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July 15, 2014 News 9 Comments

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IBM and Apple announce a partnership to develop business applications for iPhones and iPads. IBM will also sell Apple products and provide on-site services to business clients, while Apple gains business credibility and a tie-in to IBM’s big data capabilities that will make its devices decision-making tools. The deal also gives Apple’s iOS more enterprise credibility against the more widely used Android operating system. The companies say more than 100 business apps will be available by fall.


Reader Comments

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From Baron Schkinn: “Re: Siemens. The rumor is surfacing again that Cerner will buy the health IT division of Siemens and close the deal by the end of the summer, coming from an inside source who I trust. That would give Cerner a replacement for its failed ProFit, a backup center in another earthquake zone, a shot at selling to the significant number of Invision and MedSeries4 clients, and would make Cerner the #1 vendor over McKesson in revenue. They would still be left with two poor ambulatory solutions that would make them non-competitive with Epic.” Unverified, other than the seemingly solid rumor that Siemens is shopping the business it describes on its website in a predictably confusing fashion as “the Siemens Healthcare Information Technology business of Health Services, Siemens Healthcare” (which offers several humorous acronym-powered punning opportunities.) Cerner might be willing to pay the rumored $1.4 billion just to get the Siemens customer base and a few worthwhile niche-filling nuggets (MobileMD, although nothing else comes to mind given Soarian’s minimal-and-dropping competitiveness) but it would seem to be a better fit for private equity. Cerner doesn’t do a lot of acquisitions and one that size might spook Wall Street, which Cerner doesn’t like doing, but anything can happen when it comes to acquisitions.

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From BadBuy: “Re: Sunquest. Significantly behind full-year sales target, with the top two reps at just over 50 percent. Vista/Huntsman Gay made out like bandits.” Unverified. Roper Industries acquired Sunquest in July 2012 for $1.42 billion after what I’ve heard was shockingly minimal due diligence. I would assume that former owners Huntsman Gay Global Capital and Vista Equity Partners did indeed do quite well for themselves given that the former paid only $208 million to acquire 51 percent of Sunquest in December 2010, with Vista holding on to 49 percent. That means Roper paid more than three times that valuation just 19 months later. Roper executives talked up Sunquest’s revenue growth and implementation improvements in the company’s most recent earnings call, adding that Sunquest will have “quite an exceptional year in 2014.” Roper’s diversified growth is steady – share price has more than tripled in the past five years. The longer you work in this or any other industry, the more you realize it’s the generic money guys, not the deep subject matter experts or passionate advocates, who do really well. “Owning” has more potential reward (and risk) than “doing.”

From Binge and Purge: “Re: Johnathan Samples. You’ve probably already heard, but he has left Greenway after 13 years and started a new company.” Samples, who was Greenway’s chief innovation officer through last month, threw in with former Greenway Chief Product Strategist Jason Colquitt at Across Healthcare, which offers what appears to be an unfocused array of consulting and software development services.

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From Yalie: “Re: Yale-New Haven. Anything in writing about their hard Epic downtime system-wide for two days last week?” The local paper says a network switch went down Friday for a handful of hours, requiring the hospital to cancel elective surgeries. Epic information was still available from cached copies.


HIStalk Announcements and Requests

I’ve confirmed that Epic’s FDA 510k submission was for a bedside matching system, not a blood bank system.

We hear a lot about the suits in the healthcare corner offices, but not enough about the cube-dwellers who perform the actual work that pays for them. I am offering the HIStalk BOSS (Beacon of Selfless Service) Award to recognize those trench warriors (provider or vendor) who toil without bonuses, reserved parking spaces, or the ever-present validation of company-paid butt kissers. The BOSS Award isn’t a trophy or cash, but rather recognition in HIStalk of a non-management employee who went above and beyond during a specific event (downtime, sales demo, screaming surgeon demanding a new laptop, etc.) to save the day. Anyone who observed the individual’s laudable effort firsthand can nominate someone – a supervisor, peer, or customer. Submit your candidate here.

We like to keep in touch with HIStalk’s sponsors and we just sent an e-mail to all the contacts on our list. Let Lorre know if we missed you.


Acquisitions, Funding, Business, and Stock

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The US Bankruptcy Court approves MModal’s reorganization plan, allowing the company to emerge from bankruptcy in August as it had originally announced.

