AXOLOTL (OPTUMINSIGHT DATA · 2011-06-30 · HIE Study 2011 I 23 Vendor Briefs AXOLOTL...

VENDOR BRIEFS

AXOLOTL (OPTUMINSIGHT) DATA

CERNER DATA

ECLINICALWORKS DATA

EPIC DATA

GE HEALTHCARE DATA

MEDICITY DATA

MOBILEMD DATA

NEXTGEN DATA

ORION HEALTH DATA

RELAYHEALTH DATA

http://www.KLASresearch.com/klas/site/briefs/561ha12wg5.aspx










22 I HIE Study 2011 This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the retail price.

Vendor Briefs

HIE Study 2011 I 23

Vendor Briefs

AXOLOTL (OPTUMINSIGHT) ELYSIUM EXCHANGE With 14 live public HIEs (more than any other vendor) and 8 live private HIEs validated, Axolotl is one of the few vendors that can boast substantial penetration in both the public and private markets. They have been working in the HIE market since 1995, and when it comes to mindshare in the current HIE market, Axolotl is on the short list of vendors that providers consistently mention. In addition, Axolotl is one of the few HIE vendors actively pursuing opportunities in the public HIE market. Axolotl customers at public HIEs tend to be more satisfied than customers at private HIEs, as evidenced by the disparity in KLAS performance scores between the two groups—public HIEs give Axolotl an average score of 83.8, while private HIEs give them an average score of 76.4. Providers at public HIEs generally feel like they get what they expect from Axolotl and appreciate how engaged they are as a vendor. One CIO at a public HIE commented, “I worked with Axolotl to get everything up and running. I worked with their sales manager. He spent a lot of time going over what they could and, more importantly, what they couldn’t do by way of an HIE. I was very impressed and very comfortable with his honesty in telling me areas where they couldn’t help us. Axolotl worked very closely with us. As a vendor, they have my complete respect.” Some providers at private HIEs, meanwhile, feel like Axolotl hasn’t been able to deliver exactly what they need. One CIO commented, “I was very positive about Axolotl in its early years with us. . . . But we are seeing the product cracking at the seams because Axolotl has not been invested in getting things fixed or in hiring the staff that some of their competitors have.” In 2010, Axolotl was acquired by UnitedHealth Group/Ingenix. The acquisition so far has provoked mixed responses from Axolotl’s client base and providers in general. Some feel that the acquisition will give Axolotl badly needed resources to be able to address challenges with product development and expansion. Others are worried that so much patient data in the hands of a company that also owns a payer will lead to abuse of the data.

Number of Live HIEs

Claimed by Vendor

NA

Number of Live Public

HIEs Validated

14

Public HIEs Overall Score

83.8*

Number of Live Private

HIEs Validated

8

Private HIEs Overall Score

76.4*


Figure 6: Axolotl (OptumInsight): What information is currently being exchanged? (n=17)

Figure 7: Axolotl (OptumInsight): Which vendors provide the various components of your HIE?

13

79

10

12

1

7

11

11

2

2

43

1

1

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WellCentiveSiemensMultiple VendorsMirthInitiateHealthbridgeCernerSame as HIE

41%

65%

29%

94%

29%

100%

94%

100%

71%

100%

0%

20%

40%

60%

80%

100%

Average HIE Vendor

HIE Study 2011 I 25

Vendor Briefs

Figure 8: Axolotl (OptumInsight): In which areas is your HIE providing reports to Regulatory Agencies? (n=17)

29%

41%

35%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Immunization Registry Disease Registry/Population Health Bio Surveillance


