ONC will measure MACRA-mandated national interoperability progress using metrics from two existing surveys: the percentage of providers who say they are sending and receiving information (AHA’s Information Technology Supplement Survey) and the percentage who say they actually use the information of other providers to make clinical decisions (CDC’s annual EHR survey).
From Addison in Madison: “Re: Epic non-competes. Epic’s modus operandi is to demand new agreements with any change in status / business. Your employer has perhaps been steady for a while, so they are operating under an old agreement. It is when something changes that Epic introduces their new demands. What changed for Accenture was the acquisition of Sagacious. Same with Navigant’s Epic-related acquisitions. When that happened, Epic put the agreement back on the table, with the new stipulations. You can expect the same if your firm is ever acquired or does any acquiring.”
From Voice of Reason: “Re: Epic non-competes. The reason Epic might be doing this is because both Sagacious and Vonlay were bought out by Accenture and Huron Consulting Group respectively. Epic might be thinking since Accenture and Huron provide a variety of consulting services, their Epic consulting division might pass on proprietary info to their other divisions that might compete with Epic. I don’t think Nordic has these restrictions since they only deal with Epic consulting.”
From Dr. T: “Re: Epic non-competes. what may happen is when Epic learns of the new facility you are going to, there is a quiet conversation with the old employer. Then they call the new employer and say, ‘We won’t do business with that person.’ Guess what happens? You don’t have a job, you can’t prove who talked to which manager/exec, and you don’t have the deep pockets to fight it. I saw it myself and almost had to get the toes out to keep counting how many times it happened with an old employer.”
From DrM: “Re: Epic non-competes. I predict Epic’s approach to the consultants will be what brings down the whole non-compete house of cards for them. Does anyone else find it strange that, shortly after starting up their own consulting firm, they impose rules on competing consulting firms that will (purely coincidentally, I’m sure) reduce the number of available consultants? Other companies have lost anti-trust suits for doing less. I also hope in the trial they bring up their trade secrets so they can be told the definition of trade secrets, i.e., you actually have to try to keep them a secret.”
From Apt Moniker: “Re: Twitterati. I, too am never sure whether Twitter means anything in real life. However, senior execs often watch their own Twitter accounts, although not the company one.” Twitter, Facebook, and LinkedIn are, at least for individual businesspeople, vanity platforms. Heavy users like feeling followed and it gives them a place to tout their self-perceived wonderfulness in humble-bragging to others who are doing exactly the same thing in a never-ending stream of self-promotion. Twitter in particular is full of updates that are simply links to questionable source material with the apparent goal of being the first to highlight something new or to appear to be better read. My experience is the same as what big web publishers have reported – I can get a ton of tweets and retweets linking to my original HIStalk page and it doesn’t boost site traffic one bit. From that I conclude that the Twitterers are happy just to read that the page exists, but free of the motivation to click the link to see what it actually says.
From See My I/O: “Re: leading CMIOs. Here’s a link to the top 15.” Sorry, that’s just the usual time-wasting magazine crap story, or in this case, a pointless but painful to watch slideshow. There’s no stated methodology behind the list – the magazine apparently just chose some names they recognized and proclaimed those CMIOs as “leading” in trying to amass clicks that advertisers might mistake for influence.
HIStalk Announcements and Requests
We funded the DonorsChoose grant request of Mrs. H, whose Arkansas elementary school science class needed activity tubs for their Friday projects and labs. She reports, “The students really enjoyed the force and matter experiment in which they had to attach a balloon with a straw to a string and release it to see who’s balloon traveled the fastest. The conversations we got from students were amazing and after each group went students discussed what they could do better next time to make their balloon travel quicker. These were some fun times — we are so competitive.”
I pledged transparency to a reader who asked me awhile back to list not just new HIStalk sponsors, but also those companies that don’t renew. I don’t like doing that because I take it as a personal failure, but I promised. With that, I’ll say goodbye and thanks to the following companies with whom I parted ways in the past year because they were acquired, went a different direction, tightened their belts, or lost the employee who was my only contact there.
Anthelio Healthcare Solutions
Greenway Medical Technologies
XG Health Solutions
July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.
Acquisitions, Funding, Business, and Stock
Digital pathology startup Proscia raises $1 million. The founder and CEO just earned his BS from Johns Hopkins. I’m amused that the company’s write-up says the team has filed “over eight patents” and been involved with “more than four technology companies,” making me wonder what’s wrong with just saying “nine” and “five.”
