Circle Square | HIT Trends | Page 1

HIT Trends

May 2015

H E A L T H I N F O R M A T I O N T E C H N O L O G Y

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The Ups and Downs in HITMay 2015

FHIR is hot. Fast Healthcare Interoperability Resources

(FHIR) is all over the HIT news. iHealthBeat has an Insight

article that helps demystify the emerging application

programming interface (API) standard that promises much

simpler and more flexible integration among apps and EMRs.

Epic and Cerner each have made announcements that highlight

the standard.

IBM Watson Health. Watson led the news last month

with its deals with Apple, Medtronic and J&J and acquisition of

Explorys and Phytel. Its deal-making continues this month with

a report on Watson working with 14 leading oncology centers.

Epic announces it will embed Watson in its decision support

apps and the Japanese postal service will use Watson to inform

a new care management service for the country’s elderly.

Medicare CCM. Medicare’s Chronic Care Management

(CCM) program generates $500 per year per enrolled patient for

physician practices that participate. This month Allscripts

announces a few deals that include its CCM product for small

practices. And CircleLink Health is partnering with

WellTrackONE on an innovative model that couples CCM and

services to provide an annual wellness visit that captures all the

data needed for the care plan and is reimbursed by Medicare.

From the publisher…

HIT and pharma. Pharmaceutical companies partner with

Sutter Health to help design and implement consumer apps that

support specific conditions of interest: Boehringer Ingelheim and

COPD; AstraZeneca and cardiometabolic care. IMS Health, a

Big Data supplier to pharma, buys an analytics company that

will help the industry get insights from its data. And a number of

pharmas are working on projects to accumulate DNA data on

individuals for drug discovery. Trialbee raises capital to assist

pharma in clinical trials.

Accelerate and sense. The technology accelerator

trend continues this month as ONC announces its inaugural

Market R&D Pilot Challenge grant winners and athenahealth

announces new More Disruption Please app companies. And

sensors are in the news. We cover a Forbes article on brain

sensing and a new monthly column in Nature on digital health.

Thanks for reading….

MichaelMichael Lake, Publisher, HIT Trends

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ContentsMay 2015

Electronic Health Records

Epic is the usability leader in hospital EMR with room for

improvement

AHRQ report recommends core functions for pediatric EHRs

IBM Watson Health will interoperate with Epic’s decision support

apps

Enterprise EMR update: Allscripts, Cerner, MEDITECH

Health Information Exchange

Fast Healthcare Interoperability Resources (FHIR) gets

momentum

Natural language processing (NLP) can support medication

reconciliation

Surescripts reports continued growth in its network, apps and

partners

Government and HIT

EHR incentives hit $30 billion

AHA and ATA release reports that help demystify telemedicine

issues

ONC awards $300K to six small businesses for digital health pilots

Update on HIT in China

Apple and IBM collaborate with Japan Post for vulnerable elderly

Care Communications

Athenahealth updates on its More Disruption Please accelerator

Brain sensors and digital health innovations in four segments

New series on digital health launches in Nature

CMS wellness and chronic care reimbursements drive innovative

model

Opportunity for mobile health: safety net providers need

resources

HIT innovations of note for life sciences companies

Healthcare Analytics

Most providers who use analytics apps get them from their EMR

vendor

Fourteen cancer centers will deploy IBM Watson Health services

Welltok buys Predilytics, a predictive analytics company

Evolent Health files to go public

Drug manufacturers embrace genomic analytics for drug

development

Ed. Note. Please click the blue arrows to get to specific sections. Also check out the live links to original

source documents by clicking the underlined grey text on the bottom right of each story page.

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Epic is the usability leader in hospital EMR with room for improvement

KLAS Research reports that Epic remains the clear

usability leader with consistent progress. See upper

chart at right. Analyst’s note lots of room for improvement.

Cerner is significantly more involved in usability

success than competitors. See lower chart at right.

Customers uniquely attribute their progress in usability most

directly to Cerner’s efforts.

Epic has a big lead in mobile functionality throughout

the enterprise. Almost every Epic customer (88%) reports

using mobile; nearest competitor, Allscripts is half that.

Here are the overall KLAS usability ratings (CPOE,

physician documentation, problem lists and clinical decision

support)

Epic (7.2)

Cerner (6.4)

Allscripts (6.3)

MEDITECH 6.0 (5.9)

Cerner Soarian via Siemens (5.6)

McKesson (5.0)

Source: KLAS Research

May 2015Electronic Health Records

Editorial. KLAS interviewed physician leaders (CMOs, CMIOs, and medical directors at over 100 organizations) about usability of their EMRs.