CERNER HUB Cerner has made significant progress in the HIE market as of late, growing from 1 live public HIE validated by KLAS in 2009 to 2 live public HIEs and 21 live private HIEs validated in 2010. Although Cerner’s Hub solution works best when exchanging data between sites using Cerner EMRs, KLAS was able to validate that a handful of customers are using Hub, with technology provided by Certify Data Systems, to exchange data with non-Cerner EMR solutions. Providers report that Cerner provides knowledgeable implementation teams with deep clinical industry experience. One CIO commented, “We have the leadership from Cerner involved, and we are getting a lot of attention. We keep confusing ourselves on what connects where, and how quickly those connections are going to be up and running, and how to manage some of that, but Cerner has been great at thinking through some of those things with us.” However, a number of customers also report that the system has some reliability issues that need to be worked out and that they aren’t getting the help they need from Cerner to fix them. “We had some issues with information not going through the interface from PowerChart to Cerner Hub to PowerWorks. Cerner tested the problem out but didn't fix it. Now, several weeks later, we are talking to them about it and they are acting like they have never heard of the issue, even though it is all documented in the system. I think their resources must be stretched very thin.” Some providers also complain about nickel-and-diming and the cost of maintaining the system.

Number of Live HIEs

Claimed by Vendor

36


HIEs Validated

2


NA


HIEs Validated

21


70.8

HIE Study 2011 I 27

Vendor Briefs

Figure 9: Cerner: What information is currently being exchanged? (n=17)

Figure 10: Cerner: Which vendors provide the various components of your HIE?

10

812

3

6 2

1

11

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

McKessonCertified Data SystemsSame as HIE

12%

47%

12%

41%

88%

41%

59%

12%

41%

0%

20%

40%

60%

80%

100%

Average HIE Vendor


Figure 11: Cerner: In which areas is your HIE providing reports to Regulatory Agencies? (n=18)

11% 11%

17%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


HIE Study 2011 I 29

Vendor Briefs

ECLINICALWORKS

The strong presence of eClinicalWorks in the ambulatory EMR market has given them a solid base to help carry them over into the private HIE market. KLAS validated seven live private HIEs using the eClinicalWorks HIE solution, Electronic Health eXchange (eEHX), to exchange data. Of the HIE clients KLAS spoke with, 100% have eClinicalWorks as part of their long-term plans and would buy them again. Because eClinicalWorks is newer to HIE, their clients report experiencing some pains as the product matures, with early success hampered by a couple of rough, delayed implementations with poor training. Once live, clients describe the exchange as working well for data exchange between eClinicalWorks clients, with good interoperability and built-in alerts. One customer commented, “As poorly as the implementation went, eEHX does what it is supposed to do. I am hopeful that we will be better off as we are live longer.” Though commentary on eEHX’s functionality was generally positive, only 44% of respondents said the system has all the functionality they need, a lower percentage than any other HIE vendor rated in this study. In addition to sharing data between providers using the eClinicalWorks EMR, some customers reported connecting to other EMRs through the cloud, although they mentioned that eClinicalWorks has not yet created a direct bidirectional exchange with other EMR vendors. Providers also like the secure messaging piece and note that it is a fairly efficient solution once it is up and running. Note: eClinicalWorks had insufficient specialty data to chart 2011 results.

Number of Live HIEs

Claimed by Vendor

NA


HIEs Validated

0


NA


HIEs Validated

7


78.9*


EPIC CARE EVERYWHERE Epic’s HIE solution, Care Everywhere, offers clients the ability to exchange data with any Epic sites but does not yet allow most of them to exchange data with non-Epic sites. As a result, Epic’s solution is currently only used in private HIEs. KLAS has validated 26 private HIEs exchanging data using Epic’s solution. Clients using Care Everywhere report that it is a simple, easy-to-implement, and easy-to-use solution with high adoption. In addition, it is seen as a low-cost option since the application is typically already included in the price of the Epic EMR and there are no hosting fees. One executive commented, “To get Care Everywhere up and running, it was essentially a free service from a contract standpoint. . . .It ended up taking us about two weeks to implement Care Everywhere in the middle of a go live.” According to Epic’s estimates, once all pending Epic implementations are complete, over 30% of U.S. patient records will be available for exchange through Care Everywhere. In addition, Epic has announced that the ability to connect non-epic sites with Care Everywhere is in development. KLAS was able to validate one site in the early stages of using Care Everywhere to connect with non-Epic systems. Customers look forward to the expanded capabilities that this solution will bring in exchanging data with non-Epic organizations.

Number of Live HIEs

Claimed by Vendor

39


HIEs Validated

0


NA


HIEs Validated

26


84.3

HIE Study 2011 I 31

Vendor Briefs

Figure 12: Epic: What information is currently being exchanged? (n=14)

Figure 13: Epic: Which vendors provide the various components of your HIE?

