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September 8, 2016 News 5 Comments

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CMS offers providers four “pick your pace” MACRA/Quality Payment Program options for 2017:

  1. Submit test data only, which avoids a negative payment adjustment.
  2. Participate for part of the calendar year, which qualifies for a small positive payment adjustment.
  3. Participate for the full calendar year, which qualifies for a modest positive payment adjustment.
  4. Join an Advanced Alternative Payment Model, which qualifies for up to a 5 percent incentive payment.

The AMA has already issued a statement saying it “strongly applauds” the change.


Reader Comments

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From Concerned Longtime Customer: “Re: Epic’s succession plan. I don’t see how Carl won’t succeed Judy. He’s who you go to with big problems and he and Judy have similar gravitas in communicating a future direction in an artful way. I had not considered the Sumit possibility, but I see a clear drop-off since he speaks in buzzwords and cliches about how things are going to be ‘cool,’ ‘awesome,’ and I think he even pulled out an ‘insanely great’ one time. He impressed me as someone trying to play the part of Steve Jobs who doesn’t have an authentic vision of his own that reflects our needs. I have concerns about how much longer Carl will last than Judy and hope very much that Epic’s bench is deeper than I’ve seen.”

From Hissing Viper: “Re: a new nurse poll. It finds that 92 percent are dissatisfied with EHRs.” It’s always a good idea to check sources when reading health IT articles written by freelance, newly graduated authors who also craft beauty and fashion pieces.

  • It’s not a new poll. The information is from 2014 and has been amply reported previously.
  • The site you cite (no pun intended) says the survey was performed by Adventist University of Health Sciences. That is incorrect — the school simply turned existing surveys into a dumbed-down infographic as a marketing piece for its RN-to-BSN program. Using an infographic as a news source is just ridiculous.
  • The site takes 18 paragraphs to explain the infographic in failing to note the original survey source, which was Black Book.
  • Black Book still sells the old report (and thus the methodology from which it was derived) for $3,495. The number of respondents is ample, but unstated is how those respondents were selected, the respondent demographics, and the exact wording of the poll (since wording has a huge affect on how respondents answer questions).

HIStalk Announcements and Requests

[Caution: geek alert]. Several readers reported that the main HIStalk page wasn’t displaying my most recent posts due to what appeared to be some sort of caching problem, which started happening all of a sudden even though I hadn’t changed anything. I spent a ton of time trying to figure it out, working with my web host, the virtual firewall company, and an offshore guy I hired for $30. Nobody could determine what was happening, although I could see “Cache-Control:max-age=172800” headers being generated by my server from somewhere. I finally lost patience and brute forced a fix by adding “ExpiresActive Off” to the .htaccess file. I don’t like adding fixes that I don’t fully understand to address a problem that I also don’t fully understand, but at least it seems to be working.

This week on HIStalk Practice: Sahali Health Clinic implements Kannact real-time blood glucose monitoring. Cross Country Healthcare expands Boca Raton headquarters. EyeCrave Optics rolls out virtual eye exams with help from Smart Vision Labs. MMC Anesthesia Group signs on with Zotec Partners. E-MDs joins CommonWell. MarijuanaDoctors.com launches telemedicine portal.


Webinars

September 27 (Tuesday) 1:00 ET. “Stanson Clinical Decision Support: Survival Kit for Evolving Payment Models and Other Regulatory Requirements.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.

View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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For-profit hospital operator HCA will acquire Mobile Heartbeat, whose clinical communications technologies it had previously piloted. The company will continue to operate as a wholly owned subsidiary of HCA.

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Allscripts announces eRecruit, which connects Allscripts-using providers to ePatientFinder’s clinical trial patient recruitment service. 

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In what surely must be one of the oddest acquisitions by a health IT company, health coaching chat vendor Grow Fit acquires nutritional beverage vendor Drink King (I’m not sure if the pun is intentional). Both companies are in India.

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Online doctor advice vendor HealthTap expands to Great Britain.

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Google acquires API vendor Apigee for $625 million in cash. One of the company’s customers is Walgreens, which uses Apigee’s technology for ordering photo prints and managing prescription refills and transfers. Other healthcare users are McKesson, Humana, and Kaiser Permanente.

