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Monday Morning Update 7/25/16

July 24, 2016 News No Comments

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University of Mississippi Medical Center (MS) will pay $2.75 million to settle HIPAA charges related to the 2013 theft of password-protected laptop by a visitor to the hospital’s medical ICU. OCR’s investigation uncovered the fact that entry of a generic WiFi username and password provided access to an unsecured Microsoft Access database that contained the information of 10,000 patients.

OCR concluded that UMMC’s “organizational deficiencies and insufficient institutional oversight” prevented it from undertaking risk management activities even though the hospital knew it was vulnerable. It also noted that the hospital did not perform the required patient notification following the laptop’s theft.


Reader Comments

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From Sieve Crusher: “Re: US Digital Service. They’re actively recruiting. Experience in the EHR world is applicable to government work in many ways – long-time employees, legacy systems, and a culture of poor user interfaces. Silicon Valley experience isn’t needed – the government can use folks of talent. There’s also 18F, an earlier companion effort that allows remote work instead of relocation to DC, but they are backlogged with applicants.” It sounds pretty fun for someone without a family or already in the DC area since no relocation assistance is provided – it’s a one-year commitment with benefits provided and a casual work environment. Not everybody can say they spent time working for the White House.

From HER Auto Correct: “Re: article saying that EHR use decrease costs. I don’t believe it.” The 2014 article concludes that per-admission costs are 10 percent lower in hospitals that use advanced EHRs. I really dislike studies in which Database A is linked to Database B to reach a lofty conclusion implying causation vs. correlation. This is one of those. The authors sampled a 2009 inpatient treatment database and matched it up to the sometimes-accurate HIMSS Analytics database of what EHR each hospital uses. “Cost” was derived from applying the cost-to-charge ratio of each hospital to its billed charges, which is a pretty blunt measure of a hospital’s actual incremental cost, although it’s usually all we have to work with. There’s also the question of ensuring a representative sample of hospitals in all sizes and locations and selecting patients of similar complexity. All that aside, correlation is not causation and most hospitals are already using advanced EHRs, so I don’t see any practical application of the conclusions. A better study would have been to choose 10 hospitals that implemented EHRs and see how their individual costs changed afterward, although the huge problem persists in trying to factor out all other variables. One last observation: bias exists in even the topic of the study – do hospitals really expect to reduce costs by implementing EHRs? The fact that even the financially distressed hospitals don’t de-install them and go back to paper suggests a self-assessed positive ROI that may or may not be financial.


HIStalk Announcements and Requests

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Poll respondents were evenly split on their opinion of the Affordable Care Act. Comments suggested that it worked fairly well if the goal was to people insured rather than to control costs or influence personal health choices. Mary C notes that ACA didn’t provide healthcare reform, only insurance reform, while Dave says insurance companies have had to resort to high-deductible plans to shield themselves from the unaddressed issue of cost control, although he also notes that individual patients benefited since ACA eliminated coverage denial of pre-existing conditions and lifetime limits. Most commenters noted that the “affordable” part is a misnomer since ACA policies cost a lot more with fewer choices and it’s just not possible to cover all of those newly insured people for the same cost, especially given that a lot of care involves expensive, late-stage interventions of limited value. HIT Project Manager boldly opines that Medicare and Medicaid should gradually phase out paying for treatment of chronic conditions that are caused by preventable behaviors, using EHRs to identify patients who ignore advice related to obesity and smoking and making them pay fully out of pocket for their treatments. Bill says just buying insurance for a bunch more people is running up the federal deficit without any evidence that quality or cost has improved. The most positive thread of commentary is that while ACA is a long way from perfect, it can be fine tuned over time.

New poll to your right or here: for those with a recent hospital visit: does the hospital allow you to electronically submit your own data into their records? I’m sure some hospitals provide a way to import wearable or questionnaire-type patient information to populate their EHRs, but I doubt it’s the 37 percent of them that a recent AHA survey found.

I was thinking as I reviewed the journal article above that I really bristle at using the word “reimbursement” to define payments to providers. You aren’t getting reimbursed – you are sending a bill and someone pays it. Especially if you run a private medical practice, a business no different than a auto body shop in expecting insurance companies to pay up.

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We bought a robotics kit and books for the North Carolina gifted class of Ms. S, who explains the photos above in describing how she put the materials to work immediately. “I gave the kids the option to participate in a district competition at the end of May, explaining that many students had a big head start on them — they had begun working last fall, whereas we had started months later. However, my students were willing to take on the challenge! They competed their work through a combination of quick understanding (impressive!) and teamwork. I’m pleased to say that the construction claw project won first place in the competition! All of my students said they enjoyed the experience and would like to participate in robotics again next year. That is wonderful news, especially from students who may not be able to attend robotics camps or programs outside of the school setting.”


Last Week’s Most Interesting News

  • ProPublica begins publishing the  letters OCR sends in summarizing and closing HIPAA complaints.
  • Philips acquires Wellcentive.
  • An HHS report to Congress identifies the lack of applicability of HIPAA to non-covered entities, such as app vendors, and outlines the non-HIPAA enforcement authority of the Federal Trade Commission.
  • ONC publishes an online tool that grades the interoperability readiness of a submitted C-CDA document.
  • The VA hires KLAS to provide an overview of the EHR vendor landscape.
  • AMIA cautions the FDA that EHR information is not necessarily of research quality, suggesting that it focus electronic data collection efforts on clinical data warehouses or HIEs.
  • Hacker The Dark Overlord posts for sale the digital assets of integration vendor PilotFish Technology and says he pushed an update to all of its clients that allowed him to steal their EHR information.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Louis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. The presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.


Acquisitions, Funding, Business, and Stock

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The newly formed Providence St. Joseph Health acquires doctor house call scheduling app vendor Medicast, which had previously raised $2 million but hasn’t had new funding in the past two years.

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Athenahealth announces Q2 results: revenue up 17 percent, EPS $0.34 vs. $0.32, falling well short of expectations for both.  The company also announced that EVP/COO Ed Park will leave his position by the end of the year, but will likely join the company’s board. Park holds $2.3 million in stock after selling $2.2 million worth so far in 2016. ATHN shares dropped 9 percent Friday following the announcements, having shed 3.1 percent in the past year.

From the Athenahealth earnings call:

  • The company has converted 40 percent of its clients to AthenaClinicals Streamlined, with those clients averaging a 10 percent improvement in same-day encounter close rate. The company notes, however, that it is working closely with a “minority” of clients who liked their old workflow better and hints that it expects to take a short-term hit on its Net Promoter Score.
  • Eighty hospitals are using AthenaOne for hospitals.
  • The company launched AthenaInsight.com to share information collected from its user network.
  • The company admits that it’s not sure whether sales are tracking against target due to seasonality and a bottleneck in servicing inpatient demand, but also notes that the HITECH wave of “I need an EMR or I’ll be shot” is ending and that it has to adjust to the pre-HITECH world of developing by its own schedule rather than just hitting MU-driven functionality dates.
  • Athenahealth notes that its population health management product has provided “a lovely little tailwind on our growth” since it can work with Epic and Cerner and that has allowed the company to add those users back to its prospect list.
  • The company’s hospital win rate is 32 percent.
  • Jonathan Bush says the company made a “terrible operational miscalculation” when it started allowing senior support reps to travel to client sites to provide go-live support, which caused longer telephone hold times just as Streamlined was being rolled out.
  • Of the Streamlined rollout, Bush said, “Streamlined’s big mistake was that it was not an agile deployment. This was not, you get a skateboard, and then you put it back out with a handle on it, then you put it back out with a little motor on it, then you put it back out with sides, and eventually it’s a car. This was, take a skateboard, hide it, and show back up two years later with something you think will be a car, and all of the feedback that all of the customers would have had along the way comes raining down on you at once. So, we’ve had to do a lot of tuning of Streamlined once it came out of the garage. We will not be doing that kind of hide it away for years and then do a great reveal of something radically different any more in the future.”
  • Bush allowed Ed Park to summarize his career in ending the earnings call, introducing him as, “The man who brought me here, who made every theoretical PowerPoint promise I made either go away or turn into actual functioning reality at scale, Ed Park.”

People

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CTG CEO Cliff Bleustein, MD resigns “by mutual agreement” after 16 months on the job. He has been replaced by SVP/GM Bud Crumlish. I interviewed Bleustein two months ago. CTG shares are down 18.5 percent in the past year, giving the company a market value of $88 million.

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Video visit vendor MDLive names Sanjay Patil, MD (Care Connectors) as EVP/GM of health systems strategy and transformation.


Announcements and Implementations

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A new Peer60 report on cardiovascular information systems finds that hospitals expect their procedure volume to increase significantly, with the biggest driver by far being their addition of service lines, but also due to adding more providers, population growth, an aging population, and better insurance coverage. Epic and Philips are the most-recommended CVIS vendors, although nearly half of respondents say they are considering replacing their current system. Epic is the most-often considered new system by far, while McKesson is equally dominant as the vendor most likely to be displaced.   


Government and Politics

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The Department of Justice charges the owner of 30 Miami-area skilled nursing and assisted living facilities with running a $1 billion Medicare fraud scheme, the largest healthcare fraud case in US history. Philip Esformes, who is also a noted philanthropist, is accused of placing patients in his facilities who didn’t quality for that level of care, then billing Medicare and Medicaid for medically unnecessary services. He and his two co-conspirators are also charged with taking kickbacks to refer those patients to community mental health centers and home care providers who also rendered medically unnecessary services. Esformes paid $15.4 million to settle charges of exactly the same thing 10 years ago, but was able to hide his identity until HHS-OIG and the FBI used advanced data analysis and forensic accounting to unravel his current operation. His father, Rabbi Morris Esformes, was charged with taking kickbacks in 2004 when he boosted his $4,000 investment in a pharmacy to $7 million in profit when its was sold two years later by sending the pharmacy all of the business from his Chicago nursing homes, which were also the subject of complaints about poor care that he attributed to anti-Jewish sentiment.

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British Columbia’s health minister orders an immediate third-party review of Island Health’s $132 million Cerner implementation following physician complaints that the system is endangering patients and the switch back to paper of one hospital’s ICU and ED in one hospital nine weeks after go-live.

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Acting CMS Administrator Andy Slavitt is apparently not impressed with the EHRs out there.


Privacy and Security

Laser & Dermatologic Surgery Center (MO) notifies 31,000 patients that their information was exposed when its computer systems are hit with ransomware. The clinic declined to pay and instead successfully restored its systems.

The health information of nearly everybody in Denmark was exposed last year when a state office mailed two unencrypted CDs that the post office instead delivered to a China-owned bank. The CDs contained the cancer, diabetes, and psychiatric information of 5.3 million people. The bank employee realized the postal service’s mistake and took the package to the intended recipient.

Police arrest two Florida paramedics who were fired after posting pictures of themselves in their ambulances with incapacitated patients, sometimes posing them in humiliating fashion in attempting to one-up each other.

It appears the Twitter account used by hacker The Dark Overlord has been deleted and he hasn’t been heard from in a few days. I don’t know what that means


Technology

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Microsoft adds appointment-booking capability to Office 365, allowing users to choose the service they need, search for for available dates and times, and book the appointment from their PC or mobile device with confirmation and reminders to follow. Users can also cancel or reschedule their own appointments. Microsoft stuff doesn’t always catch on and I doubt this product would pass HIPAA muster, but otherwise it cold be interesting for healthcare.

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The Gates Foundation creates Chronos, a tool to help grantees meet the foundation’s open access requirement that their research be published broadly and with unrestricted access and re-use, including the underlying data sets. The service will pay publisher article processing charges, check compliance with policies, and track the impact of publishing activity, all to allow grantees to focus on their research rather than the processing of publishing it.


Other

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The Cleveland business paper covers MetroHealth’s use of 25 EHR scribes in its ED, which reports higher-quality and more timely documentation completion.

An editorial in the Lancet ponders the role of peer-reviewed medical journals in a publishing world turned upside down by the Internet, the endless quest for profitable eyeballs, and technology that “has transformed artisans into professionals.” It frets about open access journals, research misconduct, and the lack of reproducibility in many scientific studies.

The government of Indonesia arrests 23 people, including three doctors, after finding vials of vaccine that actually contained only sterile saline in 37 hospitals and clinics. An estimated 5,000 children have received fake vaccine, inciting parents to mob a Jakarta hospital and beat one of its doctors. The government caught one person who had adulterated vaccines years ago, but fined him only $100, and had not acted on vaccine manufacturer complaints of counterfeit products going back to 2011. The government vows to re-vaccinate millions of children at no charge and has established a vaccine distribution oversight group. 


Sponsor Updates

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 24, 2016 News No Comments

News 7/22/16

July 21, 2016 News 4 Comments

Top News

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ProPublica begins posting OCR’s “closure letters” indicating the resolution of HIPAA-related complaints, noting that most of the letters involve the VA and CVS Health.


Reader Comments

From Sharing CIO: “Re: Velocity Technology Solutions. My hospital was down also. They acknowledged a hardware failure that was exacerbated by human error, poor judgment, and a failed communication strategy. This is our second outage this year – the other one was Dell, who also had hardware failure combined with the fact that humans are not perfect.” More and more people are realizing that “cloud” is synonymous with “someone else’s data center” plus the hopes that a focused vendor will operate it better than they themselves. Most of the time that’s the case, but when things go wrong, the IT department is like end users in being stuck trying to get status updates, pestering the technicians who should be trying to restore systems rather than explaining why they’re down, and backseat driving the process.

From Stealers Wheel: “Re: my article. See this link!” I never know what to do when someone sends me the PDF of a book they’re working in, a LinkedIn article they wrote, or a link to a something they’ve written for a competing healthcare IT news site. I don’t really want to read someone else’s articles or using HIStalk to promote them, so I usually don’t reply because I know someone’s ego is involved.

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From LinkedInGuy: “Re: Epic. An ex-Google VP disses it.” At least he’s assertive in his cluelessness in smugly dismissing the entire healthcare IT industry on the basis of a single screenshot he doesn’t consider pretty. He’s awfully proud of his former Google background (working on games and products I’ve never heard of), so perhaps he should consider the rousing failure of Google Health, or for that matter, the horrendously awful UI and user-unfriendliness of Gmail and Google Docs, which make most healthcare software look positively cool by comparison. He seems confused  by the screen shot that he found on the Web since “most docs” don’t use a single specific EHR and the screen he illustrates is not Epic –  it’s actually a 2011-era screenshot of the Chart Talk EHR, a minor EHR player. He probably felt well informed with his tweet, but anyone who knows healthcare would infer the opposite.

From Pointy Head: “Re: work-life balance. Shouldn’t you be willing to sacrifice early in your career for later payoff?” That’s reasonable as long as you realize that the payoff might never come. There’s also that point in your career where you have to accept the reality that your career altitude has reached its zenith unless you change employers or jobs. I once worked for a health system executive who gave rather blunt but accurate advice to director-level people that applies to most everyone: if you yearn to be a C-level executive and either (a) your employer has already passed you over; or (b) you’ve hit 40, adjust expectations accordingly or perhaps start your own business if you feel your potential has been overlooked. Right or wrong, people in their 40s and certainly 50s shouldn’t confuse the hamster wheel they’re on with a career ladder in thinking they’ll get called up to the big show since the odds aren’t great. Those are the folks I hate to see busting their humps thinking they’ll somehow be rewarded accordingly.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Ms. McMahon, who requested maker space materials for her North Carolina elementary school media center. She reports, “The STEAM activities in our media center have ignited the creative spirit in my students. They just can’t wait to show me what they have created and just love to have their creation up for display or to see their picture on our website or news program. I have noticed a great improvement in the children who were often discipline problems in the past. They are engaged and excited and just hate it when its time to leave. There is high time on task and with a few rules in place – they abide by them well so that they don’t lose the privilege of working in our Creation Stations!”

I’ve been busy un-following dozens of people on Facebook who keep droning their heartfelt but one-sided and sarcasm-heavy political commentary. I really, really wish for enhancements to Facebook and Twitter that would force users to categorize their emanations into “work,” “politics,” and “114 photos of my angelic child,” allowing me to focus on the limited segments of their thought stream that I care about instead of just muting them completely. Social media have dumbed a lot of people down in filtering the news and opinion they follow, making them believe that nearly everybody thinks like they do and emboldening them to react with vitriol and personal contempt when faced with the inevitable other side of the argument. It’s like modestly talented executives who mistake the butt-kissing of their carefully chosen yes-men underlings as confirmation of their inherent brilliance. Unfortunately, real life is beginning to more and more resemble high school.

This week on HIStalk Practice: NASA deploys telemed technology in deep-sea expedition. HHS announces $9 million in grants to help improve opioid-addiction treatment in primary care practices. AHIP points to telemedicine to help alleviate physician shortages in certain states. R-Health launches independent, physician-led ACO in Southeastern Pennsylvania. Consumer sentiment reaches underwhelming levels of outrage over latest HHS privacy/security report. Surprise, surprise: Physicians do have favorite patients (and they aren’t even the most compliant.)

This week on HIStalk Connect: 2bPrecise Chief Medical Officer Joel Diamond, MD shares his thoughts on the future of precision medicine.

Listening: Cloves, who is actually 19-year-old Australian singer-songwriter Kaity Dunstan. I would say that she reminds me a lot of Adele, other than the fact that my fastest reflex is hitting “scan” on the car radio when a song by the ubiquitous Adele comes on and I’d actually stick around for Cloves.


Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Oncology precision medicine decision support vendor N-of-One raises $7 million in a Series B round, increasing its total to $11.7 million. CEO Christine Cournoyer used to be president and COO of Picis.

Theranos hires a chief compliance officer and VP for regulatory and quality, the former being McKesson assistant general counselor for regulatory law Dan Guggenheim.


Sales

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Tampa General Hospital (FL) chooses LogicStream Health’s sepsis bundle and clinical process measurement to reduce central line-associated blood stream infection.

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Adventist Health System chooses MModal’s transcription and front-end speech recognition for its 41 facilities, where it will also pilot MModal’s computer-assisted physician documentation system. .


