Acting Assistant Secretary for Health and National Coordinator Karen DeSalvo, MD, MPH tells a group that US public health is “marginalized and under-funded” as 97 percent of available federal money is spent on delivery of medical services even though 80 percent of health factors don’t involve hospitals and doctors’ offices. She adds, “The notion of population health doesn’t end with a geographic boundary … it’s everybody in the community,” giving the example that parts of Baltimore have worse health than North Korea.
From The Freshman Whisperer: “Re: Hour of Code. I was at a ninth-grade career fair last week telling students the story of technology and how the healthcare industry needs help. As a part our booth, we had students try Hour of Code. I was happy to hear that many students had tried coding before (lots even enjoyed it) and were considering a career in computer science. I wasn’t offered any coding classes in high school. Thumbs up for teachers teaching young coders. My company can’t hire enough of them!”
From Health Dataphile: “Re: HCA’s inpatient and outpatient facilities in the Southeast. Meditech went down over the weekend and, as far as I know, is still down as of Monday morning.” Unverified. Usually an outage of that magnitude would be related to data center communications or some type of network failure, which HCA might be prone to since it deploys Meditech and other systems regionally. That might be a lesson for everyone anxious to get out of the operations business and move to a cloud provider – cloud systems are probably better architected, but they can still go down or you can lose access to them if something happens to your real-world connectivity. A reader in an HCA hospital in Florida says the ICU nurses didn’t know the downtime protocol they were supposed to be following, but on the bright side, doctors fell back to writing and dictating orders instead of entering them into the computer, allowing them to leave for home earlier than ever. The nurses were worried about medication reconciliation between the MARs and Pyxis machines.
From This Is Just Silly: “Re: Judy Faulkner’s letter on exhibit at the Smithsonian. I would have rather seen the letter or email she sent to George Halvorson at Kaiser Permanente when she turned down KP’s interest in buying Epic.” The National Museum of American History’s just-opened “Giving in America” exhibit includes the letter Faulkner wrote in pledging that she will donate 99 percent of her $3 billion fortune to charity. I was just thinking that Epic must be one of very few hugely valued companies where both top executives studied computer science.
From Unscheduled: “Re: McKesson’s scheduling software. I’m hearing it is ending support. Do you know if that’s true?” I don’t, but anyone who does is welcome to comment.
From Ground Pounder: “Re: salary survey. Cute infographic hides terrible methodology.” It’s puzzling why reasonably smart people will believe a dumbed-down graphic instead of paying attention to what it’s based on, although far less puzzling why crappy “news” sites run the graphic as clickbait. The members-only report is based on a survey of only 700 people who were apparently self-selected, meaning any conclusions it attempts to draw are not believable, especially when it tries to segment the responses into subcategories. Here are some headlines the self-promoting report drew by sites that simply reworded the press release, with extra points for the first entry (which turned it into a “listicle” like you’d see on celebrity gossip sites) and the last entry (which seems to attempt a Donna Summer song pun):
- Health IT professionals think they’re underpaid: This and 9 more findings on IT salaries
- Average healthcare IT salary tops $87,000, job tracker survey finds
- Average Health IT Salary Down, but Job Satisfaction Up, Report Finds
- Health IT Professionals Report High Salaries, Job Satisfaction
- Survey: HIT workers get lower salaries than desired
- Infographic: Health IT workforce paid well, but perhaps not enough
- Health IT Pros See High Salaries Due to Increased HIT Needs
- Working Hard for the Money
HIStalk Announcements and Requests
HISsies nominations will remain open for a few more days. The best nomination I’ve received so far is in the “smartest vendor action taken” category, where someone offered, “Hiring hookers to seduce my COO.” Athenahealth has obviously put the word out to employees as indicated by both boilerplate nominations in several categories and repeated IP addresses that are dominating the responses, but that’s OK since the final ballot will be delivered by the unstuffable ballot box of direct email.
Ms. Lam from California says she assigned her first graders, most of whom are from immigrant families in which English is their second language, to work with fourth-grade partners using the hands-on Make Wonder programming and robotics kit we provided by funding her DonorsChoose grant.