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The Teamsters Union urges McKesson’s shareholders to approve its proxy proposal to eliminate the company’s change-of-control terms that will give its top executives $283 million if new owners fire them, including $140.5 million for John Hammergren alone.

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Craneware announces $70 million in sales in the first half of 2014, up 80 percent year over year.


Sales

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Saint Mary’s Hospital (CT) selects Wellsoft’s EDIS.

Wheeling Hospital (WV) adds Sunrise Financial Manager to its Allscripts systems.

Carrus Hospitals (TX) will deploy Medhost’s clinical and financial solutions via the company’s hosted Medhost Direct platform.


People

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Rob Lipowski (Cleveland Clinic) joins Perceptive Software as director of healthcare solutions.

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Perry Lewis (McKesson) is named VP of industry relations of CoverMyMeds.

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“Inc.” profiles Beyond Lucid Technologies Founder and CEO Jonathon Feit, who has Tourette Syndrome. It points out the difficulty he has in performing company pitches and recorded videos without the characteristic twitching. His company sells an electronic patient record system for first responders.


Announcements and Implementations

Summit Healthcare announces that 26 facilities are live on its Summit Care Exchange technology, which allows providers to send CCDs to a Health Information Service Provider via Direct to meet Meaningful Use requirements.  

EHNAC and WEDI launch an accreditation program for practice management systems, announcing GE Healthcare, Medinformatix, and NextGen as pilot participants.

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Elsevier Clinical Solutions announces its Clinical Documentation Improvement Reference App, which provides clinical term look-up and medical necessity information with an emphasis on ICD-10.

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New Orleans-based startup Clinicate launches its clinical file-sharing solution for providers and patients. It also contains some unrelated tools such as drug lookup. It’s free for patients and a single provider can use the system free for up to 100MB of storage.

Healthcare Data Solutions announces availability of the HealthcareData360 EHR market intelligence database, which allows looking up EHR decision-makers both within and across connected provider organizations.


Government and Politics

NIST and OCR will co-host “Safeguarding Health Information: Building Assurance through HIPAA Security” on September 23-24, 2014 at the Grand Hyatt in Washington, DC. Onsite attendance runs $345, while Webcast attendees will pay $200.

The FCC’s 17-year-old system crashes under the weight of 800,000 comments filed regarding net neutrality, forcing it to extend the comments deadline until midnight Friday. Comments can be filed (and read, in the case of the most recent 10,000 comments) here.

Eighty-nine House lawmakers sign a letter requesting that CMS remove penalties for clinical laboratories that perform tests for Medicare patients, explaining, “Pathologists have limited direct contact with patients and do not operate in EHRs. Instead, pathologists use sophisticated computerized laboratory information systems (LISs) to support the work of analyzing patient specimens and generating test results.” CMS granted pathologists a hardship exception for 2015, but the College of American Pathologists wants the requirement to be eliminated permanently.


Innovation and Research

Three computer scientists who developed the first program that passed the Turing test — convincing a human that they are interacting with another human rather than a computer — have joined startup Wholesale Change, which will develop online tools to help consumers choose Medicare insurance plans.

@Cascadia tweeted about Israel-based Tyto Care, which offers a handheld device and cloud platform that allows patients to do their own physical examination while being guided remotely by their doctor.

Chicago-area researchers query the EHRs of 23 primary care practices to identify patients likely to have undiagnosed hypertension based on their historical pattern of in-office blood pressure readings, inviting those patients to follow up with a more comprehensive series of readings. The practices not only alerted patients, but also turned their work into a quality improvement project by continuing to remind both patients and physicians of the need for follow-up until an ICD-9 code was entered indicating that hypertension had been either confirmed or ruled out.


Technology

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The Alcon division of Novartis AG licenses Google’s smart contact lens technology that will measure and report blood glucose levels. Meanwhile, the former Google X director who led the development of the contact lens as well as Google Glass announces his departure from Google and his excitement at going to work for Amazon. He made headlines last week by saying that Glass is “not necessarily the definitive answer” for wearable technology.

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Welch Allyn adds customizable patient scoring to its Connex vital signs monitor, allowing hospitals to use their own Early Warning Score to identify deteriorating patients. The company’s clinical surveillance system can send the results wirelessly to the hospital’s EMR and can also monitor for falls, pressure ulcers, and respiratory distress.


