News 11/4/16

Top News

Allscripts posts Q3 results: revenue up 11 percent, adjusted EPS $0.14 vs. $0.13, missing analyst expectations for both. The company also issued disappointing earnings guidance.

Allscripts shares are down 17 percent in the past year and have dropped 44 percent in the past five years. The company’s market value is $2.16 billion.

Netsmart contributed $38 million in revenue for the quarter. Allscripts and a private equity firm acquired the behavioral EHR vendor in April 2016 for $950 million and merged it with the homecare software business of Allscripts with the expectation of generating $250 million in annual revenue and $60 million in annual profit, although the Allscripts ownership stake was not specified. Netsmart acquired LTPAC EHR vendor HealthMEDX on October 27, 2016 for $36.3 million in cash.

Allscripts competitor Cerner also posted disappointing results this week.

Reader Comments

From JB: “Re: data blocking. A Politico piece claims Epic and EClinicalWorks are impeding the sharing of data with public and specialty registries. It’s surprising that EMR suppliers aren’t going full-tilt toward open practices given regulatory pressures and pending VA procurement.” Epic says it has a problem with the for-profit companies behind medical association registries that also sell analytics software and apparently patient data. Epic and Practice Fusion say they will submit CCDs, but registry companies complain that CCDs don’t include all the information they need and a fully automated process would require EHR vendor customization. As is always the case, the patient is excluded from the vendor-vendor bickering even though the data in question (although not necessarily the benefit from its use) is theirs. The largely overlooked open.epic.com lists the public health registries to which Epic offers standard integration. There’s also the question of whether specific EHR vendors don’t allow submission of data at all (which is apparently sometimes true in Epic’s case) or simply charge EHR users extra to do so (like EClinicalWorks). Epic is the crown jewel since its refusal to participate means that large academic and government projects (including the FDA’s planned medical device monitoring program) are missing the information of the largest health systems. A point to note: correctly or not, I’ve never seen Cerner mentioned even once as a problem – it’s nearly always Epic and EClinicalWorks that come up, such as in the AMA’s proposed policies to be discussed in its upcoming meeting that call out those vendors specifically (see above).

From David Watson: “Re: Memorial Health System in southeastern Ohio. We have deployed Meditech 6.15, including ambulatory, of which we are Meditech’s largest client. Physicians and staff alike have joined together with a small army of technology folks committing hundreds of hours to design, build, test, and validate a comprehensive solution. We appreciate their dedication to delivering a system that enhances MHS’s ability to provide exceptional patient care.” Congratulations to MHS and David, who joined the system in July after coming over from Duke.

From Chatty Kathy: “Re: online chats. I would like to see HIStalk provide scheduled ones for readers to share information.” I’m not a fan of Twitter for that purpose since it’s kind of kludgy, but perhaps other tools exist – YouTube and Facebook Live for video chats, GoToWebinar or conference calls for voice chats, and probably something other than Twitter for text chats. I’m skeptical at the level of demand for something like that since Twitter and Facebook seem to draw mostly people who aren’t decision-makers or influencers who just supportively stroke each other’s egos, but I’m open to ideas. My best one to use a moderated GoToWebinar session (one recognized speaker at a time) with the conversation transcribed afterward.

HIStalk Announcements and Requests

I admit as a card-carrying curmudgeon that I don’t understand why people identify emotionally with sports teams as though they are more than just their paying customers (except maybe for the community-owned, non-profit Green Bay Packers). The most brilliant marketing strategy in history was to brand companies that hire athlete-entertainers with city names, which profitably confuses locals into mustering misplaced civic pride in saying “we won” instead of the accurate “they won while I watched” (I’ll skip my usual porn analogy). Still, Cubs fans seem pretty excited, so perhaps their lives are now complete and at least Facebook will become nearly tolerable again once the World Series and the election are over. I lost what little interest I had when I heard that Charlie Sheen wouldn’t be allowed to reprise his “Wild Thing” Rick Vaughn character to motivate the Indians, although apparently there were some Jobu sightings.

