The Internet of Things (IoT): A consolidated market definition

A market segment, which contains the word 'things' is evidently going to become prone to a variety of interpretations and this is definitely the case with the Internet of Things (IoT.) Nevertheless, the market for IoT in healthcare has been forecasted to reach a very significant market size, for instance $117b by 2020 according to Mind Commerce. For such an influential trend, there is widespread confusion around what this term actually means and what it includes.

For this reason, this blog post will attempt to consolidate three basic definitions into one with an aim to encompass the majority of potential aspects of IoT. It's important to note that there are much deeper descriptions behind these but we're looking for the core sentence that summarize what the market actually is.

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Horses for Sources (HfS)
HfS defines IoT as: 'The association of data to a physical device and the delivery of this data from that device to a centralized repository for further processing.'

This description focuses on the data and how it is managed and processed with the physical devices simply being the enabler of the market. With this in mind, vendors who have strong capabilities in data management are likely to score highly in HfS's estimations.
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Gartner
Gartner defines IoT as: 'The network of physical objects that contain embedded technology to communicate and sense or interact with their internal states or the external environment.'

Gartner's definition focuses a lot more heavily on the devices and does not feature the word 'data' at all although it is definitely implied. Gartner also uses additional vocabulary in 'sense' and 'interact'. It's important to note that sensors, especially within the healthcare market are an integral part of IoT as they not only facilitate data transfer but in a lot of cases, they carry it out proactively.
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IDC
IDC defines IoT as: 'a network of networks of uniquely identifiable endpoints (or "things") that communicate without human interaction using IP connectivity — whether locally or globally.'

Following on from the point I made above about sensors carrying out data transfer proactively, IDC's definition highlights that IoT does not require human interaction. This aspect will provoke one of two reactions: 1) 'Fantastic, without human interaction means streamlined processes and the ability to focus our efforts on end users', or 2) 'Hmm, I'm not sure I trust endpoints communicating without human interaction.' Whilst IoT has a multitude of benefits, concerns over security must be addressed.
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Each of these definitions have their own merits and by no means are any of them wrong. At this point, I would like to propose an amalgamation of these definitions and include a nod to security, which I personally believe is critical to include for successful client interactions on an enterprise level. 

My definition would be: 'The secure communication of data which occurs between a network of endpoints and centralized repositories via IP connectivity for further processing.'

This blog post may seem trivial in nature but it is this lack of standard definition that is leading to a lack of standards. This lack of standards then naturally leads onto security concerns, which is the number one barrier to IoT adoption across all vertical industries.

What do you think? Do you agree with these definitions? Do you see a light at the end of the tunnel as it pertains to global standards for IoT? Please feel free to comment below and share on social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Aria Systems, Healthcare: A $117B opportunity for the Internet of Things, Healthcare: A $117B opportunity for the Internet of Things - See more at: https://www.ariasystems.com/blog/healthcare-a-117b-opportunity-for-the-internet-of-things/#sthash.YR2SaIEg.dpuf
2. Horses for Sources, Harman, Tech Mahindra, IBM, Accenture and Atos leading the Internet of Things phenomenon, 3rd Oct, 2015, http://www.horsesforsources.com/hfs-iot-blueprint_100315
3. Gartner, Internet of Things, http://www.gartner.com/it-glossary/internet-of-things/
4. IDC, IDC Market in a Minute: Internet of Things, http://www.idc.com/downloads/idc_market_in_a_minute_iot_infographic.pdf

Blockchain in Healthcare: Competition Winners

Following on from last week's blog post about how Blockchain is being used in healthcare, this week I wanted to focus on some of the vendors who have won competitions with their use cases which in turn, raise the profile of Blockchain in general. Despite the prize money being relatively insignificant, the real prize is exposure to potential partners who could bring these ideas to their established client bases. This blog post will look at two Blockchain startups who have won prizes for their ideas as well as startups to keep on the radar.

MedVault
MedVault very recently won a Blockchain Hackathon competition held in Ireland. MedVault's proof-of-concept centered on the use of Blockchain to store medical records whilst preserving anonymity. This would then leverage the technology of a fellow startup Colu to avoid bloating the Blockchain. As we saw from my last blog post, similar projects are being developed by the likes of Factom and BitHealth. 

In my personal opinion, this is going to be the most widely marketed use case within the healthcare market as data security is a key concern within the industry. Another very important point to note is that this competition was sponsored by Fidelity Investments, Citi and Deloitte. Partnering a consulting giant such as Deloitte with a startup in this field could prove fruitful so this is definitely one to watch.

Tierion
In September, a team led by Tierion CEO Wayne Vaughan, won the Consensus 2015 Makeathon competition. Tierion's team consisted of members from Citi, New York University, Apttus and Coin Cafe. The brief as stated on CoinDesk was to come up with 'an application that envisioned how the Blockchain could be used to produce verifiable, immutable receipts for use during an insurance claims process'. 

During the competition, the team created an app for financial giant USAA (once again providing great exposure.) This app was integrated with Tierion's blockchain receipt technology and Google Sheets so that claims could be both automatically checked against the Bitcoin Blockchain and organized in documents for end-users. 

Although this was created for a financial services client, there are two important aspects I'd like to mention. Firstly, the potential for cross pollination of Blockchain applications from financial serves into the health insurance space is very real. Healthcare payers will undoubtedly keep an eye on how it is being adopted within the financial sector to see if there are elements that can be leveraged. 

Secondly, Tierion recently announced a partnership with Philips Healthcare to look into potential applications of Blockchain technology within the vertical. Tierion will pull from these experiences in the hope of reaching a much wider market through its partner network. Exposure to new markets will enable Tierion to expand quickly whilst benefitting from the reputation of an established player such as Philips.

Although a lot will evidently be focused on the financial sector, expect to see more of these types of sponsored events as startups rally together to raise the profile of Blockchain and progressively move its way into the limelight.

Ones to watch
Although not a financial prize, VentureRadar produced the graphic below recognizing their top 25 Blockchain startups that are disrupting non-financial markets. Tierion (as mentioned above) is featured as well as BlockVerify who was featured in my last blog post. Obviously there is a much wider field in the financial services sector but it's encouraging to see that startups are starting to branch out. It will be interesting to see whether anymore of these venture into healthcare and who they partner with to accelerate their path to market.