People

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Pharmacy kit restocking software vendor Kit Check hires Cameron Ferroni (What’s Next Consulting?) as chief product officer.

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Solid state storage array vendor Pure Storage hires Vik Nagjee (Epic) as VP/CTO of global healthcare solutions. He helped develop Epic’s hosting business.


Announcements and Implementations

Cambia Health Solutions will merge its HealthSparq and SpendWell Health offerings under the HealthSparq name, offering users the ability to compare procedures and providers and then use SpendWell’s “buy now” technology to book appointments.

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University of Pennsylvania Health System (PA) will build a 540,000 square foot, 18-story Center for Healthcare Technology in downtown Philadelphia, with Penn Medicine’s IT department being a major tenant.

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Scotland’s Digital Health & Care Institute innovation center hires Scottish tennis star Andy Murray as its ambassador.

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The PillPack pharmacy uses APIs from PokitDok (Pharmacy Plan and Pharmacy Formulary ) to help its Medicare customers understand drug coverage and co-pays.


Government and Politics

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A fascinating article profiles the White House’s  US Digital Service, a group of mostly former Silicon Valley engineers that bypasses government red tape and contractors in saving taxpayers many times its $14 million annual budget by creatively solving IT problems that have long stymied federal IT lifers. It mentions Digital Service at VA (photo above), another skunkworks project that developed a new VA benefits appeals system, created a consolidated website at Vets.gov, and figured out a way for the VA and DoD to exchange scanned documents. Everybody loves the groups except fat cat IT contractors and the internal federal government bureaucracies that created the messes the kids are sent to clean up. I liked this passage about how the group broke the VA-DoD document logjam in just a few weeks:

They did not pick a toy task, but embarked on a challenge that had bedeviled the military for years. Unbelievably (except for in government), the DoD and VA use different systems for medical records, and the two systems get along just about as well as North and South Korea. Moving a medical history from one to the other — a pretty common task, since service people by definition become veterans upon discharge or retirement — could only be done by physically scanning the military records and sending files to the VA. But even that often failed, because the VA system was very finicky about file formats … “We had good people working on that, some of our best people,” says Secretary Carter. But they hadn’t cracked the problem, and indeed, hadn’t shipped anything for over a year. Nor were they thrilled at the idea of a bunch of hacker-types appearing in medias res. “At first the people who were working on the program were insulted at the suggestion they needed help,” admits Carter. “So some of them needed to be nicely helped to understand that was a good thing.”


Privacy and Security

A corporate payroll employee of the Phoenix-based Sprouts supermarket chain falls for a phishing scam in sending the 2015 W2 statements of all 20,000 employees in response to an email disguised to look as though it came from a company executive, with some employees already reporting that the scammers are trying to steal their IRS tax refunds.


Technology

BIDMC CIO John Halamka, MD touts third-party apps that layer on top of EHRs, listing three cloud-based systems BIDMC will deploy:

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The Right Place (electronic referrals for moving inpatients to post-acute care facilities).

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PatientPing (encounter notification).

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Collective Medical Technologies (team communication for managing patients who are regularly seen in multiple settings, such as EDs).


Other

South Shore Hospital (MA), whose proposed acquisition by Partners HealthCare was nixed last year due to anti-trust concerns, tries to raise $222 million in donations to pay for a campus expansion ($62 million) and its Epic implementation ($160 million).

Four noted experts offer their ideas for fixing healthcare:

  • Change the all-or-nothing FDA review of drugs into a a Consumer Reports-type rating of safety, efficacy, and degree of available evidence and let physicians and patients decide how to use them.
  • Give patients control of their electronic information as a “consumer-mediated health information exchange.”
  • Improve drug competition by speeding up FDA approvals and holding drug companies responsible for cost effectiveness by putting them at risk for outcomes.
  • Publish provider performance and cost data similarly to how businesses publish standardized accounting reports.
  • Pay hospitals based on quality in a more consistent manner, incorporating patient-reported outcomes and collecting data electronically.

Sponsor Updates

  • Winthrop Resources creates a light-hearted video about its new offering, a financial service for IT infrastructure for healthcare data centers.
  • GetWellNetwork announces that 35 hospitals and clinicals implemented its Marbella mobile rounding and patient experience solution in the first six months of 2016.
  • ZeOmega integrates Forecast Health’s patient risk analytics into its Jiva population health management product, adding the capability to perform predictive modeling based on social determinants of health.
  • Optimum Healthcare IT is recognized as one of Northeast Florida’s fastest-growing companies.
  • The St. Louis Business Journal profiles TierPoint CEO Jerry Kent.
  • Valence Health will exhibit at the MAHP Summer Conference July 20-23 in Acme, MI.
  • Verisk Health publishes the latest edition of The Globe newsletter.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 21, 2016 News 4 Comments

Philips Acquires Wellcentive

July 20, 2016 News 5 Comments

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Royal Philips announced this morning that it has acquired population health management software vendor Wellcentive. Terms were not disclosed.

Atlanta-based Wellcentive and its 115 employees has been placed within the Population Health Management group of Philips, which Wellcentive CEO Tom Zajac will lead.

Philips CEO Connected Care and Health Informatics CEO Jeroen Tas was quoted in the announcement as saying, “With this strategic acquisition, we will strengthen our Population Health Management business and its leadership, as health systems gradually shift from volume to value-based care, and provide more preventative and chronic care services outside of the hospital. Our sweet spot is at the point of care as we give consumers, patients, care teams, and clinicians the tools, such as remote monitoring solutions and therapy devices, to optimize care. Wellcentive’s solutions will provide our customers with the ability to collect data from large populations, detect patterns, assess risks, and then deploy care programs tailored to the needs of specific groups.”

I interviewed Wellcentive CEO Tom Zajac in August 2015.

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July 20, 2016 News 5 Comments

Morning Headlines 7/20/16

July 19, 2016 News No Comments

Examining Oversight of the Privacy & Security of Health Data Collected by Entities Not Regulated by HIPAA

An HHS report to Congress points out the lack of applicability of HIPAA privacy and security to non-covered entities such as app vendors, saying it will work with stakeholders to address gaps and adding that the FTC has some enforcement power.

Individuals’ Ability to Electronically Access Their Hospital Medical Records, Perform Key Tasks is Growing

An American Hospital Association survey finds that more than 80 percent of hospitals allow patients to view and download their medical record information, a significant jump since 2013.

How ‘digitizing you and me’ could revolutionize medicine. At least in theory

Eric Topol, MD of Scripps Research Institute defends the administration’s decision to give Scripps a $120 million precision medicine grant to collect and study the data of 1 million volunteers.

C-CDA Scorecard (Beta Release)

ONC creates an online tool that allows testing a C-CDA document to see how well it performs against certification criteria and advanced interoperability rules.

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July 19, 2016 News No Comments

News 7/20/16

July 19, 2016 News 3 Comments

Top News

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A new HHS report prepared for Congress notes the obvious fact that non-covered entities such as wearable and app vendors are not regulated by HIPAA, a situation it calls “a gap in oversight” that people (including vendors) don’t always understand. That gap can’t be addressed by HHS since it has no power to regulate anyone other than covered entities.

The report suggests that the FTC identify best practices. It notes that FTC’s authority includes protecting consumers from possible relevant unfair or deceptive company practices such as not following their own privacy policies, failing to disclose how consumer information is used, or failing to secure the consumer information they collect.

It’s surprising to me how often knowledgeable industry insiders cry “HIPAA violation” when the party involved is clearly not a covered entity, such as when ESPN ran a photo of an NFL player’s medical records. Anyone can violate your privacy, but only a covered entity or their business associate can violate HIPAA.

The report notes that people who share their information with non-covered entities aren’t clearly protected by federal law. It also references the little-known FTC Health Breach Notification Rule that requires PHR vendors that are not covered entities to report breaches of their systems.


Reader Comments

From Lawson CIO: “Re: downtime. We experienced almost a week of downtime with our Lawson system running on Velocity Cloud starting July 1. It must have have hit many hospitals. How many others experienced it?” Affected readers using Velocity Technology Solutions are welcome to report. I reached out to the company but they declined to respond, saying they are contractually prohibited from disclosing information to anyone other than customers.

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From Security Officer: “Re: The Dark Overlord’s most recent hack. The hacker gained access to a specific PilotFish dataset, but not for our environment. Do you have more information?” The Dark Overlord says he “used their [PilotFish’s] code to find exploits in all their clients … I signed a backdoor to get into their clients because I had access to their certificate signing. It got pushed out in an update a few weeks ago.” He also showed samples of the client EHR records he claims to have taken. The Dark Overlord has not previously overstated his accomplishments, so while there’s no proof so far that he breached every PilotFish client and took their PHI, I would operate under the assumption that he has and take action accordingly. I would expect his next move to be approaching those individual clients to demand payment since PilotFish turned down his demands. Confounding the issue is that some of PilotFish’s clients are HIEs and thus the information he claims to have stolen may have come from many providers, although maybe it cross-references a client table that he won’t bother linking to figure out the source.

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From Kyle Smith: “Re: VA hiring KLAS to advise it on commercial EHRs. It was a sole-source selection, claiming that only KLAS can do the job. I’m sure KLAS loves the kind words, but this doesn’t really sound like an accurate reflection of the work of other folks in the industry.” What we taxpayers will get for our $160K VA payment to KLAS is a six-month membership and bringing in three KLAS people for four, half-day overview meetings. Apparently the VA thinks it needs KLAS to tell it to choose between Cerner and Epic. It is probably not realistic that they would just ask DoD how its Cerner implementation is going before deciding.

From Mr. Buyer Beware: “Re: Definitive Healthcare. For those using it as their hospital data source, they are doing automatic renewals, but they increase the price without notice. Thoughts, Mr. H?” I would have to see your agreement, but I would be surprised if it doesn’t include at least some provision for increases pegged to cost-of-living percentages or something like that. They can adjust the price however they want if the contract doesn’t name a fixed price for the agreement’s term, which then might be a good indication that you as a customer shouldn’t have signed it. Ditto the automatic renewal – if the contract doesn’t say it renews automatically, then you can refuse to pay assuming that you’re willing to stop using their services. Either way, it’s a nice courtesy (and good business) for a company let customers know about the new price well in advance so they can budget for it.

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From Lifeline: “Re: taking time off from work. Like Dr. Jayne said, too many people associate their job with their identity and can’t give it up.” Job titles are like clothes – we hide behind them to prevent people from seeing us as we really are. When someone asks, “What do you do?” they are really asking, “Who are you?” with the assumption that your job defines your persona, and people often answer in that same mindset (especially executives who can’t bear the thought of not decisively differentiating themselves from us less-accomplished rabble). Folks who brag on being fully engaged in their jobs while on vacation have deathbed lessons to learn: (a) your employer and co-workers care much less about you than you think; (b) you are going to be devastated when you get fired or retire and realize all of that one-sided loyalty was misplaced as your work goes on without missing a beat in your absence; and (c) for the 99 percent of people who work at a particular job only because they need the money but would really rather be doing something else, spending more time working means spending less time living. It’s sad that people allow their identity to be subsumed into that of their employers in a form of self-enslavement. Employers have learned to maximize profits by swindling employees out of what should be their free time, now demanding their nearly undivided attention via an ankle bracelet posing as a smart phone and paying what seems like OK money for a job as long as you don’t do the per-hour math. We only think we’re immortal and the people crying graveside won’t be co-workers or customers (or in my case, readers). Welcome to the grand illusion.


HIStalk Announcements and Requests

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The DonorsChoose grant request of Ms. Hughes from South Carolina was simple: her fourth graders just needed dry erase boards and markers, which we provided. She reports, “The resources provide an easy way for the students to practice drawing models, pictures, and equations all of which are used to solve a variety of math problems. The students were so excited to see the new materials when they arrived. They kept going on about how nice it was of someone to give them to us!”


Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Cerner names its $4.45 billion, 10-building Kansas City office park that’s under construction the Innovations Campus. The first of 3,000 software engineers will move in next year, although the project won’t be finished for 10 years. The 4.7 million square foot complex — Cerner’s seventh campus outside its headquarters — was designed to house 16,000 workers. The company announced several campus design features:

  • A staircase whose metal perforations contain quotes from Cerner’s founders in binary code form (I assume one of them won’t be “Tick, tock.”)
  • A 100-person staircase “collaboratorium.”
  • A metal panel for each of the company’s 340 patents.
  • A 188-foot tall outdoor statue depicting DNA.

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Sweden-based exercise and diet tracker Lifesum raises $10 million.


People

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Alan Eisman (Information Builders) joins HBI Solutions as SVP of sales and business development.

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Cerner hires Jeff Hurst (Florida Hospital) as SVP of RCM and president of RevWorks.

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LifeImage names Janak Joshi (Deloitte) as CTO.

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Santa Rosa Holdings promotes Tom Watford to CEO. He replaces company founder Rich Helppie, who will remain board chair. The company’s businesses include Santa Rosa Consulting, Santa Rosa Staffing, InfoPartners, and Fortified Health Solutions.

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Gerald Greeley (Lahey Health) joins Signature Healthcare (MA) as CIO.

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Janet Guptill (Tatum) joins the Scottsdale Institute as executive director. She replaces Shelli Williamson, who will become vice chair of the board.


Announcements and Implementations

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In England, Wrightington, Wigan and Leigh NHS Foundation Trust  goes live on Allscripts Sunrise.

Catalyze earns HITRUST CSF certification for Amazon Web Services.

Meditech implements Access Passport for its internal electronic forms and signatures.


Government and Politics

The VA awards Leidos a prime T4NG contract in which 24 contractors are eligible to compete for $22 billion worth of IT services, network engineering, cybersecurity, and other IT work. Leidos was not included in the original list of 21 winners announced in March 2016.

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An American Hospital Association survey finds that 92 percent of hospitals allow people to view their medical records online, up from 43 percent in 2013. The most widespread adoption of technology for patients is the ability for them to pay their bills online, which is offered by 74 percent of hospitals, and two-thirds of hospitals say patients can securely message providers.

A Health Affairs blog post notes that while insurers can’t be required to submit their claims to a state’s all-payer claims database, many still will do so, giving researchers a good-enough set of information. It also notes that there never was an “all” claims database since they don’t include services for which insurance wasn’t billed.

AMIA warns FDA that while most providers are using EHRs, their data is not necessarily of research quality. AMIA suggests that FDA focus its research data collection on data warehouses, whose information has been better standardized and encoded, as opposed to relying on EHR information that was intended primarily to support individual patient encounters.

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ONC offers a C-CDA Scorecard that evaluates an electronically submitted C-CDA document in two ways: providing a pass/fail score to indicate whether it meets 2015 Edition Health IT Certification for Transitions of Care, and (b) issuing a letter grade indicating conformance with HL7’s advanced interoperability rules, which means the system’s vendor is more likely to be able to support interoperability.


Technology

Drug maker GlaxoSmithKline launches a mobility study of 300 rheumatoid arthritis patients using Apple’s ResearchKit.


Other

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The San Francisco paper finds that UCSF Medical Center CEO Mark Laret earns an average of $556,000 each year from serving on the boards of two of the hospital’s vendors, Varian Medical Systems and Nuance Communications, who have paid him more than $5 million on top of his $1.6 million annual compensation from the hospital.

Eric Topol, MD answers tough questions about precision medicine and the $120 million in NIH grants his employer, Scripps Research Institute, has received to recruit volunteer study participants. He says about the idea of  addressing patient-specific health risks instead of sequencing their genomes,

Look, we’ve had all this risk factor and lifestyle knowledge for decades. Do we have everybody practicing a healthy lifestyle? No. I don’t want to diminish the importance of it, but a lot of people have the healthiest lifestyle in the world and they get struck by things like autoimmune diseases and Alzheimer’s.  It’s not either/or, but we need to take advantage of the fact that we can know so much about any given human being — what they are at risk for, or the environmental factor that’s causing the risk.

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Kaiser Health News notes the upswing in micro-hospitals that offer EDs and primary care services but only a few inpatient beds. Sounds swell except they are usually built by big health systems trying to squeeze out competitors and bolster their bottom lines since companies that buy fancy medical equipment or build new buildings always find a way to create the demand to pay for them (not to mention the inherent inefficiency in staffing an always-open but potentially low volume building in the unfocused factory model). Walmart puts profit-boosting, scaled-down versions of their stores only where well-off people shop and hospitals are no different, so don’t expect to see mini-hospitals springing up in the downtrodden part of town. As one of my previous health system employers always said, we serve all, but market to few. As much as everyone likes to think it isn’t true, you won’t find the best hospitals and best doctors in poor or rural areas. Also true is that we’re all paying for those fancy health system buildings, the big salaries they hand out, and the enormous employee headcount that sucks up all the parking spaces for miles.

A report finds that 70 percent of physician assistants are working in specialties rather than primary care.

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A drunk, off-duty NYPD officer is charged with running over four pedestrians, killing 21-year-old MIT student Drew Esquivel, who was also working on an EHR for underserved areas.

HIMSS is running a hospital CMIO’s video pitch that claims to answer the question of why being named EMRAM Stage 7 was valuable to the hospital. The answer: it let the hospital’s IT employees feel good about their accomplishments. In other words, the hospital received no value whatsoever except IT bragging rights, about which the locals who are footing the bill could not care less. Magazines and websites create a lot of vanity-driven contests and awards that providers puzzlingly don’t see as pointless.

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Maine’s HHS typos the hotline number on the debit cards it gives to food stamp recipients, with the listed number actually ringing up a telephone sex line. Most surprising to me (beyond the fact that food stamps are now issued by debit card, which is a great fraud-tracking idea) is that such services still exist, although they apparently now charge directly via toll-free numbers instead of those 1-900 lines that funded a lot of late-night TV advertising in the 1990s.