I’m looking at tweets and streaming video as Robert Herjavec of “Shark Tank” (and founder of two IT security companies) presents at the CHIME Fall CIO Forum in Phoenix. He’s going to be a winner at HIMSS17, along with his co-star Kevin O’Leary. I watch “Shark Tank” only when traveling since as a cord-cutter I can’t get it, but those guys (and their fellow sharks) are insightful and entertaining. The recently released book by the “nice shark” gets pretty good reviews on Amazon, although the “look inside” preview shows mostly the wide-margin, collaborator-written chattiness that boosts page count without necessarily imparting additional wisdom. The CHIME tweets also make it obvious that, as is the case with HIMSS, vendors get a lot of influence, podium time, and questionably designated awards in return for their financial support. The CHIMErs were set to rock out (air quotes optional) Thursday night to Foreigner, featuring the band’s one remaining 71-year-old member from its late-1970s heyday. The best thing I can say about Foreigner is that at least they aren’t Journey.

This week on HIStalk Practice: AdvancedMD includes telemedicine capabilities in its new technology suite. Humana adds EliteHealth primary care practices to its Medicare network. Navicure’s Jeff Wood believes healthcare consumerism is finally taking off. Frederick Primary Care Associates joins Privia Medical Group. Manna Health Professional Services rebrands. MedStar National Rehabilitation Network selects WebPT tech. CMS figures out a way to pay PCPs for more time spent with patients and better coordinated care.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Recondo Technology raises $16 million in debt and capital funding to further develop API-enabled RCM, expanded claims statusing, and authorization automation.

From the Cerner earnings call:

• The company’s revenue shortfall was due to lower technology resale and software sales.
• Cerner expects to spend $30 million on a Q4 voluntary separation plan, estimating that 2 percent of employees will be affected. The company advises that “this should not be viewed as a layoff or a sign that we don’t expect to grow.”
• The company expects strong contributions from RCM and population health management technology, adding that HealthIntent mostly involves small contracts since most providers aren’t at risk for most of their populations.
• Cerner says it earned a noteworthy ambulatory win in displacing Athenahealth for ambulatory EHR and business services at what the company believes is Athenahealth’s largest customer, also replacing Athena at two other sites.
• The company blames lower software sales on the lack of MU-driven urgency among prospects, along with lower contributions from ITWorks and RevWorks.
• Cerner believes its DoD project gives it a strong competitive advantage if and when the VA decides to replace VistA.
• The company says its DoD revenue is steady but not significant, but completion of milestones in 2017 will add some modest-sized additional bookings.
• Cerner says population health represents a “very little piece of bookings growth” and that those deals of $5 million and under don’t change the overall bookings number much.

Tokyo, Japan-based NTT Data completes its $3.1 billion acquisition of Dell Services, renaming the business NTT Data Services. It was the former Perot Systems, acquired for $3.9 billion in 2009 by Dell, which apparently either overpaid or underperformed in bleeding off a large chunk of its value before offloading it to buy EMC.

Analytics vendor Inovalon (known as MedAssurant until 2012 and acquirer of Avalere Health) reports Q3 results: revenue flat, adjusted EPS $0.10 vs. $0.09, beating revenue expectations but falling short on earnings. Shares rose sharply on the news, but are still down 24 percent in the past year.

Israel-based equity crowd-funding organization OurCrowd launches a $50 million digital health fund with Johns Hopkins that will invest in early stage Israel-based companies. Accredited investors can invest as little as $10,000 in each company with pre-emptive rights to future fundraising.

Sales

Inspira Health Network (NJ) chooses Cerner Millennium, HealtheIntent, and remote hosting, replacing the former Siemens Soarian.

Penn State Health’s Hershey Medical Center (PA) will implement Cerner Millennium Revenue Cycle.

St. Claire Regional Medical Center (KY), Mary Rutan Hospital (OH), and Bella Vista Hospital (PR) will upgrade to Meditech’s Web EHR.

The DoD’s Dental Information Systems Center chooses the Dicom Systems Unifier Archive VNA.

