December 10, 2007

1. Philips To Add Emergin to Monitoring Portfolio

Facts and Background

Medical equipment and technology vendor Royal Philips Electronics NV announced Tuesday that it will acquire privately held Emergin Inc., a vendor of hospital alarm and notification systems, for undisclosed terms. The privately held Boca Raton, FL company is expected to have sales of $18 million in 2007.

Opinion

Emergin has a big vision, impressive technologies and phenomenal growth. While it's early in the company's history to be acquired, Philips obviously saw a lot of potential to use its knowledge for work in home and other remote patient monitoring.

Musings

• Philips' competitors in the medical equipment market don't like being one-upped. Several companies specialize in technologies that straddle biomedical and IT systems. Expect GE and others to look hard at the potential for similar investments.
• Clinical IT systems have simple and often retrospective messaging and notification capabilities. Emergin created a new market for products that sit between patient care devices and IT systems, handling event triggering and notification at a more comprehensive level. Philips should give that technology a wider audience.
• This is Exhibit 112 supporting the theory that biomedical devices and IT are rapidly converging, with the only hard line between the two being the FDA marketing approval required for patient care systems.
• If you like the idea of "tollgates" as a revenue source, imagine the possibility of controlling a sophisticated gateway between real-time patient events and the information systems used by clinicians. This could be that kind of tollgate.

2. New Push for Electronic Prescribing

Facts and Background

HHS Secretary Mike Leavitt issued a statement on Monday that urged Congress to require physicians to adopt information systems as a condition of not having their reimbursements reduced by 10.1% as scheduled under Medicare Part B. The American Health Information Community, a government advisory group, had previously urged Leavitt to require electronic prescribing of all physicians and pharmacies under the Medicare Modernization Act. 

Opinion

If it wasn't already obvious that e-prescribing would shortly become a standard, this should seal the deal. Huffing and puffing aside, it's a no-brainer that has little opposition beyond physicians who simply don't like being told what to do, especially by the government.

Musings

• Physicians are vendors. The government is the customer. The customer dictates invoicing terms. This is not a new concept. If Uncle Sam wants its invoices electronically, it's up to the vendor to make it happen.
• AHIC called for e-prescribing for all drugs, which would require lifting archaic Drug Enforcement Administration rules that prohibit electronic transmission of prescriptions for controlled drugs.
• MGMA is against AHIC's proposal because they're afraid the e-prescribing addendum will affect passage of the annual Part B tweak.
• AHIC also recommended undefined incentive programs for physicians and pharmacies that use electronic prescribing.

3. Big Healthcare Companies to Develop, Use Health Information Security Standards

Facts and Background

A group of nine healthcare companies announced Wednesday the formation of the Health Information Trust Alliance to develop electronic security standards for the healthcare industry. The companies include HCA, Humana, Highmark, Johnson & Johnson, Cisco, GE Healthcare, Philips Healthcare, Pitney Bowes, and CVS Caremark. The organization, which dubbed itself HITRUST, says standards will be completed by the end of 2008.

Opinion

Previous security work by other organizations apparently wasn't important or effective since HITRUST is starting over.

Musings

• It must have startled HIMSS and other groups that for-profit companies decided to take electronic security matters into their own hands.
• The initial member list represents only a narrow piece of the HIT industry (no providers, member organizations, or pure HIT vendors). However, it will eventually accept up to 155 participating organizations.
• HITRUST's announcements call it a "private, independent company" without saying whether it's for-profit or not. Or, why the work needed to be privatized under a new company in the first place.

4. Red Hat, HP Collaborate on Healthcare Data Sharing in India

Facts and Background

The India-based technology subsidiary of open source technology provider Red Hat and HP announced Thursday that the companies would collaborate on electronic data sharing projects between hospitals in India.

Opinion

HP and Red Hat collaborate on Linux for HP's servers, but neither company has significant involvement with end-user applications. Whether this news signals a change in strategy that will affect US customers is unknown.

Musings

• The report came from an Indian business publication, but is not referenced on either company's web site.
• Red Hat's clout in the open source community would help with adoption of open source applications in healthcare, which has been minimal.

5. Healthcare IT Vendors Selling Patient Data, Privacy Advocate Says

Facts and Background

Deborah Peel MD, founder of the Patient Privacy Rights Foundation,  was quoted by a Lufkin, TX newspaper as accusing healthcare IT vendors of GE, Siemens, and Cerner of contractually reserving the right to use the electronic patient information of their hospital customers. She was also quoted as saying that vendors and hospitals sell "sensitive patient records" to employers and insurers to help pay for their technologies.

Opinion

She had better have ironclad proof. Good intentions aside, accusing major multi-national corporations and hospitals of intentionally selling patient information is asking for trouble unless you've got them dead to rights. If she has that proof, I'm surprised that a Lufkin, Texas newspaper got the scoop.

Musings

• Contracts may give vendors permission to use de-identified patient for unstated purposes. That doesn't sound like the "sensitive patient records" referred to in the article.
• If someone is selling, then someone else must be buying. If vendors really are selling patient data, the companies they're selling it to will likely earn an equally embarrassing public black eye. Who wants to be known as an employer or insurer trying to buy patient data under the table for financial benefit?
• If Peel does have proof that identifiable patient data is being sold, she and the privacy movement will both get serious attention in the healthcare privacy debate going forward. People are already leery of how their confidential information is used, so one documented case of data selling could erupt a firestorm.
• Cerner, named by Peel as a vendor reserving the right to sell patient data, has an "Online Exclusive" on its site written by her that rails against that practice.
• More news is certain to follow.

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