128 11

9

105

1 1 1

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Homegrown

Covisint

Same as HIE

43%

71%

14%

93% 93%

79%

43%

79%

0%

20%

40%

60%

80%

100%

Average HIE Vendor


Figure 14: Epic: In which areas is your HIE providing reports to Regulatory Agencies? (n=14)

43%

29%

14%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


HIE Study 2011 I 33

Vendor Briefs

GE HEALTHCARE EHEALTH INFORMATION EXCHANGE GE Healthcare reportedly offers a vendor-agnostic, standards-based HIE solution. KLAS validated five live public HIE clients and three live private HIE clients using GE. GE is one of only five vendors with more than three live public HIEs. GE clients have so far given the product mixed reviews. The public HIEs have generally been pleased with GE’s engagement and service, while the private HIEs have noted more problems with GE not living up to expectations. Some clients from both groups feel the GE HIE solution is not as mature as GE led them to believe. One CIO mentioned, “We are disappointed that GE has not delivered the functionality that was promised. Every time we bring the matter up to the GE management, they push back and say they have met their contractual commitments. Apparently, the functionality we believe to be spelled out in the contract and what GE thinks the contract means are two different things.” However, GE is currently a market leader in CCD exchange, with clients reporting an average of 42% of their data being exchanged in CCD format.

Number of Live HIEs

Claimed by Vendor

8


HIEs Validated

5


NA


HIEs Validated

3


NA


Figure 15: GE Healthcare: What information is currently being exchanged? (n=6)

Figure 16: GE Healthcare: Which vendors provide the various components of your HIE?

17%

33%

50%

83%

50% 50%

33%

67%

0%

20%

40%

60%

80%

100%

Average HIE Vendor

5

2

5

3

4

1

1 11

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

NextGate

Homegrown

Same as HIE

HIE Study 2011 I 35

Vendor Briefs

Figure 17: GE Healthcare: In which areas is your HIE providing reports to Regulatory Agencies? (n=6)

33%

0% 0%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



MEDICITY NOVO GRID & MEDICITY PROACCESS Medicity is one of the best-known names in the HIE market and has deep penetration in private HIEs, with 33 live clients validated by KLAS. In addition, KLAS validated 5 live public HIEs using Medicity’s solutions, and Medicity is one of the few HIE vendors actively pursuing public HIE customers. Medicity currently offers two HIE solutions to the market: Novo Grid, which they completed a merger with in January 2009, and ProAccess. Providers indicate that Medicity is working to eventually merge the two products, but in the meantime some customers are using one of them and some are using both. KLAS currently monitors Novo Grid and ProAccess as two separate products. Novo Grid is being used by the bulk of Medicity’s private HIE clients. Providers report the solution is both easy to implement and easy to use. It is primarily used as a tool to push results out to participating clinics, and it can be delivered either through a type of portal/dropbox or directly through a clinic’s EMR, although most customers report using the dropbox. One challenge remaining for many Novo Grid customers is implementing bidirectional exchange of data as they look to go beyond simple results sharing. In addition, some customers feel that support for Novo Grid has dropped off since Medicity acquired the solution, and they express uncertainty about the future development road map. ProAccess is being used by all five of Medicity’s live public HIE clients and seven of their live private HIE clients. Customers note that ProAccess has more sophisticated functionality than Novo Grid, including the capability for bidirectional interfaces, although some mention that those interfaces can be a challenge. Many ProAccess customers describe a strong relationship with Medicity and strong implementations and training, but others feel that Medicity is struggling to keep up with customer needs for service and development. In 2010, Medicity was acquired by Aetna, a payer organization. As with the Ingenix/Axolotl acquisition, the move has so far provoked mixed responses from Medicity’s client base and providers in general, with some seeing it as an opportunity for a powerful combination of resources and data and others wary of how Aetna will use patient data.

