Allscripts CEO Paul Black on electronic health record innovation.

Digital Health

Allscripts Sells Hospital EHR Segment for $700M

The quickly shifting EHR landscape saw another major move last week following Allscripts’ announcement that it is focusing its offerings by offloading its hospital EHR assets to Harris Computer, a subsidiary of Canada-based holding company Constellation Software.

Harris is set to acquire Allscripts’ Hospitals and Large Physician Practices business segment for $670M, plus an additional $30M tied to the segment’s performance in the next two years.

• The transaction includes Allscripts’ Sunrise, Paragon, TouchWorks, STAR, Opal, HealthQuest, and dbMotion solutions, which together accounted for $928M of the company’s $1.5B total revenue in 2021, but have also been steadily losing market share.

• The $700M valuation implies a 4.8x multiple on the hospital EHR segment’s expected earnings for this year, not particularly high given that other publicly traded EHR companies command an average multiple of over 10x, which reflects two consecutive years of shrinking revenue with another decline forecast for 2022.

• By divesting the contracting division, Allscripts can now “maximize focus” on its healthier service lines like the Practice Fusion EHR for small practices and the Veradigm analytics solution, which has faster growth (up 4.6% to $552M in 2021) and healthier margins than the legacy EHR business.

• Veradigm houses one of the largest EHR-linked patient databases available for research, transforming data from Allscripts’ clients into insights that help connect providers and payors to life sciences companies. The data flow won’t be affected by the hospital EHR division’s new ownership, and the platform will now serve as the core of the company’s operations moving forward.

The Takeaway

Allscripts has been committed to refining its offerings since posting a wide net loss in 2019, a process that included similar sales of its 2bPrecise genetic research arm and its CarePort patient coordination services. Offloading the business segment that generates a majority of its revenue highlights just how committed Allscripts is to focusing its portfolio on high growth areas, and the uptick in the company’s stock price following the announcement is a good indication that investors agree with that strategy.

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The Wire

• Record Exits: Mental health tech startup funding grew 139% to a record $5.5B in 2021, according to CB Insights’ State of Mental Health Tech 2021 Report. In line with the funding, last year also saw a record-breaking 43 exits split between 35 M&As, five SPACs, and three IPOs. Digital behavioral health companies are among the largest beneficiaries of the shift to virtual care, and recent reports have shown that these solutions are increasingly viewed as true substitutes to in-person care, which could spur more substantial investments as the sector matures.

• Kintsugi Funding: Mental health startup Kintsugi recently raised a $20M Series A round (total funding now $28M) to scale its KiVA voice biomarker API that provides clinical decision support through real-time scoring of patients’ mental health during visits. The KiVA platform is distinctive due to its ability to identify signs of clinical depression and anxiety based solely on how patients speak, as opposed to the words they use, which results in machine learning models that are uniquely language-agnostic.

• Patient Preferences: JLL’s recently published 2022 Patient Consumer Survey of 4,060 US residents revealed that nearly one in three telehealth visits led to an in-person visit, which could begin to drive an increase in overall visits. Respondents reported that convenience is the primary reason for opting for a telehealth visit, but the fact that a third of these appointments resulted in an in-person visit indicates that patients are willing to sacrifice convenience for quality care when needed, and that telehealth is an augment to the physical office, not a replacement.

• Motion Trainer Launch: RecoveryOne, a digital physical therapy company focused on musculoskeletal injuries, launched its AI-enabled Motion Trainer that uses a device’s built-in camera to provide real-time audiovisual feedback during exercises. The Motion Trainer eliminates the need for wearable sensors, removing a common barrier to entry for virtual physical therapy while circumventing potential problems with improper sensor placement and Bluetooth connectivity.

• Telephone Support: A new study published in JMIR showed that telephone support improved adherence to the Reboot Online digital pain management program. Participants were separated into two groups, with 45 receiving just the Reboot Online program, and 44 receiving Reboot Online plus telephone support. Participants with phone support had significantly higher enrollment (93% vs. 78%) and higher program commencement (91% vs. 60%), although there didn’t seem to be an impact program completion (48% vs 52%), which could suggest that support resources might be best used in the onboarding phase.

• Mental Health Roadmap: In his first State of the Union address, President Joe Biden outlined plans to address the nation’s mental health epidemic, which included expanding access to virtual care options. He stated that his administration will work with Congress to ensure health plans include telebehavioral health services, and that the HHS will coordinate with state departments to address barriers that limit the delivery of telemedicine across state lines, a policy shift with the potential to dramatically improve access to care.

• DarioHealth + Sanofi: Digital therapeutics company DarioHealth announced a $30M partnership with French biopharma giant Sanofi to help commercialize Dario’s digital health solutions and develop new tools leveraging the company’s platform. Dario’s platform is aimed at managing chronic conditions such as diabetes and hypertension, solutions that Sanofi will collaboratively promote while expanding Dario’s reach with health plans and large employers.

• HIV Care Retention: Patients being treated for HIV were found to be more likely to attend telehealth visits than in-person visits, according to new research from the Mount Sinai Hospital Infectious Disease Clinic (MSHIDC). For 347 patients receiving HIV treatment at MSHIDC, attendance was higher for telehealth visits (78.9%) than in-person visits (61.9%), indicating that the flexibility provided by telehealth helps to support retention in HIV care, which is a critical component of sustaining viral suppression in these patients.

• Plume Expansion: The largest transgender healthcare provider in the U.S., Plume, is expanding to four new states: New Hampshire, Connecticut, New Mexico, and Wisconsin. For $99/month, Plume members receive 24/7 gender-affirming care, consultations, and lab monitoring, with hormone medication services also available. The expansion advances Plume’s mission of delivering holistic gender-affirming care to anyone who needs it, making the services available to 93% of the U.S. transgender population across 37 states.

• Audio-Only Preferences: A recent survey of patients and staff at two Northern California health centers found that the switch from in-person to remote care during the pandemic was difficult for nonnative English speakers. The survey showed that the nonnative speakers had trouble using video applications with English instructions, and were more comfortable with audio-only formats. Although we’ve covered similar studies before, these results highlight the importance of reimbursing audio-only visits post-pandemic to make telehealth accessible to minority populations.

• Immunization Interoperability: The coronavirus pandemic raised a need for individuals to have digital access to their vaccination history through interoperal record-keeping technology such as SMART Health Cards, and it now appears that the same tech is being broadened to other uses such as longitudinal health records. At HIMS22 later this month, MITRE Corporation’s Dr. Brian Anderson and the Washington State Department of Health’s Bryant Karras will discuss the potential to use this technology beyond recording vaccination status, as well as an upcoming collaboration with the WHO to expand the tech globally.