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April 13, 2021 News 6 Comments

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AI solutions vendor Olive acquires Empiric Health, which offers AI-powered surgical analytics software.

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My reaction to Microsoft’s planned acquisition of Nuance for nearly $20 billion:

  • About two-thirds of Nuance’s business involves healthcare, but it also offers virtual assistants to customers ranging from Best Buy to the UK government’s tax collection service and also voice print-powered biometric security.
  • Microsoft is sitting on mountains of cash and seems anxious to spend it in unrelated ways in a bid for growth, having expensively acquired LinkedIn and a videogame company, while failing in its efforts to invest in TikTok or to buy the Discord messaging platform.
  • Microsoft was as late the cloud as it was to the Internet, and catching up to global competitors by acquisition is neither easy nor cheap.
  • Microsoft, Apple, and Samsung had reportedly considered acquiring Nuance in the past but did not make an offer, and the company drew no obvious acquisition interest until Microsoft came along.
  • Microsoft could have paid a lot less for Nuance last year or the year before, suggesting that either Microsoft was desperate to increase the credibility of its recently developed Cloud for Healthcare or that Nuance’s rapid move to the cloud and strong AI story made it more appealing.
  • MSFT previously paid way too much for Skype, LinkedIn, GitHub, Nokia’s smartphone business, and AQuantitative. It will pay 14 times annual revenue for Nuance.
  • It’s not public knowledge what agreements, if any, remain in place for Apple’s use of Nuance technology to power Siri. Apple seems to have quietly gone its own way and may no longer rely on Nuance, but if money still changes hands, having Microsoft as a critical Apple supplier would be awkward.
  • Nuance has a huge healthcare customer base, but it won’t be a slam dunk for Microsoft to sell into it given that many of those customers only run some version of Dragon Medical, don’t have a deep relationship with the company or see its salespeople, and aren’t necessarily prospects for related products. Microsoft obviously priced its offer thinking it can wring more profit out of Nuance, but it’s not clear how it will do that as an occasional healthcare dabbler (see: IBM Watson Health).
  • Microsoft’s previous healthcare failures are embarrassingly legendary — HealthVault, Sentillion, Amalga, Amalga HIS (an unrelated EHR), Amicore, and COVID-19 vaccine management.
  • Was Microsoft primarily looking for a strong healthcare vendor, a strong technology player in cloud and AI, or a leader in speech recognition technology that includes ambient intelligence? It gets all three for its generous acquisition price, but we’ll have to see how it packages the Nuance business and integrates it (Microsoft is usually very good at that). It also keeps Nuance out of the hands of competitors as the preferred computer interface moves to voice.
  • Nuance’s healthcare ubiquity means the best Microsoft can do short term is to not screw the business up or alienate its customers. Otherwise, it’s a very public stage that cuts no slack. At least Microsoft is leaving Nuance CEO Mark Benjamin in charge for continuity, although he had no healthcare experience before taking the job three years ago.


April 20 (Tuesday) noon ET. “The Modern Healthcare CIO: Digital Transformation in a Post-COVID World.” Sponsors: RingCentral, Net Health. Presenters: Dwight Raum, CIO, Johns Hopkins Medicine; Jeff Buda, VP/CIO, Floyd Medical Center. A panel of CIOs from large health systems will discuss how the digital health landscape is changing and what organizations can do now to meet future patient needs. Moderator Jason James, CIO of Net Health, will guide the panelists through topics that include continuum of care and telemedicine, employer-provided care delivery, consumerization of healthcare, and sustainability and workforce management.

April 21 (Wednesday) 1 ET. “Is Gig Work For You?” Sponsor: HIStalk. Presenter: Frank L. Poggio, retired health IT executive and active job search workshop presenter.  This workshop will cover both the advantages and disadvantages of being a gig worker. Attendees will learn how to how to decide if gig work is a good personal fit, find the right company, and protect themselves from unethical ones.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock


Cohere Health raises $36 million in a Series B round, bringing its total funding to $46 million. The startup has developed care coordination and preauthorization software to improve communication and collaboration between providers, payers, and patients.


  • Value-based kidney care software and services company Strive Health will use NextGate’s Enterprise Master Patient Index.



Kaiser Permanente promotes Diane Comer to chief information technology officer.


Frank Jennings (Covera Health) joins Castlight Health as SVP and chief sales officer.


The Sequoia Project hires Alan Swenson (Kno2) as executive director of health data exchange subsidiary Carequality.


Shaillee Juneja (Lumina Health Partners) joins Divurgent as principal.

Announcements and Implementations

Twenty-three hospitals in northeastern Ontario will implement Meditech Expanse as part of a new record-keeping alliance.


GetWellNetwork announces GA of GetWell Anywhere, which gives patients the ability to access engagement and educational resources from their mobile devices throughout various care stages and settings.

Government and Politics

Federal News Network digs into the problems VA clinicians have been dealing with during the transition to Cerner Millennium – a process that, despite initial reports of success, has prompted congressional leaders to call for a review before further rollouts are initiated. Users have noted an excessive number of clicks for certain tasks, data migration failures, dropped community care referrals, and needing to use Microsoft Teams to communicate with other users about EHR problems. The House Veterans Affairs Technology Modernization Subcommittee will meet later this week to review the $16 billion, 10-year project.


FDA asks states to temporarily stop using J&J’s COVID-19 vaccine following six reports of women who developed rare blood clots days after being vaccinated, pending CDC’s review of those cases starting Wednesday. Former FDA Scott Gottlieb, MD says consumers shouldn’t be worried since the alert was intended to remind physicians to monitor vaccine recipients more closely and report milder cases they may have been missing. 

