The Senate’s HELP Committee will not vote on the House-passed 21st Century Cures act in its entirety, but instead will review it as seven separate bills. The committee will vote on an EHR bill on February 9 that covers unnecessary physician documentation, patient records access, information blocking, and EHR certification standards. In the draft legislation that was just published:
- HHS will establish goals to reduce EHR regulatory and administrative burdens.
- ONC will create voluntary EHR certification criteria for specialties, including pediatrics.
- ONC will make materials submitted by software vendors to earn certification publicly available.
- Vendors of certified software will be required to attest that they do not practice information blocking.
- ONC will publish an EHR star rating system that includes security, usability, interoperability, and testing results. One-star vendors will be required to follow a corrective action plan and can be fined or decertified if they don’t improve their rating. The government will reimburse users for the cost of decertified products.
- HHS OIG will be empowered to investigate claims of information blocking by vendors or providers, with vendors subject to fines and providers liable for an unspecified “sufficient deterrent.”
- ONC will convene groups to create a trusted exchange framework for interoperability.
- HHS will publish a provider digital contact information index.
- ONC will create a 25-member HIT Advisory Committee to develop standards and to set the agenda for a national health IT infrastructure, including privacy, accurate patient identification (an effort that will be overseen by the GAO), and de-identification.
- HHS will define a common data set for public health reporting.
- ONC will certify software using patient usability criteria, including giving patients access to their information in a single longitudinal format and giving them the ability to add to their information and share it as desired.
From Company Contact: “Re: HIMSS Analytics. The revised version looks like a search engine, returning information in a tightly nested and unreadable spreadsheet. For the fees companies pay, it’s a shame that some engineer got into their heads to change the format. “
HIStalk Announcements and Requests
Ms. Aguiar made a passionate plea for tablets and electronic flash card software for her Florida third graders, saying, “I truly believe they can and will succeed despite what society, prejudice, or others might think about them … my students don’t have have access to technology, which automatically puts them behind their high-income peers.” We funded her DonorsChoose grant request, about which she reports, “You have made a tremendous impact on our classroom and our success. Because of you, we now have access to technology in our room and now have the ability to access websites, games, and books online. We can now say that we are competing against our peers in a fair way.”
My fundraising lunch will be Wednesday of HIMSS week from 11 to 1. Vendors who donate $1,000 to DonorsChoose get to make a short pitch to the assembled CIOs and enjoy a social lunch following. CIOs from John Muir Health, Contra Costa Health Services, University of Colorado Health, Centura, UC Irvine, and several other health systems are donating their time to raise money for a worthy cause. Contact Lorre for donation instructions (the money is paid directly to DonorsChoose) and a seat at the table. I’ll mention the donations here as well.
Thanks to consulting firm Optimum Healthcare IT for joining my CIO lunch. Their $1,000 donation funded these DonorsChoose teacher requests with matching funds from third-party foundations:
- A programmable robot kit for Ms. Stokes’ elementary school gifted class in Charlotte, NC
- Three iPad Minis and cases for Mr. DePhillips’ elementary school class in Herminie, PA
- A programmable robot, vehicle building kit, iPad Mini, and case for Mrs. Bierhals’ elementary school class in Ruffs Dale, PA
- STEM manipulatives for Mrs. Lee’s kindergarten class in Tucson, AZ
- A wireless whiteboard, two iPad Minis, cases, and four science books for Mrs. Petrisko’s elementary school class in Herminie, PA
- A 26-book library for Ms. Stitt’s elementary school class in Charlotte, NC
- A listening center and 48 math skills books for Mrs. Gadsden’s kindergarten class in Durham, NC
This week on HIStalk Practice: Physiotherapy Associates rolls out the Athletic Trainer System EHR. University of Pennsylvania physicians find that fitness trackers aren’t all they’re cracked up to be. AllMeds rebrands and expands RCM offerings. De-identified health data means big bucks for business and a lack of confidence for consumers. CareCloud CEO Ken Comée recaps Practice Profitability Index findings. The American Academy of Sleep Medicine officially launches its telemedicine service. CMS tightens up on Healthcare.gov’s special enrollment periods. Panorama Orthopedics & Spine Center COO Lance Goudzwaard shares the benefits of virtual scribe technology.
This week on HIStalk Connect: The FDA publishes guidelines outlining postmarket cybersecurity requirements for medical device manufacturers. Scripps Translational Science Institute publishes results from one of the largest clinical trials measuring the effectiveness of remote patient monitoring conducted to date, finding no improvement to outcomes, overall service utilization, or cost of care. Patrick Soon-Shiong announces his own "Cancer Moonshot 2020" in conjunction with the President’s SOTU cancer moonshot announcement. Researchers from the University of Illinois unveil a new implantable brain sensor that monitors pressure and temperature, but that is made entirely of materials that break down naturally in the body over time, eliminating the need to remove implants.
