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Archive for January, 2009
Headlines for Jan 19-31
- Posted January 30th 2009
- Comments (0)
- by Janice
San Mateo-based Wellsphere is acq. by HealthCentral. PaidContent characterizes it as a technology play, along with some bump-up in scale. Wellsphere includes health-specific search engine, a mobile application, and an enterprise app. for powering a wellness portal for Stanford Univ.
Author of Nudge, the book that describes how “choice architecture” can be used to encourage healthful or otherwise beneficial behavior, gives his opinion on usefulness of medical checklists based on the recent study of noncardiac surgery checklists.
Interview with Stephen Forney, author of “10 Critical Growth Strategies Healthcare Executives Must Know”.
Consumer advocacy group, Consumer Watchdog, to change their policy and lobbying efforts to sell aggregated personal healthcare record info to advertisers.
InVivo on the Pfizer acquisition of Wyeth.
Medidata, a provider of hosted clinical development solutions, files for IPO.
David Rothman’s post points to a free online course “Understanding Evidence-based Healthcare: A Foundation for Action” offered by Consumers United for Evidence-based Healthcare (CUE)–a coalition of consumer health and consumer advocacy groups. A video describing CUE is included in post, too.
Princeton’s Uwe Reinhardt offers a primer on hospital reimbursement.
Legislation has been introduced (Physician Payments Sunshine Act) to require pharma companies and medical device manufacturers to disclose all payments to doctors.
Hospital group purchasing organization, Premier, to resell shift-scheduling application of Concerro.
John Morrow, a leader in creating and promoting systems for rating hospitals, writes on the importance of viewing value of health care from the patient’s perspective.
Elsevier adds books from W.B. Saunders, Mosby, Churchill Livingstone and Hanley & Belfus imprints to ScienceDirect.
EBSCO publishing acq. Salem Press. Companies had partnered for distribution in past and Salem created custom content for EBSCO. Salem publishes consumer health publications, as well as literature and history books. Berkery Noyes acted as advisor to Salem.
According to WSJ, talks have been underway for months and no deal is imminent, but a reported $60B deal would create a pharma giant.
Eclipsys which uses the tagline “the outcomes company” gets downgraded after missing earnings forecasts for Q4 2008 results. Analysts had expected eps of $0.35; Eclipsys announced eps of 7-11 cents for the quarter.
Headlines for Jan 19-25
- Posted January 25th 2009
- Comments (0)
- by Janice
Not health content specific, but a short, concise interview with co-founder and managing director of InfoCommerce Group, parent of Health Content Advisors. Focus on business models for publishers, esp. ad-supported vs. subscription/for fee.
Cleveland Clinic to begin adding info about financial ties to pharma, med device companies, etc. to profiles of doctors on their site. Pharma, in turn, say they will begin disclosing their payments to doctors.
Not health content specific, but relevant to online publishing: Two popular content management technology firms to merge. Interwoven includes LexisNexis and other B2B publishing companies as clients; UK-based Autonomy is also strong in legal market for e-discovery applications. Autonomy, which just reported strong Q4 20008 results to pay $775 for Interwoven. See www.autonomy.com for more details.
Peter Neupert, Corp VP, Health at Microsoft, posts on his recent testimony before Congress on health care industry improvements.
Carefx, which offers s/w that help integrate and organize data from multiple systems to improve workflow. The press release touts the addition of 200 more hospitals to its client roster and 200% revenue growth 2008/2007.
Elsevier acquires William Andrew Publishing of Norwich, NY. William Andrew is an STM publisher of applied science handbooks, references and databases.
CMS’ e-prescribing financial incentives go into effect this month. Some details on the program in this post.
Healthline’s HealthSTAT ad network ads AOL Health, iVillage, Organized Wisdon, tudiabetes.com, and WrongDiagnosis.com to its list of online health sites that use HealthSTAT to augment its direct ad sales.
David Rothman, one of the most highly regarded medical librarians, writes about the importance of promoting health literarcy, and his concern (to put it lightly) about social media enthusiasts who call for “crowdsourcing” of average citizens’ opinions to replace recommendations from medical professionals when seeking relevant health information.