UnitedHealth Group sues publicly traded American Renal Associates Holdings for fraud, complaining that the dialysis company convinced its Medicare- and Medicaid-eligible patients to instead sign up for UnitedHealth insurance at no charge, arranging to have their premiums paid by a charity whose funding comes from providers who benefit from having better-insured patients. Government programs pay American Renal Associates about $300 for a dialysis treatment while it can bill UHG $4,000 for the same session, giving the company a profitable loophole in billing more in claims than it costs to pay for the patient’s insurance. The Affordable Care Act requires insurance companies to accept all people regardless of their health, but HHS has been vague on whether it’s OK for charities that receive most of their funding from providers to pay individual premiums directly.
Mayo Clinic will implement Visage Imaging’s Visage 7 enterprise imaging platform throughout its radiology practices.
Announcements and Implementations
Carefluence earns the first API certification issued under ONC’s criteria, with Carefluence Open API 1.0 earning certification for patient selection, data category request, and data request. I note several misspellings on its home page, including a claim that it was designed to “demistify” interoperability, which suggests fog removal. The company’s website has minimal information (such as location and management team), but it appears to be connected to the equally reticent technology vendor ModuleMD.
Among the winners of MD Buyline’s user satisfaction surveys are Aesynt (pharmacy robotics), CareFusion (pharmacy automation), Epic (EHR), GE Healthcare (cardiology PACS, perinatal information systems, RTLS,and time and attendance), Healthcare Insights (financial decision support), McKesson (staff scheduling), Philips (PACS), Premier (ERP), SCC Soft Computer (laboratory information system), Siemens Healthineers (cardiology PACS), and Vital (3D advanced visualization).
Government and Politics
The government of South Australia continues to defend its over-budget and delayed $315 million EPAS patient care system even as the auditor-general warns that the project is underfunded and unlikely to deliver $113 million in savings. The Allscripts Sunrise system is live at some sites and will be phased in when the new flagship Royal Adelaide Hospital opens.
Privacy and Security
Catholic Health Care Services of the Archdiocese of Philadelphia will pay a $650,000 HIPAA settlement related to the 2014 theft of a PHI-containing, company-issued iPhone that was not password protected. The phone contained the information of 412 residents of the six nursing homes it owned and managed. OCR found that CHCS had not published a policy about taking mobile devices off campus and had not developed a risk analysis and risk management plan. Most interesting is that CHCS was charged as a business associate rather than as a covered entity since it was the corporate parent of the nursing homes and provided technology services to them.
Atlantic Health System (NJ) sends 5,000 randomly selected employees an email saying they’re getting raises, telling them to just confirm by clicking a link and entering their employee ID number, data of birth, and ZIP code. One-fourth of them opened the email and two-thirds of those provided their personal information. The email was actually a phishing test that mimicked known hacker practices such as using an originating email address ending in .com instead of .org. Several employees complained that the promised raise wasn’t real, but on the upside, quite a few reported the email as suspicious and warned co-workers not to fall for the trap.
Innovation and Research
Researchers find statistical bugs in the software that interprets functional MRI results, leading them to question the validity of 40,000 studies.Poor archiving and data sharing practices mean the existing studies can’t be re-analyzed with better software.
London’s Moorfields Eye Hospital is sharing de-identified eye scans with Google DeepMind, which is developing artificial intelligence for early detection of diabetic retinopathy and macular degeneration.
An Apple iOS 10 update this month will allow iPhone users to sign up as organ donors with the Donate Life America registry and be flagged as an organ, eye, and tissue donor on the phone’s Medical ID emergency information display.
Neuroradiologist Shyam Sabat, MD calls for BMJ to retract the “shoddy science” tabloid-like pseudo-study it published in May that claimed medical errors are the third-leading cause of death in the US. His analysis of the paper finds that four studies were improperly combined into a meta-analysis that really left just one 2004 Healthgrades study of Medicare recipients, which the authors then wildly extrapolated to all inpatient admissions. He concludes,
How a reputed group such as the BMJ could not see through these simple but outrageous statistical blunders is anyone’s guess. Did the overwhelming incentive to get a spice tabloid-type, eye-catching headlined paper prevent the editorial process from taking common sense decisions? The result is that the US medical community is being ridiculed by media and people not only from the US but the whole world who cannot understand how US medical system is so incompetent despite spending the maximum in the world and attracting the best talents from all over the world.
