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Readers Write: The Internet of Things Can Revolutionize Healthcare, But Security is Key

May 28, 2015 Readers Write 1 Comment

The Internet of Things Can Revolutionize Healthcare, But Security is Key
By David Ting

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The Internet of Things (IoT) holds tremendous promise in healthcare, potentially enabling a digital health revolution and support the future of care delivery.

Gartner estimates that approximately 3.9 billion connected things were in use in 2014. This number is expected to increase to 25 billion by 2020, a growth trajectory that will surely impact the healthcare industry, which is already being flooded with devices for generating valuable patient data.

However, the transformative potential of the IoT won’t be realized for healthcare unless data integrity and security are built into the foundations of the IoT movement.

The IoT’s network of IP-connected computers, sensors, and devices allows care providers and patients to share information to a transformative degree by:

  • Giving care providers access to a greater number of devices for accessing protected health information (PHI).
  • Allowing patients to generate real-time biometric data with low-cost devices and applications.
  • Changing the nature of encounters with care givers from episodic to real time.

For clinical staff, the ability to interact with EMRs or other applications containing PHI from any device is invaluable, especially in creating a push vs. pull dynamic for access to patient information and health records. Today’s care providers are highly mobile and the IoT can provide the ability to seamlessly use connected devices within a single session.

For patients, the IoT offers the ability to participate in their own care. Specific patient opportunities include:

  • Generating valuable health information from wearables and home health devices.
  • Allowing real-time voice, video, and data streaming for telemedicine.
  • Enabling more active patient engagement. Instead of requiring patients to take initiative to look up records or set appointments, messages can be proactively sent to patients informing them about updates or other relevant information

Some of these changes are already taking place on a small scale. But for the IoT to reach its full potential in healthcare, identity and data integrity will become critical as PHI moves from the hospital to the edge of patient care delivery, especially to assuage consumer concerns about privacy and security.

The data generated by a series of connected devices can only be captured, aggregated, analyzed, and put to meaningful use on a broad scale if the identities of providers and patients are verified. The data being generated, collected, and shared through networked devices must be protected with strong, usable authentication methods.

For providers, authentication is required to meet compliance and privacy regulations. If security considerations are baked into the IoT infrastructure, wearables or others devices can be assigned to particular users and leveraged to verify their identity. Similarly, proximity awareness technologies can simplify the user authentication process to access various devices and applications.

Patient authentication is also essential in the IoT paradigm because it ensures the correct information is being generated by and shared with the correct patient. Creating a one-to-one link between patients and their medical records can establish a foundation for additional forms of patient identification. As with providers, devices will become part of the digital credential set for patients, necessitating a secure enrollment process to bind one or more devices to unique patient identities.

Constructing the necessary infrastructure to properly manage and optimize the proliferation of connected devices in healthcare starts with security. A strong security strategy includes authentication technologies and processes to verify patient and provider identities to ensure that devices can only be used by authorized users. The communications channels between the devices within the IoT must also be secure to ensure the integrity of the information passing through them.

Putting these security building blocks in place will help create a closed-loop system in which patients and providers can securely interact in a more engaging, meaningful way. 

David Ting is chief technology officer for Imprivata.

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May 28, 2015 Readers Write 1 Comment

Readers Write: Trusted Data Is the Foundation for Advanced Analytics

May 28, 2015 Readers Write 2 Comments

Trusted Data Is the Foundation for Advanced Analytics
By Vicky Mahn-DiNicola RN

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Much has been said about using advanced predictive analytics to improve the quality of healthcare. But one thing not receiving the attention it deserves is the pre-requisite of trusted data being sewn into the fabric of the healthcare organization. Every organization has data at its fingertips, but full value of that data can only be actualized if it is properly understood and trusted.

Take a relatively straightforward data element like a patient’s weight. While it is a simple, basic element, it can create havoc for analytics teams who discover there are upwards of 17 different places in their HIT systems where weight is captured. Weight is recorded in the emergency department flow sheets, nursing assessment intake forms, pharmacy profiles, ambulatory clinic records, and daily critical care flow sheets, just to name a few. Determining which weight field is the most reliable and appropriate to use is a difficult, lengthy process and one that is multiplied by hundreds of data variables required in advanced analytics projects.

Healthcare organizations are excited by the brilliant technology coming our way in the form of genomics, mobile health, and telemedicine. But too often, the cart is put before the horse. Just as bad ingredients guarantee a bad meal for even the best of chefs,  unreliable data in healthcare will inform inaccurate, even dangerous decisions.

Effective use of analytics is not something you can buy off the shelf from a vendor. Rather it is an organizational strategy, structure, and culture that have to be developed over time. While the technical and tactical execution is delegated to others, the chief executive in a healthcare organization is responsible for determining and overseeing this direction and progress.

The executive also needs to align the organization with data cooperatives and national groups that promote data standardization. National standards have historically been ambiguous, so it is important for providers to ensure they are not working in a vacuum, but have a common understanding of national guidance.

Diversity of systems and processes breeds confusion. Because there are many ways to express any given concept, there is a need for robust crosswalk, data mapping, and standardization to ensure data integrity within, between, and across organizations. This body of work is the responsibility of a designated data governance body within an organization.

Data governance implies far more than the maintenance of documents that describe measurement plans and reporting outputs.  It is a comprehensive process of data stewardship that is adopted by all data stakeholders across the organization, from the board room to the bedside.   Data governance is critical in order to standardize data entry procedures, reporting outputs, clinical alerts, or virtually any information that is used in clinical and business decision-making.  In the era of pay-for-performance and risk-based care, data standardization is mission critical for a true, accurate comparison to take place when evaluating an organization’s performance against external benchmarks and determining reimbursement based on value.

Another final step toward creating robust data governance structures is to create a data validation process. Data cleansing and maintenance should be automated, centralized, and transparent across the organization and should be designed to accommodate the needs of both clinical and business stakeholders.

A “data librarian” should be appointed to catalogue and oversee data elements across the healthcare system. The most mature organizations will implement a master data hub that is fully integrated into their application system environments so that changes are made simultaneously to all systems that need the same data. By doing so, a simple element like a patient’s weight will always be consistent in HIT systems.

Organizations need to recognize that the advanced analytics of tomorrow will only be achieved if the data we have today can be trusted. Those who succeed in establishing proper data governance will unlock the full value data can provide in our industry, beyond regulatory reporting and retrospective benchmarking initiatives to the more exciting prospects of predictive and prescriptive analytics.

Vicky Mahn-DiNicola RN, MS, CPHQ is VP of research and market insights with Midas+ Solutions, A Xerox Company.

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May 28, 2015 Readers Write 2 Comments

CIO Unplugged 5/28/15

May 28, 2015 Ed Marx 5 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Time for Me to Fly

Speculation swirls as to the reasons for my departure from my Texas employer on April 20, 2015. It is really simple and drama free. The organization I served was awesome. The most amazing place I have ever worked. Loved it. What I can share with you is my resignation speech below.


I called you all here this morning to share something important with you in person. Most of you know what happened to me in January on my ascent of Aconcagua. I had every intent of summiting that beautiful and rugged peak, but it was not to be. I had to abandon my climb, although my team would successfully summit 10 days later.

In the same way, I won’t make our summit climb with you. But I know you will be fine without me. You are trained, you are equipped, and you know the path. The climb was never about me. It was about all of us fulfilling our calling here. You will climb to the top without me and continue to save lives.

It was exactly seven years, six months, and one day ago. I drove with my family down from Cleveland through Kentucky and Louisiana. And there it was — the vast flatlands known as east Texas. As we crossed the state line, a Ford 350 pulling a flatbed trailer carrying 20 head of cattle pulled in front of us in our yuppie Lexus.

My daughter was spinning the radio dial looking for travel music, but every station was playing Nascar or college football. Suddenly we were hit by a dust storm. No wait, that wasn’t a dust storm! We were being pelted by cow dung that exploded on the asphalt highway into shit shrapnel penetrating the wax of our freshly washed veneer. Welcome to Texas!

I showed up here not sure what I was getting myself into. Tumbleweeds? F150s? Country music? Cowshit? WTH!

I knew it would not be forever and I am thankful for the precious time I had to serve with you. My last day will be April 20. Seven years, six months and 20 days. Five years and 20 days longer than some of you thought I would last, or at least hoped for.

I am not leaving for another opportunity too good to be true. I am not unhappy here — quite the contrary. I am not looking for more time with my family. I am not trying to fulfill a promise made.

A leader knows when it is time to move on. Give others a chance to fulfill their leadership calling.

I am giving myself some time for reflection.

We have an amazing leadership team and you are part of it. I am so proud of all of you. I brag about you all the time. You are the envy of many.

My only frustration in leaving now is you don’t know how good you are. How good you have become. Those of you who have been to the CHIME CIO Boot Camp know what I am talking about.

What have we done together? What storms have we weathered? What challenges did we overcome? What have we innovated? How much did we grow? How much impact did we have? It is overwhelming to think about.

Trust me, I have focused on this the past 30 days. Sigh. When I think about us, I think about all our “one anothers.” You know, as in, “We served one another,” or, “We upheld the promise with one another.”