Press release from Companion Global announcing that they have “received second-place honors in the “Best Website for International Medical Travel” category at 2008 Consumer Health World Awards.
DeepDyve, formerly Infovell, receives $3.9 million in early stage funding to expand its medical research service and introduce similar research services in other verticals. DeepDyve was a presenter at Health Content08’s Innovators Showcase.
M&A Prognosis Remains Healthy in Our Sector
- Posted January 19th 2009
- Comments (0)
- by Janice
At a time when the overall level of financial and strategic acquisitions across most industries is anemic at best, the amount of M&A activity in the healthcare sector remains robust. According to Berkery Noyes, which just distributed their January 2009 Mergers and Acquisitions Trends Report on the Pharma and Healthcare Information and Technology Market (1)
transaction volume was up 16% in 2008 relative to 2007, although aggregate transaction value was down 9% in the same period.
Berkery’s report includes a list of the top 10 transactions for 2008, with Apax Partners’ acquisition of the TriZetto Group leading with an acquisition price of over $1.2 billion. Broken down by segment, healthcare IT, pharma IT and pharma information saw an increase in the number of deals in 2008 relative to both 2007 and 2006, with healthcare IT far surpassing all other segments. Medical information saw an increase in number of deals in 2008 over 2007, but was still well below the number of deals completed in 2006. Other segments, including medical education, pharma business services, and consumer health information had fewer transactions in 2008 than in 2007 or 2006. Healthcare business services was flat year-over-year.
One area where we predict increased activity is in cross-over deals where healthcare IT companies acquire health content companies or vice versa. Health IT vendors are seeking a better understanding of how content flows through information systems, especially in clinical decision support systems. And while health content publishers have produced some very good evidence-based decision support systems that provide quick access to bodies of authoritative content, they know there needs to be more integration among these systems as well as with other internal and external IT systems used by providers in order for these decision supports systems to achieve a higher level of productivity improvement. Merging IT vendors with the content publishers may alleviate some of the disconnect and improve the alignment of health content and IT with daily workflow for clinicians and other healthcare professionals.
Berkery expects that the healthcare sector will remain active in 2009 despite the current economic conditions and stalled PE sector, due largely to the increased focus on investing in productivity improvements in healthcare and healthcare’s general insulation from economic downturns. The economic conditions are certain to affect the level of activity by private equity groups; however Berkery writes that these firms “will continue to close deals but will need to be more creative”.
We agree with Berkery that deal activity will remain strong in the healthcare and pharma information sectors in 2009. Furthermore, the current economic and credit conditions that have hurt private equity should result in some good opportunities for strategic buyers, since valuations and multiples are down across the board and alternative exit strategies are limited.
We’ll continue to report on trends in the health content sector and provide our analysis of deals that we think demonstrate innovative combinations of health IT and content in this e-newsletter throughout the coming year, which we hope is a robust one for us all.
1 http://www.berkerynoyes.com/;
Contact Tom O’Connor, Managing Director, Berkery Noyes, for more information. (Tom@berkerynoyes.com).
Headlines for Jan 12-18
- Posted January 18th 2009
- Comments (0)
- by Janice
Bob Wachter on how insurers are getting into the act and promoting medical tourism for their insured patients.
Sage Publications signs with e-Healthcare Solutions for online advtsg of their medical journals.
Post isn’t health-focused, but anything Google does is relevant to publishing. Mentions Knol, which was seeded with paid medical contributors, and the fact that it hasn’t caught on.
Article highlights how increased focus on reporting errors leads to an initial jump in recorded errors (since many errors simply weren’t recorded previously). But, in reality, error rate may have declined.
Related to story earlier this week about settlement between UnitedHealth and NY atty general to fund development of independently produced database for calculating out-of-network reimbursement rates. UnitedHealth’s Ingenix group will pay $50M to help new db; Aetna will pay $20M to help fund the db.
Novartis Vaccines and Diagnostics wins $487 M contract to build facility to mfr cell-based vaccine.