This is a report of progress over the last two years. There is some progress with Epic and Cerner doing best. Scores overal l can still improve.

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AHRQ report recommends core functions for pediatric EHRs

Source: AHRQ

May 2015Electronic Health Records

Editorial. There is consensus in the literature that healthcare for children require these eight specific functions to ensure EHRs can provide for

quality care. At the core are a child’s evolving physiology and maturity relative to health conditions. Researchers also find that these functions

will also likely improve healthcare for adults as well.

Efficient recording of vaccine

status, e.g., bar coding.

Clinical decision support:

forecasting and reminders.

Immunization status

assessments.

Format flexibility.

Support pediatric functions

in managing a clinical

subpopulation.

Clinical decision support

reminding clinicians to

assess for ADHD.

Enable default privacy

settings for adolescents.

Hold individual EHR items

as private and transmit

settings with information.

Special consideration for

patient portals and privacy.

Sensitivity to growth norms.

Flexible data formats.

Flexible growth charts.

Subpopulation-specific

growth charts.

Growth monitoring decision

support.

Easy sharing of family

member data and linkages.

Confidentiality updated when

children reach a certain age.

Make parental connections

with children transparent.

Templates appropriate for

well-child and sick visits.

Optimized procedures for

pediatric billing, e.g.,

frequently used lists.

Pre-visit questionnaires.

Age-specific documentation

support tools.

Visit summary: height,

weight, future guidance,

immunization and school

forms and info handouts.

Weight-based dosing

calculations and range-

based alerts.

Automated dose rounding.

Age correction and

adjustments for pre-term

infants.

VACCINESROUTINE HEALTH

MAINTENANCEFAMILY DYNAMICS PRIVACY

PEDS IN VULNERABLE

POPULATIONSMEDICATIONS

DOCUMENTATION AND

BILLING

PEDS NORMS AND

GROWTH CHARTS

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IBM Watson Health will interoperate with Epic’s decision support apps

IBM Watson Health will integrate its cloud-based

cognitive computing capabilities of Watson to Epic’s

EHR for clinicians within their workflows.

Providers will share patient data in real-time at get

back the most relevant clinical evidence impacting a

patient’s specific medical situation. Watson can analyze

medical literature and clinical case studies in real-time to present

therapeutic alternatives.

Epic will embed Watson’s functions into its decision

support solutions. Via its open API using HL7 FHIR, an

emerging open high level standard.

Mayo Clinic will be implementing Epic solutions and

is already working with Watson Health on oncology

solutions.

Source: IBM; HL7 FHIR; Watson Health

May 2015Electronic Health Records

Editorial. Here’s a glimpse into the future as Epic and IBM take first steps toward enhancing clinical decision support with most relevant

clinical advice in real-time and within a physician’s workflow. Physicians are likely to see value out of the convenience of the analysis.

Epic is important here because of its scale with 350 customers and 80 million records exchanged in the last year. IBM and Epic are

partners in the bid for the EMR at the Department of Defense due to be announced in June 2015. Interoperability is a central issue in the

selection process.

COLLABORATES WITH

AND

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Enterprise EMR update: Allscripts, Cerner, MEDITECH

Source: Allscripts (CCM); (PAS); Cerner; MEDITECH; SMART

May 2015Electronic Health Records

Editorial. The Allscripts CCM program is significant. Expect to see more EHRs sign up practices. Allscripts and MEDITECH had wins in the UK.

The EU is attracting more interest from US enterprise EMR vendors. MEDITECH contracts for its new Web Ambulatory EHR demonstrates positive

momentum in linking the practices into the enterprise. Integration is a key value in the market. The other key value is interoperability. Cerner

announces a partnership with Geisinger and xG Health supporting Fast Healthcare Interoperability Resources (FHIR) and demonstrates how apps

can be integrated. It’s significant that it’s Geisinger and xG Health because they are long term Epic users, implementers and analysts. The DoD

opportunity as well as market-shifting values are driving this interoperability activity.

