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Monday Morning Update 8/11/14

August 9, 2014 News 5 Comments

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Massachusetts will upgrade Massachusetts Health Connector instead of piggybacking on Healthcare.gov, officials decide. The state will replace fired contractor CGI, to which it has paid $52 million, and replace it with Optum. The struggling site has cost $108 million so far.


Reader Comments

From Chris: “Re: jaded by the industry. We vendors are jaded too because it is a very difficult industry to serve. Fat cat EMR vendors have stolen from hospitals for years for very little value or improved outcomes. Then ACA just dumps millions into the hands of the same vendors, starving those innovating and trying to change a culture from the ‘80s. We have to deal with absurdities like IE7 (and IE8, 9, 10, and 11) while we push boundaries with iPad. There is so much apathy and very little standardization and consistency from one hospital to the next. You have to laugh at the amount of money that’s being spent to convert to electronic medical records and protect privacy. Paper wasn’t so bad after all and it was certainly cheaper. Until human behavior changes and the FDA starts protecting our food supply, we’re just fooling ourselves about improving healthcare.”

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From Sticky Clicky: “Re: Habersham Medical Center. Which EHR forced them to return their Meaningful Use payments due to lack of capability?” They’ve been running Meditech forever, I believe. The hospital spent $3 million on software upgrades and attested for Stage 1, but later found that “a statement we made to CMS that it would work was in error” so they returned the $1.5 million in incentive money.

From Equitable: “Re: a recent vendor raising debt funding. I’m guessing it’s because they failed to raise equity after hiring Blair to try. Investors were concerned about the viability of an e-prescribing vendor at this point in the market.”

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From Certified: “Re: LabCorp. Nationwide systems down as of noon Friday. Radio silence from corporate. Why aren’t they at Starbucks informing customers by Gmail? They can afford elite collection agencies, but their IT systems are primitive.” Even LabCorp.com is down as I write this Saturday evening and their portal log-in page returns an internal server error. That’s some major downtime.


HIStalk Announcements and Requests

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Two-thirds of poll respondents think the federal government should develop EHR interoperability standards and make them mandatory. New poll to your right (or here):  which EHR vendor is best positioned to support population health management?

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Last Week’s Most Interesting News

  • Cerner announces that it will acquire the healthcare IT business of Siemens for $1.3 billion in cash as Siemens finally unloads the business it bought in 2000 for $2 billion, making Cerner the biggest vendor in the industry in terms of revenue. Cerner’s interest is buying a captive audience for conversion to Millennium, incorporating patient data from the legacy systems of Siemens into a population health management system, and using R&D to blur the line between diagnostic and therapeutic equipment and IT systems in a post-EMR world.
  • Six Wisconsin health systems announced their affiliation to manage populations and earn business, including sharing patient information from the Epic system used by all six to deliver care and manage patients across institutions.
  • The annual EHR report by the Robert Wood Johnson Foundation finds that HITECH-incented hospitals and practices have rapidly implemented basic EHRs, but few are using them comprehensively and only a tiny percentage of users are ready for Meaningful Use Stage 2.
  • HHS OIG released a report that said ONC’s certification program doesn’t focus enough security issues ,such as enforcing password complexity and managing user privileges.
  • The State of Vermont ends its $83 million health insurance exchange contract with CGI, saying the site still isn’t fully functional.
  • Allscripts announces Q2 results that meet analyst expectations.

Acquisitions, Funding, Business, and Stock

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Voalte will open Voalte Labs, an independent research center, in its home town of Sarasota, FL. It will be run by Don Fletcher, PhD, the company’s chief scientist.

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From the Allscripts earnings call:

  • President and CEO Paul Black says the company will benefit “as clients look for solutions that are both interoperable and fully integrated, something Allscripts’ open platform is uniquely positioned to provide.”
  • The company’s one Sunrise hospital sale in the quarter was to a 78-bed hospital.
  • Black says the company’s new “fusion” technology will integrate parts of dbMotion, Sunrise, TouchWorks, and Pro.
  • The company blames reduced revenue vs. 2013 on “a continued shift toward subscription software arrangements.”
  • Maintenance revenue dropped as customers moved off MyWay.
  • The company blames flat transaction revenue on Medfusion, which cancelled its agreement with Allscripts claiming it wasn’t getting paid and that Allscripts was urging its portal users to switch to Allscripts acquisition Jardogs, now called FollowMyHealth.
  • The company is targeting Siemens customers now that its business will be acquired by Cerner.
  • Allscript expects international business to double as a percentage of total revenue, from 5 percent to 10 percent.

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The CEO of Siemens Healthcare, quoted in the announcement that it will sell its health IT business to Cerner, said:

We have continuously invested in our HS-portfolio and achieved significant progress on the technology side. At the same time, we realized that business success of our hospital information systems could not always keep pace with our competition. Additionally an increasing number of country-specific requirements, such as resulting from US healthcare reform, make it increasingly challenging to achieve sufficient scale effects. Going forward we will focus on the development of information systems that support our businesses in laboratory diagnostics as well as imaging and therapy.


People

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Patient data monitoring app vendor Conversa Health appoints Peter Levin, PhD (US Department of Veterans Affairs) to its board.


Announcements and Implementations

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Google announces availability of preview version of its Google Fit software development kit. It allows programmers to access a user’s fitness history as recorded on Android-powered apps and sensors. Google Fit is scheduled for a fall release.