In England, University College London Hospitals NHS Foundation Trust chooses Epic to replace GE Healthcare Centricity, citing interoperability as a key factor going with Epic instead of Cerner.

Announcements and Implementations

Great Lakes Health Connect will offer researchers access to “remnant specimens” from lab tests by matching them with patients who match their requests and who have consented to make their de-identified information available.

Catalyze participates in the HITRUST CSF Inheritance Program that allows its customers to demonstrate their security measures without doing their own testing.

Fortified Health Solutions renames itself to Fortified Health Security and launches new offerings of a virtual information security program, managed loss data prevention, and security event monitoring.

Telemedicine provider HealthTap announces an app developer platform that connects to telemedicine, health data exchange, CRM, and content. The company is also working on a blockchain product.

Mount Sinai Health System (NY) launches Rx Universe, a catalog of curated, evidence-proven mobile health apps that physicians can prescribe. The health system has launched a company, Responsive Health, that will license the app prescribing platform to other health systems.

Government and Politics

I’m really going to miss Acting CMS Administrator Andy Slavitt when he leaves the job in January. His comment above came when he was asked  why the drug industry is the only group complaining about a national test of a YMCA diabetes prevention program. He also describes healthcare cost issues in Thursday remarks to the American Academy of Actuaries:

Transparency into costs is important in a world where more people are paying their own premium. Hospital profits in many cases are double or more what they were before the ACA. Drug costs are growing at record levels. And there are more endemic issues like the costs of untreated chronic diseases like diabetes or the large “tax” the fee-for-service system imposes on us when care isn’t coordinated or when bad quality is delivered. While people may not equate these costs or inefficiencies to the premiums they pay each month, we need to make those connections clear that this is where the real work needs to happen.

ONC names the 10 Phase 1 winners of its Move Health Data Forward Challenge, which calls for using APIs to enable consumers to share their information with providers and family members. I started to list the 10 and what they offer until I realized I had never heard of any of the companies and the products all sounded the same. Anyway, the 10 will be narrowed to five finalists in the next round and then one or two winners of the final phase.

Privacy and Security

From DataBreaches.net:

• The city of El Paso, TX is scammed out of $3.3 million when officials pay a phishing hacker posing as a vendor.
• In Canada, Winnipeg Regional Health Authority reports the latest of several incidents in which paper patient records were stolen from locked cars and offices.
• Victims of Anthem’s 2015 data breach file a class action lawsuit seeking information on the Office of Personnel Management’s security audit, after which Anthem was rumored to have refused to perform the recommended security tests.
• An employee of the New Zealand Nurses Organisation sends its 47,000-member database to a hacker whose spear phishing email was disguised to look as though it came from its CEO.

A corporate lawyer sues a Miami, FL hospital for allowing its telemarketing company MedAssist to call his mother with recorded marketing messages every seven days following her hospital visit. MedAssist says its messages are informational and that the hospital’s patient waiver includes their consent to receive robocalls. The lawyer is seeking class action status.

Technology

The New York Times covers end-of-life tech startups that are trying to bring technology into the tech-resistant “death care” industry. Investor-funded companies are offering TurboTax-like products for estate planning, online funeral home directories, post-death task automation for families, and online advance directives.

Forbes profiles Magic Leap, a secretive startup valued at $4.5 billion that is developing a next-generation computer interface, a head-mounted display that projects directly onto a user’s retina to create a mixed-reality environment. They’re targeting the consumer market, but possible healthcare uses are extensive (the founder earned a master’s in biomedical engineering). The video above – recorded directly from Magic Leap – shows the possibilities in perhaps showing a patient’s medical record while talking to them, reviewing surgical information in the OR, or reviewing medical literature while rounding.

An analysis finds that Microsoft’s IE and Edge browsers have lost 331 million users so far this year, dropping the company’s browser market share from 44 percent to 23 percent even though those products are bundled with Windows. Google’s Chrome jumped from 35 percent to 55 percent market share. Firefox users (including me) held steady at around 11 percent, while Apple’s Safari represented around 5 percent.