Allscripts launches its chronic care

management (CCM) program with

two customers

CareMore Nevada

CFP Physicians Group, Florida

Four additional independent

practices are implementing ACO

services that likely include CCM

Allscripts expands its Patient

Administration System adoption in

the UK with two customers

East Kent Hospitals University

NHS Foundation Trust

Maidstone and Turnbridge Wells

NHS Trust

MEDITECH signed new agreements

for its Web Ambulatory EHR.

Henry Mayo Newhall Hospital

Good Shepherd Community

Hospital

HMC Hawaii Pacific Oncology

Center

Magnolia Regional Health Center

Galway Clinic, Ireland, is the first

MEDITECH 6.1 EHR customer in

Europe.

Cerner, Geisinger Health System

and xG Health Solutions will use

SMART® on FHIR® to integrate xG

Health’s apps to Cerner’s FHIR-

compliant Millennium EHR.

The first app focuses on graphical

views for managing the

rheumatology encounter.

xG Health expects to launch EnrG |

Rheum Summer 2015 and available

via the Cerner Store.

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Fast Healthcare Interoperability Resources (FHIR) gets momentum

FHIR, a new standards framework from HL7, is

getting industry traction. FHIR uses snippets of data to

represent clinical entities so third party apps can just plug-in to

EHRs without custom interfaces.

Argonaut is a coalition of 40 EHR vendors

working on FHIR that include:

Source: iHealthBeat; Argonaut; SMART

May 2015Health Information Exchange

Editorial. The stars are aligning for relatively rapid adoption of FHIR by vendors. Ken Terry, one of the industry’s top journalists, develops this

Insight report for iHealthBeat. He pulls together ideas from David McCallie, Jr., SVP at Cerner, Aneesh Chopra, former US CTO, and Tee

Green, CEO at Greenway. One driver, according to McCallie, is that vendors sense the government is ready to step in. Chopra argues the key

is the consumer; and that the industry will still face resistance to collaboration. Green, although not part of Argonaut, is supporting FHIR.

The FHIR Train is Leaving the Station

athenahealth

Cerner

Epic

GE

McKesson

Meditech

NextGen

Practice Fusion

FHIR is often paired with SMART, a web-based

graphical interface to FHIR designed at Boston

Children’s and Harvard. App developers writing to

SMART on FHIR specs can connect to any supporting EMR.

The 16 data elements in HL7 CCDA, the current

standard, translate into 12 FHIR profiles. FHIR

allows simpler transactions, for example, requesting single

elements as options.

Fast Health Interoperability Resources

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Natural language processing (NLP) can support medication reconciliation

A study using patient records from Cincinnati

Children’s Complex Care Center finds promising

results using machine learning and NLP

technologies for medication reconciliation.

Researchers reconciled free-text clinical notes

(unstructured data) and discharge prescription

lists (structured data) using algorithms.

The algorithm did well in medication entity

detection, attribute linkage and medication

matching. See data excepts at right.

While more work is needed to reduce false

negatives and increase recall in identifying some

errors, authors suggest impact when moved to

production will be significant.

Source: BMC

May 2015Health Information Exchange

Editorial. Machine learning and natural language processing are increasingly being utilized to capturing additional values contained in clinical

notes. Here’s an example of how NLP can reach into free-text clinical notes and find medications and compare them against other parts of a

patient’s record to ensure quality. Companies that are working on NLP in healthcare include: Apixio, Clinical Architecture, Clinithink, Health

Fidelity, Hiteks, Nuance, QPID Health, SyTrue and others.

1

2

A medication documented in the

overview note but were missed in

the discharge prescription list

A medication that had inconsistent

amount between the clinical note

and the discharge prescription list

Complex Care Center

Excerpts from the documentation

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Surescripts reports continued growth in its network, apps and partners

Network connections.

900,000 healthcare professionals serving

230,000,000 patients

3,300 hospitals and 61,000 pharmacies

700 EHRs and 32 HIEs

Electronic prescribing.

1.2 billion electronic prescriptions; 67% new

56% of total prescribers utilizing

Clinical messaging. 7.4 million messages; 974 hospitals;

160,000 provider addresses.

Medication history. 764 million transactions with 80%-

85% patient data coverage

Electronic prescribing of controlled substances. 1.6

million transactions; 73% pharmacies enabled yet few

providers.

Source: Surescripts (Progress Report); (PDR Collaboration)

May 2015Health Information Exchange

Editorial. Surescripts continues the growth of its network and its applications. The PDR collaboration confirms leadership in prior auth services.

Its 6.5B transactions is more than AmEx (6B) or PayPal (4.2B).