Are there any other Blockchain startups that are making their way into the healthcare market? Who do you think will be making waves in the coming months and years? Leave your comments below and please share via Twitter.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. CoinDesk, Medical Records Project Wins Top Prize at Blockchain Hackathon, 10th Nov 2015, http://www.coindesk.com/medvault-wins-e5000-at-deloitte-sponsored-blockchain-hackathon/
2. CoinDesk, Blockchain Insurance Solution Wins Consensus 2015 Makeathon, 10th Sep 2015, http://www.coindesk.com/blockchain-insurance-consensus-2015-makeathon/
3. VentureRadar, Top 25 non-financial Blockchain startups, http://blog.ventureradar.com/2015/09/08/top-25-non-financial-blockchain-startups/

Blockchain in healthcare: From theory to reality

This month, I've been looking at a very interesting topic that is receiving an increasing amount of attention within the IT landscape; Blockchain. Blockchain is a public ledger of transactions, which was originally founded to cater to Bitcoin transactions. Although Blockchain is much more well established within the financial services sector, it is gradually making its way into other industries such as healthcare. Previously theoretical use cases are now being acted upon by innovators in the market. This blog post will look at five examples of how it is being adopted within healthcare and life sciences:

EHR storage & security

• Blockchain is a security technology at its core and with the ever-present concern over the security of electronic health records, it is likely to cater to this challenge first as it enters healthcare. Factom, a provider of Blockchain technology, recently announced a partnership with HealthNautica, a medical records and services solutions provider. Their joint aim is to secure medical records and audit trails using the Blockchain. They will do this by cryptographically encoding private medical data and then a digital fingerprint is formed for time-stamping and verification purposes. This facilitates both the storage of the EHR and its security but what is also interesting is that organizations are also looking into how healthcare providers can send out encrypted personalized medical recommendations, which the user can access with their own, unique key.

DNA wallets

• An Israeli startup named DNA.Bits is planning to store genetic and medical data which is again secured via the blockchain and accessed using private keys and this will form a "DNA wallet". This could allow healthcare providers to securely share – and possibly monetize – patient data, helping pharmaceutical companies to tailor drugs more efficiently. What's striking about this is that the article was published over a year ago in June of 2014, which really highlights that this kind of development is becoming well established.

Bitcoin payments

• In a similar style to Factom and HealthNautica, BitHealth is also looking to store and secure medical records using the blockchain. This system also facilitates Bitcoin payments, giving patients additional options for how they pay their healthcare insurers. Although this relies on the success rate of Bitcoin in the market, insurers who offer this method will have a competitive advantage over their peers. With regards to health insurers, due to blockchain being established within the financial services sector, it is expected that lessons learned will cross over.

Anti-counterfeit drugs

• BlockVerify is looking to use blockchain in the fight against counterfeit drugs. In a similar way to M-Pedigree technologies, it features panels on drug packages that can be peeled or scratched off to reveal a unique verification tag. This is then cross referenced with the blockchain to ensure that the pharmaceutical product is legitimate. 

Protein folding

• Stanford University previously relied on expensive super computers to simulate protein folding as it happens incredibly fast. This method was obviously costly and had a single point of failure. Using the blockchain, they can instead use a decentralized network of over 170,000 computers to produce 40,000 teraflops of computing power. This example will grab the attention of other industries that utilize expensive supercomputers. This could even make its way into the analytical space by utilizing a broad base of data for predictive analytics.

Clearly these are all cutting-edge innovations, but as with the financial sector, they point the way for mainstream adoption. Have you heard any other rumblings of how Blockchain is being used in healthcare and life sciences? How else do you think this new technology could be applied to add value to customers? I'd love to hear what you think. Please comment below and if you've enjoyed this post, please share on social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Factom, HealthNautica + Factom Announce Partnership, http://blog.factom.org/post/117173667784/healthnautica-factom-announce-partnership, 23rd Apr 2015
2. City A.M., Blockchain breaks new ground with DNA wallet, http://www.cityam.com/1403865514/blockchain-breaks-new-ground-dna-wallet, 27 Jun 2014
3. BitHealth, http://devpost.com/software/bithealth
4. The Coin Front, Block Verify to fight medical counterfeiting problem, http://thecoinfront.com/block-verify-to-fight-medical-counterfeiting-problem/, 11th Mar 2015
5. Daily Trading Profits, New Uses For Blockchain Technology, http://www.dailytradingprofits.com/1279/new-uses-for-blockchain-technology/, 6th October 2014

Epic: Strategy Predictions

The EHR landscape is dominated by a few select vendors. One of those is Epic Systems. There is no shortage of analytical commentary on the strengths and weaknesses of this otherwise secretive organization. This blog will discuss a few potential strategy options for Epic going forward.

• Global expansion: Epic and Cerner are currently in a battle to gain the majority share of the US market. As you can see in the infographic below, Epic is #1 in 22 states and Cerner is #1 in 15 states. A recent survey also found that Epic is poised to gain even more market share due to prominent mind share so there is still a lot of opportunity to be had. As the battle to gain market share in the US is fierce, Epic will also look to move further into other regions to offset the saturating US market. However, a recent deployment at Cambridge University Hospitals in the UK has led to significant financial issues. Epic's premium pricing position has led to the $300m implementation being met with cynicism over the proposal's value for money. If Epic is to penetrate other regions effectively, it will need to find ways to reduce initial cost outlay.

• Solution improvement in interoperability: Despite scoring the highest mark for interoperability among its competitors in a recent Healthcare IT News consumer survey, it remained the lowest scoring element of Epic's scorecard (see below.) This is evidently an industry wide issue that needs to be addressed.

