Grand Rounds 1:53
Grand Rounds is up at Family Medicine Notes.
This marks the first year anniversary of Grand Rounds, and Dr Reider
has collected some great posts for this weeks installment.
GE to Acquire IDX
It's finally happened. GE Healthcare can now add “major player in HIT” to the list of markets it dominates. IDX
shareholders will receive $44 per share (a 25% premium), for a total
cost to GE of $1.2 billion. IDX was the third largest HIT vendor, with
$520 million in revenue in 2004 (based on Healthcare Informatics' Top 100 list for 2005). In 2004 GE Healthcare IT generated $746 million in revenue.
IDX stumbled badly earlier this summer when it was replaced by Cerner
as the UK's National Health Service (NHS) Southern region EMR vendor.
Speculation was that IDX was under staffed leading to a schedule slip
in the NHS project, and that the loss of that lucrative contract would
impact long term viability. While the stock hit a 52 week low of $28.29
shortly after losing the NHS deal, the stock gradually climbed to
$35.17 yesterday, before the GE acquisition was announced.
From the press release:
healthcare IT vendor, offering one of the most comprehensive suites of
clinical, imaging and administrative information systems on the market.
The above sounds good, but the
reality experienced by customers will depend on the effort GE puts into
actually integrating IDX systems (some with their own integration
issues) into GE Healthcare products. Irrespective of systems
integration, a key potential benefit to customers will be a single
point of contact and theoretical avoidance of vendor finger pointing.
Along with this will come an opportunity for GE to implement the
typical “single vendor solution” competitive strategies to lock in
their installed base. In every single vendor solution, some products
are dogs; which of the combined GE and IDX products will be dogs (and
how doggy the actually are) will play a key role in competitive
situations.
This move raises many interesting questions. In what ways will GE move
to leverage this acquisition with their clinical information systems
and medical device product lines? How much will they invest in R&D
to deliver on the inevitable marketing spin? How will competitors
respond? The leading HIT vendors; McKesson ($1.2 billion revenue in
2004), Cerner ($926 million revenue in 2004), Misys ($507 million
revenue in 2004), Eclipsys ($309 million revenue in 2004), Epic ($259
million revenue in 2004), and Meditech ($281 million revenue in 2004)
will all be reassessing their plans and strategies in light of this
(not so surprising) news.
UPDATE: As always, the HIStalk guy brings insight and opinion — this time to the IDX acquisition. My favorite bit:
to the mishmash of technologies it already owns, perhaps with less
interest in CareCast than us hospital IT types might assume. Can they
increase sales simply because they're a conglomerated GE Healthcare?
Maybe.
Read the whole thing.
UPDATE: More perspective from HIStalk in this follow up post on the GE acquistion of IDX.
UPDATE: Here's a slightly different take on the IDX acquisition at Peter Charbonnier's Chief Compaint. And check out this post from an IDX support specialist.
WELCOME to those who are visiting via their corporate intranets. If you
have an interest in workflow automation, medical device connectivity,
or any of the other topics listed under Categories in the left nav bar,
have a cup of coffee and spend some time poking around. You might be
surprised at what you find.
Marketing Tip for Vendors
Isn't that photo below of the IV pump cool? I think so. Every time I do
a web log post — or a PowerPoint presentation — I check company web
sites for stock photos they make available for the press, sales
prospects, customers looking to justify that upgrade, and others. So
few vendors provide any kind of images (even their boring old logos)
for use by others.
So here's some free marketing advice; put graphic files of your
logo, technology and product shots on your website. The best place for
them is under “press room” or with your press releases. Product shots
should include beauty shots on a white background (like the Hospira
pump below) first and second, if you have them, “in use” action shots.
Don't assume everyone has Photoshop, and include resolutions
appropriate for both the web and PowerPoint. The print media guys might
even pick up a shot or two if you include files suitable for their use.
Why Connect Medical Devices?
Reader Charles F. posits the question above in a recent comment on the post Current State of Medical Device Connectivity. I’ve reproduced his comment in its entirety:
Frequently missing from the device connectivity dialog is the all important question “ok, you’re connected, so what?” If the point is simply to dump device data into a database the point is being entirely missed.
Patient-attached devices are of value if ! and only if they can get their information to someone who cares…WHEN they care. Designing otherwise is to contribute to information overload and the long list of
things clinicians ignore until it’s too late. So, to improve device connectivity is just moving the problem around. What’s needed is a comprehensive approach to device data management that provides clinicians with the ability to recognize worrisome trends across multiple parameters and systems and be notified of those trends BEFORE the “mis-adventure” occurs. This, of course, begs the question of how device data management is to occur. As device suppliers increasingly get into the software business there is somehow an assumption on their part that their limited view of the patient’s condition must be a highly valuable perspective worthy of waking up the nearest attending physician. How long will THAT last? Device connectivity is a huge step forward but only in the context of systems capable of evaluating the data in real time and making prospective inferences….and then figuring out who should know.