David Williams on the Ingenix/UnitedHealth database settlement. Good points about wide variations in costs among providers.
Authors of Nudge describe Changemakers foundation & RWJF’s contest to find good ideas that encourage better health outcomes. Winners receive $5,000.
Chilmark reports on merger of two vendors in RHIO/HIE market that combined serve approx. 10% of US hospitals.
Links to presentations given at user meeting held in Scottsdale, Dec 3-5, 2008. Note, Patty Riskind, CEO of Patient Impact, one of our Innovator Showcase presentors, is included among the speakers.
More on the new Family Health History tool from Surgeon General.
My Family Health Portrait, an online health history info tool introduced in 2004, has been updated with new data stadards to facilitate info exchange with EMR and PHRs.
5-8% of Pfizer’s 10,000 research employees to be laid off by end of year.
UnitedHealth to pay $50M to finance development of new database of medical care costs by region. NY state atty general, Cuomo, had investigated the reimbursement rates in current Ingenix db (Ingenix is div. of UnitedHealth) and found that they underestimated prevailing costs by region. New db to be developed by a neutral university. According to Karen Ignani, CEO of trade group America’s Health Insurance Plans, new db will “enable customers, for the first time, to be able to know what doctors are charging for their services before they have an office visit”.
Neil Versel provides a list of the members of the leadership board for the National eHealth Collaborate, the successor to AHIC 2.0. Versel points out limited representation of nurses, and lack of medical librarians on the board.
J&J partners with Burnham Institute for Medical Research to have access to their high-throughput drug screening capability to help develop new inflamatory disease drugs.
Abry buys minority stake in Gateway EDI, a healthcare billing service compnay.
AMO, the leader in Lasik surgical devices, to be acquired by Abbott for $2.8B.
Kolltan, a spinoff from Yale Medical School, closes Series A fo over $35 M and names CEO. Kolltan is developing cancer treatments.
UnitedHealth hit again; will pay $350M settlement for AMA lawsuit
- Posted January 15th 2009
- Comments (0)
- by Janice
ModernHealthcare.com has distributed an alert to announce that UnitedHealth, which was in the news yesterday for its $50M settlement with state of NY related to its Ingenix database for calculating out-of-network reimbursements, will also pay $350M in a class-action settlement filed by AMA also related to underpayment for out-of-network care. More details to follow on ModernHealthcare.com site and other outlets.
Transparently Clear
- Posted January 14th 2009
- Comments (0)
- by Russell
In a settlement announced yesterday with the New York State Attorney General, UnitedHealth Group has agreed to shut down two databases maintained by its Ingenix subsidiary. In addition, UnitedHealth will pay $50 million to re-create the databases under the aegis of a non-profit organization to be established for the purpose.
The two Ingenix databases involved are Prevailing Health Charges System and the Medical Data Research database. The two products track “usual, customary and reasonable” physicians’ fees. Most insurers use Ingenix’s data, which is not available to the public or doctors, to calculate patients’ out-of-pocket costs when they seek out-of-network care. Physician groups have complained bitterly about under-reimbursement driven by these databases, and consumers may have been under-reimbursed as well. This settlement does not address the claim of under-reimbursement.
In addition to the under-reimbursement claim, the New York State Attorney General also attacked the Ingenix data products for “lacking transparency.” It does seem remarkable that a commercial, subscription-based data product would be obligated at all to be transparent. The New York Attorney General also charged a conflict of interest in that Ingenix is a subsidiary of a health insurer that also makes use of the Ingenix data for calculating reimbursements. Again, what’s implicit in this charge is that these databases are so important that they’ve become bigger than the organization collecting them and become something of a public trust.
This settlement brings to mind the furor that erupted in 2006 when the First DataBank unit of Hearst Corporation was engaged in what appeared to be some very sloppy updating of its wholesale average price database for pharmaceuticals. Instead of surveying the industry to develop a true price average, it was instead gathering all its data from a single drug wholesaler. As a private, subscription data product, this would normally be little more than a huge embarrassment. In the case of First DataBank, however, this database was driving pharmacy reimbursement rates nationwide and reportedly led to inflated reimbursements to the tune of many billions of dollars. Here again, we have an example of a private industry database with outsized influence. While Hearst can’t be claimed to have had any conflict of interest, this clearly seems to be a case were increased transparency regarding data collection practices might have prevented the problem in the first place.
