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News 8/28/15

August 27, 2015 News No Comments

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CMS provides results from its July round of ICD-10 testing in which no claims were rejected due to CMS software problems. Around 2 per cent of submitted claims had invalid ICD-10 codes, less than the number of claims that had incorrect ICD-9 codes. It’s important to note that the overall 87 percent claim acceptance rate includes claims that were submitted with intentional errors just to make sure CMS would kick them out. Also, the claims originated in test environments, which created errors that would not have occurred in real life.


Reader Comments

From Beltway Bandido: “Re: VA and Lockheed/Epic. I hear from talking to multiple groups that there’s a real risk to the success of the VA’s MASS scheduling system. Mainly concerns about the program’s long-term viability and the risk of adding a best-of-breed bolt-on for scheduling vs. a wholly integrated solution. Somewhat related, I’ve heard that the Coast Guard’s move to InterSystems for interoperability could be a transitional play as they downshift away from Epic. Lots of moving parts in DC right now.” The VA’s very existence was threatened by their appointment wait time scandal, so they had to fast-track their selection of a commercial solution even though, as is nearly always the case, the problem was caused by the VA’s people and the incentives provided to them rather than their technical tools. The VA neatly sidestepped Congressional demands for firings, reorganization, and funding decreases by simply throwing its scheduling system under the bus and signing up for Epic. I don’t know what it will take to compartmentalize Cadence to run without any other Epic apps and then integrate it with the VA’s systems, but I do know that standalone healthcare scheduling systems have fallen by the wayside given the need for integration. It also seems that $624 million is a lot to spend for automating a single function, but then again both the VA and DoD are used to squandering mountains of taxpayer money on systems that are often failures in every way except as never-ending revenue streams for the chosen contractor. Epic now has a foot in the VA’s door should it ever decide to part ways with VistA. The other unspoken aspect of both the VA and DoD is that a lot (most?) of the care received by current and former service members is delivered by the private sector using non-government IT systems, creating a big information flow problem no matter which systems are used internally. I’ve often argued that the VA’s hospitals and clinics should be closed or privatized since it seems unnecessary to run a separate domestic healthcare system for civilians whose history includes military service, as long as their special needs are recognized and accommodated (which even the VA struggles to do).

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From Lavosh: “Re: VA scheduling announcement. How did you get the information before anyone else? Leaks?” There were no leaks, but readers tipped me off that the announcement would be made that day and also provided the unstated major point that Epic is the subcontractor. I try to deliver only three things via HIStalk: (a) well curated and highly condensed news; (b) ideas that someone might use to create or improve something in healthcare; and (c) occasional entertainment.

From Beefy Goodness: “Re: healthcare IT contract gag clauses. I saw proof they exist in an online summary.” Of course they exist – any of us who have signed contracts on behalf of hospitals know they are common. You could have looked them up in CapSite’s database of signed contracts (obtained under Freedom of Information Act requests) until HIMSS bought that company in 2012. The most restrictive, controlling, and sometimes irrational terms I’ve seen were in Epic contracts, copies of which are almost impossible to get since Epic tells customers to forward any FOIA requests to its attorneys to be fought tooth and nail (or at least that used to be the case). The important aspect to note is that clients sign the contract willingly and knowingly, so any muzzling is voluntary and nobody else’s business. Still, I’ve always been amazed in looking at contracts from all vendors that hospitals don’t negotiate well and just accept the vendor’s favorable boilerplate.

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From HIT Wannabe: “Re: CHIME. So disheartening to come across this tweet. Aare they so hurting for cash that they are willing to go to any lengths on social media for a vendor? Forget that this vendor’s solution isn’t certified for any of the leading EMRs used by CIOs that follow CHIME.” Tweeting a link to a vendor’s promotional material is a pretty lame thing for a non-profit member organization to do. The vendor in question is equally stupid – they require anyone interested in their crappy white paper to provide 15 data fields of information, some of which are maddeningly clueless, like asking which industry the requestor works in (maybe they get a lot of hospital white paper requests from people in the mining and entertainment sectors.) CHIME is apparently in cahoots with a big media company and is now shilling for it, judging from some of its tweets. I feel equally violated when I get webinar and white paper spam from HIMSS, to whom I’m paying dues for the privilege of having them pimp out my electronic access to any willing vendor.

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Speaking of CHIME tweets, this one about the AMDIS Fall Symposium showcases either atrocious spelling or keen wit.


HIStalk Announcements and Requests

I’ve been frustrated for months with iPhone charging problems. The Lightning socket seemed to be loose, forcing me to use one specific cord (of the handful I have) and wiggling it just right. Googling seemed to indicate that the most likely problem was gunk in the port, so I dug around with a toothpick even though I couldn’t see anything in there with a flashlight. I figured I needed a socket replacement since it seemed quite loose, but the Genius Bar guy at the Apple Store fixed it by doing what I had tried only more professionally — he used a small tool to clean the port out and then blew it clean with canned air. The looseness was caused by the cable not being able to seat itself. He also cleaned out the microphone and speaker holes that were stopped up. This is apparently a frequent, gender-related problem caused by guys like me who carry their phones in linty pockets.

This week on HIStalk Practice: HelloMD CMO Perry Solomon, MD explains the company’s pivot from telemedicine to digital health for medical marijuana. The FSMB relaunches Docinfo database. Jaan Health secures $1 million for its Phamily care coordination platform. Arete Urgent Care goes with DocuTap tech, while The Iowa Clinic selects VirtuMedix for telemedicine services. Texas physicians just can’t catch a break. DuPage Medical Group CEO Mike Kasper details the impact BCBSIL claims data will have on patient care. Telemedicine comes to Ghana cocoa farmers. Patchy EHRs could be Precision Medicine Initiative’s biggest stumbling block.

This week on HIStalk Connect: Google shuts down its Google Flu Trend project, but will continue to provide public health researchers with access to its data. Bayer unveils the second class of startups to join its Berlin-based Grants4Apps accelerator program. Researchers with UC San Diego develop a fish-shaped microrobot with forward propulsion and sophisticated remote steering capabilities. Cambridge, MA-based PillPack raises a $50 million Series C funding round to expand its online pharmacy and add brick and mortar locations.


Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Medical Specialties Distributors acquires VerbalCare, whose app allows inpatients to communicate with nurses.


Sales

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Adventist Health System (FL) chooses MyRounding’s patient feedback collection tool.


People

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Ted Schwab (Strategy&) joins Huron Healthcare as managing director.

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Health Catalyst hires Dan Strong (Control4) as CFO, moves co-founder/EVP Tom Burton from product development to client operations, and promotes Dale Sanders to EVP of product development.

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Jim Pesce has retired from McKesson Enterprise Information Solutions after over 50 years in healthcare IT. Industry historian Vince Ciotti provides this review of Jim’s career: “Jim started his career in the mid-1960s with GE’s Medinet product in Boston – he actually had Larry Polimeno of later Meditech fame working for him as a night-shift computer operator. He went to McAuto in the 1970s, where he ran implementations in their Northeast region. He left McAuto for Micro Healthsystems in NJ, where his major mistake was to hire me to head up sales of their MedTake bedside system – I failed miserably! Graham King took over Micro after leaving SMS and the two of them then went to McKesson when it acquired Microin the late 1990s. Graham sent Jim to Charlotte to shut down the failing Paragon project in 2001, but Jim was so impressed by it he went back to Atlanta and told Graham they should save it. Graham said OK, then you head it up. The rest is HIS-tory.”


Announcements and Implementations

CVS will expand its in-store telemedicine capabilities and is working on pilot projects with American Well, Doctor On Demand, and Teladoc.


Government and Politics

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CMS announces that William Rogers, MD, director of its physician regulatory issues team, will serve as its ICD-10 ombudsman.

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The White House has always downplayed concerns that insurers would jack up rates following implementation of the Affordable Care Act, but state regulators are approving big increases that include a 36.3 percent hike by BCBS Tennessee and a 25.1 percent jump for Kentucky Health Cooperative. Experts say insurance companies bid low in the first two years of the ACA but have incurred losses because enrollees were sicker than they expected. Everybody else, being wary of insurance companies, assumes it’s just greedy business as usual. So much for “affordable.”


Privacy and Security

A KPMG survey finds that 80 percent of healthcare organizations have experienced at least one cyber breach, but the survey’s methodology is too shaky to earn the big headlines it’s getting: (a) only 223 healthcare executives responded and the method of their selection was not stated; (b) the survey mixed providers and payers, with fewer than half of respondents working for non-profits; (c) seventy percent of respondents were from companies with more than $1 billion in revenue, meaning either large health systems or large vendors. Perhaps the lack of a valid respondent cohort is responsible for the survey’s most questionable finding – employees (via theft, breaches, and negligence) came in at only #3 on the list of greatest vulnerability concern despite the fact that nearly every large healthcare breach is caused by successfully phishing employee emails.

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The VA OIG finds that VA employees are using the Yammer collaboration tool without approval, to the point that its former CIO broke the VA’s rules in conducting an open chat using the Microsoft-owned platform. OIG notes that the Yammer setup had no defined administrator, the access of departed employees wasn’t removed, it encouraged employees to break VA policy by sharing files, and it gave employees a convenient way to waste time much as they would using Facebook. The report says the Yammer “network” was created inadvertently when the first VA employee signed up for it using their @va.gov domain without approval. The VA had considered buying an enterprise license before Microsoft bought the company, but said it wasn’t worth $30 per seat.


Technology

Microsoft announces that Windows 10 is running on 75 million devices just four weeks since its release. My experience has been perfect since I had to get an expert to fix the networking DLLs that were trashed in a Windows update. I can’t say Win10 has changed my life, but my laptop seems to run more smoothly with lower CPU and disk utilization and some of the app replacements (the Edge browser and whatever the new media player is called) work much better.


Other

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Fast Company profiles Zoom, an ambitious, design-focused company that has expanded from walk-in clinics to offering full medical care and insurance from 28 locations in Portland, OR. The company focuses entirely on tech-savvy young people in offering its lifestyle product, saying that “one of the weaknesses of healthcare is trying to be all things to all people.” Founder Dave Sanders, MD admires Apple’s philosophy of not letting someone else control the user experience, saying that “we have to own you” as contrasted to the fragmented, wholesaler-like approach of health systems.

North Shore-LIJ Health System (NY) posts patient survey-generated ratings of its doctors online.

A study finds that medical students who were asked to evaluate their instructors rated a fictitious one, not noticing that the instructor name and photo were unrelated to their coursework. The authors conclude that basing faculty promotions and course design on student evaluations is probably not a good idea. Perhaps they will next look at how patients review doctors and hospitals.

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Weird News Andy headlines this article“Suicide prevention? There’s an app for that.” Researchers find biomarkers that when used with a mood questionnaire, can predict suicidal thoughts with 90 percent accuracy. Most interesting is that the questionnaire alone was 80 percent predictive, but just the blood analysis by itself was correlated with suicidal thoughts with 70 percent accuracy. However, WNA questions the results of a researcher who, judging from the photo, “is apparently not wise enough to close a freezer with valuable samples inside.”


Sponsor Updates

  • Medicity offers “Keeping the Data Thieves Away.”
  • Wolters Kluwer Health will exhibit its Health Language solutions at Epic UGM next week.
  • Hayes Management Consulting posts “The Imperfect Checkout Process: 6 Steps to Enhance Patient Experience.”
  • MEA/NEA offers “How to Encrypt Email Attachments, and Why You Should.”
  • MedData posts “The ABC’s of ICD-10: Comparing ICD-9 to ICD-10, Code Structure and Organization.”
  • Navicure offers “The Importance of Price Transparency – and How to Achieve It.”
  • Nordic publishes “Super users forever! Setting up an Epic super user program and keeping it running.”
  • NTT Data offers “The Transition to Data Science Architecture.”
  • NVoq asks “Are you ready for ICD-10? SayIt can help!”
  • Orion Health oposts “The Role of Open APIs in Healthcare Interoperability.”
  • Patientco offers “Consolidating Patient Payment Channels for Revenue Cycle Success.”
  • PatientKeeper writes “Big Data, Big Company, Big Possibilities.”
  • PatientPay releases a video showcasing its services (and Sharpie prowess).
  • PerfectServe offers “Patient Centered Medical Home model – Rewards of a successful transformation.”
  • PeriGen’s PeriCalm CheckList is named a finalist in the Annual Innovations in Healthcare ABBY Awards.
  • Phynd Technologies offers “The Differences between Phynd’s Unified Provider Management Platform and a Data Warehouse.”
  • PMD offers “It Takes a Village: Shared Accountability in Patient Care.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 27, 2015 News No Comments

News 8/26/15

August 25, 2015 News 1 Comment

Top News

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The VA awards its Medical Appointment Scheduling System (MASS) bid to one of its often-used contractors, Lockheed Martin-owned Systems Made Simple, which earns a seven-year, $624 million contract. The software supplier will be Epic, which gives the company a big win following the Leidos-Cerner-Accenture DoD selection. The VA issued its RFP for a commercial patient scheduling system in November 2014 following a nationwide patient wait time scandal. Lockheed Martin acquired the government healthcare IT contractor in October 2014 for an undisclosed price.


Reader Comments

From 4nER: “Re: Optum’s international push. It has dwindled – their UK-based CEO has left, Brazil acquisition Amil is struggling, and Virgin Care has beaten Optum in many NHS bids.” Unverified.

From You Don’t Need a Weatherman: “Re: Meditech. Opinion is they got into ambulatory and Web too late. As sites wait for MU Stage 3 and evaluate their vendors, Meditech is being evaluated by those sites. The timing may be perfect as Web EHR and Acute will be rolling out of 6.X as Stage 3 progresses.”

From Mark Pro: “Re: marketing people. You complain a lot about them. Don’t they do anything well?” As in most professions, the few incompetent, inexperienced, or overworked ones give the others an undeserved black eye. My favorite MBA topic by far was marketing (my second favorite was finance, strangely enough) and I really enjoyed learning about product positioning, channels, how marketing differs from advertising, etc. Marketing done right is education, collaboration, and orchestrating the intersection of product supply and customer demand. What puts a healthcare IT marketing person on my bad side:

  • Putting out incomprehensible announcements that are a BS buzzword tsunami clearly assembled by a roomful of people who are trying to advance their personal company stature rather than create clarity.
  • Expecting instant responses to their banal emails, always “circling back” because I’m too busy doing something important (like writing HIStalk) to respond immediately to their unsolicited questions. Just because you sent something I didn’t ask for doesn’t mean I’m obligated to acknowledge that I received it or to do anything more than hit “delete.”
  • Trying to do everything by committee, bugging Lorre to get on a call with a roomful of their people and then flooding her inbox with emails from each of them asking and re-asking questions she already answered. Usually that happens after they fail to read what she sent them earlier, preferring instead to waste everybody’s time in having it read to them over the phone.
  • Not following my rules, such as checking off the Readers Write submission box that says the article hasn’t appeared elsewhere, but then I find it posted on their company blog (I always Google before I run a guest post). That usually gets them banned.
  • Asking me to interview a brand new CEO (who doesn’t even know where the restrooms are yet) or an executive involved in a product launch (gee, wonder if they’ll say anything controversial?)
  • Not understanding the dynamic that I alone decide what I write, who I interview, or which products or news I consider worthy of reader time. I’m fine with companies suggesting that I interview their CEO, but I won’t allow marketing or PR people to participate. Lorre books most of the interviews for me and warns them upfront, “If he gets on the interview call and people other than the CEO are on the line, I guarantee you he’s going to hang up.” I like that nobody can whine over my head about my decisions – it’s just me, I have a long memory, and I won’t even pretend to like people who annoy me.

The marketing people I consider peers:

  • Are not new to healthcare IT, having paid their dues and learned the business, which probably means they have lost their youthful, chirpy innocence and can communicate as professionals.
  • Enjoy HIStalk and follow it even after they change jobs, often keeping in touch afterward.
  • Offer me what I need instead of what the company wants, perhaps offering to arrange an interview with a customer instead of a company executive who I’d turn down (I only interview CEOs except in rare occasions.)
  • Know not to waste my time with ghostwritten, worthless Readers Write articles that I’ll reject anyway.
  • Apologize when I call out an announcement, a newly rebranded product, or a company action as idiotic – sometimes they agree it’s bad, but explain that were overruled by the empty suits above them.
  • Request and accept my advice about how to improve an announcement, design and promote a webinar, or eliminate obvious mistakes or omissions in their web pages. I don’t volunteer to do that sort of thing, but if if someone asks and then ignores my input, I’m not going to jump at the chance to do them another favor.

HIStalk Announcements and Requests

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Jenn covered Monday’s post for me since I needed a long weekend, so I told her I’d set up a new poll when I returned. Last week’s poll respondents forced to make a big company investment would choose Health Catalyst by far, followed by NantHealth and Evolent Health. Mobile Man says Nant shows how little even smart people know about healthcare, while JR commented that some of the companies have decent prospects but he isn’t sure you’d get your money back investing in any of them at this point in their trajectory. New poll to your right or here: what will happen following the scheduled October 1 switchover to ICD-10?

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Welcome to new HIStalk Platinum Sponsor Stanson Health, which is also sponsoring HIStalk Practice at the Platinum level. The Los Angeles-based company provides easily implemented intelligent clinical decision support delivered at the point of care. Evidence-based content targets unnecessary tests and treatments while supporting Choosing Wisely and PQRS, while analytics helps organizations understand ordering patterns and identify opportunities. Of particular interest is the company’s advanced imaging content that works with any source of appropriate use criteria to reduce unnecessary imaging, inspecting 30 patient-specific data elements to minimize interruptions while tripling the inappropriate order cancellation rate compared to competitors. Cedars-Sinai Health System is saving $6 million per year after adding Stanson-powered Choosing Wisely recommendations into Epic (example: ordering an antibiotic for a patient with bronchitis issues a reminder that they don’t work for viral infections). The company also understands that patients may resist the “less medicine is sometimes better” message and has licensed content from Consumer Reports to provide them with friendly educational material. Stanson Health was co-founded by Scott Weingarten, MD, MPH (formerly co-founder and CEO of Zynx Health, now SVP/chief clinical transformation officer at Cedars-Sinai) and Darren Dworkin (SVP/CIO of Cedars-Sinai). I notice that Rick Adam is president and COO – he’s been in the industry forever as founder of Recondo Technology and New Era of Networks as well as being an executive in the early health IT days of Travenol (later Baxter). Thanks to Stanson Health for supporting HIStalk and HIStalk Practice.

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Thinking about Rick Adam sent me to the online archives, where I turned up this exclamation-point filled 1986 THIS ad from Computerworld. I haven’t been able to track down Frank Russo, who took the company through a few more gasping iterations before turning the keys over to Jeff Goodman, who was axed after the company was sold to HBOC in 1994.

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Mr. S wrote that his third grade class in Herminie, PA benefited from our contribution of STEM learning material (with matching funds from Chevron) just as the school year ended, giving his students new materials to master tricky topics that had come up through the year. He adds, “It is very important to give students every means possible of succeeding in life. Not every child learns the same way and not every child is interested in the same topics. These materials have allowed my students to succeed in my classroom in new ways and new topics. Thank you for caring about education and specifically caring about my classroom!” I still have matching money available from a generous vendor executive for companies that would like to contribute to other DonorsChoose projects via HIStalk now that the new school year is underway.

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Also from my DonorsChoose project, Teach for America teacher Ms. S in Illinois, who offers an extracurricular programming class that tries to boost the numbers of female, black, and Hispanic students interested in technology, says her kids responded with “soooo cool!” to see the MacBook accessories we purchased (SuperDrive, external hard drive, case, and cables). Our funding of $264 paid for the entire setup plus the optional donation to DonorsChoose.


Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Frank Poggio and Vince Ciotti delivered another brutally honest and opinionated HIStalk webinar on Tuesday, talking about the DoD EHR bid and how it will affect Cerner, Epic, and everybody else. I sponsored this one (meaning nobody paid anybody, in other words) and I’d be surprised if you don’t find it at least entertaining because people who’ve been in the business for a long time like Frank and Vince tend to have lost most of their muzzle and say whatever’s on their mind. If you have a non-commercial, informative, educational message that readers would enjoy, let me know and maybe you can do a webinar of your own.


Acquisitions, Funding, Business, and Stock

Cardinal Health will acquire 71 percent of Nashville-based post-acute care services and analytics vendor NaviHealth for $290 million in cash.

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Zephyr Health, which offers drug companies analytics to predict new product success using public and private databases, raises $17.5 million in funding led by Google Ventures, increasing its total to $33.5 million.


Sales

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The fire and ambulance services of Alameda, CA will use the Mediview patient care records, charting, and telemedicine pre-hospital application from Beyond Lucid Technologies.

Legacy Health (OR) chooses StrataJazz Continuous Cost Improvement as part of its five-year renewal for the full suite of Strata Decision’s products.

Missouri Delta Medical Center (MO) chooses PatientMatters for help with patient access, registration, and scheduling.

Vantage Oncology selects Wellcentive’s quality reporting and population health management solution for PQRS reporting.

Phynd Technologies recaps the six health systems that have recently signed for its Unified Provider Management Platform: Cone Health, Mount Sinai Medical Center, Kettering Health, Dayton Children’s Hospital, SCL Health System, and Presence Health.

Abington-Jefferson Health (PA) chooses the Paymode-X network from Bottomline Technologies to automate vendor payments.

Meridian Health (NJ) selects labor management solutions from Avantas.


People

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WeiserMazars LLP brings on Todd Heckman (PwC) and Jonathan Stromberger as consulting principals.

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Northern Inyo County Hospital (CA) hires Kevin Flanigan, MD, MBA (MaineCare) as chief medical officer/COO/CIO.

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Lisa McVey (McKesson) is named EVP for technology and operations at the newly opened Atlanta office of health improvement technology vendor BioIQ .

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Thomas Graf, MD (Geisinger Health System) joins The Chartis Group as national director of population health management.

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Renowned Texas surgeon James H. “Red” Duke, MD died Tuesday at 86. He was an Army veteran, professor, trauma program developer, TV personality, and cowboy folk hero. He treated President John F. Kennedy and Governor John Connally at Dallas’s Parkland Memorial Hospital on November 22, 1963 while a surgical resident. Those of a certain age will remember him from a riveting episode of the groundbreaking 1978-1979 NBC reality medical program “Operation: Lifeline” and his 15-year stint as a nationally syndicated health reporter.


Announcements and Implementations

Cerner and Hospira will further integrate the former’s EHR with the latter’s smart IV pumps using Cerner’s CareAware iBus.

Imprivata launches PatientSecure, the palm vein scanning biometric patient ID system it acquired as part of its April 2015 acquisition of HT Systems. 

Five Cerner clients in the Pacific Northwest will use CommonWell to exchange information with practices using Greenway, Athenahealth, and other systems connected to CommonWell.

Modern Healthcare names its 2015 Best Places to Work, which like every healthcare magazine’s “list” has as its primary objective selling advertising rather than conducting useful, scientifically valid research. Still, I’ll mention those HIStalk sponsor companies so named since (a) they like the recognition; (b) the awards really are driven by employee surveys; and (c) they’re good companies in multiple ways at least from the folks I know from each one: Burwood Group, CoverMyMeds, CTG Health Solutions, Cumberland Consulting Group, Divurgent, Galen Healthcare Solutions, Hayes Management Consulting, Health Catalyst, Impact Advisors, Imprivata, Park Place International, Santa Rosa Consulting, The Advisory Board Company, and The Chartis Group.

Practice Fusion will connect to Theranos for labs and RadNet for imaging in two states, collecting fees from those companies in return for connecting them with its users (that and selling supposedly de-identified patient data and pushing ads at doctors are its main revenue sources). We’ll see some interesting figures if the 10-year-old company ever does an IPO given its suggested market value of $700 million. All of that revenue requires keeping its free EHR users happy, so perhaps the incentives are well aligned for everyone.

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Medical kiosk vendor HealthSpot will roll out a new Samsung blood chemistry analyzer that will give patients their results for certain blood tests in seven minutes. It’s fascinating how quickly the tedious lab draw and results reporting process is disintermediating, just as dramatically as when lab techs were mostly replaced with sophisticated high-volume instruments, which in return came about because of regulations and when big reference labs convinced individual medical practices to stop running their own labs. With Theranos already doing tests without a doctor’s order in Arizona, the whole process may soon be in the hands of consumers.


Government and Politics

A US appeals court says hotel operator Wyndham Worldwide can be sued by the Federal Trade Commission for allowing hackers to breach its systems in stealing the credit card information of 619,000 customers. Wyndham argued that the FTC had exceeded its powers similar to being allowed to “regulate the locks on hotel room doors,” while the court responded, “Were Wyndham a supermarket, leaving so many banana peels all over the place that 619,000 customers fall hardly suggests it should be immune from liability.”


Privacy and Security

An interesting article (with healthcare consumer implications) says future currency will be data, not money, and everybody’s personal data is being taken by social networking companies whose terms of service allow them to steal photos and files under the pretense of improving their product. The interesting conclusion: perhaps individuals (and patients) should create their personal API that puts the ownership and control of the information back into the hands of the person to which it pertains. The discussion was triggered by new terms of service from streaming music Spotify, which requires users to give the company access to their photos, contacts, and device locations.


Technology

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A web ad piqued my curiosity about PillPack, a Boston-based online consumer pharmacy that just raised $50 million to expand its reach in offering individual prescription dose packs broken out into time due. The company manages all aspects of the prescription, from packaging and shipping to insurance, and will use its new funding to open brick-and-mortar storefronts and to roll out an app that will connect patients to pharmacists. The founder-pharmacist, described as looking like “the guy who you might buy pot from at a Dead concert,” says, “We should probably hire a finance guy.”


Other

A Tennessee company that runs skilled nursing and rehab facilities is forced into restructuring after implementing an EHR that caused billing delays and cash flow problems that led to its defaulting on a loan. The acting CEO, a partner with the company hired to turn the company around, says he’s seen paper-to-digital conversions cause financial problems across the country.

