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News 7/1/15

June 30, 2015 News No Comments

Top News

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Allscripts takes a 10 percent equity position in NantHealth for $200 million in cash, while NanthHealth billionaire founder Patrick Soon-Shiong personally invests $100 million in Allscripts. Co-development plans include product integration and work on personalized medicine. NantHealth is rumored to be mulling IPO plans, while Allscripts shares have dropped 16 percent in the past year.


Reader Comments

From Dr. N: “Re: EHRs. EHRs were developed out of coding and billing frameworks. This does not relate to MDs and patients. SOAP still remains the most efficient and meaningful format. However, click boxes, no doubt, would be helpful for meta data, also important. Software has the ability to pull down from the SOAP narrative format data to the click boxes. Minimal new language may need to be used by the MD in the narrative. I personally retired rather than using the completely useless EHR formats available. The current EHRs are subtly and obtusely changing MD thinking processes and predominately to the negative.”

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From Libby Litigator: “Re: Blue Shield of California. You mentioned that a former executive claims he was fired for trying to reduce the company’s outsourcing payments to Cognizant. BSCA’s former CTO also filed a lawsuit claiming he was fired for pointing out issues with Cognizant. His new employer CEO also worked for Blue Shield as a policy guy and got tired of trying to defend its non-profit status after he saw how it operated. Has anyone ever done that on the hospital side?” That is indeed a fascinating story, as former BSCA CTO Aaron Kaufman says his CIO boss fired him the day before he was due his $450K bonus for 2014 after Kaufman questioned selection of a particular vendor. BSCA countersued Kaufman in claiming that he charged $100,000 in personal expenses to his company credit card. Some of those charges involved a bowling party night out Kaufman spent with his girlfriend, “Sharknado” and “American Pie” actress Tara Reid, which made BSCA doubly unhappy because “inappropriate” photos like the one above made their way into the public eye. Kaufman said he had to use his company credit card because the wife he was divorcing had locked up his accounts. Most interesting (other than a healthcare CTO successfully wooing a Hollywood actress, even a minor and fading one like Reid) is how a supposedly non-profit insurer can justify paying a CTO an annual bonus of $450K. Kaufman is now EVP/chief product officer of SocialWellth, which earns top buzzword scores in unintelligibly describing its app certification business that it bought from the defunct Happtique as, “a digital health company that enables payers, providers, and employers to prescribe curated digital health assets and services to their end consumers at relevant touch points in their health journey, and in turn, receive actionable data to deliver value based care. Our profile-driven mobile computing platform integrates and aggregates mobile health apps, devices, and content while leveraging activation currency and social engagement to deliver personalized well-being experiences for consumers.”


HIStalk Announcements and Requests

It’s been four days since I faxed a form requesting my electronic records from a hospital and they haven’t responded. The only other method of contact listed is to call the HIM department, so I’ll do that next. I’m feeling the presence of an increasingly non-electronic bureaucratic wall.


Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.


Sales

PremierMD (FL) chooses the eClinicalWorks EHR and population health management suite.

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UC Irvine Health (CA) chooses Epic.

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UAB Medicine (AL) selects Athenahealth’s AthenaCoordinator Enterprise for patient access, referrals, and care transitions.


People

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Verisk Health hires Sean Creighton (CMS) as VP of risk adjustment solutions.

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A North Carolina newspaper’s review of 2014 CEO compensation of the state’s largest companies places Premier CEO Susan DeVore highest at $24.9 million, the first time a woman has topped the list. PINC share price is up 32 percent in the past year, valuing the company at $1.4 billion, of which DeVore holds around $8 million worth.

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Alternate site billing systems vendor Brightree hires Lori Jones (AirStrip) and Shaw Rietkerk (MModal) as EVPs.


Announcements and Implementations

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Wellcentive awards a $5,000 Medical Scholarship for Veterans to former Marine Captain Anthony DeSantis, a fourth-year medical student and Tillman Military Scholar at University of South Florida who was deployed to Fallujah, Iraq in 2007-2008.


Innovation and Research

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A seventh-grade student in Vietnam creates Health for Everyone, prize-winning software that contains clinical information, treatment plans, a drug-drug interaction checker, and a weekly medical quiz. The local hospital’s internal medicine department is using it,  proclaiming it to be “a wondrous, time-saving device which also updates doctors’ and nurses’ medical knowledge and expertise.”


