President Obama nominates National Coordinator Karen DeSalvo, MD to become HHS assistant secretary for health, a role she has held as interim (in addition to her ONC duties) since last year. The appointed position, which involves Senate confirmation and a four-year term, is the nation’s highest-ranking public health officer. Howard Koh, MD, the previous assistant secretary, resigned in July 2014 to rejoin the Harvard School of Public Health. DeSalvo will leave ONC if confirmed, which is nearly certain since both she and her HHS boss Sylvia Burwell have widespread political support that crosses party lines. Her nomination was entirely predictable from the moment she was named as interim.
From Code Jockey: “Re: Siemens. As a Siemens/Cerner HS employee I’d like to gauge the community’s thoughts. Unofficially, 200-300 people took the voluntary separation package, so where does that leave the rest? Should they look elsewhere given the probably layoffs or stick it out?” I’ll open the floor, but if it were me, I’d stick it out. Layoffs are certain but strategic, so the first wave will be in areas of obvious generic corporate redundancy such as marketing, finance, sales, and HR. Second-worst is if you work on a clearly doomed product line but even then someone has to keep the lights on until customers are prodded to move elsewhere. Otherwise, the need for technical experts for existing Siemens products isn’t just going to go away overnight. You’re working for a much more successful and US-based, healthcare-focused company now, and while I would always be keeping my ear to the ground for new opportunities as a general policy, I wouldn’t assume the worst. Speaking of Siemens, I hadn’t checked lately, but our November 2014 webinar, “Cerner Takeover of Siemens: Are You Ready?” with Vince Ciotti and Frank Poggio has been viewed over 4,000 times on YouTube.
From Ex-McK: “Re: layoffs. Heard more layoffs at McKesson and RelayHealth. How many employees are left on the technology side? Someone told me as many as 500 were let go last week. It’s definitely not the company when Pam was running the company.” Unverified. Another reader reported hearing that 300 were laid off, but I haven’t heard from any of them directly.
From Rumor Mill: “Re: MUS2 attestation date. I’m hearing it may be moved to January 2017. Any idea if this is true?”
HIStalk Announcements and Requests
This week on HIStalk Connect: Apple, in collaboration with UCSF and Mount Sinai, will update ResearchKit to support genome data collection, storage, and sharing. American Well launches a new telehealth app designed to let practices offer remote consultations to their patients. Stanford University researchers have improved on recently developed retinal implant technology and are developing a new prototype that should provide some blind patients with 20/250 restored sight. Online glasses retailer Warby Parker raises a $100 million Series D to expand its physical footprint and to develop an online eye exam that its ophthalmologists can use to prescribe lenses.
This week on HIStalk Practice: Harrington Family Health Center goes live on Athenahealth. AHRQ recommends several areas where pediatric EHRs can improve. HHS announces $101 million in funding for health centers, and prepares for artists and health data activists to converge at its headquarters. CareMore Medical Group goes with Allscripts, while Tandigm Health opts for NaviNet referral tool. Harbin Clinic welcomes a new CIO. Apple Watch users bring new meaning to the phrase "lonely hearts club." Calypso, cowbell, and Jonathan Bush converge. Dr. Gregg shares the HIT challenges of being independent (i.e., non-Borgian).
A reader asks if I listen to any Icelandic music. I do sometimes: Sigur Ros, Of Monsters and Men, and of course Bjork. The reader likes indie pop band Seabear, and having checked them out, so do I. A lot of good music comes out of a country whose population is just 300,000.
It occurred to me that just about everybody who’s salivating at the prospect of never-ending streams of real-time, sensor-powered patient data are businesspeople and technologists rather than hands-on doctors and nurses. The diagnostic value of the information is questionable, the cost of follow-up is significant, and the effect on outcomes and cost is unknown. You often can’t even get an appointment when calling in with an acute condition, so who’s going to jump on an unusual iPhone heart rate sensor value? It makes me uneasy to see the further polarization of healthcare haves and have-nots since it’s already easy to find previously undiagnosed and untreated people without using apps – it’s just that their demographics make them unprofitable and our healthcare delivery system doesn’t get excited about unprofitable public health.
DonorsChoose Project Update
I fully funded these DonorsChoose projects from the generous donations of Cerner and Epic, which I’m listing here so those companies (and Centura SVP/CIO Dana Moore since it was his idea and effort) know where their money went:
- Books and math flash cards for fourth grade classes in Indianapolis, IN.
- An iPad Mini for literacy and math stations for an elementary school class in Baltimore, MD.