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This is an unusual Craigslist ad.

BIDMC CIO John Halamka, MD says that in planning for FY16, clinicians spend too much time documenting in poorly designed EHR tools that were designed for capturing information, not managing customer relationships. He adds that consumer apps have raised user expectations and those will have to be bolted on to EHR transaction capabilities because “the difference between the $2 app and the $2 billion EHR is that the $2 app is easier to use, more convenient, and possibly even more useful.”

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Phoenix-based Banner Health, which bought Tucson’s University of Arizona Health Network in February and isn’t happy with that organization’s losses, will convert UAHN from Epic to its own Cerner system as everybody expected and will cut $100 million of UAHN’s overhead over the next three years. UAHN spent at least $115 million implementing Epic with a November 2013 go-live, which may be the only case where an over budget EHR implementation caused such significant financial woes that an academic medical center had to sell out to a competitor.

Texas physicians will be paid for school-based telemedicine consultations with Medicaid-enrolled students whose parents have signed consent forms starting September 1. Proponents say it will keep kids in school and parents at work instead of sending them both home, while opponents question why non-Medicaid students are excluded and whether remote physicians will have enough information about the students to treat them properly.

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Google shuts down its Flu Trends tracker, which got people excited for some reason back in 2008 even though its premise was ridiculous – that it could detect worldwide flu outbreaks by looking at search term patterns in a crude form of big data analysis. Not too shockingly, it didn’t work, and even if it had been able to identify outbreaks, the information would have done little to stop their spread. 

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Stanford University offers its online-delivered, $3,500 Genetics and Genomics Certificate. Just added to the curriculum is the elective course “Personal Genomics and Your Health,” which can be taken for $495.

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A bookkeeper of Buffalo, MN-based mammography informatics vendor PenRad Technologies is charged with stealing $700,000 from the company and using it to pay personal expenses and to buy silver bullion bars she stored in her house.

LA County’s second-highest-paid employee made $790,000 in 2014 without working a single day. The former chief medical officer of Harbor-UCLA Medical Center earned the money as a partial settlement after he was fired for unstated reasons (rumored to be related to his medical credentials), sued the county for defamation, then turned down its job offer and retired.

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New York’s Beth Israel Medical Center wiggles out of a $95 million lawsuit brought by the family of a wealthy heiress who claimed she was detained in a private room for several years solely to extract money from her when the statute of limitations runs out. The lawsuit charged the hospital with keeping the perfectly healthy woman in a $1,200 per day private room while hitting her up constantly for donations, including a $3 million painting the family said she donated under pressure.

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A state health department in Malaysia is investigating a doctor who posted a photo of herself flashing the peace sign along with a patient in labor whose genitals were fully exposed. The doctor had a reputation for taking perioperative selfies.

It’s not HIT-related, but if you need your spirits raised, check out this video sent over by The PACS Designer of the United States Navy Band performing hits by Frankie Valli and the Four Seasons.


Sponsor Updates

  • ZirMed Chief Data Scientist Paul Bradley, PhD will present at two upcoming big data conferences.
  • PatientSafe Solutions posts “Medication Reconciliation Safety Concerns Linger Even with EHRs.”
  • KLAS’s 2015 mid-year report ranks MModal’s Fluency for Imaging as the highest-ranking front-end speech recognition solution for diagnostic imaging.
  • Black Book Rankings names the Looking Glass enterprise content management system from Streamline Health Solutions as number one in financial management and content management solutions.
  • AdvancedMD offers “PRM Software Capabilities, part 2 of 2.”
  • Awarepoint offers a video on caregiver enablement via healthcare technology.
  • Besler Consulting offers “IPPS Advisor: In-depth review of the FY 2016 IPPS Final Rule.”
  • Bottomline Technologies will exhibit at the California Association of Healthcare Admissions Management event August 30-September 2 in Sonoma.
  • CoverMyMeds Director Julie Hessick is named a finalist for Technology Innovator of the Year at the Next-Generation Pharmacist awards.
  • Stanson Health will exhibit at UHC’s annual conference in Orlando and will participate in its Member Innovation Expo and Reception on October 1.
  • Culbert Healthcare Solutions offers “The Defining Moments Leading Up to ICD-10.”
  • MedCPU takes home the 2015 Interactive Media Award for Best Website in Healthcare from the Interactive Media Council.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 25, 2015 News 1 Comment

Monday Morning Update 8/24/15

August 23, 2015 News No Comments

Top News

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Mercy Health (OH) implements Premier’s integrated pharmacy and care management program to advance population health management initiatives at its 23 hospitals across Ohio and Kentucky.


Last Week’s Most Interesting News

  • Practice Fusion promotes Tom Langan to interim CEO, replacing founder Ryan Howard, who will move to board chair.
  • The executive exodus continues at NYC Health & Hospitals Corporation, with Paul Contino departing following an investigation of its $764 million Epic implementation.
  • Gene-sequencing company Illumina forms Helix, a business that will offer free genome sequencing to consumers and then monetize the data by selling portions of it back to patients as they need it.
  • ZocDoc raises a $130 million funding round on a $1.8 billion valuation, making it one of the most highly valued venture-backed companies in New York.
  • Leidos wins a $900 million contract to support R&D efforts within the US Army’s Medical Research and Materiel Command.
  • Epic is selected as the replacement EHR vendor for Finland’s Hospital District of Helsinki and Uusimaa, in a $424 million contract budgeted to grow to $635 million over 10 years.

Webinars

August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience.

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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San Francisco-based Zephyr Health lands $17.5 million in a funding round led by Google Ventures, with help from existing investors Icon Ventures and Kleiner Perkins Caufield Byers. The med device and biopharma analytics firm has raised $33.5 million since its founding in 2011.


People

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James Rossiter joins NextGate as CFO.

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Dawn Van Dyke (The Advisory Board) joins The Sequoia Project (fka Healtheway) as marketing director.

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Dean Schorno (Adaptive Biotechnologies) joins 23andMe as CFO and head of operations.


Sales

Cone Health (NC), Mount Sinai Medical Center (FL), Kettering Health (OH), Dayton Children’s Hospital (OH), SCL Health System (CO), and Chicago-based Presence Health sign on to the Unified Provider Management Platform from Kearney, NE-based Phynd Technologies.


Announcements and Implementations

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Cerner shop EvergreenHealth becomes the only hospital in Washington to avoid paying a hospital readmissions penalty for the fourth year in a row. The two-hospital provider achieved HIMSS Stage 6 recognition last month.

NHS facilities in Wye Valley and Salisbury announce plans to move from decades-old patient administration systems to “electronic patient record systems” over the next two years. Wye Valley will spend over $23 million on a system from IMS MSXIMS, while Salisbury NHS will continue spending money with CSC on its Lorenzo platform. CSC has earned a tainted reputation as part of the boondoggle that was the National Programme for IT (NPfIT), which imploded in 2011 due to project overruns, mismanagement,and resultant budget-busting.


Technology

ZeOmega releases an annual clinical content update for its Jiva population health platform.

Validic adds RxRevu prescription intelligence software, including prescription drug delivery options and a price transparency tool, to its digital health platform.


Government and Politics

A 68-page report from the President’s Council of Advisors on Science and Technology determines that more work is needed from federal agencies such as HHS, NIH, NIST, and the National Science Foundation to promote and utilize open standards and interfaces to leverage data analyses for healthcare delivery and biomedical research. The report recommends without a hint of irony that “NIH and HHS should create funding mechanisms that will encourage accelerated deployment, testing, and evolution of translational IT systems for clinical use.”

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The White House issues a fairly broad call to stakeholders for ideas on how to move its Precision Medicine Initiative forward, outlining 10 potential categories of ways to treat disease and improve health that have precision medicine potential. Feedback is due September 21.

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The American Red Cross honors female community leaders and volunteers who contributed significantly to the recovery of New Orleans and Louisiana after Hurricane Katrina at its inaugural Power of Women luncheon. National Coordinator and Acting Assistant HHS Secretary Karen DeSalvo, MD was among the honorees for her work as city health commissioner and senior health policy advisor to New Orleans Mayor Mitchell Landrieu from 2011-14.


Research and Innovation

Oregon Health & Science University’s Knight Cancer Institute partners with Intel to launch the Collaborative Cancer Cloud, a network that will enable providers to securely share genomic data for more personalized medicine and tailored cancer research. OSHU plans to go live in the first quarter of next year with two additional cancer centers to pilot the new technology, plus make open source its Trusted Execution Technology to ensure patient privacy.


Other

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Nancy Snyderman, MD will make her first public appearance since leaving NBC earlier this year when she hosts a discussion next month with New Jersey hospital CEOs during the Princeton Regional Chamber of Commerce Healthcare Symposium. Snyderman left the network after facing criticism for violating a voluntary agreement with the CDC to stay out of public areas after reporting from Liberia during the Ebola epidemic. Keyspeakers.com notes that her speaking fees are nothing to sneeze at.


Sponsor Updates

  • Huron Consulting offers “A Modern Commentary on Medicare at 50.”
  • The SSI Group will exhibit at the 2015 MidAmerica Summer Institute Region 8 August 26-28 in Minneapolis.
  • Streamline Health rings the Nasdaq opening bell in New York City.
  • T-System offers “ICD-10 Leniency from CMS: What You Need to Know.”
  • TeleTracking offers “One Team … Unlimited Success.”
  • Verisk Health offers “Talking Cost Drivers: How Employers Can Stop Rising Medical Costs.”
  • VitalHealth Software offers “Healthcare Outcomes: Our First Executive Forum.”
  • Voalte offers “Lessons from mHealth History.”
  • Xerox “Helps State Medicaid Organizations Reduce Costs, Improve Care.”
  • ZirMed offers “Less Than 50 Days to ICD-10: Tips to Help You Prepare.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 23, 2015 News No Comments

News 8/21/15

August 20, 2015 News 10 Comments

Top News

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Investors and genome sequencing company Illumina form Helix, an app store-like service that will sequence and store a user’s DNA for free, but then offer the user pay-as-you-go apps to access it in the future. A customer might pay $20 to see if they have a specific genetic variant, then Helix will additionally sequence all of their medically relevant variants at their own cost of $500, hoping to sell the customer other information they need later without requiring a second round of sequencing. Partners such as LabCorp and Mayo Clinic will be paid a royalty-type fee, both for getting customers to submit their initial DNA sample and for each app they sell.

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San Diego-based Illumina sold $1.8 billion of DNA equipment and tests last year and is hoping to penetrate the market for consumers, who so far have shown little interest in having their DNA sequenced. The FDA may weigh in with regulatory requirements. As the excellent MIT Technology Review concludes, “With Helix, says Flatley, companies won’t have to invest in starting a laboratory any more. Instead, he says, any developer with a computer will be able to start a genomics company.”


Reader Comments

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From Gotham Growler: “Re: NYHHC. Glen Tullman was right in the Allscripts lawsuit.” The 2012 Allscripts lawsuit had nothing to do with the current investigation into HHC’s payments to consultants or how it has managed (or mismanaged, depending on who you believe) its Epic project. Allscripts claimed that HHC’s choice of Epic over Allscripts was unfair because HHC incorrectly calculated the total cost of ownership of Allscripts, which the company says was $500 million less than the number HHC used to choose Epic. The Allscripts analysis from its lawsuit (above) shows that HHC pegged the cost of all three options (Epic, Allscripts, or doing nothing) at around $1.4 billion, which is where the project estimate stands today. The lawsuit backfired, with Allscripts earning negative publicity from an industry generally puzzled at what the company hoped to gain by suing a prospect after losing a selection — HHC responded publicly in stating that the Allscripts TCO claims were “absurd,” that Allscripts was getting beaten soundly in the market by Epic because it “lacks a truly integrated solution,” and that the lawsuit was “an ill-fated attempt to reassure investors and inflate its sagging stock price.” Allscripts filed the lawsuit on December 13, 2012. Six days later, the company announced that it had failed to find a buyer for itself and had instead hired Paul Black as CEO and fired its executive team of CEO Glen Tullman, President Lee Shapiro, Chief Client Officer Laurie McGraw, and EVP of Culture and Talent Diane Adams. Allscripts dropped the HHC lawsuit three months later. MDRX shares are up 30 percent since Black took over, although they significantly trail the Nasdaq’s 64 percent overall rise over that time.

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I went back to my October 2012 post about HHC’s original Epic decision, where I now recall that the $1.4 billion project cost was clearly spelled out to documents prepared for HHC’s board. That suggests that newspaper reports that the project is running double the expected costs of $700 million are incorrect – HHC estimated $1.4 billion from the beginning. The most interesting aspect of the lawsuit is that it disclosed that Epic’s software license fees represented $303 million of the $1.4 billion project, which is pure profit to Epic since the software carries no incremental costs. People always observe that Epic gets only a small portion of a total project cost of $500 million or $1 billion as license fees, but the lawsuit indicates that it’s around 25 percent. The Epic financial magic is high license fees, billing out freshly graduated liberal arts majors at multiples of their $50 hourly salary, and charging a significant portion of the license fees as annual maintenance with rebates for behaving in ways that Epic likes (applying updates, not bad-mouthing the company, and following Epic’s consultant hiring processes, for example.) Not too much different than any other vendor except for using newbies and putting lots of restrictive clauses in the contracts.

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From Quality is Job Open: “Re: Quality Systems/NextGen. They let CTO Steve Puckett go, but are also swapping out all of their development leadership to create an Office of the CTO with an SVP of engineering, chief architect, and chief product officer.” Unverified, but the recruiter’s email I ran across seems to confirm that newly appointed CEO Rusty Frantz is retooling the whole product development group.

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From Fly on the Wall: “Re: MediGain. The CEO and chairman are gone after a series of lawsuits claiming financial improprieties. As reported on HIStalk on 10/29/14, MediGain received an investment of $38 million from Prudential Capital Group. The latest lawsuit was filed by MedVision in January 2015, claiming that MediGain failed to pay the founders the monies due them.” Unverified, but the bios of Greg Hackney and Dinesh Butani have been removed from the executive page of the coding and revenue cycle vendor’s site.

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From Don: “Re: Theranos shout-out. I’ve used the service for nine months in Phoenix. No DMV type experience – draw stations are at Walgreens and have weekend hours. Great for people without insurance coverage, with PT/INR at $2.70 vs. $99.50 hospital bills Medicare, who pays $4.98. Fast turnaround and results are available via web, smartphone, app, and PDF download. Tests drawn at PCP are available in four hours and are available on his eClinicalWorks system and patient portal. No lab order required in Arizona. As long as Theranos meets CLIA-88, CAP, JCAHO, and other regulatory requirements, we will use them whenever possible. My only concern is that convenience and pricing could deteriorate as the company expands to meet financial viability.”


HIStalk Announcements and Requests

This week on HIStalk Practice: Circle Health launches new practice business model in San Francisco. Telemedicine comes to a pet near you. Urgent Clinics Medical Care implements DocuTap tech at Houston facilities. Millenials may not be as averse to primary care office visits as their addictions to devices would have you believe. HHS encourages health IT-savvy practices to submit nominations for the 2015 Million Hearts Hypertension Control Challenge. Palliative care via telemedicine makes a difference in rural California. Large group practices weigh in with favored vendors based on customer satisfaction.

This week on HIStalk Connect: Doctors working at Al-Shifa Hospital in the Gaza Strip have developed a 3D-printed stethoscope that can be produced for 30 cents and performs as well as modern commercial alternatives. Nutritional supplement startup WellPath announces new integration points with both Fitbit and 23andMe in an effort to enhance its ability to personalize nutritional supplements. Finnish designers have launched a Kickstarter campaign to fund the Oura Ring, a ring that tracks activity levels, caloric burn, heart rate, respiration rate, and sleep cycles.


Webinars

August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience. 

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Physician-patient matching service Grand Rounds raises another $55 million in financing, increasing its total to $106 million. Companies provide the service to their employees, who can seek second opinions, find insurance-covered doctors and have appointments made for them, and ask for medical help while hospitalized. The company digitizes and stores the medical records of its users within its app. The co-founders are Owen Tripp (co-founder of Reputation.com) and Rusty Hoffman, MD (chief of interventional radiology at Stanford Hospital).

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Doctor appointment booking app ZocDoc is valued at $1.8 billion from its most recent funding round, earning them the already-overused and annoying “unicorn” label by people whose lips are too busy to say “billion-dollar valuation.”


Sales

NeuroPsychiatric Hospitals (IN) chooses Medhost’s clinical and financial solutions.


People

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Kennedy Health (NJ) promotes Tom Balcavage from VP/CIO to SVP of technology and program services, where he will oversee ambulatory, product line, dialysis, patient experience, and imaging as well as IT.

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Consumer healthcare expense management system vendor CoPatient names Tom Torre (Alegeus Technologies) as CEO.

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William Tierney, MD (Regenstrief Institute) is named inaugural chair of population health for Dell Medical School at the University of Texas at Austin.

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Healthcare software vendor Ability Network names board chair Mark Pulido (BenefitPoint) as CEO. He was CEO of McKesson until the company fired him along most of the executives involved in its 1999 acquisition of book-cooking HBO & Company for $14 billion, with the June 1999 hit list including Pulido, Chairman Charlie McCall, CFO Richard Hawkins, Al Bergonzi, David Held, Jay Lapine, and Mike Smeraski.


Announcements and Implementations

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Allscripts will use CoverMyMeds as its prescription electronic prior authorization (ePA) solution. That’s how I read this somewhat vague announcement, anyway – Allscripts announced in December 2014 that it had developed its eAuth product for Express Scripts patients, so perhaps this agreement expands its reach.

Cerner will integrate the CoverMyMeds ePA solution with Millennium.

Cancer diagnostic vendor Guardant Health and oncology IT vendor Flatiron Health will develop a cloud-based platform to integrate liquid biopsy-based genetic testing results from Guardant’s equipment with clinical treatments and outcomes information to improve the targeting of cancer therapies.


Privacy and Security

The health minister of the Netherlands will propose that doctors be forced to turn over the medical records of patients to disability fraud investigators, although planned European Union privacy legislation may override that requirement by giving individuals more control over information about them, especially their health records. That new EU regulation will impact England’s NHS, which is making the data of non-opt-out patients available to researchers, drug chains, and private companies.

Carilion Clinic (VA) reprimands or fires 14 employees in unspecified roles for accessing patient records without legitimate need.

A former Florida TV news anchor sues his former employer, claiming he was fired for covering a story about paper medical records found in an abandoned storage unit whose contents were auctioned off. Matthew Dougherty says the station’s news director ordered him to “kill the story” when he found that the owner of the records was his own family physician, threatening him with statements that he had violated HIPAA.


Other

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The Kansas City paper writes a surprisingly insightful article on the lack of EHR interoperability, opening with a brilliant question: “Why, then, does a windowless office in Truman Medical Center need to scan 2.9 million pages of paper medical records that started out as electronic ones?” That’s pretty eloquent for a site that co-features the usual eyeball-pandering cute dog video right next to it. I like its term of “digital dead ends,” which it summarizes as, “All that scanning springs from institutional rivalries over control of your medical data. Records emerging from all that scanning give your doctor the digital age version of something pieced together with duct tape — and rendered less valuable in the process.”

It isn’t just a US problem that nobody likes taking a pay cut: China passes a law prohibiting doctors from selling drugs to patients at a markup, so to offset their loss of income, the doctors doubled the rate of inpatient care. As the abstract concludes, “The reform had an unintended consequence: China’s healthcare providers have sought new, potentially inappropriate forms of revenue.”

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Cleveland Clinic kicks McDonald’s out of its food court after years of trying to cancel the company’s lease, apparently convinced that the people who eat there (many of whom its own clinical employees) can’t be trusted to choose their food wisely during the very few hours each lifetime they’re inside the hallowed Clinic’s food court walls rather than everywhere else in Cleveland, which has 25 surviving McDonald’s. They should have instead used their copy of the franchise as a living laboratory to learn how to shift consumption to the healthier options that McDonald’s offers and that nobody buys, like salads, apple slices, and non-sugary drinks. McDonald’s, like Walmart and drug dealers, meets consumer demand that won’t go away no matter how much finger-waggers try unsuccessfully to legislate away the supply.


Sponsor Updates

  • MedData offers “The ABCs of ICD-10: Background and New Features.”
  • Navicure will exhibit at the 2015 Community Health Institute & Expo August 23-25 in Orlando.
  • ESD is included on the Inc. 500. Nordic also made the list, as did The HCI Group.
  • Netsmart offers “Leading the Interoperability Charge with Local Health Departments.”
  • Direct Consulting Associates opens its new exhibit in the Technology Showcase at the HIMSS Innovation center in Cleveland.
  • Nordic will exhibit at NeXXpo August 25 in Madison, WI.
  • SyTrue CEO Kyle Silvestro is featured in “Five Things You Never Suspected About Your Healthcare Data.”
  • Park Place International offers “Approaching VDI.”
  • Experian Health/Passport will exhibit at the National Association of Chain Drug Stores Total Store Expo August 22-25 in Denver.
  • Patientco offers “Learn How a Meditech Hospital Boosted Patient Revenue 17% by Bringing Patient Payments In House.”
  • QPID Health is identified as a sample vendor in the NLP-Clinical Enterprise category of Gartner’s Hype Cycle for healthcare technologies.
  • PMD offers “The Many Faces of Android Devices.”
  • Anthelio Healthcare Solutions is named to the HCI 100.
  • Point-of-Care Partners offers a presentation on “Advancements in Technology to Streamline and Expedite Patient Access.”
  • EClinicalWorks will exhibit at the Collaborative Care Summit 2015 August 20-21 in San Diego.
  • Extension Healthcare offers “Imitation is the Sincerest Form of Flattery.”
  • Galen Healthcare Solutions posts “Reducing Complexity in Healthcare IT: Part 2 … Preparing to move forward.”
  • Greenway Health offers “Patient Engagement: Is Fear of Commitment Keeping Your Patients From Getting Engaged?”
  • Healthfinch will exhibit at the NeXXpo: Business in Fast Forward event August 25 in Madison, WI.
  • Healthgrades offers “A Day in the Life of a Web Developer.”
  • HealthMedx will exhibit at the Missouri Health Care Association Annual Convention August 24-25 in Branson.
  • Healthwise offers “Exploring the relationship between plain language and ethics.”
  • Ingenious Med will exhibit at the HFMA Mid-America Summer Institute August 26-28 in Minneapolis.
  • InstaMed offers “The Top 3 Essentials of Payment Security in Healthcare.”
  • InterSystems publishes “Redefining Relationships: Information Sharing Among Frenemies.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 20, 2015 News 10 Comments

News 8/19/15

August 18, 2015 News 14 Comments

Top News

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CTO Paul Contino leaves NYC Health & Hospitals Corporation, the fourth high-ranking IT HHC official to depart following an investigation of its $764 million Epic implementation. HHC previously fired CIO Bert Robles, two other employees, and seven consultants. Several of the project’s top positions being filled in interim by Clinovations (acquired by The Advisory Board Company in February 2015), which was given a $4 million, 15-month contract to manage the project. HHC is investigating reports of consultant overbilling on the project that is 18 months behind schedule. Internal documents suggest an actual project cost of $1.4 billion, nearly double the announced cost. HHC chose Epic in January 2013 at an announced contract price of $302 million. It hopes to bring it live system-wide by 2018.


Reader Comments

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From Former PF Employee: “Re: Practice Fusion’s interim CEO. Ryan Howard was never going to make it as CEO through an IPO. He had too many issues and wasn’t able to temper them enough. An IPO may happen but isn’t as imminent as the PR team says — that was a tactic to distract people from the need to change CEOs. It wasn’t supposed to be this sudden, but that’s how Ryan is and part of why this is a good decision overall. Side note: why does everyone think PF only generates revenue from ads and selling data? Ads are maybe 30 percent and data actually isn’t sold (while ‘insights’ from the data are sold, that’s less than five percent too).” Unverified.

From Duluth Dilettante: “Re: Practice Fusion’s interim CEO. I agree, you don’t put in an interim CEO to prepare for an IPO. A lot of venture money was poured into both Practice Fusion and CareCloud, both of which changed CEOs. The ‘broken’ healthcare space offers opportunities but is complicated, especially when competing with incumbent vendors like Epic and Cerner. Once you take VC money, the game changes to achieving lofty financial goals or getting kicked out by impatient investors.” I can’t imagine the learning that’s required of a startup CEO who faces a tough investor grade card at each revenue milestone. Think about Neal Patterson guiding Cerner from a picnic table conversation to a huge corporation and what he had to learn along the way. CEOs who are afraid of losing their job let boards convince them to maximize short-term profits even at the expense of long-term potential, so risky innovation isn’t encouraged, like Cerner spending a fortune developing Millennium in the late 1990s. One might postulate that every publicly traded company would have been better, but not necessarily bigger, if it had stayed private and stuck with a non-quarterly mindset like Epic, InterSystems, Meditech, and quite a few other health IT companies that are still run by their very successful founders after decades.

From Hospital Money Man: “Re: CMS. Cutting it awfully close for the 2015 MU modification / alignment rule. Reporting periods need to start no later than October 2 assuming the provision sticks. There’s no time for vendors to respond and QA is the first to get cut. Some vendors will hedge in assuming NPRM will pass as written, but there’s obvious risk. Just in case anyone wonders why we’re in the position we’re in with consensus that EHR functionality is in shambles and calls for program postponement.”


HIStalk Announcements and Requests

My latest gripe: referring to provider payments as noble-sounding “reimbursement,” an especially embarrassing euphemism when the reimbursee books an annual “surplus” of hundreds of millions of dollars. Also, publications that say Congress prohibits use of a National Patient Identifier, which isn’t exactly true – it only prohibits HHS spending government money to implement it.


Webinars

August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience. 

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Wolters Kluwer will acquire physician CME provider Learners’ Digest International for $150 million in cash.

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Denver-based predictive analytics vendor NextHealth Technologies raises $1 million in funding from investors that include Nuance Healthcare President Trace Devanny.