Sponsor Updates

  • Bernoulli Enterprise is nominated for the Health 2.0 10-Year Global Retrospective Awards in the category of Tech Company.
  • Besler Consulting releases a new podcast, “Skyrocketing Costs and the Emergence of Rate Setting.”
  • CapsuleTech and Direct Consulting Associates will exhibit at MHealth + Telehealth World 2016 July 25-26 in Boston.
  • The local business paper features CoverMyMeds in a profile on startup jobs and spending.
  • Galen Healthcare Solutions publishes a new case study, “Critical Clinical Information Demystified with Database Training.”
  • Healthfinch joins the Matter community of healthcare entrepreneurs.
  • Meditech recaps its history in the acute care market in Canada.
  • Forbes interviews Healthgrades SVP and Head of Digital Mayur Gupta.
  • InstaMed publishes a new case study, “Pediatric Practice Automates 90 percent of Patient Payment Collections with InstaMed.”
  • Medecision CMO Ellen Donahue-Dalton joins the Women Business Leaders of the US Health Care Industry Foundation’s advisory board.
  • ITx honors Orion Health Product Strategist David Hay with the Excellence in Health Informatics award.
  • Patientco funds treatment for six patients through a partnership with Watsi.
  • The local business paper profiles the applicants for Cincinnati health commissioner, including Robyn Chatman of Sagacious Consultants.
  • Stella Technology announces its rebranding.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 19, 2016 News 3 Comments

Monday Morning Update 7/18/16

July 17, 2016 News 8 Comments

Top News

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Hacker The Dark Overlord, who has breached at least three healthcare organizations and then listed their patient data for sale when they refused to pay him, advertises for sale the digital assets of a healthcare IT vendor that appears to be PilotFish Technology, which offers integration tools and middleware to several industries that include healthcare. He’s asking $500,000 for HL7 source code, signing keys, and a licensing database. He says he stole the information by gaining full root-level access to the company’s servers. The Dark Overlord listed the information for sale after the company declined to pay him the $500,000 to keep quiet.

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The hacker says he has inserted a backdoor in PilotFish’s software that was pushed out in its most recent update and has since stolen the EHR records of all of the company’s customers.

Not only is PilotFish’s business at great risk, so is the information of its customers, among them Utah Health Information Network and the State of Connecticut. PilotFish launched its healthcare business in February 2014.

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The Dark Overlord breaches systems using Remote Desktop Protocol exploits, so I’ll recommend again that everybody either secure it or shut it down. He also seems to prefer targeting SRS EHR clients. His latest round of tweets suggests that at least one of the providers he hacked paid him to keep quiet last week.


Reader Comments

From Sharon M: “Re; LabCorp. I’m surprised HIStalk did not cover the IT crash that affected five states. Are you so biased that you only print the favorable reports about HIT?” This comment comes from a frequent anti-EHR troll who assumes multiple identities in unsuccessfully trying to avoid being called out, which even without the technical clues would be obvious since 99 percent of readers complain that I’m too critical of health IT instead of accusing me of being a cheerleader for it. I haven’t seen any mention of LabCorp problems anywhere, so given that I did not personally have tests performed recently in those five states, I have zero information about any downtime and have received nothing from users (including the phony Sharon M). In other anti-technology news, a traffic light went out for an hour recently, so it’s time to replace all of those unreliable devices with stop signs.

From Lysander: “Re: redirects. Why do you redirect the link from HIStalk.com to HIStalk2.com? I know it was originally related to a hosting switch, although if I know your style, that inside joke might be part of the fun.” It’s been nearly 10 years since I switched from a proprietary-technology web host while temporarily running both sites to prevent readers from getting lost. That change isn’t easy to undo, I’ve learned. I had my web host look into it yet again Friday night after your inquiry and they messed things up a bit temporarily, plus the change would probably screw up links to years’ worth of articles. I’ll add that to my inside joke collection (along with smoking doctor logos) and the list of things I’m too lazy to worry about.

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From Little Bit: “Re: mission and vision statements. I remember an academic medical center whose mission didn’t have one word about patients in it. There’s also an EHR vendor who talked a lot about their ‘Do Right’ principle, although I think they veered away from that one.” I’ve worked for executives who turfed off creation of mission and vision statements (they didn’t even understand the difference) to their underlings and it was a disaster. The back-stabbing, suck-up directors fought for attention in trying to distill a large, complex operation into a single overinflated, pithy sentence (it ended up with a lot of commas).  My takeaway: leaders without vision and character might as well have a crappy, eye-rolling vision statement that will be forgotten immediately because it’s not going to help anyway. My other takeaway is that committees are a poor substitute for leadership since they suck the life out of everything they do, and as such, should be limited to an advisory role to a clearly defined leader rather than to have actual power themselves. Give the buck a place to stop.


HIStalk Announcements and Requests

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Three-quarters of poll respondents don’t think levying HIPAA fines improves privacy or security. New poll to your right or here: what is your overall opinion of the Affordable Care Act? You can’t just leave us hanging by voting without explaining, so click the poll’s Comments link afterward to elucidate.

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Welcome to new HIStalk Platinum Sponsor Evariant. The Farmington, CT company offers enterprise-class CRM platforms for patients, consumers, and physicians that empower the marketing and physician relations teams of leading hospital networks. Evariant’s patient and consumer marketing CRM system drives targeted service line growth with attributable ROI, while its patient acquisition and engagement platform allows hospitals to target appropriate audiences for marketing as well as for education and wellness programs. Hospitals use its physician engagement technology to track referral patterns and physician loyalty in designing effective physician outreach activities. The company offers a free e-book titled “Creating Extended 360° Patient and Physician Views with Big Data Analytics.” Client success stories include Orlando Health, Wake Forest Baptist Health, University of Chicago Medicine, and Dignity Health. Thanks to Evariant for supporting HIStalk.

I found this Evariant client testimonial from University of Chicago Medicine on YouTube.

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Mrs. Roepke in Missouri had never had a DonorsChoose grant request fully funded until we provided her elementary school class with interactive math stations. She says her students cheered when they opened the box and saw the electronic flashcards and are using the many tools that were included in their small group work, to the point that they even refer to the game while working in other groups, which she calls “a proud teacher moment.”

I’ve realized what I hate about the phrase “pop health,” other than the fact that it’s an annoying shorthand for “population health,” which in this industry is invariably misused in describing “population health management” or “population health management technology,” which are entirely different things. Reporters and bloggers who bandy the term about from their cheap seats in their unwillingness to enunciate the daunting four syllables of “population” haven’t earned the right to lapse into jargon. Just like it’s insulting to Marines when people who have never served in the military shout out “Semper Fi.”

Listening: the almost-new album of one of my favorite bands, the highly listenable and brilliant Nada Surf, whose stock in trade is thoughtful lyrics, sweet harmonies, and ragged independence. Their catchy, sometimes jangly power-pop is hard to beat and they exhibit the maturity of a band whose lineup hasn’t changed in nearly 25 years. I’m offsetting that with the hard-rocking operatic Finnish metal of Nightwish, who I didn’t realize has commendably added the incomparable Floor Jansen (After Forever) as lead singer.


Last Week’s Most Interesting News

  • The VA takes more Congressional heat for lack of DoD interoperability and hints harder at replacing VistA with commercially available software in a Senate Appropriations Committee hearing.
  • A survey finds that most doctors haven’t heard of MACRA and hate the idea of tying their income to their quality.
  • OHSU pays $2.7 million to settle two HIPAA charges involving only 7,000 patients in incidents involving a stolen laptop and residents using Google Docs to store patient information.
  • Imprivata and Valence Health are acquired.
  • HHS issues ransomware guidance in declaring that a reportable HIPAA breach has occurred any time PHI is encrypted by malware.
  • CMS levies a death sentence on lab processor Theranos, banning Elizabeth Holmes from clinical laboratory ownership for two years and halting Medicare and Medicaid payments to the company.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

GE Healthcare’s management consulting group signs a five-year collaboration agreement with ThoughtWire, which offers machine intelligence software that GE Healthcare will roll out as real-time process alerting and decision support.


Sales

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University of Virginia Health System selects Evariant’s Physician Relationship Management and Physician Market Solver solutions for physician alignment.

The Medical Information Network – North Sound (WA) HIE adds Jiva Population Health Management to its ZeOmega rollout.


People

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Commonwealth Health (PA) names Denis Tucker (Main Line Health) as CIO.


Government and Politics

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England’s Secretary of State for Health and digital health supporter Jeremy Hunt is reappointed under new Prime Minister Theresa May.

The Defense Health Agency awards a five-year, $70 million to EHR Total Solutions. I found next to nothing about the company, which seems to exist purely to get military contracts. It previously reported $9 million in annual MHS contracts, so this will raise its total a lot.

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A US District Court orders MedSignals CEO Vesta Brue to pay $4.5 million for grant fraud. Her Lexington, KY companies received five NIH grants to develop electronic pillboxes, but she spent the money on plastic surgery, jewelry, and massages. She will also pay restitution and serve jail time for grant fraud related to Telehealth Holdings, Inc., a company operated by her partner Jerome Hahn.



Other

GE Healthcare sues 23-bed West Feliciana Parish Hospital (LA), complaining that it unfairly chose Hitachi Medical Systems to provide imaging equipment at a price below GEHC’s bid.

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I’m tiring of the Pokemon Go phenomenon as quickly as I did other pointless, imitative fads like the Ice Bucket Challenge and the phrase “threw up in my mouth a little bit,” but this is cool: C.S Mott Children’s Hospital (MI) is using the game to get hospitalized children to leave their beds and interact with employees and other patients. That won’t be offset by the hospital influx of dolts who are hurting themselves in their rare interactions with their actual physical surroundings while staring at their phones, but it’s a small plus. Speaking of which, as I predicted last week, game developer Niantic announces monetization plans in which it will offer retailers the ability to sponsor locations on a cost-per-visit basis in hopes of boosting their foot traffic. I predict the game will be a cringingly-recalled embarrassment in six months, just like Second Life and Google Glass.

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The former IT administrator of an Alaska health system faces 99 years in prison after pleading guilty to  possessing and distributing 2 million images and 13,000 videos of child pornography that obtained using the hospital’s network. He was not charged for distributing another disturbing image, the photo above from his LinkedIn profile.

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The Houston paper covers the “cost versus choice” out-of-network conundrum in describing a 175-bed, oncologist-owned hospital that brings in annual revenue of $1.5 billion despite not accepting any form of insurance. Aetna sued after finding that the hospital was reducing the patient responsibility portion of its bills to in-network levels by applying a “prompt pay discount,” but was sticking Aetna for their full part of the out-of-network charges (such as $200,000 to treat an abscess). Aetna claimed racketeering, while the hospital counter-sued for being blacklisted. The judge denied Aetna’s demand for $225 million in refunds, saying it’s up to Aetna to decide what part of medical costs it pays in applying usual and customary limits.

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Bizarre: several doctors in India, one of them a government official, are arrested for running a child trafficking ring from their hospital, caught as they tried to sell a four-month-old. Police are also investigating whether the doctors are running their hospital legally and whether they have actual medical degrees.


Sponsor Updates

  • T-System will exhibit at the FHIMA Annual Meeting July 18-21 in Orlando.
  • Stella Technology is sponsoring and exhibiting at the Redwood Mednet conference in Santa Rosa, CA this week.
  • Datanami.com profiles TransUnion’s management and use of big data.
  • Valence Health will host its value-based industry conference, Further 2016, September 14-16 in Chicago.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 17, 2016 News 8 Comments

News 7/15/16

July 14, 2016 News 5 Comments

Top News

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VA CIO LaVerne Council, testifying to the Senate’s Committee on Appropriations about the future of VistA, defends the status of interoperability with the DoD. She is grilled about why the military’s diagnostic images of newly discharged veterans can’t be viewed by the VA, forcing them to start over, and why Cerner’s suicide prevention algorithms can’t populate the Joint Legacy Viewer. She answers a pointed question about why the VA and DoD can’t use the same system by saying that no existing system can meet the needs of both. Council confirms that every VA VISN has a customized instance of VistA, meaning it’s really 130 similar but not identical systems.

VA Chief Information Strategy Officer David Waltman phrased an answer to a question as “until we move to a COTS solution on the digital health platform,” leaving little doubt that the VA hopes to buy a commercial product. Senator Bill Cassidy, MD (R-LA) was impressive in asking insightful questions about interoperability and federated data capabilities.

Council says the VA has engaged KLAS to build its business case (at a cost of $160,000, Politico reports) in reviewing products and options, hoping to give the next administration a business case by the end of the year. I’m not sure what KLAS has to offer that everybody doesn’t already know (it’s either Cerner or Epic – skip the RFI/RFP and just visit some sites, negotiate hard, and swallow the urge to rule out Cerner just because DoD chose it).


Reader Comments

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From Dr. Nicholas Van Helsing: “Re: Theranos. I posted a few weeks ago that it was clear the Emperor had no clothes. But put a mysterious woman dressed in black turtlenecks and a somewhat strange alto voice out front and people buy it. A similar image was creatively groomed 15 years or so for Kim Polese of Marimba. Every industry rag had a story about her every month, and then she complained that the press never left her alone. She hasn’t amounted to much, but at least Marimba sold for $239 million and only deal with software, not lives. Her next venture tanked – anyone know what she’s doing today? I think Liz is headed the same way. QED.” Polese made a lot of covers because of her appearance (despite holding a biophysics degree and being influential at Sun Microsystems for coming up with the name Java) and because women-led tech companies were rare back then. That was a reflection of widespread industry chauvinism more than any ego failings she might have had. Marimba created Castanet, a technology to allow fast downloads, but the company’s fame never approached her own, especially after it hired a PR firm who decided to make her the real story. You’ll be interested to know that she landed in healthcare as board chair of ClearStreet, which offers technology to help employers and employees manage their healthcare spending.

From Dilettante: “Re: HIStalk. I don’t believe that it’s just one person writing and reading every item that appears. Tell me who is on the team and where the company offices are located.” I get that a lot. I write every word of every news post myself, with the rare exception when I take a day off and Jenn covers. I don’t leave the otherwise empty spare bedroom (no schmoozing, speaking engagements, or sucking up – that’s the beauty of being anonymous) until I’ve written something that I’ll still be proud of years later, long after thousands of readers have forgotten it. Until I lose the ability or interest to continue doing that in a way that I think is better than anyone else, it’s just me alone feeling like I’m whispering in the ear of a single reader who is just like me in having a short attention span, a low threshold for BS and corporate incompetence, and a strong interest in doing the right thing for patients and those who pay their bills. Everybody has some weird, questionably useful talent (wiggling ears or solving a Rubik’s cube, for example) and this happens to be mine.


HIStalk Announcements and Requests

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We funded a significant DonorsChoose project (donating $500, which was matched by Chevron) in providing Mrs. Veltri’s Pennsylvania elementary school class with an iPad Mini and STEAM tools, books, and games. She reports, “Packages came to our door and our students could not contain their excitement. You should have seen their faces as they began to open boxes that gave them tools to explore new aspects of education. At this young age students need to explore science, technology, engineering, and mathematics to set their foundations for later on in their schooling. The blocks and tiles get them learning about these concepts at a young age and in a very exciting way!”

I asked Jenn to write an article about the return on investment vendors get for exhibiting at the HIMSS conference. Contact her if you would be willing to give some company perspective (anonymously if you would rather).

This week on HIStalk Practice: Enli Health Intelligence partners with Dell Services. Hawaii hopes to ease physician shortage with expanded access to telemedicine. Relatient partners with Uber. Flatirons Practice Management adds Mediware billing tools. HealthTap acquires Docphin. Drchrono partners with AHIMA to help HIM students. Colorado Springs Health Partners rolls out Clockwise.MD at urgent care facilities.

This week on HIStalk Connect: Involution Studios debuts digital healthcare cards. Tel Aviv University develops temporary emotion-mapping electronic tattoos. Eleven year-old helps Boston Children’s Hospital promote telemedicine legislation. Avizia and Progyny secure new funding rounds. Drones help coordinate care for wild ferrets.

Listening: new from Anderson/Stolt, a collaboration between former Yes singer Jon Anderson and former Flower Kings/Transatlantic guitarist Roine Stolt. Yes is on its sad last cash-cow legs, even more pathetic than the so-called Beach Boys with no original members left and a tribute band singer mangling its classics, so this is a pretty good substitute for the band’s prime 1970s years with Anderson / Squire/ Howe / Wakeman / White (or maybe Bruford if you’re a purist). Prog fans will be transported to the years when Yes and Genesis ruled the airwaves and concert stages. Anderson sounds great for a guy who’s 71 and who got fired from Yes in 2008 after serious lung problems kept him off the road and thus from playing the aging band’s primary keyboard instrument (the cash register). He’s also touring this fall with fellow Yes alumni Rick Wakeman and Trevor Rabin.


Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

Teladoc obtains a $25 million loan and $25 million line of credit.

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Care coordination software vendor Caremerge raises $14 million, increasing its total to $20 million.

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Telemedicine software and services vendor Avizia raises $11 million, increasing its total to $17 million.

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In Canada, Telus Health announces that it will acquires the Canadian EHR business of Nightingale Informatix, which is used by 4,000 physicians.

Patient experience software vendor Docent Health raises $15 million in a Series A funding round, increasing its total to $17 million.

Publicly traded Alere recalls all of its PT/INR blood coagulation testing systems as mandated by FDA, which found that the company’s software update did not fix a previously documented problem with incorrect results. Abbott had agreed to acquire the company for $5.8 billion last year but then tried to back out after Alere was investigated for foreign corruption probes, so naturally they’ll be trying even harder now. 


People

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Randy Fusco (Change Healthcare) joins patient engagement system vendor HealthGrid as EVP of product R&D.

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ID Experts hires Kimberly Holmes, JD (OneBeacon Insurance Group) as SVP and counsel for cyber insurance, liability, and emerging risks. 

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Johns Hopkins All Children’s Hospital (FL) names John McLendon (MedStar Health) as VP/CIO.

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Chris Hammack (Patientco) joins population health management consulting group Aegis Health Group as SVP of sales and business development.


Announcements and Implementations

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In Singapore, Farrer Park Hospital goes live on Meditech 6.0.

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Medecision launches Aerial for Medicaid and Medicare Advantage, a population health management system.

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Colorado Springs Health Partners (CO) goes live with online check-in by Clockwise.MD at all three of its urgent care facilities.