Government and Politics 

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Oracle sues the state of Oregon, claiming that the Cover Oregon health insurance exchange owes it $23 million for using its software. This follows the state’s announced intentions to sue Oracle for the $134 million it paid it to develop the site, which never went live because of problems. According to a state spokesperson, “The state fully expected to end up in litigation over Oracle’s failure to deliver." Oracle says the state failed to define system requirements, focused on the site’s appearance instead of its functionality, and failed to hire a systems integrator. Oracle adds that state officials went on a 60-day day retreat to define specifications but “returned empty-handed.” Legal experts say the state probably won’t win its lawsuit against Oracle because of the state’s weak contracting practices and the fact that its actual contract is with Dell, which paid Oracle time and materials as a subcontractor. Meanwhile, the state is planning to dump Cover Oregon and use Healthcare.gov after spending $250 million in federal taxpayer money on the failed website.


Innovation and Research

Here’s how surgeons use TedCas’s Microsoft Kinect-powered user interface in the OR.


Texas Health Resources / CVS MinuteClinic Affiliation

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CVS Caremark and Texas Health Resources announced an affiliation three weeks ago to provide convenient primary care services such as medication counseling, chronic disease monitoring, and wellness programs at CVS/pharmacy stores and MinuteClinic locations. The organizations hope to keep people healthier and out of the hospital and ED. I spoke to Barbara Adams, VP of Innovative Technology Services for Texas Health Physicians Group / Texas Health Resources about the relationship.

She says the driver for THR was to increase its access points. She said, “We have 250 clinics in DFW. We wanted to be able to refer after-hours patients so they don’t have to go to the emergency room. Many of the THR ED patients don’t have primary care doctors.”

Minute Clinic is staffed by nurse practitioners. Texas law requires physician supervision in the form of a review of 10 percent of charts. CVS will pay THR’s physicians for providing that supervision. THR also may gain referrals if patients choose them from the list MinuteClinic provides.

CVS is using a homegrown EMR but is moving to Epic, which THPG already uses. For now, the organizations will exchange information using Surescripts. The NP can push a message into THPG’s Epic system and the organizations can exchange CCDs over the HISP. Once CVS goes live on Epic next year, message exchange will be directional using Epic’s Care Everywhere.


Other

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TechCrunch profiles five-employee PicnicHealth, which offers a $39 per month personal health record that is populated from information the company obtains by performing manual records requests for a person’s encounters. The fee also includes ongoing digitization of new records, synching with patient portals, and unlimited records delivery to doctors. The company’s official address is a San Francisco apartment.

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HIPAA worries are causing obstetricians to remove “baby boards” that feature photos of babies they’ve delivered from their office walls. An OCR representative confirms that the practice is illegal even if the family sends the picture for that purpose since “implied consent” doesn’t count.

A new regulation in India requires doctors to write prescription in all capital letters to avoid sloppy cursive handwriting that was causing medication errors.

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A California pathologist is charged with embezzling $500,000 from the pathology company that promoted her to CFO, with one of her first accomplishments being to give herself a raise from $226,000 to $739,000.

Weird News Andy says this story involves a million-dollar typo. A family who purchased  health insurance through Nevada’s health insurance exchange finds themselves on the hook for $1.2 million in medical bills related to premature birth of their daughter because of an incorrectly entered date of birth. The state has already fired Nevada Health Link’s contractor Xerox, who says the only way to add a newborn is to cancel the family’s policy and start over.


Contacts

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

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5 Responses to “Monday Morning Update 8/11/14”

  1. 1
    vendor_neutral Says:

    how can a company as small and new as Voalte justify a skunkworks operation? this makes no sense at all. all due respect to Trey, but this is just silly.

  2. 2
    Bee_two_bee Says:

    athenahealth isn’t listed on your pop health survey, but reportedly manages half the risk-based providers in Massachusetts.

  3. 3
    HIT Vendor Says:

    I see many posts from people like Chris above vilifying EMR’s and expousing the virtues of paper systems. It is a good thing these people are not running our health system. Having spent 25 years in this business I can assure you that you cannot share paper. Standards are there and available for exchanging clinical data (XDS, XDR, SOAP, HL-7 to name a few) and they work quite well. The adoption of HIE’s has increased the availability of critical clinical information, at the point of care, to support care coordination, improve the quaility of care, lower the costs and improve outcomes. I have been cared for by a large health system in NC that went from paper to an EMR and the improvement was dramatic. There were people in this health system like Chris that resisited this positive and meaningful change, and they are no longer there, put out to pasture with others with their heads in the sand..

  4. 4
    Keith McItkin, PhD. Says:

    @chris Many agree with his take. There have been many more $ billions spent on HIT, HIT consultants, HIT repairs, HIT crashes, HIT inefficiencies, not to mention increased med mal costs, than disclosed. What do we have to show for it? Just wondering?

    And @hitvendor would appear to be a member of the worried well.
    These systems have always been superb for the worried well and simple diseases such as acne.

  5. 5
    PezMan Says:

    @Chris – I agree here as well. The big EHR vendors are charging way too much and providing not nearly enough for being in this game forever. What’s worse is that when an innovative company has a better workflow solution (i.e. easier to use, plays in the EHR whitespace & gaps in functionality), that large EHR vendor scrambles for a half attempt at a solution to stave off the threat further lulling the health system to sleep.

    @HIT Vendor – He mentioned paper in a side bar comment, not as his stump. He was basically pointing to the lack of innovation, massive price tags, and control the big EHR companies are putting on health care as a whole. Paper, or “spending nothing”, is looking like a better option to not have been stuck in this rat race mess.

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