Tag Archives: Meditech

SPI Digital Health: Luma’s MEDITECH Integration Primed for Success, but Will Need Time and Patients

Last month, patient engagement platform developer Luma Health announced an integration partnership with leading EHR vendor MEDITECH in the US. Luma claims that the tie-up will bring ‘powerful new capabilities to the thousands of healthcare providers that use the MEDITECH Expanse EHR’.  

The Signify View 

Integrating with one of the big four US hospital EHR vendors is a positive step for Luma Health and its Patient Success platform. The San Francisco-headquartered company says it serves more than 600 health systems, integrated delivery networks (IDNs), federally-qualified health centres (FQHCs), specialty networks and clinics across the country. In doing so, it supports the care of more than 35M patients.  

The tie-up with MEDITECH is one of several integrations Luma Health has with leading EHR vendors, including Oracle Cerner. Given MEDITECH’s healthy market position and the good reputation its Expanse EHR enjoys, the deal offers good upside for Luma Health. But how does it align with MEDITECH’s vendor integration and partnership strategy? 

Quality Over Quantity 

The latest chapter in the Expanse EHR story started to be written in 2017, when MEDITECH completed a major and much-needed upgrade to the solution. A move that was broadly well received by customers, hospitals and IDNs, it also transformed MEDITECH’s image from one of an old-fashioned EHR vendor to one equipped to do what few others could: go toe-to-toe with Epic. MEDITECH is a rare breed of vendor still growing its US inpatient EHR market share, and it is understandable why Luma Health would want to integrate with the Expanse EHR. 

But where Epic (whose app store listed 660 partners in March 2022), Altera/Veradigm (around 400 partners) and athenahealth (also around 400) have opted to create as many partnerships as possible, MEDITECH has taken a much more selective approach to date. It lists just a handful of integrations and partnerships on the MEDITECH Alliance app store, and most of those are deep integrations with the likes of Google Care Studio (which powers Expanse’s search function) and Innovaccer, the population health management vendor.  

In terms of patient engagement solutions, the MEDITECH Alliance lists just two vendors. One is MEDITECH’s Expanse Patient Connect solution, powered by enterprise communication platform developer Artera which is offered as a standard function on Expanse. And the other is Luma’s Patient Success platform. 

MEDITECH Alliance Programme Tiers

Status Symbols 

At first glance, both the Artera and Luma platforms provide similar functionality. Both have automated chatbots offering patient scheduling, payments, eligibility, verification, conversational messaging, forms (pre-visit and triage intake) and analytics tools for the provider. They also have automated marketing and outreach tools. But while Artera’s platform draws on the company’s historic focus on patient communications (SMS, WhatsApp etc), Luma’s Patient Success platform is positioned as a workflow tool for the entire patient journey. 

This subtle difference in positioning might explain why Artera and Luma Health have different status in the MEDITECH Alliance.  

Artera is the only patient engagement solution vendor in the Alliance with ‘Innovator’ status. This is the highest level of integration, to the point that the customer might not even know that the solution is not MEDITECH’s. This is the case for Expanse Patient Connect which, although powered by Artera, is branded as a ‘native’ MEDITECH solution. 

Luma, on the other hand, sits curiously and conspicuously as the only patient engagement solution vendor in the Alliance with ‘Accelerator’ status. ‘Accelerator’ solutions are less integrated than ‘Innovator’ solutions and are defined by MEDITECH as ‘partnerships designed for defining complex integration needs or new product integration promotional purposes’. In this category, the onus remains on the partner (not MEDITECH) to market the solution.  

Greenfield Opportunity 

Although this is by definition a ‘lower’ status than the ‘Innovator’ solution, MEDITECH’s commitment to the Luna Health partnership is clear. The two companies collaborated closely in validating the integration of Patient Success as well as MEDITECH-enabled workflows into Expanse. 

To provide Luma’s developers with hands-on access to its proprietary APIs, Luma participated in the MEDITECH Greenfield Workspace initiative. Luma describes it as a ‘preferred-access partner engagement initiative for organisations with proven, interoperable products that complement, enhance or extend the Expanse EHR’. It is effectively a ’sandbox’ where third parties like Luma Health can fine tune solutions, develop interfaces and even run pilots before testing them on a live MEDITECH EHR installation. 