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PMD adds real-time discharge alerts to its software, allowing practices that participate in Medicare’s Transitional Care Management program  to be paid for performing follow-up within 48 hours of discharge. The company offers software for charge capture, secure messaging, health information exchange, and care coordination.


Government and Politics

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Six Republican Senators introduce the EHR Regulatory Relief act that would mandate a 90-day Meaningful Use reporting window in trying to “pull the electronic medical records system out of the ditch, transforming it into something that doctors and hospitals look forward to rather than dread.” The proposed legislation would also modify the all-or-nothing MU requirements and extend the availability of hardship exemptions. Senators John Thune (R-SD), Lamar Alexander (R-TN), Mike Enzi (R-WY), Pat Roberts (R-KS), Richard Burr (R-NC), and Bill Cassidy (R-LA) are members of the Senate’s working group Re-Examining the Strategies Needed to Successfully Adopt Health IT, which somehow ended up with the contrived, catchy non-acronym REBOOT.

Meanwhile, CMS Acting Administrator Andy Slavitt tells the Senate Finance Committee that CMS is open to postponing MACRA and shortening its reporting periods.

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A Politico article calls the Affordable Care Act “the secret jobs program” in which the administration–  facing a tanking economy and the loss of millions of jobs — chose preserving healthcare employment over controlling healthcare costs in deciding not to cap healthcare spending or address provider efficiency. Healthcare employment has grown 23 percent since 2005 vs. just 6 percent in non-healthcare jobs. The excellent article notes that the “poison pill” that’s included with all those jobs is ever-growing healthcare costs (healthcare creates its own demand) footed by employers, patients, and taxpayers, noting that doctors are outnumbered by non-doctors by 16 to 1, with nine of those being paper-pushers. Experts say the investment is a poor one if health doesn’t improve. Legislators have declined to face the issue because “every job is a good job” and all of them have big-employer hospitals in their districts, with healthcare and social assistance providing the highest employment in 56 percent of Congressional districts.

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HHS lists a position for an IT security specialist, which contains mostly unsurprising duties except for the last two that cover prosecution and corrective action.

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A Deloitte survey of physicians finds that only 50 percent of the non-pediatricians have heard of MACRA, with 32 percent of them saying they’ve heard of it but don’t actually know what it is (maybe CMS should hire drug salespeople to spread the word since they seem to get doctors to pay attention, at least when they bring lunch). Nearly 80 percent of respondents say they would rather be paid under fee-for-service or salary arrangements instead of value-based payments. Three-quarters think performance reporting is burdensome and 79 percent don’t like the idea of tying their incomes to quality (that might be the scariest number of all).

An HHS report says national health spending will hit the $10,000 per person mark for the first time this year and will continue to grow at around 6 percent annually through 2025 as the economy improves, healthcare prices rise, and baby boomers get older. It predicts that spending may be moderated by higher out-of-pocket costs and says insurers will increasingly narrow their networks in trying to avoid price increases.


Privacy and Security

Oregon Health & Science University will pay $2.7 million to settle charges stemming from two 2013 data breaches involving 7,000 patients, one the theft of a surgeon’s unencrypted laptop from his vacation home and the other caused by medical residents who stored patient information in cloud-based Google Docs. That’s a big penalty considering there’s no proof anyone actually saw or used the patient information.


Other

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Healthcare Growth Partners publishes its mid-year health IT market review, which always dazzles me with its insight and brilliant writing. It notes the change since 2005 in which “solvers” (companies that do the right thing in generating profits while maximizing returns for many) now outnumber the previously dominant “exploiters” (companies that exploit inefficiencies to maximize returns for a select few), as the fee-for-service model rewards exploiters and value-based care rewards solvers. It notes that companies with just $10 million in revenue have a wide variety of investors to choose from in the immature health IT market. Respondents were mixed on whether an health IT investment bubble exists, but those who think it does point mostly at early-stage companies. There’s too much information to summarize adequately, so take a look – unless you are already an M&A expert, you’ll learn a lot by reading the report.

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Greater Baltimore Medical Center (MD) celebrates its EHR go-live with what it calls a company barbeque (which it wasn’t – it was a cookout with no low and slow smoking involved). I assume it was Epic ambulatory that went live.

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A funny spoof from the Gomerbloggers.

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Weird News Andy helpfully provides ICD-10 code Y93.C2 (activity, hand held electronic device) for treating the idiots who are harming themselves by ignoring the real world in favor of the Pokemon Go variety. He provides examples: (a) two men fall off a San Diego cliff after cutting through a protective fence in their pursuit of a character; (b) a guy crashes his car and tears up a woman’s yard while driving and chasing an imaginary monster; and (c) a 21-year-old generously absolves the game’s maker for falling off his skateboard while hunting characters, saying, “I don’t think the company is really at fault.” Meanwhile, officials at the United States Holocaust Museum, Arlington National Cemetery, and Poland’s Auschwitz Memorial ask the game’s vendor to take their sites off its monster-hunting list to keep them from being overrun by disrespectful players. The CEO of the company that developed Pokemon Go says his goals were to get people to exercise, to encourage them to explore their neighborhoods, and to serve as an icebreaker in getting strangers together, all of which could allow the game to meet the definition of a health app except that people actually use it.


Sponsor Updates

  • Ingenious Med Chief Innovation and Product Officer Todd Charest speaks at the Gwinnett Chamber of Commerce’s Wearable Technology Forum.
  • InstaMed is featured in the Deloitte Health Care Current.
  • Fifty-nine Meditech customers achieve the “Most Wired” distinction for 2016.
  • Netsmart will exhibit at the ASU Annual Summer Institute July 19 in Sedona, AZ.
  • Experian Health will host its Northeast Regional User Conference July 19 in Philadelphia.
  • Following up on an Earth Day-related pledge, PatientPay donates to The Nature Conservancy for the restoration of longleaf pine forests in the North Carolina Sandhills.
  • Teknovation.biz interviews PerfectServe CEO Terry Edwards.
  • Sunquest Information Systems will host its 35th Annual User Group Conference through July 15 in Tucson, AZ.

Blog Posts

HIStalk sponsors named among the 100 winners of Modern Healthcare’s “Best Places to Work in Healthcare 2016” are:


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 14, 2016 News 5 Comments

The War on Wearables

July 14, 2016 News 1 Comment

HIStalk looks at the bad rap wearables have been getting lately. From class action lawsuits against Fitbit to digital health snake oil comments, wearables have major ground to cover when it comes to winning over providers as medically reputable devices.
By @JennHIStalk

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Industry headlines would have you believe that it’s not the most opportune time to be in wearables. The consumer-friendly devices, most of them of the fitness-tracking variety, face abandonment rates of between 33 and 50 percent after the first six months of use, not to mention increasing scrutiny as to the accuracy of their measurements.

And then there’s the comment heard ‘round the health IT world: “From ineffective electronic health records, to an explosion of direct-to-consumer digital health products, to apps of mixed quality. This is the digital snake oil of the 21st century.”

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The comments of AMA CEO James Madara, MD during the association’s annual meeting last month was provocative to many. Although it did have a certain clickbait ring to it, his stance was born out of an underlying concern by many in the medical field that digital health tools — of which wearables take up an increasing percentage — have yet to be fully accepted by physicians. Whether it’s accuracy, usefulness, easy integration with EHRs, or reimbursement for time spent sifting through all that data, wearables haven’t achieved the panacea status many entrepreneurs would have providers and consumers believe they’re capable of.

The Physician’s Perspective

And yet there seems to be no going back. Companies continue to work wearables into their product roadmaps, even in the face of questionable data accuracy. Elmurst, IL-based Power2Practice, for example, announced Fitbit integration with its EHR for integrative medicine last month. UK-based personal health record company Medelinked has announced a similar arrangement with Jawbone.

Clinical researchers don’t seem deterred, either. The Dana-Farber Cancer Institute’s new breast cancer weight loss study has equipped all of its participants with Fitbits to track activity and weight. The examples of academic and corporate enthusiasm for wearables could — and likely will — go on, suggesting that, like the ancient medicinal properties of snake oil, there is a grain of truth to their purported value.

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Danny Sands, MD, a practicing physician at Beth Israel Deaconess Medical Center (MA), co-founder of the Society for Participatory Medicine, and chief medical officer at several healthcare companies admits to wearing a Fitbit because he likes receiving reminders that he needs to pick up the pace on a daily basis.

“I think that’s a positive step in the right direction, if you’ll excuse the play on words,” he jokes. “We have to remember that these are consumer devices. They’re not accurate clinical devices. For some people, having the Fitbit on is a motivator. I have seen firsthand how my encouragement to get a Fitbit helped one of my patients get moving and make profound changes in his life. Unfortunately, the vast majority of people who use these tracking devices don’t need to. They’re being used by the young, healthy, and wealthy, not by my patient with three chronic conditions who really should be wearing one.”

“As a primary care doctor,” Sands explains, “one of the things that is so hard and so frustrating is this issue of behavior change – how to motivate patients. If this is one more tool we can use to help motivate our patients, then I figure there’s something to it.” He adds, however, that not all physicians are comfortable recommending wearables and apps, either because they’re not familiar with what’s on the market or have no interest in diving into the back-end issues of receiving that deluge of data.

“You have to ask yourself, as a physician, is this data useful to me,” Sands says. “There it gets a little more complicated, because, first of all, there’s the issue of accuracy. Second, there’s the issue of integration with my workflow/EHR. Third, and perhaps most importantly, it’s about the volume of data that these things generate. This is only going to be useful to me in my practice if it’s information I want to see on a patient that I want to keep track of. Perhaps I’m in some sort of value-based payment contract where I have an incentive to try and keep my patients healthy. I need to figure out how to separate the signal from the noise. I need a system that’s going to show me just the data that’s important to me.”

Sands obviously isn’t convinced by the snake oil rhetoric. “Time and time again we’ve seen that a computer program in the absence of human beings providing something as well is not going to make a big difference in people’s lives. You need systems in place. You need some interface with the healthcare system. If you want to show measurable benefits, then you really have to have human beings there – some touchpoint with the healthcare system.”

The Quality vs. Quantity Conundrum

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ACT | The App Association, the Washington, DC-based nonprofit that represents software companies in the mobile app community, has been keeping a close eye on the evolution of wearables in the healthcare space. “Connected devices that we think of as wearables are undergoing a significant transition,” says Executive Director Morgan Reed. “As sensors and technology improve, these devices are rapidly blurring the line separating highly accurate medical devices and something you might pick up at an airport kiosk.”

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“The struggle,” he adds, echoing Sands’ comments, “will be taking all of that accurate information and presenting it to a care provider in a meaningful way. This is a place where the balance between quality versus quantity comes into play on the physician side. EHRs – loved or loathed – aren’t so much barriers, but instead have created a new paradigm in which medical apps and connected device makers must create technology that integrates seamlessly with those systems. An ideal interoperable system gives care providers access to a lot of data, but instead of just dumping it into one place, the system highlights the data that the physician needs the most, and makes it available in a usable format. Open APIs are a big part of the solution. The tech industry, regulators, and physicians need to work together to determine how best to create and implement these APIs and related standards.”

Workflow Integration will be Key

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Companies like Validic are helping physicians navigate the still-murky waters of wearables integration. The Durham, NC-based company recently partnered with SAP to enable its enterprise healthcare clients to easily access patient data from wearables, clinical devices, and consumer health apps using Validic’s digital health connectivity tools. Co-founder and CTO Drew Schiller believes partnerships like these will help wearables move past the early days phase they seem to be stuck in.

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“Consumer wearables as a market is still maturing, with only one IPO and a couple of exits,” Schiller explains. “We are still in the early phases of using these devices in healthcare. Given this, it’s unsurprising that there have been challenges getting adoption from providers. The ‘time to drawer’ is a concern, indicating that these devices may not have yet reached full utility.”

“The biggest barriers today have to do with presenting meaningful information in existing workflows,” he adds. “One barrier is that we are still working to understand the applications and necessary reporting mechanisms for healthcare. There are dozens of ongoing pilots, projects, and grant-funded studies looking to address these needs, and organizations like Node Health are working to bring these disparate efforts together in one place and disseminate learnings.”

“I wouldn’t say that categorically certain wearables are more conducive to integration,” Schiller points out. “However, having a single point of entry for all wearable data certainly makes things easier. Additionally, if an endpoint from the wearable already has a classification and a place in workflow, that makes the logistics of implementation much easier.”

The Biggest Impact

Despite their current shortcomings, wearables seem poised for improvement in terms of provider acceptance, ease of use and integration, overall sophistication, and, most importantly, impact on patient care.

“In the immediate term, wearables enable people to take a more active role in their health,” says Reed. “This represents a shift toward prevention instead of treatment once someone is sick. In the longer term, insights powered by mission-specific wearables and apps will be huge for physicians and patients. Patients can use connected devices to help manage chronic conditions like diabetes or complete post-operative physical therapy, all while physicians monitor progress and identify potential risks.”

Moore adds that one of the most critical issues facing the healthcare system is that of the rapidly aging US population. “By 2050, there will be 83.7 million Americans over the age of 65 – that’s more than double the number just four years ago,” he points out. “Eighty percent of them will have at least one chronic condition, and a large portion will live in rural areas far from family members that could offer support. Wearables and apps are key to empowering this population, helping them to live healthier – and independently – for much longer.”

“Looking forward,” he adds, “advanced personal emergency response systems will be wearables packed with sensors and enabled by mobile apps that can track blood sugar, blood pressure, heart rate, biomarkers for medication adherence, and geofencing for Alzheimer’s patients. The sensors in these devices will then connect to a loved one’s phone, a physician’s tablet, and a medical record system. This increasingly connected approach to healthcare will lower costs and empower aging populations to live at home longer.”

Schiller concurs that wearables will be key to helping care for an increasingly elderly population. He also points out that the devices will help make up for the physician shortage we’ve all heard so much about. “We face a generation of physicians preparing for retirement and a dearth of PCP replacements. We simply won’t have the skilled workforce to maintain business-as-usual practices in healthcare. We must better leverage technology to scale reduced healthcare resources with an eye toward preventing sickness before it becomes chronic. Wearables will play a central role in this revolution.”

Present Benefits are Possible

While the revolution is in the works, wearables, for all their documented shortcomings, are capable of offering near-term benefits to physicians and patients. “Those benefits will depend on the supporting infrastructure and tools the health system and/or EHR vendor has put in place,” Schiller says. “For example, Cerner and Meditech have built smart alerting and dashboarding into their patient portals leveraging a growing list of patient-generated data from remote monitoring devices, including wearables. Health systems such as Sutter Health have realized tremendous success with wearables in comprehensive remote patient monitoring programs for chronic diseases like hypertension. Programs like these will help a physician better treat patients by knowing precisely how well or how poorly a patient is progressing in their care.“

“Long term,” he adds, “physicians will benefit from a shift toward preventative and monitoring measures. This will enable PCPs to know how their patients are doing without physically seeing them, allowing them to spend more time with patients who need care the most.”

Time – and the Market – will Tell

“We are currently witnessing Moore’s Law as applied to wearable devices,” Schiller concludes. “Wearables on the market 18 months ago are significantly inferior to the capabilities of those on the market today, and we expect to see another jump in functionality and sophistication within the next six to 12 months. I could make some specific predictions, but it makes sense to instead state more generally that the consumer technology industry will rise above these challenges to make useful, compelling, and practical devices.”

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July 14, 2016 News 1 Comment

Evolent Health Will Acquire Valence Health for $145 Million

July 13, 2016 News 1 Comment

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Evolent Health will acquire the majority of Valence Health for $145 million, the companies have announced. The deal, which involves $35 million in cash and the remainder in Evolent shares, excludes Valence’s state insurance cooperative contracts, which will continue to operate under a newly created entity.

Evolent CEO Frank Williams said in a statement, “The addition of the Valence Health business will provide increased scale and client diversification, and we expect it to accelerate our target timeline to Adjusted EBITDA break-even in 2017 by one to two quarters. We believe this transaction will strengthen our business strategically and financially and position it for continued growth well into the future."

Chicago-based Valence Health offers technology and consulting services to providers moving to value-based care. The company last year hired as its CEO Andy Eckert, who had previously served as CEO of Eclipsys, TriZetto, and CRC Health as well as currently serving as board chair of Varian Medical Systems.

Evolent Health, which also offers integrated solutions that help providers shift to value-based care, was formed in 2011 with The Advisory Board Company and UPMC and went public in June 2015. It has a $1.2 billion market cap as share price has risen 3 percent in the year since its IPO.

I interviewed Evolent President and Co-Founder Seth Blackley in August 2015 and interviewed Valence Health then-CEO Phil Kamp (now chief strategy officer) in March 2015.

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July 13, 2016 News 1 Comment

Thoma Bravo To Acquire Imprivata for $544 Million

July 13, 2016 News No Comments

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Imprivata will be taken private by an affiliate of private equity firm Thoma Bravo for $544 million in cash, giving shareholders a 33 percent premium to the last closing stock price.

Imprivata President and CEO Omar Hussain was quoted in a statement as saying, “We’re tremendously excited about Thoma Bravo’s investment in our company and believe this transaction represents a great outcome for our current shareholders. Given Thoma Bravo’s successful track record in both security and healthcare IT, today’s partnership is an endorsement of Imprivata’s corporate vision and our relentless focus on the customer experience — a value which has established us as the vendor of choice in healthcare IT security. We are now in a stronger position to pursue market opportunities through innovating and expanding the products and services we offer.”

Thoma Bravo’s other active healthcare IT investments include Global Healthcare Exchange, Hyland Software, Mediware, and SRS Software. It also owns Bomgar Corporation, which offers remote support and identity management solutions. 

Imprivata offers single sign-on, secure virtual desktop access, patient IT, secure messaging, and two-factor authentication. The company went public in June 2014. Share price has decreased 11 percent since.

