The two big power house US corporations also are expanding rapidly outsideimage the US borders and good to take a look once in a while as all subsidiaries as I always say so you know either as a consumer or an investor where the action’s taking place today as you may not always see the entire picture.  In the UK here’s a video from Cerner which shows what the Barts Health NHS trust is doing.  More NHS locations are installing medical records from Cerner it appears.  This is interesting as we all remember the NHS home built system that had the same fate as many in the US did before hospital systems went to commercial medical records systems.  You can view the Cerner UK site’s a little different than what you see here in the US and here’s the SEC subsidiary listing  as well as a few others on Wikipedia.

Barts Health Cerner

“From ongoing government regulations to rapid technology advancements, health care is changing. Health care systems around the world are now driven by similar market pressures to achieve better outcomes with less overall spend. From a health information point of view, it is no longer enough to correctly report what happened. Success in the new environment requires tangible improvements in outcomes -- utilising automated data from different venues to impact care in the moment and for the future.”

Cerner also has a business agreement with Equinix for data center hosting so medical records can be accessed anywhere.  In May of this year, two more Trusts in the UK went to “tender” though to take bids for their electronic medical records to replace Millennium and I’m sure Cerner is in there as a bidder as I don’t know how old the current Cerner installations could be.  By 2015 several trusts are supposed to have a system in place before national contracts expire.  Back in the earlier days there were were some riffs and issues with the medical records systems while the debate continued over vendor solutions or the NHS medical record software. 

Now United Healthcare also has a UK website that lists what servicesimage they provide there as well and it appears to be growing.  What seems to be quite a few of the services listed relate to their Optum Insights or Optum division type of services as it’s discussing efficiencies and evidence based care and you can’t get away from those discussions in the US by any means.  This is where it looks like some of the same analytics are provided by Cerner as well. 

It’s kind of hard to figure that out at times as back in the US, US Cerner is a a reseller of the Ingenix Coder and Grouper Workflow within the Millennium medical records system so more money there for that division of United Healthcare with each sale.  The Ingenix name for the most part has been retired I think due to the AMA lawsuit that was settled for short paying doctors and hospitals for 15 years with their analytics.  So when a Cerner Millennium system is sold there’s money for that subsidiary of United Healthcare as this module helps with the coding for look up and connecting to state payer systems.   In the software business those are called “licenses” for software. 

The current CEO of Optum Insights division of United Healthcare joined the company in 2008 and prior to moving Prior to to OptumInsight, Bill Miller was the vice president of Technologies at Cerner Corporation in Kansas City, Mo., for more than six years.  Interesting connections here as the software end of United benefits from Cerner sales.  No wonder an executive from United Healthcare is going to work to run the NHS, you think?  There are partnerships galore but when when big corporations make big money from partnerships, it tends to draw a lot more attention with publicly traded companies.

United Healthcare Executive to Leave the US and Run the NHS in England-Big Data Math Models and Algorithmic Business Intelligence Formulas On the Move…All About Money…

United sells a software system called “HealthNumerics” and you can watch a video here on what it does with integrating with NHS IT systems to include ScriptSwitch prescribing decision making support.  We see a lot of “decision making” software talked about and installed in the US as well.  United also is promoting health assessments and more information about this effort with identifying high risk patients is here and the same thing we hear in the US basically.  In addition there’s predictive modeling software to be used with Electronic records. 

United has 15 pages of subsidiaries listed with the SEC and worth a look.  The UnitedHealthGroup India page is interesting and has all kinds of job openings for engineers and coders. 

“As a global leader in health care, UnitedHealth Group has offices in 18 countries. In India alone, we have offices in Bangalore, Gurgaon, Hyderabad, Mumbai, NOIDA and Pune. By bringing your talents to the multidisciplinary team at UnitedHealth Group, you’ll be doing work that makes a difference to improve the health outcomes for members. Things will look better and brighter from day one. You’ll expand your knowledge, broaden your opportunities, and deepen your impact.”

This has all gone through a restructure of United to have an overall entity called “UnitedHealthGroup” under which new tiers have been added in the last couple of years.  The first thing you see on the home pages are “job openings”..domestic and international with focus on looking for Medicare/Medicaid sales reps and Tri-Care jobs to include everything from pharmacy careers, technology careers and sales and marketing. 

Here you can see 24 Offices in just India alone with UnitedHealthGroup.  This kind of brings me back around to the Healthcare.Gov website in wondering how much coding and outsourcing QSSI did as their country domain is listed as India. 

India Technology To Fix US Healthcare.Gov Website Now And Has Assumed The Lead Project Manager and Integrator Role, QSSI Listed As Indian Domiciled With United Healthcare SEC Filings

So not only domestically are IT related companies growing but also big time on an international basis, and you see some of the same types of technologies developed in the US making their way outside the US.  It is interesting to see the intersecting of software within Cerner and United with big partnerships and how one sale leads to another if you will.  Especially with United there’s a lot more to the story than just premiums and policies. 

Former CEO of United Healthcare, Dr. William McGuire who was caught back dating stock in 2007 was recently still reported as the ninth best paid CEO of the decade, so his big derivate fine didn’t hurt the income much and he sits on various boards today.  The current CEO was also caught with back dated stock options if you read the court case but not as much and Hemsley and was allowed to move from Chief Operation Officer to CEO?  I guess the dollar amounts mattered?  image

Again big powerful corporations moving their boundaries beyond the US worth looking at so you know who benefits today when you may not recognize a subsidiary effort.  Today math modeling is more important than ever and former Wall Street Quant Cathy O’Neil makes that point with an essay touching on the topic and how to be skeptic when you need to be, as corporate models, companies and banks need to be more transparent and hones with their math models as if only done for profit without calling for a high level of accuracy, the numbers do bottom out at some point in time, like subprime did.  There’s also another big concern here too with Quants and Actuaries too being commoditized to kick out math models in a short amount of time.  BD 

“On Being a Data Skeptic- Modelers Have A Bigger Responsibility Now Than Ever Before”–A Must Read Essay, Start “Sniffing the Data”…



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