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Can the Benefits of Hospitals Acquiring Practices Be Achieved By Other Means?

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I’ve regularly talked about the current healthcare environment of hospitals acquiring physician practices. This trend is occurring at a really rapid rate, but in an email exchange I had recently with Dave Chase from Avado I started asking myself if the benefits of a consolidated group of providers could be achieved by other means.

At the core of the current trend is a little reimbursement loophole that many hospitals have been exploiting. I wrote about this loophole in a post on Hospital EMR and EHR called Reasons Hospitals Acquire Medical Practices. Considering this reimbursement loophole, I think there is a little that can be done to discourage hospitals that want to try and increase revenue through this loophole.

At some point Medicare is going to catch up with this and close the loophole. Once that happens, it’s worth considering the other benefits of being part of a large organization as opposed to being a solo practice. Plus, can those benefits be achieved through other means than fully acquiring a practice? This is particularly important as doctors that are currently working for hospitals choose to go back out on their own and for those organizations who haven’t already gotten on the practice acquiring bandwagon.

I think the most pressing reason that practices are interested in relationships with hospitals is based on the changing reimbursement models. It will be impossible to access the ACO money that’s coming without tight ties to a large number of organizations. One way to achieve this is for a healthcare organization to acquire all of the various healthcare organizations that will make up an ACO. I think that’s part of what we’re seeing now and I’ve discussed before how this might be the way hospitals avoid the cycle of doctors leaving. Although, we’re already seeing signs of doctors leaving for new medical models.

This seems like a pretty expensive proposition for hospitals to acquire practices just for the doctors to go back to private practice. Which makes me wonder if the benefits of an acquired practice can be achieved through software and relationships? As we’ve discussed before, interfaces in healthcare are quite hard to do. So, once you’ve been able to create that interface with a clinic or hospital, then you have some pretty solid lock in with that organization.

Although, I’m pretty sure that Dave Chase (which inspired this idea) would take this idea one step further. Imagine that most of the patients used one portal to interact with your local healthcare community. Could that portal facilitate your ACO efforts? Once the majority of patients are in that portal, will anyone in the community want to be somewhere else? There’s real lock in that can occur once patients are engaged with healthcare institutions. This occurs with the patients and with the healthcare organizations that are engaging with those patients.

I think it will be interesting to see if software can facilitate some of the same benefits to hospitals that they get from acquiring physician practices.

February 13, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Crowdfunding Healthcare Startups – Medstartr and Indiegogo

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I have been seeing more and more activity around the idea of using the crowds to fund various healthcare IT startup companies. This shouldn’t be that surprising to any of us given the success of websites like Kickstarter and Indiegogo. They’ve created a whole new way to raise money for passion projects. Plus, as they’ve grown they’ve shown a new way to see if your customer really wants what you plan to offer.

One challenge is that Kickstarter generally hasn’t approved healthcare startup company projects on their platform. In fact, a whole company was born to try and help solve the problem of making crowdfunding available to healthcare. This company is called MedStartr.

I’ve been keeping an eye on it for quite a while. So far they’ve had some successes with these projects getting funding: Medstartr, The Walking Gallery, Peer-to-Peer Global Support for Rare Disease, and Avado. Plus, Reconstruction Bras for Breast Cancer Survivors and Previvors have met their goal, but are still raising money.

I think the most exciting one is The Walking Gallery since it raised well over twice of the money requested. I’m interested to see how some of my friends like referralMD and My Crisis Records do on Medstartr. Their projects are still open if you want to back them.

I think the biggest challenge with Medstartr right now is that it’s currently a “bring your own crowd” fundraising platform. The platform works to raise money if you already have a built in audience that is willing to pay to support it. So far, Medstartr hasn’t been able to produce a large community of “backers” that can fund a project that gets listed. In fact, I don’t think Medstartr even reached its fundraising goal in its campaign (although, it’s listed as such on the website now).

What is also really interesting is a healthcare project that was posted on Indiegogo for a Asthma Education App. So far it has raised $7125 for Health Nuts Media who wants to create the app. That’s not a bad start for their app with 27 people helping to fund that goal. Although, even that number was influenced by a $5000 commitment from Medicomp Systems makers of Medcin. I’d be interested to know how they landed that backing. That’s a nice one and if they can get more of those, that will be powerful.

