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December 20, 2016 News 15 Comments

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HIMSS announces that President and CEO Steve Lieber will retire at the end of 2017. The organization has opened a search for his successor.

Lieber seems a bit young (63) to be retiring. The timing is interesting since EVPs John Hoyt and Norris Orms announced their retirement in February 2016, yet both are still working – Hoyt is consulting back with HIMSS Analytics and Orms is a VP of a recruiting firm.

About the only long-time senior executive left will be Carla Smith, who would seem to have a good shot at replacing Lieber unless the intention is to start over with a clean slate for whatever reason.


Reader Comments

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From Spilt Infinitive: “Re: like/dislike buttons for comments. Have you considered adding them? I like that online articles in the Economist, WSJ, NYT, etc. show me which comments are most liked by readers. It’s also satisfying when people ‘like’ my comments.” Good idea. I’ve added that capability to both articles and comments. You are now free to like and be liked as much as you like.


HIStalk Announcements and Requests

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An anonymous vendor executive has once again donated $10,000 for use as DonorsChoose matching funds, meaning that for every dollar donated by HIStalk readers, the executive will match it (along with likely other available  matching money from the corporate partners of DonorsChoose). I’m not soliciting donations since charitable contributions are a personal decision, but those who want to get extra bang for their educational donation buck can do this:

  1. Purchase a gift card in the amount you’d like to donate.
  2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
  3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
  4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers.

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Ms. M from Illinois expressed a lot of appreciation for our funding of her small DonorsChoose grant request (around $100) to provide nine sets of headphones for the reading center of her elementary school special education class. Students started using them the day they arrived, as she explains, “The morning of this grant getting funded, I had to throw away all of our classroom headphones because the ear pieces broke from wear and tear. All I can say, is that you made my students feel so special and they had the biggest smiles on their faces. I sincerely thank you for making such a significant sacrifice to our classroom.”

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HISsies nominations remain open. I’ve received only 12 responses that may or may not be representative of popular opinion (I can tell you for sure that some of them are way out there), so don’t blame me if major omissions creep onto the final ballot because you didn’t nominate obvious choices.

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Welcome to new HIStalk Gold Sponsor Dynamic Computing Services. The nationwide staffing and IT consulting firm — founded in 1990 by Gary Sherrell — has offices in Austin, TX and Maple Valley, WA. Healthcare makes up more than 50 percent of its business, where it has placed more than 3,100 resources and earned an 80 percent repeat business rate. DCS services include staff augmentation, legacy support, optimization, project management, analytics, and technical services. The company has completed 1,200 health IT projects – 200 of them involving Epic’s systems – and supports all major EHR vendors. Candidates can check out their open positions. Thanks to Dynamic Computing Services for supporting HIStalk.

A slight majority of poll respondents think I should list contract extensions and upgrades in my “Sales” section, but some commenters agree with me that we’re mostly interested when a hospital switches vendors. Others, however, point out that the hospital may have undertaken a full product search before re-upping with their same vendor (even though we have no way of knowing if that’s the case) and that might make it newsworthy. I think I’ll go this route – I won’t run contract extensions or seemingly minor expansions of the original agreement (like adding one more minor module when re-upping), but a product conversion like Meditech Magic to EHR or Soarian to Millennium is probably newsworthy.

To my fellow progressive music fans: Yes is finally chosen for induction in the Rock and Roll Hall of Fame after three tries. The Hall-accepted lineup contains the obvious choices from the dozens of musicians who have been part of Yes over its nearly 50 years – Anderson, Bruford, Howe, Rabin, Squire, Wakeman, White, and Kaye (I would have omitted Rabin and included Peter Banks). Yes shares a dubious distinction with its fellow 2017 inductee Journey: both bands tour today with a sound-alike replacement lead singer they found by watching YouTube videos of crappy tribute bands covering their hits, keeping the cash registers ringing from non-purist fans who just want to hear familiar heyday hits in a slightly elevated form of karaoke. It will be awkward if the bands play at their induction since they have three choices: (a) reconfigure in an uncomfortable, temporary reconciliation that omits current members who weren’t named; (b) play without key personnel from their glory years; or (c) fill the stage with a bevy of former and current members like Yes did on its cobbled-together and dishonestly named Union tour of 1991 that was more of a redundancy-filled, synergy-seeking corporate merger than an organic (no Wakeman pun intended) artistic effort.