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July 13, 2016 News No Comments

News 7/13/16

July 12, 2016 News 2 Comments

Top News

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HHS issues HIPAA guidance for ransomware attacks, saying that a reportable HIPAA breach has occurred if the malware encrypts PHI. The only exception is if the covered entity or business associate can demonstrate that the risk of PHI compromise is low, which would be difficult to accomplish in a ransomware attack.

HHS says a breach has not occurred if the user’s data was encrypted, but with a big exception –  users who are logged into a PC have made the information on their hard drive available during their session, so if that user clicks on a phishing link or opens an infected web page that triggers ransomware encryption, impermissible disclosure has occurred.


Reader Comments

From Geno Petralli: “Re: Xcite Health. A client says they’ve been bought by Athenahealth and the EncounterPro/Xcite Health program will be sunsetted and everyone moved to Athena by 1/10/17.” Here’s Athenahealth’s official response (from the head PR person) to my inquiry about this reader’s rumor:

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A few hours later, I received this “partnership” announcement from Xcite Health, confirming the reader’s statement that EHR/PM vendor Xcite Health is shutting down as of January 10, 2017 and is suggesting that its now-orphaned clients switch to Athenahealth.

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From Roll Liftface: “Re: HIT100 winners. This guy doesn’t appear to have a job beyond self-promotion. Next year you should mock the process by getting your readers to nominate Carrot Top or Prince.” I haven’t heard of at least half of the tweet-happy winners, who seem to participate in a lot of mutual back-scratching among the Twitterati. Twitter isn’t the real world and the job titles of some suggest more success in the former than the latter. I’m sure part of the motivation beyond self-validation is employment, but I think companies would be wary of hiring someone who spends that much time and energy tweeting.


HIStalk Announcements and Requests

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Elementary school librarian Ms. H in Texas created a maker space that we stocked with programmable robots and other technology kits in funding her DonorsChoose grant request. She reports, “The younger students were in awe of this technology! I had a few even say ‘It’s Magic’ and I had to respond ‘No, it’s science!’ I had first graders screaming with joy when they got their Ozobot to follow the path they had created for it.”


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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The Wall Street Journal publishes fascinating factoids about Theranos CEO Elizabeth Holmes, including that her admiration for Steve Jobs (as evidenced by her black turtlenecks) led her to maintain an Apple-like secrecy about company news until the “one more thing” type public reveal. She also hired an Academy Award-winning director to film videos of herself. She is also escorted everywhere by an earpiece-wearing security detail that refers to her as Eagle 1. The article notes that her presentation to the American Association for Clinical Chemistry next month won’t include the information she originally intended since FDA said she couldn’t, so she’s going to instead focus her talk on Theranos company history (yawn). WSJ’s readers always provide insightful comments:

  • Hey, investors in Eagle 1–do you guys really know what you’re doing? Heaven forbid that you actually consult with someone who actually KNOWS SOMETHING about diagnostics.
  • I just hope that this story helps to shed light on the loophole in the law that allowed Theranos to promote tests that were not scientifically validated or to bring a spotlight to the many start-ups that continue to raise funds on the basis of hype and revenue growth, but without any real business plan or hope of profit.
  • This is what the VC’s seemed to really lust after, the idea that Theranos was going to move the bulk of blood testing out of doctor’s offices disrupt LabCorp and Quest as if they were stodgy old taxi companies. Theranos was really an "Uber for _____" and a data hoovering company. How many more clinically relevant (but smaller and less sexy) medical companies could have been funded with the money that was wasted on this?
  • I hesitate to draw any parallels between Holmes and Jobs because Jobs actually built products that worked as advertised.
  • I know a former employee of Theranos. This person got out when they realized this company was all smoke and mirrors. Also, this person told me that the whole Elizabeth Holmes story is all PR driven fluff (boldly dropping out of Stanford, starting the company on her own, etc.). Holmes actually has a lot of political connections in DC and is related to the Fleischmann Yeast fortune. Why are there so many politicians on the Theranos board and very few MDs?
  • It is possible that the famous Reality Distortion Field attributed to Mr. Steve Jobs might have been taken one step too far in this one case.
  • She is working in that exciting grey area between novel scientific breakthrough and scam.
  • Seems "Fake it ’til you make it" doesn’t work with medical technology.

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Protesters picket Washington State clinic operator Zoom because it doesn’t accept Medicare or Medicaid, which the company logically replies is exactly its business model in offering quick, technology-powered local care for which Medicare pays poorly if at all. Protesters, many of them representing unions and those who want universal healthcare, issued a statement saying that population segmentation causes inefficient, lower-quality healthcare. Zoom’s CEO responds, “Don’t think that we have to be all things to all people.”

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Stella Technology acquires Zigron Healthcare to expands its web and mobile app development, ETL, BI, QA, and user experience design services.

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ECG Management Consultants acquires the healthcare consulting division of Kurt Salmon US.

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Emergency medical services software vendor ESO Solutions – which offers an EHR and healthcare data exchange platform — receives a growth equity investment from Accel-KKR.

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I missed this from a couple of weeks ago: investors including Blue Shield of California buy out MeYou Health, which offers behavior modification and social tools for health plan members. The new CEO is Rick Lee, co-founder of the acquired and then failed Healthrageous. MeYou Health company was previously owned by Healthways.

Aprima will consolidate its North Texas offices and 250 employees in Richardson, TX.


Sales

In the UK, Pennine Care NHS Foundation Trust chooses FormFast for its paperless health initiatives.

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Rady Children’s Hospital – San Diego (CA) selects Strata Decision Technology’s StrataJazz for decision support, cost accounting, and contract analytics.

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East Texas Medical Center Regional Healthcare System (TX) chooses Orion Health’s Rhapsody Integration Engine.


People

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Jennifer Karstens (Encore Health Resources) joins Orchestrate Healthcare as area VP.


Announcements and Implementations

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The American Heart Association’s Institute for Precision Cardiovascular Medicine will award 14 data-related grants in the next year and will provide winners access to Amazon Web Services to analyze and share their information. The grants will cover data mining, data methods validation, development of data analysis tools, and fellowships for scientists interested in computational biology training.

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NCQA awards Premier its first Electronic Clinical Quality Measures Certification, verifying its ability to report clinical data for HEDIS and CMS EHR inventive measures.


Government and Politics

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President Obama writes a JAMA paper (bylined as “Barack Obama, JD”) describing the impact of the Affordable Care Act. He describes the decrease in uninsured citizens and the elimination of cost-sharing for preventive services and lifetime coverage limits. He says reform needs to continue via CMMI, ACOs, MACRA, precision medicine, and the Cancer Moonshot. He asks Congress to revisit his original proposal to offer a Medicare-like public plan that would add competition in areas served by a small number of insurers. He also wants Congress to force drug companies to disclose their actual production costs and to give CMS the authority to negotiate prices for expensive drugs. The President warns of the influence of special interest groups:

The second lesson is that special interests pose a continued obstacle to change. We worked successfully with some health care organizations and groups, such as major hospital associations, to redirect excessive Medicare payments to federal subsidies for the uninsured. Yet others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits. We need to continue to tackle special interest dollars in politics. But we also need to reinforce the sense of mission in health care that brought us an affordable polio vaccine and widely available penicillin.

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CMS announces that the median deductible on marketplace-issued health insurance policies is $850, down from $900 last year, when the subsidies the federal government gave to 60 percent of those policy-holders is figured in. The announcement glosses over the 40 percent of people who bought insurance from Healthcare.gov and state exchanges without federal handouts for their premiums and deductibles, the latter of which for silver-level plans are often the maximum allowed $6,800 for single coverage. As is nearly always the case in the US, the rich and the poor do well at the expense of the middle class.

The Congressional Budget Office calculates that the national debt will rise to 141 percent of the economy’s size within 20 years, eclipsing the previous high of 106 percent that followed World War II. Entitlement programs such as Medicare and Social Security are mostly responsible, along with interest payments on the ever-increasing US red ink.


Privacy and Security

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A hospital in China apologizes to the parents of 6,000 newborns whose nursery videos were stolen by hackers and posted on the Internet. Experts say many website developers in China lack even basic security knowledge, adding that the hackers were probably just practicing their skills since the videos have no value otherwise.

A secretary fired by Jackson Health System (FL) for giving ESPN a photo showing the surgery schedule of football player Jason Pierre-Paul, whose finger was amputated following a fireworks accident last July 4, sues the hospital, claiming she’s had nightmares and headaches following what she says were false accusations. The hospital stands by its decision, saying they have electronic proof that she looked at Pierre-Paul’s chart at least four times and left work early the day the information was leaked. 


Other

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A hospital in the Netherlands asks players of the wildly popular week-old, GPS-powered virtual reality Pokemon Go smartphone game to stop hunting the game’s imaginary monsters on its campus after several of them wander into its restricted areas. AMC’s tweet above translates to, “There is a sick Pokemon in AMC – we will take care of him. We would appreciate your not visiting.” Other businesses are facing similar headaches: a woman demands that a music festival let her daughter on its private property to play, a cafe bans the game because customers were taking up space for hours, and officials expect game-players to be injured or killed by wandering into roadways or onto railroad tracks while absorbed in gameplay. Players have run across dead bodies, been mugged in sketchy areas in the middle of the night, and admitted playing while driving. At least people who usually sit and stare at their phones all day long will finally get some exercise. I’m sure Nintendo / Niantic are quickly plotting ways to monetize their surprise hit, such as charging businesses to host destinations or to allow users to sell accomplishments back and forth, but it will probably be killed off by the next shiny object (a la Words with Friends and Second Life) before they roll something out.

I received an email touting a healthcare IT job site’s newly published “Health IT Stress Report,” which despite being overloaded with cute infographics and lofty yet lame conclusions, is based on only 470 survey respondents whose method of selection and response rate were unstated. That usually means someone stuck a survey on their website and harvested any willing, self-selected, statistically unrepresentative people who felt like filling it out.

In Canada, a survey of unstated methodology finds that only 21 percent of Quebec residents have used online health tools, causing the cheerleading digital health company authors to incorrectly conclude, “leaving 79 percent of Quebecans wanting digital tools that would allow them to take control of their personal health” (apparently the authors reckon that every single Quebec resident wants digital health tools even though they didn’t ask them.) Respondents were a lot more interested in online banking and social media even though they obligingly answered the leading questions offered about interoperability, electronic prescribing, and EHRs.

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Weird News Andy labels this plastic surgeon as “selfieish.” The Ukraine doctor, whose motto is “Love is free, medicine is not,” specializes in breast augmentation and posting selfies and videos taken with his unconscious naked patients on social media. The shameless self-promotion is working – he has a year-long backlog of patients. 


Sponsor Updates

  • Edward-Elmhurst Health (IL) says its physicians are saving two hours per shift by using Nuance’s Dragon Medical One cloud-based clinical speech recognition.
  • Besler Consulting releases a new podcast on the comprehensive Care for Joint Replacement appeals process.
  • ECG Management Consultants will present at the HFMA Region 7 Conference July 18 in Lake Geneva, WI.
  • PMD CEO Philippe d’Offay is spotlighted in a Q&A about secure messaging for providers.
  • Forward Health Group will participate in the National Governors Association Summer Meeting 2016 July 14-17 in Des Moines, IA.
  • Impact Advisors will participate in the “Run to Home Base” fundraiser for veterans on July 25 at Fenway Park in Boston.
  • Glytec CMO Andrew Rhinehart, MD offers an overview of DPP-4 inhibitors.
  • HCS will exhibit at the Health Forum/AHA Leadership Summit July 17-19 in San Diego.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 12, 2016 News 2 Comments

Monday Morning Update 7/11/16

July 9, 2016 News 6 Comments

Top News

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In what should be the death blow to lab processor and Silicon Valley technology wannabe Theranos, CMS bans CEO Elizabeth Holmes from any clinical laboratory ownership or involvement for two years and shuts Theranos off from receiving further payments from Medicare and Medicaid.

Theranos proved its incompetence even in its response to CMS’s warning letter: the company sent CMS five password-protected flash drives containing supporting information that was so screwed up that CMS couldn’t figure it out, with reports for the same accession number spread over multiple drives, information on the drives that didn’t match the contents of an accompanying paper binder, and random fax coversheets that were not associated with patient test reports (would you really want your specimens processed by a company that can’t keep documents straight?)

The company’s response to CMS’s death sentence inexplicably says it will keep Holmes as CEO, but hints that it might pivot away from the specimen processing business, possibly believing it can license its technology. That Theranos movie Jennifer Lawrence has signed up to do will either never be finished or it will hit theaters long after anyone still cares.

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Meanwhile, pathology informaticist  Bruce Friedman, MD of Lab Soft News raises a good question: the American Association for Clinical Chemistry couldn’t resist giving Elizabeth Holmes stage time to promote her dying enterprise at their annual meeting that starts July 31, but shouldn’t they be even more embarrassed now that she’s been banned from the industry in which all of those actual experts work and maybe think about rescinding their questionable offer? She’s an even worse choice than some of the awful ones HIMSS has made (Dennis Quaid comes to mind). I’m starting my campaign to bring Martin Shkreli to the HIMSS stage.


Reader Comments

From Captain Ron: “Re: Epic’s search for a data visualization suite. Microsoft PowerBI, Qlik, and Tableau were in the running. After doing bake-offs, Epic decided to choose none of the above. They will support customers on any BI product they choose. Guess it’s up to the customers to build content for themselves against Clarity and Caboodle.” Unverified. 

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From Neo Vespers: “Re: Glenwood Systems, Waterbury, CT. I’m a consultant looking for users of its GlaceEMR – my client is having problems and I can’t find other users.” I’ve never heard of the company or product, but perhaps someone will jump in.

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From DJ D-Deadly: “Re: Politico’s e-Health News. They called you are a dirt-disher!” I resent smug attempts at cleverness in dismissing what I do as being National Enquirer-like simply because I report rumors that usually turn out to be partly or fully accurate, especially when sites make that observation even while running something they read on HIStalk and thus calling into question their entire thesis. I consider it a wash since they described me as “oracular,” which I plan to use in casual conversation every now and then. They also linked to HIStalk, unlike most of the time when reporters simply regurgitate what they’ve read here in passing it off as their original reporting.

From The PACS Designer: “Re: AI versus RI. Here in mid-2016 we’re on the cusp of a huge change in how healthcare is practiced. While artificial intelligence (AI) has been championed for decades as a solution to improved learning, healthcare will be moving toward real intelligence through the greater use of ICD-10. With the more specificity, the last year under ICD-10 Clinical Modifications (CM) has given practitioners some experience with this new format. Now on October 1 this year here in the US, we’ll begin to see the benefits of real intelligence or (RI) using ICD-10 Procedure Codes (PCS). Eric Topol from Scripps has an article highlighting where we are going with changes in healthcare through increased levels of patient engagements.” 


HIStalk Announcements and Requests

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McKesson’s planned sale of its EIS business that includes Paragon will benefit Cerner the most, poll respondents say. However, nearly as many expect Meditech to gain ground from the sale. BP opines that McKesson made a mess of its acquisitions by sucking the energy out of them, noting particularly that the company spent $500 million developing Horizon Enterprise Revenue Management only to shut it down in favor of small-hospital Paragon. He or she blames offshore-onshore waffling, scope creep, cost, and competing internal projects that left provider executives disappointed and many McKesson employees bitter after never-ending waves of restructuring. Perhaps Kd’s wry comment is the most insightful – McKesson will benefit most because it’s dumping a cash sinkhole that it doesn’t really care about anyway.

New poll to your right or here: do HIPAA fines and settlements broadly increase privacy and security?

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Mrs. S from Georgia says her students are using the iPad and quiz contest software we provided in funding her DonorsChoose grant request to reinforce their math skills by competing with each other.

I can’t decide if I’m comforted or horrified that even as the headlines get worse and the potential demise of our democracy seems to be creeping ever closer, disengaged citizens who are isolated from the real world by a self-created fantasy aura of phone geegaws are now obsessed with Pokemon Go. Want to fiddle while Rome burns? There’s an app for that.


Last Week’s Most Interesting News

  • England’s NHS scraps its plans for a national database of EHR-extracted patient information after review committees criticizes its opt-out and consent policies.
  • A Congressionally-established review committee recommends that the VA replace its old software systems – including VistA – with commercial products.
  • NIH awards $55 million in grants for the recruitment of 1 million Americans for the long-term study of their personally collected data and gives Scripps Translational Sciences Institute a five-year, $120 million grant to develop apps, sensors, and processes for recruiting the “citizen scientists.”
  • Catholic Health Care Services of the Archdiocese of Philadelphia pays $650,000 to settle HIPAA charges from the 2014 theft of a company-issued iPhone that contained the information of 412 patients, the first time a business associate has been charged with HIPAA violations.
  • ONC announces its intention to measure national interoperability progress by using the responses to to existing AHA and CDC hospital surveys.
  • A security firm’s tests find that hospitals are not always keeping the PCs and servers that control biomedical equipment current with operating system and antivirus updates, creating a digital soft spot for hackers.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


People

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HHS promotes acting CIO Beth Anne Killoran to the permanent position, noting that her IT experience with the Department of Homeland Security gives her strong cybersecurity capabilities.

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NHS England names Keith McNeil as chief clinical information officer and Will Smart as CIO. McNeil, who is a physician, resigned as CEO of Addenbrooke’s Hospital last year just before Cambridge University Hospitals NHS Foundation Trust (which includes Addenbrooke’s and The Rosie Hospital) was placed on “special measures” for a number of patient care problems; he was also CEO when the Regulator Monitor investigated the trust’s financial challenges following its $300 million Epic rollout. Smart was CIO at Royal Free London NHS Foundation Trust, which is a Cerner shop.

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Genetic testing IT systems vendor NextGxDx names Rob Metcalf (Digital Reasoning) as CEO. He replaces founder Mark Harris, PhD, who will take a demotion to chief innovation officer.


Government and Politics

The Department of Defense gives Cerner another no-bid contract for hosting its MHS Genesis EHR project, raising the project’s hosting costs from $50 million over 10 years to $74 million through the end of 2017. DoD says the extra cost won’t affect the overall $4.3 billion project budget. The Pentagon seems annoyed by the higher cost and says it may recompete the hosting contract next year. 