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Medical coding services vendor Aviacode receives a $16 million investment to further develop its marketing and technology. David Jensen founded the company in 2000.

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Rehab therapy software vendor WebPT acquires Therabill, which offers a Web-based practice management system for therapists.

Bold, insightful investment firms set a consensus target share price of $7.05 for Merge Healthcare, no doubt acting independently of the news that IBM will acquire the company for $7.13 per share.


Sales

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Hospital District of Helsinki and Uusimaa in Finland chooses Epic’s $424 million bid to replace its patient care system. Epic outscored CGI based on price, functionality, usability, and interoperability. HUS has 21,000 employees and nearly 3,000 beds.


People

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St. Jude Children’s Research Hospital (TN) names Keith Perry (University of Texas MD Anderson Cancer Center) as CIO.

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Froedtert & the Medical College of Wisconsin hires William Showalter (Wellmont Health System) as SVP/CIO.

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Steve Puckett, EVP/CTO of Quality Systems (NextGen), resigns “by mutual agreement with the company.” His duties will transition to COO Daniel Morefield.

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Meg Aranow (The Advisory Board Company) joins SRG Technology as SVP of technology.

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CareTech Solutions President and CEO Jim Giordano is appointed vice chairman of Ascension Michigan’s board.

RightCare Solutions names Jeff Edgin (Siemens Medical Solutions) as SVP of business development.


Announcements and Implementations

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Peer60 publishes “IT Infrastructure Trends in Medical Imaging 2015.” It’s interesting that hospitals are nearly equally split between wanting to buy PACS or VNA hardware on their own vs. choosing a turnkey solution. Preferred hardware vendors were Dell and HP.

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Clinical Architecture announces Content Cloud, a cloud-based terminology update service.

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Novant Health (NC), which has the highest Epic MyChart engagement in the US with 50 percent of its users logging into the portal at least monthly, will integrate user wearable data into MyChart using Apple HealthKit.

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Capital BlueCross (PA) announces that enrollees can start using its American Well-powered physician video visits on January 1, 2016.


Government and Politics

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Leidos wins another big military medical contract, earning a 10-year, $900 million bid to support US Army medical research.

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FDA, CDC, and NLM will convene a free public workshop on promoting semantic interoperability between diagnostic devices and EHRs/LISs on September 28, 2015 at the FDA’s Silver Spring, MD campus.


Privacy and Security

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The State of Colorado apologizes for sending 1,600 PHI-containing letters intended for Medicaid recipients to the mailing addresses of other people due to a vendor’s programming error.


Innovation and Research

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MIT researchers develop a cognitive assessment in which smart pens analyze the way a person draws a clock, automating a manually interpreted test and potentially allowing earlier detection of dementia.


Technology

An article about the Internet of Things says consumer and other light uses (some of them absurd, like refrigerator and trash can sensors) can’t be profitable since they communicate via expensive cellular networks.


Other

In England, local media get worked up after their Freedom of Information requests reveal that a hospital paid a cardiologist $17,000 to cover three, eight-hour holiday shifts, or compensation of $708 per hour.

UK investors complain that digital health innovation is stifled there by NHS, whose bureaucracy controls nearly all health-related spending even as NHS says its future success depends on innovative technology. A frustrated English startup CEO who moved his company to the US despite being named a NHS Innovation Accelerator Fellow says, “The NHS is optimized for people with large sales organizations and/or specific knowledge about how the system works. Although US healthcare has its problems and there are some messed-up incentives, at least there are incentives.” You can imagine a similar situation here if the federal government ran healthcare even more than it already does.

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A study of 96 medical specialists in Massachusetts finds that most are unaware of the state’s 2012 medical transparency law that requires them to provide consumers with self-pay prices within two business days. Dentists were the most accommodating, presumably because they have many patients without insurance. One ophthalmology practice quoted $140 for an eyeglass exam, but raised the price to $327 when told the patient would be paying cash. Price estimates for a colonoscopy that includes facility and anesthesiology charges ranged from $1,300 to $10,000. Some practices told the surveyor that they weren’t allowed to give prices by phone, while others were “downright rude.” The president of the state medical society blames “the complexity of the payment system.”

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The Kansas City paper digs back into Cerner history in comparing Amazon’s “brutal” workplace to Neal Patterson’s infamous 2001 threatening employee email that sent CERN shares down 20 percent after it went public. I’ve changed my opinion about the email over the years as several then-Cerner employees have said Neal was right – employees were taking advantage of the company’s management sloppiness and he had to skip those layers to get his point across directly and unequivocally. It must have worked since shares have increase somewhere around eightfold since then vs. the Nasdaq’s doubling. Still, it’s fun to run his spitting nails email every couple of years.

The New York Times publishes a great article called “How to Know Whether to Believe a Health Study.” It says the problem with randomized trials is that they focus on narrow populations of people who are most likely to benefit from the particular treatment, often also excluding older patients and children. However, it fails to mention what I see as the biggest problem – studies are often sponsored by companies that suppress publication of the negative or even inconclusive ones. The author likes observational studies in which large, existing databases are mined for new insights as long as they cover broad populations and not just people who chose to receive a particular treatment.

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Lenny Robinson, who sold his cleaning business and made a full-time job of visiting hospitalized children in Maryland costumed as Batman, was killed Sunday when his stalled Batmobile was struck by another car on Interstate 70. He was 51.


Sponsor Updates

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  • Aprima announces attendance of 800 at its user conference earlier this month.
  • Caradigm and iHT2 publish “12 Things You Need to Know About Value-Based Reimbursement.”
  • MEA|NEA is named to the Inc. 5000.
  • AdvancedMD offers a look at its new ICD-10 website.
  • AirWatch becomes a founding sponsor of the new Center for the Development and Application of Internet-of-Things Technologies at Georgia Tech.
  • Strata Decision Technology participates along with Costs of Care in a national story contest called “The Best Care, The Lowest Cost: One Idea at a Time.”
  • Aventura offers “A Nurse’s Perspective: Shifting the Focus from the Computer to the Patient.”
  • Awarepoint posts “Protect Patients, Cut Costs & Increase Compliance with Real-time Temp Monitoring.”
  • Besler Consulting offers “Medical Necessity and Ambulance Services.”
  • Cumberland Consulting Group and Divurgent are named to the Inc. 500 I 5000 list.
  • Recondo Technology will exhibit at the HFMA Region 8 Mid-America Summer Institute August 26 in Minneapolis.
  • Practice Unite offers “Achieving High Adoption of Patient Engagement Apps.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 18, 2015 News 14 Comments

Monday Morning Update 8/17/15

August 16, 2015 News 13 Comments

Top News

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Practice Fusion promotes Tom Langan to interim CEO, replacing founder Ryan Howard, who will move to board chair. That’s a bizarre move given that Langan has no CEO experience (he’s always been in sales) and he joined the company only a year ago. Practice Fusion is planning an IPO that could be imminent, but that plan seems faulty with this move. Sounds fishy to me, but then again that’s been said about the company’s free (as in advertiser-sponsored and data-selling) EHR business model from the beginning. They seemed awfully anxious to get Howard out of the CEO chair without having a viable replacement identified.


Reader Comments

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From Jed: “Re: your medical records saga. I came across PicnicHealth and I see you mentioned them back in 2014. The demo account looks pretty slick.” PicnicHealth, like CareSync, offers to manually obtain and input all of a patient’s records into its online system, which is presented in timeline form. They charge $19.95 per month for twice-yearly collection or $39.95 per month for constant updates. The company absorbs any records fees charged by providers, although it’s not clear from their site whether they obtain hospital records as well as those from practices. I mentioned PicnicHealth in August 2014, noting that they had five employees working from a San Francisco apartment or office above a Western wear store, sharing an address with the headquarters of sex party operator Kinky Salon. PicnicHealth raised $2 million in April 2015. I would be a bit concerned that its director of medical informatics, called “Doctor” throughout, is actually an ND (naturopathic doctor), although it probably doesn’t really matter for a consumer site. Still, that’s why the form “Dr. XXX” should never be used in writing, and when it is (incorrectly), I check the degree and school every time — it’s the folks trying to hide something that don’t state their actual degree or who conferred it.

From Digger: “Re: press releases. You mentioned that other sites basically rewrite them to look like news. I notice they also don’t link to them.” Of course they don’t – that would make it obvious that they did no original research or added no value at all. I always link to the source so you don’t have to take my word for it.

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From Terry: “Re: summer Sunday haha. Saw this on LinkedIn.” As you suspected, I like it.


HIStalk Announcements and Requests

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Seventy-one percent of poll respondents say Meditech’s competitive position is worsening. Reader comments include  Bread_Butter_Site: Meditech has too many platforms, got into ambulatory too late, took too long to release a Web version, and sacrificed agility to maintain their legacy platforms. PFS_Guy: Meditech offers the cheapest option for small to medium-sized facilities, but those are getting bought up by larger systems who replace it with their own system. Previous Medical User: decreasing product sales will force Meditech to raise support fees and limit product development. It’s Just Business: HCA considered moving to Epic but chose to stay on Magic.

New poll to your right or here: in which company (some publicly traded, some considering it) would you invest $10,000 if forced to choose one? I predict somebody will, as they always do, add a comment suggesting, “You should have put a ‘none of them’ response,” which of course would be irrational given the question.

Listening: new from Toto, decades-polished hard rock/progressive that stands as excellent on its own without even thinking about their late 1970s/early 1980s hits “Rosanna,” “Africa,” and “I’ll Supply the Love.” They aren’t just guys pushing 60 riding off into the sunset atop their ancient hits – the guitarist still shreds. They’re on tour now with Yes, who I say with sadness (having seen them many times as one of my favorite bands ever) is just topping off the grandchildren’s trust funds by cashing in on yet another tour as a sloppy, wooden cover band with no original members or creative energy left to do anything other than issue a zillion live albums from the band’s nearly 50 years.

Pet Twitter peeve: I’m scrolling through an endless list of utter Twitter crap, mostly retweets from the 134 people I follow (who often get maddeningly off-topic sidetracked in tweeting about baseball, a guy wearing a kilt, and pet issues like their personal airline gripes or their photography hobby) when I finally see something interesting and click on a link. Twitter then resets the very long list back to the beginning, forcing me to restart the endless scrolling. It’s time for another round of un-following.


Last Week’s Most Interesting News

  • Premier adds to its analytics arsenal by acquiring Healthcare Insights for $65 million.
  • Teladoc releases its first post-IPO quarterly report that shows a significant telemedicine usage ramp-up, but huge losses.
  • ONC announces that its IT safety center – assuming Congress changes its mind about not funding it — will be named the Health IT Safety Collaboratory.
  • A Vancouver newspaper’s investigation finds that IBM was fired from a large clinical systems transformation project and has been replaced with its subcontractor Cerner.
  • AHA complains that the FCC’s decision to open up some frequency bands to wireless microphones will interfere with Wireless Medical Telemetry Services in hospitals.
  • A GAO report finds that the VA and Department of Defense are missing key interoperability dates but are making progress, with the great unknown being how the DoD’s new Cerner project fits in.

Webinars

August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience. 

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Wireless and needle-free continuous glucose monitoring technology vendor Echo Therapeutics proves the difficulty of turning an idea into a business: the company loses $11 million in the quarter after deciding to abandon plans to license its technology and instead focus on its own product development by working with a China-based technology company. Echo’s largest investor, an arbitrage fund, agreed to invest another $4 million in the company in December in return for having the company’s board replace three of its members with its own people. The fund had previously sued the company for mismanagement, while its former CEO received a settlement from the company after suing for wrongful termination. ECTE shares peaked at around $800 in 2000 but are priced at $1.51 today, valuing the company at $17 million.


People

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Ross Martin, MD, MHA (AMIA) joins the Maryland HIE CRISP as program director.


Announcements and Implementations

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Medhost will convene “The Nashville Experience” at Nashville’s Music City Center on September 16, featuring speakers Hayley Hovious (Nashville Health Care Council), Nicholas Webb (futurist and author), Farzad Mostashari, MD (former National Coordinator and current Aledade CEO), attorney Steve Blumenthal, and Jitin Asnaani (executive director, CommonWell). Registration is $250 including meals with an optional $150 ticket to the Taste of Nashville Gala.


Government and Politics

The protest period for the DoD’s EHR bid has expired, so the contract stands with the winning team of Leidos, Cerner, Accenture, and Henry Schein. Competing bidding consortia that included partners Epic and Allscripts were rumored to have been underbid by $1 billion by the ultimate winner, making their protest unlikely since a win would require them to do the work for a lot less money than they estimated.


Privacy and Security

NHS England will give chain pharmacies access to the summary care records of all patients (excepting those few who have opted out) this fall following a pilot project involving 140 pharmacies. The records, which are on file for 96 percent of the country’s residents, contain medications and diagnoses. The pharmacist is required to ask the patient for permission to view their record during their drugstore encounter. Only 15 patients responded to surveys during the pilot, so few that their input was discarded. Pharmacists have expressed some confusion about when they need the patient’s permission and how to obtain it.

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University of Virginia announces that a China-based cyberattack affected its IT systems on June 11, but didn’t affect the UVa Health System.


Technology

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The Nashville paper suggests that hospitals and other business consider deploying beacon technology rather than apps that require installation and updates. Beacons use Bluetooth Low Energy to broadcast to nearby Android or iOS smartphones, displaying the desired information to the user and reporting back information to the business. The advantage to customers is that their location is encrypted and push notifications aren’t sent when they are out of range or their phones are turned off. Beacons cost only around $20 are even sold at Target for finding lost devices with beacons attached. Theoretically beacons could replace some hospital RFID functions or even to transmit vital signs information, although that probably strays into FDA approval territory.


Other

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The Donald is finding that it’s hard to hide from past idiocy that lives forever in social media. Many such cases!

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A reader sent over the full-text JAMIA article that bizarrely concludes that HITECH had no impact on EHR adoption. The public health professor authors used some kind of diffusion model to determine that EHR adoption was imitative rather than innovative, then wanders off to a seemingly unrelated conclusions about lack of positive EHR impact on productivity and interoperability. I think what they’re trying to prove is that HITECH drove EHR adoption for the wrong reasons and may have stifled innovation as a result, with the billions of taxpayer dollars spent on HITECH returning little value in clinical outcomes or costs. That’s just guessing since I really can’t figure it out. I’m surprised JAMIA’s editors let this run without asking for more clarification.

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The new $1.3 billion Parkland Hospital (TX), twice the size of the old building across the street, includes an interactive patient care system, Wi-Fi throughout, palm vein scanning for patient ID, and a more comprehensive ICU monitoring system.

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Graduate diploma and associate degree nurses of a struggling for-profit college chain break into tears at their first look at their licensure exam when they realize they were poorly trained, causing the community college exam proctors to bring in a mental health counselor and to hand out information about a suicide hotline. Brown Mackie College faces national fraud charges for using unqualified instructors (the Arizona campus instructor for anatomy and physiology is a lawyer) and skipping practical instruction for tasks such as starting an IV, which students tried to learn on their own by finding YouTube videos. Parent company Education Management Corporation lost more than $2 billion in 2012 to 2014 as the government cracked down on for-profit colleges marketing themselves hard to students who didn’t know better and who were likely to default on federal student loans, taking away 90 percent of the potential school profits. The Pittsburgh-based Education Management Corporation also operates Argosy University, The Art Institutes, and South University. Taxpayers will pay billions of dollars to cover the defaulted loans of students whose schools shut down as students demand that the federal government cancel their loans because they allowed themselves to be swindled. It’s not just a problem with for-profit colleges, as private and public colleges and universities woo students with the idea that they should rack up dozens or hundreds of thousands of dollars of debt in studying whatever interests them despite the almost certain likelihood that they’ll end up with no increase in employability or earning power as a result.

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Combat communications airmen with the US Air Force’s 35th Combat Communications Squadron from Tinker Air Force Base, OK rebuild the Internet connectivity of a Honduras hospital as part of a joint training exercise. The hospital had been offline for three years. Tech Sgt. Jasmine Matus says the team focused on the archives room that holds paper medical records since the hospital is hoping to migrate to digital storage. A 15-member Air Force medical team also participated, supporting classroom and drinking well construction teams from the Air Force’s 823rd Red Horse Squadron from Hurlburt Field, FL and the 271st Marine Wing Support Squadron from Marine Corps Air Station Cherry Point NC.

Employees of Willis Knighton Proton Therapy Center (LA) surprise 12-year-old spinal cord tumor patient Sophia with a flash mob dance (practiced on their own time) to celebrate the completion of her advanced proton therapy.

Weird News Andy titles this story “Jettisoned Evidence,” in which scientists study how bacterial populations differ around the world by extracting samples from the sewage holding tanks of commercial jets.


Report from the Allscripts Clinical Experience
By Joe Adkins, Clinical Pharmacist
Springhill Medical Center, Mobile, AL

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I changed my mind last week about what a healthcare IT conference is really all about.

When I made plans for the Allscripts Client Experience (ACE) held August 5-7 in Boston, I had no idea just how much my world view would be changed about what lies ahead for our industry. I planned to attend the usual technology sessions to learn about product roadmaps and functionalities.

But after experiencing the opening session, I realize what I’m doing now in my role as a clinical pharmacist is helping to build the future for healthcare’s new era of personalized medicine.

From the opening session featuring Allscripts President and CEO Paul Black along with NantHealth founder Patrick Soon-Shiong, MD, I realized that this conference isn’t just about software. It’s about saving lives, thinking big, and finding a path to predictive medicine from our current reactive medicine mode. When it comes to treating cancer and other complex diseases, genomic sequencing is going to change the game – and sooner than we know.

I was given access to some of the great thinkers on health information technology (HIT), and a view into where we’re headed not next year, but five, 10, even 15 years down the road. It was interesting to see just how far Black and Soon-Shiong are planning beyond what we even know as healthcare IT today.

What I heard them saying is that the medications we use to treat and target cancer and other complex diseases are becoming more personalized and predictive thanks to nearly commonplace access to genomic sequencing. The advances in cancer treatment alone are moving ahead by leaps and bounds that we couldn’t imagine just two years ago. All of us in HIT must step up to ensure that the clinical information needed to treat patients is available in real time at the point of care just as quickly as discoveries are made.

For example, a handful of medications treat cancer well in ways we couldn’t envision just a few years ago. Eventually, there will be several dozen types of drugs to select from, and eventually, thanks to genomic sequencing, we’ll know which one works best for each individual.

The development pathways for those types of drugs have become much, much more compressed and the industry currently has no answer for how to keep up.

But Black and Soon-Shiong provided an interesting sneak peek into the future, and they are making some bets that NantHealth has the answer. It’s a little bit of a gamble, but I think it’s a calculated, good one. We don’t know yet whether this is the direction to go, but I’m glad Allscripts and NantHealth are investigating a new path to the future of HIT.

We can save more lives if we get this right. And I’m all in for that.


Sponsor Updates

  • The SSI Group will exhibit at the 2015 MS HFMA Summer Workshop August 19-21 in Philadelphia, MS.
  • Streamline Health will ring Nasdaq’s opening bell August 19.
  • Surescripts Chief Administrative and Legal Officer Paul Uhrig is featured in a Boston Global article, “E-scrips seen as a way to combat opioid abuse.”
  • T-Systems offers “Leading with Passion: Check Your Resilience.”
  • TeleTracking posts “The Value of Time” in optimizing hospital operations.
  • TransUnion writes its first corporate social responsibility report.
  • Valence Health will exhibit at the World Congress on Health and Biomedical Informatics August 19-23 in Sao Paulo, Brazil.
  • VitalHealth Software offers, “The Patient Centered Medical Home: Will the Demonstration Projects Fail?”
  • Voalte offers a preview of VUE15, its first user experience conference, November 10-12 in Sarasota, FL.
  • West Corp. offers, “The New Healthcare Paradigm: “Think Whole Person.”
  • Xerox Healthcare explains how “Data Analytics Transforms Virginia Medicaid.”
  • ZirMed will host its 2015 UGM, ZUG 15, August 17-18 in Chicago.
  • Navicure offers “Shifting Attention: Value-Based Reimbursement Gains Traction.”
  • Nordic offers “HIT Breakdown 10 – Patient Engagement possibilities with MyChart.”
  • NTT Data posts “5 Reasons Your Cloud is About to Become a Legacy System.”
  • Oneview Healthcare offers “Yelp Comes to Healthcare.”
  • Orion Health writes “Does greater patient control equate to a better healthcare experience?”
  • Park Place International offers “Sustaining Virtual Desktop Infrastructure.”
  • Summit Healthcare reports the experience of its client Valley Regional Healthcare (NH), which is using the company’s downtime reporting system.
  • Patientco publishes a new white paper, “3 Strategies for Increasing Self-Service Patient Payments with PatientWallet.”
  • PatientKeeper offers “Relieving a Practice’s ICD-10sion.”
  • Phynd Technologies writes “Merger Mania in the Healthcare Industry.”
  • PMD submits “Digital Health: A New Haven for Physicians.”
  • RelayHealth posts a new case study, “Focusing on Patients, not Dollars, makes Cooper Bend Pharmacy unique.”
  • Sagacious Consultants offers a “Q&A with David Hammer: How Consolidation and Unified Reimbursement will Change Revenue Cycle Management.”
  • Sandlot Solutions will exhibit at the iHT2 Health IT Summit August 18-19 in Seattle.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 16, 2015 News 13 Comments

News 8/14/15

August 13, 2015 News 4 Comments

Top News

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Premier acquires financial analytics vendor Healthcare Insights for $65 million in cash. 


Reader Comments

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From Bean Enumerator: “Re: North Shore-LIJ’s JV with Newport Health. Newport says it has experienced and innovative health IT talent, but the only person listed as working for the company has no relevant experience whatsoever. It’s a bad sign when an investment banker starts a health IT company. How did Allscripts lose this one given their supposedly tight partnership with NS-LIJ and their population health management aspirations?” I couldn’t find much of anything on Newport Health other than it’s apparently connected to Newport Private Group with a real office in Newport Beach, CA and mail drawer addresses in New York and Texas. The site contains nothing that suggests why they would make a good partner for NS-LIJ or anyone else for that matter.

From Divine: “Re: Cerner. Have you heard anything about them pulling their Intermountain team back to Kansas City?” I have not.

From ACOver: “Re: Aledade. You didn’t mention that the company is expanding.” Farzad’s Aledade has nothing to do with health IT, which some of the HIT sites can’t quite grasp in confusing his former job with his current one. Non-HIT sites with healthcare reform and insurance followers are the place for that kind of story rather than HIT sites that just reword Aledade’s press releases without adding any value whatsoever.

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From GeneInsight SchmeneInsight: “Re: Sunquest and Partners HealthCare marketing GeneInsight software. While the GeneInsight investment may be helping, I spoke with two folks (Meridian Health, NJ and Main Line, PA) each doing due diligence on enterprise systems to include ripping out Sunquest. Epic and Cerner are being vetted at both sites.” Unverified. The challenge with being a best-of-breed vendor is that your fervent, enterprise-resistant users don’t have the final word when health systems consider buying a broad, good-enough integrated product line from a company that supports it all. Those dominoes have been falling for years – lab, radiology, and pharmacy are moving (or being pushed) to Epic and Cerner from their favorite departmental systems. I haven’t seen any evidence that patient outcomes or costs have suffered as a result despite the dire predictions from the folks in those departments whose niche systems were, in their minds, integral to their unique mission.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor YourCareUniverse. The Franklin, TN-based company offers cloud-based technology and expertise in consumer relationship management, putting consumers at the center of the health system’s strategy. Patient-facing modules include YourCareHealth (personal health records), YourCareWellness (a wellness portal), YourCareEverywhere (consumer health content), and YourCareNavigation (rules-based care and wellness plans). Provider-facing technologies include a patient education content repository for clinician prescribing, community risk stratification analytics, an HIE and HIE connector, a patient transfer application, a Salesforce-integrated consumer marketing system, and a referral management system. The company also offers strategic consulting to guide organizations through transformational change. YourCareUniverse quickly signed up 38 customers after it was launched early this year, with its first go-live last month at Mount San Raphael Hospital (CO), which is using the patient engagement capabilities to promote its brand to consumers. Thanks to YourCareUniverse for supporting HIStalk.

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The YourCareUniverse folks are excited to present their two-day “Transvisional Forum: Transforming the Health of Consumers Through Engagement” conference September 16-17 at the Music City Center in Nashville. Topics of the nine educational sessions include cultivating consumer loyalty, managing the digital patient, analyzing big data, and increasing volume. Keynote speakers are Nicholas Webb (author of “The Digital Innovation Playbook”), Farzad Mostashari, MD (former National Coordinator and CEO of Aledade), Steve Blumenthal, JD (health IT attorney and all-around HIStalk pal), and Jitin Asnaani (executive director, CommonWell Health Alliance). Early bird registration is $795 through this Saturday, August 15.

This week on HIStalk Practice: Texas physicians struggle to keep their doors open and spirits up. HelloMD pivots its telemedicine services to medical marijuana. The Senate approves the Electronic Health Fairness Act, while HHS gets a black eye over breaches. Kathryn Evans offers best practices for leveraging technology to ensure reliable disposal of hazardous drugs at physician practices. HHS Secretary Sylvia Burwell announces $169 million in funding for new health centers. CSI rolls out Doctor on Demand telemedicine services. SecurityMetrics develops a HIPAA Dashboard for physician practices.

This week on HIStalk Connect: Google X Labs partners with DexCom to develop a miniaturized, disposable continuous glucose monitor. Twitter introduces an API exposing its entire 500 million tweet history to software developers. A Cambridge, MA-based genetics startup raises a $120 million Series B to advance its research into CRISPR-Cas9 gene editing therapies. A consortium of European researchers is developing a "smart mirror" that will screen users for early signs of chronic diseases.

