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Digital Health Startups Get The Same Toys As Everyone Else
Editor’s note: Sean Duffy is CEO of Omada Health. Follow him on Twitter @seanduffy.
Until this summer, a significant subset of U.S.-based healthcare entrepreneurs were unable to legally use one of the most fundamental, integral, and efficiency-boosting development tools out there: Amazon Web Services (AWS). Cue the sweaty palms and standing arm hairs of any developer reading this.
That’s because any healthcare startup that electronically transmits an individuals’ health information needs to comply with a set of laws from the Health Insurance Portability and Accountability Act (HIPAA). These laws, enacted in 1996, require that certain health information be protected by a set of privacy procedures and security safeguards for electronic transfer. Fair enough.
The trouble was that Amazon Web Services was unwilling to abide by the set of procedures needed to engage with companies that a required to be HIPAA compliant. There is a common contract called a Business Associate Agreement (BAA) that goes along with HIPAA compliance, and Amazon wouldn’t touch it.
The issue wasn’t that AWS (or any other big-name vendors) had privacy or security issues. Just the opposite: a gorilla like Amazon is quite secure, above and beyond others. They’ve got no other choice. But in order to be able to sign a BAA, there are some procedures you’ve got to implement, and Amazon didn’t want to. Things like agreeing to report a data breach, and promising that you wouldn’t further disclose protected health information were tough to stomach.
But it’s not just Amazon. The same reluctance was true of so many other vendors and services that health care entrepreneurs are so eager to use (like HubScout, Survey Monkey, and BugSnag, to name a few). The easy solution for them was simply to opt out altogether, leaving thousands of healthcare startups out to dry. Again, fair enough, and completely understandable. But over the last few years, as the technical and operational bits and pieces of a startup have been increasingly outsourced to efficiency-creating vendors, the digital health sector has been disadvantaged.
But today, September 23rd, 2013, a refresh on HIPAA officially goes live by way of a new piece of legislation called the HITECH Act. Among other things, like encouraging electronic medical record adoption, the new HITECH rules radically expand the definition of who needs to comply with a subset of the HIPAA rules. This changes the game, and because of it, many of the tools that have been off limits for certain health care entrepreneurs will now be fully accessible.
You see, there is a nuance in the HITECH rule: Let’s say you’re a vendor and the last thing on earth you want is to have protected health information anywhere near your service. You’d think that excuses you from becoming compliant, but it doesn’t. After the HITECH rule, if any customer sends this information through a vendor (whether they endorse it or not), and the vendor’s servers store this information, they’re subject to the HIPAA Security Rule. There is no mitigation of liability for an entity that refuses to enter into the requisite agreements that govern this relationship (again, called a BAA). In fact, a failure to enter these agreements becomes a violation on its own.
Amazon sufficiently prepared for this moment, and as of June 18th, 2013, AWS started signing BAAs.
Just last week, Survey Monkey announced by email that they’re now supporting HIPAA and will sign BAAs for customers on a Platinum plan. And here is a vendor trying to capitalize on the fact that other vendors might not be privy to these new changes.
The dominos are falling, and more will follow suit. After today, thousands of vendors might determine that they’re not currently compliant with HIPAA but need to be.
If you’re a vendor, this probably sounds horrible: the U.S. government jamming regulations down your throat. And yes, it is annoying. But healthcare entrepreneurs sit on the other side of the table, and after you dig into the details, needing to sign a BAA and comply with the associated regulations is more like a bee sting than a broken leg. It hurts a bit at first, might swell up and itch, but then you rub on the hydrocortisone cream and a week later you’re feeling just fine.
So if you think you might be in a position of having to comply, here is the letter of the law, straight from the horse’s mouth. A Business Associate needs to comply with 45 CFR 164.308, 164.310, 164.312 and 164.316.
Electronic Code of Federal Regulations
- 164.308 – Administrative Safeguards
- 164.310 – Physical Safegaurds
- 164.312 – Technical Safegaurds
- 164.316 – Policies and procedures and documentation requirements
As you browse through these, you might find that you do a lot of this already, and if you don’t, a number of them are smart practices for any company, not just those who need to comply with HIPAA. And if you have any questions, reach out to a health care legal firm like Hooper Lundy & Bookman, P.C. Many of them are happy to have introductory conversations for no cost.
If you do need to comply, and have to start signing BAAs, keep in mind that by putting up with a bit of red tape, you’ll be helping to accelerate innovation in the digital health ecosystem. And as hundreds of entrepreneurs plug away at solving the countless problems in health care, this will ultimately benefit numerous people (and patients) across the country.
Stephen Phillips, Partner at Hooper Lundy & Bookman, P.C. (health-law.com), edited this post.
Image: Shutterstock
Up Close And Personal With Microsoft's Surface 2 And Surface Pro 2
Now that the dust from Microsoft’s Surface event has settled, we’re left with two new tablets and one grand vision for the holidays — with three Surfaces now on the market, Microsoft has carved out a seemingly strong position for itself as people began to plan for some big purchases.
But really, how solid are Microsoft’s hardware plans? Alex went over most of the details during his own hands-on impressions, but here’s another take on the company’s new Surface tabletsjust for the sake of completeness. Oh, and if you’ve got about an hour to kill, you can watch the full event unfold here.
Surface 2
I have a habit of backing the wrong horses — the only phone I ever waited in line for was the Palm Pre, and the only tablet I ever waited in line for was the original Surface RT. The big issue seems to be that I’m a sucker for interesting hardware, and the Surface series is nothing if not interesting. The Surface 2 easily clears the bar set by its predecessor, though that may not be saying a whole lot.