Webinars

January 18 (Wednesday) 1:00 ET. “Modernizing Quality Improvement Through Clinical Process Measurement.” Sponsored by LogicStream Health. Presenters: Peter Chang, MD, CMIO, Tampa General Hospital; Brita Hansen, MD, CHIO, Hennepin County Medical Center. The presenters will describe how they implemented successful quality governance programs, engaged with their health system stakeholders, and delivered actionable information to clinical leadership and front-line clinicians. Q&A will follow.

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Charlotte Brien, MBA, solutions consultant, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.


Acquisitions, Funding, Business, and Stock

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TPG Capital will acquire healthcare software vendor Mediware from its private equity owner Thoma Bravo. TPG’s portfolio also includes Evolent Health, PatientSafe Solutions, and Quintiles.

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India-based cloud services provider 8K Miles will acquire healthcare consulting firm Cornerstone Advisors Group for $10.25 million in cash and stock. Cornerstone was founded in 2008 by Keith Ryan, who was previously CIO at Stamford Health System and Elmhurst Memorial Hospital. Reader Dave notes that the acquiring US entity had $5 million in profit on $27 million in revenue last year, with the overall entity reporting $40 million in revenue.

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Active aging app vendor GreatCall acquires remote monitoring technology company HealthSense.


People

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Gil Enos (EHealth Intelligence) joins WiserMazars LLP’s healthcare consulting group as principal.

Digital rehab technology vendor Reflexion Health hires Sudipto Sur, PhD (Signal Genetics) as CTO.


Announcements and Implementations

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BayCare (FL) implements an electronic screening system for newborns that allows sending EHR-stored patient information electronically to the state’s department of health.

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University of Miami Health System (FL) will take over 17 Walgreens retail clinics in South Florida and will use the drug chain as its exclusive retail pharmacy provider. Both organizations use Epic.

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Caradigm enhances its population health management solutions to support MACRA and bundled payments, adding Care Bundles, Content Builder, MACRA solutions, Advanced Computation Engine, and Utilization and Financial Analytics.

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A Healthgrades survey finds that most consumers would choose a doctor who has limited appointment openings but who offers online scheduling over a more available doctor who schedules appointments only by telephone. Two-thirds would be willing to trade a convenient location for being able to schedule online. The company’s new physician directory enhancements include online scheduling, smart reminders, and Google Maps integration. I only wish Healthgrades would eliminate the entirely incorrect inclusion of the non-specific, redundant social title “Dr.” in front of the name that already includes the correct designation of “MD.”

Iatric Systems is developing IV-EHR interoperability with Hospira’s smart infusion pumps using its Accelero Connect technology. 


Government and Politics

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ONC’s Director of Public Affairs and Communications Meghan Roh joins Epic as director of public affairs. I don’t know if this is a newly created position, but it’s interesting that Epic is hiring someone with quite a bit of political and government experience.

A Massachusetts law takes effect January 1, 2017 that requires doctors to give patients electronic access to their medical records and to use EHRs that are connected to the Massachusetts Health Information Highway.


Privacy and Security

From DataBreaches.net:

  • A Texas company that provides elective ultrasound baby pictures exposes its images, physician reports, and employee information to Web searches after misconfiguring a server to activate an unsecured RSYNC directory synchronization protocol.

TMZ reports that UCLA Medical Center (CA) may discipline several dozen employees who couldn’t resist snooping around in the medical records of Kanye West during his recent breakdown-triggered stay. It’s not the most reliable source, but the story is easily believable since not only is Kanye a big celebrity, he lost it publicly while performing


Innovation and Research

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Glytec earns its sixth patent for precision diabetes management technologies related to its SaaS-powered eGlycemic Management System that provides personalized insulin dosing, enterprise glucose surveillance, and analytics.


