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Morning Headlines 7/2/15

July 1, 2015 Headlines No Comments

Teladoc shares surge 50% in healthy IPO debut

Dallas-based telehealth vendor Teladoc raises $157 million in its IPO debut, valuing the company at $620 million. Stocks closed at $28.50, up 50 percent on its first day.

The Fatal Cost of Hospitals’ IT Ignorance

Leah Binder, president and CEO of Leapfrog Group, publishes a Wall Street Journal editorial suggesting that poor health IT implementations are plaguing US hospitals because the health care industry lags behind in technology and, as a result, hospital administrators lack the experience needed to successfully implement the new systems.

Doctors See Big Cybersecurity Risks, Compliance as Key for Hospitals

A survey of 272 physicians, administrators, and health IT professionals finds that physicians have a significantly lower opinion of their hospital’s ability to defend against a cyber attack than health IT professionals and administrators, and are far more likely to cite EHRs as the hospital’s primary vulnerability.

CMS: Hospitals can attest to first year of ‘meaningful use’ this summer

ONC will allow hospitals participating in Meaningful Use for the first time this year to attest this summer rather than waiting until January 1 as it had previously planned. 

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July 1, 2015 Headlines No Comments

Readers Write: Building Pillars of Success on a Foundation of Failures

July 1, 2015 Readers Write 7 Comments

Building Pillars of Success on a Foundation of Failures
By Randall N. Spratt

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As the days fly by toward my retirement later this year, I’ve spent some time reflecting on my 40-year career in information technology. It feels like just yesterday I was receiving my diploma from the University of Utah, eager to jump into my career and make my mark. As college grads begin to enter the workforce, I hope that sharing my path and insights may help them build the foundation of their own leadership aspirations.

I started my technology career as a junior Fortran 77 programmer. I was good — I mean really good. I could write 10,000 lines of code without ever writing down an idea. I could produce a bug-free, error-free compile the first time. I was so good that I was quickly promoted to manager. However, it turned out that being a good programmer did not mean that I was a good manager.

On the brink of retirement, when I look back at my career, I realize that I built pillars of success on a foundation of failures. In my first management position, as a programmer, I would tell everybody how to program. When they failed, I would just do it for them.

I found myself working harder and being less effective because I wasn’t managing — I was doing. Somewhere along those first few management jobs, I had my first ah-ha moment: it was my job to deploy resources to help people do their jobs, not to tell or simply do.

Strong leaders know when to let go. They are effective in sharing a common vision with others and they make conscious — and sometimes difficult — decisions about what they do with their time.

As a programmer, I had 100 percent control over what I did at work. Every single line of code came out of my hand. No one else had anything to do with whether or not the program worked. Now, as a CIO and CTO, I have absolutely no control over anything. It has been a steady process of learning to relinquish control and replace it with influence and coaching while providing opportunities to collaborate as a team. 

It took me some time to realize this, but as soon as I did, it immediately strengthened my management skills and things got a lot easier. Eventually, I began to spend more of my time traveling to our customers’ locations to install laboratory information systems. While on site, I gained a better understanding of the customer’s needs. I realized that what I was installing wasn’t necessarily what our customers wanted. To help solve this problem, I wrote more code. I felt that I knew what the end users wanted better than anyone else in my own company.

Once again, I began to fail because I took my eye off of the job of management. I was now a manager of managers. My job was to make sure that our customers were well served and that their voice was heard. The answer wasn’t to write more code — the answer was to relay information gleaned from the customer to the groups I managed so that we shared a common vision, a common set of goals, and a common understanding about what we were trying to accomplish for the customer.

It was very time consuming. The more responsibility I got, the more work there was to do, the more people there were to talk to, the more relationships there were to build, the more details there were to cover, the more people there were to appraise, the more raises there were to give.  Everything took more and more time.

This led to my second ah-ha moment: work is part of life but, for some people, work is life. My career and leadership path would depend on how well I knew myself and how I decided to spend my time.

No matter where we are in our careers, we all have one thing in common — we have only 24 hours in every day. No more, no less. After choosing to spend some number of those hours asleep, our paths diverge. We choose when we wake up and we decide what to do once we’re awake. Some of us wake up earlier and choose to go running, while others start later and sit with the paper and coffee. Some fire up email, some talk to a spouse or a friend. But each one of us makes choices about how to use our time.

At that point in my career, I discovered I would never understand the term work-life balance. It is not about balance, it’s about choices, decisions, and how you choose where to spend your 24 hours. Sooner or later you are going to be faced with tradeoffs and decisions. You can’t be a top developer or a CIO of a company and think that you’re still going to service every hobby, every person, and every relationship in your life in the same way. 

I created the time to be a leader in my field and I often had to give things up. Throughout the years, I gave up sports and many hobbies. As I began to have children, I chose to spend more time with my family and gave up time with friends. These choices were made consciously, with a deep knowledge of myself and a realization that although I was letting go of some things, I was gaining others.

As I look back at my career, I can recall many choices — some lucky, some wise, some painful, and some necessary. Writing code was easy — just me and the keyboard. The results spoke for themselves. Cultivating the skills to become a leader was much more subtle and nuanced, but in many respects, far more rewarding.

Randy Spratt is CIO and CTO of  McKesson Corporation.

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July 1, 2015 Readers Write 7 Comments

Morning Headlines 7/1/15

June 30, 2015 Headlines No Comments

Allscripts Takes $200M Equity Position in NantHealth and Expands Strategic Alliance to Enhance Precision Genomic Medicine at Point of Care

Allscripts invests $200 million in billionaire Patrick Soon-Shiong, MD’s startup NantHealth, taking 10 percent ownership of the company in return. At the same time, Soon-Shiong personally invests $100 million in Allscripts. The two have formed a partnerships to integrate and market their respective product offerings together.

Patient Use of Email, Facebook, and Physician Websites to Communicate with Physicians: A National Online Survey of Retail Pharmacy Users

CVS publishes findings from a study of customers with at least one chronic condition, finding that 37 percent reported contacting their physician by email within the last six-months.

Epic chosen as new electronic health record system for UC Irvine Health

UC Irvine Health (CA) announces that it will implement Epic as its next EHR.

Vietnamese 7th grader devises comprehensive, handy medical software

A seventh grader in Vietnam has coded a program designed to help doctors and medical students review the latest medical research for conditions they see regularly. The system includes 300 evidence-based treatment plans and is now being used at Hau Giang General Hospital’s Internal Medicine Faculty.

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June 30, 2015 Headlines No Comments

News 7/1/15

June 30, 2015 News No Comments

Top News

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Allscripts takes a 10 percent equity position in NantHealth for $200 million in cash, while NanthHealth billionaire founder Patrick Soon-Shiong personally invests $100 million in Allscripts. Co-development plans include product integration and work on personalized medicine. NantHealth is rumored to be mulling IPO plans, while Allscripts shares have dropped 16 percent in the past year.


Reader Comments

From Dr. N: “Re: EHRs. EHRs were developed out of coding and billing frameworks. This does not relate to MDs and patients. SOAP still remains the most efficient and meaningful format. However, click boxes, no doubt, would be helpful for meta data, also important. Software has the ability to pull down from the SOAP narrative format data to the click boxes. Minimal new language may need to be used by the MD in the narrative. I personally retired rather than using the completely useless EHR formats available. The current EHRs are subtly and obtusely changing MD thinking processes and predominately to the negative.”

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From Libby Litigator: “Re: Blue Shield of California. You mentioned that a former executive claims he was fired for trying to reduce the company’s outsourcing payments to Cognizant. BSCA’s former CTO also filed a lawsuit claiming he was fired for pointing out issues with Cognizant. His new employer CEO also worked for Blue Shield as a policy guy and got tired of trying to defend its non-profit status after he saw how it operated. Has anyone ever done that on the hospital side?” That is indeed a fascinating story, as former BSCA CTO Aaron Kaufman says his CIO boss fired him the day before he was due his $450K bonus for 2014 after Kaufman questioned selection of a particular vendor. BSCA countersued Kaufman in claiming that he charged $100,000 in personal expenses to his company credit card. Some of those charges involved a bowling party night out Kaufman spent with his girlfriend, “Sharknado” and “American Pie” actress Tara Reid, which made BSCA doubly unhappy because “inappropriate” photos like the one above made their way into the public eye. Kaufman said he had to use his company credit card because the wife he was divorcing had locked up his accounts. Most interesting (other than a healthcare CTO successfully wooing a Hollywood actress, even a minor and fading one like Reid) is how a supposedly non-profit insurer can justify paying a CTO an annual bonus of $450K. Kaufman is now EVP/chief product officer of SocialWellth, which earns top buzzword scores in unintelligibly describing its app certification business that it bought from the defunct Happtique as, “a digital health company that enables payers, providers, and employers to prescribe curated digital health assets and services to their end consumers at relevant touch points in their health journey, and in turn, receive actionable data to deliver value based care. Our profile-driven mobile computing platform integrates and aggregates mobile health apps, devices, and content while leveraging activation currency and social engagement to deliver personalized well-being experiences for consumers.”


HIStalk Announcements and Requests

It’s been four days since I faxed a form requesting my electronic records from a hospital and they haven’t responded. The only other method of contact listed is to call the HIM department, so I’ll do that next. I’m feeling the presence of an increasingly non-electronic bureaucratic wall.


Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.


Sales

PremierMD (FL) chooses the eClinicalWorks EHR and population health management suite.

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UC Irvine Health (CA) chooses Epic.

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UAB Medicine (AL) selects Athenahealth’s AthenaCoordinator Enterprise for patient access, referrals, and care transitions.


People

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Verisk Health hires Sean Creighton (CMS) as VP of risk adjustment solutions.

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A North Carolina newspaper’s review of 2014 CEO compensation of the state’s largest companies places Premier CEO Susan DeVore highest at $24.9 million, the first time a woman has topped the list. PINC share price is up 32 percent in the past year, valuing the company at $1.4 billion, of which DeVore holds around $8 million worth.

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Alternate site billing systems vendor Brightree hires Lori Jones (AirStrip) and Shaw Rietkerk (MModal) as EVPs.