- A Common Core math manipulatives set for grades 3-5 in Baltimore, MD.
- A laptop computer for programming Lego EV3 robots for grades 6-8 in Hartford, KY.
- Two programmable rover robots for a fifth grade class in Clarendon, TX.
- Six Makey Makey computer invention kits for K-5 classes in Hull, GA.
- A Lego EV3 programmable robot and reference books for a middle school robotics competition team in New York, NY.
- A STEM bundle, three STEM kits, and four engineering centers for first grade recess learning at a bilingual learning school in Columbus, OH.
- A portable air conditioner for an elementary school classroom in Paterson, NJ.
- Two iPad Minis for a third grade technology workstation in Tulsa, OK.
- A math manipulatives library for grades 3-5 in King City, CA.
- Two Kindle Fires for technology learning for a kindergarten class in Indianapolis, IN.
- 25 scientific calculators and clipboards for a high school chemistry class in Indianapolis, IN.
- An iPad Air for reading and math practice for an elementary school in Henderson, NV.
- Summer school supplies for an elementary school in Norfolk, VA.
- Educational computer games for a class of pre-K through second grade students with autism in Indianapolis, IN.
- A library of math books for an elementary school class in Indianapolis, IN.
- A STEM bundle for grades 4-5 at an elementary school in Fairfield, CA.
- Two STEM bundles for an elementary school class in Tulsa, OK.
- An iPad Mini, case, and earphones for a kindergarten class in Aloha, OR.
- A set of Rekenreks math learning tools for an elementary school class in Indianapolis, IN.
- Interactive math tools for an elementary school class in Wilder, ID.
- Math games for first graders at a Spanish immersion school in Minneapolis, MN.
- Macbook accessories for programming courses at a college prep school in Chicago, IL.
- Four Kindle Fires for a grade 5-6 math classroom in New York, NY
- A STEM bundle for a second grade class in Fort Walton Beach, FL.
- A listening center for grades 3-5 at a Bureau of Indian Affairs school in Hayward, WI.
- A Bluetooth speaker to play music during gym class at a middle school in Milwaukee, WI.
- A Samsung tablet and case for reading work at an elementary school in Middleton, WI.
- Scientific calculators and learning supplies for an at-risk middle school class in Cottage Grove, WI.
- 20 STEM professional resource books and an iPad Mini for an elementary school teacher in Green Bay, WI
Mrs. Anderson from Colorado sent over photos of the TV and flash drive paid for by our donations. She placed it in the library as the first thing students see when entering or leaving as it runs new book advertisements and school announcements. She reports that students gave it a lot of “oohs and ahhhs” and checked out three new books the first day by 10:30 a.m. even though the books had been sitting untouched on the new book display for the three weeks before the TV went up. Meanwhile, Mrs. McDermott of Brooklyn sent a note about the four Kindle Fires for her math class: “Thank you so much for your incredibly generous donation. I can’t even believe it! I’m currently on Spring Break, and I woke up thinking of all the things I need to do in order to prepare for when the kids come back, and then I see this wonderful email! I appreciate it from the bottom of my heart! Thank you, thank you, thank you! These Kindles are going to be so helpful in my classroom, and the kids are going to be so excited to have some technology JUST for math class. You are an AMAZING human being!” (it’s actually amazing companies donating, so I’ll accept on their behalf).
May 12 (Tuesday) 1:00 ET. “HIStalk Interviews Regina Holliday.” Catch up with Regina Holliday and her recent patient advocacy efforts as she chats with HIStalk’s Lorre and Jenn about the HIMSS conference, The Walking Gallery, her upcoming advocacy events, and her new book. Regina will talk about how providers and vendors are working to make the patient voice heard.
May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.
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.
Acquisitions, Funding, Business, and Stock
Harris Corp. eliminates the headquarters function of its Herndon, VA-based Integrated Network Solutions business, which includes Healthcare Solutions, as it plans for the integration of defense contractor Excelis, which Harris is acquiring for $4.5 billion. SEC filings suggest that the company may be considering divesting the INS businesses, which in addition to healthcare, include IT services and telecommunications. Harris Healthcare Solutions offers the FusionFX care collaboration suite, FusionIQ analytics, and FusionOS middleware, acquired with its $155 million acquisition of Carefx in 2011.
IMS Health acquires England-based Dataline Software, which offers healthcare cost analytics and develops custom hospital software.
Castlight Heath reports Q1 results: revenue up 90 percent, adjusted EPS –$0.17 vs. –$0.72, beating expectations for both. Shares jumped on the news but are still down 31 percent on the year, valuing the company at $739 million.