Technology

I’m questioning the quality of Wired’s breezy reporting in claiming that medical records are a “hot commodity” on the Dark Web, or as it dramatically intones, “the hidden recesses of the Internet” (accompanied by unrelated pictures lifted from Flickr users). They might well be a hot commodity as has been amply reported elsewhere, but this story adds nothing to the discussion. The reporter didn’t uncover a single new fact in simply reciting uncredited headlines from elsewhere and taking as gospel what some IBM guy told her about the Dark Web. She makes the puzzling assertion that hackers intentionally delete patient allergies from their medical record, which I’ve never heard of. She claims that doctors “are reluctant to use dual-factor authentication” without citing any source. She finishes by rambling off topic about steps patients can take to protect their information: don’t email information forms, make sure someone is standing by the fax machine if you fax something (does anyone really do that?), and ask why providers need your Social Security number. The overripe headline is like a movie trailer that baits movie-goers with the best scenes in ringing up their ticket purchase without delivering anything in return once they’ve settled into their seats. It’s pretty scary to see the low standard to which journalism is held these days, where desperate tricks to lure temporary eyeballs somehow continue convincing clueless advertisers to underwrite dumbed-down work.


Other

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Ambulatory physicians at  University of Michigan Health System weren’t any more satisfied with Epic than with the homegrown CareWeb it replaced, a two-year study finds, refuting the common belief that post-implementation physician satisfaction improves over time in a J-curve. Instead, most measures exhibited L-curve behavior where they dropped and stayed below baseline. Physician job satisfaction decreased after Epic went live and didn’t catch up in the 25 months afterward; a majority of the doctor respondents believed throughout the two years that Epic hadn’t improved patient safety over the old system; and the EHR’s positive contribution to physician job satisfaction dropped from 62 percent with CareWeb to 8 percent with Epic.

I’ve received several “vote for me” messages via people on LinkedIn and Twitter who desperately want to be named to the pointless HIT100 list of prolific tweeters. Are they really going to be proud of winning, sprinting breathlessly to update their resumes with a faux award and feeling good about their place in the universe for having won it by strong-arming their social media contacts to support them, which suggests that those folks probably wouldn’t have chosen them otherwise?

A Wall Street Journal report says anger is building among patients who are treated in an in-network hospital but who are stuck with non-covered bills from the hospital’s out-of-network specialists. Three-fourths of ACA-issued policies provide no out-of-network coverage at all except in emergencies, and since out-of-pocket maximums don’t apply to out-of-network charges, the patient faces unlimited costs at the non-discounted rates that nobody else pays. ED doctors complain that insurers have reduce their payments knowing they have to treat their patients anyway, while insurance companies say that ED docs reject in-network rates so they can charge whatever they want on out-of-network bills.

China launches a year-long campaign that urges angry patients and their families to refrain from attacking the employees of its overloaded hospitals.


Sponsor Updates

  • Valence Health will exhibit at the AHA Leadership Summit July 17-19 in San Diego.
  • Huron Consulting Group will present at the AHA Leadership Summit July 17-19 in San Diego.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 9, 2016 News 6 Comments

News 7/8/16

July 7, 2016 News 8 Comments

Top News

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England’s NHS scraps its plan to create Care.data, a huge national database of patient information that was to be extracted from provider EHRs.

NHS planned to sell the partially de-identified information of patients who didn’t opt out to drug companies and other willing purchasers, but decided to end the program after two commissioned reports criticized its opt-out and consent policies as being less than transparent.


Reader Comments

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From Jolter: “Re: Athenahealth. The company is not immune to the same challenges as competitors, as feedback on this software rating site about their Streamlined upgrade says. I had caught wind on their last investor call that Streamlined isn’t well regarded within their customer base. Instead of worrying about unbreaking healthcare, they should be unbreaking AthenaClinicals.” Physician customers say Streamlined has changed Athenahealth’s EHR into a click-intensive “opaque, cumbersome product” that “has made a mockery of the Athena system” that is now “the worst system I could have ever imagined,” with Athena’s support reps blaming Microsoft or whatever browser the customer is using for their many problems. A pulmonologist says Athena is “crippling my practice” and claims the company is censoring its client forum. Athenahealth is also getting publicly ripped by many customers on Facebook over the forced upgrade. One doctor summarizes Streamlined as, “When it works, it stinks. When it does not work, it really stinks.” It’s tough to keep riding the “disruptor” horse when you’re a publicly traded company worth $5.5 billion, have an installed base of customers to maintain, and need to fawn to impatient investors who constantly demand improving profits. Imagine the outraged fun Jonathan Bush would have with this seemingly major stumble if he ran Epic or Cerner. Athena has quite a few product and acquisition balls in the air, so this is where they get to prove that they earned their seat at the Wall Street table as something more than a future-promising puppy nipping at the heels of dowdier but much larger and experienced competitors.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Mrs. D from Nevada in providing math learning games for her kindergarten students. She reports, “As I pulled each math activity out of the box, they cheered, begging me to open it! …  the students thought it was ‘amazing’ and ‘so cool’ that a complete stranger would give us math games … The real gift within that box was the gift of knowledge and understanding. For some of my students, these math games are more than just math games, they are clarity and a road to success and confidence. I have witnessed so many ‘light-bulb-moments’ while using these games. Knowing my students are grasping complex mathematical concepts (for their age) is the greatest experience!”

This week on HIStalk Practice: Sciton gets into practice support. MyIdealDoctor adds behavioral health to its telemedicine services. VITL presses for a less burdensome patient opt-out policy. HHS ramps up opioid prevention efforts, including mandatory PDMP use at FQHCs. Urgent care clinic closes in the face of telemedicine competition. AAPS caves to Brexit clickbait.


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Scotland-based Craneware announces record sales for the year ending June 30, with revenue rising 60 percent on $58 million worth of contracts.


Sales

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UC Irvine Health (CA) chooses Infinite Computer Solutions and Optimum Healthcare IT for EHR migration.


People

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Nat’e Guyton, RN, PhD (Trinity Health) joins Spok as chief nursing officer.

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Bob Sullivan (IBM Watson Health) joins interactive patient technology vendor Sonifi Solutions as GM of its healthcare division.

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Bob Kyte (Adventist Risk Management) replaces the recently retired Don Kemper as CEO of Healthwise.


Announcements and Implementations

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Validic joins SAP’s Connected Health ecosystem, offering users of SAP Health Engagement the ability to integrate patient-generated health data.


Government and Politics

ONC issues a white paper contest for the potential uses of blockchain in healthcare, with submissions due July 29. Up to eight winners get their  travel expenses paid to present their paper at a NIST-hosted workshop September 26-27 in Gaithersburg, MD.

The government of South Australia finally funds the initial planning project for the migration of SA Health’s long-sunsetted patient administration software. The system’s vendor, Global Health, sued the government for breach of contract after it repeatedly refused to stop using the 1980s-era system, of which it is the only remaining user. The SA government has been focused on its troubled Allscripts EPAS rollout, but the state’s rural hospitals aren’t included in the implementation plan and also haven’t committed to upgrading to the current Global Health product.

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Peer60 is doing research on Brexit’s impact on England’s NHS. I was curious about its preliminary results even though they’ve surveyed only 80 hospital leaders so far (out of 200+ responses expected). Respondents offered some interesting comments:

  • “Prior to the referendum, both campaigns threatened Armageddon if we left/stayed in EU. They both also said we’d each receive a puppy and have champagne for breakfast if we left/stayed in EU. We’d also be better looking and lose weight if we left/stayed in the EU. None of these have come true. The distinct lack of definitive outcomes, even now, make it difficult to have an opinion, apart from the long-standing one that Westminster is full of liars and has absolutely no interest in the well-being of UK citizens.”
  • “Welcome to the third world.”
  • “More likely to have positive impact as will help with controls re: EU residents who do not pay UK national insurance and taxes from using NHS resources –  this service will need to be funded in the future. We can work through the staffing issue by working differently, researchers will find ways to continue to collaborate. Impact is in needing to find work around and other change.”

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John Halamka suggests that CMS eliminate existing EHR certification requirements and instead require vendors to demonstrate only five specific EHR capabilities:

  • Use OAUTH2/OpenID to verify trusted exchange partners.
  • Use a FHIR-based query to request an electronic endpoint address.
  • Use a RESTful approach to push data to an endpoint.
  • Use a FHIR-based query to request the location of a patient’s records.
  • Use a FHIR-based query to exchange a common data set of key elements.

The Federal Trade Commission drops its anti-trust challenge of the proposed merger of the only two hospitals in Huntington, WV following the state’s passage of a law that was intentionally written to shield hospital mergers from federal scrutiny. The FTC walks away with a warning that hospitals can work together to deliver clinical integrated care without buying each other in reducing competition, noting specifically that while it rarely intervenes in such hospital mergers, its quality and cost red flags were raised in the Huntington market.

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The independent Commission on Care, established by Congress to review the VA following the wait times scandal, includes among its recommendations that the VA replace its “antiquated, disjointed clinical and administrative systems” with commercial software products and that it establish a VHA Care System CIO position reporting to the chief executive. The chair and vice-chair of the commission are both CEOs of provider organizations that use Epic (Henry Ford Health System and Cleveland Clinic).


Privacy and Security

A federal appeals rules that anyone who shares a password may be violating the Computer Fraud and Abuse Act, which is intended to address hackers. The case in question involved an employee who gave his company password to former employees, but the ruling could technically allow people to be prosecuted under federal law for sharing their Netflix log-ins.


Innovation and Research

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NIH awards $55 million in precision medicine grants to study the self-contributed data of 1 million volunteers, with the lead recruiting centers being Columbia University Medical Center (NY), Northwestern University School of Medicine (IL), the University of Arizona (AZ), the University of Pittsburgh (PA), and the VA. Vanderbilt, Verily, and the Broad Institute will provide data analytics. In addition, Scripps Translational Science Institute and Eric Topol, MD (whose summary of the project is above) will  get $120 million over five years to develop apps, sensors, and processes to recruit the “citizen scientists” and give them the ability to share their collected information with their physicians. The scientist in me loves the idea, but the public health angel on my other shoulder wishes we would focus on the less-sexy blocking and tackling of reducing infant mortality, managing expensive chronic conditions, addressing social determinants of health, and resolving the ugly dichotomy of expensive “healthcare” vs. “health” in applying equal vigor to chasing goals that move the overall health needle further without having as their primary motivation the eventual lining of someone’s pocket.


Technology

The Wall Street Journal suggests that Apple fanboys resist the urge to pounce on the just-released public beta of iOS 10, warning that it’s buggy (not surprising for a beta release) and a pain to revert back to the prior version if things go wrong. The article tries to talk up a few new features, but they seem lame.


Other

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Mylan Pharmaceuticals has jacked up the price of decades-old emergency allergy auto-injection EpiPen to nearly $600 per two-pack over the past few years, giving cash-poor, high-deductible insurance consumers and public service agencies the choice to either go without the drug or draw up the much-cheaper generic ampules into syringes as needed for emergency doses. The drug was prescribed 3.6 million times last year as Mylan turned its 2007 acquisition into a billion-dollar product that provides 40 percent of its profits, pushing federal legislation that encourages schools to stock the injections and to recommend two doses instead of one per allergic episode. Mylan, which has a market cap of $22 billion and makes a lot of money selling drugs to the federal government via Medicare, shifted its headquarters offshore in 2015 to dodge US taxes.

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The number of HIEs has dropped from 119 to 106 as federal funding ended, a study finds, with half of the surviving ones reporting that they are not financially viable. The most prevalent HIE problems include lack of a sustainable business model, the inability to integrate HIE information into provider workflow, and lack of funding.

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Another study in Health Affairs that reviewed AHA’s IT survey data finds that hospitals that use their area’s dominant EHR (usually Epic or Cerner) engaged in a lot more data exchange than their competitors that run other EHRs, which the authors speculate is because it’s easier to exchange information with other Cerner or Epic shops and that those vendors will help make it happen. My takeaway is that hospitals in a mostly-Cerner or mostly-Epic region that use different EHRs have to spend more money to exchange information and are thus less likely to do so, especially if their competitors are indifferent or hostile to the idea.

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AdvancedMD tweeted out this photo of their team-building Lego derby. It’s always fun to see the folks in the trenches.

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Smokers are less likely to buy health insurance than non-smokers, apparently because they are unwilling or unable to pay the higher smoker premiums allowed by the Affordable Care Act. The penalties levied for not being insured don’t seem to be working, especially when they represent only a small fraction of the cost of insurance.

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I’m not entirely convinced that this Microsoft email is genuine even though he company has apologized for it, but it’s still funny to picture some low-level, corporately oppressed recruiter (whether it be at Microsoft or Epic) trying to relate to the kids he or she is recruiting by inviting them — in their cringe-worthy, baby-talk vernacular – to stop by for “hella noms” and  “dranks” just like someone’s white bread mom scanning Urban Dictionary looking for hip phrases to drop at the most embarrassing moment possible.


Sponsor Updates

  • Aprima announces that its EHR/PM meets MACRA/MIPS requirements.
  • ID Experts will present at the SANS Data Breach Summit August 18 in Chicago.
  • Navicure will exhibit at Mississippi MGMA July 13-16 in Biloxi.
  • Experian Health will exhibit at the Nebraska Association of Healthcare Access Management July 14-15 in Grand Island.
  • The SSI Group will exhibit at the FSASC Annual Conference & Trade Show July 13-15 in Orlando.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 7, 2016 News 8 Comments

The House Call Comeback

July 6, 2016 News No Comments

HIStalk looks at the resurgence of house calls, aided in part by government-sponsored value-based care programs, a need for increased market share, and growing consumer demand for app-enabled convenience and pricing transparency.
By @JennHIStalk

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In today’s technology-driven society, the concept of the house call may seem quaint, evoking Norman Rockwell-esque images of the neighborhood physician toting his black bag down Main Street to Grandma’s house. Mobile health tools, however, are turning that image on its head as providers look to increase market share by increasing patient access points.

While house calls have always been around to some degree, digital health startups like Pager, Heal, and PediaQ are putting a new spin on what it means to “go to the doctor.” Even more traditional home care companies like Visiting Physicians Association are placing more emphasis on the role technology plays in caring for the elderly and chronically ill, often with the aid of government-backed incentives.

This new era of house calls is not without its detractors, however. Some physicians are quick to point out that patients can’t establish a true, trusting relationship with this new generation of house-call providers, and that care coordination will suffer. Others, especially those in more metropolitan areas, point to struggles for market share between the local health system, urgent care centers, and app-based house call companies.

Consumers will likely have the last word, as their increasing insistence on convenience and easy access, plus heightened awareness of healthcare costs, leads them away from higher-priced health system monopolies into the arms of the more tech-savvy (but somewhat unproven) competition.

Smart Phones Make the Difference

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Dallas-based PediaQ has made technology a core part of its business model. Founded in 2014, the app-based pediatric house call provider has raised $6.4 million to date and has already expanded beyond Dallas to three additional cities in the Lone Star state.

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“PediaQ has been developed as a function of change in our culture towards on-demand services, as well as innovation in creating new access points for health systems that are expanding their networks to capture market share,” explains CEO Jon O’Sullivan, adding that the cultural shift to making purchasing decisions via smart phone played a big part in PediaQ’s decision to steer clear of brick-and-mortar locations. “I’ve been on the business strategy side of provider services in healthcare for over 25 years now, and for much of that time I worked with health systems that sought to expand their market share through their provider networks. Throughout that time, I’ve watched the healthcare market evolve to a much more consumer-driven equation.”

While PediaQ’s funding seems to indicate investor confidence, O’Sullivan points out that building trust with customers and the surrounding healthcare community has taken time. “Initially, like any new brand, we had to spend a majority of our resources on consumer education,” he says. “However, once parents started using PediaQ and were able to experience the ease and comfort of a house call for a sick child, the results were nothing short of phenomenal. The main catalyst for our consumer activation and expansion very quickly became the users themselves.”

When it comes to perceived competition with local PCPs, O’Sullivan points out that the company sees itself as an augmenter and supporter of the relationships its customers have with their PCPs. “We’re not out to replace that relationship,” he says, “which is reflected in the fact that PediaQ focuses on after-hours care and ensures that the medical record from the visit is delivered to the PCP the next day.”

Easier Access, Less Windshield Time

Aside from apps, telemedicine has probably had the biggest impact on the resurgence in house calls. It has certainly given companies like Aspire Health and MedZed an edge over more traditional home care companies, especially when it comes to “windshield time.”

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Technology has been crucial to the nascent success of Atlanta-based MedZed, which identifies itself as a telemedicine-enabled home care company that provides “21st century house calls” for high-risk and needy patients.

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“We decided we had to go into the home in order to service these people,” says MedZed co-founder and chief medical officer Neil Solomon, MD. “We were also well aware that it’s very expensive to pay a doctor or even a nurse practitioner to drive all over the place, especially in certain geographies that are either very spread out or have heavy traffic, like Los Angeles. You can only do maybe four or five visits in a day if you’re driving. It’s inefficient. Plus, there aren’t enough doctors to do this in order to scale this kind of business.

“Our model utilizes telemedicine to make the delivery of care much more efficient,” Solomon says, adding that the first half of a MedZed visit is spent between a care provider and patient going over medications, screenings, and assessments, while the second half is spent on remote consult with a physician, all of which is documented in MedZed’s Drchrono EHR.

“All of our care providers can see the same notes in our EHR,” Solomon explains. “We can export those notes in a fashion that other EHRs can read. We can import laboratory and pharmacy data from other sources so that we can see the full picture of the patient.”

MedZed seems to have distinguished itself from other modern-day house call companies in that it has written its own software for HIPAA-compliant video conferencing and logistics.

“Writing the logistics software was challenging,” Solomon admits. “It helps determine where to send each care provider during the course of the day, figures out drive times, and interfaces with the PM systems of MedZed-affiliated physicians so that they can easily access our video consults. We couldn’t find software on the market that could do all of that.”