Other 

A new HIMSS Analytics report says “germ-related hospital applications” have high growth potential. That oddly phrased category (clinicians never say “germs” unless talking slowly to laypeople who possess limited medical comprehension) includes systems for infection surveillance, patient acuity, and laboratory outreach.

HIMSS14 is named the fourth-largest medical meeting of 2013 with its 36,5325 attendees, following the FIME (Florida International Medical Expo) trade show in Miami, the Greater New York Dental Meeting, and RSNA.

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Two surgeons from UNC Hospitals (NC) open a burn center in Malawi, which has 14 million people and only 20 surgeons. One of the UNC surgeons added that UNC’s new Epic electronic medical record and potentially the addition of telemedicine services will help it treat patients in their local areas of North Carolina rather than transporting them to Chapel Hill.

Let’s hope Massachusetts isn’t the national healthcare model everybody brags on: healthcare will eat up almost a third of the new state budget vs. the 20 percent it consumed in 2001.

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An article describes how 25-bed Cottage Hospital (NH) became one of the first hospitals to attest for Meaningful Use Stage 2. It’s a Medhost facility and hired an informatics nurse to keep things moving along.

“US News & World Report” lists its “Best Hospitals 2014-15”: (1) Mayo Clinic; (2) Mass General; (3) Johns Hopkins; (4) Cleveland Clinic; (5) UCLA Medical Center; (6) New York-Presbyterian; (7) HUP; (8) UCSF; (9) Brigham and Women’s; (10) Northwestern Memorial; (11) University of Washington; (12) Cedars-Sinai, tied with UPMC; (14) Duke; (15) NYU Langone; (16) Mount Sinai; and (17) Barnes-Jewish. 

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“The Wall Street Journal” reports that the ambitious $54 million biotech facility created from the converted Brooklyn Army Terminal stands nearly empty, reportedly because of squabbles between its two developers, SUNY Downstate Medical Center and the city’s Economic Development Corp. The project’s former executive director, who left last year, said public agencies are lousy at running speculative developments because they have too much bureaucracy behind them and lack the mindset to get it done. The project is limping along by renting space to non-biotech companies at a discount despite its mission of boosting the city’s biotech presence.

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Madison, WI’s weekly hippie newspaper covers Epic’s purchase of wacky artwork at the summer art fair run by the Madison Museum of Contemporary Art, saying that Judy Faulkner brings an employee team armed with a “generous budget” (some of it in cash) to find big, bold, and whimsical pieces.

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A father whose six-week-old daughter died of a liver tumor after spending her entire life in the hospital posts a request on Reddit asking for help to Photoshop the only photos he had of her, all of them showing her with tubes in place since she had never been without them. His post generated 2,700 comments of support and many photographs and drawings. He called attention to “Now I Lay Me Down to Sleep,” whose volunteer photographers take portraits of families with their dying or deceased child.


Sponsor Updates

  • The Sunquest User Group conference is being held this week at the JW Marriott Desert Ridge Resort in Scottsdale, AZ.
  • HealthMEDX sponsored the “Prescription for Change” technology discussion for long-term and post-acute care providers, with CEO Pam Pure and Medical Director Charles Rogers, MD participating.
  • Laura Argauer of CTG co-presented “Using Transformational Data Analytics to Improve Care Valuation, Management and Outcomes of Chronic Kidney Disease Patients” at the Healthcare Analytics Symposium & Expo 2014 this week.
  • Health Catalyst shares a case study on Crystal Run Healthcare (NY), explaining why they bought rather than built a data warehouse.
  • Predixion CEO Simon Arkell will discuss the explosion of connected devices and predictive analytics challenges in healthcare during the Microsoft Worldwide Partnership Conference in Washington, DC this week.
  • Kari Bunting, RN of MedStar Franklin Square Medical Center (MD) will present her research on reducing excessive uterine contractions aided by PeriGen’s PeriCALM Patterns EFM at the Summer Institute in Nursing Informatics in Baltimore, MD this week.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
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Currently there are "9 comments" on this Article:

  1. I would applaud your bringing to our attention the dire plight which our nation faces in maximizing our healthcare are outcomes, but to formulate an assessment about the ACA based upon the Massachusetts budget for 2015 is, at the least, specious. Yes, we have terrible problems in controlling our healthcare costs. Yes, the State of Massachusetts has significant budgetary problems. But, to aver that the growth in Massachusetts state spending demonstrates our inability to control costs is simply a fallacious correlation. Enrollment in MassHealth has grown roughly 55% in the 14 years; the growth in Q1 2014 alone was 19%. When you add in the CPI increases for healthcare costs since 2000 as well as federal payments to the state, it would seem that program initiated by Mr. Romney has done a pretty good job in reducing the number of uncovered people, thereby proving them with better primary care resources and alleviating the burden of non-reimbursed care upon providers.