PDR provides drug information, prescriber

communications and behavior-based patient and

consumer health information.

Surescripts brings its network and CompletEPA

product; PDR brings an extensive library of EPA

forms.

Features of the Surescripts CompletEPA service:

Prior authorizations automatically routed to health

plan

Real-time health plan responses delivered to the

EHR

Forms auto-populated with patient demographics

Only relevant questions required

Fully electronic (no faxes or portals)

EHR integration

2014 National Progress Report

highlights 6.5 billion transactions

Surescripts and PDR collaborate on an

electronic prior authorization platform

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EHR incentives hit $30 billion

Source: CMS; Healthcare IT News

May 2015Government and HIT

Editorial. CMS has paid out more than $30 billion in EHR incentive payments to hospitals and providers who have attested to meaningful use as

of March 2015. Epic accounts for 186,000 of total meaningful use attestations; Cerner has120,331; Allscripts with 99,091 to date.

Meaningful Use Attestations by Vendor

Meaningful Use Attestations by Year

Meaningful Use Incentives Paid Total

Num

ber

of A

ttesta

tions

Num

ber

of A

ttesta

tions

2011 2012 2013 2014

400K

300K

200K

100K

0

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AHA and ATA release reports that help demystify telemedicine issues

Source: AHA Report; ATA Report; Modern Healthcare

May 2015Government and HIT

Editorial. The AHA report was authored by two attorneys from EBG Law (16 pages). The ATA report is 98 pages and includes an extensive

reference section. Both include easy to understand maps showing state by state issues and are linked lower right. Additionally this month, AL

and MN joined the Federation of State Medical Board’s interstate compact creating a quorum to facilitate physician licensing across state lines.

AHA released a report that focuses on the legal and

regulatory challenges in telehealth for providers in

these areas:

Coverage and payment

Health professional licensure

Credentialing and privileging

Online prescribing

Medical malpractice and professional liability

insurance

Privacy and security

Fraud and abuse

Some federal and state laws and regs are also aimed

at giving more flexibility and access to telehealth via

Medicare and Medicaid programs.

ATA released a report that focuses on the policy

landscape of 50 states with 50 different telemedicine

policies and answers these two questions:

How does my state compare regarding policies that

promote telemedicine adoption?

What should my state do to improve policies that promote

telemedicine adoption?

It uses a 13 variable analysis to grade each state:

States with top grades include: ME, VT, VA, DC, TN, NM

States with failing grades include: CT and RI

The analysis of each state includes: Payer parity, Medicaid

service coverage and conditions of payment; and innovative

payment or service delivery models.

Realizing the Promise of

Telehealth: Understanding Legal

and Regulatory Challenges

Fifty State Telemedicine Gap

Analysis: Coverage and

Reimbursement

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ONC awards $300K to six small businesses for digital health pilots

Tracks patients and visualizes critical

tasks to be completed by providers

The pilot with Lowell General Hospital will test

CoordinationBox’s efficacy in coordinating

care and engaging patients during surgical

episodes.

My Care Communicator engages

patients in diverse populations

MHP Salud will pilot the solution in the Texas

Rio Grande Valley to enhance the impact of

its Community Health Worker programming in

the areas of diabetes prevention and

breastfeeding.

CareTRx simplifies asthma and COPD

management via remote monitoring

Boston Children’s Hospital will evaluate the

effectiveness of CareTRx on asthma self-

management among urban school children

compared to traditional self-management

practices.

Optima4BP provides personalized Rx

recommendations for hypertension

The pilot with UCSF Cardiology will evaluate

the efficacy of Optima4BP in improving care

coordination for patients with uncontrolled

hypertension.

Personalized analytics for physiology

data compared to a baseline

The pilot with Henry Ford Health System will

evaluate physIQ’s platform’s ability to reduce

hospital readmissions for heart failure and

COPD patients.

Connects senior populations to

preventive and care management

The pilot with Dominican Sisters Family Health

Service will test STATS’ efficacy in increasing

access to primary and secondary prevention

services.

Source: HealthIT Buzz

May 2015Government and HIT

Editorial. ONC announces its inaugural Market R&D Pilot Challenge grant winners. Each will test new HIT apps in healthcare settings in collaboration

with their provider organization partners, beginning in August. The focus is on improving consumer engagement and care coordination. ONC reviewed

78 host-innovator applications to the challenge. Health 2.0 facilitated the process. Note: more information about each company is linked to the logos.

