In late 2011, Siemens became the latest in a long procession of healthcare behemoths to scoop up a health information exchange vendor, with its acquisition of Yardley, Pa.-based MobileMD.

Casting an eye towards shifting reimbursement models, Siemens officials say MobileMD’s cloud-based HIE service, with its focus on community-wide connectivity and care coordination beyond the walls of the hospital, will give a leg up for coming ACO initiatives.

John Glaser, CEO of Siemens Healthcare Health Services Business Unit, says the acquisition is in line with health reform's aim "to improve the quality of care by doing two basic things: increase utilization of electronic technology, for a variety of benefits, and improve the coordination of care among entities that had previously not shared data well."

MobileMD's technology is used by more than 110 hospitals and more than 2,000 physician practices. By enabling connectivity regardless of location, affiliation or EMR technology, hospitals connect even more doctors with critical patient data.

Todd Fisher, vice president of MobileMD, said the fact that Siemens, which of course has myriad products serving the acute care settings, is adding an HIE and care coordination platform will be "critically important to enable outreach to the ambulatory community and create an advantage for their health system clients," positioning the company for health reform as it merges "quality and holistic responsibility for a patient."

Siemens can leverage the acquisition to grow its client base: as MobileMD continues to sell to other physician practices and IDNs, the hope is that "in the future they'll see the light and buy more Siemens portfolio products," says Fisher.

Another appealing aspect, he says, is that MobileMD has “always pursued private exchanges, believing – and I believe our thesis is being proven – that the nationwide health information network is going to bubble up and grow similar to the way the World Wide Web developed: from the ground up, rather than the top down.”

"I think the private market has proven that it is going to take this torch and carry it to its logical conclusion: to wire the U.S. in such a way that health information can much more readily flow," he says.

Chilmark Research analyst John Moore notes that, although Siemens has an existing partnership with NextGen for ambulatory EHRs NextGen’s closed-system HIE prevented Siemens from being able to leverage that partnership for their clients' need to interface with many EHR vendors. He also wrote on the Chilmark site that he's "quite sure Siemens paid a premium for MobileMD."

That said, Moore guessed that most existing MobileMD customers are relieved with the buy. "Unlike the acquisitions of Axolotl and Medicity, which both fell into the hands of payers" – OptumInsight (UnitedHealth) and Aetna, respectively – "MobileMD is going to a fellow HIT vendor, which must assuage the fears of more than a few MobileMD customers and prospects," he wrote.

Steven Roth, CIO at Harrisburg-based Pinnacle Health, is one of those customers. And he doesn't mince words. He calls MobileMD "the best vendor I have ever worked with."

Pinnacle is a longtime Siemens user too, and Roth says the Soarian suite "has matured in a big way over the past five years."

But MobileMD "just got it," he says. "They understood exactly where I wanted to bring this initiative, [bringing] Pinnacle into the marketplace, as a 'private exchange,' but with the ability to incorporate content and participation and engagement from others in the market, including our competitors, if that's the direction we wanted to take with it."

Doctors "want information," says Roth, "and our ancillary services folks wanted an improved ability to provide the information. Knowing that this was a privately-funded initiative, knowing that in the long run we may want the other health systems to jump on as well, that drove the decision criteria around the vendors."

If, as Fisher says, there were a lot of "synergy points" for both Siemens and MobileMD to do this deal, Roth says organizations such as his own benefit from deals like this one, too.

The clinical benefits are paramount, of course. But in order for HIEs to bear care-improving fruit they need to stay up and running. "Organizations in a given market need to think about the ability of the HIE to drive business, and have clinical exchange and patient wellness and those kinds of things secondarily," says Roth. "That's a very capitalist model. But that's a model that can help fund a private exchange. Right now, I think there is a tremendous amount of opportunity for private exchanges."

A deal like this is good for "enterprises who are taking on physician practices who already have EMRs, using the HIE as that information exchange internally," he says. "We can connect our docs with hospital content without having to rip out all the EMRs that have been prevalent in the marketplace."

Three years ago, says Roth, "if a CIO said to me that they have five or six EMRs in their portfolio, I would have scratched my head and said, 'how and why would you want that?' Today, we have six ambulatory EMRs in our portfolio. We're using HIE to ease the transition, to allow information exchange between the employed physician and the organization without having each one of the practices start over from an IT infrastructure perspective.”

Roth likes the Siemens deal, but confesses that he had some trepidation. "My first thoughts were, 'I hope that the relationship and MobileMD's ability to execute doesn't get hampered by becoming a small piece of a big company,' he says.

"I also hope Siemens learns a little bit from Mobile MD," he adds. "I know Siemens has a strategy about how they'll incorporate third-party clinical content into the Soarian platform. So I'm hoping MobileMD can actually help them deliver on that strategy."

Likewise, he's "excited, in that I think capital infusion into MobileMD will help them progress where they were heading even more quickly. "