A study finds that people who are hospitalized with the B117 coronavirus variant experience outcomes that are no worse than patients infected with other variants, while another study concludes that vaccines seem to be effective against B117.

Salesforce will allow only fully vaccinated employees to return to work in its San Francisco tower, raising questions about vaccine accessibility and the legality of mandating use of a product that has not earned full FDA approval.

China’s disease control director says the country’s self-developed vaccines offer low COVID-19 protection, leading it consider using MRNA vaccines such as those produced by Pfizer and Moderna. The official, who had previously questioned the safety of MRNA vaccines, walked back his comments afterward, saying that he was referring to all vaccines and not those specifically rolled out by China that use a more primitive vaccine platform. Another official says that China is developing its own MRNA-based vaccines.

Former CDC Director Robert Redfield, MD joins the board of Big Ass Fans, which makes unproven coronavirus claims about its $10,000 ionization fans for commercial spaces.



Google will conduct a user feedback study as it prepares to develop a consumer-facing health record tool similar to Apple’s Health Record app. Three hundred patients are being recruited for the study from Epic customers in Atlanta, Chicago, and Northern California. The search engine company’s last foray into personal health records, Google Health, lasted just three years, shutting down at the end of 2011. As I opined then, “The only model Google knows involves near-universal adoption that gets advertisers salivating, not having a tiny contingent of wellness buffs and savvy chronic disease sufferers using their free online service. Ultimately, Google’s problem is that an awful lot of Americans care about reality TV and celebrity gossip more than their health. They’re more interested in patch-me-up-doc ‘healthcare’ than I-need-to-make-better-choices ‘health’ that requires proactive electronic tools. The most shocking aspect of Google Health’s announcement in 2008 was either that Google hadn’t figured that out or that they thought they could succeed anyway.”

University of Wisconsin – Madison researchers find that use of the e-prescribing transaction type CancelRx increased the percentage of successfully discontinued outpatient prescriptions at UW Health. CancelRx, which was developed by the National Council for Prescription Drug Programs, sends pharmacies an electronic notice via Surescripts to not fill a previously sent prescription, which is then acknowledged by the pharmacy. It prevents meds from being filled or refilled in the case of an allergic reaction, a prescriber error, or a change in patient status. The authors note that few providers use CancelRx. I’ve seen previous implementation reports and a common problem is that since pharmacies are rarely set up to accept CancelRx transactions, provider EHRs require modification to turn the transaction into a fax.

Sponsor Updates

  • Cerner releases a new podcast, “Cerner Health Forum ’21 preview – Improving clinician efficiency and operational excellence.”
  • PerfectServe has placed among the top large vendors in a new KLAS report, “Vendor Performance in Response to the COVID-19 Crisis.”
  • OptimizeRx is named to the Financial Times list of “The Americas Fastest-Growing Companies” list for the second consecutive year.
  • Kyruus joins the Athenahealth Marketplace Program, enabling joint customers to offer seamless online appointment scheduling.
  • Premier joins a dozen organizations in urging HHS Secretary Xavier Becerra to extend the Next Generation ACO Model through 2022 and to create a permanent, full risk ACO option based on the NGACO model.
  • Meditech posts a new podcast titled “Different than a tornado: How Phoebe Putney Health System navigated the disaster response challenges of COVID-19.”
  • PatientBond publishes a white paper titled “Driving COVID-19 Vaccinations Using Healthcare Consumer Psychographic Segmentation: Research Insights and Solutions.”
  • InterSystems makes its IRIS data platform available on AWS Quick Start.

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Currently there are "6 comments" on this Article:

  1. Think MrHIStalk is right about Microsoft Nuance and I’m spitballing & not qualified for this back of envelope logic BUT if they are paying 14 times rev for Nuance AND they manage to get almost all the Nuance revenue into the Azure “bucket” AND revenue to Azure is more profitable than the rest of MSFT and bumps up overall market cap, can they mark this whole thing as a win by adding more to MSFTS market cap?

    • Yeah. This was less than 1% market cap for Microsoft and it fits relatively well with Azure. They don’t care so much about selling Dragon in the long run, they care about tapping the potential for the underlying tech over the next 10 years. If it doesn’t pan out they’ll just write it down as a tax loss and move the best developers (developers! developers! developers!) to other teams. If it does pan out, HIT software vendors will have one more reason to be hosted by msft instead of self, aws, etc. Maybe they are overpaying here but I don’t see that much downside, and could turn out pretty good for them.

    • I think this acquisition makes a lot of sense for Microsoft. The future is not on a mouse and keyboard, it’s voice control and augmented reality. There will be an exciting opportunity to integrate this with the Holo Lens which as far as I can tell is one of the more mature AR gadgets out there. When you pair Dragon + Holo Lens + Hey, Epic! and other types of integrations, you have the potential for a must-have product for certain types of providers. As others noted, this will be yet another reason for existing customers to adopt Azure and/or Azure AD. Azure AD identity integration is going to play a bigger role in healthcare consolidation than people realize. Managing healthcare user identities for external users and mergers is a PITA and Azure AD helps reduce the complexity quite a bit. Dragon can now bolt right on to that.

    • I agree with your analysis. I would add that Cortana hasn’t been well received by the market, so picking Dragon’s voice rec is a nice cherry on top of the reasons you state. They may not plan to sell a lot of the standalone product, but adding underlying technology to their stack is appealing. The talent acquisition is also nice.

  2. re: Kaiser Permanente promoting Diane Comer. VERY glad to see a woman landing the CTO role. Need to see more of this, more frequently and beyond Medical Officer, HR and Legal C-Suite positions.

  3. The Central Logic blog/post was riveting, or maybe better said, just mindless vendor fluff bolstered by military credentials, (which deserves honor in and of itself) that being said it was still a waste of print.

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