  • We labored with one another.
  • We danced with one another.
  • We did obstacle courses with one another.
  • We hopped on 3 a.m. severity one calls with one another.
  • We drank with one another.
  • We stayed up 24+ hours with one another.
  • We cheered and experienced joy with one another.
  • We engaged with one another.
  • We elevated with one another.
  • We excelled with one another.
  • We passed out with one another.
  • We cared for one another.
  • We rounded at every hospital with one another.
  • We got tattoos with one another.
  • We played soccer with one another.
  • We played volleyball with one another.
  • We played softball with one another.
  • We took grief from clinicians with one another.
  • We sang carols with one another.
  • We debated with one another.
  • We challenged one another.
  • We loved one another.
  • We broke bread with one another.
  • We listened to Ralph’s SEAL Team stories with one another.
  • We made meals for one another.
  • We took care of each other’s families with one another.
  • We read books with one another.
  • We supported go-lives with one another.
  • We did karaoke with one another.
  • We did way more than IT for our customers with one another.
  • We survived audits with one another.
  • We bared emotions with one another.
  • We rebounded with one another.
  • We were mesmerized by Ferdie’s chants with one another
  • We broke silly rules with one another.
  • We cried with one another.
  • We survived (name removed) with one another.
  • We endured Dale Carnegie with one another.
  • We discovered and learned with one another.
  • We worked from home with one another.
  • We climbed mountains with one another.
  • We preserved through RIFs with one another.
  • We celebrated weddings with one another.
  • We had all our expense reports rejected with one another.
  • We climbed ropes with one another.
  • We played jokes on one another.
  • We achieved the highest levels of physician satisfaction with one another.
  • We prayed with one another.
  • We laughed with one another.
  • We enabled the dignity of death with one another.
  • We won Davies with one another.
  • We visited many bedsides with one another.
  • We worked out with one another.
  • We held hands with one another.
  • We consistently achieved world-class customer satisfaction with one another.
  • We attended Leadercast with one another.
  • We lovingly tolerated security with one another.
  • We bar crawled with one another.
  • We improved business outcomes with one another.
  • We were with the family of Stacy with one another.
  • We were with the family of Dale with one another.
  • We were with the family of Fred with one another.
  • We were with the family of Renee with one another.
  • We were with the family of Carole with one another.
  • We spent time in my home with one another.
  • We received way too many texts from Jim with one another.
  • We yammered with one another.
  • We created TEDx with one another.
  • We suffered through ITSM classes with one another.
  • We improved clinical quality with one another.
  • We improve patient safety with one another.
  • But most of all, but most of all, we saved lives with one another!

@#%$@ I watched so many of you blossom into amazing leaders that enabled these one anothers!

The future is awesome. The summit is in your sights. You have what it takes. You are leaders, you got this! You will become stronger without me But be assured. I will be watching you. You better not @$#%!@ up!

Jeremiah 29:11 says, “I know what I am doing. I have it all planned out. Plans to take care of you, not abandon you, plans to give you the future you hope for.”

I have tried to live my life embracing the following verses. I fall short, but share it with you nevertheless. It is aspirational. I pray this for you.

I Corinthians 9:24-27: “You have all been to the stadium and seen the athletes race. Everyone runs; one wins. Run to win. All good athletes train hard. They do it for a gold medal that tarnishes and fades. You are after one that is gold eternally.

I don’t know about you, but I am running hard for the finish line. I am giving it every thing that I got. No sloppy living for me. I am staying alert and in top condition. I am not going to get caught napping, telling everyone else all about it, and then missing out myself.

I will miss you. #@!&&^% I will always love you. You have no idea the depth of the pride and love I have for each of you.

We will always be about…one another…and saving lives. That’s our legacy.


I then went one by one to every VP, director, and manager and laid hands on them and spoke to their soul. I knew my people. I asked God to give me the words to encourage each one. I gave each one a specific word.

And when the last person left the room. I wept.

Today I have the privilege to serve the people of the world’s greatest city working in public health. Through an arrangement with The Advisory Board Group/Clinovations, I am part of the NYC Health and Hospitals Corporation IT leadership team. I could not be happier. Perhaps a future post I will get into more details.

And yes, I still have my eye on my Texas colleagues.

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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May 28, 2015 Ed Marx 5 Comments

Morning Headlines 5/28/15

May 27, 2015 Headlines No Comments

Medicaid rule could extend health IT support to behavioral health, long-term care

A newly proposed CMS rule governing Medicaid managed-care plans has implications on health IT. The rule authorizes state Medicaid programs to offer incentive payments for organizations that do not qualify to participate in the Meaningful Use program, like behavioral health providers and long-term care providers, to purchase and implement EHRs. The new rule also authorizes states to mandate participation in health information exchanges as part of their contracts with Medicaid managed care organizations.

Telemedicine exams result in antibiotics as often as regular exams, study finds

A new RAND corporation study published in JAMA Internal Medicine finds that antibiotic prescribing rates are comparable between office-based visits and telehealth visits, but notes that virtually-treated patients were more likely to be prescribed a broad-spectrum antibiotic, which is concerning because use of these drugs drives up costs and contributes to antibiotic resistance.

Antitrust Lawsuits Target Blue Cross and Blue Shield

Two antitrust lawsuits filed independently by health care providers and employers is advancing in federal court in Alabama. The suits charge Blue Cross and Blue Shield with acting as a single, illegal cartel, rather than as 37 independently owned companies to minimize competition. BCBS currently covers one-third of all Americans.

Early Marketplace Enrollees Were Older And Used More Medication Than Later Enrollees; Marketplaces Pooled Risk

Researchers assessed the medication needs of the 7.3 million Americans that signed up for health insurance through the 2014 Affordable Care Act marketplaces and found that marketplace enrollees had a lower average drug spending and were less likely to use most medication classes than an employer-sponsored comparison group.

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May 27, 2015 Headlines No Comments

Morning Headlines 5/27/15

May 26, 2015 Headlines 2 Comments

Chronic Care and Population Health Company Persivia Acquires Alere Analytics to Help Healthcare Organizations Manage Clinical and Financial Outcomes Risk

Chronic care management vendor Persivia buys back Alere Analytics, the population analytics solution that it sold to Alere in 2014 for $600 million, for an undisclosed sum.

Varian Medical Systems and Flatiron Health to Develop Next Generation of Cloud-based Oncology Software

Varian Medical Systems is partnering with Flatiron Health to develop a cloud-based oncology EHR.

The Triple Aimers have missed the mark

Former Beth Israel Deaconess Medical Center CEO Paul Levy writes an article claiming that the Triple Aim has been hijacked by ACOs and, more specifically, by the academic medical institutions that tend to be the dominant player in them.

Drugmakers funnel payments to high-prescribing doctors

Modern Healthcare publishes an article claiming that nearly one-quarter of Medicare’s top-prescribing physicians received non-research related payments from the manufacturers of the drugs they prescribed in 2013.

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May 26, 2015 Headlines 2 Comments

News 5/27/15

May 26, 2015 News 4 Comments

Top News

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The two entrepreneurs who sold DiagnosisOne to Alere in 2012 buy back their former business, now known as Alere Analytics, to form Persivia. Alere bailed out of healthcare in the fall of 2014 by selling Alere Health to Optum for $600 million in an attempt to pay down company debt, with several of Alere Health’s products reverting back to their original owners. Alere is doing better after sticking with its diagnostics business – shares are up 43 percent in the past year after a price run-up that started in early January.


Reader Comments

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From Stay KLASsy: “Re: Epic. The company has been abuzz in recent years about a downward trend in KLAS ratings. KLAS identified a distinct trend among Epic clients who have gone live in the past three years, who as a group are unhappy compared to customers that have been live longer. KLAS made the point in a presentation in Deep Space that was emphasized much more heavily in private meetings with Epic leadership. KLAS says Epic customers need Sherpas to help them up the mountain. Many of those recent go-live customers will be executing a ‘Sherpa Plan’ to make it all better. Let the flailing begin.” I’m always amazed that Epic’s high-paying customers happily accept full responsibility for helping the company solve its problems. Software is an ongoing relationship business – nobody who spends $200 million to implement software expects to just walk away with their purchase since they, too benefit from product improvements, but Epic excels at convincing passionate and heavily invested users to spend even more of their time to help it improve its products and services. Even Apple doesn’t have its own 11,400-seat underground auditorium.

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From Truven Watcher: “Re: Truven’s Q1 results. Earnings are good, but increases in revenue were due solely to 2014 acquisitions. Debt has risen from $800 million at launch to $971 million today and lines of credit are decreasing from use with nearly zero free cash flow to invest in the business. No wonder Veritas Capital is looking to do an IPO – with lack of investor return, nobody would pay a premium to the $1.3 billion Veritas paid to buy the company from Thomson Reuters.” The great thing about IPOs in general (if you’re selling rather than buying, anyway) is that the army of calculator-fingering analysts who will later shred the company for missing revenue expectations by a tiny percentage are noticeably absent in critiquing whether the IPO price is fundamentally worth it – buyers are simply rolling the dice that the company’s story will be good enough to sell shares profitably to a greater fool down the road. The other great thing about being an IPO seller – other than making fistfuls of money – is that you as an expert insider know far more about what you’re selling than your buyer does, allowing you to set the price at which you’re willing to give up your shares to a seller who doesn’t have a clue. Veritas Capital paid $1.25 billion for what is now Truven in 2012 is rumored to be planning a $3 billion IPO, which would be a heck of a return after just three years of seemingly modest performance.