In Luma’s case, the real-life MEDITECH EHR installation was on Expanse at Phelps Memorial Health Centre, a critical access hospital in Nebraska. Luma claims implementation was ‘fast and smooth’, delivered ‘significant patient success outcomes’ and that nurses at the hospital saw a ‘significant reduction’ in the time spent contacting patients about appointments and test results.  

Burning Question 

The Phelps project was a valuable proving ground for the Patient Success platform, and this will be valuable to Luma moving forward. Despite MEDITECH’s clear commitment to the solution, the fact that Patient Success does not enjoy top-tier status in the Alliance means Luma must put in the hard yards to market it. It will have to persuade its customers why they should pay for its solution over the native application offered by MEDITECH and Artera.  

Patient engagement is a highly competitive arena with a very fragmented ecosystem of vendors, but in MEDITECH, Luma has a partner that is in the top four hospital EHR vendors in the US with a solid primary care EHR footprint to boot. It is also one of a select few vendors whose solutions cover IDNs’ entire needs.  

But still, the nagging question remains: why would MEDITECH allocate so much time and resources to Luma when it has a ‘native’ solution in the Expanse Patient Engagement platform already in place? Is there a problem with the Artera solution? Or is it simply trying to build its MEDITECH Alliance membership with a focus on quality rather than quantity?  

The answer is probably the latter, and in any case the Luma partnership is of limited cost burden for MEDITECH. Amid a concerted regulatory push in the US towards more open interoperability standards across healthcare IT, including for EHR vendors – and given that EHR integrations are based on an open standard FHIR-based data exchange platform – development overheads for Patient Success are minimal for MEDITECH (and far lower than they would have been for the ‘native’, MEDITECH-branded solution). As a result, MEDITECH has almost nothing to lose by supporting the Luma Health integration. 

Clearly, MEDITECH is taking a different approach, for now at least, to building its Alliance than rival vendors like Epic and Allscripts and their partnership ecosystems. Its initial focus on building Innovator and Accelerator status portfolios speaks of a ‘quality over quantity’ strategy that most EHR vendors, who are much further along the journey, have moved away from.  

But these are early days for the MEDITECH Alliance.  

Signify Premium Insight: MEDITECH’s Expanse-ive Innovaccer tie-up

This Insight is part of the Signify Premium Insights (SPI)-Digital Health service, which will launch on 9 January 2023. From that date, this and all SPI-Digital Health Insights will be available only by paid subscription. Click here for a free one month trial of this service. 

In mid-October, US EHR vendor MEDITECH announced the launch of Expanse Population Insight, a new population health management (PHM) solution powered by Innovaccer.  

The tie-up between MEDITECH, an established tier-1 EHR vendor and Innovaccer, which has a reputation as a PHM/value-based care (VBC) disruptor, is a potentially potent combination.  

But as US hospital EHR buyers converge their procurement around large single-source vendors (like Epic) covering multiple different care settings, what does the future hold for Expanse Population Insight and, more broadly, the MEDITECH-Innovaccer partnership? 

The Signify View 

MEDITECH and Innovaccer both bring plenty to the partnership table. Since bringing the first iteration of its Expanse EHR solution to market in 2018, MEDITECH’s customer base has expanded and its annual revenues have grown. 

The company has carved a solid competitive position for itself, moving away from the point solution model of similar-sized rivals. Unlike CPSI (which only offers an EHR solution for small hospitals) or NextGen and eClinical Works (which offer only an EHR for ambulatory primary care), MEDITECH’s reach is wider and deeper. It serves not only small, independent hospitals (which are its core business) but has also established a foothold among larger health systems and Integrated Delivery Networks (IDNs). Just last month, MEDITECH announced a large-scale Expanse deployment for HCA Healthcare, a large healthcare service provider that manages 182 hospitals and 2,300 care sites across the US and UK. 

With a customer base of around 500 hospitals in the US, MEDITECH now sits behind only Epic, Cerner and Altera Health in the US hospital/health system EHR pecking order. While the company is highly unlikely to unseat its much larger rivals, notably only it and Epic are currently gaining appreciable market share in the US inpatient/health systems/IDNs market (see chart below).  