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Update on HIT in China

Alibaba is rolling out a three-hour delivery service for

healthcare goods in five cities growing to nineteen this

year. It works through five pharmacy chains that sell on Alibaba’s

Tmall.com website

The Ji Su Da service (fast delivery) links consumers to the closest

of 1500 drugstores

Cainiao is the logistics partner that picks up and delivers the order

It is piloting a mobile service for prescriptions: Customers upload a photo of their prescription and get price bids

from nearby retail pharmacies

They pay through Alibaba’s mobile payment system, AliPay, and

the medication is delivered to their door

Tencent invested $70M into China’s largest medical

website (Dingxiangyuan) and $100M into appointment

scheduling in hospitals (Guahaowang).

Baidu also provides appointment scheduling. It provides

mobile health monitoring, analyzing and advising to consumers in

Beijing.

Source: The Diplomat; Reuters; Want China Times

May 2015Government and HIT

Editorial. Alibaba is 24% owned by Yahoo and 36% owned by Softbank. Its recent market moves are an attempt to disrupt the prescription

market which is dominated by hospitals. The mobile digital health segment is predicted to hit $2B in 2017 growing at 70% a year.

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Apple and IBM collaborate with Japan Post for vulnerable elderly

Japan Post Holdings is deploying IBM’s data

analytics technology and Apple’s devices to

improve care for elderly Japanese as the

population ages. JP Holdings is Japan’s state-owned

financial and postal services organization.

Japan Post provides a service to visit the

elderly on behalf of family members.

Apple will provide its devices to collect

information on senior citizens that will be

analyzed by IBM Watson Health analytics

services.

Japan Post will develop the software to run on

the Apple iPads and will begin testing with

1000 citizens in October 2015. The program will

also support shopping and other health care functions.

Source: Japan Times; JP Holdings

May 2015Government and HIT

Editorial. Japan Post is positioning for an IPO later this year. It’s wanting to leverage its vast network of post offices for other business uses to

generate additional revenue streams. Apple is looking to sell more iPads as sales slump. And IBM is aggressively pursuing opportunities to

generate revenue from its large Watson Health investment. Japan has one of the world’s eldest populations. It will lead the way for many

modern economies where eldercare is moving higher on national agendas.

CEOs at Apple, Japan Post, IBM (left to

right) make the announcement

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Athenahealth updates on its More Disruption Please accelerator

Source: athenahealth; MobiHealth

May 2015Care Communications

Connects clinical teams and their

patients between visits

Patients can upload photos and videos.

Care teams collaboratively tag patient records

and get alerts when patients enter new info.

Company management with significant tech

user experience design expertise.

Stores personal health info for retrieval

in an emergency using QR codes

Founded in 2011 with funding from Kleiner.

Available in Northern California in 2012.

After entering medical info, consumers are

mailed Lifesquare stickers that may be

scanned by emergency personnel.

Small physician practice customer

marketing platform

Helps small practices acquire patients,

manage online reputation, communicate with

patients and measure practice performance.

Company reports a 78% rise in search engine

rankings and a 5X ROI for customers.

Announcing new companies in San Francisco

Update on existing companies in Boston

Smart Scheduling product predicts

patient no-shows and late cancels

Machine learning and predictive advises of

potential for scheduling issues.

In use in hospitals (Martin’s Point) and got

seed funding from Rock Health.

Tracks physician credentials and

automates verification for providers

Founded in 2013 with seed funding from

Blueprint Health.

Other investors include Primary Venture

Partners, Bovary Capital and Tigerlabs.

Connects primary care providers to

remote specialists for e-consults

Clinician requests specialist input; assigned

specialist shares e-consult within hours.

Investors include Blueprint Health and Center

for Primary Care at Harvard.

Editorial. Companies get seed funding, free office space, mentorship and access to athenahealth’s network of 64,000 providers. Athenahealth will open

a new MDP location in Austin. It looks for companies who have a product that is ready to scale via access to its provider customers. Click on the logos

for more information about each company.

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Brain sensors and digital health innovations in four segments

Source: Forbes; Note: click the logos for more info about each company

May 2015Care Communications

Memory Support is currently one of the most popular

segments. Lumosity, which specializes in brain training

the participants with interactive games on one’s desktop

or smart device, is a good example. These types of

products are collaborative and fun methods to track and

compare scores of recall and other cognitive skill games.