From Solemn Observer: “Re: Welltok’s acquisition of Predilytics. Welltok CEO Jeff Margolis was on the board of Predilytics, which has high-profile investors who may have seen Welltok as a higher-profile company with a better path to liquidity and value. All of these patient/consumer engagement companies are looking for an analytics angle.

From Jerry Aldini: “Re: Ontario eHealth program. Still dealing with the fallout after years of controversy.” Scandal-ridden eHealth Ontario and CGI go to arbitration over their dueling lawsuits related to CGI’s firing in 2012, as the parties blame each other for missed deadlines and deliverables on the $37 million diabetes registry contract.

From F.Y. Cannibal: “Re: Meaningful Use. The Society for Participatory Medicine has complained to HHS about the proposed change from 5 percent of patients to just a single patient who must view, download, or transmit their information to meet the MU threshold.” I support the ability of patients to access their own information electronically, but I don’t agree with the need to protest the proposed MU changes, for the following reasons:

  • Doctors can’t control what their patients do. The unintended consequence of requiring them to view their information electronically is that patients will be tricked or forced into doing so, which seems to run counter to the demand that patients be willing and empowered participants in their health.
  • Providers already can’t hit the minimal 5 percent of patients threshold, indicating a clear lack of patient interest that isn’t the practice’s problem.
  • The purpose of Meaningful Use (other than interfering with the EHR free market using taxpayer dollars to fund a clash-for-clunkers program) was to encourage provider EHR adoption, not to force patients to change their behaviors against their will. The proposed “one patient” standard proves that the provider offers the capability and that should be threshold enough. Patients aren’t Meaningful Users.
  • Patient advocates should be marketing V/D/T to patients to create demand, not holding doctors accountable for the lack of it.
  • Lack of a randomly chosen V/D/T Meaningful Use threshold isn’t a vote against patient access or patient portals. It just means consumers need to demand it, use it, and be willing to change providers if they don’t get it. There’s inherently nothing pro- or anti-patient engagement in letting the market determine how widely offered and used patient engagement tools are. Just because something seems inherently desirable doesn’t mean the government needs to get involved to ensure that it happens.

From Sassy Lassie: “Re: Washington HIMSS board elections. All candidates appear to be vendors.” I’ve served on a HIMSS state chapter board and disproportionate vendor representation is their biggest problem. Health system people don’t have the time or motivation to participate, so vendor employees who are anxious for resume-building activities and networking opportunities dominate leadership positions, presenter slots, and meeting attendance. I won’t attend any event where vendor presenters outnumber provider ones – my assessment (as unintentionally insulting as it may be to vendor people) is that I’m not willing to spend my time and money to hear a vendor employee speak. I don’t question their competence or experience, just their ability to deliver an objective and interesting message after being subject to subtle, non-stop  employer brainwashing and implicit muzzling. Chapter-level presentations aren’t usually very good in my experience anyway – chapters have to settle for whoever they can get and most of those folks are begrudging slot-fillers rather than brilliant, inspiring presenters who will take the time to craft a compelling message. My lessons learned as a chapter officer planning conferences are: (1) allow a ton of networking time; (2) schedule the day to end early since locals are more likely to sign up if they can get home by their normal quitting time; and (3) put most of your time and energy into feeding them.


HIStalk Announcements and Requests

My latest pet peeve: needy people who post dramatic Facebook non-sequiturs such as “I hate people” or “my life sucks,” desperately hoping one of their “friends” will urge them to elaborate so they can share an outburst of grammatically-challenged emotion in search of shallow empathy from people who aren’t interested enough to actually drop by or pick up the phone.

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Hopefully it wasn’t lost in all the fun Memorial Day activities that the holiday is intended not for cookouts and car races, but rather to honor those who died while serving in the military.

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Mrs. B sent over photos of her California first graders with severe disabilities using the sand and water table provided via our DonorsChoose project, saying they love the sensory learning time that also improves their social skills. Ms. T says the excitement and reading participation her Oklahoma sixth grade class has been “astounding” as they use the three iPad Minis we bought them for reading programs and to record themselves delivering presentations. I defy you to look at those faces and convince me that the money wasn’t well invested.

I was thinking about how expectations that patient portals be de-siloed are unique to healthcare. Nobody would expect competing online retailers to happily contribute their proprietary customer information into a single, unaffiliated website no matter how beneficial and convenient it might be for customers. I am constantly reminded of the healthcare relevance of my favorite quote from the magnificent football movie “North Dallas Forty” that also describes the incompatible business and social missions of healthcare: “Every time I call it a game, you call it a business. And every time I call it a business, you call it a game.”

A term I don’t like is “revenue leakage,” describing the ambitious desire of supposedly non-profit health systems to keep their patients from seeking care where they want it, an entitlement expectation that wouldn’t even be spoken aloud by any other business (does the CFO of Chili’s have an intervention plan to address the revenue leakage caused by my desire to go to Chipotle once in a while?) The term also reminds of the olestra-cooked, fat-free potato chip (Lay’s WOW) craze of the late 1990s, of which customers became scarce after being warned of chip-induced “anal oil leakage.”

Listening: envelope-pushing, technically flawless inspirational Christian thrash-metalcore from Pennsylvania-based August Burns Red, whose lyrics are as profound as they are unintelligible. Also: new 1980s-sounding hard rock from the trio of metal virtuosos in LA’s Winery Dogs, which has me desk-drumming along with former Dream Theater drummer Mike Portnoy since I’m hopped up on iced tea and diet cherry cola.


Webinars

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.

June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.


Acquisitions, Funding, Business, and Stock

Varian Medical Systems, Flatiron Health, and UPMC will build an oncology EHR with analytics and decision support. One of the uncritical rags portrayed their motivation as the noble-sounding “fighting cancer” rather than the more closely aligned “hoping to make big profits” in which cancer is their widget of choice.

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New Zealand-based Orion Health files its first financial update following its November IPO on the NZX, reporting a one-year loss of $44 million despite a 7 percent increase in revenue. The company’s North America business dragged down its numbers as the company blamed (as companies often do) the move to a recurring, subscription-based revenue model.

Penny stock sleep apnea and infrared thermometer technology vendor Sanomedics acquires addiction treatment EHR vendor ZenCharts, which it characterizes as “developmental stage.” Hopefully the price was right for the bizarre acquisition given that the most recent Sanomedics quarterly income was less than $200,000 vs. losses of $500,000 and its overall financial position is laid out in its most recent quarterly report as, “The Company currently has a working capital deficiency, limited revenue, and is experiencing recurring losses which have caused an accumulated deficit of $20,937,278 and a working capital deficit of $4,618,649 as of March 31, 2015. These factors raise substantial doubt about its ability to continue as a going concern. Management has financed the Company’s operations principally through the issuance of convertible debt instruments and loans from an affiliate of a former officer of the Company and a principal shareholder.” Imagine how desperate ZenCharts must have been if this was their best potential buyer.


Sales

Two UK trusts sign up for Allscripts PAS, which the announcement questionably fails to explain is the company’s UK-specific Patient Administration System.

Cedars-Sinai Health System chooses Bottomline Technologies for privacy and security technology.


People

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Indianapolis-based onsite clinic provider OurHealth hires Sherry Slick (AchieveEHR) as CIO.


Announcements and Implementations

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I missed this UCSF article from last month that describes technologies used at UCSF Medical Center at Mission Bay, which includes the interactive patient care system of Oneview Healthcare and employee communications provided by Voalte.  

Health Catalyst announces its Health Catalyst Academy educational program for clinical quality and efficiency.


Government and Politics

Part of the proposed 21st Century Cures legislation calls for FDA to capture and consider patient feedback as it reviews medical devices for approval.

Senator Joe Manchin (D-WV), stung by reports that 200 million doses of hydrocodone and oxycodone were shipped to the state’s 1.85 million residents over six years (that’s 18 doses of “hillbilly heroin” per year per person) demands that drug wholesalers to provide lists of where the drugs were sent so the state can look for “pill mills” (hint: look for the long but fast-moving lines). The large number of doses doesn’t include those bought from the country’s largest wholesaler, McKesson, since that company as well as second-largest Cardinal Health have declined to provide their numbers.

The VA says the 13 malware-infected medical devices it reported in January is down to four, but it still has problems with equipment that requires Windows XP and by technicians who scan for vulnerabilities using laptops that were also used for Web surfing.


Technology

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Apple and IBM announce Apple Watch support for their Hospital RN app that I assume nobody is actually using yet.

A group of Kansas City high school and college students develops a wayfinding app for Children’s Mercy Hospital that brilliantly works around the lack of GPS signal penetration in hospitals by calculating routes based on the user’s manually entered “what do you see around you” visible landmarks, such as a room number or department name.


Other

An interesting Modern Healthcare analysis finds that 23 percent of doctors who prescribed at least $1 million worth of a given drug to Medicare patients were paid directly by the manufacturers of those drugs via consulting fees. For example, a since-indicted neurologist who directed $6.4 million in taxpayer spending for a pain relief drug was paid $56,000 by the drug’s manufacturer for various non-research services. It’s easy to determine which doctors hold an unhealthy appreciation for a given drug despite lack of evidence of its superiority, although much harder to peg their motivations to personal benefit.