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My love-hate affair with Windows 10 continues after one of its silent updates trashed my laptop’s Wi-Fi connectivity yesterday due to what I initially thought was device driver incompatibility. I spent a couple of hours trying to fix it before giving up and taking it to the repair shop (which I’ve never had to do since I can usually fix things myself). The shop owner left a message last night saying he had spent hours of analysis without figuring out a solution, with the only option he could suggest being to downgrade back to Windows 8.1. I returned his call this morning and he had experienced some sort of nocturnal epiphany and fixed the update-corrupted Windows networking components by matching up individual DLLs with versions and dates and then reinstalling and registering them one at a time. It’s back on my desk working fine. The $89 cost was worth it and I’m pretty happy to keep Win10, although I’m annoyed at the exasperation and expense of fixing the damage it caused and fearing the havoc the next update will wreak. The repair shop owner has added my problem to his Win10 issues folder, which is rather thick after just two weeks of its availability. He’s probably thrilled at the business uptick.


Webinars

August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience. 

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Roswell, GA-based Tea Leaves Health, which sells hospital marketing software, will be acquired for $30 million by consumer health website publisher Everyday Health. Tea Leaves Founder Reuben Kennedy will make a pile of money he doesn’t really need given his LinkedIn endorsement of a car detailing company that attends to his “five Ferraris, several Porsches, and a Lamborghini.”

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PokitDok, which offers 16 healthcare transaction APIs for application developers, raises $34 million.

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DispatchHealth, which offers cities a mobile acute care alternative to dispatching an ambulance in response to 911 calls, raises $3.6 million. Dispatchers route non-urgent calls to the company, which sends out cars with a clinician, a mobile lab, medical equipment, medications, and Internet connectivity. The company was previously known as True North Health Navigation. It doesn’t indicate pricing, but a FAQ on its old site suggests $200 to $300 per visit with insurance accepted.  

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Freshly IPOed telehealth vendor Teladoc reports Q2 results: revenue up 78 percent, EPS –$7.20 vs. -$2.15. The company warns that it expects to lose $50 million in the fiscal year. Teladoc reports that 83 percent of its revenue comes from the per-member, per-month fees paid by employers, health plans, and health systems, with the remaining 17 percent coming from visit fees averaging $40. Teladoc made reference to future possibilities that include behavioral health, dermatology, second opinions, at-home testing and biometrics, post-discharge monitoring, and wellness programs.

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In a strange business shift, HelloMD, which previously offered expensive, cash-only video visits with big-name medical specialists, relaunches itself as a seller of $49 video consultations for medical marijuana cards. Note that the site says “Approved in 20 mins,” which suggests that a minimal amount of clinical rigor is applied during the video visit. The lady on its home page indeed seems to have been relieved of all her medical suffering and is now in a blissful state of deep-breathing wellness, surrounded by clouds.


Sales

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BayCare Health System (FL) chooses Legacy Data Access to retire its SoftMed application.

New England Healthcare Exchange Network chooses Cognizant and its TriZetto subsidiary to manage its technology infrastructure.

University Hospitals (OH) will use Sectra’s vendor-neutral archive.

Cambridge Health Alliance (MA) chooses Imprivata’s two-factor authentication for e-prescribing of controlled substances.

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Athol Hospital (MA) will implement Medhost’s ED information system.


People

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Cureatr appoints former Highmark CEO William Winkenwerder, Jr., MD to its board.

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Bill Wallace (Kansas HIE, BCBS of Kansas) takes over as interim CEO of the Kansas Foundation for Medical Care.

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University of Iowa Health Care names Maia Hightower, MD, MBA, MPH (Stanford Health Care) as CMIO. She replaces Douglas Van Daele, MD, who will serve as executive director of University of Iowa Physicians.


Announcements and Implementations

InterSystems will use technology from Validic to integrate user-generated and wearables data into its HealthShare interoperability suite.

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HIMSS brags on its Cleveland conference center and its role in helping its vendor members market their products as it trolls for “collaborators” (i.e., paying tenants). The upcoming events list isn’t very compelling with mostly small HIMSS meetings and vendor presentations for attendees yearning for a junket to Cleveland. I’m starting to think that from my experience with health systems and member organizations that the concept of non-profit (meaning “non-taxpaying”) organizations should be eliminated.


Government and Politics

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A GAO analysis finds that the VA and DoD are working on interoperability between their systems, but are missing dates and won’t be finished until 2018.


Privacy and Security

The Economist ponders whether databases can remain useful after being anonymized, or if in fact real anonymization is even possible given the relative ease of matching one database to another to re-identify the information. Possible solutions include releasing data only to researchers rather than to the general public, making data recipients sign use contracts, making re-identification illegal, encrypting data queries as a package so that researchers can’t see the underlying data rows, and dividing the database among multiple hosts.

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The Greater New York Hospital Association bans filming in the city’s hospitals without the the prior written consent of patients, embarrassed by a 2012 episode of “NY Med” that captured the ED death of a patient whose family recognized him on TV despite his digitally obscured face.


Innovation and Research

I can’t see the full article since I don’t subscribe to JAMIA, but I would question the methodology of this study, which concludes that HITECH didn’t change the EHR adoption trajectory – it was just practices without EHRs imitating those that had them.


Other

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Peer60 publishes a “Rapid Reaction Report” on IBM’s planned acquisition of Merge Healthcare, collecting thoughts from 130 healthcare leaders in the two days following the announcement. One-third of the Merge customer contacts said the acquisition will be negative, but 20 percent said they will expand their use of Merge’s solutions under IBM’s ownership. Radiology and non-CIO IT folks felt pretty good about the announcement, but 60 percent of CIOs see it as negative. The main concern seems to be whether IBM is too big and too light on PACS knowledge to keep Merge customers happy while they try to sex up Watson with Merge-supplied “eyes.”

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A British newspaper profiles EMIS Health Managing Director and former Misys Healthcare executive Duane Lawrence, noting that he was the #1 territory sales manager for Coca-Cola at 22 years of age before deciding, “I wanted to do something that was going to make a difference.” I can’t think of any positive healthcare difference Misys ever made other than getting out of it, but perhaps he has finally found his calling.

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The shrill shrieking for Internet attention has unfortunately encouraged the proliferation of witless, intellect-insulting puns in headlines, I’ve noticed. The reporter’s credentials suggest he should know better, although maybe I’m expecting too much since he also contributes to “Painting and Wallcovering Contractor.”

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Nice job spell-checking, Health Gorilla (or is that Health Gorrila?)

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The former network manager of Yukon Kuskokwim Health Corporation (AK) is indicted for collecting and distributing child pornography over the hospital’s network after investigators find 29 terabytes of images and videos.

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An Accenture analysis of 900 digital health IT startups labels half of them as “zombies” that are likely to fail in their first two years, creating a “vulture capital’ market in which better companies pick at their carcasses for people and technologies. The report identified the zombie startups as those “dead but unaware of it” companies that raised up to $50 million from 2008 through 2013 but haven’t had new financing in the past 20 months. I’m not as optimistic as Accenture that those struggling newcomers have people or intellectual property worth poaching, but we’ll see. They left out the most interesting part – the list of those companies they targeted as zombies. It would be fun to run a death pool contest.

In Australia, a state review of the new Queensland children’s hospital finds that patients were endangered in the rush to open the facility quickly before medical equipment, computer systems, and even hand sanitizers were in place. Employees didn’t meet each other for the first time until the day of opening. Everyone agrees now that the hospital needed another two months before opening its doors.

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I winced when I saw the “register for HIMSS16” subject line in my inbox. The pushed-back Chicago version was like Daylight Saving Time – it was great having the extra weeks before last year’s conference, but now we’ll all pay as the clocks are set forward for Las Vegas and the dreaded week comes all too quickly (you’re likely an HIT newbie or anything-to-miss-work conference junkie if you actually look forward to it). Early bird member registration runs $765. Las Vegas always requires messing up the familiar schedule to accommodate the busloads of gamblers that the hotels and casinos won’t displace over the weekend, meaning the HIMSS conference runs Monday through Friday instead of Sunday through Thursday. The opening keynote will be at 5:00 p.m. Monday and the exhibit hall won’t open until Tuesday morning. HIStalkapalooza will be Monday night as usual, so hopefully the opening keynote will be as unappealing as in the past several years so people can bail out to arrive at my event on time. The closing keynote will be delivered by noted healthcare IT expert Peyton Manning, who will face a Friday afternoon audience smaller than at a Denver Broncos closed practice scrimmage. Hotel rates are, as always, jacked up for expense account attendees, with the same Treasure Island room running triple what it would cost to go next week in the miserably hot Las Vegas summer. In case you forgot, HIMSS announced earlier this year that the conference will alternate between Las Vegas and Orlando, having outgrown all the more interesting places.


Sponsor Updates

  • E-MDs offers a free ICD-10 Survival Kit.
  • Extension Healthcare offers “Market Trends: Counting Down to Alarm Safety Readiness.”
  • Galen Healthcare offers “Healthcare Interoperability Musings: Incentives, Barriers, Blocking.”
  • Access demonstrated its electronic forms and signatures solutions at Meditech South Africa’s event in Johannesburg.
  • Greenway Health posts “Electronic Prescribing of Controlled Substances: a Convenient Tool to Improve Patient Care and Safety.”
  • Hayes Management Consulting offers “Secure Messaging – Why It Makes Your Job Easier & Your Patients Happier.”
  • ZeOmega earns NCQA’s disease management certification.
  • The HCI Group publishes “4 Steps for Success: ICD-10 Training for Physicians and Non-Clinicians.”
  • HDS offers “FDA Warns of Medical Device Hacking.”
  • Cumberland Consulting Group is named to the Inc. 5000.
  • Healthfinch says “Document, Document, Document!”
  • HealthMedx offers “Proposed CMS rules set new destinations for SNFs … but where’s the path?”
  • Healthwise offers “Engaging Moms on Medicaid.”
  • Iatric Systems posts “EHR Optimization: Go-LIVE Marks the Beginning.”
  • VitalWare is named to the Inc. 500/5000.
  • Impact Advisors is recognized by KLAS for service performance.
  • InstaMed offers “In Healthcare Payments, EMV May be a Driver, But Dodging PCI is the Benefit.”
  • InterSystems and Leidos Health will exhibit at the Defense Health Information Technology Symposium August 18-20 in Orlando.
  • Liaison Technologies is named a finalist in the 2015 North Carolina Healthcare Information and Communications Alliance Health IT Transformation Awards.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 13, 2015 News 4 Comments

News 8/12/15

August 11, 2015 News 6 Comments

Top News

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North Shore-LIJ Health System signs a joint venture agreement with population health management system vendor Newport Health Solutions. The new company will complete the installation of Newport’s Health Connect throughout NS-LIJ, then try to sell it commercially. The only listed officer of Newport is Sophia Teng, whose experience is entirely in investment banking rather than healthcare.


Reader Comments

From EMRYouThere: “Re: EMR. One of our physicians runs two clinics for underserved patients in Guatemala. He would like to get them on an EMR but they are under-resourced. Suggestions?” The first ones I thought of were the open source OpenMRS, FreeMed, and iSante, but certainly others are available. I assume that Internet connectivity may be unreliable or slow, but if that isn’t the case, a cloud-based solution would probably require less setup and maintenance. I’ll invite readers to weigh in.

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From Ian: “Re: Sandlot Solutions. Ten to 15 people laid off, CTO Telly Shakelford has left.” I asked Rich Helppie (above), chairman and CEO of Santa Rosa Holdings, which includes Sandlot Solutions, Santa Rosa Consulting, InfoPartners, and Fortified Health Solutions. Rich says there was no material event – the company is fine-tuning its resources to match customer needs and is still hiring. He wouldn’t comment on specific current or former employees, but Telly’s bio has been removed from the company’s executive team page.

From J. Ferguson: “Re: Dim-Sum. I just read the HIStalk Dim-Sum reports, each and every one across 2014. He is hilarious, opinionated, and smart. This guy (I am assuming here) seems bright, on his game, and very aware of how IT works in the medical environment. I am surprised that more people did not initiate, demand, or at least ask for ongoing commentary via HIStalk because it is the perfect forum for someone that is informed and willing to express an opinion. I found nothing on-line about DHMSM that was compelling or interesting until this guy.  He seems like a person that could help initiate discussions and perhaps even be a catalyst for positive change in our industry. I have been in IT for a long while, most of it in healthcare, and he is spot on with occasional sarcasm, but it is entertaining and more than 95 percent accurate. I listened to the commentary via the webinar and his knowledge is very impressive, better than people that will be managing DHMSM I’m sure. Good luck and someone should hire this guy before he wanders off into anonymity.” I agree, his writings (here, here, here, and here) and webinar were outstanding. We haven’t spoken for some time, but last I heard he was hoping I would start some regular feature or site that covers the DoD’s progress.


HIStalk Announcements and Requests

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It appears that my unblemished streak of Windows 10 success has ended. Windows automatically applied an update to my laptop today, after which I couldn’t access the Internet. I tried everything I could think of – repairing the connection, flushing the DNS cache, tethering to my phone instead, rolling back to an older Wi-Fi adapter driver, de-installing and re-installing the Wi-Fi adapter, and checking the TCP-IP configuration. I gave up and called the computer repair place and the guy says he’s fixed half a dozen PCs with the same problem since the July 29 Win10 release date because of incompatible Wi-Fi adapter drivers. It will cost me around $100 to diagnose and fix (probably involving a new Wi-Fi adapter with a known Win10-compatible driver), I wasted a couple of hours of troubleshooting time, and I had to drag out my Win8 desktop while the laptop is in the shop. At least I was lucky enough to be home when it happened and not stuck elsewhere without an alternative.

My latest Internet gripe: those scroll-happy, overly wordy web pages that tell long stories when a short news item would suffice, especially when those painfully overwrought pieces masquerade as news but aren’t dated. 

Listening: new from Jack + Eliza, a college student duo that sounds like sunny, trippy 1960s groups like the Cowsills or Mamas and the Papas. I needed an antidote to all that cheery music, so I turned to Atlanta-based Mastodon and their upcoming tour-mates Corrosion of Conformity


Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Medical device Olympus, whose redesigned but not FDA-approved duodenoscopes have been implicated in spreading bacteria that in some cases killed patients, reports a record-breaking $130 million profit and a 14 percent sales increase in the devices, for which it holds an 85 percent market share. The Department of Justice has subpoenaed the company over the infections. Olympus is also being investigated for corruption in South America and has set aside $450 million to settle US kickback charges. Feel free to insert your own GI tract-related punch line.

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Castlight Health announces Q2 results: revenue up 76 percent, adjusted EPS –$0.19 vs. –$0.21, missing earnings expectations. Shares swirled even deeper around the bowl on the news, with the graph above showing CSLT shares dropping 85 percent since the company’s high-flying March 2014 IPO as its market cap has dropped to just over $500 million. The investor conference call covered just about every vanity metric and excuse buzzword.

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Data integration and cloud vendor Informatica goes private in a $5.3 billion deal that includes secondary funding from Microsoft and Salesforce.

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Sunquest’s year-old investment in Partners HealthCare subsidiary GeneInsight is paying off, the company says, as Sunquest has gained knowledge that it is incorporating into its anatomic pathology product and GeneInsight gets access to Sunquest customers.


Sales

The US Coast Guard chooses InterSystems HealthShare to provide a comprehensive, longitudinal EHR view across its disparate systems.

Christus Health will expand its use of Wellcentive’s value-based care and population health management solutions to most of its US operations.

Providence Health & Services chooses QPID Health to automatically search and interpret free text patient information for quality reports and registry forms.


People

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Orion health promotes Cheryl McKay, PhD, RN to chief nursing officer.

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Mark McMath (Indiana University Health Bloomington Hospital) joins Methodist Le Bonheur Healthcare as CIO.

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PatientSafe Solutions hires Balaji Sekar (Sutherland Healthcare Solution) as CFO.


Government and Politics

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A presentation to the Health IT Policy Committee on Tuesday seems to suggest that ONC’s proposed health IT safety center will be called “Health IT Safety Collaboratory.” I can’t decide if that’s innovative or annoying, but I’m leaning toward the latter.

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Also from Tuesday’s HITPC meeting: hospitals blame other providers for their lack of information exchange, with 59 percent saying their partners lack the technology. The AHA-sponsored survey questionably concludes that hospitals would love to exchange information with their competitors if only the technology supported it.

Meanwhile, ONC seeks a consumer-patient representative for the HIT Policy Committee and several members for the HIT Standards Committee.

A software error in the VA’s eligibility system has caused 35,000 combat veterans to be denied enrollment. Combat veterans are automatically entitled to free care for five years, but the VA’s system rejected their applications if they didn’t fill out a family income form. Nearly half of those who were rejected had applied more than five years ago, meaning their eligibility has since expired without their receiving any benefits.

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CMS awards Booz Allen Hamilton a five-year, $202 million contract to run Healthcare.gov. 

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HELP Committee member Senator Patty Murray (D-WA) urges President Obama to issue an executive order that would guarantee paid sick days to 28 million federal contractors, saying, “Our nation needs it.” She could just save time and propose raising the minimum wage to $100 per hour, which will be (as is true with all government tinkering with employee compensation terms) fantastic for everybody left standing after companies lay off enough people to pay for their newly mandated largesse.


Privacy and Security

The SEC brings charges against two Ukrainian hackers who breached the systems of three press release companies (PRNewswire, Marketwired, and BusinessWire) and sold pre-release, market-moving company earnings announcements to 30 stock traders around the world who bought or sold shares minutes before the news went public, earning the traders $100 million in illegal profits. The hackers created a video of themselves breaching the systems to sell their services to the traders, who sometimes agreed to give the hackers a percentage of the profits.

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Some patients who were among the 3.9 million whose information was exposed in the Medical Informatics Engineering breach complain that they are confused by the online form to request credit monitoring and can’t get through on the telephone hotlines provided. Experian has added call center agents and online signup tips.

A cybersecurity expert notes that it’s easy to look up physician credentials in public databases, then use them to sign up for access to the national electronic registries for births and deaths. The hacker can then file a death certificate that allows someone to collect life insurance or change the age on a birth certificate.


Other

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A freedom of information request by the Vancouver newspaper finds that the health minister fired IBM in April 2015 from its $640 million, province-wide clinical systems transformation project and has now replaced it with Cerner. The 10-year-old project involves 1.2 million patients. Cerner’s deal extends through 2026. IBM’s problems included unmet deadlines, too many consultants and too few informaticists involved, and the rejection by clinicians of every treatment plan IBM designed. Cerner was already providing most of the systems involved. It’s interesting that IBM gets fired as prime contractor with Cerner as its sub in Canada, then loses the US DoD bid to the Leidos-Cerner team when partnered with Epic. Equally interesting is that while large-scale health IT projects fail with alarming regularity (generally because incompetent government bureaucrats are running them), the largest successful health IT project is arguably Kaiser Permanente’s Epic rollout, which happened only after KP fired IBM. Maybe they need to rethink that old saying that nobody gets fired for buying IBM.

Medsphere President and CEO Irv Lichtenwald quotes my interview with Grahame Grieve in an editorial titled “FHIR will not save us. We need national patient identifiers.” He cites the automobile industry’s well-financed, self-serving resistance to implementing VIN (vehicle identification numbers) that stood until the federal government insisted that it be put in place to track theft, accidents, and recalls. He adds, “This is disconcerting. On the one hand, the current Congress is passing legislation like the 21st Century Cures Act that mandates interoperability without mandating a certain standard. On the other, a previous Congress avoided the responsibility of creating the prerequisite for interoperability in a national patient identifier.”

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Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai, says that as a clinical front-liner, he knows digital health is harder than technology companies believe and is in fact still in its infancy. He urges rigorous research rather than self-proclaimed success to figure out where digital health really proves value and says its imperative to interview real patients, adding a tremendously insightful conclusion: “Next time you read a forward-reaching statement about the glory of digital health, ask yourself whether the author has ever placed a digital device on an actual patient.” He gives some Cedars lessons learned:

  • Streams of data often make no sense until you talk to the patient about what they were doing and feeling at the time.
  • Patients won’t wear sensors that must be applied to a specific part of the body or that are visible.
  • Some technologies, like virtual reality goggles, sound great in theory but won’t necessarily be accepted by patients in distress.
  • Patients lose devices and misuse them in ways that seem impossible.
  • Humans react to designs, even simple aspects like colors and method of attachment, in unpredictable ways.
  • Build it and they won’t necessarily come – Cedars got endless publicity (including from Apple’s Tim Cook on the stage) for its HealthKit and wearables integration with Epic, but of the 80,000 MyChart users who were invited to sign up, only 500 (or 0.6 percent) uploaded their information even once.

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UNC Health Care (NC) reports that its operating income for the first 11 months of the year is $121 million vs. the $50 million it expected, which it attributes to the opening of new facilities, better expense management, and its implementation of Epic.

I keep reading about companies determined to be “the Uber of healthcare” in offering on-demand, smartphone-requested house calls. Note to those companies: there’s a nearly endless supply of potential Uber drivers, but not of licensed physicians. You’re going to run out of doctors (and thus runway) as everybody chases the same idea. Our medical education model restricts — intentionally or otherwise — the number of physicians it produces and many of those are opting out of practicing after graduation, which is why it seems that at least a third of the doctors listed on any insurance company’s list weren’t born in the US. Video visits hold more promise since they are geographically indifferent (other than archaic state-by-state licensure), ideal for part-timers, and more efficient overall than traipsing around to the houses of individual callers.

I find this hard to believe: American Academy of Family Physicians endorses HealthFusion’s EHR to its members, but claims it wasn’t paid to do so.

Coca-Cola funds a new non-profit that will fund the research of scientists trying to prove that obesity is due to lack of exercise, not guzzling the gallons of obscenely sugary water sold under Coke’s nameplate. One of the fund’s main researchers is the dean of the public health school of West Virginia University, located in the state that perpetually battles Mississippi for obesity bragging rights.

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Anaheim, CA and other cities are running pilot projects in which nurse practitioners accompany paramedics on non-urgent 911 calls, diagnosing and treating the callers in their homes instead of taking them to overcrowded ED. A third of Anaheim’s medical 911 calls are from people reporting non-urgent situations such as headaches and stomach aches, all of whom would have otherwise ended up in the ED.

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A Kim Kardashian Instagram post in which she extols (with the obligatorily enthusiastic “OMG”) the virtues of a drug sold by a company “that I’m partnering with” without including the drug’s mandatory risks earns the manufacturer an FDA warning. The company responds (I’m paraphrasing) that Kardashian is an airhead celebrity of questionably earned fame who probably thinks a package insert is an OMG-cool sexual practice and it will muzzle her appropriately. FDA insists that, “To the extent possible, corrective messaging should be distributed using the same media, and generally for the same duration of time and with the same frequency that the violative promotional material was disseminated,” which I paraphrase as, “She needs to retake that selfie holding up the warnings and precautions, preferably with the same OMG so her dimwitted followers can understand their folly in taking medical advice from a reality TV star.”


Sponsor Updates

  • First Databank adds a new column titled “Little Known Facts About Drugs” to its company blog.
  • KLAS scores Impact Advisors services as an overall 92.8 in its mid-year report.
  • The Chartis Group publishes “Consortium Model Networks: Evaluating the Potential of Collaboration.”
  • Zynx Health adds transitions of care content to its ZynxCarebook mobile care coordination solutions.
  • AdvancedMD offers “Level the financial data playing field.”
  • AirStrip offers “Midwives and Technology: Maximizing Local Care.”
  • Anthelio Healthcare Solutions CEO Asif Ahmad discusses healthcare technology trends driving development of products and services in a new video.
  • Besler Consulting offers “The CCJR is distinctly different from other bundled payment models.”
  • Billian’s HealthDATA offers “Trends in Healthcare Finance.”
  • Caradigm posts “Engaging High-Risk Patients through Care Management.”
  • CareTechSolutions’ Jim Giordano presented the “Whatever IT Takes” award to Sammi Goulet, who worked 22 hours straight on a recent go-live
  • CenterX will exhibit at the National Council for Prescription Drug Programs Workgroup Meeting August 12-14 in Minneapolis.
  • Clinical Architecture offers “A Meaningful Scavenger Hunt.”
  • CoverMyMeds posts “Pelotonia Fundraiser ‘Bump, Set, Cure!’” D
  • Divurgent offers “Why Cerner? Reflecting on DoD’s EHR Decision & The Role of Cyber-Security.”
  • PracticeUnite offers “Developing User Friendly UI for Secure Texting Patient Apps.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 11, 2015 News 6 Comments

Monday Morning Update 8/10/15

August 9, 2015 News 2 Comments

Top News

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The American Hospital Association complains that the FCC’s decision to open up TV and 600mHz bands to unlicensed devices such as wireless microphones places hospitals at risk since Wireless Medical Telemetry Service uses 608-614 mHz. The FCC denied AHA’s request for a delay but agreed to increase the geographical buffer zone to several hundred meters, leaving it up for hospitals to figure out how to enforce it to avoid interference with their vital signs and cardiac monitors. Hospitals request the buffer zone by registering each device in a central AHA database that unlicensed devices are supposed to check in finding a vacant frequency.


Reader Comments

From PollyWantACracker: “Re: Yale Physician Services. I played golf with two of their MDs. They both stated that Epic had a terrible rollout, they are still trying to figure it out, and they wished they hadn’t switched.” Sounds like par for the course (no pun intended) following an EHR rollout. I thought Epic had been live there for some time, so either they still aren’t over it or perhaps their practice was implemented later in the cycle.

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From Howdy Partner: “Re: Microsoft’s US partners of the year. Will be announced soon, but here’s the slide from their user group meeting last week announcing the winners.” Hopefully Microsoft will realize that it spelled the name of its Rising Star Partner of the Year incorrectly – Health Catalyst is two words.