Announcements and Implementations

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Wellcentive awards a $5,000 Medical Scholarship for Veterans to former Marine Captain Anthony DeSantis, a fourth-year medical student and Tillman Military Scholar at University of South Florida who was deployed to Fallujah, Iraq in 2007-2008.


Innovation and Research

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A seventh-grade student in Vietnam creates Health for Everyone, prize-winning software that contains clinical information, treatment plans, a drug-drug interaction checker, and a weekly medical quiz. The local hospital’s internal medicine department is using it,  proclaiming it to be “a wondrous, time-saving device which also updates doctors’ and nurses’ medical knowledge and expertise.”


Other

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A Wall Street Journal article called “How to Take Charge of Your Medical Records” urges patients to serve as their own data hub instead of relying on providers and their incompatible systems to send information back and forth. The reporter got a bit confused in thinking that the Blue Button website contains actual Medicare and VA patient information and the article takes a puzzling turn into the privacy of wearable device data, but it was otherwise a pretty good consumer-focused overview. I was interested that the ICEBlueButton app from Humetrix displays a QR code on a smartphone’s lock screen that paramedics can scan to display emergency medical information, with a $20 per year option to also immediately alert their emergency contacts.

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An AHRQ-funded study finds that providers like the convenience of allowing patients to upload information via their patient portal, but patients themselves struggle with usability issues and rarely upload anything. Secure messaging was accepted by both groups but sometimes caused provider workflow and workload problems. The study concludes that health IT improves outcomes only if used as part of more comprehensive programs and poor application usability impedes workflow.

Analysts from Goldman Sachs estimate that digital technology (in the form of the Internet of Things) will save $300 billion in annual US healthcare costs and generate $32 billion in revenue. My cynical experience is that the latter is much more likely to be realized than the former. One person’s excess costs is another person’s income and that other person often hires lobbyists, lawyers, and trade groups to keep the excess costs flowing into their pockets. 

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Eaze, the California company whose fast-track marijuana delivery service is known as “the Uber of pot,” jumps into telemedicine with with EazeMD, which consumers can use to obtain a medical marijuana card following a $25 video visit with a physician.

Tuesday night (June 30) is Leap Second, where the world’s clocks adjust for the slowing in the Earth’s rotation by adding an extra second to the day. Amazon had problems the last time it happened (in 2012) but has since changed its systems to add a tiny bit of time to each day rather than all at once.

A New Zealand doctor whose patient died after he unknowingly prescribed an inappropriate drug says he will no longer rely on his EHR’s automatic warnings and will instead review the records himself. The doctor says he doesn’t remember receiving a computer warning. The local hospital was also blamed for failing to integrate its systems after acquiring another practice.

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A decently designed survey of CVS pharmacy customers with at least one chronic condition finds that 37 percent have communicated with their physician by email. Around half are interested in tracking health, refilling prescriptions, and looking up information, with their preferred method being via online portals, which finished slightly ahead of email or mobile apps. Oddly, the study commentary opines that patients prefer email and Facebook to physician portals even though its results indicate otherwise. Nearly 20 percent of respondents said they have contacted their physicians on Facebook, which will surely alarm hospital risk managers everywhere. The study is disappointing only in that it took two years for it to wind its way through the bowels of journal publishing – the survey was performed in May and June of 2013, a decade ago in social media time.

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Unrelated but bizarre: two airline pilots from Argentina are fired for posting a YouTube video in which they turn over the controls of their plane during takeoff to a model who has been featured in Playboy. The passengers are filing suit against the airline, while the model says she will sue the pilot and co-pilot for sexual harassment in claiming they fondled her while fastening her seat belt.

Weird News Andy titles this story “Child to Be Raised By Wolves” in expressing relief that mom and baby Romulus are fine. A pregnant woman gets lost in a national forest while driving to her parents’ house and is stranded for three days when she runs out of gas and her cell phone battery dies. She gives birth and is finally rescued by Forest Service rangers responding to the forest fire she accidentally started.


Sponsor Updates

  • John Moore, managing partner of Chilmark Research, will deliver the keynote address at Galen Healthcare’s Galen Partner Advisory Council in Boston August 3-4.
  • ADP AdvancedMD offers “Flag these ICD-10 codes for the Fourth of July.”
  • Team AirStrip wins the San Diego International Triathlon Mixed Relay.
  • AirWatch offers “IDC confirms: AirWatch by VMware holds largest EMM market share.”
  • Besler Consulting posts “Making the Case for Dedicated Observation Units.”
  • CapsuleTech offers “AMIA Task Force Calls for Simplification and Speed in EHR Use.”
  • Caradigm offers “Super Clinically Integrated Networks will Lead the Way to Population Health.”
  • CareSync publishes “Project Manager Field Research.”
  • CitiusTech celebrates its 10th anniversary.
  • CoverMyMeds offers “CoverMyMeds – As Secure as Ever.”
  • CTG participates in the 20th annual Ride for Roswell to raise funds for the Roswell Park Cancer Institute.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 30, 2015 News No Comments

Morning Headlines 6/30/15

June 29, 2015 Headlines No Comments

Source Data Capture From Electronic Health Records: Using Standardized Clinical Research Data

The FDA will host a demonstration day for vendors to showcase technology that will help it mine EHRs for automated clinical trial data capture.

Despite Threats, Senate Appropriations Bill Currently Remains Free of ICD-10 Delay Amendment

Though a number of competing bills have recently been introduced in Congress to delay or outright cancel the upcoming ICD-10 transition, AHIMA reports that the Senate Appropriations Bill remains free of any language that could derail the transition.

Improving prediction of fall risk among nursing home residents using electronic medical records

Researchers develop an algorithm that uses either EHR data or MDS 3.0 data to predict fall risk for patients in the nursing home setting, finding that EHR data was almost 10 percent more accurate at forecasting falls.

Texas medical fraud case screams for tighter auditing by feds

The Dallas Morning News looks back on the $18 million Meaningful Use attestation fraud scam that left the owner and CFO of Shelby Regional Medical Center (TX) in jail, citing it as a key example of why the program needs more stringent audits.

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June 29, 2015 Headlines No Comments

Curbside Consult with Dr. Jayne 6/29/15

June 29, 2015 News No Comments

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I agree with Mr. H that this is a slow time of year for healthcare IT news. Not only is it a slow time for news, but it seems to be a slow time for overall productivity as well.

I’m working with a client right now that is having a hard time getting anything done. Their teams are extremely lean and most staff operate without a backup, so vacations have a significant impact. Additionally, it feels like when we have the right people in place from the client side, there is a good likelihood that someone will be out from the vendor side.

I did some work a couple of years ago that involved a Swedish vendor. We were up against an extremely tight timeline because we had been warned that the entire company (literally) would be on vacation for four weeks during the summer. I remember thinking they must be terribly progressive, some kind of Scandinavian high-tech outlier going to extremes to keep their staff happy. After a little digging, we determined it wasn’t that unusual at all – since the late 1970s, Sweden has mandated five weeks of vacation for their workers. Many take the majority of them in the summer.

There are a variety of reasons that approach wouldn’t get very far in the United States. In addition to the political and economic factors opposing it, think about the planning needed to pull it off. Even for a small company, it would involve a great deal of strategic planning to ensure that the time off is factored into all projects. It would also require that projects are actually executed on time so that there are no last-minute pushes into the vacation.

In digging into the economic factors, though, I wonder if the return on investment for something like that might be real. If you look at the lost productivity encountered at a hospital like my current client, it’s significant. Workers are continually coming to the office late or leaving early for a variety of issues: traffic patterns are different with children out of school; childcare situations may be less predictable during the summer months; and tourism picks up in the city, resulting in parking and other logistical issues. We’re also seeing more people working from home to keep an eye on their children, resulting in a greater percentage of online meetings with barking dogs, background noise, and the occasional yelling dad who forgets to use the mute button.

I was looking for information on countries with more liberal vacation policies and came across this great Washington Post summary. It discusses the work of Swedish environmental psychologist Terry Hartig, who notes that those returning from a relaxing vacation tend to return to the office relaxed. I see more and more people “vacationing” with their smartphones, laptops, and piles of documents. Not only are they not enjoying their time away, but I’ve also seen feelings of guilt for those back in the office who feel bad for having to contact them. For those staffers who manage to avoid calling in for meetings, there are productivity-sapping discussions when their colleagues discuss the Facebook posts of those who are soaking up the sun.

Hartig’s research looked at prescriptions for anti-depressant drugs in Sweden over more than a decade. When people vacationed simultaneously, there were fewer prescriptions. The article (from 2014) lists the annual cost of depression at $23 billion a year in the US, so we can add that into the ROI calculation. Hartig also notes that Europeans spend less on healthcare and live longer than Americans – and have 20 to 30 vacation days a year. US companies seem to be cutting back on vacation unless it’s contractually mandated.

A couple of years ago, my health system did a “realignment” of vacation and sick time policies. They essentially declared that ours were too generous and out of line with other employers in our metropolitan area. We had previously been allotted seven corporate holidays and two personal holidays. The personal holidays were originally intended to allow employees to have time off for those holidays that were not corporately-declared, such as Christmas Eve, New Year’s Eve, Columbus Day, Presidents Day, Martin Luther King Day, Veterans Day, etc. if they were important to the employee. The HR people found out that no one else offered anything like that, so the personal days were cut.

That began a race to the bottom that ended with not only the elimination of the personal holidays, but all personal days in general. They also reduced the ability to carry over vacation days from year to year and eliminated the existing vacation buy-back program. They announced the new carry over rules during the last two months of the year. Many departments were getting ready for a major system migration after the first of the year and vacations weren’t being approved, resulting in many more employees who had to lose it rather than use it. Managers were given virtually no flexibility to accommodate their employees. The end result felt a lot like theft.