USA Today profiles patient advocate Regina Holliday.

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The FDA approves the marketing of InvisionHeart’s mobile, cloud-based ECG solution.

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The Houston newspaper covers the practice of suing patients by Memorial Hermann’s Texas Medical Center. An uninsured oncology nurse patient who didn’t get a bill from the hospital found a lawsuit notice taped on her home’s front door but even then couldn’t get an itemized bill because the hospital’s two-year-old records had been archived. She finally found out that she had been charged $32,000 for two nights of observation, which the hospital wanted paid along with legal fees and interest. An attorney who represents the patients the hospital sues (it files more patient lawsuits than all other area hospitals) says nobody told them about charity care while they were in the hospital and the lawsuit documents always have the itemized medical charges redacted.

Former Beth Israel Deaconess Medical Center CEO Paul Levy names names in saying that the noble Triple Aim has been hijacked by big hospitals to suit their own ambitions, such as ACOs that are usually formed by economically inefficient health systems that wrest patient control from physician practices that might otherwise help them choose a hospital based on outcomes and costs, sticking consumers with the resulting loss of choice and higher costs. The places he calls out but also warns that it’s not just them by any means:

Places like Mayo Clinic, investing $180 million in a proton beam facility when there are similar facilities within easy traveling distance for those very few families who can benefit clinically from them. Places like North Shore-Long Island Jewish, belying its stated strategic objectives ("to realize cost efficiencies and ensure patient safety through adherence to best practices") by providing space, support, and publicity for a prominent doctor who affirmatively advocates overuse of diagnostic tools. Places like the University of Illinois-Chicago, the University of California, and dozens of others who gladly accept "walking around money" for themselves and their surgeons from a medical equipment supplier to invest in market-share-growing robotic surgery.

Levy explains from one of his previous posts:

It’s not that the doctors and nurses are any less caring or dedicated, but rather that the leaders of these centers have become calcified with regard to their social mission. They focus instead on expanding market share, growing margins, and attracting philanthropists to contribute to unnecessary and flamboyant edifices. They have no real interest in reducing costs, but rather in obtaining and securing revenue streams to cover ever-increasing costs. Most importantly, they neglect the harm they cause to patients in their facilities, preferring to assert that they deliver high quality care without being willing to be transparent with regard to actual clinical outcomes.

Weird News Andy calls this story “worst nurse cursed.” A London hospital nurse gets a life sentence for overdosing 21 hospital patients with insulin, killing two of them, by injecting it into stock IV bags and allowing other nurses to earn undeserved guilt by unwittingly administering them.


Sponsor Updates

  • VBP Monitor publishes “Exchange and Narrow Network Dominance: Market Implications for Healthcare Providers” by Valence Health Co-Founder/COO Todd Stockard.
  • Divurgent will host a cybersecurity dinner discussion with John Gomez of Sensato May 28 in New York City.
  • MEA/NEA CEO Lindy Benton publishes an article announcing that CMS records show that the company has exchanged 425,000 unique medical records via esMD (electronic submission of medical documentation), more than any other vendor.
  • PatientKeeper will showcase its physician workflow software at the 2015 International MUSE Conference that started Tuesday in Nashville.
  • AirStrip offers “Keeping Up with (and Getting Ahead of) an Every-Changing Healthcare Model.”
  • Caradigm offers “Rethinking the Business of Healthcare.”
  • Inc. takes a look at the ways in which CommVault keeps its employees happy and healthy.
  • CoverMyMeds will exhibit at AMIA’s iHealth 2015 Conference May 28-29 in Boston.
  • CitiusTech, CTG and Cumberland Consulting Group will exhibit at AHIP 2015 June 3-5 in Nashville, TN.
  • Baystate Health CMIO Neil Kudler, MD breaks down his four-pillared approach to population health management in a new Medicision video.
  • Besler Consulting explains that “Rebilling Medicare claims outside of timely filing is possible.”
  • An Israel-based business website covers MedCPU’s participation in a delegation of Israeli digital healthcare companies visiting the US.

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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May 26, 2015 News 4 Comments

Morning Headlines 5/26/15

May 25, 2015 Headlines No Comments

EHRA Recommends Changes To ONC’s Standards Advisory Proposal

The HIMSS EHR Association responds to ONC’s Standards Advisory Proposal, citing concerns that the newly established standards, and their intended uses, could be unintentionally misinterpreted without explicit clarifications.

America’s Health Rankings Senior Report

The United Health Foundation publishes a report on senior’s health, finding that preventable hospitalizations within this sub-group have dropped 6.8 percent since 2014, and 11 percent since 2013.

Why We Need Design Thinking In Healthcare

Deonard D’Avolio, PhD and Director of Informatics at Airadne Labs, a joint venture between Harvard School of Public Health and Brigham and Women’s Hospital, authors a piece in InformationWeek calling for better design in healthcare, rather than a re-engineering of systems and processes. He uses the recent debacle at Texas Health Presbyterian Hospital Dallas in which an ER doctor missed the travel history of a patient with Ebola and sent him home, and argues that the systems being implemented work as designed, but the design is not always inline with clinical workflows or expectations.

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May 25, 2015 Headlines No Comments

Morning Headlines 5/25/15

May 24, 2015 Headlines No Comments

Patterson: No intersection has ‘more potential than what we’re at’ — health care, IT

Cerner booked $4.25 billion in new sales in 2014, beating its previous record of $3.8 billion. The company also reports that it expects its Siemens acquisition to return $1 billion in revenue in 2015.

Thompson and Rangel Introduce Veterans E-Health & Telemedicine Support Act of 2015

Representatives Glenn Thompson (R- PA) and Charles Rangel (D-NY) introduce H.R. 2516, the Veterans E-Health and Telemedicine Support Act of 2015, which would expand access to telehealth services for veterans by authorizing VA clinicians to practice medicine across state lines without running afoul of state or local regulations.

Connecticut Senate adopts major health care changes

Connecticut’s state Senate has passed a bipartisan bill that funds the development of a health information exchange for the state, replacing its failed $4.3 million first attempt.

eQHealth Solutions Selected by Colorado Department of Health Care Policy and Financing to Provide Medical Management Services

Colorado selects non-profit population health vendor eQHealth Solutions to provide solutions for Colorado’s Medicaid program.

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May 24, 2015 Headlines No Comments

Monday Morning Update 5/25/15

May 24, 2015 News No Comments

Top News

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Cerner tops its 2013 $3.8 billion new contract sales record with $4.25 billion in new sales in 2014, according to figures released during the company’s annual shareholders meeting. The company expects $1 billion in 2015 revenue to come from its Siemens acquisition. Cerner saw new business growth with state, specialty, regional, and community hospitals, and record contract sales in the physician market. CEO Neal Patterson focused on the need to look beyond EHRs to keep the company’s fiscal success going: "It’s up to us as leaders to continue the growth. You couldn’t find an intersection that has got more potential than what we’re at.”


HIStalk Announcements and Requests

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Check out Jenn’s weekly wrap up of population health management news.


Last Week’s Most Interesting News

  • Allscripts lays off 250 employees across its service, support, solutions management, sales, and G&A departments as part of a wider “rebalancing” effort.
  • The House Energy and Commerce Committee unanimously approves the 21st Century Cures Act, sending the legislation to the House floor for a vote.
  • Lahey Health (MA) lays off 130 people due to the unusually brutal winter in New England this year and its $160 million Epic implementation, which together resulted in a $21 million operating loss for the first six months of 2015.
  • CareFirst BlueCross BlueShield announces a June 2014 data breach affecting 1.1 million members in Maryland and Washington, D.C.
  • The battle of the ICD-10 bills heats up: Rep. Diane Black (R-TN) introduces the ICD-TEN Act, a bill that would introduce an 18-month period during which providers could submit claims in either ICD-9 or ICD-10 format, while the AHA proclaims its support for Rep. Ted Poe’s (R-TX) Cutting Costly Codes Act of 2015, which would cancel the migration to ICD-10 completely.

Webinars

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Announcements and Implementations

The Colorado Dept. of Health Care Policy and Financing selects nonprofit population health management technology company eQHealth Solutions to manage its ColoradoPAR utilization management program for Medicaid patients.

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Visage Imaging receives FDA clearance for the use of its Visage Ease Pro app, part of its enterprise imaging platform, for mobile diagnostic interpretation of all imaging studies except mammography.


Government and Politics

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Rep. Glenn Thompson (R-PA) and Rep. Charles Rangel (D-NY) introduce H.R. 2516, the Veterans E-Health and Telemedicine Support Act of 2015. The bipartisan legislation would enable VA health professionals to practice telemedicine across state lines if they are qualified, and practice within the scope of their authorized federal duties. It would also enable veterans to receive telemedicine treatment from anywhere, including their home or a community center, rather than solely at a federally owned facility. 

The Connecticut Senate passes a bill that includes provision for a new state HIE. This would mark the second time the state has attempted to stand up a HIE. The first one, HITE-CT, was shuttered last July after burning through $4.3 millions in four years with no discernible progress made. (Former HITE-CT Board Member Ellen Andrews paints a pretty scathing picture of the ineptitudes that led to the HIE’s failure.) Legislators intend to put out out a RFP to contract with an existing system or come up with an alternative plan.