From Will Bloom: “Re: cloud. I ran across your 2008 article. It was pretty forward thinking then.” I had to dig to figure out which one the reader was referring to. I think it’s this one, where I argued for SaaS and connected networks in opining:

In other words, I don’t need a loaded PC any more than I need a gas generator, a TV antenna, or an outhouse. The grid is better, cheaper, and more reliable to meet those needs. All I need is a connected appliance. But more importantly, the network adds tremendous value. You contribute a little by joining, but you get a lot in return … The Holy Grail is to pull data back out in a way that lets hospitals learn something actionable, like which antibiotics work best or which lab values correlate with genomic profiles. Few hospitals have the capability to even get that kind of information from their own locally stored data. Fewer still can tap into the collective knowledge of their fellow IDN members. And nearly none can focus the accumulated intelligence of hundreds of peers when making important clinical and business decisions … It will soon make good sense to shut down the endlessly duplicated silos of locally maintained hospital IT and get on the grid instead.

From Hacky Sacker: “Re: hackable medical devices. You mentioned the FDA’s warning about wirelessly controlled infusion pumps that can be taken over by hackers. Here’s a live demo of an actual IV pump hack as performed at the recent BlackBerry Security Summit.” The live hack of a PCA pump is sobering, although hackers have limited incentive to prowl security camera-equipped hospital hallways looking for medical equipment to hack. The demo hacker connects the PCA pump to his laptop via Ethernet, uses hacker tools to see what network services and ports the pump is using, uses unsecured Telnet and FTP to gain root access to the pump, then finds the wireless network name and unencrypted WEP passwords to log into the pump wirelessly as well. He installs malware into the pump’s firmware and changes settings freely, such as increasing the narcotic dose to a level that would have killed the attached patient.


HIStalk Announcements and Requests

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Poll respondents minimized Cerner’s contribution to the DoD win by Leidos, Accenture, Cerner, and Henry Schein, with 42 percent of them crediting the DoD’s incumbent vendor Leidos, 26 percent saying the selection was due to political influence, and 17 percent suggesting that  DoD chose the Leidos team strictly on price. New poll to your right or here, triggered by my report on Meditech’s latest financials and the company’s ensuing response: is Meditech’s market position getting better or worse?

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Welcome to new HIStalk Gold Sponsor Bernoulli. The Milford, CT medical device integration company has been a leader since 1989 in real-time data integration and patient safety surveillance for clinical areas, ICUs, and telemedicine settings. Bernoulli Enterprise offers an enterprise, vendor-neutral medical device integration platform; alarm management; a virtual ICU; remote patient monitoring with built-in dashboards and viewers; and analytics that provide clinical decision support and outcomes analysis. Customers with some of the company’s 35,000 installed beds include Duke University Medical Center and Memorial Sloan-Kettering Cancer Center. The company’s CEO is industry long-timer Janet Dillione, who many folks will remember used to run Siemens Health Services and Nuance Healthcare. Thanks to Bernoulli for supporting HIStalk.

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Elementary schoolteacher Mrs. F from Wisconsin sent a thank-you note and photos about the STEM professional development library and iPad Mini we funded via vendor donations (with matching funds from the  Bill & Melinda Gates Foundation). She says neither she nor her school district could have afforded the 20 books that she’s studying on her own time this summer in a pilot project to prepare for the upcoming school year. Her school is moving toward a STEM (science, technology, engineering, math) emphasis and she and her colleagues needed to dig deeper into how to prepare students for 21st century careers. She especially liked the units on MakerSpaces, do-it-yourself labs where students are provided with tools, supplies, and space to explore their scientific interests. Vendors who donate $1,000 or more to my DonorsChoose project get a mention here on HIStalk and have their funds matched by an anonymous vendor executive benefactor.

My latest LinkedIn gripe: executives who lack advanced degrees (usually sales and CEO types) who pad their resumes with “executive coursework” from big-name schools that offer expensive weekend programs for status-sensitive executives who couldn’t be bothered to actually attend graduate school.

The update on my Windows 10 experience is as positive as I could hope – I’ve had no problems or seen any puzzling or questionable behavior. I had ongoing memory and disk problems under Windows 8 , not a big deal, but near-lockups that occasionally required bringing up Task Manager to kill piggish, long-running apps like Firefox. I haven’t had to do that under Win10 and my CPU and desk utilization are still low, dropping down to 1 percent or so when I’m not doing anything. I hadn’t thought of using the laptop’s webcam microphone to give verbal requests to Cortana, but that’s working too, although its speech recognition isn’t nearly as good as on my Amazon Echo, so I’ll stick to keyboard entry.


Last Week’s Most Interesting News

  • IBM announces plans to acquire Merge Healthcare for $1 billion to add imaging capability to Watson.
  • The Senate moves along the confirmation of Karen DeSalvo as HHS assistant secretary for health.
  • Cerner’s Q2 results miss analyst revenue expectations, sending shares down 9 percent for the week.
  • Meditech’s quarterly results show a 16 percent revenue drop on a 42 percent decrease in sales.
  • Allscripts announces flat quarterly revenue and reduced losses, with the company adding one Sunrise sale in the quarter.
  • Papworth Hospital in England changes its plans to install Epic and instead will look for a more cost-effective system.
  • Medical Informatics Engineering informs HHS that its May cyberbreach exposed the information of 3.9 million patients of dozens of provider organizations to unknown hackers.
  • CHIME announces Gretchen Tegethoff as VP of its for-profit business that charges vendors for access and sales to its CIO members.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Sales

Streamline Health Solutions will implement the abstracting module of its Looking Glass solution at one of its existing, unnamed customers through a channel partner.


People

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Texas Health Resources promotes Joey Sudomir to CIO.

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Citra Health Solutions names Eric Olofson (Olofson Group) as COO/CIO.

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Well-being technology vendor Healthways names board chair Donato Tramuto as CEO. He’s also chairman and CEO of Physicians Interactive, which sells “digital marketing tactics” to drug companies.


Announcements and Implementations

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Physicians’ Desk Reference updates its mobilePDR smartphone app to feature concise drug label information such as indications, dosing, adverse effects, side-by-side drug comparison, interaction checker, and pill identifier. The iOS and Android apps are free for US healthcare professionals.


Technology

Baidu, the Google-like China-based web services company, develops “Ask a Doctor,” a voice translation application that allows users to speak their symptoms to then receive a possible diagnosis and link to a nearby medical specialists. The company says its goal is “to build a medical robot.” The company is building artificial neural networks to allow it to accept voice input in the complex Mandarin language. It also hopes to connect to EHRs, which are in early deployment in China.

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The Privacy Visor, $240 eyeglasses that trick facial recognition systems so they can’t identify the wearer in a form of visual opting out, will go on sale in Japan within a year. They were developed by a government-affiliated institute.


Other

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A Health Affairs Blog post asks a question I’ve raised many times myself: why do veterinary practices, especially those in chain pet stores, have far better patient portals and EHRs than their medical practice and hospital counterparts?

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This tweet makes perfect sense: why are hospitals considered the organizations best equipped to manage overall individual or population health? Not only do most people spend only a tiny fraction of their lives interacting with hospitals, hospitals don’t even make up a significant percentage of the time a given patient spends interaction with the healthcare system since most care is delivered from physician practices, pharmacies, walk-in clinics, etc. Unstated bias puts hospitals in the healthcare driver’s seat when they have always been the poorest performing, most expensive, and most consumer-indifferent healthcare resource, not to mention the one patients would most like to avoid. Hospitals made their fortunes cranking out highly paid and questionably effective procedures while blaming insurance companies and doctors for most of what’s wrong with healthcare, and now that the market is less inclined to pay for those procedures, hospitals have suddenly developed a keen interest in the overall wellbeing of their customers.

Researchers find that EHR medication lists perfectly match a patient’s claims data only 24 percent of the time, with 60 percent of the discrepancies involving EHR-profiled meds with no claim filed and 40 percent having meds for which a claim was filed that didn’t appear in the EHR.

China’s technology-driven healthcare reform has stalled, with policy changes and innovative technology startups failing to overcome inadequate IT systems, overregulation, and pressure from the dominant state-run hospitals that still deliver 90 percent of visits. Doctors are also pushing back against reform that would reduce hospital reliance on drug sales for income, saying they need the money to stay open.

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Greece’s financial crisis has led to the formation of illegal free clinics, most of which refuse to register with the government because they say the government is legally responsible for providing the care they are delivering. The country’s 25 percent of hospitals that are not government run are struggling with patients who can’t afford their services and who are instead crowding public hospitals, which are 40 percent fuller than before despite an austerity-mandated hiring freeze that has been in effect since 2011.

Healthloop founder Jordan Shlain, MD says public reporting of surgical outcomes (“data scalpels”) is causing surgical teams to review their overall performance since every person on it contributes to outcomes (“your income will be dependent on your outcomes.”) He urges physicians to collect and analyze their own data instead of letting insurance company statisticians boil it down to their own questionable conclusion.


Sponsor Updates

  • The SSI Group and T-System will exhibit at the HFMA Region 10 Healthcare Conference August 12-14 in Colorado Springs, CO.
  • Forward Health Group creates a music video to promote its August 27 open house. It seems to have been created as a single, two-minute roving video that involved everybody in the office lip syncing, which must have been quite a coordination challenge.
  • Streamline Health will attend Medhost’s “The Nashville Experience” event September 16 in Nashville.
  • Surescripts offers “I’ll Take One Refill, Hold the Fax.”
  • SyTrue founder Kyle Silvestro is featured in a NewsReview article on data-driven healthcare.
  • TeleTracking offers “Lean Strategies in Healthcare.”
  • Fujifilm Teramedica offers “VNAs usher in new opportunities for healthcare.”
  • GetWellNetwork publishes a white paper on Carilion Roanoke Memorial Hospital’s implementation of its interactive patient care system.
  • TransUnion postss “For Healthcare Companies, Data Security is a Critical Test.”
  • Verisk Health offers “5 Tips for a Successful HEDIS Season.”
  • Versus Technology publishes “5 Myths and Misunderstandings About RTLS.”
  • The Information Difference names VisionWare a leading technology vendor in the Master Data Management space.
  • Recondo’s EmpoweredPatientAccess suite earns a most-improved score in a KLAS mid-year report.
  • VitalHealth Software will host an Executive Forum on “Healthcare Outcomes – what we measure matters” August 12 in Minneapolis.
  • Voalte offers a guest post, “Changing the Game and Getting it Right.”
  • Huron Consulting will exhibit at CORE Conference 2015 August 12-14 in Salt Lake City.
  • West Corp. offers “How Chronic Care Management is Like Going to the Gym.”
  • Xerox offers “An Overlooked Member of an Effective Healthcare Team.”
  • ZirMed offers “Diagnosing the Increase in Surprise Bills at Urgent Care Centers.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 9, 2015 News 2 Comments

News 8/7/15

August 6, 2015 News 11 Comments

Top News

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IBM will acquire Merge Healthcare for $1 billion, giving IBM’s Watson product “eyes” that will allow users to compare images within a single patient or across similar patients for diagnosis and treatment. IBM will pay $7.13 per MRGE share, a 32 percent premium to Wednesday’s closing price. Merge shares haven’t hit that price since late 2006, having dropped 58 percent in the past 10 years as the Nasdaq rose 135 percent.


Reader Comments

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From Helen Waters: “Re: MEDITECH’s financial report. To reference a famous quote: ‘The reports of my death have been greatly exaggerated.’ (Mark Twain, 1897). MEDITECH is ushering in a long overdue level of energy and meaningful innovation to the EHR market. Our customers, and the EHR industry, should expect more. We are delivering disruptive innovation with fiscal responsibility, which we believe the industry very much needs. No other company is better positioned to deliver an advanced and contemporary EHR solution that addresses the needs of the market at an affordable price point. We are doing that. Let’s stop assuming that if you pay more, you get more. To what degree has that premise really been vetted? The EHR vendor community needs to work harder for your health care IT dollar. As healthcare leaders, you owe it to your organization, and as vendors, we owe it in partnership with the national agenda. We are all being called upon to drive down the cost of delivering efficient and effective quality healthcare, as well as to spend the healthcare dollar more wisely, and this includes information technology. We are fortunate to have a big seat at the EHR table, and we intend to preserve and grow it. While you note a change in our revenue and earnings, given these transformative efforts, this was not unexpected. Please know we are responsibly at the table, and we are committed to our existing customer base, providing them with an affordable option to migrate to our latest platform. We celebrate the success of our customer base and the impact they’ve had advancing the delivery of high quality healthcare for the communities they serve. At times, the EHR market feels a bit irrational relative to IT decisions and the promise of utopia often being trumpeted with selecting one system over another. We are proud of our past, executing in the present, and delivering for the future of healthcare technology.” Helen is VP of sales and marketing for Meditech and references my mention of the numbers above from its Q2 report.

From DoD: “Re: DoD contract. The actual amount Cerner got is very small and will need to be shared with Intermountain. I suspect we’ll see a tremendous amount of infighting in this group as they begin the work of delivering while not being paid until the users come online as the contract requires. That stretches payments over seven years, but the investment needs to be done up front. There are several off ramps built in and some strict deliveries. The prime will have to beat the subs into submission in order to deliver on the commitments while withholding payments for years.” Unverified. I’m not sure what Intermountain contributed to the bid or what they’ll get in return.

From Doogie: “Re: Epic. In light of news of Epic’s failures in the UK, coupled with DoD decision, Epic should probably start worrying about its public image. Judy’s silence may have worked for her in the past, but now that Epic is finally being held accountable for its shortcomings, people are going to start wondering if there’s nothing to hide why not comment? One thing is certain, Epic’s stubborn refusal to join CommonWell, among many other things, may finally be backfiring.”

From Concerned Reader: “Re: HIStalk. You’re a Cerner hater and an Epic lover. I have decided to stop reading HIStalk because your bias affects your reporting to the extent of being unethical journalism. On Monday the morning update headlined Cerner missing financial projections in the first line and Epic’s loss of the UK hospital as the very last line.” One thing I’ve learned in writing HIStalk for 12 years is that I can’t mention Epic, religion, or George Bush in any capacity without having a few hysterical, anonymous readers react like a bull instinctively charging a red cape. It doesn’t matter what I actually say — just seeing the words on the page sends a few grudge-bearing readers off screaming with fingers in ears. Lt. Dan writes the headlines and wisely chose Cerner’s earnings report (along with those of Allscripts and Meditech) as the top headline  – Cerner’s report and comments were more important given their DoD win and continued integration of Siemens Health Services. If you’re truly going to stop reading HIStalk (those who threaten almost never do), consider first Googling to see which of the cookie cutter, opinion-free alternatives covered Epic’s reported loss at Papworth – I don’t see even one, which means your only source of that negative Epic news was right here on good old unethical and Epic-loving HIStalk.

From Out of Touch: “Re: KLAS. Using ‘fighting words’ and posturing as they holding vendors hostage on a topic KLAS clearly doesn’t understand. Irrelevant. For a price, I bet.” KLAS says many large vendors “challenged KLAS to step up and be the Switzerland of interoperability,” an assignment it accepted “with trepidation” in offering to convene a meeting along with CHIME. It adds that, “Congress and federal agencies are likely to cheer when they know such action is voluntarily taken” and lists as participants CEOs of Allscripts, Cerner, Epic, Athenahealth, Meditech, and others. I’m not sure I would expect KLAS to be the Switzerland of anything or to lead the interoperability charge while selling non-interoperable vendors reports as its main focus, but we’ll see what the participants come up with.

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From Mute Pointer: “Re: BJC. Says their downtime wasn’t due to a hack.” MP forwarded an internal email describing the results of BJC’s investigation, which concluded that “inadvertent actions within our own IS department” flooded the network and caused its protection systems to restrict application access. They’ve hired an external consulting firm to review their IT infrastructure, having not done one since 2013.

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From Isadore Nobb: “Re: AHA Solutions. I don’t think any product has failed to earn their ‘vetting’ approval as long as the company paid. With one contract at least, they added a huge group of solutions from a business unit without any process other than to require another million dollars and a percentage of sales. Turns your ethical stomach.” Unverified.


HIStalk Announcements and Requests

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I took a deep breath of hesitation before clicking the button to upgrade my primary PC to Windows 10. It was painless and has been perfect so far, with zero learning curve, no unexpected gotchas, and no incompatible programs. The only extra step for me was to install a new Win10-compatible version of Bitdefender Total Security 2015 and the upgrade even prompted me to do that automatically. Win10 has a good user interface and just feels right all around. Here’s what I’ve discovered so far with a small amount of use:

  • The Cortana “ask me anything” digital assistant box is useful, even if only to avoid navigating trying to find commonly used functions like Device Manager.
  • The Start Menu is not only back, it has been enhanced to display some of the Metro live tiles by default (but that can be turned off, too).
  • The Edge browser replacement for Internet Explorer feels really fast and lightweight – it brings up the HIStalk page faster than Firefox by my timing.
  • Task View does something with virtual desktops that would seem to be useful, although I haven’t done anything with it.
  • The Action Center icon rides in the system tray and offers one-click access to some settings and a log of recent system activity. The much-hated “hover to see the charms” option is gone.
  • I haven’t studied it in depth, but looking at Task Manager’s CPU and disk utilization, Win10 seems to be much more efficient. My CPU usage always seemed to be high under Win8, but it’s at 1 percent right now and so is disk utilization. I don’t know what actually changed, but everything feels snappier.

So far, I would say this is the best and easiest Windows upgrade ever. That only negative I’ve read is that some basic and not universally used features (being able to play DVDs, for example, or play ad-free Solitaire) have been removed from the basic free upgrade and are now paid options in the previously little-used Microsoft Store, raising the possibility that Microsoft plans to give away the basic OS (to previous consumer-only licensees, of course – businesses and new users still pay) and charge more for optional individual apps and services in a cafeteria-style promotion. In that regard, Microsoft may have moved Windows into the ultimate machine for generating recurring revenue instead of a one-and-done upgrade.

My server took a temporary break when I sent out the email blast about the IBM-Merge deal Thursday, just like it did last week on DoD news, which I thought was a one-time overload of readers. The result was a “you’re going to need a bigger boat” maxing out of server memory to the point it couldn’t even swap out storage even though I’m running a dedicated server with a Xeon E3 four-core processor, 16GB of memory, and solid-state disk. I’ve placed an order to upgrade the server yet again, a problem I’ll happily accept every time since it means someone is reading other than me.

My present grammar gripe, which isn’t really a gripe since it’s cutely old school: referring to a “piece of software” as though the user gets just one slice of the larger software pie.

This week on HIStalk Practice: Dr. Gregg composes a moving requiem for the patient portal. AncestryHealth Chief Health Officer Cathy Petti discusses company plans to move member health histories into EHRs. Practice Fusion ramps up executive team in preparation for IPO. WEDI survey confirms what other ICD-10 research has already shown: Physician practices aren’t ready for October 1. AMA lobbying dollars come under scrutiny. Azalea Health secures a new round of financing. Premier Physician Network goes live on Centricity. The newly formed Ohio Independent Collaborative looks to extend the livelihoods of independent physicians.

This week on HIStalk Connect: Yelp expands its consumer review platform to include Medicare performance data for hospitals, dialysis clinics, and nursing homes. The FDA issues a safety alert over cybersecurity vulnerabilities found within Hospira infusion pumps. Developers in South Korea introduce a new Braille-based smartwatch for the visually impaired. A new startup focused on women’s health unveils an earbud that tracks basal body temperature during sleep, plotting it on a paired smartphone app.


Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Computer cart maker Capsa Solutions acquires Rubbermaid Healthcare., which offers basically the same product line.

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Marlin Equity Partners will acquire ambulatory EHR/PM vendor AdvancedMD. ADP bought the company in early 2011. Marlin also owns e-MDs and MDeverywhere.

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Health Catalyst acquires Health Care DataWorks, the early but lagging data warehouse vendor that was spun off from Ohio State with former CIO Herb Smaltz in 2008.

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India-based Cognizant reports a 39 percent increase in its healthcare business is it continues to boost revenue and profits following its September 2014 acquisition of TriZetto for $2.7 billion.Health makes up 29 percent of the company’s business. Share price rose 50 percent in the past year, valuing the company at $41 billion.

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Leidos Holdings reports Q2 results: revenue up 4 percent, adjusted EPS $0.73 $0.61, with its health and engineering segment losing $7 million vs. a loss of $482 million in the previous year. Chairman and CEO Roger Krone said of the company’s Department of Defense EHR bid, “We’re in that weird period between the award and the expiration of the protest period, so we’re not going to give a lot of guidance on what’s going on. We probably have another five days or so until we think we’re safely on the other side of the protest period.”

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McDonald’s tries to stem its dramatic business downturn by naming Dignity Health CEO Lloyd Dean to its board. Perhaps it missed Dignity’s web page declaration that “in today’s fast-paced, fast-food society, it can be tough to make healthy decisions for kids.” McDonald’s is getting endless pressure from franchisees unhappy with out-of-touch management and lack of buyers for their underperforming locations; competition from fresher offerings at Burger King, Wendy’s, Shake Shack, and Chipotle; and strongly slumping sales.

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India-based provider search website Practo raises $90 million in funding from investors that include Google.


Sales

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WellStar Health System (GA) chooses Legacy Data Access to retire its McKesson Horizon applications.

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The FDA awards genome informatics vendor DNAnexus a contract to build precisionFDA, an open source platform for sharing genetic information as part of the White House’s precision medicine initiative.


Announcements and Implementations

Extension Healthcare publishes a guide for hospitals working to comply with the Joint Commission’s January 1, 2016  alarm safety goal.

Long-term care software vendor PointClickCare adds the ability for customers to receive radiology tests results into their EHR using technology from Liaison Healthcare. 

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Yelp will add ProPublica-produced data to its provider business listings, including ED wait times, fines paid, and readmission information. It’s a bit of an odd relationship given that ProPublica is a non-profit, public-spirited news reporting organization now turned data vendor to a commercial customer via an undisclosed business arrangement. I took the screen shot above Wednesday afternoon. Hospitals will learn that Yelpers tend to get dramatic given one bad experience even after many good ones, so it’s common for an otherwise quiet or even complimentary Yelper to suddenly go off on a one-star tirade over something only marginally related to the business’s main focus, as they often do when they can’t get a table at their favorite restaurant or find an error in their credit card charge after the fact (you really are only as good as your latest review).

HIMSS offers so many conferences that it is now co-locating them in confusing attendees about what they’re signing up for. The latest: the Connected Health Conference in chilly National Harbor, MD in November, which includes the mHealth Summit, Cyber Security Summit, and Population Health Summit. Each requires $695 registration, but signing up for one allows attending the others.

Apple’s ResearchKit gets its first international use as Stanford’s MyHeart Counts app is made available to people living in Hong Kong and UK.


Government and Politics

The Senate’s HELP committee unanimously approves the promotion of Karen DeSalvo, MD, MPH to HHS assistant secretary for health without a hearing Thursday, clearing the way for a full Senate vote following its recess through September 8. DeSalvo has been holding the assistant secretary position since October 2014 while remaining National Coordinator. In that role, she oversees the Surgeon General, communications, regional health administrators, and a number of public health related offices.

The SEC approves a new rule that will require most public companies to publish the ratio of CEO pay to its average overall employee salary.

Ireland will roll out a national patient identifier, with the automatically assigned record including a signature and photograph. According to the health minister, “It will allow us to follow patients and staff as they move through the service in a way we currently can’t. This will improve patient safety, reduce duplication and errors, and give us a huge amount of new data that we can use to make services more efficient and improve planning.”

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The American Hospital Associates asks the Department of Justice to review possible increase in healthcare costs that the proposed merger of Anthem and Cigna could cause. Perhaps the insurance companies should ask DOJ to look at hospital mergers since those seem to be increasing opportunistic pricing as well.

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Arizona Governor Doug Ducey announces a plan to improve the state’s Medicaid program that includes offering personal savings accounts for paying for non-covered services and an app- and portal-based member system that includes appointment reminders, disease management tools, and a provider locator. 


Innovation and Research

Johns Hopkins University researchers develop an algorithm that uses 27 factors to predict septic shock in 85 percent of cases.


Other

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A Commonwealth Fund survey finds that 50 percent of primary care physicians see technology as improving care quality, with 28 percent feeling that HIT makes it worse. Their feelings about ACO impact are all over the place, with only 30 percent of those actually participating in an ACO saying they have a positive impact on patient care. Nearly half of PCP physicians say healthcare trends are causing them to consider early retirement.

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Phoebe Putney Memorial Hospital (GA) will go live on Meditech on October 1 at a total project price of $50 million. It chose Meditech 6.1 in April 2014.

The family of a 14-year-old girl who died at a “Foam Wonderland” rave concert at the New Mexico State Fair sues the state, three promoters, two security firms, an ambulance company, a hospital, and two paramedics, claiming that all of them contributed to her death by their recklessness and negligence in failing to save her from her MDMA overdose.