Number of Live HIEs

Claimed by Vendor

111

Novo Grid/ ProAccess


HIEs Validated

0/ 5


NA/ NA


HIEs Validated

26/ 7


84.3/ 78.8*

HIE Study 2011 I 37

Vendor Briefs

Figure 18: Medicity: What information is currently being exchanged? (Novo Grid n=15; ProAccess n=9)

Figure 19: Medicity: Which vendors provide the various components of your HIE?

7%

27%

13%

53%

7%

100%

40%

80%

27%

80%

11%

33% 33%

89%

56%

78%

11%

67%

0%

20%

40%

60%

80%

100%Medicity Novo Grid

Medicity ProAccess

Average HIE Vendor

85

2

4

14 67

48

51

1

1

1

1

11

1

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

Me

dic

ity

No

vo G

rid

Me

dic

ity

Pro

Acc

ess

EMPI/Patient Record

CDR ElectronicData Exchange

Patient Consent/Privacy

Clinical Viewer and Data

Config. Tools

Personal Health Record

Lite EMR

Multiple VendorsMEDITECHeClinicalWorksCintexCernerSame as HIE


Figure 20: Medicity: In which areas is your HIE providing reports to Regulatory Agencies? (Novo Grid n=17; ProAccess n=8)

12%

18%

12%13% 13% 13%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Medicity Novo Grid Medicity ProAccess

HIE Study 2011 I 39

Vendor Briefs

MOBILEMD MobileMD has established itself as a mainstream player in the HIE market, with seven live private HIEs validated by KLAS—the second-highest private HIE total among vendors not associated with a CIS vendor. MobileMD’s recent growth is fairly remarkable given that KLAS validated only one live HIE using MobileMD in last year’s study. Customers consistently describe MobileMD as a vendor that is a pleasure to work with, noting professionalism and good communication from MobileMD’s support staff. Clients also note that MobileMD is very proactive in working to help them improve the solution and how it is being used. One provider commented, “Our relationship and interaction with MobileMD and their product are the best of any vendor we are working with. MobileMD has been exceptionally responsive to our needs to evolve as the needs of our community evolve.” Other customers echoed this sentiment. Providers also feel that MobileMD is particularly skilled at building interfaces into provider EMRs and that the system is very physician friendly. One CMIO remarked, “We use MobileMD for our connectivity to our physician practices, and we interface to practically all EMR vendors. . . . It takes literally one email from me to the MobileMD team to get another practice hooked up, and they take it from there to get it live.”

Number of Live HIEs

Claimed by Vendor

30


HIEs Validated

0


NA


HIEs Validated

7


94.5*


Figure 21: MobileMD: What information is currently being exchanged? (n=6)

Figure 22: MobileMD: Which vendors provide the various components of your HIE?

4

43

3

5

1

1

1 11

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Siemens

MEDITECH

McKesson

Homegrown

Same as HIE

33%

67%

33%

83%

17%

100%

67%

100%

50%

83%

0%

20%

40%

60%

80%

100%

Average HIE Vendor

HIE Study 2011 I 41

Vendor Briefs

Figure 23: MobileMD: In which areas is your HIE providing reports to Regulatory Agencies? (n=6)

33% 33% 33%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



NEXTGEN NextGen’s Health Information Exchange solution began as a portal solution that they are working to leverage into a full HIE. KLAS validated six live private HIEs that are using the NextGen solution. Clients describe using “template triggers” to select data from one EMR, including medications, allergies, diagnoses, and demographic data, and populating that data onto CCDs that they then send out to other NextGen sites. The solution itself is reported as fairly simple to use with good data exchange between NextGen sites. Although clients report struggles in exchanging data with providers not using the NextGen EMR, they note enthusiasm and high collaboration from NextGen as they try to make that happen. Some providers mention NextGen is building a CCD interface to try to reach non-NextGen providers, and others say that NextGen is working on a case-by-case basis. A number of respondents note struggles with physician adoption, saying their physicians dislike the NextGen portal and wish the documents flowed directly into the EMR. Some also mention slow implementations, while others describe NextGen as very proactive in trying to customize the solution according to customer needs. Note: NextGen had insufficient specialty data to chart 2011 results.