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Agriculture Secretary Tom Vilsack announces that the USDA is accepting applications for its Distance Learning and Telemedicine grant program, which provides increased access to education, training, and healthcare resources in rural areas.


Sales

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Auburn Community Hospital (NY) selects revenue cycle software solutions from Mediscribes venture ezDI, including clinical documentation improvement and compliance auditing modules, analytics tools and dashboards, and computer-assisted coding.


Technology

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Oculus Health launches a chronic care management and coordination platform with remote monitoring capabilities.


People

Ram Udupa (QIM Analytics) joins Paragon Development Systems (PDS) as vice president of product management.

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Saint Francis Medical Center (MO) promotes Gene Magnus to director of IS.


Other

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Forbes profiles Gaumard Scientific, a family business that has developed and manufactured robotic patients for over 60 years. Patriarch and founder George Baine, a physician with the British army during World War II, founded the company in 1946 and now counts Cedars-Sinai Medical Center, John Hopkins Hospital, and George Washington University Medical School among the clients that helps it generate more than $60 million in revenue annually.

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Vancouver high school student Raymond Wang wins $75,000 in the Intel International Science and Engineering Fair for his design of an air inlet system for planes that can reduce disease transmission by up to 55 times, and improve fresh airflow by almost 200 percent. The system can be installed in a plane in just one night for the price of a single passenger’s airline ticket. Wang is pursuing a patent for his design.


Sponsor Updates

  • Navicure asks, “Are You on a ‘Need to Know’ Basis with Value-Based Reimbursement?” in a new blog.
  • The Netsmart Technologies men’s volleyball team wins bronze at the Kansas City Corporate Challenge.
  • The New York eHealth Collaborative will exhibit at the d.health summit May 29 in New York City.
  • Nordic offers the latest edition of its HIT Breakdown video series, focusing on engagement in population health.
  • Orion Health offers a new blog entitled, “The IT Inclusion Paradox.”
  • PDS offers a new blog entitled, “Software-Defined Data Center: A Long and Winding Road.”
  • PMD offers a new blog entitled, “Health Exchange Video: The Art of Narration.”
  • Sagacious Consultants offers a new blog entitled, “5 Things that Might not be Working in Your IT Department.
  • SCI Solutions offers a new blog entitled, “Five Top Revenue Generation Strategies for CFOs.”
  • The SSI Group will exhibit at the South Carolina HFMA Annual Institute 2015 May 26-29 in Myrtle Beach.
  • TeleTracking announces that Scott Halford will keynote its user conference October 25-28 in Las Vegas.
  • Truven Health Analytics will exhibit at the American Society of Clinical Oncology annual meeting May 29 in Chicago.
  • Valence Health opens registration for its Further 2015 client conference September 30-October 2 in Chicago.
  • Versus Technology offers a new blog recapping client Community Hospital’s presentation at HIMSS15 on technology’s role in containing MERS.
  • Voalte offers a new blog entitled, “Off the Cuff.”
  • Huron Consulting will sponsor Father of the Year Awards May 27 in Riverside, CA in support of the American Diabetes Association and the Father’s Day Council.
  • ZirMed is honored by Louisville Central Community Centers Inc. with its 2014 Corporate Community Service Award.
  • Several HIStalk sponsors will exhibit at the 2015 International MUSE Conference May 26-29 in Nashville, including Park Place International, Passport Health, PatientSafe Solutions, PatientKeeper, Sandlot Solutions, Summit Healthcare, Surgical Information Systems, T-System, Winthrop Resources, and Zynx Health.

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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May 24, 2015 News No Comments

Morning Headlines 5/22/15

May 21, 2015 News 3 Comments

Cures Act heads to House floor

The House Energy and Commerce Committee approved the 21st Century Cures Act with a unanimous 51-0 vote, sending the legislation to the House floor for a vote. The new law would require EHR vendors to meet yet to be defined interoperability standards by 2018 or risk being decertified.

“I will not stop until we have the right to see our own information” – Part 2 –2015

Regina Holiday and a group of fellow patient advocates held a “paint-in” protest in front of HHS to protest the decision to reduce the MU2 view/download/transmit requirement from from five percent of discharged patients to just a single patient, calling the deprioritization a “slap in the face to patient rights.”

Lahey Health exec sheds light on reasons for layoffs

Lahey Health (MA) announces that it has laid off 130 people, or one percent of its workforce due to both the unusually brutal winter in New England this year, and also the $160 million Epic implementation, which together resulted in a $21 million operating loss for the first six months of 2015.

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May 21, 2015 News 3 Comments

News 5/22/15

May 21, 2015 News 1 Comment

Top News

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CareFirst BlueCross BlueShield, which provides insurance to residents in Maryland and Washington DC, becomes the latest victim of a targeted cyberattack. Carried out in June 2014, the attack was discovered during a system-wide security audit. Hackers gained access to a total of 1.1 million patient records. While Social Security numbers, medical claims, and financial information were not compromised, hackers did gain access to member names, birth dates, email addresses, and subscriber identification numbers.


Reader Comments

From: Clinic Maven: “Re: Greenway’s Walgreens business is about to shut down.” Greenway’s relationship with Walgreens began in 2010 when it deployed its PrimeSUITE EHR at subsidiary Take Care Health Employer Solutions pharmacies and clinics. The company has worked with Walgreens over the last several years to finish up a pharmacy-wide roll out of the WellHealth EHR, built on the Greenway platform. Greenway Health CMO Robin Hackney responded to my request for verification: “As you know, Walgreens has announced a strategic and financial review of all of its operations, so even if we did have any insight into its plans we couldn’t share them. Speaking on behalf of Greenway Health, however, we remain extremely excited about the future of retail health as part of the nation’s health ecosystem and our opportunity to serve American healthcare consumers in new, innovative, and cost-effective ways.”

From: Bubble Guy: “Re: Welltok acquisition of Predilytics. It was just an "acquihire.” The investors in the last round did not make money. They just invested nine months ago. There was little cash and just stock in Welltok given. This is the dark side of analytics and digital health. Many companies won’t make it and if one doesn’t know that all acquisitions are not the same, then it may appear this acquisition was actually good news. I suppose it’s good if the alternative was winding down at Predilytics.


HIStalk Announcements and Requests

This week on HIStalk Connect: Stanford University researchers unveil a promising new gene therapy technique that can reprogram retinal cells to behave like rods and cones, potentially restoring vision to a subset of blind patients. MindBody files its SEC forms in preparation of a $100 million IPO. Stride Health, a private health insurance exchange startup, raises a $13 million Series A to expand its platform nationally.

This Week on HIStalk Practice: Aledade opens for ACO business in Florida. AMA President Robert Wah, MD discusses the need to move beyond the EHR as the ERP of healthcare. Modernizing Medicine partners with MLS on new specialty EHR. SpineZone founder looks to posture sensors for better outcomes. Updox secures $3.5 million in credit. Reno Sparks Tribal Health Center opts to consolidate multiple systems into one NextGen platform. New CareCloud CEO shares his vision. Brad Boyd offers strategies from The Consultant’s Corner to integrate patient access and physician compensation initiatives. Thanks for reading.


Webinars

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Announcements and Implementations

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Three Metro Care Connection school-based clinics in Cedar Rapids, IA, go live on Mercy Medical Center’s Epic EHR. Clinic staff are especially excited about the transition from paper to digital, given that the schools lost paper student medical records during a 2008 flood.

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The Autism Center at Hospital for Special Care (CT) becomes the first organization to receive the Patient Centered Specialty Practice recognition for Autism from the National Committee for Quality Assurance. The center attributes the recognition to its Allscripts Sunrise Ambulatory Care solution.

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Graham Hospital (IL), a Meditech shop, achieves Stage 6 of the HIMSS Analytics EMR Adoption Model.

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SSM St. Mary’s Hospital and Medical Group (MO), both part of SSM Health, will launch Epic across their facilities early next month.


Acquisitions, Funding, Business, and Stock

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Lahey Health (MA) plans to lay off 130 employees, with seniors executives taking a voluntary 10-percent pay cut for the rest of the year. Lahey Hospital & Medical Center CEO Joanne Conroy, MD cited the system’s $160 million EHR implementation as a contributing factor to the system’s financial difficulties. It signed an agreement with Epic in 2013, noting that it would create 100 new jobs to handle the roll out. 


Government and Politics

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The House Energy and Commerce Committee unanimously approves the 21st Century Cures bill in a 51-0 vote. Premier was quick to chime in with kudos for the bill’s supporters: “We … wish to thank Committee members Joe Pitts (R-PA), Frank Pallone (D-NJ), Gene Green (D- TX), Michael Burgess (R-TX) and Doris Matsui (D-CA) for their support of interoperability standards in the legislation, and for their efforts to ensure that the technology systems of the future will be built using open source codes that enable applications to seamlessly exchange data/information across disparate systems in healthcare.” Given the speed with which it has flown through committee, it will likely pass in the full House and land in the Senate sometime this fall.

ONC announces that it will sunset the Health IT Standards Committee’s permanent workgroups, replacing them with a series of time-limited task forces that will study and make recommendations on specific issues. The intent is to create a more agile HITSC and to increase public engagement by offering an opportunity to participate in smaller, less time-intensive projects.