Sponsor Updates

  • Medicity CEO Nancy Ham co-authors the HFMA article “The Financial Impact of Population Health Analytics in the Shift to Value-Based Models.”
  • Billian’s HealthData and Porter Research invite responses from professional marketers in a survey on marketing practices.
  • Hayes Management Consulting posts “Prepping Your Staff for a Successful EHR implementation, what you need to know.”
  • MBA Health Group and Netsmart will exhibit at the Allscripts Client Experience 2015 through August 7 in Boston.
  • MedAptus offers “A Glimpse into the Facility Billing World from a Split-Billing Expert.”
  • MedData offers “The Wait is Over: Welcome to ‘The Impatient Patient.’”
  • Navicure offers “Increasing Patient Payments with Clarity.”
  • Nordic offers the latest video in its “Making the Cut” series on Epic conversion planning.
  • NTT Data offers “Six Reasons You’re Not Yet on the Cloud.”
  • NVoq offers “Your iPhone has Good Dictation. Why Doesn’t Your Enterprise Application?”
  • Oneview Healthcare will host Health Facilities Design and Development Victoria August 17-19 in Melbourne, Australia.
  • Experian Health/Passport Director of Strategy and Innovation Karly Rowe is featured in Washington Business Journal’s “4 things to know about data security after the Children’s hack.”
  • PatientSafe Solutions offers “Alarm hazards as patient safety concern.”
  • UlteraDigital interviews Patientco Director of Marketing Josh Byrd about redesigning PatientWallet and the need for innovation in healthcare.
  • PatientKeeper offers “The Physics of EHR Advocacy.”
  • PerfectServe offers “Put down the phone, and other communication lessons from healthcare professionals.”
  • PeriGen piblishes “How research resulted in a checklist solution.”
  • Phynd Technologies offers “Is There a Solution to Provider Abuse of the Medicare System?”
  • PMD posts “Client-Server Architecture and Finding the Right Balance.”
  • Qpid Health offers “Getting meaning from patient records stuffed full of results and statistics.”
  • Sagacious Consultants launches a charity ad campaign for Tri 4 Schools at the Dane County Regional Airport in Madison, WI.
  • Salar Inc. offers “ICD-10 is still on track to launch October 1, 2015, will you be ready?”
  • Sandlot Solutions will exhibit at the EHealth Initiative’s IThrive Innovation Challenge August 12-13 in Washington, DC.
  • Elsevier Clinical Solutions, Impact Advisors, and Intelligent Medical Objects will exhibit at the Allscripts Client Experience through August 7 in Boston.
  • EClinicalWorks offers “1.5 Million Referrals Exchanged via P2POpen.”
  • Galen Healthcare Solutions publishes “Clinical Data: Hey, You Are Migrating Your EHR, Take Me with You!!”
  • Greenway Health offers “CMS Expands ICD-10 Grace Period Guidance.”
  • The HCI Group offers “Epic Consultant Corner: Robert Kight Interview.”
  • HDS offers “Thoughts on Meaningful Use by the Brookings Institution.”
  • Healthcare Growth Partners advises GMed on its sale to Modernizing Medicine.
  • Healthfinch offers “It’s Not Just a Formality: Formal Refill Protocols are a Must.”
  • Healthgrades recaps its second HG Challenge hackathon.
  • HealthMedx will exhibit at the Arizona Health Care Association Annual Conference & Trade Show August 18-20 in Scottsdale.
  • Holon Solutions offers “Next Up For Enabling Data Exchange: Transitions of Care Between Hospitals and Nursing Homes.”
  • Influence Health posts “Engaging Patients for Impactful Changes.”
  • Ingenious Med offers “IM1: Solving ZDoggMD’s Readmission Problem.”
  • InterSystems publishes “From Opposition to Cooperation: Payers Join the Care Team.”
  • LifeImage offers “The Top 5 Reasons to Integrate Image Exchange with Your EMR.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 6, 2015 News 11 Comments

IBM to Acquire Merge Healthcare for $1 Billion

August 6, 2015 News 1 Comment

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IBM announced this morning that it will acquire Merge Healthcare for $1 billion, planning to add Merge’s imaging and clinical systems to its Watson Health analytics unit. IBM says Merge’s systems will allow Watson to “see” and will “unlock the value of medical images to help physicians make better care decisions.”

Merge has 7,500 customer sites, which IBM sees as prospects for its Watson Health Cloud. The company suggests it could be used to compare a patient’s images to previously taken ones and with those of similar patients. Specific use cases include clinical trials design, making diagnosis and treatment decisions, optimizing patient engagement, and delivering value-based care.

IBM SVP John Kelly said in a statement, “As a proven leader in delivering healthcare solutions for over 20 years, Merge is a tremendous addition to the Watson Health platform.  Healthcare will be one of IBM’s biggest growth areas over the next 10 years, which is why  we are making a major investment to drive industry transformation and to facilitate a higher quality of care. Watson’s powerful cognitive and analytic capabilities, coupled with those from Merge and our other major strategic acquisitions, position IBM to partner with healthcare providers, research institutions, biomedical companies, insurers and other organizations committed to changing the very nature of health and healthcare in the 21st century. Giving Watson ‘eyes’ on medical images unlocks entirely new possibilities for the industry.”

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August 6, 2015 News 1 Comment

News 8/5/15

August 4, 2015 News 12 Comments

Top News

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Cerner announces Q2 results: revenue up 32 percent, adjusted EPS $0.52 vs. $0.40, meeting earnings estimates but falling short on revenue expectations as service revenue declined and operating expenses jumped 53 percent. The company raised full-year earnings guidance but lowered full-year revenue guidance, sending CERN shares down 3.5 percent in after-market trading following the market’s close Tuesday. CERN shares are up 26 percent in the past year vs. the Nasdaq’s 17 percent.

From the Cerner earnings call:

  • CFO Marc Naughton says the company is disappointed that it missed its guided revenue estimates, but is happy with its all-time high strong sales and positive outlook.
  • Recurring revenue from the Siemens acquisition is tracking as expected, but fewer than expected customers committing to moving to Millennium or buying additional of the former Siemens solutions as they are “holding pat with their hand.”
  • President Zane Burke says Cerner differentiates itself (presumably from Epic) on predictable costs of ownership, fixed-fee implementations, and partial or full IT department outsourcing.
  • Cerner says (without naming names) that it is gaining ambulatory business at the expense of Athenahealth because it offers better service and value.
  • Burke says Cerner is happy to have been chosen by the DoD as part of the Leidos bid, but doesn’t expect a material impact on sales, revenue, or profits in the near term. He adds that the DoD’s project estimate is $9 billion over 18 years, but the value of the contract awarded is less.
  • Cerner says its customers “are actually very excited” about its DoD win.
  • Cerner’s new campus construction will require a capital expenditure of $150 million in the fiscal year.
  • CEO Neal Patterson was supposed to join the call for Q&A, but did not participate.

Reader Comments

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From Captain Cupric: “Re: CHIME’s for-profit vendor-CIO matchmaking service. Isn’t that what the AHA’s AHA Solutions group does? Vendors pay hundreds of thousands of dollars (sometimes more than a million dollars) for an agreement, then pay a percentage of sales for ‘introductions’ to decision makers.” I believe that’s the case, although AHA Solutions does have some sort of vetting procedure (other than having the vendor’s check clear) before anointing their solutions as “endorsed.” It annoys me when supposedly non-profit member organizations can’t resist the lure of transforming themselves into richly rewarded pimps who arrange vendor-member liaisons in exploiting the “Ladies Drink Free” business model. The healthcare history is rich with examples (AHA, AMA, HIMSS, etc.) and CHIME seems anxious to pile onto the financial bandwagon in selling access to its provider members.

From CIO Doc: “Re: DoD EHR coverage. HIStalk had all I needed to know, from the early rumors to Dim-Sum’s webinar to critical analysis of the selection and then contract and vendor insight.” The other sites didn’t get anything wrong, they just didn’t add much value to the single-paragraph DoD contract notice (which is all they had to work with) in cranking out mindless articles and tweet-seeking missiles like (a) plucking a few random tweets or reader comments about the selection and passing them off as an insightful article representing the industry’s collective reaction; (b) running a long piece about how Epic feels about getting passed over in repurposing content from a rather sloppy Madison newspaper article; (c) asking but not answering questions in headlines; and (d) assembling random, pointless factoids together in proclaiming “X things to know” that were in fact not at all worth knowing. I don’t see much value in having writers with zero healthcare or IT experience rewording public information to seem like fresh news, hoping to attract reader eyeballs and advertiser support with stories that provide those readers with little value, but that’s just me.

From Horse Hockey: “Re: Healthcare IT News. Tooting its own horn in an odd press release. It’s odd that they brag on their unstated DoD reader numbers and even more that they issued a press release about themselves – what editor other than their own would think something like that is newsworthy?” I hesitate to comment since this reader’s email came after I had already written my media diatribe in response to the comment above, but the HIMSS-owned HITN issues a self-congratulatory news flash stating that its (unstated) readership numbers temporarily rose by an (unstated) percentage after they stopped the online presses for lightweight articles as, “CIOs ‘surprised’ at Cerner DoD win,” “Is DoD’s EHR modernization bound to fail?” and “The good, the bad, and the ugly: social media’s response to DoD Cerner EHR contract win.” I don’t read any health IT sites since I’ve yet to find anything there that wasn’t amply described elsewhere, but more power to everybody who can earn and keep readers, especially if they’re trying to do it as cheap seats observers.

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From Informatics Please: “Re: Tampa General Hospital. Has extended their instance of Epic to the University of South Florida in a large ambulatory Epic Connect project involving 850 physicians and 2,800 users.” Unverified, but the source is sound.

From RingRing-Tom Brady: “Re: question for clinical readers. What about a vendor prompts them to want more in going to the vendor’s website or picking up the phone? I’m interviewing and am amazed at how much faith sales and marketing people place in their CRM and automated marketing platforms to drive sales. Is email outreach and social media really making an impact or is it just lazy selling? Does it matter how many touches you hit a prospect with, or do they just hit delete? Does an old-school ‘let me tell you how I can help solve your problem’ work?” I’ll let readers weigh in, but I’ll say this: I often find that clueless sales and marketing people who measure vanity but irrelevant metrics such as ad clicks to be employed by equally clueless and unsuccessful vendors. I’ll also opine that any company that relies on Twitter and Facebook to drive sales might as well lock up and go home since most heavy users of social media (both vendors and providers) are junior employees rather than decision-making executives. I would wager that most healthcare IT sales come from word of mouth or existing personal relationships, not a flashier HIMSS booth or insultingly boilerplated emails.


HIStalk Announcements and Requests

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Welcome new HIStalk Platinum Sponsor VitalHealth Software. The company, co-founded by Mayo Clinic and Noaber Foundation in 2006, offers cloud-based solutions that include chronic disease care management, patient questionnaires, an integrated digital interventions portal, a next-generation heath IT application development environment for deploying cloud-based EHR solutions, and a Mayo-designed EHR for specialty practices. The company is a certified supplier of ICHOM, which defines global outcomes standards for issues that matter most to patients. The company’s global eHealth solutions are used by 100 healthcare networks in the US, Argentina, China, Spain, and several other countries, with a project in China, for example, providing cost-effective telemedicine services with shared medical records, risk profiles, and patient access to their medical records by smartphone. Thanks to VitalHealth Software for supporting HIStalk.

I found this YouTube video describing the use of VitalHealth Software’s QuestLink questionnaire platform for patient-reported outcomes.

I was about to eat an apple this morning and polished it on my shirt, leading me to ponder, why do I do that? The apple has passed through a lot of unwashed hands on its way from orchard to me, so anything short of washing it or peeling it isn’t going to accomplish much (not to mention that polishing it will deposit cloth particles and whatever’s on my shirt on the peel I’m about to eat). It’s almost as mystifying as why many men (not me) pointlessly spit in a public restroom urinal before using it.

Listening: Vaults, a London-based synth pop trio that nobody seems to know anything about — their website says nothing about them and they aren’t even on Wikipedia or Amazon. Their melodic, slow, bass-heavy music is fronted by a siren-like singer. Trying to find them turned up “In Vaults,” a new album of Chicago-based, female-led prog rock from District 97. The band played an amazing live version of “Starless” that features King Crimson’s vocalist/bass player John Wetton, who sang the original version of that King Crimson musical epitaph to itself on the group’s 1974 final album “Red” and who delivered an engaged performance here, unlike most of his 1970s-era music peers who just prop themselves up on stage like sagging, lip-syncing Disney audio-animatrons.

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I’m happy to report that most of the HIStalapalooza sponsorship spots have been claimed, meaning the odds have improved that I won’t go broke in throwing the industry a free party next February. Still available are the all-access CEO Rock Star package and one I’m calling HIStalkacabana, although we’ll still consider the needs of smaller companies who want to be involved (we’ve customized some packages already). Contact Lorre. Thanks for the companies that have stepped up – it’s going to be a great evening as always.


Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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Activist investor Starboard Value, which holds an 8.7 percent stake in MedAssets, calls for the company to replace some of its board members, questioning its acquisition track record and undervalued share price. MedAssets also files SEC disclosure that Tenet will not renew its group purchasing contract with the company, costing MedAssets $44 million in annual revenue or about six percent of its total, but Tenet will continue using its revenue cycle technology products under a separate agreement. MedAssets reiterated that it is continuing to pursue a “value creation plan” and the loss of the Tenet contract may cause “expense reductions, restructuring charges, and/or investments in products or services to help drive long-term growth.” Above is the one-year share price chart of MDAS (blue, up 1 percent) vs. the Nasdaq (red, up 17.3 percent). The company’s market cap is $1.3 billion, helped along by the prospect of Starboard Value taking control from present management.

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Preventative care and disease management platform startup Zest Health, co-founded by former Allscripts executives Glen Tullman and Lee Shapiro, raises $6 million in Series A funding, with an unstated amount of the money coming from the Tullman-Shapiro-led 7wireVentures.

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Aetna announces Q2 results: revenue up 4 percent, EPS $2.05 vs. $1.69, falling short of revenue expectations but beating on earnings. AET shares rose 46 percent in the past year, with CEO Mark Bertolini holding $83 million worth.

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CVS Health announces Q2 results: revenue up 7.4 percent, EPS $1.12 vs. $1.06, beating earnings expectations but reporting a front-of-store sales drop of 7.8 percent following the company’s decision to stop selling tobacco products last fall.

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The Advisory Board Company reports Q2 results: revenue up 30 percent, adjusted EPS $0.40 vs. $0.30. The company also announces a new healthcare marketing product, Audience RX.

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Allscripts reports Q2 results: revenue flat, adjusted EPS $0.12 vs. $0.09. GAAP numbers showed the company losing $3.2 million in the quarter. From the Allscripts earnings call:

  • CEO Paul Black is happy with the company’s sales, revenue, profitability, gross margin, and recurring revenue.
  • The company added 180 new customers in the quarter.
  • The company signed one net-new Sunrise client, a 50-bed hospital.
  • Allscripts will work with NantHealth on API integration between their respective systems and in integrating genomic data.

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I reported a reader’s rumor on July 29 that said a company (whose name I omitted) would divest several hospitals and its consulting company. I omitted some of the details since they involved the publicly traded Community Health Systems, which announces exactly what the reader reported – it will spin off 38 of its rural hospitals and Quorum Health Resources. CYH share price has risen 60 percent in the past year, valuing the company at $7 billion and the holdings of CEO Wayne Smith at $61 million.

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Premier acquires supply chain and performance services vendor CeCity for $400 million. The company offers PQRS reporting, an educational platform, clinical data registries, and a performance and population health management system. CEO Lloyd Myers, a pharmacist, founded the Pittsburgh-based company in 1996.

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Meditech’s Q2 report shows total revenue down 16 percent and product revenue down a startling 42 percent as the company moves from $23.4 million net income to just over $17 million quarter over quarter, reporting EPS of $0.46 vs. $0.63. Six-month net income dropped from $85.4 million to $37 million. Sales dropped nearly $26 million as maintenance fees made up more of the company’s total revenue, with that big sales drop seeming to prove the market perception that Meditech is no longer a significant challenger as Cerner and Epic make it a two-horse health system EHR race as they move down the food chain into smaller and acquired hospitals.


Sales

Delaware Valley ACO chooses Wellcentive’s value-based care solution.

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Presbyterian Healthcare Services (NM) will deploy Zynx Health’s Knowledge Analyzer to standardize its clinical decision support using evidence-based intelligence.

University Health System (TX) chooses Spok for enterprise clinical communications.

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Baptist Health South Florida chooses Cerner Millennium and HealtheIntent for all of its locations, apparently replacing Soarian clinicals but keeping Soarian financials in favor of Cerner’s own offering.

Spartanburg Regional Healthcare System chooses HCTec Partners for Epic 2015 implementation consulting.


People

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Hebrew SeniorLife (MA) names Peter Ingram (MetroChicago HIE) as CIO.

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Diana Nole (Carestream Health) will join Wolters Kluwer Health as CEO.

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Ingenious Med names Todd Charest (Cogent Healthcare) as chief innovation and product officer.

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SRG Technology, which offers population health management technology it developed with Massachusetts General Hospital, hires Adrian Zai, MD, PhD, MPH (MGH) as CMIO.

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Greenway Health names David Wirta (Vista Consulting Group) to the newly created position of chief revenue officer.


Announcements and Implementations

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NTT Data acquires global exclusive rights to products from it business partner InteHealth, which include a cloud-based HIE and portals for patients and physicians. The LinkedIn profile of former InteHealth VP Frank Nash (now senior director at NTT Data) says NTT Data acquired the assets of InteHealth on June 1, 2015 and the company is now part of NTT’s Healthcare Convergence Group.

London-based EY (the former Ernst & Young) consolidates its health consulting offerings in a barrage of obfuscatory buzzwords, promising to “collaborate with clients on improving efficiencies, catalyzing new digital health technologies, and helping to ensure wellness and prevention.” The company promotes Jacques Mulder to Global Health Sector Leader, a title that begs to be uttered in a Darth Vader voice.


Government and Politics

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The Senate’s HELP committee is scheduled to discuss Karen DeSalvo’s nomination for HHS assistant secretary of health on Thursday, August 6. This is probably the Senate’s first step in confirming President Obama’s May 2015 nomination of DeSalvo for the HHS promotion, which would leave ONC searching for its next National Coordinator. She won’t get much if any opposition. 


Privacy and Security

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Sensato and Divurgent will offer a three-day workshop titled “Designing Secure Healthcare Systems” October 27-29, 2015 in Long Branch, NJ. It would be fun to attend a hacker’s conference – I bet they are constantly trying to pry into each other’s Wi-Fi connections to earn happy hour bragging rights before the World of Warcraft all-nighter.

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Indiana-based NoMoreClipboard vendor Medical Informatics Engineering says the medical information of 3.9 million people was exposed its May 2015 breach by unknown hackers. The long list of affected health organizations include Concentra, Franciscan St. Francis Health Indianapolis, and Rochester Medical Group. The company’s former president says it took in $18 million in 2014 revenue from 2,500 commercial clients, all of which could go right down the tubes after this massive breach. MIE’s other claim to fame is that it invented the phony Extormity and SEEDIE sites that made fun of EHRs a few years back, an attempt to gain the company publicity that unfortunately fell far short of the exposure it’s getting from spilling the data of millions of people into the hackersphere.


Innovation and Research

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The FDA approves Spritam, the first drug to be manufactured by 3D printing. Manufacturer Aprecia holds an exclusive worldwide license for MIT-developed 3DP (powder-liquid three- dimensional printing) technology, which can deliver a high-dose drug in a quickly dissolved tablet. Spritam is a new formulation of the existing epilepsy drug levetiracetam (Keppra).


Other

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In England, Papworth Hospital NHS Foundation Trust backs out of its commitment to implement Epic following an investigation into the Epic implementation of Cambridge University Hospitals NHS Foundation Trust, with which Papworth jointly chose Epic in the spring of 2013. Papworth’s board concluded last week that Epic won’t deliver optimal value and says it will consider other vendors to provide “a cost-effective ICT system which meets our patients’ needs.” I like that they’re thinking value, as they obviously do in working from building that looks like a slightly decrepit hotel rather than the obscenely glitzy edifice complex palaces commonly found in even financially teetering US hospitals.

Athenahealth posts a video of CEO Jonathan Bush interviewing oncologist, author, and Affordable Care Act contributor Ezekiel Emanuel, MD, PhD. Emanuel says excess hospital bed capacity, low margins, and the fact that nobody really wants to be hospitalized will cause 1,000 hospitals to close as their bond market drives up, while the survivors will shift into other care venues. He’s against health system consolidation, which focuses on controlling the market, vs. more care-focused integration. He says most hospital executives have no idea what it costs to perform a given procedure or service, so any claims that they lose money on Medicare or Medicaid patients aren’t fact-based. Emanuel says EHR information can drive quality and price transparency. He thinks video visits are the wave of the future.

Researchers find that hospitals that score well on clinical quality metrics often have quality-focused boards of directors.

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Computer systems at the fantastically named Credit Valley Hospital in Ontario, Canada go down for a day and a half following flooding that took out its telecommunications systems. As is always the case, the hospital claims patient care was not impacted in moving back to paper, which if you take at face value raises the question of why they bothered installing those systems in the first place.


Sponsor Updates

  • Peer60 names Nuance as the leading provider of medical image-sharing offerings with its PowerShare Network.
  • ADP AdvancedMD offers “5 ways to enhance your current ICD-10 transition plan.”
  • Aprima will hold its user conference August 7-9 in Dallas.
  • Aventura, Capsule Tech, CareSync, and Culbert Healthcare Solutions will exhibit at the Allscripts Client Experience August 5-7 in Boston.
  • Billian’s HealthData offers “Traversing the Path to Patient Data Access.”
  • Caradigm posts “Moving Healthcare Analytics from Measurement into Management.”
  • Jaffer Traish, director of Epic consulting with Culbert Healthcare Solutions, publishes a letter to the editor of the Boston Globe titled “Celebrating strides being made in electronic health records.”
  • CitiusTech wins the “2015 Best Companies to Work For” award from the Great Place to Work Institute for the fourth consecutive year.
  • ClinicalArchitecture offers “Semantically Enabled Medication Reconciliation.”
  • The Detroit News features Clockwise.md in a profile of the Henry Ford QuickCare Clinic.
  • CoverMyMeds offers “Prior Authorization, Step Therapy and Quantity Limit … What’s the Difference?”
  • Cumberland Consulting Group is named by the Nashville Business Journal as one of the 25 fastest growing private companies for 2015.
  • Innovista Health CIO David McCormick explains how the organization’s partnership with Medecision helped move the network towards value-based care.
  • Burwood Group is named one of Chicago’s “101 Best & Brightest Companies to Work For in 2015.”
  • Recondo Technology will exhibit at the HFMA Region 10 Conference August 10 in Colorado Springs, CO.
  • Practice Unite offers “6 Ways Secure Texting & Mobile Patient Engagement Apps Improve Patient Experience.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 4, 2015 News 12 Comments

Monday Morning Update 8/3/15

August 2, 2015 News 1 Comment

Top News

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England’s Monitor regulatory program is investigating the $300 million Epic rollout and overall financial management of Cambridge University Hospitals NHS Foundation Trust. Cambridge was Epic’s first UK client, with the 10-year, $250 million contract announced in early 2013. 


Reader Comments

From Military Medicine: “Re: DoD EHR bid. Your estimate of 10-20 percent of the total contract value going to Cerner is a bit high from what I’ve heard – it might have been as low as 9-15 percent, which is why Cerner cautioned investors not to get overly excited about their potential revenue and profit. I also suspect Leidos won’t be all that excited about rolling out a new solution since they have the lucrative contract to maintain the old system – they will let the government delay at every step they can bill for working on both systems at the same time.” Leidos its later spinoff SAIC have been paid billions to create and support the DoD’s AHLTA, the renamed Composite Health Care System that wags say stands for “oh, hell, let’s try again.” Leidos has incentive to milk AHLTA for as long as possible while simultaneously collecting checks for its new project work. Using the low end of that range, Cerner’s cut of the rumored $1.7 billion in guaranteed money over 10 years would be only $15 million per year, which given Cerner’s annual revenue would indeed not be an investor-cheered windfall.

From Grunt in Green: “Re: DoD EHR bid. For those who say this is the world’s largest HIT procurement, 60 percent of DoD care is handled by civilian delivery systems under TriCare, so quite a few systems are already larger than DoD, including Kaiser for sure and probably Sutter and Providence.”

From Bang a Gong: “Re: DoD EHR bid. I hope everyone watches closely as Leidos goes over their $1.7 billion bid, then blows through the $2.6 billion in contingencies, and then keeps right on running up the project’s tab while simultaneously renewing their sustainment contracts for AHLTA. By the time they realize how far over this will go, they’ll be beyond the point of no return and will have to finish it, even with huge overages, to avoid an even bigger NPfIT debacle.” Of that I have little doubt since government IT projects never come in on schedule and at the original cost estimate.

From UberUser: “Re: Uber’s user rating added in the latest update. Lots of HIS consultants and vendors use Uber. I wonder if anyone has attained the elusive 5.0 rating? I have a 4.7 with 50 rides, so I probably got a 1 from a guy I complained about.” I checked mine and it’s 4.9. I’m a bit less enamored than I once was with Uber due to (a) frequent surge pricing that makes me suspect that it’s more reflective of company need for profits rather than the demand for rides; (b) drivers who cancel the arranged ride because they don’t want to travel that far to pick me up; (c) lack of drivers in some areas so that you can’t get a ride at all; and (d) imposition of minimum pricing in some cities and when traveling from some airports such that it’s cheaper to just get a cab or an airport limo. I miss Uber when it’s not available, though, such as in Las Vegas, where cab driver protests and the city’s powerful taxi lobby (which includes two former Nevada governors as lobbyists) got Uber shut down awhile back, although I hear it may return. I tried to use Uber in Seattle and only Uber Black (not Uber X) is available at the airport, with the $50 flat rate charge to downtown being $5 more expensive than booking a car on the spot, which in my case turned out to be a stretch limo for the flat $45.


HIStalk Announcements and Requests

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Eighty percent of poll respondents check their work email or voicemail at least once per day while on vacation, most just a handful of times, but 12 percent admit that they do so nearly constantly. New poll to your right or here: what factor was most responsible for the Leidos-Cerner-Accenture DoD EHR win?

Readers continued to seek information on the DoD’s EHR project Thursday, when HIStalk pages were displayed 17,000 times in 12,000 unique visits, beating the all-time record set the day before. Since then, though, newsworthy “news” has been close to non-existent. Today’s post is short, but includes everything important — there just isn’t much of it post-DoD announcement and I won’t waste your time with faux news.

Here’s a tip to folks running tiny (or even one-person) companies: it’s pompous to call yourself CEO when you don’t really have many executive duties. I hereby create an industry rule: you can use the title “president” once you’ve hit five employees, but you can’t brag on being “CEO” until you have 25 employees. Fewer than five employees makes you a “principal” or “owner” or whatever else you like the suggests roll-up-your-sleeves work rather than jetting off to board meetings or delivering weighty speeches.

