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Monday Morning Update 5/9/16

May 8, 2016 News 5 Comments

Top News

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HHS Secretary Sylvia Burwell tells the American College of Physicians that not only do some EHRs lack interoperability, but health systems sometimes don’t want to share information and providers aren’t paid in a way that rewards information sharing. She acknowledges that Meaningful Use has been hard on doctors with its “burdensome reporting and inflexible requirements.”

Burwell says HHS will set common interoperability standards, chane the culture in hospitals and practices regarding the right of patients to access their own information, and make sure its rules and regulations support the smooth movement of healthcare data.


Reader Comments

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From Frank Poggio: “Re: MACRA. Dr. Halamka’s assessment isn’t surprising. The federal government’s objective is to control healthcare costs even though most of the escalation is due to societal failings like obesity and smoking. The provider is stuck in the middle and the middle gets squeezed every time. Providers play ball with payers and government trying to keep impending regulations from going off the track, and when the changes don’t meet the cost savings goal the feds sold to Congress, the bureaucrats have no choice but to go off track, blaming it on providers and promulgating even more onerous rules (remember that HITECH was supposed to pay back $800 billion over 10 years). This bureaucratic insanity will continue as the government continues to ignore the basic issues that drive healthcare costs. Unfortunately, that guarantees there will be many versions of the good Dr. Halamka over succeeding decades.”

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From Skitch Henderson: “Re: medical error deaths. How many of those were IT-related, I wonder?” We in healthcare unfortunately kill some patients with the best of intentions but the worst of execution, but nobody really knows how many, much less how those deaths break out by individual cause. Keep in mind that the widely-quoted recent study (with obligatory clickbait headlines, including that of the Washington Post above that inserts the incorrect “now” in falsely suggesting a fresh trend) doesn’t represent new information or signify a rising trend – the authors merely used a different calculation method to create a new estimate from old data using massive extrapolation. Even the authors seem embarrassed that their results have been so overblown in trying to put a new number on an old problem using questionably useful methods. We simply don’t know when medical treatment causes a patient’s death – you can bet that a lot of death certificates say “heart attack” only because nobody knows for sure.


HIStalk Announcements and Requests

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Two-thirds of poll respondents think MACRA’s Advancing Care Information is better than Meaningful Use. Meltoots says it’s just more of the same for physicians who are already burned out, adding new measures that haven’t been proven to improve care, cost, efficiency, safety, or interoperability. New poll to your right or here: who is most responsible for physician dissatisfaction? Like those dissatisfied physicians, I am interested in your personal narrative and not just your check-the-box answer, so click the poll’s Comments link after voting to document your story.

It occurs to me that the acronym-obsessed healthcare industry hasn’t yet abbreviated the new program, so I hereby dub it MACI (MACRA Advancing Care Information). You are welcome.

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Mrs. R from Ohio says her third graders ask every day if it’s a tablet day, referring to the iPad Mini and case we provided in funding her DonorsChoose grant request. Her students are using it to practice their math skills, perform research, and teach each other to use the iPad.

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Also checking in is Mr. Willet from North Carolina, who says the faces of his elementary school students light up with pure joy when he brings out the programmable robot kit for his digital lab program, which he says enhances not only their math skills, but their communication and critical thinking. A surprising 15 percent of the students in his school are homeless, so the only technology access many of them have is at school, and quite a few students go home on Friday with donations from the local food bank in their backpacks. It’s interesting that schools are better than hospitals at identifying social determinants of health and connecting those in need with resources.

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

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Last Week’s Most Interesting News

  • BIDMC CIO John Halamka criticizes proposed MACRA rules, saying that nobody can understand them and that it’s time for physicians to consider leaving their profession if the government’s trajectory doesn’t change.
  • Siemens Healthcare renames itself to Siemens Healthineers.
  • IMS Health and Quintiles announce plans to merge in creating a pharma services business with $7 billion in annual revenue.
  • Joint Commission reverses its 2011 decision that prohibits sending orders by text messaging, provided that the messaging platform meets specific technical requirements.

Webinars

May 11 (Wednesday) noon ET. “Measuring the Impact of ACA on Providers.” Sponsored by Athenahealth. Presenters: Dan Haley, general counsel, Athenahealth; Josh Gray, VP, AthenaResearch. Athenahealth will share the findings of real-time analysis of its provider network. The presenters will describe how patient financial obligations have changed, how physician reimbursement is trending, the patterns created by increased ACA coverage, and the effect of the latest ACA trends on physician practices.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Here’s the recording of a recent Webinar, “Provider-Led Care Management: Trends and Opportunities in a Growing Market.” Our presenter had audio problems during the live Webinar, so we recorded a new version.