Other

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A Wall Street Journal article called “How to Take Charge of Your Medical Records” urges patients to serve as their own data hub instead of relying on providers and their incompatible systems to send information back and forth. The reporter got a bit confused in thinking that the Blue Button website contains actual Medicare and VA patient information and the article takes a puzzling turn into the privacy of wearable device data, but it was otherwise a pretty good consumer-focused overview. I was interested that the ICEBlueButton app from Humetrix displays a QR code on a smartphone’s lock screen that paramedics can scan to display emergency medical information, with a $20 per year option to also immediately alert their emergency contacts.

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An AHRQ-funded study finds that providers like the convenience of allowing patients to upload information via their patient portal, but patients themselves struggle with usability issues and rarely upload anything. Secure messaging was accepted by both groups but sometimes caused provider workflow and workload problems. The study concludes that health IT improves outcomes only if used as part of more comprehensive programs and poor application usability impedes workflow.

Analysts from Goldman Sachs estimate that digital technology (in the form of the Internet of Things) will save $300 billion in annual US healthcare costs and generate $32 billion in revenue. My cynical experience is that the latter is much more likely to be realized than the former. One person’s excess costs is another person’s income and that other person often hires lobbyists, lawyers, and trade groups to keep the excess costs flowing into their pockets. 

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Eaze, the California company whose fast-track marijuana delivery service is known as “the Uber of pot,” jumps into telemedicine with with EazeMD, which consumers can use to obtain a medical marijuana card following a $25 video visit with a physician.

Tuesday night (June 30) is Leap Second, where the world’s clocks adjust for the slowing in the Earth’s rotation by adding an extra second to the day. Amazon had problems the last time it happened (in 2012) but has since changed its systems to add a tiny bit of time to each day rather than all at once.

A New Zealand doctor whose patient died after he unknowingly prescribed an inappropriate drug says he will no longer rely on his EHR’s automatic warnings and will instead review the records himself. The doctor says he doesn’t remember receiving a computer warning. The local hospital was also blamed for failing to integrate its systems after acquiring another practice.

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A decently designed survey of CVS pharmacy customers with at least one chronic condition finds that 37 percent have communicated with their physician by email. Around half are interested in tracking health, refilling prescriptions, and looking up information, with their preferred method being via online portals, which finished slightly ahead of email or mobile apps. Oddly, the study commentary opines that patients prefer email and Facebook to physician portals even though its results indicate otherwise. Nearly 20 percent of respondents said they have contacted their physicians on Facebook, which will surely alarm hospital risk managers everywhere. The study is disappointing only in that it took two years for it to wind its way through the bowels of journal publishing – the survey was performed in May and June of 2013, a decade ago in social media time.

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Unrelated but bizarre: two airline pilots from Argentina are fired for posting a YouTube video in which they turn over the controls of their plane during takeoff to a model who has been featured in Playboy. The passengers are filing suit against the airline, while the model says she will sue the pilot and co-pilot for sexual harassment in claiming they fondled her while fastening her seat belt.

Weird News Andy titles this story “Child to Be Raised By Wolves” in expressing relief that mom and baby Romulus are fine. A pregnant woman gets lost in a national forest while driving to her parents’ house and is stranded for three days when she runs out of gas and her cell phone battery dies. She gives birth and is finally rescued by Forest Service rangers responding to the forest fire she accidentally started.


Sponsor Updates

  • John Moore, managing partner of Chilmark Research, will deliver the keynote address at Galen Healthcare’s Galen Partner Advisory Council in Boston August 3-4.
  • ADP AdvancedMD offers “Flag these ICD-10 codes for the Fourth of July.”
  • Team AirStrip wins the San Diego International Triathlon Mixed Relay.
  • AirWatch offers “IDC confirms: AirWatch by VMware holds largest EMM market share.”
  • Besler Consulting posts “Making the Case for Dedicated Observation Units.”
  • CapsuleTech offers “AMIA Task Force Calls for Simplification and Speed in EHR Use.”
  • Caradigm offers “Super Clinically Integrated Networks will Lead the Way to Population Health.”
  • CareSync publishes “Project Manager Field Research.”
  • CitiusTech celebrates its 10th anniversary.
  • CoverMyMeds offers “CoverMyMeds – As Secure as Ever.”
  • CTG participates in the 20th annual Ride for Roswell to raise funds for the Roswell Park Cancer Institute.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 30, 2015 News No Comments

Curbside Consult with Dr. Jayne 6/29/15

June 29, 2015 News No Comments

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I agree with Mr. H that this is a slow time of year for healthcare IT news. Not only is it a slow time for news, but it seems to be a slow time for overall productivity as well.

