-line” has become increasingly important with the formation of accountable care organizations (ACOs) that aim to reward provider organizations and payers that meet the “triple-aim”: high-quality care for the population, high-quality care for the patient, at the most affordable cost. Unfortunately, current practices at the “bedside” reportedly generate approximately $700 billion in care that isn’t necessary and may even be potentially harmful to the “bottom-line.” Moreover, despite healthcare expenditures of 17 percent of our GDP, the U.S. lags behind most industrial nations when looking at composite measures of healthcare quality.
With the increasing use of health information technology and data we should be able to shorten the time between “bench” to “bedside” and improve the “bottom line.”
“Big data” is data that is of high volume, variety and of sufficient velocity that is not amenable to traditional data storage and analysis tools. This “big data” is most typically generated from health systems’ electronic health records (EHRs), laboratory, radiology, financial and billing systems, personal health records, biometrics and smart devices. In addition, patients today are oftentimes utilizing various mobile health and wellness apps and wearable devices which also collect a plethora of data, which only adds to the complexity.
The aggregation of de-identified medical information across millions of health records from varying venues of care facilitating a longitudinal view of a person can be incredibly beneficial for researchers focused on net new knowledge discovery. For data from disparate health systems to be aggregated, it is vital that it is standardized and that subjects across health systems can be matched. This harmonization of disparate data coupled with the appropriate analytics software is critical to identify patterns in the data.
In this setting, the larger the data set, the more likely that a signal can be detected through the noise, even in the rarest of conditions. Fortunately, many hypotheses can be conceived and tested through appropriate analytics within this real-world data set in a much more cost-effective manner than conducting full-scale clinical trials. Furthermore, if a signal is detected or a pattern is found, researchers can then design a more focused explanatory or pragmatic clinical trial to prospectively test the hypotheses. For example, over the past few years within the Explorys network, more than a dozen peer-reviewed abstracts and publications have been generated by leveraging a de-identified data set comprised of nearly 48 million subjects, searchable by a specialized browser-based analysis and query application.
instaRounds provides the most comprehensive mobile and web platform for physicians to communicate with one another, share call schedules, follow their appointments, allow cross coverage and, for the first time ever, give physicians a mobile patient sign-out application.
Imagine a platform in which physicians can communicate in a Twitter-like feed with one another about those patients currently under their care. By real-time updates, critical decision making and care planning can occur seamlessly with the patient benefiting the most.
instaRounds is a mobile and web platform that enables physicians to securely communicate with one another in a patients’ care team, by use of a patent-pending format that allows simple-to-use template interfaces that provides seamless patient sign out. Studies have shown that the most critical time in patient care is during the handoff of the patients from one provider to another; instaRounds nearly eliminates errors in sign out.
Providers can use either a web interface or the more popular mobile app, available on iTunes and Google Play, to communicate with members of their team.
instaRounds was founded by Kurian Thott, MD, a gynecologic surgeon who felt the void in patient care when it was almost impossible for members in his own practice to communicate securely and HIPAA compliantly. He figured there had to be a better way and when he found none, he created instaRounds. Built on the idea that for patient care to be better, physicians needed to communicate with one another, and instaRounds gives physicians this power.
Dr. Cliff Bleustein, chief medical officer and head of Dell’s global healthcare consulting services, leads an integrated team of clinical, business, and technical professionals who provide expertise to health systems, hospitals, physician practices, health plans and life sciences organizations. Here he discusses Dell’s healthcare vision; improving patient engagement and how he defines the term; data security; and trends that he thinks will be worth tracking in the near term — here’s a hint: smartphones, yes; wearables, no.
In your new role as chief medical officer and global head of healthcare consulting at Dell Services, what are your responsibilities?
As chief medical officer, I play a key role in Dell Services’ healthcare division supporting our aggressive strategic initiative to revolutionize the way healthcare is managed. I spend a lot time listening to customers and helping them to better manage patient-specific data that spans the entire continuum of care. Ultimately, better information and technology will drive improvements in quality, patient safety, efficiency and outcomes. I help shape our strategy and ensure that it meets the needs of our customers, both now and in the future.
Tell me about your background in healthcare and how you came to be passionate about the space.
