MSIA on the warpath as Genie is let out of the bottle

A big week in health IT kicked off on Monday with the announcement that medical specialist software vendor Genie Solutions had been sold to Citadel Group for the very healthy sum of $260 million. Considering that a majority stake in Genie was sold just four years ago for $55m, this is a pretty good return on investment for its private equity investors, but coming off the back of the extraordinary amount that Telstra Health paid for MedicalDirector, it shows that there is serious money out there at the moment for technology stocks.

We understand from immaculate sources that Genie Solutions was still planning to publicly list as late as last week, but had also been in discussions with Citadel for some time and was also offered up to Telstra Health. Telstra had to decide between MedicalDirector and Genie as it could not afford both, and chose the former, paying $350m for the GP sector’s second most used software. While understandable in the short term considering Telstra has long spoken about joining up disparate parts of the healthcare system in Australia, of which GPs are fundamental, but when it comes to long-term growth, we think Genie was the better bet.

We had a chat to Citadel Group MD Mark McConnell this week and he was bullish about Genie’s potential, not just in Australia’s specialist market but overseas as well. While we doubt MedicalDirector’s potential – or any GP product for that matter – in overseas markets, specialists are a different matter. $260m is still probably too much, but there is some seriously crazy money around at the moment so well done to Citadel and Genie’s management, and more importantly to Genie’s former majority owner IFM Private Equity, which has played a blinder.

In other big news this week, both Australia and New Zealand revealed more details on how each jurisdiction will roll out vaccination certificates as we all look to open up from lockdown. NSW is allegedly trialling the addition of the vaccine certificates available through the Medicare Express Plus app to its Service NSW app in some regional areas this week. However, not much more information has been forthcoming and with a new premier announcing a new roadmap to opening up from next Monday, we are not filled with confidence that this is anything but a short-term solution.

As we learned from Senate hearings last week, the four jurisdictions using the ACT’s Check-in CBR app are planning to add the Medicare Express Plus functionality to their solutions, but it is obvious this will necessitate any visitors to Australia downloading a different app for each state or territory visited. Meanwhile, New Zealand revealed this week that it will begin issuing vaccination certificates through a new website, My Covid Record, which should be operational next month.

This announcement was received with scorn by Orion Health CEO Ian McCrae over how long it has taken to organise and the cost of the whole immunisation solution. Perhaps still smarting at having not been able to tender for the contract in the first place, Mr McCrae has also taken aim at the Ministry of Health’s plans to offer paper as well as digital certificates. All jurisdictions are doing that, Ian, so it’s not an argument in your favour. Some people do not have mobile devices and some don’t want their healthcare data stored on them, so paper simply must be an option.

We also heard this week about a longer-term solution to all of these worries, which is what HL7’s FHIR-based SMART Health cards purport to be. We sat in on a fascinating webinar this week addressed by some leading lights in health informatics, such as Microsoft’s lead architect for the SMART project Josh Mandel, co-founder of the Commons Project Foundation JP Pollak, Apple’s clinical and health informatics lead Ricky Bloomfield, and our own Grahame Grieve, FHIR creator and product manager.

Sydney Local Health District is this week beginning to offer SMART Health cards for COVID vaccinations at its Sydney Olympic Park mass vaccination hub in Homebush, presaging how this sort of information will be provided in future. SMART Health cards are not limited to COVID vax records, but can encompass test results and prescription records, and are already being used by some very large jurisdictions, including New York State and California in the US, several Canadian provinces, several European countries, and now a rather large Australian health service. This is the future. They can be issued as digital cards, as paper print-outs, and even printed on T-shirts, if that’s your thing.

And finally, a big stink has erupted locally following a decision by the Western Australian Primary Health Alliance (WAPHA) to request on behalf of the other PHNs that they be given an exemption from normal competition rules in order to build and deploy a new data extraction tool to streamline and improve data collection for programs such as the PIP QI.