Other

An AHRQ-authored Health Affairs article raises concerns about the financial burden caused by high-deductible health insurance policies. I might take the contrarian approach in suggesting that high-deductible plans were created for exactly that reason – to encourage better self-care and rational health choices while exposing high prices in hopes healthcare competition will kick in (note: it hasn’t – the big just keep getting bigger). Our healthcare dollars provide way too much profit for the companies and people involved, but we also need to change the attitude that health and healthcare costs should be convenient.

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Jordan Shlain, MD is a good writer whose latest work, “Medicineball is the new Moneyball,” argues that doctors need to develop a data perspective for the good of patients. He says,

The crazy thing is that doctors, and I am one, have historically not participated in the data collection game. This was just a artifact of geeky computer science engineers building crappy code that doctors hated using (and still, mostly do.) Data will give us a new perspective — A data perspective. This new illuminating presence is an opportunity that presents itself once in a generation. We can now see things in a new light.

This puts doctors into the precarious position of being in the “if you’re not at the table, you may be on the menu” paradigm. Physician data is currently collected by EMR vendors, insurance companies, laboratory and radiology companies, pharmacies, revenue cycle management companies, and a host of other third parties — but not the doctor….or if they do, it’s the exception. I have a hard time believing that your friendly, local insurance company will happily supply doctors all they data they want. This data is expensive, comes at a premium, and is viewed through the lens of market share; not necessarily patient care. Doctors need to step up and start collecting their own data.

A New York Times article questions whether taxpayers get a good deal when NIH researchers help develop promising immunotherapy cancer drugs that are then licensed to drug companies that will make millions of dollars. Critics point out that taxpayers paying for the drugs twice — once to develop them, then again in buying them at high list prices since Medicare isn’t allowed to negotiate prices. NIH gets a tiny chunk of the proceeds as royalties, but has removed from its contracts a requirement that the drug companies sell the products at a “reasonable price.” The article notes that a  prostate cancer drug that sells for $129,000 per year in the US (two to four times what other countries pay) netted UCLA $500 million when it sold its royalties, but NIH says it’s not qualified to determine whether the price is reasonable and thus likely to make it unavailable to most people. 

An article notes indignantly but unsurprisingly that “pharmaceutical distributors have been quietly stocking pharmacy shelves with these pills in areas where addiction is the highest,” with a single West Virginia pharmacy in a town of 300 people receiving 9 million narcotics tablets to resell in two years. The article fails to mention that those doses were dispensed because they were prescribed by doctors and presumably requested by patients, both of whom escape the article’s misplaced wrath in shooting the literal messenger. The same investigative reporting methods could probably self-righteously proclaim that McDonald’s, during the same time period, sold a lot of hamburgers to massively overweight West Virginians. The key in both cases is to reduce demand, not complain that suppliers meet it.

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A JAMA-published observational study finds that Medicare patients managed by female intensivists experience lower mortality and readmission rates than those who are managed by their male counterparts. The authors cite previous studies in which female doctors were found to be more likely to practice evidence-based medicine, deliver more patient-centered care, and approach problem-solving more deliberately. The difference is not large enough to get excited about (despite the moronic USA Today headline above), but my takeaways are: (a) anyone who thinks female doctors are somehow less competent – if indeed any of those folks are still around — can see how wrong they are; and (b) it would also be interesting to similarly look at outcomes by country of medical training and the age and personality type of the doctor. I’ve worked with some flamingly incompetent physicians and many of them were questionably qualified foreign medical graduates, but that was a long time ago when standards were lower and this was in geographically undesirable areas where most of the dangerous docs were unmotivated locals or overseas opportunity-seekers. I would be happy now to have a doctor who graduated outside the US, especially since their educational system is a lot better than ours.


Sponsor Updates

Holiday Activities

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PerfectServe employees are supporting charitable programs that include donating duffel bags packed with personal items for adolescents completing treatment services; providing financial support to a co-worker who lost belongings in an apartment fire; collecting food and supplies for families affected by the Gatlinburg, TN fires; and collecting food for the Chicago food bank.