I’m working with a client right now that is having a hard time getting anything done. Their teams are extremely lean and most staff operate without a backup, so vacations have a significant impact. Additionally, it feels like when we have the right people in place from the client side, there is a good likelihood that someone will be out from the vendor side.

I did some work a couple of years ago that involved a Swedish vendor. We were up against an extremely tight timeline because we had been warned that the entire company (literally) would be on vacation for four weeks during the summer. I remember thinking they must be terribly progressive, some kind of Scandinavian high-tech outlier going to extremes to keep their staff happy. After a little digging, we determined it wasn’t that unusual at all – since the late 1970s, Sweden has mandated five weeks of vacation for their workers. Many take the majority of them in the summer.

There are a variety of reasons that approach wouldn’t get very far in the United States. In addition to the political and economic factors opposing it, think about the planning needed to pull it off. Even for a small company, it would involve a great deal of strategic planning to ensure that the time off is factored into all projects. It would also require that projects are actually executed on time so that there are no last-minute pushes into the vacation.

In digging into the economic factors, though, I wonder if the return on investment for something like that might be real. If you look at the lost productivity encountered at a hospital like my current client, it’s significant. Workers are continually coming to the office late or leaving early for a variety of issues: traffic patterns are different with children out of school; childcare situations may be less predictable during the summer months; and tourism picks up in the city, resulting in parking and other logistical issues. We’re also seeing more people working from home to keep an eye on their children, resulting in a greater percentage of online meetings with barking dogs, background noise, and the occasional yelling dad who forgets to use the mute button.

I was looking for information on countries with more liberal vacation policies and came across this great Washington Post summary. It discusses the work of Swedish environmental psychologist Terry Hartig, who notes that those returning from a relaxing vacation tend to return to the office relaxed. I see more and more people “vacationing” with their smartphones, laptops, and piles of documents. Not only are they not enjoying their time away, but I’ve also seen feelings of guilt for those back in the office who feel bad for having to contact them. For those staffers who manage to avoid calling in for meetings, there are productivity-sapping discussions when their colleagues discuss the Facebook posts of those who are soaking up the sun.

Hartig’s research looked at prescriptions for anti-depressant drugs in Sweden over more than a decade. When people vacationed simultaneously, there were fewer prescriptions. The article (from 2014) lists the annual cost of depression at $23 billion a year in the US, so we can add that into the ROI calculation. Hartig also notes that Europeans spend less on healthcare and live longer than Americans – and have 20 to 30 vacation days a year. US companies seem to be cutting back on vacation unless it’s contractually mandated.

A couple of years ago, my health system did a “realignment” of vacation and sick time policies. They essentially declared that ours were too generous and out of line with other employers in our metropolitan area. We had previously been allotted seven corporate holidays and two personal holidays. The personal holidays were originally intended to allow employees to have time off for those holidays that were not corporately-declared, such as Christmas Eve, New Year’s Eve, Columbus Day, Presidents Day, Martin Luther King Day, Veterans Day, etc. if they were important to the employee. The HR people found out that no one else offered anything like that, so the personal days were cut.

That began a race to the bottom that ended with not only the elimination of the personal holidays, but all personal days in general. They also reduced the ability to carry over vacation days from year to year and eliminated the existing vacation buy-back program. They announced the new carry over rules during the last two months of the year. Many departments were getting ready for a major system migration after the first of the year and vacations weren’t being approved, resulting in many more employees who had to lose it rather than use it. Managers were given virtually no flexibility to accommodate their employees. The end result felt a lot like theft.

The Washington Post piece also notes that “the US is the only advanced economy with no national vacation policy (unless you count Suriname, Nepal, and Guyana).” Nearly 25 percent of workers have no paid vacation at all with those who do have vacation averaging 10-14 days a year. When I left my CMIO role, the vacation policies were a total patchwork. Employed physicians in direct patient care were allotted 15 vacation days and five continuing medical education (CME) days for a total of 20 days plus the corporate holidays. Administrative physicians had the same number of vacation days and holidays, but were allocated no CME days. I suppose that means that once you are an administrator you either lack the capacity to learn or the organization assumes you already know everything.