Number of Live HIEs

Claimed by Vendor

NA


HIEs Validated

0


NA


HIEs Validated

6


83.0*

HIE Study 2011 I 43

Vendor Briefs

ORION HEALTH Orion Health’s origins lie in the international market, where they have pioneered their HIE technology in a number of different countries. However, Orion Health has a large U.S. client base using their Rhapsody Integration Engine solution, and they now have a substantial footprint in the U.S. HIE market, with seven live public HIEs. Orion Health now trails only Axolotl in terms of live clients in the public HIE space. KLAS also validated one live private HIE using Orion Health’s solution. Customers report that the solution is easy to use and that Orion Health goes above and beyond to ensure that client needs are met. One CIO commented, “We had an issue, and they rolled right into action. Orion doesn’t get into finger-pointing debates. It is a very different dialogue with them, which makes Orion more productive to work with.” Orion Health’s solution delivers data to physicians primarily through a portal, but customers report that the portal retains patient context and can easily be accessed from within the EMR, which aids with physician adoption. Moving forward, Orion Health will likely continue to leverage their existing integration engine client base to expand their presence in the U.S. HIE market.

Number of Live HIEs

Claimed by Vendor

12


HIEs Validated

7


85.5*


HIEs Validated

1


NA


Figure 24: Orion Health: What information is currently being exchanged? (n=7)

Figure 25: Orion Health: Which vendors provide the various components of your HIE?

4

5 6

4

7

1

3

1

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Multiple VendorsInitiateHomegrownSame as HIE

71%

100%

29%

100%

86%

71%

86%

0%

20%

40%

60%

80%

100%

Average HIE Vendor

HIE Study 2011 I 45

Vendor Briefs

Figure 26: Orion Health: In which areas is your HIE providing reports to Regulatory Agencies? (n=7)

Insufficient data to chart.


RELAYHEALTH With 23 live private HIEs, RelayHealth is second only to Medicity in the number of live private HIEs validated by KLAS. Their growth from 8 live private HIEs validated in 2009 to 23 in 2010 is one of the largest increases in this study. In addition, KLAS validated one live public HIE using RelayHealth’s solution, although RelayHealth has indicated that their primary focus will remain on private HIEs. RelayHealth’s HIE solution is closely tied to their PHR and patient portal solutions, so much so that it is difficult for some providers to differentiate between where one ends and the other begins. They are one of the only HIE vendors that has a substantial portion of their customer base using their PHR and Lite EMR components. Providers report that RelayHealth is a proactive vendor partner that listens to customers and solicits feedback on how to improve the product. Clients are also generally pleased with the functionality of the RelayHealth solution as well as its look and feel, but some complain that RelayHealth’s level of support for the product is not where it should be. Several customers report that RelayHealth struggles to implement interfaces into provider EMRs, which can make physician adoption difficult. Some clients are particularly frustrated that RelayHealth does not interface well with McKesson solutions, since RelayHealth is owned by McKesson. One customer commented, “There are still some things I think the vendor is struggling with; [one of which] is just the integration with [McKesson] Practice Partner. [RelayHealth and Practice Partner] are both McKesson applications, but they don’t always connect well together.” A few customers also complain that RelayHealth oversold them on the capabilities of the product.

Number of Live HIEs

Claimed by Vendor

73


HIEs Validated

1


NA


HIEs Validated

23


79.0

HIE Study 2011 I 47

Vendor Briefs

Figure 27: RelayHealth: What information is currently being exchanged? (n=18)

Figure 28: RelayHealth: Which vendors provide the various components of your HIE?

14

6

15

12

15 13 6

1

2

3

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

McKesson

Cerner

Same as HIE

11%

39%

6%

56%

11%

100%

39%

83%

50%

61%

0%

20%

40%

60%

80%

100%

Average HIE Vendor


Figure 29: RelayHealth: In which areas is your HIE providing reports to Regulatory Agencies? (n=18)

11%

6% 6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


AXOLOTL (OPTUMINSIGHT DATA · 2011-06-30 · HIE Study 2011 I 23 Vendor Briefs AXOLOTL...

Documents

Transcript of AXOLOTL (OPTUMINSIGHT DATA · 2011-06-30 · HIE Study 2011 I 23 Vendor Briefs AXOLOTL...