Already under scrutiny for being allowed to build the Primary Care Insights national data storage and analytics solution, the move by the PHNs to develop a new tool in competition with existing ones like Pen CS’s CAT4 and Outcome Health’s POLAR has infuriated the Medical Software Industry Association (MSIA), which sent off a completely over the top letter to the Australian Competition and Consumer Commission (ACCC) last week to complain about how it would be the ruination of the current government’s digital and innovation policies.

We don’t think it is that tragic but there really is no need for the PHNs to use public funds to develop their own software when perfectly good tools already exist. If they are looking for improvements, perhaps talk to the vendors and see what you can achieve that way.

That brings us to our poll question for the week:

Should PHNs be involved in developing clinical software?

Vote here or leave your comments below.

Last week we asked: Should medical apps be regulated? Yes, most of our readers said, with 82 per cent voting in favour and 18 per cent against. Our options asked questions about how they should be regulated, and by whom. You can see readers’ responses here.

Comments  

0 # Simon James 2021-10-15 12:57
Last week we asked: Should PHNs be involved in developing clinical software? Most (70%) said no, but these comments on why are illuminating.

- Absolutely not I don’t have the experience all the long Jevity in the market it’s ridiculous

- Definitely not they don’t have any experience or the advantage of developing these programs over the last 30 years

- If they do they should subject to ASD certification

- I believe it is essential that PHNs participate in the development of clinical software.

- There are opportunities here for cloud providers that can assist the PHN’s.

- This program is a national PHN data extraction and analysis service.

- Anyone who has been involved in the planning and development of the service or with PHNs are aware of this.

- The service has been discussed extensively across PHNs and with the Commonwealth Department of Health and AIHW for over 3 years. It is strongly supported by the DOH. It forms an integral part of the development of an informed primary care data set to support national primary care planning and service delivery, improving health outcomes for all Australians. While Australia through the AIHW has good quality data on hospitals it has very little on primary care.

- There has been a detailed business case.

- While I am not across the particular competition law intricacies, I’m not a lawyer, PHNs are not in competition with each other as they have defined regions set by the DOH. Participation by general practices is voluntary. Practices need to be accredited to be eligible for the Quality PIP payment. This again is a voluntary process and only around 70% are accredited. Rather than having 31 separate data collection and analysis software systems, the PHNs and the DOH agreed to develop a national system and further agreed that the WA Primary Health Alliance which runs the three WA PHNs was the appropriate manager.

- There is too much legacy with some of the current systems and getting any changes is slow.Involved Yes. That does not mean re-invent the wheel by building and deploying.

- They should be involved in offering advice to clinicians and involved in standard settings only

- We don't need yet another niche product that has the capability of leaking sensitive health data.

- Support the existing software vendors to have their products communicate with each other.

- Absolutely! PHNs are working with primary care to improve health outcomes.They should stick to their expertise of clinical care and meeting many of the WA community care gaps out there (there’s plenty!) and partner with IT experts - ask the vendors to meet their needs. They probably don’t know what these are. Typical WA health and IT!

- Good for competition

- They should engage industry to assist in the development of tools and focus on their own role

- Only to fill gaps not already met.I have no problem with the competitive angle of it, but it isn't their core business and trying to commercialise it is a poor use of public funds.

- unless true market failure exists - they need to talk to industry to establish what is possible to know this

- They aren’t software developers. They should stick to their core business. It will end in tears otherwise. PS: no idea what that is really!

- Where gaps exist - and there are many

- Using Government (public) funds for software development by PHNs is inefficient (subsidising failures) and ineffective (standards, registration, etc controls absent) which the commercial sector is better able to deliver to tender & contract specifications at a negotiated price.

- There is perfectly good software already created.

- There are enough wheels already, poor use of funds to invent another.

- Not a level playing field in terms of capital at risk

- The Industry (PMS's) have spend millions in time and development why should the Gov now allow tax payer funds to again be wasted this is a JOKE

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