The Washington Post piece also notes that “the US is the only advanced economy with no national vacation policy (unless you count Suriname, Nepal, and Guyana).” Nearly 25 percent of workers have no paid vacation at all with those who do have vacation averaging 10-14 days a year. When I left my CMIO role, the vacation policies were a total patchwork. Employed physicians in direct patient care were allotted 15 vacation days and five continuing medical education (CME) days for a total of 20 days plus the corporate holidays. Administrative physicians had the same number of vacation days and holidays, but were allocated no CME days. I suppose that means that once you are an administrator you either lack the capacity to learn or the organization assumes you already know everything.

Anyone less than a manager title only got 10 vacation days, regardless of seniority. Even the sick-time policy was confusing. Hourly employees could take their time in one-hour increments but salaried employees had to take it in four-hour blocks. Although they told us that as salaried employees we had the ability to take an hour off here and there without formally requesting it, there was a lot of pressure to make up any time out of the office. The net result was that very few salaried employees were actually able to take advantage of their sick time unless they were seriously ill.

Losing vacation and sick days is fairly common, with the article mentioning an estimated 577 million unused days each year which equates to “$67 billion in lost travel spending and 1.2 million jobs.” Adding that to the ROI, I’m starting to wonder if we can afford to NOT take more vacation. It also mentions some interesting political facts:

  • In 1910, William Howard Taft proposed giving American workers two to three months of paid vacation each year.
  • John Muir recommended compulsory vacationing as better for the country than compulsory schooling.
  • The 1938 Congress proposed the 40-hour work week, a minimum wage, and two weeks paid vacation.

I’m taking several vacations this summer, mostly to make up for the lack of them during the last several years. I also have the luxury of being my own boss right now, so it’s much easier than before to schedule a vacation. It’s a bit harder to execute, though, since I’m a corporation of one. Even when clients are understanding and know I will be out of the office, it takes a conscious effort to disconnect. Checking my phone is tempting but it usually results in at least half an hour of work, so I try not to do it at all.

I’m staging all my projects for the next couple of weeks in preparation for some wilderness adventures. I can’t wait to be not only out of the office but in a place that literally has no cell towers or electricity. It also has no running water, but I’m not exactly looking forward to that. I’m sure some of my fellow travelers will be bringing solar chargers or Biolite stoves, but I’m not even taking anything with a USB port.

What’s your strategy for disconnecting when you’re out of the office? Email me.

Email Dr. Jayne.

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June 29, 2015 News No Comments

Morning Headlines 6/29/15

June 28, 2015 Headlines No Comments

Indictment In UPMC Stolen Identity Scheme

A federal grand jury in Pittsburgh returned a 21-count indictment against a foreign suspect charged with filing 900 fraudulent tax returns using the information of UPMC employees, The employee’s data was compromised in a 2014 breach that impacted 62,000 employees.

State Of Software Security – Volume 6: Focus on Industry Verticals

A Veracode report finds that healthcare is poor at keeping up with security policy compliance, with 80 percent of tested healthcare applications containing cryptographic issues, and only 43 percent of known issues being corrected.

Electronic Health Records Come Under Fire in Ventura County, Calif.

The Ventura County (CA) civil grand jury says that the Ventura County Health Care Agency failed to adequately prepare for its $50 million implementation of Cerner across two hospitals and 40 clinics. The new system, which the director of the Health Care Agency says is working fine, reportedly caused frequent crashes and problems generating prescription labels.

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June 28, 2015 Headlines No Comments

Monday Morning Update 6/29/15

June 27, 2015 News 2 Comments

Top News

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A federal grand jury indicts a foreign suspect for using employee information obtained in the 2014 hacking of UPMC’s computer systems to file 900 fraudulent federal tax returns that netted a group of conspirators $1.5 million.


Reader Comments

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From FM: “Re: Brian Weiss’s article. Great article, Brian. The ‘HIE of one’ is the most simple, and most disruptive, way to achieve interoperability, and all enabled by simple technical building blocks (Direct, C-CDA) plus our inalienable civil rights. All we have to do now is ask. #GetMyHealthData.” I’m doing my own HIE of one, as you’ll read in the next paragraph. I invite readers to do the same and report their results. We keep talking about information blocking, so let’s name names in trying to wrest an electronically transmitted C-CDA from providers who have eagerly lapped from the Meaningful Use trough and therefore should be able to provide one.


HIStalk Announcements and Requests

I am accepting Brian Weiss’s suggestion that we all become Open Provider Authorized Testing Bodies in requesting an electronic copy of my discharge summary from my one and only hospital admission, which lasted less than a day. It’s an EMRAM Stage 7, Epic-using, MU2-attesting medical center that should be able to send a C-CDA to my newly created Direct address (via Carebox, signup for which took 10 seconds). I suspect clashes with a clueless bureaucracy are in my future as I’ve already had to print a confusing HIM-centric paper form, fill it out (minus my medical record number, since it’s ridiculous that they expect patients to know that), and fax it back (using a free Internet fax service since I don’t even have a landline, much less a fax machine). I’ll be interested to see how they verify my identity and respond to my request for an electronic copy, which could be either easier or harder since they use an outsourced release of information company. The form didn’t even ask what method of delivery I preferred, so if it weren’t for the fact that they’ll probably call up wanting a per-page fee paid before sending me my records, I would probably get a package of paper in the mail by default.

Speaking of Brian’s article, I’ll offer a counterpoint to his suggestion that getting a copy of your own C-CDA means the sender’s EHR is open. That’s a great start, but it doesn’t do a whole lot for interoperability with other providers. It’s annoying for health systems and practices to send out C-CDAs to patients, but it’s downright threatening for them to open up their full patient information to competitors, which is what you would want as the subject of the overused “unconscious in the ED” scenario.

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Poll respondents are split as to whether the EXTREME criteria adequately define open, interoperable EHRs. The no-voters unfortunately didn’t tell us what the authors missed. IP address analysis showed no evidence of ballot box stuffing, but I noticed that most of the Epic-based respondents chose “no.” New poll to your right or here, as suggested by a reader’s comment: is HIPAA’s impact on privacy positive or negative? It seems like an obvious “positive” on first glance, but as the reader points out, HHS gave providers complete control to use patient information without consent and with minimal disclosure requirements, pretty much killing the idea that patients own their data (not to mention that the full law failed to accomplish the “P” of insurance portability that didn’t happen until ACA). Rampant misinterpretation of HIPAA, where providers conveniently claim that anything they don’t want to do is prohibited by HIPAA, is a different issue.

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Need consulting help? Consider using the RFI Blaster, which lets you send a brief description of your project to one or several consulting firms via one simple online form, also allowing you to choose your desired method of contact (phone number is optional, in other words). The CIO of a large health system suggested I create it and he’s had success using it since it puts him in control while requiring little of his time or energy.

I’m on a pet peeve streak, apparently. For those who latched onto the trite phrase “not so much,” it’s as eye-rollingly out of touch as a leisure suit. I’m also annoyed at the traffic-desperate “news” sites that repeatedly tweet out old stories like “Epic CEO to donate 99 percent of fortune” over and over again for many days (the actual story was published 12 days ago and they’re still tweeting about it, while another just-tweeted story was posted 22 days ago) hoping to eventually con followers into clicking. It’s also like CNN, which keeps old stories high on the page hoping bored passers-by will click out of instinct, which at least isn’t as bad as milking minimal impact stories (still-missing flights or still-fleeing prisoners) while ignoring less entertaining but far more important topics, such as whether Greece will default or the impact of terrorist attacks in Tunisia.

It’s going to be an easy read today because nearly nothing is happening in healthcare IT this holiday week. I won’t waste your time passing off junk as news.


Last Week’s Most Interesting News

  • The Supreme Court upholds the legality of the Affordable Care Act’s subsidies for residents of states that don’t run their own health insurance exchanges, leaving ACA intact and sending shares of insurance companies and for-profit hospital companies soaring.
  • Google confirms that it is developing an industrial-grade, prescription-only wristband that will collect patient and environmental information for clinical studies.
  • Aurora Health Care (WI) takes a lead investor role in StartUp Health.
  • A Federal Aviation Administration RFI discloses its intentions to connect its pilot medical exam system to government EHRs, hoping to detect safety-endangering medical conditions such as depression.
  • Video visit provider MDLive raises $50 million in funding.

Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.


Announcements and Implementations

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Private equity firm co-founder Joshua Harris donates $5 million to create a precision wellness center at Mount Sinai Hospital (NY).


Privacy and Security

Google is caught secretly installing audio listening software as part of its Chrome browser extension that allows it to respond to audio commands.

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A Veracode report finds that healthcare implements security poorly, with 80 percent of applications having cryptographic issues such as weak algorithms and  only 43 percent of known vulnerabilities being fixed. Still, healthcare scored much higher than the bottom-dwelling government. The numbers aren’t necessarily relevant, however, since they include only those self-selected organizations that engaged Veracode to assess their software risk.


Other

A grand jury finds that Ventura County, CA prepared poorly for its $50 million Cerner implementation, with frequent downtime causing care delays. The agency defended itself by questioning why their project required a third review, with the jury foreman explaining, “We had complaints from the public concerning what happened after the system was live. There were still an awful lot of complaints.”

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Bristol Hospital (CT) lays off 5 percent of its workforce in four areas, one of them the IT department.

The City of Pittsburgh drops its lawsuit challenging UPMC’s tax-exempt status and UPMC does the same with its countersuit, with the cash-strapped city hoping that more cordial relations will save legal costs and possibly convince UPMC (as well as Highmark, the University of Pittsburgh, and Carnegie Mellon University) to chip in some of the $20 million the city wants non-profits to pay toward their consumption of city services.

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A former executive of Blue Shield of California files a wrongful termination lawsuit claiming that he was fired for trying to reduce its use of outsourcer Cognizant. He claims that a Cognizant VP tried to bribe him by offering, “You can join me for a party at a sex club in Sacramento. We have some very beautiful women there.” The company fired him for sexual harassment of women, saying his homosexuality was irrelevant.