I wrote earlier this week about a friend who keeps working for her vendor employer even while fighting the cancer that will almost surely kill her because she’s worried she isn’t replaceable at work. It resonated with a reader who sent me an internal executive email exchange from a few years ago. An employee of a large health IT vendor was determined to keep working despite having cancer (of which she died shortly after) so that her retirement plan could vest for her surviving family. I’m paraphrasing the exchange below:
[Executive to CFO]: The employee thinks she needs to push through and keep working even though it will be one of the last things she will do on this Earth. Without being too nosy, can we vest the retirement even though the dates haven’t arrived?
[CFO] I want to make this happen and will approve the change under my board-delegated authority. Consider this as my approval. This is the only time I have ever approved such an action, but it seemed appropriate. A great example of why it feels great to work at [vendor name omitted].
[CEO] I am in complete agreement. Today is a gift – that is why they call it the present.
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Acquisitions, Funding, Business, and Stock
San Diego-based MD Revolution raises $23 million. It offers a patient engagement platform that allows providers to bill Medicare for delivering chronic care management services.
UL acquires InfoGard, an IT accreditor whose offerings include certification of EHRs and electronic prescribing of controlled substances systems.
EClinicalWorks will spend $30 million in India to build a data center and increase its 1,000-employee headcount there by at least 300 in the next three months. The company will offer consumers in India an app to view lab results, find doctors, maintain personal health records, and schedule appointments. The company has already signed 40 hospitals and 20 practices in India.
The Wall Street Journal summarizes the strategy behind the turnaround of Valeant Pharmaceuticals that has brought criticism as well as a 4,000 percent share price increase that gave its CEO $2 billion in holdings:
- Cut research and development expense.
- Take over dozens of drug companies.
- Buy undervalued drugs and raise their prices.
- Focus on skin treatments, mostly just redesigning old ones rather than researching new ones, knowing that dermatologists are responsive to drug salespeople and prescribe by habit.
- Sell its dermatology products through a now-closed mail order pharmacy that used aggressive sales tactics.
Twine Health, which offers health coaching software developed at MIT, raises $6.75 million.
San Francisco-based concierge medicine provider One Medical Group raises $65 million to expand its service area and to further develop its enterprise and mobile technology solutions, increasing its total to $182 million.
Google has renamed many of its business and does the same with Google Life Sciences medical device group, now known as Verily. Meanwhile, GV (formerly known as Google Ventures) says it is less interested in seed-stage investing and will instead pursue more mature companies, with an ongoing emphasis on healthcare and life sciences firms.
Harris Computer Systems relocates its QuadraMed EMPI Solutions business to a high security office in Plano, TX that can house up to 100 employees.
Weirton Medical Center (WV) chooses Besler Consulting’s Transfer DRG Revenue Recovery Service.
Scripps Health (CA) chooses the Health Gorilla Clinical Network to provide patients with access to imaging and lab information.
Announcements and Implementations
Intelligent Medical Objects announces GA of its 2.0 release that includes silent terminology updates, support for natural language processing, quarterly refreshes of major dictionaries, and a CQM dashboard.
PatientPay announces that customer Greenwood Pediatrics (CO) reduced its billing costs by 47 percent by switching from paper to the company’s online bill review and payment.
Cloud hosting provider Infinitely Virtual announces that it has passed the HIPAA audit that allows it to offer health IT hosting plans, including a $10 per month option for full-disk encryption for each virtual machine.
Telemedicine services company Virtual Radiologic announces that it has applied artificial intelligence to data from the 90,000 head CTs it performs monthly to create a real-time warning to its teleradiologists that a patient might be experiencing intracranial hemorrhage.
A Finland-based software vendor licenses a web-based geriatric assessment system developed by the University of Queensland in Australia. The software records and monitors the progress of elderly patients before, during, and after hospital stays and can be used to deliver telehealth services. The CeGa Online system is already offered by Queensland Health. The same researchers have also developed a residential care version.
SAP announces software for medical data analysis and clinical trials recruitment.
Government and Politics
The White House enlists ZocDoc and Oscar Health Insurance Corp. to provide free advertising that will urge uninsured people to buy insurance via Healthcare.gov in the final week of open enrollment. ZocDoc will target customers who have paid cash for the appointments they booked through its scheduling service, while Oscar chas reated an explainer video that it will distribute in the handful of states where it sells plans.
Privacy and Security
A physician-written editorial in the Journal of American Physicians and Surgeons says that patient privacy is an illusion because of electronic medical records that make data available without patient consent for oversight and research. The psychiatrist, Susan Israel, MD, wants EHRs redesigned to give patients control of their information via consent requirements “regardless of cost and complexities involved.”