 

• Bolster analytical capabilities with IBM's Watson: Epic has a large foundation of patient data and information. As it continues to gain market share in hosting this information, it will also aim to improve its analytical capabilities to derive real value from this data. Epic's experience with IBM on the DoD bid in working jointly with Mayo Clinic has forged a relationship which will see Epic explore how Watson's cognitive computing capabilities could be applied into Epic's EHR base. 
• Develop mobile health applications: Epic announced in late 2014 that it is building a data center to transition its healthcare IT apps to a cloud-based model due to growing demand. Coupled with this, Epic also announced that it would be working with Apple to develop mobile health applications for Apple HealthKit. Cloud-based health applications connecting healthcare providers and patients to Epic's EHR will improve its standing in the mobility space.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. TechTarget, Infographic: Epic leads Cerner in battle for EHR market, http://searchhealthit.techtarget.com/news/4500250294/Infographic-Epic-leads-Cerner-in-battle-for-EHR-market, 21st Jul 2015
2. EHR Intelligence, Epic Systems Tabbed to Expand Hold of Ambulatory EHR Market, https://ehrintelligence.com/news/epic-systems-tabbed-to-expand-hold-of-ambulatory-ehr-market, 13th Oct 2015
3. Healthcare IT News, Epic EHR adds to UK hospital's financial mess, http://www.healthcareitnews.com/news/epic-ehr-adds-uk-hospital-money-woes, 28th Sep 2015
4. Healthcare IT News, 2015 EHR Satisfaction Survey vendor report card: Epic, http://www.healthcareitnews.com/infographic/2015-ehr-satisfaction-survey-vendor-report-card-epic, 9th Sep 2015

Recent developments at TraceLink

I have recently been looking at the Life Sciences supply chain competitive landscape and in particular, a vendor called TraceLink. TraceLink labels itself as 'the world's largest track and trace network for connecting the Life Sciences supply chain and eliminating counterfeit drugs from the global marketplace'. It has also seen a few interesting developments as of late so here's a top 5 countdown along with my independent analysis, enjoy:

• Targetting the Brazilian market: TraceLink recently formed an alliance with Brazilian based pharma IT services and automation specialist, SPI. The motivation behind this move was to assist life sciences clients in meeting requirements for track-and-trace due in December 2015. Under these new regulations, life sciences organizations are required to have serialized and tracked three batches of product through the supply chain. This will then become mandatory for all pharmaceuticals one year later. TraceLink will benefit from early entry into the market, focusing on this regulation, but will draw attention from competitors eagerly watching how the market situation develops.
• Onboarding industry expertise: In July, TraceLink announced that it had brought three industry experts into its management team: Michael Ventura (Director, Industry Solutions) from GSK, Elizabeth Waldorf (Director, Global Traceability) from AMGEN and Marcel Zutter (Senior Implementation Program Manager, EMEA) from Abbott. Bringing in senior level management with decades worth of expertise at reputable Life Sciences organizations such as these only further validates TraceLink's commitment to the industry and aligns its strategy with market demand. 
• Partnership with the Yankee Alliance: Very recently, TraceLink launched the Yankee Alliance Preferred Partner Program. This enables more than 12,000 Yankee Alliance member pharmacies, clinics, hospitals, care facilities and physician practices to take advantage of reduced rates of its Product Track software in order to comply with the US Drug Supply Chain Security Act (DSCSA.) It makes sense for an organization to adopt the industry standard solution and although interoperable tracking software may not be a priority right now, it may facilitate some trend analysis in the near future to determine best practices for supply chain optimization. 
• Strong Q2 2015 results: Last month, TraceLink announced its Q2 results for 2015 and one of the highlights was that it had added 50 new customers within the quarter, resulting in a 76% increase in quarterly sales bookings and a 128% increase in year-over-year bookings. TraceLink also recorded a 178% year-over-year staff increase in Q2, exhibiting its growth potential. Growth in sales is primarily down to regulatory compliance pressures and although the full list of clients is not publically available, their expansion into Brazil is a definite contributor to these impressive figures.
• Nexus '15: TraceLink will be holding a track-and-trace event later this month to bring together experts and leaders from various disciplines to discuss track-and-trace strategies. Two major themes emerge from this announcement as TraceLink look to delve into how the Internet of Things (IoT) and Mobility will impact regulatory compliance. It will be interesting to see how TraceLink will prepare and react to the evolving regulatory landscape as new workflow processes become standard.

Many thanks for taking the time to read this blog. As always, if you found it useful and/or interesting, please share this on social media and if you have any comments or questions, please feel free to leave them below.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

Is "sharing" really "caring"?

The Telegraph recently published an article based on the announcement that high street pharmacies will be given access to NHS medical records in a move that has provoked privacy campaigners. There are arguments both for and against this move, which I have listed below:

Con

• The process: A large part of the argument against this move is the way in which national policy has been implemented. The test sample on which this policy was based came from just 15 patients. This is very difficult to justify and unfortunately adds to the already significant level mistrust in policy makers.
• The hard sell: There is concern that giving access to sensitive data to large commercial high street pharmacies will lead to the targeting of vulnerable patients with hard sell tactics. Despite the likes of Tesco stating that they would never use this data to market to customers, campaigners are not convinced.
• Confusion over guidelines: The results of the small sample found that pharmacy staff were confused about getting consent from patients before accessing sensitive data. This issue needs to be addressed to avoid data breaches and misuse due to human error or lack of training.
• Data security: Another concern from patients is that loyalty cards may be linked to personal medical records. The number of healthcare data breaches in the past leads to concerns that as medical data would now be bundled with other personal data held by the retailer, the combined value of this data would become more attractive to hackers.
• Confidentiality: One of the most fundamental arguments against this move is that there still remains a large portion of the population who simply do not want to share their data. The NHS has tried to calm these concerns with the insistence that pharmacy staff gain permission before viewing this data but undoubtedly a lot will still be unhappy that they have access to it in the first place.

Pro

• A necessary step: The ultimate goal is for a fully integrated healthcare ecosystem whereby insurers, providers, pharmaceutical companies and indeed the patients work together to improve the health of individuals and the nation. There are a lot of benefits that come from sharing, accessing and utilizing data (especially in mass) but with data kept in silos, this is simply not possible.
• Results of the sample: Although the sample used was incredibly small, the results “proved extremely beneficial”. These benefits have come from individual sites and so if used on a national level (a la population health), economies of scale would be achieved as well as leveraging analytical capabilities to improve healthcare delivery.
• Personalized service: Enabling access to medical data will promote a personal and customized service for the individual patient. A personalized service which aims to improve the health of the population will ultimately also lead to cost savings for the healthcare ecosystem. The bargaining power (although often criticized) of large retailers such as Tesco could also lead to lower pharmaceutical costs.
• Less pressure on family doctors: NHS England claim that sharing medical data with high street pharmacies will ease pressure on family doctors. Doctors will benefit from better processes as well as having a clear view of what pharmaceutical products have been purchased. It's also important to consider that the flow of data should not be one way and can benefit providers as well as pharmacies.
• Reduction in improper medication: A comment on the article also pointed out that some patients may struggle to remember the types of medication they are taking as well as the dosages. With high street pharmacies able to access your file (with your consent), this will reduce the number of instances of patients purchasing and taking the wrong medication or under/overdosing.