Weird News Andy says this was an easily made termination, although firing isn’t enough. The Detroit Fire Department terminates an EMT who refused to respond to the house of an eight-month-old baby whose mother called 911 to report that she wasn’t breathing, with the EMT providing as an excuse to the dispatcher, “I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”


Sponsor Updates

  • Valence Health announces Penn professor and author Ezekiel Emanuel, MD, PhD a keynote speaker for its value-based care conference in Chicago September 30 – October 2.
  • Aventura describes implementation of its Roaming Aware Desktop at Republic County Hospital (KS).
  • Surgical Information Systems announces that motivational speaker Denise Ryan will keynote its Go!2015 User Meeting August 23-26 in Atlanta.
  • T-System will exhibit at TxHIMA June 28-30 in San Marcos, TX.
  • Zynx Health posts “Going Beyond the Web and Mobile Tech: Enhancing the Patient Experience Through the Next Wave of Digital Innovation.”
  • Valence Health will exhibit at the Health Technology Research Alliance & Council Summit June 28-30 in Gettysburg, PA.
  • ZirMed offers “How to reduce time spent working denials by 66%, streamlining front-end tasks to spend more time on patient care, and ANI news.”
  • Voalte offers “With Humility Comes Many Blessings.”
  • West Corp.’s Laura Bramschreiber offers “Helping patients graduate to good health” on the HIMSS Future Care blog.
  • ZeOmega offers “Payer/Provider Collaboration: What Works?”
  • Xerox Healthcare offers “Data Science That Simplifies Healthcare Delivery Analytics.”
  • Verisk Health partners with the Association for Community Affiliated Plans to provide its members with healthcare analytics education and results-driven programs.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 27, 2015 News 2 Comments

Startup CEOs and Investors: Brian Weiss

We Need Open Providers (An Alternative View on Open EHR)
By Brian Weiss

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Open EHRs, Soft Drinks, and Leprechauns

Just under a year ago, having surfaced the disturbing and shocking possibility that EHR vendor marketing claims may not all be objectively measured and verified, Mr. H issued a challenge to have someone (other than EHR vendors) define what an “open” EHR really is. That call was answered by two PhDs named Sittig and Wright and a summary of their work was recently published on HIStalk.

You know Mr. H must be pretty excited about something when – despite his admirable track record of correctly calling out flawed survey/study methodologies by others – he set up this week a Yes/No survey with the guidance that if you provide the answer he wants (in support of the self-declared “consensus” about what a great job Sittig and Wright did) you can just vote “yes”, but “if you vote no, it’s only fair that you click the poll’s Comments link to describe what they missed.” Since not everyone is prepared to challenge (in writing) the work of well-credentialed experts, I’m thinking that might introduce a little unintended skew into the survey results.

I think it’s always good for HIStalk when Mr. H is passionate about a subject. However, if we’re going to go after questionable marketing claims, I think it would be great if Mr. H challenged readers to draft measurable standards for claims in other industries as well. For example, what criteria must a cola beverage meet to legitimately claim to be “The Real Thing” or to “Change the Game?”

Does the DoD purchase soft drinks for its personnel? If so, maybe we can get Congress involved here as well. Granted, we probably should stick to the IT realm in general and open IT systems in particular, where the government has demonstrated a strong track record. I’m sure you have also been impressed with the government work being done on Open Personnel Management Systems, which enable a much more efficient global process on security clearances without all that redundant background checking work by multiple countries.

So, no reason to limit ourselves to health IT. I noticed that Sittig and Wright established as a must-have criteria for EHRs that, “An organization can move all its patient records to a new EHR.” Can we do that in other IT areas as well so that purchasers of all IT systems always know they can change their mind at any time? How about with cellular phone plans?

But I digress. Mr. H has earned the right to establish what it is we should be debating and defining, and if he wants us to figure out whether Goofy is or isn’t a dog, what a Leprechaun is, or what an open EHR really is, I’m there.

Send Me the Encyclopedia

I actually don’t have any issues with the specific criteria proposed by Sittig and Wright for defining the mythological creature I’ll call Nessie and they refer to as an open EHR. Even if I did, how can I argue with a summary when I can’t even begin to fathom the precise definition of most of the terms it uses? We can spend years debating what it means for an EHR to provide “role-based access,” “where data are stored and what they mean,” “controlled clinical vocabulary,” “record-locator service functionality,” “existing metadata,” “appropriate support and maintenance,” or “authorized users.” This is how Meaningful Use regulations get to be thousands of pages long.

I’m also not really sure which EHR vendors can actually submit their products for evaluation since the authors of the summary indicated that any vendor that chooses to “maintain a degree of control over access to their software for financial, security, intellectual property, and reliability reasons” can’t be considered “truly open.” And I fear some EHR vendors might fall into that category.

Again, I digress. All in all, I think the Sittig and Wright piece is a pretty good summary of conventional thinking on what constitutes an open EHR.

Welcome to our Dysfunctional Family

My issue is not with the proposed definition of what an open EHR is or isn’t. My issue is that I think we’re focused on the wrong approach to achieving our goals. Like the “National Health Network” or “Beacon HIEs” or “Interoperability Alliances” before it, debating the definition of an open EHR is like looking for a lost wallet where the lighting is best rather than where it might actually be found.

What is it we are looking for? I think Sittig and Wright say it pretty well: “… to address the needs of patients, so they can access their personal health information no matter where they receive their healthcare; clinicians, so they can provide safe and effective healthcare; researchers, so they can advance our understanding of disease and healthcare processes… and software developers, so they can… create new applications to improve the practice of medicine …”

Why is open EHR where the light (of Congress, HIStalk, and so many vendors and providers in the HIT world) is shining, but not where we can find the answer? I think Sittig and Wright started to also say that pretty well: “…in addition to having all EHRs meet these technical requirements, we must also begin addressing the myriad socio-legal barriers (e.g., lack of a unique patient identifier, information blocking, high margin fee-for-service clinical testing) to widespread health information exchange required to transform the modern EHR-enabled healthcare delivery system.”

In my view, “myriad of socio-legal barriers” is a huge understatement. EHR vendor product features (open or otherwise) are a tiny fraction of the issue. And what about all the new forms of healthcare data sources like telehealth, urgent care centers, mail-in clinical or genetic lab tests, personal monitoring devices,  and everything else that isn’t an EHR (open or otherwise)?

Don’t Forget To Update Me on Progress Next Decade

What I think we are capturing in a potential Mr. H-driven consensus on the definition of an open EHR is another meaningless piece of a puzzle that, when complete, will give us a vision of what a theoretical fantasy healthcare world might look like in “one decade from now” (meaning, one decade from whenever you choose to take a look, for eternity).

I have no illusion that the people who are still reading this article are going to be convinced by what I’ve written. And even if all three of them are convinced, I don’t think that will alter the course of the ongoing Congressional hearings, ONC roadmaps, standards body committees, industry consortiums, EHR vendor leader visions, and everything else driving all the never-ending work on “legacy approaches to healthcare data interoperability.”

Plus, other than my youngest son (who is already rapidly changing his mind), does anybody else think that I know more than everyone else? Given the more qualified, more experienced, and smarter people working on this stuff, not only won’t I stop them, I really don’t want to. What if they are right and the emperor is in a stunning getup?

My plea is only this. Let’s also consider an alternative, parallel approach. One from the world I termed (in my not-academic, 20-minute study titled A Tale of Two Healthcare Worlds) “CCHIT” – consumer-centric healthcare IT.

In the few words I (really don’t) have left in this article (even my beloved three readers are now fading fast), I will now publish my definition of open EHR, and more importantly, open provider (note, Mr. H, that unlike Sittig and Wright, I don’t work for a provider, so it’s legit for me to do this one).

You Probably Already Have an Open EHR

If your EHR is MU2-compliant, it’s open enough for me. You just need to validate it is configured (as it should be, and most are) to send MU2-compatible C-CDA documents to any patient-authorized application using Direct Messaging.

Yes, I know CDA is ambiguous and has other issues. As long as the CDAs the EHR sends pass the MU2 certification validator (flawed as it is), that’s good enough.

To meet my self-appointed standards for open EHR, you need to make sure the freely downloadable NATE NBB4C trust-bundle is loaded. That means the EHR can easily and instantly send a patient clinical summary directly to any consumer/personal health product that is part of that NATE NBB4C trust bundle (which they all should be).

Nothing new to buy, no new standards or regulations needed. We’re done. Open EHR is here (and everywhere). Now comes the hard part … 

Open Provider

To save HIStalk PhD readers the work of defining it, let’s jump straight to the certification/testing process for open provider. I now officially declare every patient in America an “Open Provider Authorized Testing Body” (OPATB). Here’s what you do:

  1. Sign up for a free Carebox at https://carebox.it.
  2. Go to the “DIRECT Inbox” feature under “Import” and note your personal Direct Messaging address.
  3. Go to any doctor or hospital that received at least one penny in Meaningful Use money and ask them to send you your clinical summary to that address using their EHR.

OK, you don’t really have to use my product for Steps 1 and 2. There are plenty of other applications that will give you a Direct Messaging address. But since I am making up the rules here, I get to self-promote a little. Plus, mine is free right now and there’s nothing to install, so you can just ignore it after you are done with your role as an OPATB.

Here’s how you score the provider. If in less than five minutes your clinical summary shows up in Carebox, you give them an open provider certificate, a sash they can wear at next year’s HIStalkapalooza, and a big hug from me.

If they ask you to pay anything, make you fill out forms, tell you it’s a “HIPAA issue” for them (it is, but in the sense that HIPAA says they have to do this, not the other way around), send you across town to their “records department,” ask you to provide them a self-addressed stamped envelope and expect some paper records within 30 days, or anything else, you can let Dr. Halamka know that he can stop working so hard to find an “Information Blocker,” at least by my definition.

Which Brings Me Back to Cerner

Mr. H started his initial open EHR challenge last year because he was upset with something that a reader reported was stated on a Cerner conference call about how they were open and others were not. So, Mr. H probably will not be happy to learn that I’m compiling a list of open EHR vendors who support open providers, and guess who is at the top of the list?

Why? Because I got an unsolicited call from two gentlemen at Cerner (I’d be thrilled to name them, but I don’t know if they want me to) who work on Direct Messaging. They wanted to be sure that bi-directional CCD exchange between Cerner and my no-name little startup product actually works. They showed me how easy it was for any PowerChart user — as well as users of many other Cerner apps, which all come pre-enabled to “Send Direct” and pre-configured to support the NBB4C trust bundle noted above – to send any patient’s record right into their Carebox. It worked flawlessly on the first try.