Palliative Care Made Easier

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Founded in 2013 with high-profile help from former Senator Bill Frist, MD, Nashville, TN-based Aspire Health incorporates telemedicine as well as a number of other technologies into its business model, which focuses on home care for seriously ill and end-of-life patients. Aspire Health Chief Medical Officer Andrew Lasher, MD has seen technology make a tremendous impact on the company’s ability to provide compassionate palliative care to its patients in 11 states and Washington, DC.

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“Patients and families are more connected than ever,” he points out. “Secure video conferencing can be an incredible adjunct to high-touch care at the bedside, and in some cases can act as a stand-alone visit. Much of what we do at Aspire is communicate – clearly and compassionately – with vulnerable patients and the people who love them. These family members often live far away, and we can use telemedicine to bring a distant family member to the bedside. There are also medical conditions that can be evaluated perfectly well with video, and many patients will tell you that the conversations they have with a doctor or nurse practitioner through telemedicine is every bit as sacred and impactful as the ones they have in person.”

“There are a number of other technology supports that can support care of the seriously ill,” Lasher adds. “We’re only just beginning to scratch the surface with remote-monitoring devices that help keep track of blood sugar, blood pressure, and that connect isolated patients to Aspire and community-based resources in moments of crisis. We’re seeing that these sorts of devices can integrate fairly seamlessly and in no way hurt the patient experience. Patients can often be reassured through technologic connection, and it only makes the care we provide more personalized.”

Aside from telemedicine, the Aspire team is also looking at solutions around the storage and transmission of advance care-planning documentation, solutions around immediate notification of when patients go to the ER or hospital, and placing tablets in patient homes that enable Aspire caregivers to monitor symptoms and needs on a daily basis. “Anything that helps us relieve a patient’s suffering or avoid an unnecessary and dangerous hospital stay is something we’ll investigate,” says Lasher. “I expect that we’ll be doing more with technology in the next year as the evidence base increases and the offerings improve.”

Analytics and Home Monitoring will be Key to Independence at Home

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Home monitoring technologies are also in the cards for the Visiting Physicians Association, a key participant in the Independence at Home program for Medicare beneficiaries with complicated chronic health problems and disabilities. The pilot house call program, now in its second year, helped save Medicare $25 million in its first year thanks to reduced costs associated with improved medication adherence and fewer ER visits and hospital readmissions. Nine of the 14 participating practices, five of which are run by VPA, earned bonuses totaling nearly $12 million.

“VPA has achieved favorable results because of the technology we deployed into the home setting,” explains Dave Viniza, chief information officer of US Medical Management, VPA’s management services organization. “Our Aprima EHR has offline capacity second to none. Our physicians have a full patient medical record regardless of the connectivity of the patient’s home. Because we were searching for consistent, informed, real-time medical decision-making, VPA also deployed StatusScope, a home-grown application that keeps providers informed, during their visits, of recommended disease-driven protocols.”

“VPA has also used predictive analytics to identify the most at-risk patients and prevent unwanted ER visits,” he says. “By reducing those, we reduce unnecessary and unwanted hospitalizations. We’re continuing to develop those analytic tools. We’re implementing an enterprise data warehouse and dashboard analytics system, as well as implementing a care management system that will automate and streamline the development of non-physician care plans and patient management.”

“We’re also investigating appropriate home-monitoring tools for our patients,” Viniza adds. “We would like to marry the monitoring to predictive applications so that we can improve early identification of approaching medical needs. The end goal is to continue reducing ambulatory-sensitive ER and hospital utilization.”

Opportunity Abounds

While there’s no doubt that this new era of house calls is being fueled by technology, the industry-wide shift to value-based care – however slow it may be – is also helping things along.

“Patients prefer to be at home when they can be,” Lasher says. “That’s especially true for patients with chronic or life-limiting conditions. They know that the hospital isn’t always the best place to be, and that the best treatment for them may occur in their home – treatments that can help them live longer and feel better. For Aspire, seeing our patients where they live is a real privilege. Value-based care is such an accurate statement, since, for the vast majority of our patients, their own personal values make it clear what kind of care they want, and how it should be delivered.

“Clearly, there’s a lot of opportunity to expand what can be done outside the hospital or clinic, and to care for people on their own turf, rather than in a medical setting,” he adds. “Black doctors’ bags are going to be back in style, if they’re not already.”

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July 6, 2016 News No Comments

News 7/6/16

July 5, 2016 News 14 Comments

Top News

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ONC will measure MACRA-mandated national interoperability progress using metrics from two existing surveys: the percentage of providers who say they are sending and receiving information (AHA’s Information Technology Supplement Survey) and the percentage who say they actually use the information of other providers to make clinical decisions (CDC’s annual EHR survey).


Reader Comments

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From Addison in Madison: “Re: Epic non-competes. Epic’s modus operandi is to demand new agreements with any change in status / business. Your employer has perhaps been steady for a while, so they are operating under an old agreement. It is when something changes that Epic introduces their new demands. What changed for Accenture was the acquisition of Sagacious. Same with Navigant’s Epic-related acquisitions. When that happened, Epic put the agreement back on the table, with the new stipulations. You can expect the same if your firm is ever acquired or does any acquiring.”

From Voice of Reason: “Re: Epic non-competes. The reason Epic might be doing this is because both Sagacious and Vonlay were bought out by Accenture and Huron Consulting Group respectively. Epic might be thinking since Accenture and Huron provide a variety of consulting services, their Epic consulting division might pass on proprietary info to their other divisions that might compete with Epic. I don’t think Nordic has these restrictions since they only deal with Epic consulting.”

From Dr. T: “Re: Epic non-competes. what may happen is when Epic learns of the new facility you are going to, there is a quiet conversation with the old employer. Then they call the new employer and say, ‘We won’t do business with that person.’ Guess what happens? You don’t have a job, you can’t prove who talked to which manager/exec, and you don’t have the deep pockets to fight it. I saw it myself and almost had to get the toes out to keep counting how many times it happened with an old employer.”

From DrM: “Re: Epic non-competes. I predict Epic’s approach to the consultants will be what brings down the whole non-compete house of cards for them. Does anyone else find it strange that, shortly after starting up their own consulting firm, they impose rules on competing consulting firms that will (purely coincidentally, I’m sure) reduce the number of available consultants? Other companies have lost anti-trust suits for doing less. I also hope in the trial they bring up their trade secrets so they can be told the definition of trade secrets, i.e., you actually have to try to keep them a secret.”

From Apt Moniker: “Re: Twitterati. I, too am never sure whether Twitter means anything in real life. However, senior execs often watch their own Twitter accounts, although not the company one.” Twitter, Facebook, and LinkedIn are, at least for individual businesspeople, vanity platforms. Heavy users like feeling followed and it gives them a place to tout their self-perceived wonderfulness in humble-bragging to others who are doing exactly the same thing in a never-ending stream of self-promotion. Twitter in particular is full of updates that are simply links to questionable source material with the apparent goal of being the first to highlight something new or to appear to be better read. My experience is the same as what big web publishers have reported – I can get a ton of tweets and retweets linking to my original HIStalk page and it doesn’t boost site traffic one bit. From that I conclude that the Twitterers are happy just to read that the page exists, but free of the motivation to click the link to see what it actually says.

From See My I/O: “Re: leading CMIOs. Here’s a link to the top 15.” Sorry, that’s just the usual time-wasting magazine crap story, or in this case, a pointless but painful to watch slideshow. There’s no stated methodology behind the list – the magazine apparently just chose some names they recognized and proclaimed those CMIOs as “leading” in trying to amass clicks that advertisers might mistake for influence.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Mrs. H, whose Arkansas elementary school science class needed activity tubs for their Friday projects and labs. She reports, “The students really enjoyed the force and matter experiment in which they had to attach a balloon with a straw to a string and release it to see who’s balloon traveled the fastest. The conversations we got from students were amazing and after each group went students discussed what they could do better next time to make their balloon travel quicker. These were some fun times — we are so competitive.”

I pledged transparency to a reader who asked me awhile back to list not just new HIStalk sponsors, but also those companies that don’t renew. I don’t like doing that because I take it as a personal failure, but I promised. With that, I’ll say goodbye and thanks to the following companies with whom I parted ways in the past year because they were acquired, went a different direction, tightened their belts, or lost the employee who was my only contact there.

AirStrip
Anthelio Healthcare Solutions
AT&T
Aviance Suite
Awarepoint
Burwood Group
CareTech Solutions
CitiusTech
DataMotion
Greencastle Group
Greenway Medical Technologies
MBA HealthGroup
McKinnis Consulting
MedAptus
Oneview Healthcare
PDS
Porter Research
Provation Medical
Sensato
Streamline Health
VMware
XG Health Solutions


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Digital pathology startup Proscia raises $1 million. The founder and CEO just earned his BS from Johns Hopkins. I’m amused that the company’s write-up says the team has filed “over eight patents” and been involved with “more than four technology companies,” making me wonder what’s wrong with just saying “nine” and “five.”

UnitedHealth Group sues publicly traded American Renal Associates Holdings for fraud, complaining that the dialysis company convinced its Medicare- and Medicaid-eligible patients to instead sign up for UnitedHealth insurance at no charge, arranging to have their premiums paid by a charity whose funding comes from providers who benefit from having better-insured patients. Government programs pay American Renal Associates about $300 for a dialysis treatment while it can bill UHG $4,000 for the same session, giving the company a profitable loophole in billing more in claims than it costs to pay for the patient’s insurance. The Affordable Care Act requires insurance companies to accept all people regardless of their health, but HHS has been vague on whether it’s OK for charities that receive most of their funding from providers to pay individual premiums directly.


Sales

Mayo Clinic will implement Visage Imaging’s Visage 7 enterprise imaging platform throughout its radiology practices.


Announcements and Implementations

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Carefluence earns the first API certification issued under ONC’s criteria, with Carefluence Open API 1.0 earning certification for patient selection, data category request, and data request. I note several misspellings on its home page, including a claim that it was designed to “demistify” interoperability, which suggests fog removal. The company’s website has minimal information (such as location and management team), but it appears to be connected to the equally reticent technology vendor ModuleMD.

Among the winners of MD Buyline’s user satisfaction surveys are Aesynt (pharmacy robotics), CareFusion (pharmacy automation), Epic (EHR), GE Healthcare (cardiology PACS, perinatal information systems, RTLS,and time and attendance), Healthcare Insights (financial decision support), McKesson (staff scheduling), Philips (PACS), Premier (ERP), SCC Soft Computer (laboratory information system), Siemens Healthineers (cardiology PACS), and Vital (3D advanced visualization).


Government and Politics

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The government of South Australia continues to defend its over-budget and delayed $315 million EPAS patient care system even as the auditor-general warns that the project is underfunded and unlikely to deliver $113 million in savings. The Allscripts Sunrise system is live at some sites and will be phased in when the new flagship Royal Adelaide Hospital opens.


Privacy and Security

Catholic Health Care Services of the Archdiocese of Philadelphia will pay a $650,000 HIPAA settlement related to the 2014 theft of a PHI-containing, company-issued iPhone that was not password protected. The phone contained the information of 412 residents of the six nursing homes it owned and managed. OCR found that CHCS had not published a policy about taking mobile devices off campus and had not developed a risk analysis and risk management plan. Most interesting is that CHCS was charged as a business associate rather than as a covered entity since it was the corporate parent of the nursing homes and provided technology services to them.

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Atlantic Health System (NJ) sends 5,000 randomly selected employees an email saying they’re getting raises, telling them to just confirm by clicking a link and entering their employee ID number, data of birth, and ZIP code. One-fourth of them opened the email and two-thirds of those provided their personal information. The email was actually a phishing test that mimicked known hacker practices such as using an originating email address ending in .com instead of .org. Several employees complained that the promised raise wasn’t real, but on the upside, quite a few reported the email as suspicious and warned co-workers not to fall for the trap.


Innovation and Research

Researchers find statistical bugs in the software that interprets functional MRI results, leading them to question the validity of 40,000 studies.Poor archiving and data sharing practices mean the existing studies can’t be re-analyzed with better software.


Technology

London’s Moorfields Eye Hospital is sharing de-identified eye scans with Google DeepMind, which is developing artificial intelligence for early detection of diabetic retinopathy and macular degeneration.

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An Apple iOS 10 update this month will allow iPhone users to sign up as organ donors with the Donate Life America registry and be flagged as an organ, eye, and tissue donor on the phone’s Medical ID emergency information display.


Other

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Neuroradiologist Shyam Sabat, MD calls for BMJ to retract the “shoddy science” tabloid-like pseudo-study it published in May that claimed medical errors are the third-leading cause of death in the US. His analysis of the paper finds that four studies were improperly combined into a meta-analysis that really left just one 2004 Healthgrades study of Medicare recipients, which the authors then wildly extrapolated to all inpatient admissions. He concludes,

How a reputed group such as the BMJ could not see through these simple but outrageous statistical blunders is anyone’s guess. Did the overwhelming incentive to get a spice tabloid-type, eye-catching headlined paper prevent the editorial process from taking common sense decisions? The result is that the US medical community is being ridiculed by media and people not only from the US but the whole world who cannot understand how US medical system is so incompetent despite spending the maximum in the world and attracting the best talents from all over the world.

The Boston Globe notes the trend of doctors working night shifts in hospitals, where “nocturnalists” oversee the activities of overworked residents, reduce the number of calls to attendings, and get patients out of the ED and into beds when indicated.

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Cleveland stakes its claim as “The Medical Capital” by launching a rebranding initiative, a new website, and a new testimonial video. In other words, you should take their word for it because they blew through a ton of marketing money in proclaiming themselves #1. Maybe it will draw business, but I can recall many weed-infested empty lots bordering desolate highways festooned with signs proclaiming that area to be some town’s “high-tech corridor” that never quite caught on.

Dear naive people who cry foul when drug companies raise the prices of critical drugs for no good reason, saying those companies are “putting profits ahead of patients:” that’s exactly what for-profit companies are supposed to do. It’s unconscionable when health systems and insurance companies hide their huge bottom lines behind non-profit status, but for-profit corporations exist for a singular purpose, to deliver maximal profits to shareholders. The understandable outrage would be better focused on advocating for government-led drug price involvement like the rest of the world uses, which leaves US consumers footing the bill for most drug company profits and research investment.

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Powell Valley Hospital (WY), which struggled for years to get its $2 million NextGen hospital EHR working well enough to earn Meaningful Use money, learns that the product’s new owner, Harris Computer Corporation, won’t add MU Stage 3 capabilities to the product. Harris has offered to replace NextGen with QuadraMed for just the installation cost, but the hospital would still need to spend over $1 million. Harris confirmed that it will provide only break-fix support for the NextGen hospital system, saying it acquired the product because NextGen was going to shut it down anyway.

A former naturopath (ND) who left a lucrative practice after observing a colleague administered an unapproved cancer drug says that “naturopathic services are quackery” and scoffs at ND ambitions to be recognized as primary care physicians. She writes,

Essentially, naturopaths want to be allowed to take shortcuts. Instead of attending medical school, naturopaths attend their own, self-accredited programs with low acceptance standards and faculty who are not qualified to teach medicine. Instead of a standardized and peer-reviewed medical licensing exam, naturopaths take their own secretive licensing exam that tests on homeopathy and other dubious treatments. What little medical standards that seem to be tested on the exam have been botched, like the one question in which a child is gasping for air and the correct answer on how to treat is to give a homeopathic remedy.


Sponsor Updates

  • Clockwise.MD will exhibit at the UCAOA Regional Conference in Philadelphia on July 14-15.
  • Audacious Inquiry comments on MACRA NPRM V5.
  • Boston Software Systems launches a podcast series covering EHR migration, system optimization, and the sunsetting of legacy systems.
  • CareSync is featured in a USF Health article on Tampa’s digital health opportunities.
  • ClinicalArchitecture will exhibit at the Military & Government HER & Health IT Symposium July 13-14 in Arlington, VA.
  • Cumberland Consulting Group will attend the 340B Coalition Summer Conference July 11-13 in Washington, DC.
  • Elsevier will develop a free benchmarking report detailing the current landscape of cancer research and collaborations as part of the national Cancer Moonshot initiative.
  • Healthfinch joins the Athenahealth Marketplace.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.Send news or rumors.
Contact us.

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July 5, 2016 News 14 Comments

Monday Morning Update 7/4/16

July 4, 2016 News 6 Comments

Top News

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A security firm’s research finds that PCs and servers controlling hospital medical equipment often run outdated operating systems that are vulnerable to old malware such as the Conficker worm, giving hackers an easy back door into the hospital’s network. The report notes that hospitals are usually zealous in protecting end user PCs, but sometimes forget the computers that run CT scanners, dialysis machines, and other FDA-approved medical devices.

A case study involves a top hospital whose X-ray equipment was running Windows NT 4.0, which the security firm observed being penetrated in time to stop it. Honeypots created at another hospital found hackers hitting Windows XP-based systems for radiation oncology and fluoroscopy.


Reader Comments

From Orlando: “Re: Epic’s non-compete provisions. I wonder if they’ll try this in California?” California’s position on non-competes is that anything that restrains competition is automatically void. However, we’re back to the fundamental problem: no matter how questionably enforceable a non-compete agreement is, the employee has to decide whether to sign it and hope it will all work out when they leave because their only other option is to mount a long, expensive legal challenge either before or after their departure. Readers have pointed out that both Epic and Cerner have aggressive, mandatory non-compete agreements with employees but rarely enforce them if the employee leaves in a civil manner. Another challenge is that Epic could kill an employment offer from a third-party consulting firm or a health system by simply placing an off-the-record phone call. “You’ll never work in this town again” is pretty much true if you cross someone at Epic an try to jump ship to work for someone who relies on Epic’s goodwill, regardless of what legal terms you did or did not sign.


HIStalk Announcements and Requests

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McKesson’s health IT legacy will be modest, suggest poll respondents who characterize its contributions as poor (45 percent) or fair (43 percent). Commenters blamed disconnected and poorly managed acquisitions, a lack of healthcare IT focus similar to other companies that entered health IT with a big splash and later slunk out quietly (Siemens, GE, AT&T, IBM, and Oracle), and leadership pulled from the sales ranks. New poll to your right or here: which company will benefit most when McKesson sells its EIS business that includes Paragon?