“So what,” indeed. The connectivity market requirement that is most embraced by both vendors and users is dumping device data into some sort of software — be it for data analysis and reporting in a diagnostic system, or documentation for paperless charting. This capability is driven by growth of the paperless charting market. Medical device data acquisition is a critical requirement for successful EMR adoption, and
a considerable challenge all on its own. This is important, but to Charles’ point, of little value from a patient care and safety perspective.
Medical device connectivity has been rolling through the industry for 20 years, and has finally hit a wall at the point of care. The point of care brings together a plethora of medical devices (and no one vendor makes pumps, vents, and patient monitors); many clinicians, caregivers, and diagnosticians; and patient data aggregated from many sources presented in a clinical information system. There are no single vendor solutions here. Dumping data into the electronic medical record (EMR) is at least something relatively straight forward and within the control of a single vendor. Hospitals, who have to deal with a large installed base of legacy devices (that frequently average 5 or more years in age), networked in a myriad of private subnets or supporting device specific proprietary serial interfaces (both protocols and pin-outs), and usually a few newer networked devices (all incompatible, of course) face a significant need to move beyond point solutions dressed up as expensive upgrades and find an enterprise solution.
Applications like patient centric alerts and medical device alarm management must deal with complex workflows, multiple vendors, and numerous users. It is so natural for a device vendor to see the world as though defined by their own product centric market. Traditional clinical information systems vendors view market requirements from a broader user’s perspective, but despair at dealing with a multitude of device vendors and new regulatory hurdles (i.e., the FDA). Hospital leadership, having been burned before on complex systems integration, is not likely to rush to buy into the first point of care solution that comes along. There’s not even a name for this new area; point of care automation really doesn’t express the breadth and complexity (nor the promise) of this new frontier. Any suggestions?
The good news is that there are clear benefits to the kind of point of care integration and workflow support that Charles alludes to; things like reduced length of stay (LOS), improved patient safety, and reduced medical errors will drive this market segment to broad adoption. The eventual market leaders in this new segment will surprise us all, and represents a great opportunity for newcomers to grab a big piece of this market and existing players to retool their business models to meet this new combination of requirements. There is no doubt that early innovator hospitals are currently looking for solutions, and that select vendors are working on solutions. Navigating the next several years until the market has matured will be a challenge for buyers and sellers alike.
Johnson Controls Enters Hospital WLAN Installation Business
Baptist Memorial Health Care signed a $6 million deal with Johnson
Controls to install a wireless broad band distribution infrastructure
in 6 of their hospitals over the next 12 months (press release).
system will provide wireless coverage throughout Baptist’s six
locations by means of a single broadband infrastructure. The system,
which will be installed in the next 12 months, will support the
delivery of voice and data systems—such as personal communications
systems and cellular carriers, local area networks, two-way radios,
digital paging systems, handheld clinical devices and medical
telemetry—throughout each location. Also, the wireless system will
eliminate the need for separate, multiple wireless networks and can
easily support changes or the addition of future applications.
Wow, the questions… like, who is Johnson Controls, what's Johnson
Controls doing installing wireless networks, and boy, doesn't
this sound a lot like InnerWireless' distributed antenna system? For
you clinical or IT folks, Johnson Controls provides building automation
systems that control things like heating, ventilation and air
conditioning (HVAC), and fire alarm systems. I'd tell you more, but
their web site is a classic example of “corporate speak” that's short
on details. Their site does mention that Johnson Controls is installed
in 40% of US hospitals. A Google search did turn up a couple of interesting bits. Here's a news brief (scroll down) from June of 2004:
to offer an in-building wireless distribution system. This system
provides complete wireless coverage for a full range of voice and data
services. Called the InnerMobile wireless distribution system, it is
installed once. According to the companies, it can then be modified and
expanded without intrusive, costly infrastructure changes. Johnson
Controls and InnerWireless signed a joint development agreement for
initiatives related to the InnerMobile system. Additionally, Johnson
Controls became an equity investor in InnerWireless.
Google also turned up this Johnson Controls web page on Wireless Solutions.
The Wireless Solutions page does not seem to be accessible from their
web own web site (nor the site map). The page layout is different on
this mystery page (much nicer I think) and I'm wondering if it's part
of a new site design that's not been rolled out yet.
A peek at InnerWireless press release archive
shows Johnson Controls as lead investor in InnerWireless' Series B
round (to the tune of $12 million), sold their first wireless
infrastructure deal 6 months after striking their alliance (Mountain
States Health Alliance), with Johnson Controls getting a board seat a
month after that. (Sorry, no links are provided to the actual press
releases; you'll have to look them up yourselves.)
I feel so behind the curve…
UPDATE: I found a link to the Wireless Solutions page on the Controls Press Room page.