Regardless of the criticisms of this rollout, with the right regulations, safeguards and guidelines in place, many commentators believe the personal and social benefits will be become apparent very quickly.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. The Telegraph, Boots, Tesco and Superdrug to get access to NHS medical records, 09 Aug 2015, http://www.telegraph.co.uk/news/health/11790711/Boots-Tesco-and-Superdrug-to-get-access-to-NHS-medical-records.html

What can we learn from the Cognizant-Health Net situation?

For those following the healthcare IT market, you will more than likely already be aware of what has happened between Cognizant and Health Net. For those who are not, I shall quickly set the scene. 

In August 2014, Cognizant won a seven year, $2.7b engagement with California-based care management provider Health Net. Service was due to commence in the second half of 2015 but in July, it was announced that Centene Corporation was intending to acquire Health Net, which would delay the contract until after the merger had been completed and may not even go ahead at all due to the overlap with Centene's current IT services vendor landscape. Cognizant instead was able to extend its existing applications outsourcing (AO) and business process outsourcing (BPO) services for Health Net out till 2020 at a value of $520m as well as being able to licence some of Health Net's IP.

So what can we learn from this?

All IT service providers must be on red alert: The chart at the top of this page was produced by Everest (link to the article at the bottom) and shows how deeply entrenched IT vendors are within Healthcare Payer organizations. This chart acts as a warning to all vendors that they should be wary of their current client base and how it could potentially be affected by a merger/acquisition.

The Healthcare Payer ecosystem is shrinking: Centene's intent to acquire Health Net is just one of a series of acquisition announcements in the Healthcare Payer market this year. This was followed by Aetna's $37b purchase of Humana as well as Anthem's $54b purchase of Cigna. Suddenly, we're faced with a market where the top 7 have consolidated into a top 4 in a matter of weeks. There's even speculation that UnitedHealth Group may put in a counter offer for Health Net, which, if higher, would dissolve Centene's offer. These deals have been driven by market changes such as the Accountable Care Act (ACA) and the Supreme Court’s recent decision to subsidize poorer Americans. Keep an eye on UnitedHealth Group to see what its next move will be.

Consolidation equals both opportunities and threats for IT service providers: Although Cognizant's deal may have gone sour after the announcement, it looks as though they will survive after renegotiating the existing AO & BPO contract. As other Payers consolidate, existing deals may come under threat and clients may look to consolidate their vendor landscapes but new opportunities will arise as the newly merged organizations require IT support to ensure the transition goes smoothly and that IT systems are integrated properly.

Thank you once again for taking the time to stop by, I hope you found this interesting and thought provoking. If you have any comments, feel free to leave them below and share via social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Everest, Health Net – Centene Merger Leaves a (Slightly) Bitter Pill for Cognizant, 6th July 2015, http://www.everestgrp.com/2015-07-health-net-centene-merger-leaves-a-slightly-bitter-pill-for-cognizant-sherpas-in-blue-shirts-18205.html

Top 3: UK Coordinated Care Findings

Care Coordination is a key concern in the UK healthcare landscape as it is globally. The need for systems to be integrated in order to reap business process benefits as well as capitalizing on the sheer mass of data that healthcare organizations produce on a daily basis is driving healthcare providers to seek out assistance from IT service providers to not only establish an integrated infrastructure but to also guide them through the possibilities of what value can be attained through this exercise. Today, I look at three characteristics of the UK healthcare ecosystem and its current status with coordinated care.

1. Healthcare providers struggle to coordinate care outside of the hospital: Between 2013 and 2014, the National Survey of Bereaved People (VOICES) was commissioned by the NHS to assess experiences of care in the last three months of patients' lives. The key point that stood out the most in my opinion was that healthcare providers struggle to coordinate care when the patient is outside of their usual care setting whether that be a hospital or at home. By no means is there a lack of technology in this area to enable coordination as there is a multitude of devices and means of communicating between care sites. The healthcare ecosystem however struggles with streamlining, integrating and standardizing workflow processes and in conjunction with telehealth technological developments, this is where IT service vendors need to be able to add value to their clients and ultimately their patients.
2. The introduction of the NHS vanguard sites demands care coordination: In January 2015, the NHS launched a program inviting individual organizations and partnerships to apply to become 'vanguard sites'. These are, in essence, test cases for new models of care going forward. Looking at the requirements set forth by the NHS, it is clear that success will not be possible without coordinated care. Throughout the ideologies of what the new models of care will look like, we see direct references to becoming an "integrated provider", having a "joined-up electronic health record" and using "patient population segmentation". In fact, the description of 'Enhanced health in care homes', even references how new telehealth technologies can be applied to provide better care. Together with MarketsandMarkets' forecast that the Population Health Management market will grow at a staggering 26% CAGR between 2013-2018, this further supports the need for IT vendors to sharpen up their integration capabilities and offer solutions that genuinely deliver coordination across the IT landscape.
3. The NHS is investing in support for harnessing technology such as interoperability: On the 31st July 2015, the NHS published a support pack for all vanguard sites. In section 5 of this document, it speaks to what will be made available for participating vanguard sites. Apart from a £200m transformation fund (of which around £140m remains unallocated as of this blog post), they plan to provide dedicated support for items such as interoperability, information governance and digital strategy. They are also looking to leverage best practice examples both from within and outside of the UK and so IT vendors will need to ensure they have solid case studies to back up their sales pitches.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Office for National Statistics, Statistical bulletin: National Survey of Bereaved People (VOICES), 2013, http://www.ons.gov.uk/ons/rel/subnational-health1/national-survey-of-bereaved-people--voices-/2013/stb---national-survey-of-bereaved-people--voices-.html?format=print
2. NHS England, New care models – vanguard sites, http://www.england.nhs.uk/ourwork/futurenhs/5yfv-ch3/new-care-models/
3. MarketsandMarkets, Population Health Management Market worth $40.6 Billion by 2018, http://www.marketsandmarkets.com/PressReleases/population-health-management.asp
4. NHS England, Vanguard support package launched, 31 July 2015, http://www.england.nhs.uk/2015/07/31/vanguard-support/

Accenture: Using terminology as a competitive differentiator

I'd like to reference two articles in this blog post if I may. The first was written by Stuart Lauchlan of Diginomica entitled 'Don't mention the outsourcing, but dig deep into digital at Accenture'. In this article, he credits Accenture with entering the 'digital' market early as it is now reaping the rewards of strong, consistent growth. Lauchlan later goes on to recall how Pierre Nanterme, Accenture CEO, chose to abandon traditional terminology such as 'consulting' and 'outsourcing' as he believed they did not represent Accenture's true capabilities. My initial reaction to this is that it was a clever and easy move to make. Although there has been significant changes in the IT world, does Accenture still outsource? Yes. Does Accenture still consult? Yes. Nothing has changed drastically, yet it has re-branded its marketing strategy to align itself with market demand.