Hopefully other EHR vendors will call soon or someone can tell me who I should call so I can certify them as a great open EHR for open providers to use. Because my taxpayer-funded budget for this program is a bit limited (I’m not even tax-deductible), I’ll settle for self-certification to start. Just send me an e-mail and let me know that you sent a CCD from your EHR to Carebox and it worked. No reason it shouldn’t, if you claim MU2-compatibility. If you have any issues — since I’m told EHR vendors all want to work together to advance healthcare for everyone – I’m sure if you give Cerner a call, they’ll be happy to help you out.

Now all I need to do is convince Neal Patterson of Cerner to get his wife Jeanne to trade in the “bags and bags of records” that he speaks and wrote about her needing to carry around in exchange for a Carebox. Then, in parallel to him figuring out how to get every current or future source of our healthcare data to join CommonWell (good luck!), we can unleash thousands of startups who can help all of us transform US healthcare the CCHIT way.

Are We There Yet?

Freeing up patient data so that patients can authorize the use of that data in any clinical, research, analytics, or application context they want is — in my book — “The Real Thing” and “Changes the Game.” It doesn’t help you quench your thirst (with caffeine, a possible diuretic) or get Type II diabetes, but my CCHIT startup friends and I can try to get ONC or the White House to help us spin up some committees to work on those parts.

I think all of the constituents noted in the earlier quote above from Sittig and Wright will benefit — patients, clinicians, researchers, and software developers. I think we will get “there” a whole lot faster than by following Mr. H’s prescription for “putting the screws” to EHR vendors about what they have to prove to claim they are “open.” Of course, that is going to be lots of fun, too, so we can do that as well.

One Less Study for Mankind

What really compelled me to write this too-long article is that just a few weeks ago, Mr. H. wrote this about patient access to their own healthcare records: “Someone should perform a study to determine the level of demand and the reasons people aren’t requesting their information.”

I started writing a snarky article (do I write any other kind?) suggesting that we go back in time and commission a study in the 1970s about why nobody wants downloadable apps from Apple on their phone (both the rotary and the newer touch-tone kind).

But then along came Sittig and Wright and the associated consensus. It occurred to me that some really smart people might already be hard at work on Mr. H’s newer study request above and I probably missed the boat on my alternative recommendation.

So before it’s too late, I want to suggest that instead of spinning up another study – not to mention all the challenges associated with the time machine and the questionable value of going back to the 1970s, if we did mine – we might all be better served if we just get open providers (who are not information blockers) to free up electronic copies of our own health data that we are all entitled to get under HIPAA Right to Access. To do that, most can use their “already open” (at the “not ideal but good enough for now” MU2-level) EHRs. Then, instead of reading more studies and articles, we can all watch in amazement what happens in months and years from now, not decades.

Brian Weiss is founder of Carebox.

 

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June 26, 2015 Startup CEOs and Investors 5 Comments

Morning Headlines 6/26/15

June 25, 2015 Headlines No Comments

Supreme Court saves Obamacare

In a 6-3 decision, the Supreme Court rules in favor of preserving ACA subsidies for the six million users obtaining insurance through Healthcare.gov.

Arcadia Healthcare Solutions Acquires Leading Managed Care and ACO Implementation Provider Sage Technologies

Data aggregation and analytics firm Arcadia Healthcare Solutions acquires Sage Technologies, a company focused on helping provider groups transition from fee-for-service to value-based reimbursement models.

CVS Health Announces New Clinical Affiliations with Four Leading Health Care Organizations

CVS will use its Epic EHR to begin sharing visit and prescription information with four new clinical affiliates: Sutter Health (CA), Millennium Physician Group (FL) Bryan Health Connect (NE), and Mount Kisco Medical Group (NY).

HIStalk Practice Interviews Steven Stack, MD President, AMA

HIStalk’s own Jenn interview’s incoming AMA president Steven Stack, to discuss chronic disease management and prevention, improvements to medical education, and the impact EHRs and reimbursement reform is having on the provider community.

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June 25, 2015 Headlines No Comments

News 6/26/15

June 25, 2015 News 3 Comments

Top News

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The Supreme Court upholds the legality of  federal medical insurance subsidies for consumers in all states — including those 34 that don’t run their own health insurance exchanges — in a 6-3 decision that preserves the Affordable Care Act.  Shares of publicly traded insurance companies and for-profit hospital operators jumped sharply on news of the decision.


Reader Comments

From Blue Eyes: “Re: 12 years of HIStalk. Seriously? I often think of what it would be like without HIStalk.” I calculate that since I started writing HIStalk in 2003, I’ve posted maybe 5,000 times and done around 500 interviews in writing many millions of words each year. I still can’t wait to start filling the blank screen every day.

From LaToya: “Re: [vendor name omitted.] Aren’t they HIStalk sponsors any more?” I sometimes get remarkably frank comments from company employees who explain why they aren’t continuing their sponsorship, most often: (a) we don’t have money in the budget since we’re cutting back all over the place; (b) we are thinking about pulling out of healthcare; (c) we have changed focus to work through resellers or partnerships instead of trying to sell directly to hospitals; and (d) the only person who knew anything about marketing quit, nobody’s really in charge, and we don’t know what HIStalk is. Some of the statements would make juicy gossip items were I inclined to kiss and tell, which I am not.


HIStalk Announcements and Requests

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My latest annoyance: people who email me and then email again when I don’t respond quickly enough to suit them. Nothing is more vexing than a company’s PR person emailing everybody they can think of demanding to know why I haven’t run their news item when (a) they didn’t read HIStalk to see that I already mentioned the item since I’m perfectly capable of finding my own news, or (b) they’re unfamiliar with HIStalk and don’t know that I write news posts only on Tuesday and Thursday nights and over the weekend, so it stands to reason that their Monday announcement won’t have run here by Tuesday morning no matter how newsworthy. I’ll also observe that companies invariably think that all their announcements are stop-the-presses critical when 99 percent of them aren’t even close.

A note to the industry: “population health” isn’t the same as “population health management” which isn’t the same as “population health management technology.”

This week on HIStalk Practice: AMA President Steven Stack, MD shares his healthcare IT goals for the coming year. Physician willingness to offer telemedicine reflects an untapped market. Atlantic Dialysis Management Services goes with BridgeFront Web resources. Community Health Partnership joins the CORHIO HIE. CVS Health announces new clinical affiliations with emphasis on EHRs. Zen Charts zeroes in on addiction treatment centers.

This week on HIStalk Connect: Telehealth vendor MDLive continues the telehealth funding spree with a $50 million private equity investment. The FDA approves a new medical device that helps the blind "see" by delivering information about their surroundings through a vibrating array held in the mouth. Sano Intelligence raises a $10 million seed round to launch its non-invasive glucose monitoring wearable device. Engineering students at Johns Hopkins invent a tamper-proof pill bottle that it hopes will help curb the rise in prescription-related drug overdoses.


Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.


Acquisitions, Funding, Business, and Stock

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EHR data aggregation and analytics vendor Arcadia Healthcare Solutions acquires Sage Technologies, which offers services to providers transitioning to value-based care.

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Mobile care coordination solutions vendor Cureatr raises $13 million in a Series B funding round, which the company will use to expand its Care Transition Notification network. 

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Video visit provider MDLive raises $50 million, increasing its total to $74 million.

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Non-profit Healtheway, which operates the eHealth Exchange and Carequality interoperability initiatives, renames itself The Sequoia Project. The announcement includes a convoluted, marketing-created rationale for the “rebranding process” and “new tagline” that were apparently vital for future success in choosing a name that sounds like a tree-hugging protest group instead of the perfectly good (and easier to spell) name it was already using. Founding members are AMA, Epic, ICA, Kaiser Permanente, MedVirginia, MiHIN, Mirth, New York eHealth Collaborative, Orion Health, and WEDI.

Castlight Health invests $3.1 million in new startup Lyra Health — which offers screening tools, patient-provider matching, and care navigators for behavioral health – and will sell its products with its own. 


Sales

OSS Health (PA) chooses Strata Decision’s StrataJazz for decision support and financial planning.


People

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Alex Popowycz (Fidelity Investments) joins Health First (FL) as SVP/CIO. At least one site reported that he’s Health First’s first CIO, somehow forgetting Rich Rogers and then Lori DeLone, which takes us all the way back to 1995.

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Huron Healthcare hires managing directors Linda Generotti (Siemens Healthcare) and Lynn Grennan (University of Arizona Health Network), focused respectively on clinical operations and physician organizations.

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Greencastle Senior Management Consultant Troy Beane is promoted to Major in the Army National Guard. He earned the Bronze Star in 2009 as commander of Delta Company, 112th Infantry Division, while deployed in Iraq.


Announcements and Implementations

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Philips announces a tablet-based, subscription-priced ultrasound solution called Lumify, although its transducer isn’t available in the US yet.

CVS announces affiliations with Sutter Health and three physician groups that will receive patient visit and prescription information from CVS’s Epic EHR.

In Scotland, three life sciences companies – including revenue cycle solutions vendor Craneware – sign the Scottish Business Pledge partnership between government and business.

Health-related companies making Computerworld’s “Best Places to Work in IT” for 2015 are Lafayette General Health, Sharp HealthCare, Nicklaus Children’s Hospital, CHG Healthcare Services, Halifax Health, Kaiser Permanente, Medtronic, Children’s Hospital of Philadelphia, Genesis HealthCare, Humana, Adventist Health System, Cerner, OhioHealth, Cancer Treatment Centers of America, Palmetto Health, Intermountain Healthcare, McKesson, Carolinas HealthCare, and Cook Children’s Health Care System.

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Patient satisfaction scores at HealthAlliance of the Hudson Valley (NY) rose after its implementation of CipherHealth’s Orchid tablet-based nurse rounding application.

GetWellNetwork names the first two family engagement nurse scholar fellows supported by its O’Neil Center at the University of Pittsburgh School of Nursing.