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Cumberland Consulting Group team members wrap presents for the Youth Villages Holiday Heroes Program in Nashville.

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The Ingenious Med sales team creates care packages for The Packaged Good.

  • The Chartis Group publishes a white paper titled “Post-Election Analysis: Strategic Imperatives for Providers in an Uncertain Landscape.”
  • Besler Consulting releases a new podcast, “The potential impact of the Tom Price nomination as HHS Secretary.”
  • MModal is awarded a three-year agreement as an awarded supplier to Vizient’s Novaplus, its exclusive provider of clinical documentation improvement.
  • Black Book’s latest user survey ranks Oracle Healthcare Cloud the number one ERP solution for value-based care processes.
  • InstaMed opens registration for its User Conference 2017 March 27-29 in Philadelphia.

Blog Posts


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Currently there are "15 comments" on this Article:

  1. Re: “The same investigative reporting methods could probably self-righteously proclaim that McDonald’s, during the same time period, sold a lot of hamburgers to massively overweight West Virginians. The key in both cases is to reduce demand, not complain that suppliers meet it.”

    I find this analogy incredibly ignorant and lacking in empathy. Let’s not blame drug cartels, gun manufacturers and cigarette companies while we’re at it. If only stupid, moronic simpletons knew better than to buy such products, these evil entities would not exist! I’m not the biggest drug addict advocate, but I know a lot of people were told they would not become dependent on opioids when they were originally prescribed them.

    Please read Drug Dealer, MD, a recently published book that explains a lot of the contributing factors to the current opioid epidemic in the US. I think you’ll feel differently about “pharmaceutical distributors” after you read some history.

    https://www.amazon.com/Drug-Dealer-MD-Doctors-Patients/dp/1421421402

  2. Well, your musical tribute to Yes certainly contained an ocean of topographic de-tales, I must say.

    [From Mr H] no credit to me – I’m just the Relayer.

  3. Re: RNR hall of fame 3x a charm for YES, Mr H, as their fellow inductees would have told you “Dont stop believin’.” 🙂

  4. Now we get to the real outrage of the HISTalk world. Neither Deep Purple NOR The Scorpions are in RocknRoll Hall of Fame! Appalling!

    [From Mr H] Any group with both Jon Lord and Ritchie Blackmore should be a shoo-in!

  5. PERFECT!
    “I might take the contrarian approach in suggesting that high-deductible plans were created for exactly that reason – to encourage better self-care and rational health choices while exposing high prices in hopes healthcare competition will kick in (note: it hasn’t – the big just keep getting bigger). Our healthcare dollars provide way too much profit for the companies and people involved, but we also need to change the attitude that health and healthcare costs should be convenient”

    The least regulated industry, who has yet to sacrifice margin, in the entire healthcare ecosystem is BIG HEALTH INSURANCE!.

  6. Yes Please on Carla Smith taking over as HIMSS CEO. She is smart, insightful and in touch with healthcareIT. I would very much welcome her expanded leadership!

  7. re:Publius comment — I agree with Mr H that demand is the issue. Finding solutions to reduce or eliminate demand is the solution rather than try to control supply. Someone, legal or not, will fill the supply chain if demand exists. Mr H did not demonize the addicts just the report.

  8. Re: rxpete comment – Tell that to the families of all the people that died of opiate overdoses. This isn’t a supply issue, the problem is morally-devoid drug addicts. But look Pete, I know you have your quotas to meet, so keep pushing those opiates.

  9. For years I’ve snubbed the RnR Hall of Fame. 1) The gala should be occurring in Cleveland; 2) Madonna? Run-D.M.C.? ABBA? Even as “influencers” of RnR?. Give a few years and classical musicians will be inducted.

  10. I think little Mr. Publius here is missing the point (that trying to stem demand is a far more effective long-term strategy than playing a game of whack-a-mole with suppliers) because of his weirdo need to frame everything in moral terms. The only crapping on ‘morally-devoid drug addicts’ is coming from the straw men dude is setting up.