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

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We funded the DonorsChoose grant request of Mrs. Robles from Arizona, who says the iPad Mini and multimedia receiver we provided to her middle school class has been “a game-changer for all of us” as the students have been more inspired to work harder at math using the lessons and discussions she assigns.

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Also checking in is Miss V from Utah, who had said in her grant request that she was “sometimes embarrassed as their teacher because we are a STEM school and yet I don’t have a single math manipulative in my classroom.” We bought her several sets, leading to her update: “The manipulatives you donated are more versatile than I ever thought possible, we use the counters for language bingo, shapes, math, and much more. Since we have received your donation, math in our classroom has become a lot more interactive and hands on. Miss V. and the math detectives will be solving hard math problems for years to come thanks to your amazing gift!”

Here’s how you know you’re in a low-growth geographic area: the clerk at Walgreens asks for your telephone number to look up your Balance Rewards Card and enters it wrong as you’re reciting it because they weren’t expecting a non-local area code. That suggests: (a) the area hasn’t grown enough to need more than one area code, and (b) they don’t get many people moving in since most would keep their old cell number containing their original area codes.


Last Week’s Most Interesting News

  • A hacker offers the patient databases of three providers for sale after those organizations decline to pay him or her to keep them private.
  • Teladoc announces plans to acquire consumer engagement software vendor HealthiestYou for $155 million in cash and stock.
  • AMIA announces the requirements for taking its informatics certification exam.
  • McKesson announces that it will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare and that it will exit the business following the new company’s 2017 IPO. McKesson will also seek strategic alternatives for its Enterprise Information Solutions business, which includes the Paragon hospital information system.
  • Allscripts brings back three original executives from its EPSi financial planning business and files a lawsuit against competitor Strata Decision Technology, accusing the company and former Allscripts chief marketing and strategy officer Dan Michelson – hired by Strata as CEO in 2012 – of using confidential Allscripts information to improve the KLAS rankings of StrataJazz in displacing Allscripts’ EPSi from the #1 spot.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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UK-based Network Locum, which matches hospitals with available locum tenens doctors, raises $7 million.

Xerox will lay off 95 employees of its Orlando-based Medicaid administration program due to “the business decision of a single client.” 


Sales

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East Jefferson General Hospital (LA) chooses NThrive – the former MedAssets, Precyse, and Equation – for revenue cycle outsourcing.


Government and Politics

The Brexit-induced devaluation of the British pound could leave NHS unable to afford expensive drugs manufactured elsewhere, experts fear.

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Go Andy Slavitt. You’re going to miss him when he leaves his federal job soon.

The federal government erases $171 million in loans made to students of bankrupt, for-profit Corinthian Colleges, which at its peak ran 100 campuses serving 75,000 students who received $1.4 billion per year in federal student loans. The students who voluntarily chose the aggressively marketed but questionably useful training programs (some healthcare-related) offered by Corinthian Colleges get to walk away from their debt as does the company itself, leaving federal taxpayers holding the bag for the unwise decisions made by everyone except themselves.


Other

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Vancouver’s Island Health will press on with its $135 million Cerner implementation despite last week’s unanimous no-confidence vote by its medical staff, who warn that the system’s electronic order entry is changing, cancelling, and overriding their orders. ED and ICU physicians have already gone back to paper orders after voicing similar patient safety concerns.

Catholic Health Initiatives will get out of the health insurance business after incurring big losses, adding big non-profit health systems to the list of organizations that believed they could compete with much-hated big insurers despite having minimal expertise in assembling a good risk pool and managing member health. 

Endocrinologist Joseph Aloi, MD of Wake Forest Baptist Medical Center (NC) describes in an interview how he uses Glytec’s Glucommander software to manage diabetic ketoacidosis. He notes that the #1 concern in treating older diabetic patients is hypoglycemia and it’s often caused by inpatient transfers out of dialysis, patients who aren’t eating, or NPO patients whose routine insulin dose isn’t adjusted. They’re looking at using Epic as a teaching tool to warn physicians if an insulin drip is discontinued and there’s no order for basal insulin, a practice used successfully used by Sentara.

I was wondering while watching fireworks Sunday night if any NFL’ers blew their fingers with firecrackers off this year.

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This is a pretty funny tweet, although I wouldn’t have been as kind in not calling out the fact that there’s no such thing as EST until the clocks move back in November. Why do Americans struggle so much with the simple concept of EST in the winter, EDT in the summer? (or just plain ET year round for those who just can’t keep them straight.) I’m not clear on what the HIT100 is, but it seems to reward and excite the Twitterati. I used to feel proud when a big company re-tweeted me until I realized it was a 24-year-old marketing assistant charged with tweeting something positive about the company. It’s not like Neal Patterson is manning or even reading Cerner’s Twitter since most decision-makers have more important things to do than screwing around with social media.

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This must be doubly digital medicine: a robotic rectum developed by Imperial College London for practicing rectal exams.


Sponsor Updates

  • Over 500 WeiserMazars employees volunteer at over 20 community organizations in five states during its second annual “Days of Service.”
  • ZeOmega receives a perfect SOC 2, Type 2 Report following an audit of its IS services.
  • Xerox is named a leading contact center outsourcing service provider in Everest Group’s 2016 report.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

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July 4, 2016 News 6 Comments

News 7/1/16

June 30, 2016 News 13 Comments

Top News

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Massachusetts General Hospital (MA) notifies 4,300 patients that their information was exposed in a February 2016 breach of dental practice systems vendor Patterson Dental Supply. Dental system security guy Justin Shafer notified the company in February that all instances of its Eaglesoft software are insecure because the database uses a default username of “dba” and a password  of “sql.”

The company expressed its thanks in May 2016  by filing a Computer Fraud and Abuse Act claim in which it notified the FBI that Shafer had illegally accessed its server, leading to a pre-dawn raid on his home by a dozen armed agents who hauled him away in handcuffs.

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SRS commented on the screenshots I ran showing hacker TheDarkOverlord (who I’ll refer to as “he” even though he or she hasn’t divulged gender) sitting on an SRS EHR log-in screen as he apparently used Remote Desktop Protocol (RDP) to steal their client’s patient data:

Protecting our clients’ patients’ information is a top priority at SRS. Upon receiving notification that patient data from one of our clients may have been compromised, we immediately launched an investigation. While our investigation has concluded that the SRS system itself was not compromised, we are working in partnership with our client to assist in any way we can. At this time, the matter has been turned over to the appropriate authorities.

The hacker published several SRS screen shots showing full patient information. SRS is right, though – accessing a system by breaching RDP isn’t taking advantage of a vulnerability of any system other than RDP. It’s just logging in using someone else’s credentials. The real question is how he obtained the log-in information. RDP can store system usernames and passwords that can be displayed with readily available utilities. It would be interesting to know whether the clinic had set up RDP for its own users or whether a software vendor had configured it for remote support use.

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Justin Shafer (see above) speculates that the SRS client is Athens Orthopedic Clinic (GA) based on partially readable information in the SRS screen shots. DataBreaches.net contacted the clinic and received this response from its CEO:

In the last 48 hours, we were made aware of a potential data breach relating to our online patient records. Today, we also received an email requesting that we comply with the hacker’s request (which has been published in various forms online.) We take the privacy of our patients very seriously, as well as the laws that guide patient privacy, and we are investigating what may have happened through the proper channels. When we have more information to share with you and your readers, we will be in touch. Kayo Elliott, CEO, Athens Orthopedic Center.

TheDarkOverlord also named the Midwest provider from whose system 98,000 records were stolen and then listed for sale: Midwest Orthopedic Pain & Spine in Farmington, MO.

The hacker says he contacted each provider and offered to destroy his copies of their records if they paid him, with the alternative being that he would offer their records for sale. All of the providers declined. Note that this is extortion rather than a ransomware attack since he didn’t lock the users out of their own databases – he just demanded money in return for not publishing the records. He also apparently accessed the systems using manual intrusion methods rather than automated malware.

I scoured the Web for how to secure RDP:

  • Use strong passwords.
  • Keep both client and server versions current since older versions have many vulnerabilities.
  • Enable network-level authentication.
  • Administrator-level users can run RDP by default, so either remote unneeded administrator access or remove the administrator account from RDP access and add a technical group instead.
  • Set a local security polity limiting the number of password attempts.
  • Change RDP’s listening port so it can’t be easily seen in hacker network scans.

Here’s a chillingly factual description of how to hack RDP to steal the sysadmin password. The hacker uses address resolution protocol scanning software to find device IP addresses; captures the data stream when an RDP client connects to the RDP server (such as when a vendor connects to provide technical support); and then looks for passwords in the sniffer file, visible as individual user keystrokes (or the hacker can use a brute force password cracker).

Vendors, you might want to give your customers some emergency security guidance about configuring RDP, TeamViewer, LogMeIn, or any other remote support tool your support agreement requires.


Reader Comments

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From Green Tomato: “Re: forcing consulting firm employees to sign Epic’s non-compete agreement. Here’s a copy of what my employer insists we sign. Interesting contents: (a) it completely restricts access to Epic code without ‘pursuant to a customer schedule’ language, so the company has already run into engagements that require review of Epic code; (b) it restricts access to the Chronicles database, again costing my company a couple of engagements because they needed to query Chronicles to support a customer; and (c) it includes the hugely overreaching and offensive clauses declaring that we can’t work for an Epic competitor for one year after leaving our current jobs. I’ve heard that other consulting companies have signed agreements without the non-compete clause. I am standing up to my employer in not signing the agreement and will likely lose my job in the next few weeks. Without getting a group together for class action lawsuit, I’m essentially screwed, and even with a group it would be an uphill battle.”I don’t have the expertise to evaluate the legality of a company requiring its employees to sign another company’s non-compete agreement, but firing someone for declining to sign would seem to sit in wrongful termination territory. The fact that your employer even put this in front of you is indicative of just how scared companies are of getting on Epic’s bad side. I invite legal opinion, although I think you are correct that, right or wrong, you would need a lot of time and money to mount a challenge, and by the time you prevail, you will have moved on. You also have the document in Word, so you could add “not” in a key place (such as, “This restriction will not apply to you”), print it, and sign it hoping that nobody notices your edit.

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From ThisChangeIsNotGood: “Re: McKesson and Emdeon. They fall short in integrating acquired products and their customer service lacks. Change Healthcare and Relay have KLAS scores that lag almost 10 points behind their competitors. Why will bringing two challenged organizations together be good for customers? The obvious answer is that it won’t – it’s just a very profitable transaction for Blackstone. They acquired Emdeon for $3 billion and used at least $1.5 billion in debt, so this deal gives them $1.75 billion in cash ($250 million in profit) plus they still own 30 percent of the resulting entity. The release mentions $150 million in cost reductions which has to be mostly employees – the companies are huge cash generators because their customer contracts are old and those customers are drastically overpaying. The question is how long hospital CFOs will tolerate out-of-market prices with mediocre solutions and customer satisfaction.” There’s also the question about the degree of alienation felt by McKesson Technology Solutions customers and whether they see that getting better or worse once they’ve been dealt off to NewCo since, most importantly to McKesson, they buy a lot of non-IT stuff that McKesson actually cares about.

From HIStalkFan: “Re: [vendor name omitted.] VP of operations is leaving after the international sales VP left in the past month as well. The company has fired 20 folks in the past few months and seems to be losing business fast.” I left out the name of the cardiovascular information systems vendor for now since the VP is still listed on the company’s executive page. 

From Luke: “Re: VistA. Says its 40-year-old code is hard to manage, unlike that of commercial products.” Maybe, but Epic has been around nearly that long and Cerner Millennium was built in the 1990s. All three products have been enhanced continuously since they were developed, so it’s not like running an un-updated copy of Windows 3.11. The problem with both the DoD and the VA is that they’re going to hand billions over to contractors no matter what product they use and will probably botch their implementations via poor planning and oversight.


HIStalk Announcements and Requests

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Mr. H says his Texas after-school STEM class is “beyond excited” about the STEM kits we provided in funding his DonorsChoose grant request. The students have built a robot arm and analyzed pond water, with one student proudly exclaiming while experimenting with a marble roller coaster, “We are engineers in the making!”

Listening: Gary Clark, Jr., accurately characterized by the reader who recommended him as “born two generations too late, Jimi Hendrix crossed with Stevie Ray Vaughn.”

This week on HIStalk Practice: ManagementPlus launches revenue cycle solutions for eye care practices. Jonathan Bush waxes lyrical about his political plans. Allergy Partners develops app to help its patients track meds, triggers, symptoms. VillageMD partners with New Hampshire-based practices to assist with value-based care transitions. HHS selects 200 physician practices to participate in its Medicare Oncology Care Model. "Dr. Trump" promises perfect healthcare for all.


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Marketing intelligence vendor Definitive Healthcare acquires competitor Billian’s HealthData.

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Teladoc will acquire telehealth consumer engagement platform vendor HealthiestYou for $155 million in cash and stock. Scottsdale, AZ-based HealthiestYou lost money on $10 million in FY2015 revenue, while Teladoc confirms that it will lose around $50 million in 2016. HealthiestYou offers price comparison and provider search. It seems like a ridiculous multiple for Teladoc to pay for an app that doesn’t seem all that interesting or related to its core telehealth business, but they must know what they’re doing.

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Google Capital takes a $46 million position in publicly traded marketplace Care.com, which matches families with caregivers.

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Allscripts sues its former chief marketing and strategy officer Dan Michelson – hired by competitor Strata Decision Technology as CEO in 2012 – as well as Strata, claiming that Michelson “has in his possession an external hard drive containing highly confidential and trade secret Allscripts documents and information.” Allscripts claims that Michelson has disclosed its information to Strata employees in violation of his Allscripts employment agreement. The lawsuit also notes that Strata hired several other Allscripts employees, several of whom worked in sales for EPSi, the Allscripts financial planning product that competes with Strata’s StrataJazz. Allscripts contends that it lost the #1 KLAS spot for Decision Support – Business in 2014 to StrataJazz because of the exposed information, causing EPSi to drop to fourth place in the 2015 report.


Sales

GoHealth Urgent Care chooses Orion Health’s Rhapsody integration engine to connect with its health system partners.


Government and Politics

Vice President Biden, questioned at a cancer summit about why medical institutions that receive government grants don’t always publish their research data, responds angrily, “I’m going to find out of it’s true. And if it’s true, I’m going to cut funding. That’s a promise.” NIH Director Francis Collins says the 2008 law requiring taxpayer-funded researchers to submit their clinical trials data to NIH-run ClinicalTrials.gov does not provide an enforcement mechanism, but he expects changes that will allow NIH to levy fines on those who don’t comply or the power to ban them from receiving further grants.

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The Wall Street Journal says health insurance deductibles should become the next health policy debate now that 91 percent of the US population has coverage. Since 2004, co-pays have dropped, worker wages have increased modestly, and deductibles have jumped 256 percent to become the #1 health cost concern of consumers as well as the preferred tool for employers trying to rein in annual premium increases.

Congress works on a financial bailout of Puerto Rico, where 9 percent of its population has moved to the US, causing its hospitals to struggle with unfilled beds and an exodus of clinicians that may cause a further downward spiral in employment and business investment. Puerto Rico’s governor observes that its residents pay the same Medicare tax as mainland residents, but it gets less federal funding than the states. Lenders have cut off further loans as debt soars, with one surgeon noting that the hospital’s electricity was turned off for non-payment in the middle of a surgery he was performing.


Other

AMIA announces the eligibility requirements to take the exam for its Advanced Health Informatics Certification, an alternative to the physician-only clinical informatics subspecialty. Until an unspecified time until which the majority of graduate informatics programs are accredited, the requirements are:

  • Employment in an operational health informatics role.
  • Attainment of a health professions graduate degree plus a master’s in health informatics (for which 36 months of informatics experience in the US or Canada can be substituted). Examples of acceptable degrees are MSN, MPH, NP, PA, DDS, DNP, PharmD, DO, and MD.
  • 18 months of informatics work experience.

AMIA’s next steps are to develop the exam’s core content, choose a certifying entity, and launch the accreditation of graduate health informatics programs.

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Commonwealth Fund President and former National Coordinator David Blumenthal, MD, MPP says that instead of trying to convince providers to share their patient information, a better way to eliminate information blocking is to put patients in control of their own records as a “consumer-mediated health information exchange.” Patients or their paid vendors would manage and distribute their own information to parties they specify, which could include researchers or public health authorities. Blumenthal says the next steps would be to certify and/or regulate the organizations that will help patients share their information and to give those organizations access to provider EHRs.

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Informaticist Harris Stutman, MD ended his “Jeopardy” run Wednesday, earning second place for the day but taking home three-day winnings of $63,500.

BMJ ponders whether it’s OK for conferences to ban live-tweeting of their educational sessions. Arguments for: (a) presentations may include unpublished results and preliminary conclusions; and (b) the presenters may have granted a copyright to journal that is publishing their work. The author suggests that conferences make their tweeting policy clear and that speakers indicate on their title slide whether they are OK with having attendees tweet out photos of their other slides and handouts.


Sponsor Updates

  • Audacious Inquiry announces that its Encounter Notification Service is delivering1 million ADT notifications per month.
  • Boston Software Systems launches an EHR migration and optimization podcast series.
  • Netsmart helps prepare health and human services providers for CARF and The Joint Commission accreditations.
  • Representatives from 30 healthcare organizations in Canada visited Toronto’s Humber River Hospital, which claims to be North America’s first full digital hospital, to learn about its Meditech 6.1 system.
  • CloudWave is named by Hewlett Packard Enterprise as Preferred Healthcare Network Partner.
  • Red Hat will host its annual summit will take place May 2-5, 2017 in Boston.
  • Sagacious Consultants releases the June 2016 edition of its Sagacious Pulse newsletter.
  • SK&A publishes its annual pharmacy compliance report.
  • Sunquest Information Systems hosts a Cancer Moonshot Summit in Tucson, AZ.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

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