Should private sector databases that are used to drive payment systems, particularly where taxpayer dollars are involved, seek to meet a higher standard of transparency? On reflection, I think the answer is “yes.” Data publishers whose products fuel mission-critical applications shouldn’t need to hide their work. If your work is sloppy, you have a perpetual litigation threat hanging over your head, as these two cases well illustrate. If your work is first-rate, you have a selling advantage. As to the proprietary aspects of building a database, I’m not (necessarily) suggesting that you open your algorithms to the world, since their quality can be measured based on results. Rather, I am suggesting that your data inputs and your process for creating gold from dross might benefit from some sunshine. After all, any data publishing veteran knows well that most of our value is wrapped up not in secret methodologies but rather that we sat down and did the messy work nobody else wanted to do. We aggregate, we scrub, we normalize, we purify. It’s not rocket science, and there are few secrets, just skilled practitioners. In our business, transparency builds trust, and trust builds increased utilization, meaning greater revenues. Suddenly, the case for transparency seems perfectly clear.
Headlines for Jan 5-11
- Posted January 11th 2009
- Comments (0)
- by Janice
CareFirst will upgrade Benefitfocus’ eEnrollment application to the more comprehensive “Model Office” that includes eBilling, eSales, Video, and electronic exchange.
A review of hospital info portals versus push delivery systems. This article seems to suggest that centralized info systems that can be accessed on-demand are at odds with info services that are delivered to mobile apps or other point-of-care systems. Problem may be that writer is assuming a web 1.0-type portal, versus a more current business intelligence system that integrates more seemlessly with a specific user’s workflow.
“…we will make the immediate investments necessary to ensure that within 5 years, all of America’s medical records are computerized,” Obama said in speech on Jan 8, according to HDM.
Glaxo CEO Andre Witty, at Goldman Sachs conf. in NY, says he will focus on smaller bolt-on acq. in 2009.
Very good list of websites to help patients research and find doctors and research medical conidtions.
Roundup of recent funding activity in Boston area; many funded firms in pharma or biotech.
Only peripherally related to health content, but a noteworthy development in field of self-publishing, where technology and online marketing (esp. via Amazon) has made it much less expensive/easier to self-publish.
Sidney Wolfe, author of Worst Pills Best pills (www.worstpills.org) joins FDA.
Wyeth reportedly in talks to acquire Curcell. Subscription only content from WSJ.
NEJM changes policy on disclosuring pending patents of authors.
New website: Clinician-Consumer Health Advisory Information Network (CHAIN) offers educational resources about medical therapeutics for both health care professionals and consumers. Clinicians can adapt info from the slide library for clinical education; education info includes resources to help with clinician-patient conversations. Created in conjunction with CERTS (Center for Education and Research on Therapeutics), a federally sponsored network of >dozen research centers across the country.
NY’s Whitney M. Young Jr Health Services receives $2.7M grant to pilot a diabetes care management program that includes text messaging to report blood work, send appt. reminders and facilitate communication from patient to providers, too.
Calif. chiropractor sues over review on Yelp that criticized his billing practices.
Advertising-supported resource for patients that provides pricing info for range of medical services, along with other information to help patients who are paying out of pocket for medical services. Owned by CareOperative, which provides pricing strategy guidance to employers and payer organizations.
Patient Safety & Quality Healthcare Magazine and PDC (Precision Dynamics Corp) announce winners of Patient Safety Success Story Contest. PDC is a provider of labeling systems and other healthcare products that improve patient safety.
PatientFlow specializes in performance improvement in patient flow issues such as “emergency room overcrowding, long wait times, bumped or dealyed surgeries, and lack of beds”. Terms not disclosed.
Informed Patient lists some new and some favorite consumer health websites.