Technology

Virtru launches the Virtru Pro HIPAA-compliant email service.

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Time profiles the launch of startup AnalyticsMD’s Web-based efficiency index, which offers consumers an easy way to look up and compare hospital strengths and weaknesses in the areas of ER, patient satisfaction, and cost. The California-based company hopes the index will also offer hospital administrators an easy way to benchmark and compare their efficiencies with peer facilities.


People

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Richard Gibson, MD (Providence Health & Services) joins PeraHealth as physician executive.

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Evangelical Community Hospital (PA) promotes Kendra Aucker to CEO.


Other

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Regina Holliday, members of The Walking Gallery, and a reporter or two gather outside of the HHS building in Washington, D.C. to paint and protest the agency’s step back from patient engagement in Meaningful Use criteria. (Check out Jenn’s interview with Regina for the full story behind her advocacy efforts.) KP MD and spectator/supporter Ted Eytan shares a few interesting details of the “brutalistic” building’s history in his blog about the event: “In other wackiness in the 1970s, by the way, plans for a gym in the building were scrapped as executives were told they ‘would be expected to get their exercise by running upstairs and chasing welfare fathers.’

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Winners of Canada-based William Osler Health System’s student app contest develop the Osler Outpatient app, which the health system will roll out next week. The Android-based app aims to help patients at Brampton Civic Hospital and Etobicoke General Hospital better manage their care after discharge.


Sponsor Updates

  • The Atlanta Journal-Constitution talks with Greenway Health’s Paula Kepes, vice president of talent, about the company’s hiring plans at its locations in Atlanta and Carrollton.
  • PerfectServe hosts its annual Customer Advisory Panel gathering today at the Grand Hyatt Hotel in Dallas.
  • Extension Healthcare offers a new blog entitled, “The Skeptical Biomedical Manager – Is Alarm Middleware Necessary?”
  • Galen Healthcare Solutions posts a new blog entitled, “The Viral Workflow: The Bug That Spreads Within Your Organization’s EHR.”
  • Greythorn previews its participation at the upcoming eHealth 2015 conference in a new blog.
  • Hayes Management Consulting offers a new blog entitled, “Budgeting for EHR Go-Live: Everything You Wanted to Know but Were Afraid to Ask.”
  • HCS team members compete in the New Jersey Family Mud Run in support of client Specialty Hospital of Central New Jersey.
  • The HCI Group offers a new white paper entitled, “Protecting ePHI: 5 Tenets of an Effective Cyber Defense System.”
  • Utah Business magazine names Health Catalyst Executive Vice President and Chief Clinical Officer Holly Rimmasch one of Utah’s top woman executives..
  • Healthfinch offers a new blog entitled, “Supercharge Your Delegation Model.”
  • Impact Advisors COO Todd Hollowell is named to Consulting Magazine’s “Top 25 Consultants” List.
  • Intelligent Medical Objects and Iatric Systems will exhibit at the 2015 International MUSE Conference May 26-29 in Nashville, TN.
  • NTT Data will sponsor Tony Kanaan’s Chevrolet IndyCar in this Sunday’s Indianapolis 500.
  • Peer60 releases a new report on 2015 imaging IT purchases in Europe.
  • PDR CEO Mark Heinold is named one of the 60 most influential people in the healthcare industry by PM360 magazine.

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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May 21, 2015 News 1 Comment

EPtalk by Dr. Jayne 5/21/15

May 21, 2015 News 7 Comments

I received a large number of comments and emails in response to my post about Windows 8. Except for one, all were supportive or empathetic with several offering specific suggestions to improve my user experience. The one that I found most thought-provoking, however, was the response blaming the user:

From Cynical: “This post is indicative of the larger problem in the Health IT space. Users are reluctant to embrace change – why not try peeking your head out from underneath a rock once or twice a decade and change won’t be so hard. I won’t say that Windows 8.1 isn’t without flaws, but the majority of the whining in this post is likely attributable to user error or someone who’s 50+ who is terrified of technology. In an age where I can SMS my coffee maker in the morning to start brewing, start my car from my smart phone and adjust the climate control in my home from half a world away we’re at a point where the internet of things is here, and here to stay. “You can’t do anything without being online” isn’t a new concept and it’s not a bad concept either, but maybe that’s the view in healthcare where there are still attitudes that connectedness and sharing information may blow someone’s competitive advantage. Posts like these remind me why it seems like a losing battle to try and advance tech in the healthcare space. Users who have no desire or aptitude to learn and embrace new tools, a generation of technology leaders who think innovation is implementing Epic. A leading HIT blog like HIStalk should be embarrassed to post this.”

Reading through this, I wondered if my former CIO was stalking me. It was actually pretty funny to read, having been on the bleeding edge of healthcare IT during my time as a CMIO and doing extensive change management work to help a large health system do EHR well before everyone else was doing it (and successfully so). Let’s talk about some of the themes:

Users are reluctant to embrace change. Yes, they are. Most health IT users are concerned about the patient in front of them and the care they need to deliver. If they’re not, then they should be. When technology interrupts that, serious patient harm can result. The point of the piece was illustrating the challenges faced by someone who is reasonably tech savvy (and decidedly younger than 50) but still can’t “get it” and runs into problems executing what should be simple workflows. Having studied change management and usability for a long time, one can attribute user resistance to several things including fear, inadequate training, poor system design, and more.

Over the last several years, I’ve become more aware of the role of learning styles in regards to stalled change processes. Although we hope that systems are intuitive, sometimes they’re just not. Sometimes vendors fail to hire actual healthcare usability experts. Sometimes they hire no usability experts. Sometimes users do not have the capability to learn on their own or intuit how something is supposed to work. Learners process information in many different ways and for us as IT professionals, we need to recognize that and offer solutions that meet their needs. As more people enter the workforce with documented learning disabilities and that may require accommodation under the Americans with Disabilities Act, we’re going to need to adapt. These weren’t diagnosed as often 20 years ago and they’re changing the demographic of the workforce. We also have traditional learners with their own needs, as well as an aging workforce with specific physical requirements (increased contrast, larger fonts, etc.).

I’ve seen the assumption that everyone is keeping up with the relentless push of technology turn into a fatal flaw for multiple implementations. If valuable (but non-tech savvy) staff are to be retained, it might require sending an intern to teach them solitaire so they can develop mouse skills. It might require longer periods of elbow support. It might require a user psychology intervention. We can’t just throw away workers because they can’t pick up the latest and greatest on their own. And we need to understand that people learn differently. Webinars are highly distracting for some, who may do much better in a classroom setting. Some people need 1:1 training. Others need multiple solutions and methodologies to be successful.

Users choose not to keep with the times. Cynical’s premise is that failure to embrace new technology is a result of intentional isolation or resistance. In my situation, I’ve spent the last decade leading a major organization with a specific technology portfolio. While working a full-time CMIO job and a part-time clinical job (as well as writing for HIStalk), I didn’t have the free time to explore new pieces of technology that came out unless they directly impacted my livelihood in one way or another. Although my work situation is unique in that I choose to work multiple jobs, it’s representative of most of my workforce. The majority of our clinical end users are running on the treadmill of life faster than they ever have. In addition to increased work demands, they’re trying to be parents, children of adults that need care, spouses, little league coaches, and volunteers. Some are indeed working multiple jobs due to the part-time-ization of work. Sometimes things have to be prioritized and I can completely understand how someone winds up “under a rock” because they’re just trying to get by every day. Whether my post is agreed with or not, blaming users isn’t a strong position and it’s up to us as IT people to help them through when they’ve gotten behind.

You can’t do anything without being online. Although the Internet of Things is here to stay, it’s not everywhere. Right now, I’m working a locum tenens assignment in a community that does not have universal access to broadband. Yes, you heard me right. No high speed Internet. In 2015. The hospital is connected and a couple of businesses offer free wi-fi, but the community is rural and people can’t afford satellite service or it’s not a priority for them. Non-smart phones abound. I find it hard to criticize hard working people because they don’t message their appliances or tweak their thermostat from afar. There are people out there who use healthcare technology all day, every day, who may never leave the state where they were born. I agree the world is increasingly global, but that’s the reality here.

There’s also the reality of downtime. I’d like to be able to use my computer when I’m on a plane without wi-fi, or somewhere with a poor signal, or when the sewer company cuts Verizon’s line while doing a repair. Although being online is great (as I celebrated with my online shopping), sometimes it’s not available. We’re also in a destabilized world where we don’t just have to worry about natural disasters or weather events. Civil unrest is a real consideration and many organizations can’t afford the redundancy solutions needed for business continuity. That doesn’t make it right, but it’s a reality.

The view in healthcare is that connectedness and sharing information may blow someone’s competitive advantage. I agree this attitude is out there but there are equal numbers of us fighting to open the doors. I stood up the first HIE in my state (although it was a private one – we were tired of waiting for the state to catch up with us) and worked to lobby for legislation protecting physicians from liability around data sharing when it was done for the right reasons. Given the recent breach culture however, more patients are becoming concerned about privacy and security and want to minimize online exposure and sharing. They want to control who receives their data and when. I support that is a key tenet of patient autonomy, but it certainly makes my job as a physician harder when I don’t have all the pieces of the puzzle.