The good thing with Indiegogo is that whatever money is raised the project gets. In Kickstarter you have to reach your goal or the project gets $0 of funding. I haven’t heard which model Medstartr has chosen to adopt.

We’re still in the early days of Crowdfunding. Plus, true crowdfunding (ie. small investment for small equity) is still waiting on the official rules to be put out. That could really change how companies get funded. I’m excited about the opportunity, but cautious about the challenge of getting enough people to care about healthcare enough to support those projects.

October 5, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Patient Relationship Management Taking on the Patient Portal and PHR

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The other day I had the chance to get a demo of Avado‘s PRM (Patient Relationship Management) system from Dave Chase. I’d seen a lot of the writings of Dave Chase throughout the internet. He’s been really smart to go after a number of really high profile tech blogs to get some good exposure for Avado. This isn’t a good strategy for a lot of healthcare IT companies, but it can work really well for the right ones. Either way, I was fascinated by many of Dave Chase’s writings and so I knew it would be an interesting experience.

Needless to say, Dave Chase and Avado are looking at the physician patient relationship quite different from many others. At some point, I may do a full write up of the Avado service, but I think this slide that Dave Chase showed me summed up the comprehensive way that Avado looks at the physician patient relationship. Take a look at the comparison of Avado with a patient portal (I wish PHR was included in the chart as well):

I love companies that look at situations in a really comprehensive manner. Avado seems to be a company that does that. I think it’s still early to know if Avado will be able to execute on this comprehensive approach, but I think it’s a good starting point. Many who have looked at patient portals and PHR software in the past probably wondered why many of the things listed in the chart above weren’t features of the portal or PHR.

I must admit, my next idea for this list is to take it and see how the various PHR and portals handle each of the items on the list. Considering the new emphasis on the patient portal thanks to meaningful use stage 2, physicians might want to give a little extra thought into what the patient portal they adopt is able to do.

May 8, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Health IT Twitter Roundup – Healthcare IT Company Edition

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As you know, every Sunday I like to round up some of the various tweets I’ve seen out there talking about EMR, EHR, Healthcare IT and related subjects. Some are funny. Some are insightful. Some are interesting. Some are awkward. Some are way out there. In fact, isn’t that the beauty and the beast of Twitter? It includes all of those things from anyone who wants to participate. The nice thing is that you can always ignore someone if you don’t like what they’re saying.

With that said, this week’s edition of my healthcare IT Twitter roundup is focused on comments and announcements from a number of healthcare IT companies. Hopefully you’ll find them interesting.


This article is written by Dave Chase. I had the chance to see a demo of his Avado product last week. I’ll do a full writeup on it at some point in the future. Let’s just say I was impressed with Dave and his view of the healthcare IT world. I’m not sure I agree that meaningful use 2.0 is about talking to patients. Sure, it cracks the door open a little bit, but doctors can easily shut it again.


This won’t be a surprise to those who work in the industry. Although, this was from a survey of professionals in healthcare IT. Doesn’t seem like the best methodology for making this conclusion.


I first learned about these services from Dell at HIMSS. I’d been meaning to write about them and just never have been able to fit it into my publishing schedule. Until I do, I think it’s interesting to note that Dell’s offering these clinical help desk services to hospitals.


I’ve been a fan of Practice Fusion’s culture ever since the “scrappy” part was exhibited by their PR person trying to get me to write about them on my site a number of years back. It’s been quite interesting to see the company evolve. In the past I described them as the most “silicon valley” startup EMR company out there. I’ll be interested to see what “silicon valley” path the company takes from here. Startup companies are a hobby of mine and so it will be quite interesting to see Practice Fusion evolve as they continue to grow the company. Considering the amount of funding they’ve taken on, they’re going to have to grow the company really big in order to provide their VC’s the required return. When you grow that big that fast it’s a challenge to keep the culture.

Full Disclosure: Practice Fusion is an advertiser on this website.

April 15, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.