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call:

  • President Richard Poulton says the Netsmart transaction will allow patients to be managed across acute and chronic illness to health maintenance.
  • CEO Paul Black says the company is building a precision medicine knowledge hub.
  • Allscripts offers 135 certified solutions in its application store and developers are using its APIs to work on 1,550 applications.
  • Black quoted a recent study that found that 87 percent of financially challenged hospitals regret changing IT systems, 90 percent of nurses say EHRs impede their ability to deliver care, 63 percent of executives say their jobs or those of their peers were threatened by an EHR replacement, and 78 of physicians say replacement EHRs didn’t deliver the expected clinical buy-in.
  • Responding to an analyst’s question about rumored loss of market share in the independent physician segment, Black said that every vendor has churn but that of Allscripts is within expectations.
  • Black expects MACRA to cause some of the nearly 500 certified EHR vendors to leave the market, creating replacement opportunity.
  • Asked about the NantHealth partnership, Black says that two or three Sunrise customers will be going live on integrated Eviti protocols soon and that he expects to gain EHR business from the partnership.
  • Black says the physician complaints in South Australia got more press than either the client or Allscripts wanted, but haven’t damaged the relationship.

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From the Cerner earnings call:

  • The company says its win rate against Epic is at an all-time high, which it attributes to product improvements, predictable delivery, lower cost of ownership, population health capabilities, and an open platform.
  • Cerner says the number of hospitals moving from the former Siemens products to Millennium is ahead of expectations, while the overall financial and operational objectives of the acquisition are on track.
  • The company says its HealthIntent population health management product is a differentiator when competing for new EHR business, with most new customers choosing it.
  • Cerner’s go-forward product for patient accounting remains Millennium, but the company will continue to offer the Soarian product to the 25 percent of the market that wants a standalone patient accounting product.

I checked the five-day share price performance of a few companies that recently announced earnings: Cerner (down 4.5 percent), Allscripts (down 1.7 percent), Athenahealth (down 2.8 percent), McKesson (up 0.2 percent), CPSI (down 12.4 percent), and Imprivata (up 0.4 percent).

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I’m enjoying the savagely clever commentary about Siemens changing the name of Siemens Healthcare to Siemens Healthineers, as the company apparently intends to spin it off (Siemens says the “eers” part refers to “pioneers” rather than “engineers” like you might expect). Much of the scorn involves an employee-posted video (with 450,000 YouTube views) of the obviously expensive yet hilariously awful employee kickoff event that Siemens held in its home town in Germany, which to many typifies everything that’s wrong with big companies — cluelessness, mandatory employee attendance at morale-boosting events that actually kill morale, spending money on frivolity while laying people off, and inadvertently emphasizing the multi-faceted chasm between the richly compensated executives and the trudging masses who do the actual work. Some of my favorite comments from a Reddit topic titled “Siemens embarrasses 44,000 employees with new ‘Healthineer’ mandatory dance concert”:

  • Can confirm – this killed all productivity at our newly-christened Healthineers office today. It was hard to get any work done in between the fits of laughter and moments of dumbfounded shock that anyone, anywhere, thought this was going to be a step in the right direction.
  • Siemens made ovens at Auschwitz. I think they will regret this more.
  • Hawaiian Shirt Friday.
  • Siemens: we’ll lay off 12,000 employees to keep profits up. Now show us how much you love your job! Dance, puppets, dance!
  • First, do no harmineering.
  • This event was probably a huge success. Nothing brings people together quite like hating something together.
  • Look at all those people watching this " concert" in dead silence. That pretty much tells they were forced to attend this s&^%. Besides, this reeks of brainwashing and reminiscent of propaganda videos that dictators release un-ironically.
  • When the camera pans across the crowd … wow. It’s like a bunch of KISS fans who accidentally showed up at a gospel festival, or vice-versa.
  • After this presentation, Hermann von Siemens was exhumed and charged with war crimes for a second time.
  • The balding, middle-aged engineers in the audience seem to be as horrified and bewildered as we are, so we can at least have some faith that the people who do the actual work at Siemens have their s&^% together despite upper management’s cluelessness.
  • I was waiting for one of the blue morph suit guys to tear their mask off, revealing a Michael Scott glowing with so much pride it hurt to look at.
  • It really pains me to know that this is what our healthcare dollars are being spent on.
  • I think the world is finally getting over giggling at the pronunciation of our company’s name. We need to up the ante with something else embarrassing.
  • This is great marketing material … for GE and Phillips. How can a company be taken seriously if they are so out of touch to think this was a good idea?
  • I feel like there must be some elderly Germans left around who would be more than willing to tell you that this is, in fact, a very clear sign of things about to go very, very wrong.
  • It is cringingly awesome how they have the lyrics highlighted as if they thought everyone would want to sing along.
  • Suffering through that pap is one thing, but having to tell people who ask that you work for Siemens Healthineers? That’s torture.

Sales

Grace Health System (TX) selects Patientco for its patient-focused payments solution.


People

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Imprivata hires Aaron Miri (Walnut Hill Medical Center) as CIO and VP of government relations.