Other

Facebook panders to drug companies with big advertising budgets in creating a new automatic scrolling for long lists of side effects, allowing drug companies to turn off comments on pages that promote their products to relieve them of their FDA responsibility to report any unverified side effects that patients might enter, and creating condition-specific community pages that drug companies can sponsor to promote their product. Facebook put together a team just to work with drug companies, explaining, “This was borne out of tons of interest we were getting from pharmaceutical advertisers to figure out Facebook.”

A South Florida woman complains that Boca Regional Regional Hospital charged her $7,000 for delivering her baby even though she gave birth in the hospital parking lot before she could get inside. Laypeople will miss the RCM aspect of the story – she didn’t get the bill until seven months later.

An attorney sues the Popeyes fried chicken restaurant for including only a spork in his drive-through order, claiming that be choked for lack of a plastic knife. In an update, the attorney drops his suit following “extreme comments directed to me and my family.”

Sponsor Updates

• Intelligent Medical Objects will offer a free workshop titled “Terminology: The Secret to Leveraging your EHR for MIPS and MACRA” at AMIA 2016 on November 12, with non-AMIA attendees invited to participate as well.
• Gartner lists Medecision as a representative vendor of PHM platforms for providers in its latest “Market Guide for Healthcare Provider Population Health Management Platforms.”
• KLAS recognizes Uniphy Health for accomplishments in secure messaging in its report, “Secure Communication 2016: Vendors Transitioning to Secure Communication Platforms.”
• The Tampa Bay Technology Forum recognizes CareSync as 2016 Technology Company of the Year.
• Ingenious Med releases a major update to its IM1 patient encounter solution, adding real-time care team member interaction.
• Iatric Systems, Imprivata, InterSystems, MedCPU, Nordic exhibits at the CHIME Fall CIO Forum through November 4 in Phoenix.
• InstaMed, Intelligent Medical Objects will exhibit at the NextGen One UGM November 6-9 in Las Vegas.
• Kyruus will exhibit at HCIC November 7-9 in Las Vegas.
• MedData will exhibit at the HFMA Region 9 Annual Conference November 6-9 in New Orleans.
• Meditech will exhibit at the American Association of Physician Leadership 2016 Fall Institute November 4-8 in Chandler, AZ.
• NTT Data will host an Innovation Summit November 10 in Charlotte, NC.
• Obix Perinatal Data System will exhibit at the South Carolina HIMSS Annual Fall Conference November 9-10 in Columbia.
• KLAS recognizes PatientSafe Solutions as one of the strongest platform options for care team communication in its 2016 Secure Communication Report.
• PatientKeeper and Summit Healthcare will exhibit at HealthAchieve November 7-9 in Toronto.
• The Institute of Healthcare Consumerism features PokitDok on Healthcare Consumerism Radio.
• The SSI Group and Streamline Health will exhibit at the HFMA Region 9 Annual Conference November 6-8 in New Orleans.

Blog Posts

• What Will MIPS and MACRA Cost You? (Medicomp Systems)
• Realizing Clinical Benefits: Part 2 – Identifying Benefits (Impact Advisors)
• Ransomware in the Healthcare Space (ID Experts)
• Securing the perimeter: A national cyber security awareness month Q&A (Imprivata)
• 3 Questions You Need to Ask When Developing Your Healthcare Marketing Strategy (Influence Health)
• Secure Texting’s Evolution (Spok)
• Five True Tales of Terror: How Liaison Solves Customers’ Spookiest Integration and Data Management Problems (Liaison Healthcare)
• New FHIR Integration Helps Hospitals Connect Imaging Data Across Disparate Systems (LifeImage)
• Bundled Payments and Radiology (National Decision Support Company)
• Putting the “Precision” in Precision Medicine (Orion Health)
• How much time on charting (PeriGen)
• Addressing the Disruption in Provider Data Caused by Clinically Integrated Networks and Value-based Care (Phynd Technologies)
• Top 10 Takeaways from the MACRA Final Rule (Point-of-Care Partners)
• Criminal Insider Reach Extends Far Beyond Credit Card Fraud (Protenus)
• Patient Friendly Billing in Context (Sagacious Consultants)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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