The Boston Globe notes the trend of doctors working night shifts in hospitals, where “nocturnalists” oversee the activities of overworked residents, reduce the number of calls to attendings, and get patients out of the ED and into beds when indicated.
Cleveland stakes its claim as “The Medical Capital” by launching a rebranding initiative, a new website, and a new testimonial video. In other words, you should take their word for it because they blew through a ton of marketing money in proclaiming themselves #1. Maybe it will draw business, but I can recall many weed-infested empty lots bordering desolate highways festooned with signs proclaiming that area to be some town’s “high-tech corridor” that never quite caught on.
Dear naive people who cry foul when drug companies raise the prices of critical drugs for no good reason, saying those companies are “putting profits ahead of patients:” that’s exactly what for-profit companies are supposed to do. It’s unconscionable when health systems and insurance companies hide their huge bottom lines behind non-profit status, but for-profit corporations exist for a singular purpose, to deliver maximal profits to shareholders. The understandable outrage would be better focused on advocating for government-led drug price involvement like the rest of the world uses, which leaves US consumers footing the bill for most drug company profits and research investment.
Powell Valley Hospital (WY), which struggled for years to get its $2 million NextGen hospital EHR working well enough to earn Meaningful Use money, learns that the product’s new owner, Harris Computer Corporation, won’t add MU Stage 3 capabilities to the product. Harris has offered to replace NextGen with QuadraMed for just the installation cost, but the hospital would still need to spend over $1 million. Harris confirmed that it will provide only break-fix support for the NextGen hospital system, saying it acquired the product because NextGen was going to shut it down anyway.
A former naturopath (ND) who left a lucrative practice after observing a colleague administered an unapproved cancer drug says that “naturopathic services are quackery” and scoffs at ND ambitions to be recognized as primary care physicians. She writes,
Essentially, naturopaths want to be allowed to take shortcuts. Instead of attending medical school, naturopaths attend their own, self-accredited programs with low acceptance standards and faculty who are not qualified to teach medicine. Instead of a standardized and peer-reviewed medical licensing exam, naturopaths take their own secretive licensing exam that tests on homeopathy and other dubious treatments. What little medical standards that seem to be tested on the exam have been botched, like the one question in which a child is gasping for air and the correct answer on how to treat is to give a homeopathic remedy.
- Clockwise.MD will exhibit at the UCAOA Regional Conference in Philadelphia on July 14-15.
- Audacious Inquiry comments on MACRA NPRM V5.
- Boston Software Systems launches a podcast series covering EHR migration, system optimization, and the sunsetting of legacy systems.
- CareSync is featured in a USF Health article on Tampa’s digital health opportunities.
- ClinicalArchitecture will exhibit at the Military & Government HER & Health IT Symposium July 13-14 in Arlington, VA.
- Cumberland Consulting Group will attend the 340B Coalition Summer Conference July 11-13 in Washington, DC.
- Elsevier will develop a free benchmarking report detailing the current landscape of cancer research and collaborations as part of the national Cancer Moonshot initiative.
- Healthfinch joins the Athenahealth Marketplace.
- Meditech 6.x Outperforms Other EHRs on CMS Quality and Value Measures (Meditech)
- Advanced Practice Training: AdvancedInsight Reimbursement Analysis (AdvancedMD)
- Curing Weak Patient Engagement with mHealth Apps (AirWatch)
- Burgers and Fries and Data (Arcadia Healthcare Solutions)
- Live from HFMA ANI 2016 (Besler Consulting)
- MACRA: Reporting for Quality’s Sake (Caradigm)
- Oncology Care Model: 196 Physician Group Practices and 17 Insurance Companies to Participate (Carevive Systems)
- When an EHR Isn’t Enough (ECG Management Consultants)
- Meditech 6.X: Facing Transition Decisions (Galen Healthcare Solutions)
- MACRA 101: 9 Things to Know (Hayes Management Consultants)
- Building Rapport – Relationships for Success (HCTec)
- Go-Live Support: Procedures & Reporting (The HCI Group)
- Declaration of Health Independence (Healthwise)