McKesson Acquires RelayHealth

McKesson rounded out their Personal Health Solutions group offering this week by acquiring physician/patient communications startup RelayHealth.

RelayHealth, founded in 1999, allows patients to maintain their own
personal health records at home, keep track of prescriptions, set
appointments, get test results and talk to their doctors over a secure
connection with its webVisit service. About 18,000 health care workers,
600,000 patients and more than a dozen health plans use the network.

In addition to this acquisition, McKesson announced the formation of the Personal Health Solutions Group, to be run by Giovanni Colella, M.D., RelayHealth's former president and CEO.

In addition to RelayHealth, McKesson's personal health solutions
include in-home patient monitoring, Web portal technology, triage
software and personal emergency response systems, to name a few. The
full solution suite will include products and services from recently
acquired HealthCom Partners, LLC, which provides patient billing
solutions designed to simplify and enhance financial interactions
between healthcare providers and their patients.

The recent announcement of Continua Health Alliance included about a dozen different vendors and health care delivery organizations - notable in their absence were HIT vendors like McKesson. Clearly HIT vendors are investing heavily in the remote monitoring market; their lack of involvement in Continua speaks volumes about their product and go-to-market strategies.

UPDATE: Here's a follow-on story about the RelayHealth acquisition.

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New Health Care IT Stock Index

Speaking of stocks, Wm Blair & Company has launched a new health care IT stock index.

Driven largely by the convergence of several important trends, the health care IT (HCIT) industry
continues to benefit from heightened demand for clinical information systems. These trends have
translated into attractive returns for HCIT investors in recent years, although the extent of this
performance has been arguably difficult to quantify on an aggregate basis.

The William Blair Health Care IT Index (WBHCIT), an equal-weighted basket comprising 31 HCIT
stocks, has been created to capitalize on the above-mentioned trends.

You won't find McKesson, GE Healthcare, Philips or Siemens because companies in the index must generate at least 50% of their revenue from HIT.

Now if some marketing guy at Wm Blair could create a little Java bug that showed a graph or current index value with a link to the index - that would be cool.

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Survey of Remote Monitoring Products.

Emily Goodson has a good post at the IBM blog, HealthNex, on some of the remote monitoring products available on the market. She rightly notes that the technology required for these kinds of products is readily available, and asks if the remote monitoring market will ever really take off. (you can read my reasonably coherent response there.)

In related news, Reuters has a story on the slow adoption of DexCom's very cool diabetes monitoring system (more on product here). The cost of their wireless sensors ($50 each and replaced every 3 days) has limited insurance companies and Medicare reimbursement to, well, zero. DexCom's stock fell 17% after a stock analyst lowered DexCom's stock from “outperform” to “neutral” on reimbursement concerns. Medtronic has a continuous glucose monitoring (CGM) product, and Abbott Labs has one in development (which they acquired with TheraSense).

“The technology, just to have real-time continuous glucose
monitoring, that is a big thing. We've been waiting for that for years
and years, and now it's here,” said Dr. Robert Gabbay, director of the
diabetes program at Pennsylvania State University College of Medicine.

the expense of the disposable sensors, the DexCom monitor costs about
$800, while the Medtronic device costs about $1,000. Medtronic also
recently introduced a glucose monitor combined with an insulin pump
that sells for about $2,100.

While some patients would clearly benefit from CGM, reimbursement will hinge on developing criteria for identifying those patients and demonstrating a return on the additional costs for payors. DexCom has said they expect reimbursement for CGM to take 12 to 24 months. In the interum, the lobbyists are out in force:

DexCom supported Medtronic's request for reimbursement from Medicare at
a recent hearing, and members of Congress have sent letters to the
agency in favor of reimbursement, Kemper said.

Figuring out the money (especially reimbursement) is a common reason why most health care innovations fail.

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Nurse Practitioners Improve Care at The Methodist Hospital

Reading between the lines of this story in ADVANCDE for Nurses, The Methodist Hospital in Houston is using nurse practitioners as an alternative to hospitalists. The problems at Methodist are common - attending physicians are frequently unavailable and higher patient acuity on nursing units. Rather than using hospitalists, Methodist uses nurse practitioners to support caregivers. The program has been a great success. By facilitating faster interventions, patient outcomes have been improved.

shortening patient stays, lowering
complication rates and providing conveniences for physicians,
especially in the late-night or weekend hours, said Michelle Williams,
NP, interim director of the program.

Attending physicians, whose support is essential to the program's success, like the reduced number of interruptions that are now handled by nurse practitioners. Nurse practitioners also serve on the hospital's Clinical
Emergency Response Team, which is on call 24×7 to rush to a patient's bedside, perform an assessment, and begin early
interventions. The teams consist of one nurse practitioner, a
respiratory therapist and an EKG technician.

Pictured right:  Charlene Tharp, a UT nurse practitioner student, talks with Dr.
Michael Cromer. Tharp worked under Cromer’s supervision while earning
clinical hours at Northwest Family Medical Center in Tampa. From The University of Tampa.

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