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Medical device manufacturer St. Jude Medical sues medical security vulnerability vendor MedSec and investment research firm Muddy Waters for share price manipulation. St. Jude says Muddy Waters conspired with MedSec to short-sell St. Jude’s shares before MedSec’s critical security report was published. St. Jude also says the vulnerability report is wrong because MedSec used poor testing methodology on outdated versions of its software.


Sales

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In England, North West London Pathology Consortium signs a $19 million contract with Sunquest Europe for a hosted laboratory information system. The pathology operation is a shared service among several NHS trusts.

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LA County Department of Health Services (CA) chooses Cerner’s HealthIntent for population health management.

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Inova (VA) selects clinical decision support and analytics from Stanson Health to provide patient- and context-specific evidence-based recommendations at the point of care. 


Announcements and Implementations

Optimum Healthcare IT expands its Epic Community Connect practice and hires two executive directors to run it, Jon Straffon and Kelli Mangino from Cleveland Clinic.

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Surescripts announces Medication History for Panel Management, which supports population health management by connecting health systems, ACOs, and analytics vendors to the medication data of 14 nationwide pharmacies.

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Apple announces yet another annual round of marginally improved iPhones that will inexplicably create Apple Store lines of fanboys desperately seeking personal validation via loss of their headphone jack , the addition of waterproofing, and slightly less crappy cameras, none of which are compelling reasons to replace my iPhone 5. The company will also offer Pokemon Go for the Apple Watch, pairing a rapidly fading star with an already-faded one. The company once known for universe-denting innovation is now milking the cash cow via planned obsolescence and piling on pointless features hoping to entice overly loyal fans to ante up yet again in Apple’s form of hardware annual subscription pricing. The iPhone holds only 15 percent of the world smartphone market and these dull announcements aren’t likely to boost that number. Apple announced nothing for the ancient Mac product line. It sounds like the company is perfectly suited for its rumored entry into healthcare.

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Cerner opens a clinic and health center for the 2,200 employees of its Bangalore, India campus, which technically gives the company its first Millennium client in that country.

Imprivata adds clinical speech recognition from Nuance’s Dragon Medical One to its Cortext secure communications platform.


Government and Politics

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Blue Cross Blue Shield of Arizona steps in to offer an ACA insurance plan in Pinal County, AZ, saving the federal government the embarrassment of having one US county in which consumers have no Healthcare.gov coverage option. However, the insurer also warns that, as the only company offering plans in 13 of Arizona’s 15 counties, the government needs to stabilize the market. BCBS of Arizona has lost $185 million in the past two years selling ACA plans and isn’t thrilled about coming back to Pinal County. A study predicts that people in 31 percent of US counties will have only on ACA insurer to choose from, while another 31 percent will have only two.

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The UK’s Department of Health publishes its IT advisory committee’s report on how to spend the $5.6 billion that has been earmarked for NHS digitization that the committee says should be complete by 2023. It attempts to answer the question of whether the UK has the money (especially after recently blowing $15 billion on the overly ambitious and mostly failed NPfIT project) with, “The one thing that NHS cannot afford to do is to remain a largely non-digital system. It is time to get on with IT.” Their report calls for the government to:

  • Stage digitization efforts within trusts that are ready rather than trying to bring them all along at once.
  • Expect the short-term return on investment to be in the form of safety and quality improvements rather than financial.
  • Create and enforce national interoperability standards.
  • Give patients full access to their electronic information, including clinician notes.
  • Create a national chief clinical information officer (CCIO) position that will oversee the project and then appoint a clinician-informatician to serve as CCIO within each trust who will oversee at least five clinicians with advanced informatics training.

The UK’s report was written by UCSF professor, best-selling author, and medical malpractice insurance pitch man Bob Wachter, MD (asked by Secretary of State for Health Jeremy Hunt to chair the group) and his journalist wife. It not only reflects his personal feelings about US healthcare IT efforts, but also manages to promote his own book, “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.” His bio doesn’t list any informatics education, training, or job responsibilities, although he’s a paid board member of some health IT vendors. The committee’s participation was in the form of nine, two-hour teleconferences and a two-day meeting.