The second article I'd like to refer to was written by Varun Sinha entitled 'How Accenture Has Emerged as a Threat to Infosys, Wipro'. Like the former, this was written following Accenture's quarterly earnings announcement and it goes on to describe how Accenture's growth both signaled a growing market for India-led vendors but also increased competition as Accenture continues to grow faster. It is touched upon briefly in this article but what struck me was the notion of whether Accenture's decision to abandon traditional terminology was a way of differentiating itself from traditional, India-led competitors.

Instinctively, when you hear the word 'outsourcing', it leads you to the thought of reducing operations in one country in favor of a lower cost country. This fundamental thought process was originally a competitive differentiator for India-led organizations but with Accenture's repositioning of terminology, it can now bask in the perceived imagery of higher value services at a premium.

Finally, I looked at relative R&D spend statistics among some of the largest IT services vendors to see whether this repositioning was potentially supported by investment. Although it doesn't go into detail of how R&D was spent, Accenture's R&D spend as a percentage of its annual revenue rose from 2.01% (2012) to 2.50% (2013), a rise of over $150m, before settling back down in 2014. Other vendors had either reduced/maintained R&D spend or increased its percentage as part of a lower annual revenue whereas Accenture saw a rise in both. Although not conclusive, this suggests that Accenture could have invested in digital technologies to support its marketing efforts.

I commend Accenture for the foresight to take this step. The question I'd like to leave you with is this: 'Which era will we be entering next?' Maybe 'virtual services' for example? I'd love to hear what you have to think so please leave your comments below and if you've enjoyed reading this post, feel free to share it on social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Diginomica, Don’t mention the outsourcing, but dig deep into digital at Accenture, http://diginomica.com/2015/06/26/dont-mention-the-outsourcing-but-dig-deep-into-digital-at-accenture/#.Va0P7PlViko, 26th Jun 2015
2. NDTV Profit, How Accenture Has Emerged as a Threat to Infosys, Wipro, http://profit.ndtv.com/news/corporates/article-how-accenture-has-emerged-as-a-threat-to-infosys-wipro-775537, 26th Jun 2015

Analyzing the Genpact Payer infographic

I recently saw an infographic from Genpact (available here) on the top concerns for Payers and found it very interesting and insightful. The survey was conducted across 920 senior executives in Payer organizations in North America.

The survey found that the top three concerns were: Compliance, Customer Satisfaction and Cost Reduction. It then goes into what solutions Payers believe would have a material effect on these concerns. At this point, I'd like to present the data in a slightly different way. The table below shows the percentage of survey respondents who believe that the solution on the left can have a material impact on the top three concerns at the top.

* Colours represent heat mapping from low response % (red) to high response % (green)

There are several ways of looking at this but one of the biggest takeaways for me personally is in the BI & Analytics row. 

Almost 3/4 of survey respondents believe that BI and Analytics can help reduce costs. This may not be where your eye is immediately drawn to from this table but when you read further down, it then shows you that Payers' BI & Analytics capabilities are still viewed as immature by almost a third of respondents and that 40% believe they are unprepared. It seems as though, even across industries, we have only just scratched the surface of what is possible through the use of analytics and so it is understandable that Payers will require support to achieve the full potential of this solution area.

If we work our way down the infographic, we then see that 51% of respondents believe that an improved use of Information Technology can have a material impact on the function and that 70% have initiatives underway in BI & Analytics. Although this is a large percentage, why isn't it higher? Presumably, some Payers are holding back to see what lessons are learned by early adopters but at this stage, surely they are risking falling behind the pack. 

If we finally look at the last two rows, interestingly we find that respondents do not believe that BI & Analytics doesn't necessarily require Business Process Re-engineering or Advanced Organizational Structures. Other areas such as Customer Service and Claims Processing & Adjudication score much higher as necessary for improvement.

If we therefore look at BI & Analytics in its entirety, in regards to this infographic, we see that the potential value to the Payer is huge as is the opportunity for IT vendors to support them in making this a reality. 

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Genpact, Healthcare COO’s untapped strategic lever: Advanced operating models, http://www.genpact.com/docs/resource-/healthcare-coos-untapped-strategic-lever-advanced-operating-models

Analyzing the HP Sales Approach

This month we've been looking at HP within the Healthcare sector. With so much activity going on at the moment including the company split, the acquisition rumors and of course the $11b DHMSM result looming, it's a very eventful time to be focusing on HP and so in this blog post, we are going to be looking at HP and a few of the characteristics of HP's go-to-market sales approach, enjoy!

• Speak to the CIO whilst partners speak to the business: HP, like CSC, is seen very much as a technology player and it is happy to carry on fulfilling that role. Its in-road into a client is usually via the CIO, which is completely understandable. HP also has a strong partner network with vendors who speak more to the LoBs, such as Deloitte and so will rely on them to deepen the client relationship where necessary.
• Solution-in-a-box: HP typically prefers to craft a solution that can be implemented easily, quickly and cleanly. Once this solution is formulated, it can then work on customizing it and pitching it to different vertical industries.
• Leverage eHealth centers in India: As well as increasing headcount in India as part of its restructuring plan, HP is also leveraging its six eHealth centers in India. This has potential benefits both for the local communities as well as strengthening its value propositions around big data and telehealth for example.
• Concentrate on maintaining and growing existing client base: As its core business continues to dwindle, HP is fighting to at least maintain its existing client base and capitalizing on the loyalty its clients have to EDS after its acquisition.
• Capitalize on the regulatory environment: The ICD-10 deadline gives HP the opportunity to really push the value of its RCM and BPO solution portfolio.