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

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My Medical Records Saga Continues

I faxed my request for a copy of my medical records to the hospital on June 26. This past Friday, five weeks later, an letter-sized hospital envelope came in the mail with my name and address handwritten on it with no indication of what was inside. I opened it up and there was my visit summary, contained on two pages front and back as printed off from the hospital’s Epic system. The hospital didn’t include a greeting or explanation or anything to indicate why they had sent the copies – it was just the two pages in an envelope with the hand-scrawled address, which was a long way from being professional. I was surprise they didn’t include a marketing or personal message knowing that most people request their records because they’re going to seek care elsewhere or file a lawsuit, either situation being an excellent time to engage positively with the patient.


Last Week’s Most Interesting News

  • The Department of Defense chooses the team of Leidos, Cerner, Accenture, and Henry Schein for its EHR implementation project.
  • McKesson CEO John Hammergren says in the company’s earnings call that “we have been struggling in the hospital IT business.”
  • Rep. Renee Ellmers (R-NC) introduces the Flex-IT 2 act that would delay Meaningful Use Stage 3 until at least 2017.
  • An investment fund co-founded by Harvard professor and disruption author Clayton Christensen invests $8.4 million in care coordination vendor ACT.md, whose platform was developed by Zak Kohane, MD, PhD and Ken Mandl, MD, MPH from the informatics department of Harvard’s Boston Children’s Hospital.
  • NantHealth Founder Patrick Soon-Shiong, MD takes his cancer drug firm NantKwest public, valuing his holdings at $1.6 billion, 33 times the amount he paid for the company a year earlier.
  • UMass Memorial Health Care (MA) says its implementation of Epic will cost $700 million over 10 years, the health system’s largest capital expense ever.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Sales

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Department of Vermont Health Access chooses eQHealth Solutions for population health management technology.


People

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Gretchen Tegethoff (TechExec Advisors) is named to a newly created CHIME VP position overseeing its for-profit CHIME Technologies. The business apparently charges vendors an enrollment fee and then takes a percentage of each sale made to CHIME members. Even HIMSS isn’t so brazen as to pimp out its dues-paying members for a percentage piece of the sales action.


Announcements and Implementations

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Allscripts Sunrise user National Institutes of Health Clinical Center attains HIMSS EMRAM Stage 7.


Privacy and Security

FDA advises hospitals not to use Hospira’s Symbiq infusion pump following a Homeland Security warning that it is susceptible to attacks from hackers who could gain access to a hospital’s network. It’s the first time FDA has issued a cybersecurity-related medical device product warning. Hospira had been phasing out the Symbiq pumps since 2013, when FDA raised product quality concerns.


Innovation and Research

An Institute of Medicine report titled “Transforming Health Care Scheduling and Access: Getting to Now” lists patient scheduling best practices that include having the scheduler delve deeper into the patient’s need, give the patient options for appointment times, and providing alternatives to a clinician visit.


Other

I was talking to an ENT surgeon last week and asked him about his EHR. He says his office uses the NextGen practice management system, but gave up on its EHR because it was too cumbersome and slow. He said he enjoys e-prescribing, but uses a standalone product instead because NextGen’s module isn’t workflow friendly. It sounds as though he might be better served with a specialty EHR.

Ten leukemia patients in Australia receive half the intended dose of cytarabine due to what sounds like an incorrectly created order set.

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Former Kaiser Permanente semantic interoperability expert and former HL7 board member Robert Dolin, MD surrenders his medical license following his September 2014 sentencing for possession of child pornography.

Rocky Mountain Health Plans rolls out its MyDigitalMD video visit service with a funny parody video called “Save the Hipsters.”

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Weird News Andy calls this a “s-s-s-selfie.” A man poses for a photo with a rattlesnake in Yellowstone National Park, with his resulting snakebite requiring a five-day, $150,000 hospital stay for treatment and antivenin (which only one company makes at $5,000 per vial.) That reminds me of an old snakebite joke you probably know whose punch line is, “He says you’re going to die.”


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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August 2, 2015 News 1 Comment

News 7/31/15

July 30, 2015 News 1 Comment

Top News

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The Department of Defense awards a $4.3 billion renewable EHR contract to the team of Leidos, Accenture, Cerner, Henry Schein, and 31 partner companies, with the DoD estimating its total project cost at $9 billion over 18 years. The roster of companies in the Leidos Partnership for Defense Health includes:

3M
Accenture
Apex Systems
Aderas
ASM Research
Athena Consulting Group
Blue Ridge Federal Consulting
Bridgemore Concepts
Cambridge International Systems
Cerner
Clinovations Government Health
Cognitive Medical Systems
CWS
Ecco Select
EHR Total Solutions
Enterprise Management Systems
Exact Data
Henry Schein
Holland Square Group
HP
ICSA Labs
Intellitronics
Iris Partners
Leidos
ManTech
MBC
MedPro Techologies
MedRed
Medsys Group
NetVision Resources
Ocean Bay Information & Systems Management
ProSource360
SAIC
Security Risk Solutions
Spin Systems
Tiag
Universal Consulting Services
Valytics

Most interesting of these subcontractors is the apparently defunct Ocean Bay Information & Systems Management LLC, launched in April 2012 in Alaska and shut down in December 2014 without an online trace. Its founder, Ernest Anastos, lists his current occupation as “versatile executive seeking new challenges.” The meaty part of his bio is further down the page: he was a former CEO of the Navy Medical Information Management Center and handled Navy acquisitions (DHMSM is a Navy project).


Reader Comments

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From HIPAA Love: “Re: requiring a signature on patient information requests. It’s not a HIPAA requirement, but HIPAA allows covered entities to require individuals to make their requests in writing as long as it tells them so.” Thanks. That means hospitals and practices that require patients to fax or mail a signed request form are just making their own rule, not enforcing a HIPAA requirement.

From Denominator: “Re: former Epic employees. Profiled on a Madison site.” The article describes a few former Epic project managers and implementation consultants who struck out on their own after growing tired of endless travel, long hours, and lack of personal satisfaction. They twenty-somethings report changing jobs to fulfill their true passions despite walking away from an average Epic salary of $83,000.

From Red Man Walking: “Re: companies and CEOs. Which ones have you advised or worked with?” None. My life’s work seems to be sitting in an empty room filling an empty screen every single day, but perhaps I’m missing an opportunity to become a “Consigliere to the CEO Stars,” where I would serve as the invisible, ambition-free, bias-free source of truth for CEOs who don’t trust their ambitious, biased VPs to challenge their decisions, provide brutally honest advice, or provide a spin-free assessment of what customers and the market are saying. I like to think that my complete lack of qualifications (having never run a business or climbed the executive ladder) is offset by my naive objectivity and lack of a socially acceptable verbal filter.

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From Festus: “Re: BJC HealthCare. Experienced a system-wide computer outage this week.” The St. Louis-based system goes down for 20 hours through Wednesday morning, leaving its 13 hospitals with no access to its EHR, administrative systems, and email. The hospitals went back to paper and turned away transfer patients. BJC hasn’t announced the cause, although with all systems down you would have to assume network problems or maybe even a malware attack since otherwise I would expect the hospital to have diagnosed and announced what went wrong.


HIStalk Announcements and Requests

You may have noticed that you couldn’t bring up the HIStalk page for part of Wednesday afternoon. So many readers were looking for DoD news that my web hosting provider initially thought it was a denial of service attack. Even though the site couldn’t handle all the readers with the server’s CPU usage needle pegged, it still received 16,000 page views in 12,000 unique visits Wednesday, which I’m pretty sure is a record. I’m writing this Thursday evening and today’s numbers are tracking just about as high. A couple of people emailed me to say that I should start a DoD EHR site, although I think interest will wane as the hard work goes underground and there’s not much to talk about for a year or two.

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Here’s a shout-out to Carla from Health Data Specialists, who asked for a “we sponsor HIStalk” website badge since they are fans. I didn’t give much direction to the offshore guy to whom I paid $15 to design the graphic figuring it wasn’t all that important, but Carla was right  – dozens of sponsors have asked for it for their own sites after I mentioned it in my email to them. It’s gratifying to be supported so enthusiastically.

This week on HIStalk Connect: Nike and Apple settle a class-action lawsuit alleging that the companies knowingly marketed FuelBand activity trackers as more accurate than they actually are. German engineers develop a prosthetic hand capable of mimicking details muscle memory functions. AstraZeneca partners with Adherium, a New Zealand based digital health company that makes smartphone-connected inhalers to help COPD and Asthma patients track medication adherence. Illinois amends its blue sky laws to allow startups to run equity-backed crowdfunding campaigns worth up to $4 million.


My Medical Records Saga Continues

Add to my list of ways providers can make patient electronic records requests easier by sending me your ideas. Here’s one I received:

Provide several ways for patients to request them. Over the phone, online, patient portal, etc. Ensure that in order to receive the records, patient needs to provide several key identifiers that ensure the information is secure and is only provided to said patient (or patient POA). Have a dedicated person and/or department handle these requests so that there is an efficient process and patients don’t have to wait to receive information that is rightfully theirs.


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Thoughts on the DoD’s selection of Leidos, Cerner, Accenture, and Henry Schein

  • The DoD notified the bidders of its decision early Wednesday morning but asked them not to comment until after its contract announcement, which was posted online at just after 5:00 p.m. Eastern time. Analysts for the publicly traded participants apparently started leaking the news at between 3:00 and 3:30, giving shares of Cerner and Leidos a sharp rise on high volume by around 3:30.
  • This was not a typical EHR procurement given that the package includes a lot more than just a single product. It wasn’t just Allscripts, Cerner, and Epic that were being evaluated, but rather an extensive package of services, infrastructure, maintenance, and willingness to meet the DoD’s ongoing needs. It would be interesting to know how much of the final scoring involved the actual EHR product and vendor.
  • Self-proclaimed experts lauded the decision in suggesting that “openness” played a part even though: (a) they didn’t define “open”; (b) they didn’t say how they determined that Cerner is more open than Epic or Allscripts; and (c) DoD didn’t say how (or if) it measured and scored “openness.”
  • Most of the industry – me included – underestimated the importance of the military’s comfort level with the prime contractor based on what knowledgeable readers have told me since the bid was announced. I’ve heard that IBM isn’t strong in defense contracting compared to the winning consortium’s defense powerhouse of Leidos, Accenture, and SAIC.
  • Allscripts had one good partner (HP) and one not-so-good one (CSC) and a product with tiny market share and limited breadth, making that team the obvious long shot no matter how you look at it. Clearly nobody expected the Allscripts group to win given that MDRX shares didn’t drop on the news that it lost.
  • Accenture’s participation may have tipped the scales slightly for Leidos since it helped save Healthcare.gov.
  • The DoD says it has spent more time on the EHR project so far than it did on the trillion-dollar F-35 Joint Strike Fighter.
  • Leidos operated as SAIC until it spun that unit off as a separate business and renamed itself Leidos in September 2013. SAIC has outperformed Leidos on the stock market in the past year, with its shares up 28 percent compared to those of Leidos at 6.5 percent.
  • Cerner will replace the military’s present system, the many-billion dollar, contractor-enriching, VA-ignoring, custom-written taxpayer boondoggle known as AHLTA.
  • Cerner did not win the bid, Leidos did. It’s an important distinction since Cerner is not accustomed to taking a second banana position. Cerner as a company is worth nearly nine times the stock market value of Leidos. Even Henry Schein is four times larger than Leidos.
  • I’ve heard rumors that Leidos won the bid mostly on price and DoD comments seem to reflect that. The company needed good news after recent major business problems (huge losses, CEO replacement, and a big drop in its healthcare business) and may have bid aggressively for that reason.
  • I’ve also heard that a lot of the $4.3 billion initial contract value (more than half, in fact) isn’t guaranteed, but rather is set up as contingency money. Leidos and its partners excel at extracting money from the often clueless Washington bureaucracy, a capability that will be essential if the contract really does put so much of the contract value at risk. The #1 rule of government software project bidders: put in a lowball bid knowing that once you get your foot in the door, you can figure out ways to enrich the deal.
  • If indeed so much of the contract is at risk, that leaves Leidos and its 34 partners with maybe $2 billion guaranteed over 10 years before extensions, which includes all costs related to implementation, support, and software maintenance. Leidos as the prime contractor will certainly be squeezing its subs (including Cerner) to keep as much of the money for itself as it can.
  • I don’t know how much Cerner gets from the total project award, but a SWAG might place it at 10-20 percent. If only $2 billion or so is guaranteed, maybe Cerner gets $200-$400 million guaranteed over 10 years (obviously I don’t have insider information so this is just speculation for entertainment’s sake). If that’s anywhere close, $40 million per year isn’t going to change Cerner’s life all that much given that it’s already tracking close to $4 billion in annual revenue.
  • One-third of the non-software cost has to be subbed out to small, minority, or veteran-owned businesses. That means Leidos will have to contract out quite a bit of even the software maintenance fees. Check the list I posted at the top of the page – many of the companies partnering with Leidos trumpet their set-aside status more than anything else.
  • Cerner tagged Intermountain as a “strategic partner” that will provide “clinical governance of solutions and workflow,” although I don’t understand what battlefield and military hospital expertise Intermountain brings to the table.
  • Cerner and Leidos are going to need a bunch of experienced project people, and in the absence of restrictive policies like Epic’s that prevent experienced people from moving on to better jobs with other hospitals or consulting firms, the poaching is probably already underway.
  • The contract has a first-year budget of $149 million and an expected total lifetime cost of $9 billion over the next 18 years (keep an eye on that estimate because you won’t see it that low again).
  • Let’s not forget that Henry Schein was a big winner, too, as one of the four winning core partners in contributing its dental system expertise.
  • I can’t imagine that the Epic and Allscripts teams will fight the DoD’s decision barring some major contracting gaffe, but it does bring back memories of the then-tanking, Tullman-led Allscripts throwing a lawsuit tantrum when New York City Health and Hospitals chose Epic over Allscripts in 2012, when Allscripts cried that it wasn’t fair that their prospect was willing to pay more to get Epic.
  • It’s hard to predict how each company will fare now that the die has been cast. Will Cerner gain knowledge and experience that it can roll into products for the general market or will DoD consume so much of its energy that it will get distracted? Will Epic lose prestige and sales now that it has lost the biggest procurement in health IT history or will it bear down harder in competing with Cerner? Does Allscripts keep trying with Sunrise or just concede the hospital EHR market and focus on ambulatory systems and population health? Do existing customers of each vendor win or lose?
  • It’s good for the market that Cerner won since Epic needs more competition, although it’s a shame that we don’t have a strong third competitor.
  • I remember the excitement when companies won those big NPfIT contracts years ago and it turned out to be a bloodbath for them when they were held accountable for delivering what they promised. Let’s hope (against hope) this project delivers more than a spectacular NPfIT bonfire of British pounds. Big government IT projects hardly ever hit their planned budget, timeline, and benefits, but contractors and taxpayers keep lining up at the trough to take another swing.

Speaking of the DoD, it’s a good time to re-watch Dim-Sum’s September 2014 HIStalk webinar titled “DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project,” which has been viewed a couple of thousand times on YouTube. Spoiler: Leidos wins at the end.


Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Here’s a just-completed (and outstanding) webinar titled “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.”

We also just finished “De-Silo Your Disparate IT Systems Around the Patient with VNA” by Lexmark.


Acquisitions, Funding, Business, and Stock

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McKesson reports Q1 results: revenue up 9 percent, adjusted EPS $3.14 vs. $2.47, beating analyst expectations for both. Technology Solutions revenue was down 7 percent due to the company’s anticipated drop-off in hospital IT business and the sale of its nurse triage operation, but tempered by good performance from RelayHealth and the physician revenue cycle business. CEO John Hammergren said in the earnings call that, “We have been struggling in the hospital IT business, where we have been reinvesting in the go-forward products and de-investing in the products that we’ve already announced that we plan to sunset” as the company tries to “put the momentum back in the business.”

CVS Health will co-develop a chronic disease care management solution with IBM’s Watson group, planning to sell it to insurers and use it in its own pharmacies and MinuteClinics.

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MedAssets reports Q2 results: revenue up 13 percent, adjusted EPS $0.31 vs. $0.30, beating expectations for both.

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Lockeed Martin exhibits atrocious timing in announcing its Healthcare Technology Alliance the day Leidos and Accenture hogged the government contractor limelight with the DoD’s announcement, but if anyone cares, the Alliance’s founding members are Cisco, Cloudera, Illumina, Intel, and Montgomery College.


People

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Stephanie Wallace (Greythorn Healthcare IT) joins Huntzinger Management Group as national sales director.

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Cumberland Consulting Group promotes Praneet Nirmul and Adam Seyb to partner.

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Margaret Laws (California HealthCare Foundation) is named president and CEO of HopeLab, which develops children’s health-related technology.

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Valence Health names former TriZetto and Eclipsys CEO Andy Eckert as CEO. Founding CEO Phil Kamp will move into a chief strategy officer role. Eckert is chairman of Varian Medical Systems.


Announcements and Implementations

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John Gomez (Sensato) and Colin Konschak (Divurgent) publish “Cyber-Security in Healthcare 2015,” available as a free e-book download from iTunes.


Government and Politics

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Rep. Renee Ellmers (R-NC) introduces the Flex-IT 2 act that would delay Meaningful Use Stage 3 until at least 2017. CHIME chimes in with its support for the bill, saying it will ensure Meaningful Use’s “long-term vitality,” meaning it likes the EHR welfare program as long as the provider bar is set low enough that everybody collects taxpayer cash, not really buying into the idea that the MU program was supposed to be a  short-term, cash-for-clunkers stimulus project.


Privacy and Security

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Partners HealthCare-owned McLean Hospital loses four unencrypted backup tapes containing information on 12,600 people who have designated their brains to be donated upon their death.


Other

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Healthcare Growth Partners publishes its mid-year health IT review with a focus on IPOs. I can’t say enough about HGP’s reports – they are stellar at summarizing the challenges and opportunities of healthcare and healthcare IT in a macroeconomic way. HGP gives their reports away when other firms produce reports with a tiny fraction of their insight and charge handsomely for them. The graphic above nicely compares the 2007 publicly traded health IT market to that of 2015. I also enjoyed this brilliant summary of US healthcare:

Healthcare spending in the US is about 90 percent higher than in most other industrialized countries. The US ranks #46 out of 48 in terms of efficiency – one place below Iran, and that’s without economic sanctions. Inefficient markets typically result in a mispricing of goods and services. The cause is often due to monopolies, poor regulation, and a lack of market transparency. Each is a contributor to inefficiency in the US healthcare economy, but the primary shortcoming is the lack of market transparency, or information, needed to define the cost and quality of goods and services, otherwise known as value. Restated, we must define the cost of care and we must define the quality of care in order to determine the value of care. That information then must be made available to consumers who can act on it to create a market-based economy, which in turn theoretically leads to outcomes and efficiencies. The concept of “value” is behind nearly all health IT investment activity, and in a market as personalized and complex as healthcare, the amount of investment required to achieve it is staggering.

Four hospital ED nurses in Saudi Arabia face prosecution for causing injuries that require a six-year-old’s hand to be amputated after their failed attempt to start an IV.

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HIMSS is attempting to insert itself into the DoD’s EHR project by announcing how happy it will be if someone will just invite it to participate, so I will issue an equally self-serving statement of my own:

As the Department of Defense moves forward with its modernization project, Mr. HIStalk is committed to working closely with the DoD on the planning and implementation stages in providing biting commentary for those involved.

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Weird News Andy applies his own product name of “iDon’t Touch” to iSperm, which turns an iPad into a sperm counter. WNA also likes this story about nice Canadians (he says the term is redundant) in which a woman stuck in the ED with her sick child posts her status to a Facebook new moms group worrying about her car being towed, after which several strangers feed the parking meter until she is able to leave. WNA pipes up one more time to comment on the CVS-IBM Watson story, titling it, “Come here, Watson, I need you” in picturing a CVS customer answering Watson’s questions about intestinal distress with, “Alimentary, my dear Watson.”


Sponsor Updates

  • An independent analyst firm places VisionWare among the leaders in master data management technology and customer satisfaction.
  • A Validic survey finds that 59 percent of healthcare respondents are either behind on their digital strategy or don’t have one.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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July 30, 2015 News 1 Comment

Leidos, Cerner, Accenture Win $9 Billion DoD EHR Project

July 29, 2015 News 25 Comments

The Department of Defense announces that its EHR project, with an overall estimated cost of $9 billion, will be executed by the team of Leidos, Cerner, and Accenture. Leidos has been awarded a two-year, $4.3 billion renewable contract. 

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July 29, 2015 News 25 Comments

News 7/29/15

July 28, 2015 News 5 Comments

Top News

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An investment firm founded by Harvard professor and disruption author Clayton Christensen invests $8.4 million in ACT.md, a care coordination platform developed by Zak Kohane, MD, PhD and Ken Mandl, MD, MPH from the informatics department of Harvard’s Boston Children’s Hospital, both of whom are also on the company’s board. The advisory board includes Mark Frisse of Vanderbilt and John Halamka of BIDMC.


Reader Comments

From GraySky: “Re: [hospital system name omitted]. Will announce on July 30 that it will spin off several hospitals and its management and consulting company.” Unverified. I’ve left out the system’s name for reasons that will become apparent if the rumor turns out to be true.

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From WikiStiki: “Re: Wikipedia’s hot mess entry on ‘electronic health record.’ It really needs to be rewritten.” The page is pretty much a disaster, an unfocused collection of facts (and quite a few opinions) written by people who don’t understand the big picture. WikiStiki offered to rewrite it if a sponsor will help cover some of the cost of her time, so I’m wondering if anyone thinks it’s worth doing. The page is probably read only by non-industry people, but that might make it even more important that it be accurate, timely, and clear (it’s none of those things now).

From Polite Spokesperson: “Re: startups. Another responsibility of startups is to create jobs.” Not true. Companies don’t hire people just to be nice or to bolster the local economy. The last thing I want as an investor or shareholder is for a company to pad its payroll with unnecessary employees since that just makes the company non-competitive. We’re just starting to realize in America that we have more people who need jobs than we have companies who need employees given farm and manufacturing productivity increases caused by technology (not to mention citizens who have prepared themselves poorly for decent jobs). However, I’ll return to your assertion to agree that people who find themselves unemployed or underemployed need to consider an alternative to wage slavery, such as jumping on the 1099 economy by starting a small business or contracting themselves out. People gripe endlessly about their employers, but don’t position themselves to do anything more than find another job working for someone else to be unhappy about. We don’t raise entrepreneurs like they do in hungrier countries, but that seems to be slowly changing. The future of our economy is small businesses, especially those that can turn impressive per-employee revenue.


HIStalk Announcements and Requests

Here’s how a monopoly behaves from an example I was reading about. Electric companies whose customers install solar panels are required by law to buy back any excess energy that customer generates, allowing solar customers to lower their monthly electric bills to a very low rate that will eventually offset the high cost of the initial installation. Electric companies, alarmed at the possibility of widespread consumer choice, are now lobbying to change the laws to not only eliminate the requirement that they buy customer-generated power, but they also want to charge those customers more than their actual electricity usage because they see solar users as freeloaders who use their grid without paying their fair share (the entitlement attitude is rampant among utilities). Electric companies are worried that as more customers use less of their product in favor of cheaper alternatives, they will have to spread their high fixed costs over fewer and fewer full-paying customers, feeding the cycle all over again as solar panels become even more cost effective. That’s the same problem the post office can’t figure out. You might well find similarities in healthcare. Government and monopolistic organizations never graciously accept getting smaller and instead find more desperate ways to protect their government-granted fiefdoms against declining market demand.


My Medical Records Saga Update

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A reader asked for ideas about how hospitals and providers could respond more effectively to patient requests for electronic copies of their records. Send me your thoughts via this quick online form (it saves you from having to compose an email) and I’ll summarize them. My main takeaway is that records requests go to the hospital’s HIM department, which is usually clueless about anything electronic such as the hospital’s patient portal and not all that user friendly when it comes to patient requests. It’s also bizarre that a business case even exists for release of information companies to place themselves between patients and providers, but that’s another issue. Meanwhile, here’s what I came up with.

  1. Records requests should be automated via online form for folks who have that access and technical knowledge. PDF downloads, scanning, and faxing are not reasonable.
  2. ID verification should be by "what you know" rather than "what you have." No scanned driver license or form — just DOB, last four digits of SSN, address, etc. Or, use SMS messaging to send a text message to a mobile phone number and then use the generated coded to validate that the phone number is active and in possession of the requester.
  3. The request form (hopefully online) should be tailored specifically to patients requesting their own information, with a separate form available for other entities making similar requests.
  4. The form should not require medical record number (hospitals are ridiculous in making it the patient’s job to memorize their assigned MRN).
  5. The form should provide information for using the provider’s portal. It should offer a phone number or email address for signing up or getting a password/userID reminder (providers should like the idea of increased portal usage) and should compare paper copies, online access, and an electronic download and how to request each. It’s not reasonable that the HIM department handles medical records requests without having any knowledge or interest in their own employer’s patient portal that might be more appropriate for the patient’s needs.
  6. The request should open some sort of help desk ticket so it can be tracked by the patient. I can imagine patients giving up in frustration unless someone feels pressure to close the ticket to the patient’s satisfaction (possibly measured by a follow-up survey link).
  7. The form should include the records charges and how those are calculated. I really don’t see how a provider can justify charging for an electronic copy that surely already exists in their systems, but naturally hospitals rarely turn down the chance to create a charge.

If you want to critique your own provider, here are some ideas. Email me your experience. You don’t even need to actually make the records request – just see what’s involved.

  • Is information about record requests available online where it can be easily found by patients?
  • Is the form or process easy to understand?
  • How does the provider validate the requestor’s ID?
  • Does the request spell out what the patient will be charged for copies? Does it involve a “per page” figure that doesn’t make sense for electronic records?
  • Does the request form indicate that data can be sent electronically or does it offer only paper copies?
  • Does any step involve a physical trip, a fax machine, or information the average patient won’t have (like MRN)?
  • Does the request form indicate the existence of a patient portal, explain why that might be a better option than requesting records copies, and describe the steps needed to gain access to it?