Privacy and Security

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From DataBreaches.net:

  • The information of 43,000 patients of Baltimore-based substance abuse treatment provider Man Alive is listed for sale on the Dark Web, stolen by a Russian hacker who sent an employee a phishing email containing a macro-loaded Word document. The hacker reports that he has already sold some of the information following the facility’s refusal to pay him $9,400. Interestingly, DataBreaches.net notified the FBI that the information was listed for sale and they declined to do anything, including letting the facility know.
  • CHI Franciscan Health Highline Medical Center (WA) notifies 18,000 patients that their information was exposed in the same error by R-C Healthcare Management that affected 655,000 patients of Bon Secours Health System (VA). The difference in this case is that R-C Healthcare Management hadn’t performed any work for the hospital since 2014, so the information exposed was old cost-reporting data. R-C Healthcare Management misconfigured its network in April 2016, exposing the files it contained to the Internet.

Technology

An article in Nature reviews pharmacogenetics, the science of using a patient’s genetic profile to choose optimal drugs and doses. The article notes that only a handful of tests are being used and that the real value can be delivered only if patients are tested proactively instead of after they’ve had problems. Evidence from randomized clinical trials is not compelling, but advocates say the genetic tests are being held to an overly high standard.

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Maritime connectivity vendor Marlink announces a telemedicine solution that includes a central unit, touch screen, HD camera, ECG monitor, blood pressure monitor, pulse oximeter, and several other optional medical sensors. The system provides 24/7 consultations with on-shore doctors and includes a secure web portal for patient medical information. The announcement notes that emergency ship re-routing for a medical emergency costs around $180,000, making the company’s fully managed telemedicine service cost effective. 

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University of Washington researchers develop a smartphone app that can detect anemia by measuring blood color by shining the phone’s flash through the subject’s finger. Possibly aware that earning FDA approval is likely to be challenging, the researchers say the best use of HemaApp would be for screening before performing more expensive tests in “limited-resource environments,” i.e. not in the US.


Other

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In England, Google-owned DeepMind Health halts use of its Streams kidney injury detection app pending its approval by the UK’s version of the FDA. That means the company and NHS were using the app on hospitalized patients as an unregistered medical device.

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Epic petitions the US Supreme Court to weigh in on a lower court’s decision in May that the company cannot require employees to arbitrate employment disputes individually instead of by filing class action lawsuits.

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UCSF will lay off 17 percent of its IT staff, blaming reduced hospital payments under the Affordable Care Act and the doubling of IT expenses from 3 percent of the operating budget to 6 percent in the past five years (they went live on Epic in June 2012). The laid-off employees will be expected to train their India-based replacements from University of California system contractor HCL.

A study in Health Affairs finds that while hospital charge masters were supposed to become obsolete with the implementation of DRGs in 1985, hospitals are still using them to increase revenue and to force insurance companies to include their facilities in their networks using the threat of high list prices if they don’t. The authors suggest that legislators require more markup transparency to protect patients who have zero negotiation power with hospitals when faced with excessive charges.

A Florida TV station covers the local hospital’s use of Natus Newborn Care’s Nicview, which allows parents of babies who are in the NICU to view streaming webcam video and nurse messages.

A woman bitten by a stray dog while traveling abroad is given the same rabies drug at four locations in three countries and is shocked by the price variation: $125 (Cambodia), $18.50 (Thailand), $5,255 (a US hospital, that required an ED visit), and $427 (a US medical group). Her travel insurance covered the cost, but her husband, a former CFO, said that of the four providers, only the US hospital sent a bill that was not itemized and was impossible to understand. Healthcare economist Uwe Reinhardt offered a comment for the article:

It’s obvious that our system is unlike any other health system. Other systems were set up to care for patients. Ours was set up by the providers — the hospitals and drug companies — for their own benefit.

The New York Times notes that it’s hard for any of us – including presidential candidates — to assemble our medical records from a lifetime of providers (some probably retired or dead) who used their individual paper or electronic systems. The exception was presidential candidate Senator John McCain, who was able to release his 1,000-page medical record only because it had been assembled for a military study in which he participated, but later he was treated at Mayo Clinic and his campaign had to postpone the release of his records because they couldn’t collect all his records from several Mayo doctors. The article puts forth an interesting alternative to assessing health via old records: have each candidate examined by an independent physician panel hired by the federal government.