Once again, many thanks for taking the time to read this blog post. If you enjoyed it and would like to see more then please share this on social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

Coordination > Consolidation

As we have seen over previous years, there has been widespread consolidation in the healthcare market. Both providers and payers alike have been making acquisitions within their locales. Their goals include improving integration across their organization while reaping other benefits such as expanding revenue streams. Although this may seem a viable option right now, this will present challenges in the near future and so here are a few reasons why coordination might be a better bet than consolidation:

Consolidation

• Fewer options will result in higher cost for the patient: In some areas of the US, there are only one or two insurers. As competition decreases, the market drives towards a virtual monopoly and these payers are able to demand higher prices from consumers. This will drive consumers to seek out alternatives, and with this consumer demand will come new independent entrants into the market delivering a greater quality/value proposition, with whom the larger, consolidated health systems will struggle to compete.
• The rise of telehealth: As payers and providers consolidate, they solely focus on their immediate locale. With the gradual increase in adoption of telehealth, these regional borders will start to fade and patients will be exposed to more future-ready and cheaper alternatives leaving the larger, more expensive networks behind. Although consolidated health systems have the ability to drive scale and invest in telehealth, they are likely to be increasingly subjected to competitors further afield who can offer cheaper telehealth services from remote locations for non-critical care.
• Consolidation doesn't necessarily reap economies of scale: One reason why providers are looking to consolidate is to grow economies of scale. However, a 2012 study by the Robert Wood Johnson Foundation found that the main driver was to simply improve bargaining power with payers and so consolidation did not lead to true integration or enhanced performance.

Coordination

• Remain agile: Formal and informal care coordination enables both payers and providers to leverage their partner networks whilst also remaining agile enough to respond to market shifts, new competition and consumer demand. Larger, consolidated systems will find themselves unable to compete on price in a market where already around 20% of Americans cannot afford health insurance. This is supported by the RWJ Foundation study which found that price increases exceeded 20% when mergers occurred in concentrated markets. 
• Coordinated care encourages a value-based reimbursement model: As mentioned above, although consolidation seems to promote care coordination on the surface, it is usually due to financial reasons and so fails to achieve improved patient care. As the healthcare market progresses from a fee-for-service model to a value-based-care model, providers will be judged on the quality of care they are administering. A true effort to coordinate care will improve the quality of care whereas those purely looking for financial benefit may end up having to play catch-up.
• A multitude of both financial and operational benefits: The benefits of care coordination range from empowering patients, improving the delivery of care and increased efficiency to reduced costs, streamlined workflows, reduced waiting times and improved patient outcomes. Providers who have not consolidated have still been able to reap the benefits of coordinated care and so it makes sense to integrate, coordinate and remain agile.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

Bridging the Payer-Provider trust gap

Through my research into the Healthcare Payer market, it is apparent that there is a significant trust issue between Payers and Providers. In a market where we're seeing an ever increasing percentage of convergence between the two parties, this mistrust serves as an unwelcome roadblock to innovation and unfortunately the patients are likely to be the ones who suffer.

As we've seen in the recently published PayerView report by Athenahealth and ReviveHealth, although overall benefit reliability is improving, there is still a lot of work to do in regards to streamlining workflows, making processes more efficient and ultimately bridging the trust gap.

In this blog, I'm going to lay out a few recommendations for both Payers and Providers on how to build trust with the other party based on what I've come across during my research. Many of these points apply to both entities but for the purposes of this blog post, we'll look at them separately:

Payers

• Remain agile: As can be seen in the PayerView rankings, the top two performers are small, commercial players. Although there's a general assumption that smaller organisations are more agile, regardless of the size, Payers must be able to quickly react to market shifts including regulatory changes.
• Integrate and coordinate your data: Easier said than done but integrating and coordinating your data will have many benefits as it will streamline workflows, simplify claims processing and make transactions more accurate and efficient. Also, once your data is aggregated, this then enables you to analyze it for future improvements.
• Communicate: Communication is vital with both patients and Providers. Technologies such as portals, patient accessible EHRs, mobile access and secure messaging will engage patients while clinical information sharing, timely pre-authorizations and a reduction of unnecessary procedures will bridge the gap with Providers.

Providers

• Learn from Payers: Payers are well versed in areas such as patient engagement despite Providers having more direct contact. With the rise of technologies like telehealth, remote monitoring, mobile access etc, Providers should look at what Payers are doing to retain and engage patients and if appropriate, learn from them.
• Invest in HIT: Payers are more likely to contract with Providers who deploy software and systems supporting clinical integration and Population Health Management. The associated analytical efforts based on these would help Payers in calculating more accurate insurance premiums as well as having many patient health benefits.
• Discuss financial risk bearing: As the market embraces a value-based reimbursement model, one of the primary reasons Payers do not trust Providers is the unwillingness to accept financial risk. Once again, this is not an easy fix but clear and transparent communication on mutual goals will certainly help this process.

Once again, many thanks for taking the time to read my blog. I hope you found it useful and welcome any feedback you may have. If you enjoyed this post, please feel free to share it on social media with your friends and colleagues.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Athenahealth, PayerView 2015, http://www.athenahealth.com/network-data-insights/payerview
2. Managed Healthcare Executive, Best practices for payers and providers to cooperate in the era of convergence, http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/best-practices-payers-and-providers-cooperate-era-convergence, 23 Dec 2014
3. HealthcareIT News, Engaging patients: 5 things providers can learn from payers, http://www.healthcareitnews.com/blog/engaging-patients-5-things-providers-can-learn-payers, 8 Sep 2014
4. FTI Consulting, Gap Separates Payers and Physicians on Value-Based Arrangements, According to a New Study Released by FTI Consulting, http://www.fticonsulting.co.uk/global2/press-releases/united-states/gap-separates-payers-and-physicians-by-fti-consulting.aspx, 30 Jul 2014

Best of the Best: Analyzing the leaders in Healthcare

Welcome everybody to another Health Care Bear blog post! This month, I've been looking at industry award winners in healthcare in an effort to find the best use cases of technology and identify patterns between them that could be emulated for other healthcare systems.