Government and Politics

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Florida’s Agency for Health Care Administration will host a half-day symposium on healthcare IT on Friday, June 26, at 8 a.m. in Tallahassee. Speakers include folks from Tallahassee Memorial Hospital, Baptist Healthcare, the Department of Health, and HIMSS. The organizers tell me that interest is good (90 registrations vs. the original 75 cap) so it may turn into a full HIT Summit later this year.

The Department of Justice sues four Michigan hospitals (Hillsdale, Branch, ProMedica, and Allegiance) for illegally agreeing not to compete in each other’s territories.


Privacy and Security

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US healthcare organizations seem to be hardest hit by the password-stealing, difficult-to-detect Stegoloader trojan, which embeds much of its execution code inside photos. Security experts think hackers may be targeting healthcare, but my suspicion is that health systems just have a lot more people with limited technology skills using computers (and inadvertently launching malware) than do other industries.


Technology

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The New York Times ponders the questionable business motivation behind precision medicine and gene testing, highlighting a company that paid doctors $75 for each patient they enrolled and took in $130 million in Medicare money before CMS launched a review of the company’s billing practices, effectively shutting down the 800-employee Renaissance RX. The founders ran an earlier company that also earned Medicare’s death penalty for fraud. Critics say “enthusiasm outpaces evidence” as Medicare was paying for experiments rather than proven treatments. Healthcare wouldn’t get such a bad fraud rap if Medicare was better at performing due diligence before mailing out big checks – couldn’t they have figured out that the people already accused of fraud were involved in the new company?


Other

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Jenn interviewed newly installed AMA President Steven Stack, MD on HIStalk Practice. A snip:

Physicians are very frustrated with these systems, and then we’re very frustrated that the Meaningful Use program that we’re all subject to is overly prescriptive. It lacks flexibility where needed and has compelled us to purchase non-functioning tools to use them in ways that degrade our practice. Let’s not forget that more than half of Medicare physicians are being penalized by Medicare with a one-percent reduction in  compensation because the tools that we are given are so poor and the program the government created so rigid. Now we’re being punished for our inability to achieve what I think, if we really discuss it very openly, is a program that isn’t well designed and sets us up for failure. Needless to say, EHRs continue to be a challenge, and physicians are very frustrated that their input has been disregarded in ways that are injurious to the work we’re trying to do …  Health IT has been helpful and will be far more helpful when these records are actually interoperable. We’ve created digital silos that don’t share information any better than the old system where we had to have people send information via fax machine. If the federal government and software vendors would work much more attentively on making these things interoperable for those things that are of high use to us, I think that physicians would find a lot more joy from the tool than just the current reality where they contribute more misery than joy.

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Radiologist Dr. Dalai says radiologist leadership shouldn’t be pushing them to get closer to patients “as part of the team” in order to prove their value, adding that he’s not comfortable in showing up out of the blue to explain his findings when the patient expects to receive that news from their own doctor. He also wonders whether radiologists will “be told we killed Grandma” in trying to serve as gatekeepers in restricting medically questionable exams. He adds,

When a study comes through on my PACS, I could come running out of the reading room; seek out the patient; act like I’m his or her new best friend, playing a warm, fuzzy Marcus Welby (a TV doc from way back, sort of the opposite of House); and discuss the results of the test. Instant gratification! If you knew me personally, you would realize that I really am a warm, fuzzy, caring kind of guy. But when those radiographs come though on my PACS screen, I don’t know anything about the patient other than the two- or three-word history the physician has lowered himself to give me. If I should happen to have a functioning electronic medical record (a contradiction in terms), I might be able to get some lab values and maybe some additional history. But … I still don’t know the patients like the clinical doctors do. I haven’t talked to them, I haven’t touched them, and I haven’t examined them. So would I be doing them a favor by indulging the itch for an immediate answer? … My solution probably comes too late: Avoid joining anything resembling an ACO. You see, we radiologists do add value — with every single exam. Even a normal chest radiograph adds value, but it isn’t "sexy" and doesn’t increase our self-aggrandizement.

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Weird News Andy labels this widely reported story as “Smart Phone, Dumb Doctor.” A man hits “record” on his smart phone just before his colonoscopy begins so he can capture his doctor’s instructions. The playback reveals a “while you were sleeping” view of what anesthesiologist Tiffany Ingham, MD really thinks as she tells her sleeping patient, “I wanted to punch you in the face and man you up a little bit;” calls him a “retard;”makes fun of a rash on his penis; agrees to falsify the medical record in claiming the team provided post-procedure instructions; speculates whether the man is gay because he attended a previously all-women’s school; and tells staff she’s adding a diagnosis of hemorrhoids even though she saw no evidence of them. She suggests to the gastroenterologist that he pretend to receive an urgent page to avoid having to speak to the patient after the procedure, saying that she has done it before herself and adding, “Round and round we go, wheel of annoying patients we go, where it will land, nobody knows.” The man sued the anesthesiologist for defamation and malpractice and won, with the jury ordering her and her practice to pay $500,000. It wasn’t her lack of credentials – she is dual boarded (anesthesiology and internal medicine) and is a major in the Air Force Reserve, having been deployed short term to Afghanistan as a flight surgeon.


Sponsor Updates

  • Medicity offers “New survey identifies the state of cost control in hospitals, health systems and physician organizations.”
  • DocuSign offers “Yes, this crazy scribble is my signature. And I’m proud of it!”
  • Extension Healthcare offers “Market Trends: Survey Examines Nurse Call Communication Preferences.”
  • Galen Healthcare publishes “ICD-10 Clinical Documentation Improvement (CDI) – Now is the Time!”
  • Greenway Health offers a transparent and collective approach to politics.
  • Healthcare Data Solutions offers “Email Marketing Roundup: Which Metrics Should You Use?”
  • Healthfinch posts “AMA STEPS Forward to Address Provider Burnout.”
  • Impact Advisors offers “Healthcare CIOs Discuss Top Healthcare IT Optimization Strategies.”
  • HealthMedx will exhibit at the New York State Health Facilities Association Conference June 28-July 1 in Saratoga Springs.
  • EClinicalWorks will exhibit at the NATA 2015 66th Clinical Symposia & AT Expo June 24-26 in St. Louis.
  • Healthwise offers “Helping our employees be ‘healthy, happy, and wise.’”
  • Holon Solutions will exhibit at the TORCH Critical Access Hospital Conference & Tradeshow June 25-26 in San Antonio.
  • Iatric Solutions offers “Making Your EMPI solution work for you.”
  • MedData is named a 2015 Top Workplace by the Cleveland Plain Dealer.
  • NextGen parent company Quality Systems Inc. is recognized in eight categories of the 13th Annual American Business Awards program.
  • Navicure offers “How Can You Collect More From Your Patients?”
  • New York eHealth Collaborative will exhibit at Wearable Tech + Digital Health NYC 2015 June 30 in New York City.
  • Oneview Healthcare offers “Digital health revolution? Perhaps evolution better describes what’s actually going on.”
  • Experian/Passport Health will exhibit at the HIMSS Privacy & Security Forum June 30-July 1 in Chicago.
  • PDS IT offers “A Roles-Based Approach to Epic Security.”
  • PeriGen offers slides and materials from its AWOHNN presentation on “A New Way to Handle Checklists.”
  • PMD offers “Health Exchange Video: Style Boards.”
  • Qpid Health posts “Is NLP-Enabled Data Mining the Digital Breakthrough We’ve Been Waiting For?”

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 25, 2015 News 3 Comments

EPtalk by Dr. Jayne 6/25/15

June 25, 2015 Dr. Jayne No Comments

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I’ve been on the road fairly often over the last month. Most of my trips have been to work with small or mid-size provider groups for ICD-10 training. The sheer amount of misinformation floating around the physician lounges across the country appears to be staggering.

At the site I visited today, the physician leaders were actually cringing at some of the questions their providers were asking. I’m sure they thought they had already done a fairly good job educating their providers, but it just goes to show that you can never have enough training. It reminded me a bit of when our residents used to teach a sex education class at the local middle school and kids had the opportunity to ask anonymous (and often myth-laden) questions on slips of paper. We saw some doozies, but this was even more fun because very educated people were asking these wild questions out loud and in front of their peers.

Most of the questions revolved around creative ways to avoid ICD-10 or the lack of need to learn it since it has so many codes it might as well be impossible. It’s hard to convince people that it’s not going away when we’ve had unexpected delays before. It’s also hard to keep them from acting out of fear or panic because they haven’t done anything to prepare for the last several years despite plenty of advance warning. I’m hoping that the fact that their organizations paid good money to bring in an honest to goodness physician to deliver their training will help add a reality check.

Despite the fear and resistance, most of them have done just fine during our structured practice sessions. The fact that they’re using EHRs is going to make the transition pretty seamless, unlike having to use pocket reference cards or laminated cheat sheets.

One of my clients made me smile as their planning document kept going back and forth in email. They wanted me to train onsite at their clinics and were trying to figure out the best way to block schedules and ensure adequate time with the care teams as I crisscrossed the city. When the last document arrived, it was named “Copy of copy of copy of final schedule working copy version8.” I’m glad that explaining document versioning was out of scope for this engagement because I probably couldn’t have done it with a straight face. I give them full credit for trying, however.

Since I had six flights this week, I honed my personal ICD-10 skills:

  • H91.23 – Sudden hearing loss of bilateral ears due to having your music playing so loud I could hear it through your headphones like I was wearing them myself.
  • G47.62 – Sleep-related leg cramps for the passenger across the aisle.
  • S37.20xA – Injury of bladder, initial encounter for the passengers consuming a mammoth cup of coffee prior to takeoff, then being foiled by a persistent “fasten seat belt” sign.
  • R45.82 – Worry, for the kindly older woman next to me who kept waking me up to see if I wanted a drink, pretzels, or crackers

Unfortunately, I couldn’t find a code for “personal psychotic reaction due to child playing games on iPad without headphones.” so if anyone locates it, please let me know. I heard from a fellow road warrior that there is a restaurant that allows you to relive the glory days of flying as you dine aboard a replica Pan Am 747. I’m thinking it might be time to find a client in Los Angeles so I can check it out.