BioMarin offers “carefully staged” deal for La Jolla Pharmaceutical’s Riquent, a treatment for lupus. Deal includes small case & equity payment upfront, plus $147.5 M for meeting clinical/reg milestones and another $126M for achieving sales targets.
Some info on Wellpoint’s med tourism program that encourages travel to India for knee and hip replacement surgery.
Press release from HealthCentral that placed its online sites in the top 3, with WebMD and Everyday Health. HealthCentral touts its audience engagement techniques and authoritative content.
More on the HIMSS’ acq. of 1105 Media’s Government Health IT publication, conference, and related assets.
Neil Versel discusses the acq. of Government Health IT by HIMSS.
Pharmablog takes a look at iGuard, a site that includes basic drug info, supplemented by patient feedback on the drugs.
Pharma company, Endo, based in Chadds Ford, PA, acquires Indevus, a biotech company based in Lexington, MA, for its testoterone replacement drug, its histrelin drug that treats precocious puberty, and another drug in final stage of clinical trials. We expect to see a lot more acquisitions of biotech companies by pharma in 2009.
CMS reports 6.1% growth in healthcare spending for 2007, a slight decrease in rate of growth of 6.7% from 2006 (note lag in reporting period). For 2007, hc spending grew to represent 16.2% of GDP, up from 16% in 2006.
Ed Silverman, who wrote the Pharmalot blog, is moving to Elsevier’s Pharma Business Intelligence Unit and will write for In Vivo and the Pink Sheet, and the In Vivo blog.
Eclipsys announced planned acq. of Premise for $38.5M in case. Premise sells hospital bed mgmt and patient transport s/w.
Prevention Quality Indicator (PQI) web site reports rates of hospitalization for preventable conditions, including diabetes, asthma, high blood pressure. Objective to “better inform future health planning efforts”.
Pfizer sponsors pilot program at Mass General & Brigham and Women’s hospitals to use technology to simplify the reporting drug side effects.
Link to Congressional Research Service (CRS) report on future of SCHIP.
HHS/CMS press release about enhanced measures to guard against Medicare fraud my med device companies.
Overview of plans by Angie’s List as they expand into ratings of health care providers. Service will move beyond the amount of info available for home improvement contractors that form the core of Angie’s List. “Members can read reviews by other members for health providers in almost 1,400 categories (ranging from surgeons, hospitals and health insurers to acupuncturists). But the new interface will also link users to Web sites and information resources sponsored by professional medical societies and the government where they can access data on provider certification and credentials, disciplinary actions, treatment outcomes and other clinical data. Members also will be able to see which health insurance plans a provider accepts.” Note, Angie Hicks was a keynote speaker at our InfoCommerce Conference in November.
Headlines for Dec 27-Jan 4
- Posted January 6th 2009
- Comments (0)
- by Janice
“Drugstore.com Inc. is working with Medco Health Solutions Inc., a pharmacy benefits manager, to launch a Medco-branded online store by mid-year. Drugstore.com will provide Medco with technical development and operations services, consumer health products and over-the-counter medicines, fulfillment, and customer care for non-prescription drug products.”
NY subsidizing implementation of Mass-based eClinicalWorks for small practices.
Review of financial condition of hospitals, many that have expanded or planned expansion financed with debt.
Focuses mostly on electronic health records, but ties in how data from EMRs and PHRs can be used in improving the practice of evidence-based medicine.
Overview of personalized medicine with viewpoints from former pres. of Affymetrix who is now partner at Mohr Davidow, and Elissa Levin of Navigenics.
Sermo joins the fray — along with Google — in using online tools to track spread of flu. Sermo has advantage of compiling clinical observations rather than inferring data from search queries as does Google.
From Toronto Public Library Consumer Health Information Service, a list of top 10 health-related websites from 1999 and update on where they stand today, as well as some notable new sources.
Google’s Research Datasets project is shutdown. Announced about a year ago, Research Datasets was seeking to aggregate large datasets that backed research projects. One 30 datasets were uploaded, but some were huge (Hubble project with 120TBs). Media focus has pointed to storage costs as problem, but the need to reduce # of early-stage projects at Google also contributed to the decision. Google says it will focus on G Scholar instead.
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