For the purposes of my research, I have analyzed three of the HIMSS Davies Enterprise Award winners based on their use of IT (primarily EHR implementations.) These are (in no particular order: Children's Health System of Texas (Children's), Texas Health Resources (THR) and the University of Iowa Hospitals & Clinics (UIHC.) To make it a little easier, I am focusing on US based healthcare systems as healthcare structures vary greatly from country to country. These are a few of the key notes from my research:

1. UIHC absolutely dominated against the other two chosen hospitals by achieving not only the most ROI ($103.6m (159%)) of the three but also invested the least to achieve this ($65.30m), which is incredible.
2. Even if UIHC hadn't received Government incentives, it still would have achieved 104% ROI, mainly due to the financial benefits of integrating monitoring devices which reaped $37.16m (36% of total ROI.)
3. Both Children's and THR have a common IS Vendor Selection Strategy in that they are looking to migrate towards a single vendor approach. UIHC however is looking to migrate toward best of suite/cluter throughout its organization. What is interesting is that this approach is also taken by the top 3 most profitable healthcare systems of America*.
4. The same pattern arises as UIHC is the only hospital not stated as having a Health Information Exchange (HIE) / Regional Health Information Organization (RHIO) initiative either planned or in use.
5. The number of IT vendors these hospitals deal with is staggering with 70 listed between the three chosen for this research. Considering two of them are looking to reduce the number of vendors, this could lead to significant vendor landscape consolidation.

That's it for now folks! Many thanks for staying tuned and as always, I'd love to hear your feedback in the comments below and if you liked this post, please spread the word via social media and finally check out my earlier blog posts. Ciao for now!

* Top 3 most profitable healthcare systems of America selected through the ownership of the top 20 most profitable hospitals of America.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. HIMSS Enterprise Davies Award Recipients, http://www.himss.org/resourcelibrary/TopicList.aspx?MetaDataID=2803

Dell's Competitive Advantage in Prescriptive Analytics

Hello there and welcome to another blog post by the Health Care Bear! I've recently been looking at Dell's position in the Healthcare industry and one talking point that stood out for me was its strategy and focus on prescriptive analytics. As we all know, IBM is at the forefront of the analytics space with Watson but it looks as though Dell is looking to nibble into that market so I thought I'd write a few words on what I've come across during my research and how Dell has a competitive advantage in this area. As always, I'd love to hear what you have to say so please leave your comments below and share this on social media with your friends and colleagues. Let's begin...

1. Analytics relies on a lot of data: You may be wondering why I included the image at the top as we're not talking about the cloud at the moment. The reason I included this was because of the factoid that Dell manages over 6 billion diagnostic image objects in the cloud, which covers 7% of the US Population (these stats are from 2013 so have likely increased since.) This is a huge competitive differentiator as the larger the data set, the greater the analytical potential. As Dell considers the US Provider market as its largest and most fruitful, it would make sense to focus on this and build up its repository which will simultaneously add potency to its analytical offerings.
2. Growing ability to speak to the business: Traditionally, Dell has struggled to shake off the perception of being purely IT focused and so usually finds itself speaking to the IT department. A vendor is able to culture much stronger and longer client relationships if it can speak to the business value of the solution it is putting forward. Although this is currently one of Dell's weaknesses, it's interesting to note that its partnership with Deloitte could assist in this area as they will be able to capitalize on each others' strengths and this will help Dell take more of a consulting approach, thereby selling into the business. If it can properly articulate the business value of the prescriptive analytics it is selling, this will increase its win:loss ratio.
3. Dell has a solid network of partners: The chart below, although from 2011, shows that Dell is partnering with some of the most influential players in Healthcare at this time. When you also add its more recent partnership with CGI, which focuses on cloud solutions, security solutions and vertical-specific analytics, it's easy to see that it is well positioned to not only capitalize on the amount of data at its disposal but also bring in partners' capabilities to expand the possibilities of what can be done with this data.

That's it for today folks, I sincerely hope you've enjoyed this blog post and look forward to hearing from you!

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Dell, Future Ready Healthcare IT Programs, 2013, http://www.slideshare.net/dellenterprise/futureready-healthcase-it-platforms-get-to-the-cloud
2. Dell, Healthcare ISV Alliance Program, 2011, http://www.slideshare.net/ericvanthoff/dell-healthcare-isv-emea-alliance-program-11601716

The Big Blue Apple: Analyzing the IBM & Apple Alliance

 

Welcome everybody to my latest blog post! Today, I will be looking at the recently formed partnership between IBM and Apple. 

My high level view of this partnership from the start was that it made the world of sense. On one side, you've got a marketing juggernaut with a reputation for innovation and a firm grasp on the consumer market. On the other, you've got arguably the most notable IT vendor in the world with a solid reputation for its work on an enterprise level. Together, their strategy for producing applications for enterprises is perfect and if they can overcome previous personality clashes, they will compliment each other very well indeed.

At the end of last year, IBM and Apple announced that they plan to launch 100 enterprise apps on IBM's 'Mobile First' cloud platform by the end of 2015. So far, 22 apps have been released and healthcare is definitely a key target vertical. Four apps related to healthcare are as follows:

• Hospital RN: Enables nurses to tap into record keeping systems, organization tools and iBeacon technology for streamlined management tasks.
• Hospital Tech: Lets nursing assistants organize and prioritize tasks, freeing up time for patient care.
• Hospital Lead: Helps care managers and charge nurses better manage workloads, staff assignments and patient discharge tasks.
• Home RN: Provides tools to gain greater efficiency in managing caseloads and reporting needs to specialists during home care interaction. [1]

So why are these apps receiving such a warm welcome? They are not aimed at management, they are aimed at those on the front line. Nurses and doctors have been crying out for help for years and will embrace any technology which makes carrying out their jobs easier, quicker, more efficient and less stressful. These apps put more power into the practitioners' hands and with a wider range of operational roles influencing IT purchasing decisions, this is a positive step forward.

What will be interesting to see down the road is how IBM is going to incorporate Watson into these apps. As the apps are managed centrally and used globally, the amount of incoming data will be considerable and given IBM's background and expertise in analytics, it's only a matter of time before they will be able to use this data and incorporate it into other apps or best practice consulting engagements. Currently, as the apps focus on workloads rather than clinical data, analysis would be limited to finding the most efficient way of managing a daily routine. This could be useful for training purposes and for setting goals. 

If any future applications incorporate clinical data then the possibilities will sky rocket as it would enable practitioners from all over the world feed into a central data repository, compare notes in forums and chat rooms and use a critical mass of clinical data to analyze best possible treatments. In fact, it would not surprise me at all if this was the ultimate end game for this partnership, to centralize and collect masses of data from a popular technology vendor such as Apple, apply world class analytics from IBM's Watson and then build up a large global knowledge base which can be utilized and offered to enterprise clients.

That's all for today folks! I'd love to hear what you think about the IBM and Apple alliance so please leave a comment below and if you enjoyed this post, please share it on social media and spread the word.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Fierce Mobile Healthcare, Apple-IBM mobile health apps: Just what the nurse ordered, 6 April 2015, http://www.fiercemobilehealthcare.com/story/apple-ibm-mobile-health-apps-just-what-nurse-ordered/2015-04-06

A Norwegian, a Dane, a Swede and an Indian walk into a hospital...