Let’s consider the innards. My old RT seemed to groan under the weight of certain apps and services, but the Surface 2 seems better equipped to deal with the ol’ daily routine thanks to the inclusion of an NVIDIA Tegra 4 chipset (and 2GB of RAM) — it seemed plenty snapped as I fired up apps and swiped through websites. Battery life has gotten a boost as well, though the original was generally pretty trusty when it came to longevity, too.
And let’s not forget the screen. The increased color accuracy and bump in screen resolution (1080p vs 768p) means that the Surface 2′s display is a far cry over the panel Microsoft went with the last time. Sound quality has apparently been improved as well thanks to the inclusion of Dolby Digital sound, though it was nigh impossible to really get a feel for those aural nuances in a room full of loud, clamoring journalists.
There are little things, too. Though the weight difference between the original Surface and the Surface 2 is basically negligible (4 grams, if you’re splitting hairs), this new model feels remarkably more svelte and portable. The new color scheme is also pretty fetching; the Surface Pros retain their dark magnesium chassis, but the RT model is clad in a matte, smudge-resistant gray that serves as a neat little visual differentiator. It looks and feels great.
And yet I still can’t help but think the Surface 2 suffers from the same issue its older brother did: The hardware itself is respectable, impressive even, but Windows RT still doesn’t feel like it’s up to snuff from a consumer standpoint. There’s no denying that Windows 8.1 RT has patched some considerable holes and added some much-needed functionality to the mix, and the number of apps available in the Windows Store continues to swell — there are now more than 100,000 of them waiting to be downloaded. Still, running a version of Windows that can’t run the same apps or perform the way full-blown Windows devices do can be a hard proposition to grok for your average holiday buyer.
Regardless, this new version is a clear improvement over the model that came before, and with a price tag starting at $449, the Surface 2 just may give the iPad a run for its money (unless you wanted one of those fancy keyboard covers). I’m not convinced that RT is going to be around for the long haul, but I hope Microsoft manages to surprise me.
Surface Pro 2
Your mileage may vary, but I can’t help but think of the Surface Pro 2 as the real eyecatcher of the day. Yes, it looks functionally identical (by which I mean dark and chunky) to the model that came before it. Yes, the improvements may seem incremental. That said, all these changes add up in such a way that the Pro 2 seems like an awfully compelling piece of kit.
Inside the Pro 2 is a 1.6GHz Intel Core i5 chip, and you’ve got your choice of RAM and storage configurations (the priciest model tops out with 8GB of RAM and a 512GB SSD). It’s always tricky to get a feel for performance out in the field — and on apparently non-final hardware no less — but the Pro 2 easily kept up with me as I fired up apps with reckless abandon and indulged in a little midday Portal 2. Surface GM Panay said that the Pro 2 is more powerful than 95 percent of laptops on the market, and I’m looking forward to really putting this thing through its paces once the final models hit store shelves.
And then there’s the battery. Let’s face it: the Surface Pro was downright wimpy when it came to battery life, a major strike against the more robust tablet. This time around, we’re told that the Surface Pro 2 lasts between 60 and 75 percent longer than the model that preceded it — going off the results we saw in our review, that should net users somewhere between six and eight hours. Maybe not up to par with some of the more competitive ultrabooks out there, but it’s a damn sight better than what we’re used to with the older model. Throw in a 10.6-inch 1080p screen that’s tuned for color accuracy like the Surface 2 and you’ve got quite a mobile companion.
Well, sort of. With all that said, the form factor still presents some issues. No matter how clever Microsoft has been with its new two-stage kickstand design (and it’s really rather useful), propping a tablet on your lap and pecking away on a touchscreen is a tricky proposition for mobile workhorses. I don’t know that I’d necessarily choose the Surface Pro 2 over a more traditional notebook, but it’s definitely worth a second look if you’re shopping for your next portable PC.
C9 Hires A New CEO And Raises $12M For Sales Forecasting SaaS
C9 has a new CEO and $12 million in funding for its platform that helps customers forecast sales revenues. The Series D round was led by existing investors Mayfield Fund, InterWest Partners and Leapfrog Ventures. The company has raised a total of $40 million.
New CEO Michael Howard previously worked as chief marketing officer at EMC Greenplum. He replaces former CEO Jim Burleigh who is now Chief Operating Officer at Engine Yard. Founder Scott Weiner sits on the C9 board of directors.
C9 describes itself as a revenue performance management company. Its analytics platform helps companies gain insights through historical trends. It looks at what deals are not going to close or what is wrong with deals starting at the beginning of the quarter to help companies focus on the most important accounts or determine how to improve the sales process.
Underneath the hood is a data analytics technology that processes information with a NoSQL database. On top of it is an SQL layer for doing queries. It also has a data cache for in-memory analytics. Through its sales reports and dashboards, customers set filters that allow a data analyst to see in real time how sales are faring.
C9 competes with companies, such as Tibco Spotfire, Tableau Software, Lattice Engine and Birst, and customers include LinkedIn, Pandora and Thomson Reuters. It gets decent, but not across-the-board excellent reviews. On Trust Radius, one customer cited C9′s real-time views into the sales pipeline but dinged it for outages and occasional syncing issues with Salesforce.com. That’s enough for one DocuSign sales operations manager to consider different platforms. One customer said it is an excellent tool for sales, but a broader business intelligence tool might be just as useful.
The market for predictive analytics is getting more competitive with the advent of powerful data-analytics options. For companies like C9, the focus will have to be on quality of service. There is nothing worse than having a service fail that customers depend on to run their businesses.
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