Mr. H mentioned earlier this week about his LinkedIn pet peeves. Although he focused on problems with user profile pictures, I wanted to throw in my two cents. If you’re going to try to connect with me, I am more likely to ignore you if you use the stock “I’d like to connect with you on LinkedIn” greeting. Even if we just met in passing or you’re a friend of a friend, at least add a personal comment that lets me know you’re not an anonymous “medical researcher” or a medical student from halfway around the world just looking to connect with MDs.

From Jimmy the Greek: “Re: patient recording colonoscopy. Please tell me this is at least as good as a Weird News Andy piece.” Yes, yes it is. A Virginia man receives $500K after recording his physician’s inappropriate comments during a colonoscopy. Although I don’t in any way condone the physician behavior, I wonder why the patient had his phone during the procedure. At most of the facilities where I’ve worked, patients who are being sedated have to put their personal belongings in a locker during procedures. Even if you’re not sedated, I doubt they’d let you take your phone to the GI lab. I’d hope that clinicians would be professional at all times, but this should be a lesson for our colleagues with borderline (or over the line) behavior.

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My nephews like to play Mad Libs, the word game where you one player asks for a list of nouns, adverbs, and adjectives then reads back a funny story populated with the words. I received a spam email the other day that must have come from the creators of Mad Libs. Rather than parts of speech, though, it was populated with random, techy-sounding words strung together to form the name of the company and its services. Anyone asking for “thought leadership content” cracks me up, as did the suggestion that the sender had met me at a party at my home in a state where I’ve never lived. Nice try, but no go.

What’s your most entertaining variety of spam? Email me.

Email Dr. Jayne.

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June 25, 2015 Dr. Jayne No Comments

Morning Headlines 6/25/15

June 25, 2015 Headlines No Comments

MDLIVE raises $50M from private equity firm

Telehealth vendor MDLive raises a $50 million investment round from private equity firm Bedford Funding.

Best Places to Work in IT 2015

Health IT was well represented on Computerworld’s “100 Best Places To Work In IT” list for 2015. The list included Cerner, Humana, Kaiser Permanente, Intermountain Healthcare,  HCA, and a number of other health systems.

Mobile app improves rates of CPR in cardiac arrest cases, studies find

A New England Journal of Medicine study investigates a mobile app that alerts CPR trained individuals when someone nearby needs help by pulling information from 911 dispatch systems. In the study, the app increased the likelihood of heart attack patients receiving CPR by almost 15 percent.

Welcome to our Newest CommonWell General Members

CommonWell Health Alliance welcomes T-Systems, Caremerge, and HIEs from Michigan and Texas to its health data exchange platform.

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June 25, 2015 Headlines No Comments

HIStalk Interviews Adam Turinas, CEO, Practice Unite

June 24, 2015 Interviews No Comments

Adam Turinas is CEO of Practice Unite of Newark, NJ.

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Tell me about yourself and the company.

Three of us started the company. I have a background in digital communications, building various digital user experiences for a couple of decades. My partner Stu Hochron is a 30-year practicing physician. The third leg of the stool is Ed Guy, who’s a PhD in computer science and who has developed mobile applications and voice over IP and things like that for as long as these things have been in existence. That’s the three of us who created Practice Unite.

This is our fourth year in the market. We started as a specialized consulting organization focused on helping healthcare organizations improve communications because we think that it’s, if not the biggest, certainly one of the biggest problems in healthcare. Within a few months, we thought, wait a second, mobile applications can clearly help solve a lot of these problems. That inspired the idea for Practice Unite. That was about three years ago.

We’ve evolved Practice Unite to be a mobile enablement platform for healthcare. What that means is that we have a system for delivering configured mobile applications that help clinicians communicate more effectively, help improve the way that healthcare systems engage with the patient, and also help address communication workflows and things like the management of high-risk patients. Even solving some of the issues in home care.

We’re casting across all of the different domains in healthcare because there are some common communication problems. We’re able to do that because we have a system that allows us to create highly configured applications pretty much on the fly.

Who are your competitors and how do their products compare?

The core competitors are in the secure texting space — TigerText, Cortext, companies like that. Our differentiation is the ability to deliver a much more customized and configured solution. We can deliver a customized solution which includes an integrated on-call system with the ability to escalate integration with the EMR so that lab results and consults are delivered into different containers within the application. Then it gives the hospital system the ability to do things like target different types of content for different users.

For example, we can do things like deliver KPIs to an individual physician. If you think about secure texting as being the fundamental commodity — the foundation of this new generation of communications products — we’ve taken it to another level by using that as a foundation for creating different communications solutions.

The other element is that we bring in other modes of communication. We include voice communications, whether that’s simply using the phone’s dialer in a way that makes it easy for physicians to call each other or integrating voice over IP. We have our own client for that. We’re now rolling out secure video communications as well.

When you look across the market right now, the primary buyers for mobile communications solutions are the CIOs, the IT teams for the various healthcare organizations. They default to secure text, so there’s lots of RFPs out there for secure texting solutions. But as they get into it, they immediately see that there’s a lot more that we could be doing with this mobile application. If we’re going to go to the trouble of deploying a secure text solution, let’s address a range of use cases. It might be about improving different workflows. It might be about making it easier to find a physician on call. It might be escalation or delivering clinical data. The market has evolved from being a point solution for secure texting to becoming platforms for delivering all kinds of different solutions.

When we entered the market, there were a number of secure texting vendors who were out there doing very well with it. We thought, we’ve got to go a step beyond that. When we built Practice Unite, we built it with a view of, this is where the market is going to be in two years. We’re finding that that’s the case.

What are examples of clients using photos and video?

I’ll give you a simple text and voice example. One of the things that we’re doing is integrating hospital systems and phone systems into the solution. You have a nurse web-based desktop because nurses tend to want to put the application on their own devices, a whole other BYOD thing. The desktop is configured so that when they send a message out to a physician, it automatically puts their extension in. The nurse might send a message to Dr. Smith, “Please call me about patient Jenny Jones. I need to update you on her condition.” The doctor receives that text message and can click the message and automatically be routed through to that nurse. One of our hospitals actually went from doing 150 overhead pages a day down to three because the nurses don’t have to page anybody any more. That’s a simple use case.

There’s a video on our website — it’s a wonderful story. The very busy ENT surgeon at one of our customers is also chief medical officer. At the end of the day, a small child presents with an upper airway obstruction. He has the child admitted, runs some tests, and tells the hospital that he’ll come back in the morning and most likely operate, but he’s not really sure because he isn’t really sure what is going on with the child. By the time he gets home, he gets a critical lab result that shows that the child’s white count is highly elevated. He gets a radiology impression, which confirms that the child has a mass that is probably an abscess. He opens up the app, opens up the on-call system, finds the resident on call, texts and says, “Send me a screenshot of the the MRI.” The resident takes a screenshot of it, texts it to him, and he responds back saying, “Put the child in for the OR and I’ll operate in the morning.” He came in the next morning, operated, and the child was back in his bed by 7:30 and was discharged later that day.

What he said to us was, putting aside the economics of it, the child spends probably less than 24 hours in the hospital when he’d likely be spending 36 or 48 hours in the hospital. Putting that aside, it’s better for the patient. The parents of the child know what’s going on because he’s able to give them accurate information quickly. The surgeon’s life is a lot better because he knows what’s going on. A simple combination of different communications modes working together very quickly is what’s compressing the time.

We’re getting into some very interesting telemedicine pilots. I can’t go into the details, but we’re in conversation with a group that’s taking care of some very high-risk patients with a serious infectious disease. What they want is for the care manager to have the ability to do a secure video communication with the patient on a daily basis. You can do that with Skype, but because they’re doing it through a mobile app, you can then add other features into the mobile app.

For example, the patient can provide updates on their condition or they can send a text message to the care manager between the calls, because they’re probably only going to do a video call once a week. Between those calls, they can send a daily update on the condition. They can send a text message that says, “I’m really not feeling well today.” That way the care manager gets ongoing feedback from the patient on the condition and then once a week can do a video call with them.

What’s the future of secure messaging over the next five years?

Secure texting is becoming a basic fundamental part of everything. The notion of a standalone secure texting application will pretty much be obsolete within a couple of years. I can’t see a reason why people would just buy a secure texting application on its own. Secure texting will become an ingredient for a different solution.

Where I think the market is going for us and where I think we’re evolving to is the ability to be in the middle of mobile-enabling all of these different workflows and all of these different interactions between clinicians and each other and clinicians and their patients.

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June 24, 2015 Interviews No Comments

Morning Headlines 6/24/15

June 23, 2015 Headlines No Comments

Google Reveals Health-Tracking Wristband

Google X Labs has developed a health tracking wristband that monitors pulse, heart rhythm, sink temperature, and environmental conditions such as light exposure and noise levels. “Our intended use is for this to become a medical device that’s prescribed to patients or used for clinical trials,” says Andrew Conrad, head of the life sciences team within X Labs.

Less than 15% of Doctors Use RI Health Information Exchange

In Rhode Island, less than 15 percent of providers are using the state’s $25 million health information exchange, while 75 percent have yet to even setup their account.

Healthcare Revenue Cycle Management | 2015

Peer60 publishes a report on value-based payment models, with 36 percent of respondents reporting that they have already migrated to a new reimbursement model. Respondents expect that the changes will reduce capital spend, but only seven percent expect efficiency gains.

Beacon Hospital to become Ireland’s first paperless hospital

In Ireland, Beacon Hospital signs with EHR vendor Sláinte Healthcare in a deal worth $3.5 to $5 million USD. While a local paper predicts the deal will result in the first paperless hospital in Ireland, Sláinte’s CEO subtly clarifies, “It will scan historical charts and paper files as necessary.”

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June 23, 2015 Headlines No Comments

News 6/24/15

June 23, 2015 News 4 Comments

Top News

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Google’s research division creates a prescription-only vital signs tracking wristband that will provide research-quality data for clinical trials. Testing of the device — which monitors heart rhythm, skin temperature, and environmental factors — will begin this summer and the company hopes to earn FDA approval.