Ever since I was a child, I knew that I wanted to be a physician. Originally I was fascinated with the ability of body builders to be able to grow muscle to such huge proportions and lift weights several times greater than their mass. As my career developed, I focused on how treatments and diagnostics could move from the lab to the bedside. During training and private practice, I became more involved in understanding how systems work and function and what drives them. I was fortunate enough in my career to work internationally, as well. This gives a much broader view about how healthcare can be improved on a larger scale. I am driven by a desire to continue to disrupt the market with new technologies and solutions that can have a meaningful impact on improving health at scale.
What is Dell’s background in healthcare IT and why does the company put an emphasis on this sector (other than for obvious financial reasons)?
People are often surprised to learn that Dell has more than 20 years of experience in serving healthcare customers. That, combined with our deep bench of clinical and technical experts, is why Gartner has ranked Dell number one among healthcare IT service providers for four years running. But it goes beyond that; it’s also personal. Michael Dell is keenly interested in exploring how technology can improve healthcare systems around the globe. And we have thousands of employees who get up every day and focus solely on the needs of our healthcare customers. With an aging population and the impact of chronic diseases, such as heart disease and diabetes, we must find ways to reduce cost, improve productivity and improve health outcomes. Technology has a huge role to play. We also know we can’t do it alone, and for that reason we work with and partner with some of the leading companies in the industry.
What solutions does Dell offer and how do they set the company apart from competing vendors?
What sets Dell apart is our holistic approach. It’s not enough to just add technology. It’s also about connecting people to the right technology and integrating that technology into their workflows. Processes need to be re-examined and, in many cases, re-engineered. So, in addition to the traditional IT products and services Dell is known for, we also offer a robust suite of solutions and services that are specially designed for healthcare. These include secure cloud solutions such as our Unified Clinical Archive, EHR implementation, mobile clinical computing, sophisticated analytics tools, social media integration, HIX and HIE services and support, and clinical transformation. We also have a strong focus on the life sciences, with a genomics analysis platform that supports clinical trials investigating personalized treatments for cancer.
Guest post by Tom Giannulli, MS, MD, chief medical information officer, Kareo.
It seems like everywhere you look there is a new piece of wearable technology to help people monitor their health and lifestyle. The latest and greatest, of course, is the Apple Watch, which hit the newswire with a bang last month.
There is no doubt that mobile health apps and wearable technology and devices are big business. Both patients and clinicians are using mHealth apps on their smartphones and other devices. There are tens of thousands of these apps, and the Robert Wood Johnson Foundation says this number will grow by 25 percent a year. Their research also shows that by 2018 1.7 billion people worldwide will download a health app.
Despite what the media may say, the fact is most people aren’t using these apps and devices yet according to a new study from Technology Advice. Their research found that nearly 75 percent of adults do not track their weight, diet, or exercise using a fitness tracking device or app and most cited reason was general lack of interest.
However, one interesting thing to note is that more than half said they would be more likely to use a health tracking app or device if there was a possibility of lowering their insurance premiums. Just over 40 percent said better advice from their healthcare provider would be a possible incentive to use a fitness tracker.
Guest post by Allison Errickson, CPC-H, director of coding compliance, ProVation Medical, with Wolters Kluwer Health.
Never before have effective revenue cycle management strategies been so critical to future positioning in hospitals and health networks. In today’s lean environment of declining and unpredictable reimbursement, effective oversight of timely billing practices can simply be a make or break element to success.
Because the revenue cycle is dependent on the time-to-bill for procedures and diagnostic care, healthcare organizations must enact processes to support the most efficient coding practices to speed receipt of payment. Success in this area remains an obstacle for many organizations struggling with how to allocate limited resources to ensure the most accurate coding and efficient turn-around.
Denials plague the industry in terms of maintaining consistent cash flow. Inaccurate or incomplete documentation can impact as much as 5 percent of revenues if a healthcare organization is experiencing denial rates of 25 percent or more. Revenue is also negatively impacted when documentation does not support the highest level of acuity, minimizing reimbursement potential.
While accurate documentation remains an ongoing issue, resource allocation to effectively address the issue will likely be further impacted with the introduction of ICD-10. The industry has been granted a reprieve with the recent deadline extension of Oct. 1, 2015, but the reality of the transition will be coming into focus very soon. Coding challenges will be exacerbated as coders will now have 72,000 unique procedure codes to choose from, increasing the complexities associated with specificity and accurately coding to the highest level of reimbursement.