  2. MA biggest problem is exactly what plagues the US – they simply had too high of a unit cost basis to start with even by 2000. No one wants to hear that in the US it is the single biggest issue that plagues the US health care system & it has been a long-standing problem when US health care unit costs really started to diverge from the rest of the world.

  3. Massachusetts…health care 33% of budget…
    I am with Mr. H on this. Arlen, I think all your points are good ones and solid reasons why health care is eating up a significant part of the State budget. But let me ask you this. What percent of a government’s budget should go to health care? Is 40% or 51% or 61% too much?
    Secondly, in my 40+ years in the health care industry I have heard a million times that the more primary and preventive care we do the lower the total the total health care expenditure will be. So when do you think we will see that happen in MA.?

  4. Medicaid is a huge problem and it has increased from roughly ~20% on average of state spending in FY95 to over 24% in FY13. That doesn’t sound huge but it has really started to crowd-out other necessary physical and human capital investments required for the future.

    https://www.nasbo.org/sites/default/files/State%20Expenditure%20Report%20%28Fiscal%202011-2013%20Data%29.pdf

    Some of it is certainly due to the expanded Medicaid rolls/slow recovery in terms of jobs but the single biggest expense in Medicaid is almost every state is assisted living facilities & care for the elderly. Another topic no one wants to touch in either party is how elderly transfer payments (along with military spending) are bankrupting the U.S at the federal level.

  5. HIStalk BOSS (Beacon of Selfless Service) Award – LOVE IT!

    I’d nominate, but I’m a “vendor” and having come from the provider side, I firmly believe no matter what we do – they deserve it more.

  6. Solution to costs: simply pay every clinician $1million per year and tell them to go out there and practice good medicine and do what is cost effective and appropriate for the patient.

    Problem: many hospitals will close because there will no longer be unnecessary surgery and tests.

  7. This kind of logic leads to things like the auto bailout. The solution to costs is accountability not hand outs. You hit the nail on the head that it makes no sense to be conducting unnecessary surgery or tests.

    We need a market based system. At some point in the US, we stopped holding people accountable. If you’re obese because you choose to eat unhealthy food and not work out, you should pay more for your care. It’s going to be a tragic mistake that insurance companies cannot refuse to sell coverage based on pre-existing conditions. People don’t worry about losing their auto insurance and a big reason for that isn’t auto insurance is so different. You can cause $100K-$1MMs of damage with a car. Its that auto insurance is a market based system. When you get your car fixed you get different estimates so auto mechanics compete on price. Why is it Doctor’s get a free pass? The notion of just paying them $1MM is the wrong approach.

    The lack of accountability seems to permeate many corners of health care. For example, when faced with a surgeon that’s literally killing or maiming their patients. The administrators of that hospital just let it continue. How about comparing the prices of a service? Most health care organizations couldn’t even tell you the actual costs of their treatments.

    Imagine a world where bankruptcies were caused by the outrageous cost of utilities. We’d do something about it. But yet in health care, it’s the #1 reason for bankruptcy and we don’t (http://www.cnbc.com/id/100840148). We do things like Meaningful Use Incentives that potentially increase the cost of care. We suggest ideas like “pay the doc $1M and just let him handle it”. Becoming a Doctor used to be the life long dream of so many because of the power that came with being able to cure and heal people. The US has so mis-managed its health care system that today’s Doctor’s are primarily focused on a big paycheck and not creating innovate ways to take care of the population. The US needs a health care system that’s market-based to spur the innovation that we see in other industries. We simply cannot afford to continue down the same path.

  8. Unfortunately, Massachusetts’s budgetary problem is that tax revenues have remained constant over the course of the past five years while their obligations to provide healthcare have increased, thereby resulting in less revenues for investment into infrastructures other than the wellbeing of it citizens. (I would suggest that the health of workers is of paramount importance since workers are much of an asset as a bridge or a road.) Clearly, we cannot sustain such expenses if they continue to escalate, and we will have to ask just what do we ration? The question should not be whether we should have universal healthcare access, but rather at just what cost do we take care of our populace?