The Disorder Support segment is also significant in

healthcare as EEG feedback can be used to control

prosthetics or move a wheelchair with brain-computer

interfaces. Researchers at University of Houston are

building bionic hands for amputees that are controlled by

brain signals.

Healthcare is one of the most promising areas for brain

wearables. Companies offer devices that assist in

monitoring EEG waves to assess individual emotional

states and assist in changing them. Thync is a good

example. It uses neuro-signaling to either stimulate or

calm the brain without the use of drugs.

Environment Interaction is one of the more futuristic

segments and EMOTIVE is a good example. It has

products that can be used in a variety of scenarios from

controlling a video game to monitoring performance

such as anxiety, focus or stress levels. Tasks are

completed using EEG waves and facial expressions.

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New series on digital health launches in Nature

Continuous and remote monitoring. Tracking and analysis of data gathered longitudinally

reveals new patterns of markers that open up new lines of

investigation for researchers

Continuous monitoring and prevention tools mediated

through digital devices blurring lines between diagnosis and

monitoring encouraging earlier interventions.

Examples cited include AliveCor (ECG), Kinsa

(thermometer) and Sanofi’s iBGStar (glucose monitor)

The digital phenotype. Digital biomarkers, when combined with personal omics

enables more comprehensive disease modeling

Alzheimer’s research is an example where digital tools

broaden the biometric profile and ability to detect disease

An example is Ginger.io which captures data about a user’s

phone usage detecting signs of depression

Remote disease management. Omada Health digital

programs are guided by online coaches encouraging compliance;

Propeller Health uses a sensor attached to an inhaler to guide use;

Empatica monitors brain activity to help manage epileptic seizures.

Source: Nature; PureTech

May 2015Care Communications

Editorial. Executives at PureTech, a healthcare innovations company, have launched a monthly column at Nature covering digital health. We are

including excepts and summaries from three themes from its inaugural article and will check back in occasionally to keep our readers up to date.

Physiological data types and

companies marketing

wearable sensors

Three themes from the inaugural article

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CMS wellness and chronic care reimbursements drive innovative model

Source: CircleLink Health; WellTrackONE

May 2015Care Communications

Editorial. This idea is likely to get market attention. The combined reimbursements of around $700 per patient per year should be enough to

provide incentives to physician practices with high Medicare populations and a return to service providers. One added benefi t to this approach

is that it generates enough data in the wellness visit to drive a care plan. WellTrackONE clinicians provide the wellness visits in the physician’s

offices. CircleLink has experience in care management for disadvantaged populations via mobile phones.

Annual Wellness Visit and

Chronic Care Management

CircleLink Health and WellTrackONE are launching an

integrated solution for providers to support new

Medicare reimbursement opportunities.

The service integrates annual wellness visits (AWV)

and chronic care management (CCM) services for a

practice’s Medicare population. AWV: $125-$200 per patient per year

CCM: $500 per patient per year

Patient assessment data collected at the wellness visit

drives a personalized care plan that is monitored

continuously for gaps and alerts.

CircleLink Health has been providing chronic care

management services through mobile phones since

2010. Customers have included Johns Hopkins, Tulane, Montefiore,

Henry Ford, Emory, University of Maryland, Vanderbilt and UPMC.

WellTrackONE provides the initial and follow-up

wellness visits that feed the CCM services.

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Opportunity for mobile health: safety net providers need resources

The Commonwealth Fund survey (2013), focused on

the desire for, current use of, and barriers to cell phone

apps in clinical care in underserved areas.

Most want to use mobile for patient engagement for

chronic and preventive care and wellness programs,

but most are focused on appointment reminders. See

charts above.

Source: Commonwealth Fund

May 2015Care Communications

Editorial. EMR adoption in the safety net has been closing the technology gap in recent reports, but not yet in the use of mobile and cell phones in

particular for patient engagement. Texting and other mobile apps are proving to be impactful for health and likely would del iver a good return to

state health agencies and other payers. While EMR vendors have some capabilities in this area, perhaps niche companies focused on mobile and

cellular applications also have a role to play. By satisfying this segment, vendors have a path to international applications of the service as well.

Desired areas for patient engagement Current area of interventions using cell phones

Mobile Health and Patient Engagement in the Safety Net:

A Survey of Community Health Centers and Clinics

Just 27% used mobile in care delivery. And most of these

(62%) get the functions from their EMR vendor.