Voluntary reports from Kentucky hospitals indicate that 15 people overdosed on heroin over the Labor Day weekend, with 12 of them dying. This follows reports of a mid-August weekend in nearby Huntington, WV, population less than 50,000, where 26 heroin overdoses were reported in just four hours, tying up every ambulance in the county.


Sponsor Updates

  • InstaMed Senior Vice President of Product Management Jeff Lin will keynote the NTC Healthcare 2016 Symposium October 19 in Irving, TX.
  • InterSystems will exhibit at the HIMSS-NCA monthly education meeting September 15 in Arlington, VA.
  • LiveProcess will exhibit at Emergency Nursing 2016 September 14-17 in Los Angeles.
  • Ability Network is named as one of the world’s top 100 private cloud companies.
  • Access launches a newly redesigned website.
  • Aprima recaps its first-half 2016 success.
  • MedData will exhibit at the 2016 TAHFA & HFMA South Texas Fall Symposium September 11-13 in San Antonio.
  • EMDs joins the CommonWell Health Alliance.
  • BizTech Magazine features Navicure IT Director Donald Wilkins.
  • Santa Rosa Consulting assists King’s Daughters Medical center (MS) with its migration to Meditech 6.15.
  • Spok partners with Australia-based unified communication solutions integrator Progility Technologies.
  • Meditech’s Catherine Campbell is elected quality measurements vice chair of the HIMSS EHRA.
  • NTT Data Healthcare Technologies will host its annual client conference September 11-14 in Newport Beach, CA.
  • NVoq will exhibit at the AAFP Family Medicine Experience Annual Meeting September 16-24 in Orlando.
  • Obix Perinatal Data System will exhibit at the Summit of the Southeast September 14-15 in Nashville.
  • Meditech posts a case study titled “Valley Hospital Identifies and Prevents Infections with Meditech Surveillance.”
  • Experian Health will exhibit at HFMA Northern California September 15-16 in Concord.
  • PatientMatters will exhibit at the Illinois Hospital Association Leadership Summit September 15-18 in Lombard.
  • PatientPay will present at the 2016 Council for Entrepreneurial Development Tech Venture Conference September 13-14 in Raleigh, NC.
  • The SSI Group will exhibit at the NTT Data Client Conference September 11-14 in Newport Beach, CA.
  • Streamline Health will host its annual client conference September 11-13 in New York City.

Blog Posts

Learn More

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Frost & Sullivan calls Validic the de facto standard and industry leader in patient-generated health data interoperability. The company’s digital health platform connects providers, pharmaceutical companies, payers, wellness companies, and health IT vendors with data harvested from 300 in-home clinical devices, wearables, and consumer health apps. It reaches 223 million lives in 47 countries and delivers the insight needed to improve health outcomes, population health, care coordination, and patient engagement. Validic helps healthcare companies accelerate their strategic business initiatives. Learn more on the company’s website.


Contacts

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

  1. I really like Carl and I really like Sumit… but in response to @longtimeconcernedcustomer I would remind him/her that Sumit is a young guy, and by definition uses language differently than us codgers. Please let’s avoid leveling such superficial critiques.

  2. “Epic petitions the US Supreme Court to weigh in on a lower court’s decision in May that the company cannot require employees to arbitrate employment disputes individually instead of by filing class action lawsuits.”

    Yeah, good luck with that. The US Supreme Court just loves to take away federal protection rights from workers.

    Does Judy still claim to be liberal and donate to Democrats?

  3. Re: Concerned Longtime Customer

    Yes, Carl is the #2 man at Epic and he might even be CEO one day, but he’s still up there in age (I would guess he’s around 65-70) so he won’t be at Epic that much longer either. Sumit is relatively young (around 40) and he still has many more years ahead of him which is why I think his tenure as CEO would be much more consequential than Carl’s tenure.

    Also, thanks to the couple of people that fact checked me on Stirling being a developer.

  4. RE: Presidential medical care exams:

    A panel is a great idea. But a huge part of any competent opinion is a careful review of old records, which frequently reveal things the patient and his doctors are unaware of.







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