The Advisory Board Company announces Q4 results: revenue up 30 percent, adjusted EPS $0.31 vs. $0.34, missing expectations for both. ABCO acquired educational enrollment vendor Royall & Company for $850 million in December 2014 and most of the analyst questions in the earnings call involved that topic.
DrFirst raises $3.5 million in new financing.
Cerner reports Q1 results: revenue up 27 percent, adjusted EPS $0.45 vs. $0.37, falling short of revenue expectations due to “a combination of lower-than-expected revenue from the recently closed acquisition of Siemens Health Services and lower revenue in our existing business.” It’s a rare and somewhat shocking miss for CERN.
Allscripts announces Q1 results: revenue down 2 percent, adjusted EPS $0.08 vs. $0.07, falling short of expectations for both by quite a bit.
Fitbit earns $142 million profit on $745 million in revenue in 2014 and announces plans to IPO after raising $100 million, having valued itself previously at $1.2 billion. The company also disclosed that its product recall in response to consumer complaints about band-induced rashes cost it $107 million plus settlements for lawsuits both settled and open. Fitbit says less than half of the total devices it has sold are being actively used.
Private equity firm ABRY Partners will acquire pharmacy 340B systems vendor Sentry Data Systems, with an unannounced price that one banker says is more than $200 million.
Population health management vendor Evolent Health files for a $100 million IPO.
England-based urgent care provider Coordinate My care selects InterSystems for care coordination.
Andrew Rhinehart, MD (Johnston Memorial Center for Comprehensive Wound Care) joins Glytec as chief medical officer.
Harbin Clinic (GA) names Andrew Goodwin (Georgia Hospital Association) as CIO.
Announcements and Implementations
Zynx Health announces the annual Clinical Improvement Through Evidence (CITE) Award for nurses leading a clinical decision support team. Nominations are due June 15.
The Indiana Rural Health Association announces that the tobacco referral application by Holon Solutions is being used by 11 clinics and three hospitals, replacing faxed referrals with one-click electronic access.
Government and Politics
The fired head of the Phoenix VA hospital that falsified wait times sues to get her job back, saying she was a scapegoat. In response, Rep. Kyrsten Sinema (D-AZ, above), annoyed that the VA pays terminated employees for months to years of appeals and that it lied about the number of employees it fired related to the scandal, has introduced legislation to hold the VA and its employees more accountable, explaining, “It’s now been over a year and these two are on paid administrative leave. That’s ridiculous. They’ve been sitting at home eating bonbons getting paid and they’ve done jack. Every time I talk to the secretary, I’m like, ‘Why have you not fired more people?’ And the secretary says, ‘Well, the process is very long and there’s due process, there’s all these steps, blah, blah, blah’… This is precisely the type of situation that makes the average citizen lose faith in their government.” The Congresswoman’s bio is fascinating.
Privacy and Security
A Ponemon Institute report (which you ironically can’t read without divulging private information) finds that the number one cause of healthcare data breaches is now criminal attacks, with a 125 percent uptick over five years.
Two unnamed hospitals will test PowerGuard, a medical device malware detection system that looks for unusual power consumption without touching the underlying FDA-regulated hardware and software. The PhDs that started the company found that they could recognize when a computer accessed a particularly website by analyzing its power frequency footprints.
Innovation and Research
Brigham and Women’s Hospital (MA) will validate the offerings of startups in which Rock Health invests.
A UC Berkeley engineering team develops CellScope, a smartphone video blood microscope that can diagnose parasitic worm diseases that are common in Africa. Their work was funded by the Bill and Melinda Gates Foundation.
Here’s a reader-sent photo of folks representing most of the lab middleware vendors (including Liaison Healthcare Informatics, Lifepoint, CareEvolve, and Atlas Healthcare) taken at a recent conference. They talked about issues of mutual concern, including how to get more value from conferences and trade shows.
An employee of the Broward County, FL sheriff’s office faces 15 years in prison for attempting to extort $7,000 from a doctor she met on “married but dating” site AshleyMadison.com.
Weird News Andy titles this, “Not Exactly Wearable.” University students design seat-based airplane heart rate sensors that could allow flight attendants to identify passengers who are anxious or ill.
Report from the American Telemedicine Association Conference
By Bill Rieger, CIO, Flagler Hospital
The ATA conference, held this week in Los Angeles, was the largest in the 20-year history of the association. What is the ATA? American Telemedicine Association, of course. Did you know that association existed? Sadly, until last year, I wasn’t aware of it. Historically, unless you were dealing with the challenges of rural healthcare, you may not have had the desire or need to think about telemedicine. A couple of industry dynamics are changing that.