Hej, Hallå, Hallo and Namaste! Welcome to a new blog post from the Health Care Bear! After potentially destroying several languages in the first sentence, I'd like to introduce today's topic: The rise of India-led pureplay vendors in the Nordics. Although this can be classed as a cross-industry topic, it has significant relevance to the Healthcare vertical as well so stay with me. 

India-led pure plays have been making inroads into the Nordic private sector over the past few years and so I wanted to write a blog post pointing at a few drivers for their success. Enjoy...

Cost reduction is a top priority in the Nordics: CIO surveys from the likes of Gartner and IDC all highlight the fact that organizations in the Nordics are looking to reduce costs. It is also clear that they are looking to achieve these cost savings through making business processes more efficient. It goes without saying that India-led IT vendors thrive in low cost engagements and so this trend plays to their strengths. Other vendors however can capitalize on other priorities such as a need for agility on a smaller scale due to numerous large scale IT deployments being unsuccessful in the private sector.

Organizations generally indifferent to cloud: Cloud has taken the world by storm. Despite security concerns still present in the market, it is quickly becoming the norm (that rhymes by the way.) I'm sure this is not an isolated case in the Nordics but a lot of organizations are of the opinion that they are being evermore forcefully nudged into deploying cloud solutions. With IT providers looking to capitalize on this global trend as well as smaller niche providers offering only SaaS solutions, it seems to them that they don't really have much choice. Nordic CIOs are indifferent as to which solution to choose as long as it reaps the results they are looking for. Cloud is no longer a differentiator and so if IT infrastructure is disappearing, what's stopping clients from choosing an India-led vendor? Other aspects such as onshore presence, local knowledge and scalability are important but cloud is levelling the playing field.

High percentage of CIOs reporting into CFOs: There is a higher percentage, compared to other regions, of CIOs in the Nordics reporting into CFOs. It may seem as though I'm repeating myself here but this plays well into the hands of India-led vendors as CIOs will take a much more black & white approach to selecting a vendor based on financial viability and efficiency. Public sector CIOs in the Nordics hold substantial IT budgets and so if the likes of Infosys, TCS, Wipro etc are able to break into the Public sector based on their success in the Private sector, they would be able to use this mentality to their advantage and the competitive landscape could drastically change.

That's all for today, I hope you enjoyed this latest blog post. If you did, then please share on social media with your colleagues. Many thanks for your time, look forward to posting again shortly.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

Infosys: What went wrong?

Bonjour everybody and welcome to another Health Care Bear blog post. Today we shall be looking at the India-led IT Consulting and Services multinational, Infosys. Infosys has been through a tough few years recently, which has gradually pushed it towards the back of the line when it comes to winning Healthcare business. Granted, its strengths lie more in the manufacturing space but without a doubt, it does recognize the growth potential in Healthcare. So today I am going to be looking at a few areas which have hindered Infosys' Healthcare business. If you have any comments then please feel free to leave them below as I'd love to hear what you think. Let's get started...

Constant reorganization: Although not necessarily directly related to Healthcare, the image at the top of this blog post shows that there has been a lot of top-level reorganization within Infosys over the past few years. Whilst it focuses on restructuring its internal workforce to position itself for future growth, it cannot properly focus on winning new business in Healthcare and will suffer from leadership inconsistency. If these recent changes weren't enough, Infosys recently announced that it will be once again restructuring its business from the 1st April 2015. Despite the potential benefits of this restructure such as enhanced flexibility, its clients may once again suffer. At a time when it is looking to renew core existing contracts, this is very inconvenient timing. Such is the desperation of keeping hold of these clients, the CEO himself is even taking charge of around a dozen top customer projects.

Underdeveloped solution portfolio: In the past year, Infosys launched just two healthcare-centric platforms; Clinical Trial Supply Management and Osteoporosis Solutions. Over the same timeframe, Infosys won only two engagements; a contract renewal with the District of Columbia for health information exchange (HIE) and an ERP deal for implementation services with L.A. Care Health Plan. Such lackluster effort for a vertical which it recognizes has growth potential is disconcerting, especially when you see competitors such as Cognizant and IBM make strides through acquisitions and expanded capabilities in strategic areas such as cloud. It can no longer rely on its previous BPO success and must innovate to just keep up.

Startup acquisition strategy: This seems to be a trend among many India-led IT service providers. They are looking to invest in the "next big thing" in order to bolster their innovation credentials and pull away from the pack. According to the Economic Times, Infosys has a $500m fund to invest in startups pursuing disruptive ideas. Due to Infosys falling behind the pack over the past few years, this is a survival strategy. It's reportedly failed acquisition of TriZetto to fellow India-led competitor Cognizant potentially exhibited an appetite for larger acquisitions but due to its investment in other startups, it looks as though it will stick with partnering in Healthcare. Meanwhile, Cognizant's acquisition of TriZetto is enabling it to pull away from the India-led pack and take a high-value-add approach with further onshore presence. Unless Infosys finds a diamond among the coal or invests in an established player, it may stay in limbo and be forced to rely on its network of partnerships to win business in Healthcare.

That's all for today folks! Many thanks for taking the time to read my blog, it's very much appreciated. If you did enjoy it and found it useful then please share it on social media as it would greatly help.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Business Today, Missing Murthy, 17 Feb 2013, http://businesstoday.intoday.in/story/infosys-woes-profit-revenue-growth/1/191782.html
2. Zacks, Infosys (INFY) to Restructure Business: Time to Buy?, 9 Feb 2015, http://www.zacks.com/stock/news/163721/infosys-infy-to-restructure-business-time-to-buy
3. Times of India, Infosys, Wipro set to enter Rs 12,000 crore renewal ring, 6 March 2015, http://timesofindia.indiatimes.com/tech/tech-news/Infosys-Wipro-set-to-enter-Rs-12000-crore-renewal-ring/articleshow/46476526.cms
4. TBR, Infosys PSBQ 4Q14, 2 Feb 2015
5. Economic Times, Why Wipro, TCS, Infosys are wooing retail, healthcare startups and investing in them for survival, 11 Feb 2015, http://articles.economictimes.indiatimes.com/2015-02-11/news/59043865_1_startups-wipro-ceo-tk-kurien-silicon-valley