Innovaccer has a similarly impressive backstory. Its annual revenues have jumped more than five-fold from 2017 to more than $100M in 2022. The company currently has around 70 health systems on its books, and is valued at $3B. Innovaccer has built strong relationships with hospital IT buyers, and is viewed by many as the preferred independent PHM/VBC platform solution.  

Expanse-ive Strategy 

As a data aggregation solution, Expanse Population Insight plays neatly into the integrated care/PHM evolution in the US. Data aggregation remains the biggest PHM revenue driver at present (see chart below) in the US. 

The overall PHM US market is forecast to be worth $10.2B in 2026 ($5.3B in 2021).  

The tie-up also gives Innovaccer a better route to market than it has had historically. Rather than having to reply on selling its solution directly to buyers, Innovaccer can now leverage MEDITECH’s installed base and marketing might via Expanse Population Insight. And in MEDITECH it has a partner which is solidly grounded in the US EHR market covering all main care settings. The relationship has the potential to be expanded outside of the US, into countries such as the UK, where MEDITECH has a sizeable installed base of customers and Innovaccer has ambitions.  

On the face of it, this is an ideal match for both companies. Expanse Population Insight will not propel MEDITECH onto the top table of US EHR, but it will certainly give the current incumbents something to think about, in the short-term at least. There are, however, potential obstacles lurking in the shadows. 

Clouds Gathering 

MEDITECH’s growth trajectory may be impressive, and it may still be gaining market share, but it is still a far smaller player than heavyweights like Epic and Cerner. Without the resources to develop its platform solutions in-house, MEDITECH’s approach has been to seek high calibre partnerships. Hence Innovaccer, and also its early-2022 link up with Google, with the intention of integrating the tech giant’s CareStudio platform into Expanse. 

The Innovaccer partnership carries some risk. While MEDITECH’s core business leans a little more towards smaller, independent hospitals, Innovaccer’s PHM solution is far better suited to an IDN, where it can manage a whole population across multiple different care settings and where the reach into the community is much deeper. This risk might be mitigated by MEDITECH’s healthy roots in larger health systems, but in reality it is nowhere near as dominant as Epic in this. 

The problem for MEDITECH and Innovaccer is that, as much as they have the solutions to sell to the large healthcare systems and IDNs – and in truth there is still a loyal fanbase of hospital IT buyers who prefer independent vendors like Innovaccer – there is a defined shift in procurement towards large, single-source EHR vendors, and in particular Epic. The big IDNs and hospital health systems are very much Epic and Oracle Cerner territory, and there is a real risk that in this environment MEDITECH will lose out in the medium-term. 

It’s Complicated 

The MEDITECH-Innovaccer tie-up also throws up some other intriguing relationship dynamics. For one, it appears to sound the death knell for MEDITECH’s PHM solution collaboration with Arcadia Healthcare Solutions, whose data aggregation platform had been supporting MEDITECH’s Web EHR and analytics solution since 2018. This is clearly good news for Innovaccer. 

As is MEDITECH’s relationship with Google. The tech giant would have seen CareStudio as the first step towards forging a deeper relationship with MEDITECH. This deeper relationship could have offered other opportunities that utilise Google’s abilities to drive insights from data in VBC (e g via its Healthcare Data Engine (HDE) accelerators). The MEDITECH-Innovaccer deal appears to limit potential for future VBC product development between the companies in this area. That said Google and MEDITECH continue to develop their relationship in other areas. For example it recently announced that it was working with MEDITECH in terms of cloud services for Expanse.  

Innovaccer faces relationship challenges of its own, however, again around the broader trend towards consolidation around a single EHR vendor. We understand that some of Innovaccer’s customers, who are fans of the Innovaccer platform, are also supporting the development of Epic’s Healthy Planet PHM platform in order to support a longer-term strategy of IT consolidation around Epic. The assumption is that, once Healthy Planet’s functionality matches that of the Innovaccer platform, some of Innovaccer’s customers will migrate over to Epic. 

Measured MEDITECH 

MEDITECH is taking a measured, partnership-based growth approach. In the short-term, these partnerships will bear fruit and enable the company to compete with its larger rivals, and the Innovaccer tie-up will give it a sharper edge in PHM. While momentum is with MEDITECH and Innovaccer right now, the complex and ever-changing nature of the EHR and Value-based Care IT market in the US means that both will need to continue to innovate to stave off Epic.