First, some definitions for those of you like me who are just awakening to the world of telemedicine. Telemedicine refers to the use of video or telephone technology used to reach those who would not normally have easy access to healthcare. Telehealth, a newer term that is more personal, is the use of technology to deliver healthcare. This can be wearables, remote monitoring, or even going to Dr. Oz’s website to get health tips that can impact your life. The terms are not really interchangeable, although they are commonly used that way. The conference was full of education and vendor booths that supported both concepts.
I went this year because we are trying to leverage both telehealth and telemedicine within the construct of our ACO. We have plans to use telemedicine to both reduce readmission rates and provide additional benefits to employers as we look to contract directly with them in our community. This is now common in most cities as the use of clinically integrated networks grows . In addition to ACOs driving use of telemedicine, the change in technology itself makes a case for increased use. Remote monitoring of patients in the least-expensive setting of care is just plain smart. Monitoring at home was a huge focus at the conference and the technology used to do this is exploding.
There were two main issues discussed in the keynote panel discussion and they were both excellent topics. The first one was interoperability. That’s right, that $10 word thrown around at HIMSS for the last few years. Well, that word did not even make it to the showroom floor at ATA. When I walked around and talked to vendors, their technology was great, but the data resided in their individual cloud servers that could only be accessed through their proprietary Web-based or mobile application. Ugh!
Frustration filtered through me as I walked around and heard this repeatedly. Some of them mumbled something about HL7, but it clearly wasn’t a focus or priority. This is problematic for the industry as we look to consolidate data through the increasing use of private and public HIE strategies. It will be left to the health systems leveraging these technologies to assimilate the data into their EMR and HIE systems.
The other issue debated was standards of care. I was happy to hear about the new partnership between the ATA and the AMA. The AMA is starting to understand the potential of telemedicine and has determined that they needed to partner with this rapidly growing initiative and ensure there is a focus on patient safety, quality, and coordination of care. I look forward to seeing this relationship grow.
Eventually, I anticipate Joint Commission-like standards being put in place for the use of telemedicine. That will have to be done for the physician office and the hospital. Sprinkle some MU-like regulations for vendors that focus on interoperability and you will have just what we need — more innovation stifled by bureaucracy. Personal feelings aside, it seems too loose and Wild West right now, especially in the telehealth arena. Maybe I have been a part of the establishment too long to recognize the strength in loosely managed innovation. At the end of the day, a patient is involved, so no matter how cool or innovative, patient safety, quality, and coordinated care has to be addressed in some fashion.
The trip was well worth it. The conference was well run, although there were some minor hotel issues. There were minimal booth babes there, mostly telemedicine techno geeks that loved to talk. I learned a lot about telemedicine and telehealth and how different organizations are leveraging these technologies across the globe to improve access of care. I definitely recommend attending next year in Minnesota.
- DocuSign will exhibit at Microsoft Ignite through May 8 in Chicago.
- Extension Healthcare celebrates National Nurses week with a #NursesRock Twitter contest.
- ZirMed’s ZUG 15 user conference will be held August 17-18 in Chicago.
- Galen Healthcare offers “eRX Refills – Just Click the Button, Right?”
- Hayes Management Consulting offers five things to know after EHR implementation.
- SyTrue CEO Kyle Silvestro is quoted in an article titled “Unlocking Unstructured, Qualitative Data Is Key to Analytics.”
- HealthMEDX will host its user group meeting May 12-14 in St. Louis.
- Healthwise offers “Apps and APIs: A Positive Step for Patients.”
- Access customer Hilo Medical Center says the company’s electronic patient signature helped it attain HIMSS EMRAM Stage 7 and saved it $200,000 annually on consent forms.
- Holon Solutions will exhibit at the New England Regional MGMA Meeting May 13-15 in Rockport, ME.
- Impact Advisors offers “Revenue Cycle Management – What Does it Encompass?”
- Aspen Advisors publishes “Transforming Care Delivery: The Power of Clinical Variation Management.”
- Ivenix offers a new white paper entitled, “Improving Intravenous Therapy: Opportunities for Designing the Next Generation Infusion System, Part 1: Supporting Medication Safety.”
- Logicworks publishes “Managing Hybrid Clouds: What Team Do IT Leaders Need?”
- Medecision’s Aerial InCircle mobile application is named a finalist for Dorland Health’s 6th Annual Case in Point Platinum Awards in the patient engagement category.