Innovation and Research
Google patents a needle-free blood draw system that uses compressed gas to pierce skin and then draw the resulting blood into a collection chamber. The patient covers two possible devices, one for diabetic finger-sticks and the other worn as a wristband. Companies seem to be enchanted with the idea that patients need an alternative to needles and the collection volume of standard blood draws, but for me, that’s far less important than avoiding the inhospitable long waits at LabCorp and Quest drawing centers full of people whose NPO stomachs growl as they watch awful TV shows that working people rarely see.
Carequality releases its interoperability framework (legal terms policies, technical specifications, and governance processes) that allows organizations to quickly establish data sharing agreements with partners.
Brigham and Women’s Hospital misses its budget surplus target for FY2015 by $53 million, which it blames on weather, employee retirement costs, and the cost of transitioning to Epic. The hospital had budgeted $47 million for its Epic conversion, but instead spent $74 million. Revenue also fell short by $13.5 million as employees didn’t code cases correctly on Epic.
A summary of McKinsey’s previous healthcare consumerism studies concludes that while patients say their outcome is the most important factor in their satisfaction with providers, it’s actually clinician empathy (especially from nurses) and the information they are given before and after treatment that is most closely correlated to satisfaction. Access to medical records wasn’t all that important and neither was the perception of value received. A study also found that while 40-50 percent of patients aged 18-34 want to use technology to speak to their provider by phone, schedule appointments, and check health status, the percentage drops sharply for those aged 35-55. Respondents are also willing to share health monitoring data capture with their PCPs, but not very many would do so with friends, family, insurance companies, and employers.
Researchers mine EHR databases at two hospitals to detect a previously unknown correlation between the use of androgen deprivation therapy and later development of Alzheimer’s disease. The study used text-based data mining methods developed by one of the authors that were patented by Stanford University. The hidden value of a study like this is that researchers can look at the entire patient population of a health system rather than just individual patients who opt in for a study that was designed to test a particular theory.
A study in England proves that patients are as clueless about antibiotics as doctors keep saying. Two-thirds of them expect to get an antibiotic prescription for a cold or flu, one-third think they should stop taking antibiotics once they feel better, and three-quarters believe it’s the human body rather than bacteria that grow resistant to the drugs. Doctors who apply sound science to writing antibiotic prescriptions are seeing their patient satisfaction ratings fall, with a 3- to 6-percentile drop for every 25 percent reduction in prescriptions. The other GPs just keep cranking them out to keep patients happy, with half of those patients receiving an inappropriate antibiotic prescription.
A Florida woman is jailed for hit and run when her car’s crash-triggered electronic monitoring system automatically calls 911. The operator, suspicious of the woman’s insistence that nothing had happened when the device clearly showed that it had, dispatched police, who found her car damaged with the airbag deployed.
- Forrester Research ranks AirWatch as an enterprise mobile management leader.
- TransUnion Healthcare announces that its eScan product has found patient insurance coverage worth $1 billion in hospital payments that would have otherwise been written off to bad debt and charity care.
- Sixteen Influence Health clients receive eHealth Leadership Awards.
- LiveProcess exhibits at the National Healthcare Coalition Preparedness Conference through December 4 in San Diego.
- Oneview Healthcare launches an internship competition.
- 5 Year-End Tips to Get the Most Out of 2016 (AdvancedMD)
- FHIR Up Population Health (Caradigm)
- The Fine Line Between Implementation & Optimization (Culbert Healthcare Solutions)
- The Biggest, Baddest Breaches of 2015 (ID Experts)
- Giving Thanks for Family (Impact Advisors)
- Healthcare’s Black Friday: Lessons Providers can Learn from Retail’s Biggest Day (InstaMed)
- Is Your Business a Center of Excellence? Probably! (Liaison Technologies)
- Key Steps to an Effective Image Exchange Implementation (LifeImage)
- The Top Ten Thanksgiving Mishaps via ICD-10 (MedAptus)
- Training Patient Service Representatives to Make a Difference (MedData)
- Ready to Take Your Place in the Cockpit? What Healthcare BI Strategies Have in Common with Altimeters and Accelerometers (Navicure)
- Dictate and Review Images Simultaneously: See How at RSNA 2015 (NVoq)
- Meet Susan Anderson, Managing Director for Orion Health Canada (Orion Health)