Last call: if you want to come to HIStalkapalooza, fill out the request form. I will almost certainly be able to invite everyone who asks, which hasn’t been the case in most years. Remember that I’m sticking with Monday night even with the screwy Las Vegas HIMSS schedule that is driven by casino greed, so you can make Michael Dell’s 5:00 p.m. keynote (if you care enough to bother, which I can’t say I do) but not the opening reception that runs the odd hours of 7:00 to 8:30 p.m. I guarantee that my event will be much more fun and memorable.
HIStalkapalooza Sponsor Profile – Wellcentive
The business case for quality has never been stronger. Incentives, penalties, risk, and market competition is at an all-time high. Is your organization positioned for success relational to quality, revenue, and transformation? Since 2005, Wellcentive has partnered with organizations to ensure successful transitions to value-based care. Our solutions are consistently ranked as a top performers by KLAS, IDC Health Insights, Chilmark, and Black Book. Stop by booth #468 and network with professionals leading some of the most complex transformations being witnessed today. Lastly, in the spirit of care, for every minute you spend with us, Wellcentive will donate $1 to impact the 20 million (or one in five) Americans living with an autoimmune disease. As a Histalkapalooza sponsor, join us and last year’s HIStalk King Wellcentive’s Gabe O for the party of the conference
Acquisitions, Funding, Business, and Stock
Free EHR vendor Practice Fusion hired investment bankers to explore a 2017 IPO last year, but its plans may have changed due to poor stock market conditions, according to the New York Times. JPMorgan originally estimated that the IPO would value the company at $1.5 billion based on revenue growth assumptions that the company later reduced. Practice Fusion, which has raised $149 million, expected to lose $26 million on revenue of $46 million in 2015. Found Ryan Howard was replaced as CEO in November 2015 by the promoted Tom Langan, who has no CEO experience.
Agfa Healthcare buys a 27 percent equity position in My Personal Health Record Express, which offers the Minerva data aggregation platform.
Reuters reports that Leidos is finalizing a $5 billion deal to acquire Lockheed Martin’s government IT business.
Tuba City Regional Health Care (AZ) chooses Allscripts Sunrise and Care Director for its 73-bed hospital and clinics.
Neighbors Emergency Center, which operates 12 freestanding emergency departments, chooses T-System’s EDIS.
Centegra Health System (IL) expands its use of FormFast electronic forms to Centegra Hospital-Huntley.
Easter Seals Southern California chooses Netsmart’s EHR for providing services to 6,000 children and adults with intellectual and developmental disabilities.
The Military Health System selects McKesson’s InterQual for utilization management.
Pamplona Capital Management names Joel Hackney, Jr. (Avintiv) as CEO of the new company created by the merger of its holdings, MedAssets and Precyse.
Identity resolution vendor CrossChx hires former HHS CTO Bryan Sivak and former ONC chief medical officer Jacob Reider, MD for part-time, unstated roles.
WEDI names Charles Stellar (AHIP) as interim president and CEO.
Announcements and Implementations
Ireland-based patient engagement and clinical workflow technology vendor Oneview appoints two new board members following its $13 million capital raise in December.
Wolters Kluwer announces that it gained 113 customers for its procedure documentation system ProVation MD in 2015 and signed agreements with 86 healthcare facilities to replace the retired EndoWorks by Olympus, which named ProVation MD as its preferred replacement.
Experian Health announces its largest-ever Q3 results with 66 newly signed contracts and additional product selection by 192 customers.
Athenahealth, eClinicalWorks, Epic, NextGen Healthcare, and Surescripts are named as the initial implementers of the Carequality Interoperability Framework that was released in December 2015.
Government and Politics
CMS tightens up Healthcare.gov’s special enrollment period policies to eliminate “unintended loopholes,” such as people switching or dropping plans mid-year for purely financial reasons. CMS will reduce the number of those periods, clarify that a consumer’s relocation must be permanent to be eligible for move-related plan changes, and warns that it will audit consumer-entered information for accuracy. CMS helpfully clarifies that “special enrollment periods are not allowed for people who choose to remain uninsured and then decide they need health insurance when they get sick.”
Veterans Affairs Secretary Robert McDonald testifies to the Senate Committee on Veterans Affairs, outlining plans to transform the VA as the #1 customer service agency in government. Among his goals is to transform the VA from “sick care” to “healthcare.” He also wants to “bring our information technology infrastructure into the 21st century” and listed the IT-related goals above.
ONC announces that Franciscan Missionaries of Our Lady Health System VP/CIO Vindell Washington, MD will join the organization as principal deputy national coordinator.