  11. re: randy – Drug companies made considerable investments in driving up demand for opiates:

    “So for example, what they did was Purdue Pharma joined forces with the Joint Commission, and the Joint Commission is an organization that accredits hospitals, and Purdue Pharma gave all kinds of teaching material to the Joint Commission and said, ‘You really need to make doctors treat pain more aggressively and that needs to be a quality measure.’ So the Joint Commission said, ‘You know what? You’re absolutely right, and we’re going to do that and we’re going to take your videos that you made that tell doctors that opioids aren’t addictive as long as they’re treating them for pain.'”

    http://www.npr.org/sections/health-shots/2016/12/15/505710073/drug-dealer-md-contends-that-well-meaning-docs-drove-the-opioid-epidemic

    Now that the demand is increased due to their efforts in misleading doctors and patients, drug distributors and manufacturers argue that we shouldn’t point fingers at them? This is literally taken from the cigarette company playbook. I didn’t realize how many pharma shills read this blog. I thought it was mostly EMR and other healthcare IT people.

  12. re: Publius and Randy – I think you both have a very valid point. However, from an economic standpoint this is a demand issue. Supply side economics is just repackaged trickle down economics (not real). To attack a problem from an economic perspective your theory must be rooted in demand side when creating policy and action to address the issue. This has been proven time and time again throughout economic history.

    Now I think the thing we see with opiate demand is that it is very unique in the way this demand was created. It was largely created by suppliers (big pharma) pushing opiates onto docs when other pain treatments would have sufficed. The problem is when saying it this way it still sounds like the easy answer is to address the supply side (Big Pharma). However, this is not the case…the demand side (doctors and patients) are where the issue arises. Tackling this problem at the level of the patient and the clinician is where true progress will be made.

  13. re: High deductible plans – I hold that same contrarian view, with some caveats. You don’t buy car insurance for oil changes or homeowner’s insurance to keep your plants watered. Perhaps healthcare should be run on the same model. The question is whether the average patient would do the preventative maintenance necessary to keep the clunker running (the analog to oil changes – regular wellness checks?). I’m not sure that they do now, so you might not lose much, but you might gain the advantage of cost transparency and competitive pressures.

    There are some other devil-in-the-details moral hazards and incentive issues that would need to be worked through.

    The problem is that with the historically comprehensive employer plans and the plans ACA requires, people are now used to having their “oil changes” and “plant watering” covered without ever seeing the costs, they just magically get taken care of. Changing that mindset is going to be very hard, with lots of folks complaining about their right to decent healthcare being taken away.

  14. “The key in both cases is to reduce demand, not complain that suppliers meet it.”

    Hmmm. Why is it not possible to do both? Also, I’m simply not morally cool with giving suppliers of problematic products (opiates) a total pass. They are profiting from addiction and I’ll bet they well know it.

    The smart thing to do is to intervene at the control points of the system. The fewer people you have to identify and intervene with, the better.

    When you can establish that “…a single West Virginia pharmacy in a town of 300 people receiving 9 million narcotics tablets to resell in two years”, that seems like a pretty big red flag. So use that red flag. It’s a sign of trouble and that should be step one.

    Step two is to start interviewing prescribers and inquiring about their clinical practices. Simply asking questions will send a big message. They have clinical practice guidelines and I’ll bet some prescribers aren’t following them. However they are liable through the AMA and that’s a huge lever.

    Step three is to offer more addiction treatment services to the patients. Now you are directly addressing the demand side, but progress will be slow. That’s part of why you don’t want this to be the only response.







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Reader Comments

  • PM_from_haities: While I support moral stands, the reality is there are only so many health systems and starting new ones is nearly impos...
  • RollingMyEyes: Re: Opioid statistics. Interestingly, under President Trump's proposed budge, AHRQ's budget will be cut by 18% and it wi...
  • Stephen Fiehler: I see Apple continue to nibble on healthcare IT without taking a major plunge, such as buying athenahealth [ATHN], like ...
  • LFI Masuka: "Fortunately, my schedule doesn’t allow...." Your words say that this is bad, but then as a business, you don't back ...
  • Jonathan: Does anyone have the scoop on why Ben Chu so abruptly left Memorial Hermann?...

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