There are barriers to overcome. Two most cited:

Lack of external funding

Limited human and technical resources to support the

implementation

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HIT innovations of note for life sciences companies

Source: Sutter; IMS; Trialbee

May 2015Care Communications

Editorial. Sutter Health in Northern California has been a pioneer in HIT. It has been deploying Epic throughout the enterprise. I expect we’ll see

more life sciences company partner with health systems around specific conditions of interest looking for condition-specific innovations in digital

health to complement respective drug therapies. IMS Health makes a smart acquisition that should benefit its life sciences clients. Dataline’s

visual analytics will add value to its offering for RWE analytics. And Swedish Trialbee gets investment to expand its services in Europe and rollout

in the US.

Boeringer Ingelheim and Sutter

Health collaborate on a five-year

project to test the impact on care

beginning with COPD.

Tablet or kiosk-based data

collection by patient during every

encounter

Visually display clinical and

patient reported data for

communications and shared

decision making

Sutter and AstraZeneca will

collaborate on a three-year project to

leverage new technology for

cardiometabolic care.

Trialbee raises $5M series A round

by Industrifonden and Briban Invest. Total capital raised since 2010 founding is

$8.4M.

Trialbee provides a patient-centered

cloud-based platform for recruiting

patients to clinical trials. There are

11K industry sponsored clinical trials

recruiting patients; 80% will fail to meet

targets due to recruitment challenges.

The company is a 2015 Red Herring

Europe Top 100 company.

IMS Health has acquired Dataline

Software, a UK-based healthcare

analytics solution provider.

Dataline enables new features in

IMS Evidence 360™ real-world

evidence platform.

Dataline patented algorithm

enhances search of EMR

datasets

Dataline resources improve the

platform’s clinical trial research

and operations applications

Dataline visualization enhance

usability of insights

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Most providers who use analytics apps get them from their EMR vendor

HIMSS Analytics released a few data points

from its provider survey on clinical and

business intelligence solutions.

Adoption of these solutions by healthcare

organizations increased from 46% to 52%, up

17% in two years.

Of the 52% who have adopted solutions, 54%

report using their EHR for analytics.

Of those that haven’t yet adopted, 51%

remain unsure about future plans to invest in

clinical and business intelligence tools.

The healthcare organizations’ focus has

changed from accountable care to population

health over the last two years.

HIMSS Analytics reviewed their internal data

and polled 189 healthcare organization execs.

Source: iHealthBeat; HIMSS Analytics

May 2015Healthcare Analytics

Editorial. This analysis maps to the findings of other industry analysts who are assessing healthcare analytics. There’s been modest growth

over the last couple of years, but healthcare organizations use of these technologies remains relatively immature. In a recent KLAS Research

report on the segment, it found three active segments: cross industry (Oracle, Qlik), large EMR (Epic, Cerner) and healthcare niche (Health

Catalyst, Advisory Board).

HIMSS Analytics maturity model for analytics use

Circle Square | HIT Trends | Page 23

Fourteen cancer centers will deploy IBM Watson Health services

Cancer centers will apply Watson's cognitive capabilities

to translate DNA insights to personalize treatment

options in minutes.

Watson Genomic Analytics services aid clinicians

evaluate a specific patient’s case by presenting relevant

drug options alongside literature references.

The work is applicable to all types of cancer. Including:

lymphoma, melanoma, pancreatic, ovarian, brain, lung, breast and

colorectal cancer.

Here are the cancer centers with more expected later

this year:

Source: IBM; Watson Health

May 2015Healthcare Analytics

Editorial. It’s the speed of Watson analysis that makes this

viable in the workflow. Clinicians can use the results of the

analysis in personalizing cancer treatments, particularly when

patients are unresponsive to the standard protocols. The

genomic analysis technology looks for variations in the full

human genome and presents best evidence from the literature

and associated drug therapies for clinician evaluation.

Ann & Robert H Lurie

Children’s Hospital of

Chicago

BC Cancer Agency

City of Hope

Cleveland Clinic

Duke Cancer Institute

Fred & Pamela Buffett

Cancer Center in Omaha,

Nebraska

McDonnell Genome Institute

at Washington University in

St. Louis

New York Genome Center

Sanford Health

University of Kansas Cancer

Center

University of North Carolina

Lineberger Cancer Center

University of Southern

California Center for Applied

Molecular Medicine

University of Washington

Medical Center

Yale Cancer Center

Circle Square | HIT Trends | Page 24

Welltok buys Predilytics, a predictive analytics company

Welltok, a wellness and condition management company

serving large employers and health plans, acquired

Predilytics, a healthcare analytics company.