Additionally, our friends in government have solidified some of the problems around competitive advantage. A mere five to seven years ago, I had the autonomy to refer to whoever I wanted to and to whoever I thought would give the best care to the patient in front of me based on their unique situation. Now, thanks to narrow networks and ACOs, I’m forced to refer to a subset of providers who are cost-effective rather than to those that are the best for my patients. As a physician, I know that’s not necessarily the right thing to do for patients but most patients can’t afford to go out of network. The healthcare free-market economy is over and done with, at least until we get payers and government out of the business of dictating clinical care. I could write a month’s worth of blogs on those topics but I have to start rounding on real live patients in a few minutes.

Users don’t have the aptitude to learn and embrace new tools. My thinking as a CMIO is that if my users (who are often smart, college-degreed or highly experienced workers) can’t learn a new tool that maybe there is something wrong with the tool rather than with the user. Assuming that a tool is one size fits all is another fatal mistake. Tools are not always scalable and don’t always fit the user culture and workplace. Following the crowd and selecting a system because everyone else seems to be doing it may not be the right decision for your customers, and I agree with Cynical that the sometimes unthinking adoption of Epic is a problem.

Tools can also be frankly broken (like the sticky “I” key on my keyboard). I’m sure I would have had an entirely different experience getting used to Windows 8 if the keyboard worked. But instead, that particular hardware failure marred the entire experience. Imagine if you were an end user who didn’t understand the statistics (that if you buy 2,000 PCs for your staff, there’s odds that a certain percentage will malfunction) and that faulty one was your PC and you had no recourse. And there we get to the entire point of the post:

Everyone experiences technology changes differently. We all come from different experiences and different places of knowledge. Some of us are just trying to get through the day and others are more contemplative about the big picture. In my case, I researched for months and selected the device I thought would most meet my needs. Money was not a constraint. I’m an experienced IT person who has personally trained hundreds of end users and supervised the training of thousands more. I’m an early adopter for the most part and I understand the psychology about adoption. I understand the risks and benefits of the change and the limitations of my old technology and the benefits of the new. I was ready to make a change, excited about the change, and had a plan to embrace it slowly and in a non-threatening way, yet it still slapped me in the face. I literally had to put the technology aside because I physically could not do my job with it.

The story is indicative of what our end users face every day and I wasn’t embarrassed to share it. I’ve learned in the CMIO trenches that empathy and humility go a long way towards making things better.

Email Dr. Jayne.

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May 21, 2015 News 7 Comments

Morning Headlines 5/21/15

May 20, 2015 Headlines No Comments

CareFirst BlueCross BlueShield has been the target of a cyberattack

CareFirst BlueCross BlueShield, which provides insurance to residents in Maryland and Washington DC, is the latest victim of a targeted cyberattack. The attack was carried out in June 2014 but was only just discovered during a system-wide security audit.  Hackers gained access to a total of 1.1 million patient records.

AHA recommends changes to 21st Century Cures interoperability provisions

In a letter to the House Energy and Commerce Committee, AHA Executive Vice President Rick Pollack expresses concerns over interoperability requirements outlined in the 21st Century Cures Act currently being debated in Congress, suggesting that instead of establishing information blocking penalties that could be applied to providers, which he calls duplicative, the bill simply funds the FTC to investigate and address anti-competitive information blocking practices among EHR vendors.

Health IT Standards Committee and Task Forces

ONC announces that it will sunset the Health IT Standards Committee’s permanent workgroups, replacing them with a series of time-limited task forces that will study and make recommendations on specific issues. The intent is to create a more agile HITSC and to increase public engagement by offering an opportunity to participate in smaller, less time-intensive projects.   

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May 20, 2015 Headlines No Comments

Morning Headlines 5/20/15

May 19, 2015 Headlines No Comments

Allscripts layoffs to impact Raleigh headcount

Allscripts lays off 250 employees across its service, support, solutions management, sales, and G&A departments as part of a wider “rebalancing” effort. The layoffs were alluded to during the company’s Q1 earnings call and were reported via reader tips on HIStalk earlier in the month.

Welltok Acquires Leading Healthcare Analytics Company Predilytics

Population health vendor Welltok acquires Predilytics, an analytics company that uses machine learning to segment patients based on risk. Financial details were not disclosed.

Detecting Unplanned Care From Clinician Notes in Electronic Health Records

Researchers at Stanford University use natural language processing to analyze free-text clinical notes to detect patients with reported unplanned episodes of care at outside locations, increasing identification of patients with one or more unplanned care visits by 32 percent.

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May 19, 2015 Headlines No Comments

News 5/20/15

May 19, 2015 News 16 Comments

Top News

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Allscripts layoffs, which HIStalk readers have been reporting for the last several weeks, finally happen, with 250 indeed being the magic number. Several readers chimed in with their opinions just as the company made the cuts. Allscripts Peon pointed out that Allscripts “continues to lie to employees and cut staffing levels. Last month, 250-300 employees were cut so leadership could ‘right size’ the company. At that time, senior leaders told remaining employees that further cuts were not anticipated or being contemplated. Last Friday (5/15), another 250 or more employees got the axe as executives again said they were ‘right sizing’ the company. Apparently Paul Black and his team have no clue what the right size is for Allscripts.” Broadway Joe added that layoffs affected DBMotion, too. In terms of “right sizing,” the layoffs represent 3.5 percent of the company’s global workforce. Spokeswoman Concetta DiFranco explained that, “As a normal course of business, we are rebalancing our teams to ensure we have the right resources allocated to the right projects." I’m wondering how “right” those 250 folks feel right about now.


Webinars

Here’s the video from Tuesday’s webinar with Imprivata, which featured tips on how to prevent phishing attacks at healthcare facilities, as well as lessons learned from Yale New Have Health System.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Acquisitions, Funding, Business, and Stock

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Welltok acquires predictive analytics company Predilytics for an undisclosed sum. The timing is interesting, given that Predilytics secured a $10 million Series C round last December. Welltok will likely incorporate the new company’s tools into its CaféWell health optimization platform.


Announcements and Implementations

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ADP AdvancedMD launches patient and administrative kiosk apps, plus corresponding electronic check-in and consent forms.

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Surescripts announces the processing of 6.5 billion health data transactions last year, surpassing transaction heavyweights American Express and PayPal.

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The Hilo Medical Center’s Hawaii Pacific Oncology Center implements Meditech Oncology 6.0x, making it the ninth and final clinic in the HMC network to migrate from paper to the EHR. The five-year, system-wide project also included implementation of secure patient bill pay through the East Hawaii Regional Patient Portal.

Arkansas Heart Hospital and Arkansas Urology implement Pingmd’s secure text messaging solution across 35 facilities. The app has been in use at each organization’s main facility in Little Rock for over a year.

Stoltenberg Consulting partners with Qlik to offer the visual analytics vendor’s data solutions to its clients.

HealthCare Synergy becomes the first home health EHR vendor to partner with Great Lakes Health Connect, a Michigan-based HIE that connects over 80 percent of hospital beds and 10,000 providers throughout the state.


Government and Politics

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An OIG report finds the Coast Guard sorely lacking when it comes to protecting personnel medical records, citing a lack of instruction and process to periodically review health data security measures. The report also found no evidence of meetings between the Coast Guard’s privacy and HIPAA officers, and noted a lack of leadership as the main barrier to be overcome. The copious amounts of paper files pictured in the report (along with one black-and-white photo of a flooded records room) are also cause for concern.


Privacy and Security

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The IEEE Cybersecurity Initiative releases “Building Code for Medical Device Software Security,” a 23-page set of guidelines that aims to help companies “establish a secure baseline for software development and production practices of medical devices.”


Innovation and Research

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New York-Presbyterian Hospital launches InnovateNYP, a 10-week technology competition in which contestants will develop working prototypes that improve patient engagement or provider collaboration. Entries are due July 24, with a top prize of $15,000.

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A study of over 300,000 free-text machine-readable documents in the Stanford Health Care EHR finds that text-mining tools can be used to detect unplanned care episodes documented in clinician notes or in coded encounter data. Researchers believe their methods could be used for quality improvement efforts in which “events of interest occur outside of a network that allows for patient data sharing.”

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MD Anderson Cancer Center at Cooper (NJ) and behavioral health technology company Polaris Health Directions will launch a breast cancer behavioral health pilot project incorporating the Apple Watch. Wearable data on treatment side effects, sleep patterns, activity levels, and mood will be combined with patient EHR and population health data from within the Cooper health system to provide researchers with greater insight into engagement, feedback, and intervention.


Technology

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Flatiron Health will incorporate National Comprehensive Cancer Network Chemotherapy Order Templates into its OncoEMR, beginning with breast, colon, and non-small cell lung cancers. The EHR will also link to NCCN’s website to provide oncologists with additional resources.

Fruit Street Health taps Validic to integrate wearable devices and applications into its telehealth software, PHR, and video-conferencing platform.

Proxsys partners with mobile technology developer Catavolt to create a bedside discharge delivery app for tablets. The new app will be deployed throughout the Proxsys Rx Integrated Outpatient Pharmacy Provider network.


People

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Jonathan Scholl (Texas Health Resources) joins Leidos as health and engineering sector president.