Reader Comments

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From The PACS Designer: “Re: USB computer. The Intel Compute Stick can be used anywhere with a wireless keyboard and could be used in wireless more via the HDTV USB port.” The $150 USB gadget turns an HDMI-ready TV or monitor into a computer, with the Atom-powered Windows 8.1 version including 2 GB of memory and 32 GB of storage. Intel suggests such use as digital signage, home entertainment, or as a thin client. User reviews on Amazon are mixed, mostly complaining about slow performance, iffy Wi-Fi, the single USB port, and the limited storage capacity. You could get a Chromebook, Android tablet, or almost a low-end laptop (certainly a refurb) for about the same money and then you’d have the keyboard, monitor, and USB ports.

From Graham: “Re: your comment about the healthcare status quo stifling innovation with political influence and financial clout. Regulatory capture will deepen for the next five years. It’s going to be a very rough ride, particularly in the USA where money is so influential in government. But eventually the stink will become too great for the treasure to ignore and change will happen.” My theory is that no matter what change begrudgingly occurs, the same companies and people will end up with all the money, just like that economic theory that you redistribute the wealth of the world’s 100 richest people and they would have it back within 10 years. That’s OK as long as overall healthcare cost and quality is improved – we’re wasting untold fortunes on US healthcare,  so at least we should perform better or spend less.

From James: “Re: Cache database. InterSystems claims it’s the fastest object database. I’d like to substantiate that claim by trying out their benchmark, but have made an inquiry with no response. Do your readers have insights?”


HIStalk Announcements and Requests

I always forgot to observe HIStalk’s birthday, which I believe was June 6. I started writing it in 2003, so that makes it 12 years old.

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The folks at FormFast made a generous $1,000 donation to my DonorsChoose project, which was even more effective because of the matching funds provided by an anonymous health IT vendor executive (your company’s donation is welcome as well). I put the total $2,000 donation on the educational street quickly, as follows:

  • iPad Minis, math manipulatives, and write and wipe boards for a K-2 class in Lake Charles, LA.
  • Two Kindle Fires for small group math exercises in a Grades 5-6 class in New York, NY
  • A STEM bundle for a Grade 4-5 class in Glasford, IL.
  • A STEM bundle for a Grade 2-3 class in Knoxville, TN.
  • Electronics kits for STEM lessons for Grade 6-8 intellectually disabled and autistic students in New York, NY.
  • Wireless math manipulatives for a Grades 6-8 class in Shreveport, LA.
  • A STEM bundle for a Grade 5 class in Little Falls, MN.
  • Math games for an 8th grade class in Niagara Falls, NY.

Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

I’m running a summer special on both produced and promoted webinars since the industry is like a snoozing man in hammock for the next few weeks and I get antsy when it’s quiet. Sign up by July 31 and get a sizeable discount. Contact Lorre. We get good turnout — especially when companies take our advice about content, title, and presentation – and the ones we produce keep getting hundreds of views well after the fact from our YouTube channel. The record is held by the one Vince and Frank did on the Cerner takeover of Siemens, which has been viewed over 5,000 times.


Acquisitions, Funding, Business, and Stock

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Fantastically named Myelin Communications acquires Dodge Communications, which does quite a bit of public relations work for health IT vendors. That also pairs Dodge with an odd sibling – Duet Health, which sells patient engagement technology.

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Accretive Health, which has been on a financial rollercoaster and executive merry-go-round since its strong-arm patient collection techniques got the attention of Minnesota’s attorney general in 2011, lost $80 million in 2014 as net services revenue dropped nearly 60 percent.

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Aurora Health Care (W) takes a lead investor role in StartUp Health, giving it early access to digital health investment opportunities and technologies.

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Heal, which desperately wants to be Uber in offering $99 doctor house calls in Los Angeles in San Francisco, raises $5 million in funding for expansion. The company uses technology such as AliveCor ECG, CellScope otoscope, and electronic medical records.


Sales

St. Barnabas Hospital (NY) chooses Strata Decision’s StrataJazz for decision support.

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Dublin-based Beacon Hospital signs for Slainte Healthcare’s EHR, hoping to become Ireland’s first digital, paperless hospital. Hint: as in US “paperless” hospitals, the folks making the proclamation aren’t watching the pallets of paper coming in via the loading dock, the elimination of which would send the hospital into immediate chaos.


People

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McKesson names Kathy McElligott (Emerson) as CIO/CTO.

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Ed Kopetsky, CIO of Stanford Children’s Health, is presented with a lifetime achievement award from a Bay Area business publication group.

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Staff scheduling system vendor OpenTempo names Andy Comeau (Cerner) as CEO, with former President, CEO, and Co-Founder Rich Miller moving to chief strategy officer. Andy’s LinkedIn profile has an artistic but news-worthless long shot of him standing unrecognizably in front of a mountain (which I’m using above anyway to make a point), so perhaps it’s a good time to recite the LinkedIn photo rules: (a) use a professional head shot only, not one cropped out of a frat party group photo or police lineup; (b) post the photo in large size and high resolution so that news sites can use it without excessive graininess – LinkedIn will automatically thumbnail it so that clicking brings up the high-res version; (c) don’t get artsy-craftsy with a picture taken at a weird angle, with head or chin cropped out, or with a mountain in the background. LinkedIn is for business and profiles should include an appropriate photo, although mine doesn’t because the LinkedIn police made me take by Carl Spackler photo down (kudos to them for recognizing it, though).

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EXL names Scott McFarland (McFarland & Associates) as SVP/GM of its healthcare business.


Announcements and Implementations

McKesson releases Paragon Clinician Hub, a Web-based navigation and workflow tool, as part of Release 13.0. Also included in Release 13.0 is integration with Zynx Health’s ZynxOrder order set management.

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Peer60’s revenue cycle management report finds that CFOs are worried about value-based payment models and are anxious to reduce capital spending and IT costs. A pessimistic 14 percent of respondents say value-based payments will “bankrupt us,” while the roll-up-our-sleeves types are focusing on ICD-10 migration, improving the patient experience, and improving point-of-sale collection.

ZirMed announces a Denial and Appeals Management solution.

Nuance will include data analytics from Jvion in its Advance Practice Clinical Documentation Improvement to compare clinical documentation to payments and quality scores.

T-System joins the CommonWell Health Alliance.

A statistically lacking HIMSS survey of health information organizations (75 responses) finds that Direct messaging is popular for care coordination, but connectivity to EHRs isn’t great.


Other

Orange County (CA) Health Care Agency requests double its original estimate of $796,000 to complete the second phase of its Cerner behavioral EHR project for mental health patients, with the total project cost increased to $8.8 million.

The Providence, RI newspaper observes that less than 15 percent of the state’s physicians use the state’s HIE, which cost $25 million in federal money plus the state’s cost. A representative from the state medical society says, “It will make docs’ lives easier eventually, but so far, it’s only made insurance companies and EHR companies happy.”

The American Society of Clinical Oncology publishes a formula to assess the cost vs. benefit of new cancer drugs, the first step in developing software that can be used by oncologists at the point of care. One drug that costs nearly $10,000 per month in generating $2.8 billion per year for its manufacturer scored a zero in net health benefit.

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Weird News Andy says, “You CAN handle the truth” in describing the $13 bacteria-killing door handle invented by two Hong Kong high school students. WNA also proclaims “strangling her legs” in describing a case study of a woman with temporary leg nerve and tissue damage caused by squatting too much in her skinny jeans, which were so tight doctors had to cut them off.


Sponsor Updates

  • ZeOmega posts “Payer/Provider Collaboration: What Works?”
  • Coalfire Systems analyzes the security of InstaMed’s healthcare payment solutions and concludes that they “have the most effective data security controls available in healthcare today.”
  • Experian Health partners with two companies to offer healthcare organizations a credit card processing device that meets the October 1 deadline for implementing EMV chip-authenticated credit card standards.
  • AirStrip offers “Shifting Our Thinking to Prepare for the Future.”
  • Besler Consulting offers a podcast on the “QualityNet Hospital-Specific Report.”
  • Clinical Architecture offers “Understanding ICD-10-CM – Part III – A Terminology by the Book.”
  • Atlanta public radio highlights Clockwise.MD in “Local App Reduces Time Spent in Urgent Care Waiting Rooms.”
  • Gartner positions Commvault in the Leaders quadrant of the Magic Quadrant for Enterprise Backup Software and Integrated Appliances.
  • CoverMyMeds offers “Proactive, Analytical and Interoperable Trends Affecting Today’s EHR Systems.”
  • Culbert Healthcare Solutions offers tips for “Allscripts Upgrade Services.”
  • AirWatch offers “Virtual Training Experience available with AirWatch Labs.”
  • Burwood Group is named one of “Chicago’s Best and Brightest Companies to Work For.”
  • Anthelio Healthcare Solutions will exhibit at the 2015 TxHIMA Convention June 28-30 in San Marcos, TX.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 23, 2015 News 4 Comments

Morning Headlines 6/23/15

June 22, 2015 Headlines No Comments

Provider Experiences with HIE: Key Findings from a Six-State Review

ONC publishes a report on provider perceptions of state health information exchanges, finding that the needs of providers and ACOs have surpassed the basic requirements outlined in MU. Access to care summaries, ADT alerts, and medication reconciliation support are the most valued services offered by HIEs.

Cigna rejects Anthem takeover bid

Cigna has rejected a $47 billion offer to acquire the insurer by larger rival Anthem, calling the offer inadequate and “woefully skewed in favor of Anthem shareholders." The offer came in at $184 per share, an 18 percent premium on Cigna’s closing stock price on Friday.

Budgetary and Economic Effects of Repealing the Affordable Care Act

The CBO publishes the financial implications of repealing the ACA, finding that regardless of whether the entire law is repealed or only the contested federal subsidy portion, any repeal will add to the national deficit.

House votes to repeal medical device tax

A bi-partisan majority in the House of Representatives votes to repeal the Medical Device Tax enacted as part of the ACA. The President has promised a veto should the bill clear the Senate.

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June 22, 2015 Headlines No Comments

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