    What portion of our budget is enough? Rather than looking at Massachusetts’s budget, we should probably compare what portion of our GDP goes for healthcare to that of other countries. Conservative economist Bruce Bartlett, who held senior policy roles in the Reagan and George H.W. Bush administrations, analyzed total taxes as a share of GDP of developed countries belonging to the Organization for Economic Cooperation and Development in 2011. The United States was 30th on this list at 26.6%. The U.K. was 15th at 35.7%; and France, fifth at 43.2%. At first blush, it would seem that we have extra opportunity to support healthcare.

    But, let’s dig deeper. The Commonwealth Fund has consistently rated the United States healthcare system as number 11 out of 11 nations studied in 2014, as it did in 2010, 2007, 2006 and 2004. The World Bank reported that over the period of 2009-20013 that the United States spent 17.9% of its GDP on healthcare compared to the UK’s 9.4% and France’s 11.7%. You really have to ask what you’re getting for your dollar.

    The good news is that the rate of growth of healthcare expenses has slowed down, not only in the U.S., but globally according to the Organization for Economic Cooperation and Development. Development of new expensive medical technologies has slowed as well, and there has been a significant cost reduction with the expiration of medication patents.

    But, we still have to address why such a disproportionate amount of our GDP is spent on healthcare. The OECD’s own economists in a 2014 article in The Lancet point to higher prices in the U.S. as being the major differentiator between the U.S. and other developed countries. I can’t address that issue, so I am just going to plug along in supporting workflow improvement and standard vocabularies to support result reporting, interoperability, and analytics.

  9. You have to ask what you’re getting for your dollar, but we also have to ask “why are we getting so little for our dollar?”

    Comparing % GDP is an interesting way to look at health care spending until you look at absolute terms the US GDP is $15.6 trillion, the UK is $2.435 trillion, and France is $2.613 in 2012. Given that we spent 17.9% of GDP on health care that equates to $2.79 trillion in health care spending more than the GDP of France or the UK.

    Let’s take a closer look at the UK. In the UK most health care is provided by the National Health Services (NHS). People fixate on the “universal” nature as an important aspect of a health care system. However, the UK keeps cost under control not because their system is universal, but that it is accountable. The National Audit Office (NAO) reports annually on the accounts of the NHS. The NAO monitors how much the UK is spending on health care. There is also many that view the UK system as inefficient (no word on what they say about the US).

    In the US, we have no such accountable body. We may track some Medicare and Medicaid costs. We’re getting better at that tracking with recent data releases. However, we still don’t have anyone tracking the costs. Meaningful Use Incentives give a hand out for some specific metrics many of which INCREASE cost (e.g. Patient Portals, Compliance, EHRs upgrades, etc.). Insurance companies pay hospitals. Patients receive insurance purchased from their employers. Health care providers raise costs and pass them on to insurance companies. Insurance companies simply pass the costs on to employers. The patient has very little input in deciding where to go receive care based on costs. Even hospitals aren’t really sure what a procedure will cost the patient until insurances are billed. As a result, health care administrators and Doctors line their pockets while looking the other way by bankrupting many poor people in need. The system is horribly and tragically broken.

    The technology clearly exists today to quickly and reliably publish the fee schedules of specific procedures. The Expedia or Priceline for health care is coming if only we’d focus on American market based principles and apply them to health care. The power to select and purchase insurance needs to live with the employee (not the employer) so that insurance companies know that if they pass the costs on their customers can bolt to a more affordable and reliable plan. Insurance companies would change over night because they would be incentivised to keep their insured population healthy to keep prices in check to remain open for business. No one today is really accountable except for the patient in need who may eventually join the long line of health care cost related bankruptcies.







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Reader Comments

  • HIT Girl: And this is how it propagates all the way up to the Executive branch of our government -- nobody says "no". Nobody puts...
  • Friday Interoppin': Re: Commonwell (by way of Ex Epic) So, 29,360ish Cerner-using facilities have the capability of sharing clinical docu...
  • Sam Lawrence: Any idea how many of those Cerner sales were Sorian to Cerner conversions? Or was that the number you pointed out as ad...
  • Chris Grover: My opinion. Good read. Let's all please remember that the VA can negotiate price with Pharma and pay 2/3rds of what the ...
  • JustaGuy: You should attach Ed's post from today to the termination letter.......

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