Welltok provides its CaféWell services to a million people

on behalf of 20 customers including: IBM, Aetna, Centura Health,

Cigna, Colorado, Coventry, Community Health Plan of WA, BCBS,

UnitedHealthcare.

Welltok’s CaféWell Health Optimization Platform includes:

CaféWell Core builds a personal health itinerary

CaféWell Rewards for incentives

CaféWell Connect integrates dozens of health devices and apps

CaféWell Concierge personalizes via IBM Watson

Predilytics, founded in 2011, uses its big data approach to

identify who is most likely to respond to offers and services.

It had raised $20 million in venture funds from Qualcomm, Google and

Flybridge.

Predilytics has curated and analyzed data for 250 million

consumers using 1,600 different variables.

Source: Welltok; Forbes

May 2015Healthcare Analytics

Editorial. Welltok makes an important acquisition that brings unique predictive analytics about consumer behavior to its platform. It competes

with Keas, Limeade and Rally Health (UnitedHealthcare). It has raised over $90 million to date and has pioneered the IBM Watson work.

ACQUIRES

Circle Square | HIT Trends | Page 25

Evolent Health files to go public

Evolent Health has filed to raise $100-$150 million in

public funds via an Initial Public Offering of stock. Evolent was formed in 2011 by UPMC Health Plan and The Advisory

Board and has previously raised $124 million.

Evolent provides technology and services that enable

providers to transition to value-based payment models. Strategy and performance consulting; population health technology

(Identifi); clinical and operational capabilities; go-to-market strategy.

It reports 10 long-term contracts with customers, four of

which make up 76% of its 2014 revenues of $100M:

Indiana University Health (25%)

WakeMed Health and Hospitals (21%)

Piedmont WellStar Health Plan (16%)

Premier Health Partners (14%)

Senior management from UPMC and The Advisory

Board lead the company. Currently 836 employees.

The company estimates the market at $10B growing to

$46B by 2020, based on health insurance spending.

Source: S1; Evolent Health

May 2015Healthcare Analytics

Editorial. There’s been an uptick in health technology IPOs and filings in a favorable stock market. While there’s some risk here, as a lways, to

investors because it’s an early adopter market so far for Evolent services, I like the thinking that it’s going to take a lot of resources to compete.

It’s possible to get a consumer-centric app going with a few million dollars; not so with enterprise platforms. It will also take technology plus

expertise in healthcare operations. Evolent brings both.

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM S-1

REGISTRATION STATEMENT

UNDER

THE SECURITIES ACT OF 1933

Evolent Health, Inc.(Exact Name of Registrant as Specified in Its Charter)

Circle Square | HIT Trends | Page 26

Drug manufacturers embrace genomic analytics for drug development

Pharma companies are building up repositories of

human DNA to shorten the time to develop drugs. Researchers use the data to identify rare genetic mutations.

The cost of the genetic sequencing has dropped by

more than 10X in five years to $1,500.

Regeneron partnered with Geisinger last year to sequence

partial genomes of 250,000 volunteers

Pfizer, Roche and Biogen are conducting similar projects for

new drugs and predicting side effects

US 2016 federal budget asks for funds to build a

genetics database of a million volunteers.

Other efforts include:

Amgen bought Decode Genetics (2012) in part for its genetic

database of 2,600 Icelanders

Genentech partnered with Genomic Medicine on a large

sequencing project

23andMe inked deals with Pfizer and Genentech for access

to its patient data for Lupus and Parkinson’s respectively.

Biogen formed a $30 million research alliance with Columbia

University’s sequencing center

Source: Reuters

May 2015Healthcare Analytics

Editorial. Reuters reports this uptick in DNA analytics by pharma is driven by lower costs, but also by successful research. Regeneron says

they learned a lot about treatments for high cholesterol. Pfizer has had success in the approach for lung cancer treatment and Vertex for cystic

fibrosis. Amgen has had success in understanding more about Alzheimer’s, diabetes and atrial fibrillation. Regeneron is also working on

genetic implications of obesity in children

Circle Square | HIT Trends | Page 27

HIT Trends © 2015 Circle Square Inc.Michael Lake | Publisher | www.circlesquareinc.com

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