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Hai Tran (BioScrip) joins Specialists on Call as CFO.

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Recondo Technology appoints Eldon Richards (PatientPoint) CTO and Perry Sweet (Allscripts) as chief client officer.

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Mark Reed, MD (Seattle Children’s Hospital) joins JWA Consulting, a part of Truven Health Analytics, as medical director.


Other

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This article highlights the decade-long collaboration between physicians at the Uganda Cancer Institute and Fred Hutchinson Cancer Research Center (Seattle). The two organizations are preparing to open a new research, training, and outpatient facility in Uganda. It will be the first comprehensive cancer center jointly built by U.S. and African cancer institutions in sub-Saharan Africa.

HIMSS issues a call for members of its new Health Business Solutions Technology Task Force. The group will facilitate discussion between health IT vendors and end-users, review legislative and administrative initiatives, and educate policymakers on aligning regulatory requirements with business needs.


Sponsor Updates

  • ADP AdvancedMD explains “What the Meaningful Use deadline means for your practice” in a new blog.
  • The San Antonio Express-News covers AirStrip’s expansion into home health.
  • AirWatch recaps its first annual employee hackathon in a new blog.
  • AtHoc recaps its annual user conference in its latest blog.
  • Besler Consulting explains “The Role of Discharge Disposition in Preventing Hospital Readmissions” in a new blog.
  • Bottomline Technologies and Cornerstone Advisors Group will exhibit at the MUSE conference May 26-29 in Nashville, TN.
  • CapsuleTech offers a new blog entitled, “Are you aware that your patient’s ventilator has just disconnected?”
  • Caradigm outlines “How Population Health Enriches the Patient Record” in a new blog.
  • CareTech Solutions offers a new video explaining the benefits of cloud services in today’s healthcare environment.
  • Clinical Architecture recaps its HIMSS15 fundraising efforts for the Music Empowers Foundation, Illinois Tornado Relief Effort, and St. Joseph the Worker School
  • CommVault adds several new cloud solutions to its line of enterprise products.
  • Connance’s Patient-Pay optimization solution receives HFMA Peer Review designation.
  • CoverMyMeds Vice President of Customer Relations Michelle Brown discusses how to scale up a company’s culture during a Startup Week event in Columbus, OH.
  • Culbert Healthcare Solutions offers a new blog on “Improving Population Health using Epic’s Healthy Planet.”
  • Divurgent offers a new white paper entitled, “Population Health: Laying the Foundation of Healthcare’s Next Generation of Care.”
  • Medecision offers a new blog entitled, “From Patients to People: Leveraging Analytics to Improve Population Health.”
  • Burwood Group posts a new blog entitled, “ED Caregivers, Tech – Let’s Get Together.”
  • Practice Unite offers a new blog entitled, “[Checklist] Evaluating Mobile Patient Engagement Apps.”
  • SyTrue offers a new visual blog focusing on industry response to its Radiology NLP offering. 
  • Microsoft blogs about its experience demonstrating nVoq’s SayIt speech-recognition solution on Surface Pro 3 tablets at HIMSS.

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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May 19, 2015 News 16 Comments

Morning Headlines 5/19/15

May 18, 2015 Headlines 1 Comment

Interoperability Roadmap Public Comments

ONC publishes all of the public comments it received on its interoperability roadmap (PDF).

ICD-10 Transition Testing Proposed

Rep. Diane Black (R-TN) introduces the ICD-TEN Act, a bill that would introduce an 18-month period during which providers could submit claims in either ICD-9 or ICD-10 format, and during which CMS would be barred from denying claims due to inaccurate ICD-10 sub-coding.

Interstate telehealth licensing compact set to become reality

A compact drafted by the Federation of State Medical Boards that would allow providers to practice medicine across state lines looks likely to be enacted. The compact was written in an effort to ease regulatory barriers to broader telemedicine adoption. The compact required that seven states formally adopt it before it would become active.  Alabama has just passed legislation adopting the compact and as soon as the Alabama governor signs the bill into law, the compact will have met its seven-state requirement and will be enacted nationally.

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May 18, 2015 Headlines 1 Comment

Curbside Consult with Dr. Jayne 5/18/15

May 18, 2015 News 15 Comments

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Dr. Jayne Adapts to New IT (and Lives to Tell the Tale)

Sometimes it’s important for those of us in healthcare IT to eat our own proverbial dog food. This week was one of those times, when I decided to buy a new laptop before heading out on a locum tenens gig. Although I did plenty of research and thought about it for several months before I took the plunge, I had some unexpected surprises. Much like EHRs, it had plenty of “undocumented functionality” to keep me guessing.

At my previous employer, we had three choices for end-user devices: standardized desktop PC, standardized laptop, or standardized convertible tablet PC. Regardless of which you selected, the desktop images were pretty much the same. I’ve always opted for the latter because it worked well for me in clinical settings. I liked to use it basically as a touch-screen laptop, so I could free text easily while navigating through EHR screens. Our hardware refresh cycle was typically 4+ years, so it had been a while since I had anything new. Additionally, we were still using Windows 7 and I had not yet had the adventure that is Windows 8.

While shopping for my new hardware, I worried that I had become out of touch with consumer electronics because I had been insulated in the IT silo of Big Health System. That became a reality when it finally arrived on Friday afternoon. I have to say, Dell does a snazzy job with their packaging. The new laptop came in a glossy box with full-color photographic images on it. I was worried that my new device was heavier than anticipated, but discovered that a good chunk of the weight was the decorator-quality box. The real shock, though, came when I tried to start setting it up.

First, I guess you can’t do anything anymore without being online. Despite having purchased full versions of several applications along with the PC, it wanted me to go online to download updates before I could do anything. I had heard a lot about the Windows 8 interface so I was prepared to not have my familiar landmarks. I was not prepared, though for how clicky it is just to navigate to items that previously lived in the start menu. Rumor has it that Microsoft is bringing back the start menu with Windows 10, and I daresay I’ll probably be looking forward to it.

I spent a good hour downloading non-Internet Explorer browsers and configuring links and bookmarks just the way I like them, not to mention the general appearance and settings items. The new keyboard has a totally different feel than what I am used to and I knew there would be a learning curve, so I decided to start slowly with some online shopping. Running skirts on sale, y’all. Get ‘em while they’re hot! I placed my order and felt I was doing well getting used to the new touchpad when I had a big surprise – apparently this model is now touch screen! When I originally researched it a few months ago, they offered it in two versions – with and without. Now, apparently, they only offer it with the touch screen and I didn’t notice when I bought it since it was the same price as what I had researched before.

Although cool, it made me wonder whether the privacy filter I purchased would work with it. Especially now that I travel a fair amount, I don’t need people reading my work on the plane. I wanted to get things organized before I had to leave town, so I left that as a project for another day. I started moving files over from my old machine. I was feeling pretty good on the new keyboard and only typing gibberish now and then, so decided to do some real work. I’ve been working on a textbook chapter for a couple of months and emailing back and forth with a collaborator. We’ve had some bad experiences with Google Docs (which everyone and their cousin seems to use for collaboration), so we do our revisions old-school, emailing them back and forth after each update. I couldn’t open the most recent document from my partner and the laptop threw some ridiculous out of memory error at me despite the fact that Chrome was the only thing running.

I ended up having to download the document on another laptop and move it via USB, so I was already aggravated and distracted. Then, while I was trying to write, I kept getting emails from Gmail alerting me that my various accounts had been signed into from new IP addresses and new browsers. I plowed through some edits then got ready to save. Unfortunately, it stuck my draft not in the good old Documents folder as I had specified, but in some AppData/Roaming folder, which apparently is a hidden folder in file explorer. Not cool.

The last straw was when I got the email from Dropbox announcing that it had somehow (and seemingly without my permission) mated with Microsoft Office Online. Seriously? By this point I was ready to go online to my local school district and start looking for community education courses to help me navigate this mess. I’m really a pretty basic user at home – word processing, email, Internet, accounting software, spreadsheets, Twitter, and the occasional Facebook. I don’t do any multimedia or gaming and don’t like storing data in the cloud unless I really have to, hence the Dropbox account. (Yes, I’m a bit of a curmudgeon that way.)

But here I was with my applications melding in a way I didn’t understand or know how to control without doing a bunch of research or calling the teenager across the street. I decided to give up on the textbook and start writing Curbside Consult. Mind you, I’ve had this computer less than 72 hours and have barely used it. I was looking forward to some straightforward word processing and what happens next? The “I” key decides to stick. The screen instantly fills with the letter I and I’m prying it up with my fingernails to get it to stop. I tried for a good 15 minutes to get it to work right and no luck. Apparently the key has three modes: stick and type a thousand letters, stick and type nothing, or depress and type nothing.

By this point I was ready to throw in the towel and returned to my lowly HP with 2 GB of RAM that I bought in 2009. It’s slow and cantankerous, but has all its vowels and consonants in fine order. As for the new one, it’ll have to wait until I get back in town and am ready to deal with it. If nothing else though, I have a new appreciation for what physicians feel like when we throw new hardware or a new operating system at them without adequate orientation and training.

What’s your take on Windows 8? Email me.

Email Dr. Jayne

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May 18, 2015 News 15 Comments

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