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Allscripts hires Tess Coody-Anders (Resolute Health) as SVP/GM of consumer health.


Announcements and Implementations

Centura Health (CO) went live on Epic at five hospitals and their clinics on May 1.


Privacy and Security

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A hacker steals the W2s of all 2,800 employees of Saint Agnes Medical Center (CA) when one of them falls for a phishing email.


Other

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The Irish government gives initial approval to a nine-year, $1 billion plan to provide all patients with a digital health record. The one-year product selection will start at the end of 2016. The first go-live will be the new National Children’s Hospital in Dublin.

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Allegheny Health Network (PA) blames an unexpected operating loss on the one-time costs of implementing Epic.

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The local paper notes that St. Charles Health System (OR) will implement Epic, creating 100 jobs in reversing their late-2014 decision to stick with McKesson Paragon. This will be the health system’s fourth EHR, having previously chosen to move from McKesson Horizon to Paragon.

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Kaiser Family Foundation tweets out a timely graphic showing the primary role mothers have in keeping their children healthy.

This interesting video shows how Cedars-Sinai is using virtual reality to reduce the boredom of hospitalized patients. I would be happy just to get fast WiFi since my one and only night in a hospital for observation was like spending a night in jail – I didn’t get dinner because they didn’t find me a bed in time and all they had was fruit juice, there was no WiFi, my bed was missing the TV remote/call button combo, and I was in the dreaded “semi-private” room (meaning separated by only a paper-thin curtain that allowed every sound, smell, and silhouetted image to pass freely) with a guy who was a lot worse off than me. I was also awakened frequently by the nurse charged with writing down what the gadgets around me displayed, which must have required a lot of her focus because she didn’t notice that my IV ran dry and didn’t give me the meds that were ordered. This was the hospital that refused to give me an electronic copy of my medical records with the excuse that “we only do that for doctors.”

Here’s Part 3 of Vince and Susan’s vendor review. It’s fact-filled and entertaining as always.


Sponsor Updates

  • TeleTracking will host an executive forum on transforming patient access May 10 in Long Island.
  • Midmark closes its acquisition of Versus Technology.
  • WeiserMazars #BestAdvice campaign wins the Association for Accounting Marketing’s National Social Media Campaign of the Year.
  • Optimum Healthcare IT is ranked among the top two Epic consulting vendors for overall broad performance by KLAS.
  • ZirMed will exhibit at the Zoll Data Summit May 17-20 in Denver.
  • Experian Health will exhibit at the HFMA/MO Joint Conference May 11-13 in St. Louis.
  • PeriGen offers a National (OB!) Nurses Week Appreciation Toolkit.
  • Streamline Health will exhibit at the 2016 National Rural Health Association Innovation Summit May 10-13 in Minneapolis.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Currently there are "5 comments" on this Article:

  1. Re: Breakouts by causation and how many deaths were IT related:

    I find your question to be both unsettling and comforting. I exchanged a stethoscope for a database; I am on the one hand glad people are asking, and on the other, discomforted that there isn’t any clear data.

    While we may never know (or, even at the end of the day, ever need to know) precisely what percentage of deaths are caused by an HIT error, we can, and must, acknowledge all medical errors are preventable.

    I don’t need data to know we can do more. For instance, the long standing practice of keeping quiet when we do know an error is made has been shown to be ineffective at reducing law suits, as compared with an honest and thorough evaluation of the events that killed a patient and an even more honest apology.

    There is data that proves transparency and candor save more lives, cost less money, and earn more trust than the proverbial sweeping it under the rug.

    Doctors have long had safe spaces to discuss how and why a death occurred and this is good; but it’s not enough. A culture of protectionism and safe harbor for physicians while punishing nurses and others for their mistakes is not a just one. The cultures cannot coexist in the same system–at least not without blame (and perhaps more errors).

    When we cannot confront the failures we make as a whole, the part we all play within an organization, we fail both ourselves and our patients, no matter in what department we work or title we have.

  2. RE: St. Charles Health System (OR) will implement Epic, creating 100 jobs

    This is the first time I have seen a business which was required to add a significant number of non-billable IT staff to support a new IT system call it “creating jobs”. I am used to this being called an increase in annual OpEx.







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Reader Comments

  • Dysf(n): I would say the speaker meant "epic" (vs "epoch"), using the concept from Agile development. I don't have hard data, but...
  • Agile Ninja: I agree the tenant/tenet one is maddening, but I'm not sure epics is wrong. Agile project management works in "user sto...
  • Mr. HIStalk: I hate typos and I'm happy to have fixed this one. Thanks....
  • Mr. HIStalk: Thanks! I'm too trusting of my editing software "remembering" the URL of the page I visited last. Fixed....
  • Sam: Minor correction (aptly timed given comments about tenant/tenet) - Epic's population health platform is Healthy Planet, ...

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