Privacy and Security
Titus Regional Medical Center (TX) loses access to its EHR for several days when its database servers are hit with ransomware, which demands payment to restore access to the information. The hospital doesn’t know when it will get its systems back following the January 15 incident, explaining, “It’s just like in the 1970s, before electronic medical records. Everything is on paper and people are serving as runners. There’s no automation.”
The malware that took down the pathology department of Australia’s Royal Melbourne Hospital has been identified as a new variant of the Qbot worm. The department is still running Windows XP PCs and its laboratory information system runs on Windows Server 2003. Both products have been retired and are no longer supported by Microsoft. Qbot had a moment of fame in 2014 when security experts found that it had compromised 500,000 computers after being distributed from infected web pages, with its apparently Russian authors having stolen login credentials for up to 800,000 bank accounts.
Two-thirds of hospitals don’t expect precision medicine to have much of an impact on their organizations in the next five years, according to a fairly small survey by Health Catalyst that also finds that few providers are adding genomic capabilities to their EHRs.
A NEJM opinion piece by Ken Mandl and Zak Kohane of Harvard and the SMART program observes that providers have mostly ignored their requirement under HIPAA to give patients copies of their medical records, often because they are protecting their competitive position. It adds that document exchange via C-CDA failed because it wasn’t standardized and Blue Button hasn’t matured. It urges IT purchasers to demand a patient-controlled solution powered by open APIs.
A study in JAMA Internal Medicine finds that people who spend less on healthcare after switching to high-deductible medical insurance aren’t shopping for care more wisely – they just use less of it because it costs them more. That throws water on the theory that people who are paying out of their own pocket seek lower-cost providers.
The International Committee of Medical Journal Editors proposes that its member journals (Annals of Internal Medicine, NEJM, JAMA, and others) require authors to share the de-identified patient data from clinical trials they used.
A San Franciso startup whose app allows women to easily obtain birth control seems to be crossing a telemedicine line it may not realize exists. Women fill out an online form that includes the brand name of product they want, a doctor reviews their information and issues a prescription, and the birth control product arrives within two days and is refilled automatically going forward. The patient never actually interacts with the doctor.
- InterSystems will exhibit at the IHE North America Connectathon 2016 January 25-29 in Cleveland.
- Leidos Health will exhibit at the CHIME Spring Forum January 28-29 in Las Vegas.
- KLAS recognizes LifeImage as the market leader in image exchange.
- MedData will exhibit at the Texas Hospital Association Annual Conference January 21-22 in Dallas.
- Direct Consulting Associates will exhibit at the IHE North American Connectathon 2016 January 25-29 in Cleveland.
- EClinicalWorks releases a new podcast on the benefits of RCM at HCA.
- Healthgrades announces the 2016 Distinguished Hospital Award for Clinical Excellence recipients.
- Patientco will exhibit at HFMA’s Annual Revenue Cycle on January 22 in Foxborough, MA.
- Porter Research helps to develop the Institute of Health Information Technology’s annual HIT workforce report, and Navicure’s latest ICD-10 survey.
- Red Hat is recognized as a leader in two Forrester research reports ranking private cloud software suites and hybrid cloud management solutions.
- Sagacious Consultants releases the latest edition of its Sagacious Pulse newsletter.
- The SSI Group and Streamline Health will exhibit at the HFMA Region 11 Healthcare Symposium January 24-27 in San Diego.
- Summit Healthcare will participate in the IHE North American Connectathon January 25-29 in Cleveland.
- Medical Device Protection: 13 Tips (ID Experts)
- #1 New Year’s Resolution for Providers: Collect More Patient Payments (InstaMed)
- Invisibility Cloak: Good for Superheroes, Bad for Data (Liaison Technologies)
- Do It and I’ll Shut Up (MedAptus)
- High Five! Our Top Five Blog Posts from 2015 (Navicure)
- Apply supply and demand to grow strategically while increasing revenue and reputation (Nordic)
- Residents Love Texting – But Do They Fully Understand Their Options? (Spok)
- Health Systems Call for a Halt to Meaningful Use Stage 3 (E-MDs)
- Balancing Act: How to Effectively Maintain Your Legacy System During the Chaos of an Install (Hayes Management Consulting)
- 8 Essential Factors for a Successful Epic EHR Upgrade (The HCI Group)
- Prescription Medication Errors: Latest Reports (Healthcare Data Solutions)
- Competing Viewpoints Wanted! (Healthfinch)
- Using the “Pre-Mortem” Process for Success in Implementations (Impact Advisors)
- Meaningful Progress (PatientKeeper)
- Bootstrapping Your Startup (PMD)