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I decided to randomly choose a hospital and see how they handle records requests from patients. This is from Beth Israel Deaconess Medical Center, which accepts requests only via a mailed form and offers only paper copies of records, taking up to 14-21 business days (it’s odd to count business days in seven-day full-week increments) and costing the requestor around $600 (!!) for copies of a full chart. The “internal only” portion of the form suggests that the patient must produce a photo ID. I bet John Halamka’s IT group has nothing to do with this process and he’s probably not even aware of it since the chasm between HIM and IT is wide in hospitals.

I’ve noticed that other hospital sites say that HIPAA prevents them from providing records without the patient’s signature, meaning electronic requests can’t be accepted. I’m not so sure this is true, but perhaps a HIPAA expert can weigh in.

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Florida Hospital’s medical records page tells patients upfront that they can get a lot of their information from their portal, to which it provides a link. Every hospital should do this. Hospitals need to get with the 21st century and realize that the HIM department is no longer the obvious and sole gatekeeper for patient records requests. All of this presumes a patient has Internet access and capability – I can only imagine the roadblocks they would find calling the hospital switchboard.


Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

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NantHealth founder Patrick Soon-Shiong, MD takes cancer drugmaker NantKwest public Tuesday in the biggest biotech IPO in several years at a $2.7 billion market cap. He bought Conkwest less than a year ago for $48 million, renamed it, and kept 60 percent of shares, valuing his newly IPO’ed holdings at $1.6 billion or 33 times what he paid for the company a few months ago.

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Small practice EHR vendor Kareo raises $55 million.

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Israel-based home telehealth sensor vendor TytoCare raises $11 million in a Series B funding round.


Sales

Prestige Emergency Room (TX) chooses Wellsoft’s EDIS.

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Covenant Health (TN) chooses Strata Decision’s StrataJazz for decision support and budgeting.

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UF Health Shands Hospital (FL) selects Lexmark’s vendor-neutral archive.

The Banner Health Network (AZ) ACO chooses eClinicalWorks EHR and population health management systems.

Abbeville Area Medical Center (SC) will implement Medhost’s EDIS.


People

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Jason Friedman (Ascension Information Services) joins Oneview Healthcare as VP of solutions.


Announcements and Implementations

Stella Technology announces Inspector of Quality Healthcare Data, developed with New York’s HealthElink HIE to evaluate the quality of HIE-collected data.


Government and Politics

ONC awards $29.6 million in grants to 12 state entities to expand adoption of HIEs, $2.2 million to Academy Health to create population health strategies, and $6.7 million to six colleges and universities to update HITECH’s workforce development curriculum.


Privacy and Security

A security researcher finds a flaw that lets hackers take over Android phones by simply sending a self-destructing text message, meaning all they need is the victim’s cell phone number to launch a Stagefright trojan attack that can’t be detected or prevented.


Other

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A new report from Peer60 finds that 20 percent of community hospitals are planning to replace their EHRs, with the major complaints being poor usability and missing functionality. Meditech is the dominant product, followed by McKesson Paragon, Cerner, and Healthland, but the hospitals are focusing on Epic, Cerner, and Meditech in considering new systems.

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Fortune magazine seems to have dumbed itself down considerably in the past few years, but it also seems to believe its readers are getting stupider along with it as it sleuths out an under-the-covers scrappy healthcare startup called McKesson (#11 on the magazine’s own list of largest US corporations). John Hammergren surely grimaced at the writer’s obvious lack of industry knowledge in trying unsuccessfully to pose insightful questions.

In Canada, Nova Scotia stops further hospital EHR rollout amidst physician complaints about inefficiency, lack of consistency between practice and hospital EHRs, and worries that practices maintain information that they don’t share. The province issued a “One Person, One Record” RFP in April 2015 with hopes of replacing the three hospital EHRs it had previously approved, use of which the government says is “beyond what we can sustain in a province the size of Nova Scotia.”

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A study finds that hospital checklists, which delivered dramatic clinical results when first introduced several years ago as described in Atul Gawande’s “The Checklist Manifesto,” often fail to deliver similar results when rolled out on a broad scale. A 101-hospital study that found no improvement after checklists were mandated suggests that the problem isn’t the concept but rather its implementation, which is dependent on rollout methods, localization, and staff resistance. In other words, as is often the case, hospitals manage to mess up projects that seem foolproof via their stubborn culture of accepted mediocrity and lack of accountability.

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The CEO of UMass Memorial Health Care (MA) says the system will spend $700 million over 10 years to implement Epic, its largest capital expense ever. He adds that Epic cost 10-20 percent more than its competitors, but 500 employees voted Epic as their top choice following demos.

QPID Health posts a pretty funny video called “Squirrelnado 2, the QPID Edition” that has some fun pop culture references that include, “You’re going to need a bigger nutcracker” and the “Nut Bucket Challenge.”

Former Stanford hospitalist turned concierge medicine provider ZDoggMD creates a superb, non-humorous (angry, in fact) video called “Ain’t the Way to Die.” It should serve as a call to action for the half of my recent poll respondents who unwisely haven’t created an advance directive. You might as well do it right now since insurance companies are increasingly requiring it since they otherwise have to eat the cost of long-term ventilator care that patients probably don’t want anyway. I keep watching it over and over. A sample of the lyrics:

Let me go, I’m leaving you—no I ain’t
Tube is out, you put it right back, here we go again
It’s so insane, ’cause though you think it’s good, I’m so in pain
I’m more machine than man now, I’m Anakin

But no advance directive, I feel so ashamed
And, crap, who’s that nurse? I don’t even know her name
You lay hands on me, to prolong my life again
I guess you must think that this is livin’…

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Weird News Andy is fascinated that new guidelines for healthcare mobile device security were published by NIST just as the DEA investigates the explosion of an apparent meth lab running inside NIST’s headquarters, leading WNA to question the security of NIST’s immobile devices. He also likes the article description of NIST as "the federal agency responsible for setting standards for precise measurement of just about everything.”


Sponsor Updates

  • An imaging site reviews the VA Midwest’s deconstructed PACS project that includes an imaging viewer from Visage Imaging, vendor-neutral archive from Lexmark, and a work list module from Medicalis.
  • Zynx Health adds Android support to its ZynxCarebook mobile care coordination solution.
  • Video clinical pathways vendor ViiMed will use InterSystems HealthShare to integrate with provider EHRs.
  • Voalte will hold its inaugural Voalte User Experience conference (VUE15) in Sarasota, FL on November 10-12.
  • AirStrip CEO Alan Portela pens “A Ray of Hope from Washington? Don’t Rush Meaningful Use.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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July 28, 2015 News 5 Comments

Monday Morning Update 7/27/15

July 26, 2015 News 6 Comments

Top News

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NIST publishes a draft guide for securing medical information on mobile devices that includes a risk assessment. It’s pretty geeky in places, which is a good thing since the last thing anybody needs is more feel-bad security hysteria that isn’t actionable. This is a must-read for health system CISOs and network engineers and probably their vendors as well.


Reader Comments

From Jack: “Re: Meaningful Use payments to providers. Explain it like I’m five: how can I tell if mine has been paid for MU2? CMS also doesn’t seem to have a good way to see which providers have invested in their Continuity of Care bits. I’m trying to empower my community, remove hassle, and get rid of impediments to care and this seems like a major ‘all of the above.’”

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From The PACS Designer: “Re: Windows 10 readiness. With the launch of free Windows 10 sometime after July 29, it’s a good time to get existing systems ready for the 3GB install. Best thing to do before that date is to go to Control Panel and enter Defrag, and Remove in the Search Box to review what should be removed to make room for the upgrade. For Defragmentation, if percentage is more than 5 percent,  run the option. Also for Win7/8, enter ClearType to improve the crispness of text in documents.” I thought it was smart of Microsoft to drop the Windows icon in the taskbar to click for notification when Win10 is ready for download sometime after Tuesday. It’s also nice that the upgrade is free. I’ve signed up.

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From Petty Officer: “Re: Catholic Health Initiatives. Minimizing Wipro in choosing Cerner ITWorks.” CHI contracts for Cerner’s managed IT services even though it signed a $200 million IT outsourcing agreement with India-based Wipro in 2013.

From Linky: “Re: Military Health System. CIO David Bown may have spilled the beans on DoD’s EHR selection when he said they are working on EHR infrastructure in the Pacific Northwest. January news stories said that IBM/Epic are piloting their system at Tacoma, WA-based MultiCare.” It is interesting, although perhaps IBM/Epic was aware of the initial rollout plans early (maybe it was mentioned in the RFI) and smartly planned their own pilots for the same region.

From NantWhere?: “Re: NantHealth. Purchased Harris healthcare division for $50 million and agreed to keep 170 employees for at least a year in addition. Nant is clearing house to make way for a floundering organization with no sales for over a year. Where is NantHealth going and who will be left to do the work?” Unverified. Harris must have really botched its healthcare business that it bought for $155 million (in the form of Carefx) in 2011 if it really did dump it for just $50 million after deciding to remove its tentative toe from the healthcare waters and focus on big government defense contracts (I apologize for the redundancy – all government defense projects, and in fact all government projects, are “big” and usually grow a lot bigger before they’re either finished or abandoned, which happens with roughly equal frequency.)

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From Robert Lafsky, MD: “Re: New Yorker article. Somehow this made me think of you.” The article urges people to “communicate your needs and desires via email that doesn’t require the use of ‘please find.’” I like it, although “please find” irritates me less than the smarmily obsequious “please know.” I blame teachers for telling students they shouldn’t write like they talk, which results in artificially flowery and awkward phrases that are painful to read.

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From Ashley Madison: “Re: Ashley Madison breach. Lots of adulterers getting nervous out there!” The site — which proclaims itself “the most famous name in infidelity and married dating” with 38 million members — is breached, with all of its members’ records now in the hands of cyberhackers who are already spamming them and threatening to take their information public if the site isn’t shut down. The company is providing no updates to its users, most of whom are probably just curious without seriously contemplating extramarital relationships. Men, who make up most of the paying customers, spend up to $300 per year hoping to contact women that are in many cases literally unreal (one woman sued the company for wrist injuries she sustained in manually creating thousands of fake female subscriber profiles). A few users have anonymously threatened suicide on various sites. Parent company Avid Life planned an IPO following steady profits that rose to $55 million in 2014, but selectively moral potential investors steered clear.


HIStalk Announcements and Requests

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Most poll respondents will take 10 to 19 paid days off in 2015, although a healthy number (pun intended) will be away from work for 20 to 29 days. Shockingly to some of those folks, their employer will not descend into chaos due to their absence, that same reality that sets in when your appreciative, associate-friendly employer suddenly lays you off without even a blip in corporate output as less-expensive replacement hamsters are brought in to keep the wheel turning. A couple of readers noted that despite their alleged time “off,” they are still tethered and sometimes pulled back into “I need you now” situations. Readers also suggested the follow-up poll to your right or here: how often do you check work email or voicemail on a vacation day? Thank the dearly departed Steve Jobs for inventing the iPhone and thereby eliminating the “I’m out of the office not checking email” concept that worked just fine when we all had email access only from our work desktops and we could therefore vacate the office both physically and virtually rather than only the former.

I’m back from vacation, facing thousands of emails and the infuriating “you didn’t reply within a day or two, so I’m sending it again” messages from people (all of them, not coincidentally, from PR companies) who obviously don’t read HIStalk, which is exactly why I don’t set an “out of office” message since readers and sponsors already know I’m offline, selectively responding to anything critical but otherwise not sharing anybody else’s urgency. Jenn admirably covered for me on the Tuesday and Thursday posts, which I read to make sure nothing earth-shattering occurred. I’ll be catching up this week.


A “My Medical Records Saga” Update

I still haven’t heard from the hospital or the Office for Civil Rights regarding my complaint that the hospital refused to provide electronic copy of my records. I used CareSync to request my PCP’s records and the company uploaded and transcribed the information quickly, giving me both discrete data elements and the practice’s scanned reports. CareSync also fixed the technical handshake between its system and Carebox and I was able to effortlessly shoot those records over to Carebox via a Direct message, which required only that I click CareSync’s “share” button and provide my Carebox-assigned Direct address. It was maybe two minutes later that I received Carebox’s “got it” email and was able to view a  nicely formatted record, including a beautiful BlueButton extract. The process was immensely satisfying on both ends.

CareSync is a deeper and richer application than I expected and having real humans assemble and upload the records makes it painless. They will even initiate the process of correcting information that the provider has recorded inaccurately (like the hospital flagging me as a smoker for some reason). I haven’t really explored what else CareSync does, but I see that it allows bringing in data from wearables, adding personal and insurance documents, scheduling appointments, setting medication reminders, assigning health maintenance tasks, and viewing a nicely formatted health timeline. You can add a family member as a user, allowing them to view and manage your information.

I think I read somewhere that CareSync offers a “break the glass” one-time password  option for emergencies, although I haven’t figured that out yet (it would be cool to have an emergency bracelet thingy to solve that “unconscious in the ED” problem that RHIOs failed to fix). In fact, CareSync could be an opt-in HIE if it could just solve the legal and logistical challenges of polling the user’s defined providers regularly to automatically update information from new visits — you have to request them each time.

I recall that in China, each person maintains their own paper medical records, bringing them along every time they have an encounter and then taking them back home afterward with the new information added. Most people here would think that’s a Luddite system, but I’ve always thought it’s pretty smart given the pathetic state of interoperability in this country, where your ED or hospital outcome will probably already have been decided one way or another before your medical history ever arrives (assuming that the ED or hospital even bothers to try to get it, which I seriously doubt). I would much rather give a provider access to information that  I’ve already reviewed with my own comments added, hoping they review it right then and there to avoid errors, conflicts, and expensive duplicate testing. That’s also the logical place to store an advance directive and power of medical attorney since a shocking number of those are ignored because nobody knows they exist or they can’t be found when needed.

Maybe someday we’ll figure this provider-to-provider interoperability thing out despite competing special interests, but until then, the only sure thing is for patients to collect and share their own information. CareSync happened to be the application I tried and I can see great possibilities in providers using it to provide ongoing care management and communication, but I’m sure competing products also do a good job. It has been an eye-opening experience for me to see health IT from the other side of the provider-patient relationship, to take control of my records, and to see what’s been recorded about me by providers, sometimes incorrectly.


Book Review: The Lean Startup

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I’m short on time having been away, so I will simply summarize the startup advice as suggested by “The Lean Startup,” which was recommended to me by DrLyle. Quite a bit of it is relevant to healthcare IT and software development in particular, even for large companies interested in increasing their innovation and creating new growth. It’s like an MBA program for startups in highlighting the difference between running a big business and starting a small business with big ambitions.

  • Most startups fail not because they lacked a good idea, didn’t have the right stuff, or had poor timing, but rather because they don’t follow a process that seems too much like the much-maligned “management” that the corporate world embraces.
  • The prime focus of a startup isn’t to develop or sell products – it’s to learn via validated experiments that force the entrepreneur to test individual elements of their vision, resulting the measurable discovery of truths that keep the company optimally focused and moving forward.
  • A startup’s activities should revolve around the Build-Measure-Learn cycle that tells the company whether to stick it our or to pivot (“pivot” being defined as changing direction with one foot planted in the current state, not abandoning the concept for something unrelated).
  • While management methods used by established companies – such as market research, forecasting, and accounting – don’t work for startups and result in “achieving failure,” just diving in while merrily abandoning any sort of managerial discipline is also likely to ensure failure.
  • Success results from the ongoing measuring and tuning of the “engine of growth.”
  • Products should be developed in small batches or even via continuous deployment (which is counter-intuitive in a production-oriented environment), tested with a subset of customers, and negative changes backed out or fixed quickly. Startups don’t have much of a reputation to be tarnished, so it’s OK to fail.
  • Ongoing customer contact and behavior monitoring is critical.
  • The customer will tell a company what they need or want, which might not be what the company originally thought. Assumptions are often wrong, but the time spent chasing the wrong objective still results in valuable learning.
  • Companies need to understand which activities add measurable value and eliminate those that don’t.
  • It’s paradoxically easier to raise money with zero revenue and zero customers because small numbers eliminate the possibility of overnight success.
  • The initial product release should be the minimum viable product that can be released and tested quickly even without features that may seem essential, followed by intense measurement of product use and customer response to see if the “leap of faith” assumptions on which the company was based are accurate.
  • Startups have to manage by non-vanity metrics that portray the true growth trajectory.
  • Customer behavior should be tracked by cohort rather than in aggregate to understand how each demographic group responds to product attributes and to design a sales funnel-type process.
  • The paid engine of growth is to either increase revenue from each customer or reduce the cost of getting a new customer.
  • Companies can fail by efficiently making changes that inflate vanity metrics without changing customer behavior, which then creates a crisis when the growth tapers off with no new activities underway to replace the inevitable slowdown.
  • Deciding which incremental investments to make can be done by the Five Whys, addressing a given problem by asking incremental “why” questions five times to arrive at the root cause.

Last Week’s Most Interesting News

  • Anthem finalizes its deal to acquire Cigna for $54 billion.
  • UCLA Health announces that a September 2014 cyberattack exposed the information of 4.5 million patients.
  • An ONC-commissioned consultant’s report outlines a five-year plan for a $20 million, 10-employee Health IT Safety Center whose focus will be “convening, researching, and disseminating.”
  • Ascension Health offers to buy revenue cycle services vendor Accretive Health — which gets half its revenue from Ascension — for half its stock market value, sending shares down 50 percent as the company rejects the uninvited offer and issues a “seek strategic alternatives” cry for help.
  • UMass Memorial Health care (MA) announces that it will replace the former Siemens (now Cerner) Soarian with Epic, abandoning a bizarre $100 million best-of-breed project announced in 2010 that had the organization trying to cobble together systems from Allscripts, Siemens, Picis, IBM, and Hyland as planned by then-CIO, now-resigned George Brenckle.

Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.


Acquisitions, Funding, Business, and Stock

Marketing company Physicians Interactive acquires Qauntia, which offers the QuantiaMd collaboration platform and mobile community for physicians.

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Dermatology EHR vendor Modernizing Medicine will acquire gastroenterology EHR vendor gMed.

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Athenahealth reports Q2 results: revenue up 21 percent, adjusted EPS $0.32 vs. $0.32, falling short of revenue expectations but handily beating on earnings with shares spiking upward on the news. Above is the one-year price chart of ATHN (blue, up 2.8 percent) vs. the Nasdaq (red, up 14.5 percent).

From the Athenahealth earnings call:

  • The company is approaching $1 billion in annual revenue.
  • Athena expect to receive 75,000 applications for the 1,500 positions it will fill in 2015.
  • CEO Jonathan Bush says the under-50 bed hospitals that are prospects for the RazorInsights product it acquired don’t have a strong balance sheet or deep IT talent, which the company will approach as it did small practices originally as in, “We’re not just going to sell you a system, we’re going to give you a system and we’re going to do the crap work that you hate and struggle with that gets in the way of treating patients for you. And so, instead of charging you X hundred thousand or million dollars upfront, we won’t charge you upfront, and we’ll take over these functions, get you more cash faster. And in the course of doing so, give you the clinical and financial systems that you need and keep them current forever.”
  • Bush says value-based care is a great opportunity for the company, and while ACOs are “a really badly written risk contract,” Athenahealth can move its focus from Meaningful Use compliance towards portal adoption, care coordination, and system scheduling.
  • Bush says the expansion of AthenaCollector to the hospital market is “incredibly synergistic” since a hospital claim has “all of the information on an ambulatory claim with three times the money on it and maybe 10 percent more information” and the company’s ambulatory claims experience allows it to reduce hospital collection cost using the information hospitals already have.
  • Bush says of its Enterprise segment, “We are getting access into the Cerner and Epic systems that we’ve never had before and are able to provide an integrated view of the patient’s experience inside and outside of AthenaNet. You’ve always been able to see where a patient’s been inside of AthenaNet even if it’s a different practice, but you’ve never been able to see very cleanly and reliably stuff that’s gone on in the hospital … we’ve always had major Cerner customers, but now we’ve got major Epic customers, not just throw out all of Epic, but you deal with the 50 percent of their admissions that come from outside of that directly-employed inner circle, maybe even some of the guys in the inner circle that are enraged and frustrated and are flight risks to the hospital for being on a hospital-controlled flow-centric system.”
  • RazorInsights will disappear as a separate product by next year as it is rolled into AthenaOne, while its acquisition of BIDMC’s WebOMR was scarcely mentioned in the call.
  • Bush describes the company’s transactional revenue of 250 information exchanges per doctor per day as, “You’ve got eligibility checks, claims submissions, claim status inquiries, lab accessions, lab results, referrals, authorizations, get me another one, in-office exchanges. So, every time somebody uses an integrated blood pressure cuff, and so the thing goes off from AthenaNet to Welch Allyn and back, each one of those counts on the server. Each one of those is a tick.” The company is measuring that as its total automation rate, which it says is at 57.2 percent.

Besler Consulting acquires the transfer DRG recovery business of DRG Review.


Sales

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SCL Health (CO) chooses Phynd for profiling and credentialing its 25,000 physicians across multiple IT systems.

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Charleston Area Medical Center (WV) will convert from the former Siemens Soarian to Cerner’s other product (Millennium) by next July, saying they are “first in line” to make the move. The health system also says only 25 of its 1,200 doctors have completed ICD-10 training and those who haven’t done so my Monday will have their Soarian access removed.


People

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Dan Critchley (University of Arizona Health Network) joins Optimum Healthcare IT as CEO of managed services.

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Roy Moxam (McKesson) joins Sunquest as VP of client experience.

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Impact Advisors hires Scott Pillittere (Huron Consulting Group) as VP.

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Nick van Terheyden, MD (Nuance) joins Dell Healthcare as chief medical officer.


Announcements and Implementations

Medidata will integrate patient-generated data into its clinical trials platform using Validic’s digital health platform.

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Harvard licenses its sleep apnea monitoring software to startup MediCollector.


Government and Politics

Researchers Dean Sittig and Hardeep Singh post a Health Affairs review of ONC’s plan for a Health IT Safety Center, saying that it’s a step forward given the absence of any other form of clinical systems oversight but suggesting that a VA-type safety events analysis service is still needed. ONC’s proposal calls for the Health IT Safety Center to avoid doing such investigations, which the article says will probably have to be performed internally by individual health systems with the Center possibly aggregating and reporting their findings.

HHS’s OIG posts a job opening for CIO, with applications due today (7/27).

A San Diego newspaper article questions whether Medicare can afford personalized medicine as patients demand more expensive custom treatments and tests. However, proponents expect cost avoidance in finding drugs that work for a given patient, citing the fact that cancer drugs fail 75 percent of the time. A health policy researcher says Medicare should change its payment model so that successful treatments for a given patient carry a higher price tag than the same drug, test, or procedure that delivers a less-impressive result for another patient.


Technology

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The New York Times profiles the Lively safety watch, a stylish alternative to the “I’ve fallen and I can’t get up” one-push alert button that also counts steps and provides medication alerts via an in-home cellular hub with sensors for pill containers and the refrigerator. The watch costs $50 and the monitoring service is $30 per month. It looks a lot like the Apple Watch.

Nike will pay $2.4 million to purchasers of its FuelBand following a class action lawsuit claiming that the company sold the fitness trackers even though they knew its measurements were inaccurate. It appears the wearables fad is tapering off as users don’t find their habits changing and the devices capture information that is a primitive health marker at best. I have at least a couple of them tossed aside in drawers and I bet you do, too.


Other

Global Health Limited sues the government of South Australia, claiming that the state is using its Chiron patient management software despite holding an expired license. The state has been the last user of the outdated software since 2008 but had asked Global Health for permission to keep using it since its implementation of Allscripts Sunrise Clinical Manager for the new Royal Adelaide Hospital is behind schedule.

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Western Australia has IT problems of its own as the new Fiona Stanley Hospital reports problems with IT systems that include lack of integration and a 15-minute delay after a physician logs in. Clinicians and patients also report problems with the hospital’s in-room interactive patient entertainment system. The hospital, which was supposed to be paperless, is running well over budget and behind schedule on its $150 million IT project.

A group of fund managers who invest in drug companies launches a US campaign calling for clinical trials to be registered and all data published within a year of study completion. AllTrials recently sued FDA to force it to release clinical trials data for two new, expensive drugs for hepatitis C. Its call to action petition can be signed here and it seeks volunteers to post its videos, host website buttons, and distribute flyers.

Insert your own punch line here: analysis of CMS payment data finds that Dr. Oz made $1.17 million from a hemorrhoid treatment he shilled, albeit at least with disclosure that he was involved in its development, which is about as ethical as he’s ever going to get.

Weird News Andy says he knows Bay Area real estate is expensive, but $2,000 for a bag of dirt might be a bit much. A fake doctor running a fake California cancer treatment center is charged with giving patients treatments consisting of baggies of expired medications and dirt, telling his patients to mix and swallow them with any resulting burning sensation meaning his concoction was working.


Sponsor Updates

  • Medicity client Great Lakes Health Connect surpasses its goal of having 1,000 medical practices using its referral application and will soon exceed 1,000 practices that are linked to Michigan’s immunization registry.
  • Huntzinger Management Group expands its technology service offerings to include technical advisory, security, operational improvements, and end user services.
  • Forward Health Group joins CMS’s Health Care Payment Learning and Action Network, charged with moving Medicare toward more value-based payments.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Reader Comments

  • InfoWayBack: Thank you, Rich - articulate, as usual. It was rewarding and professionally stimulating working with you and for you....
  • FCGeez: To bad Rich's team will not be the ones that will be successful with these start-ups. The team that's left around him i...
  • Tuck Crocker: Painfully accurate and really well-thought out. There are about 5 successful startup ideas in his comments....
  • j Mac: Interesting that there are only 35 doctors in this list. I wonder if this relates to the cost of healthcare....
  • seahawkdoc: Gordon the point is no one on that list is going hungry or looking to shake things up. The fact that you even bring up 1...

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