Anyone less than a manager title only got 10 vacation days, regardless of seniority. Even the sick-time policy was confusing. Hourly employees could take their time in one-hour increments but salaried employees had to take it in four-hour blocks. Although they told us that as salaried employees we had the ability to take an hour off here and there without formally requesting it, there was a lot of pressure to make up any time out of the office. The net result was that very few salaried employees were actually able to take advantage of their sick time unless they were seriously ill.

Losing vacation and sick days is fairly common, with the article mentioning an estimated 577 million unused days each year which equates to “$67 billion in lost travel spending and 1.2 million jobs.” Adding that to the ROI, I’m starting to wonder if we can afford to NOT take more vacation. It also mentions some interesting political facts:

  • In 1910, William Howard Taft proposed giving American workers two to three months of paid vacation each year.
  • John Muir recommended compulsory vacationing as better for the country than compulsory schooling.
  • The 1938 Congress proposed the 40-hour work week, a minimum wage, and two weeks paid vacation.

I’m taking several vacations this summer, mostly to make up for the lack of them during the last several years. I also have the luxury of being my own boss right now, so it’s much easier than before to schedule a vacation. It’s a bit harder to execute, though, since I’m a corporation of one. Even when clients are understanding and know I will be out of the office, it takes a conscious effort to disconnect. Checking my phone is tempting but it usually results in at least half an hour of work, so I try not to do it at all.

I’m staging all my projects for the next couple of weeks in preparation for some wilderness adventures. I can’t wait to be not only out of the office but in a place that literally has no cell towers or electricity. It also has no running water, but I’m not exactly looking forward to that. I’m sure some of my fellow travelers will be bringing solar chargers or Biolite stoves, but I’m not even taking anything with a USB port.

What’s your strategy for disconnecting when you’re out of the office? Email me.

Email Dr. Jayne.

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June 29, 2015 News No Comments

Monday Morning Update 6/29/15

June 27, 2015 News 2 Comments

Top News

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A federal grand jury indicts a foreign suspect for using employee information obtained in the 2014 hacking of UPMC’s computer systems to file 900 fraudulent federal tax returns that netted a group of conspirators $1.5 million.


Reader Comments

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From FM: “Re: Brian Weiss’s article. Great article, Brian. The ‘HIE of one’ is the most simple, and most disruptive, way to achieve interoperability, and all enabled by simple technical building blocks (Direct, C-CDA) plus our inalienable civil rights. All we have to do now is ask. #GetMyHealthData.” I’m doing my own HIE of one, as you’ll read in the next paragraph. I invite readers to do the same and report their results. We keep talking about information blocking, so let’s name names in trying to wrest an electronically transmitted C-CDA from providers who have eagerly lapped from the Meaningful Use trough and therefore should be able to provide one.


HIStalk Announcements and Requests

I am accepting Brian Weiss’s suggestion that we all become Open Provider Authorized Testing Bodies in requesting an electronic copy of my discharge summary from my one and only hospital admission, which lasted less than a day. It’s an EMRAM Stage 7, Epic-using, MU2-attesting medical center that should be able to send a C-CDA to my newly created Direct address (via Carebox, signup for which took 10 seconds). I suspect clashes with a clueless bureaucracy are in my future as I’ve already had to print a confusing HIM-centric paper form, fill it out (minus my medical record number, since it’s ridiculous that they expect patients to know that), and fax it back (using a free Internet fax service since I don’t even have a landline, much less a fax machine). I’ll be interested to see how they verify my identity and respond to my request for an electronic copy, which could be either easier or harder since they use an outsourced release of information company. The form didn’t even ask what method of delivery I preferred, so if it weren’t for the fact that they’ll probably call up wanting a per-page fee paid before sending me my records, I would probably get a package of paper in the mail by default.

Speaking of Brian’s article, I’ll offer a counterpoint to his suggestion that getting a copy of your own C-CDA means the sender’s EHR is open. That’s a great start, but it doesn’t do a whole lot for interoperability with other providers. It’s annoying for health systems and practices to send out C-CDAs to patients, but it’s downright threatening for them to open up their full patient information to competitors, which is what you would want as the subject of the overused “unconscious in the ED” scenario.

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Poll respondents are split as to whether the EXTREME criteria adequately define open, interoperable EHRs. The no-voters unfortunately didn’t tell us what the authors missed. IP address analysis showed no evidence of ballot box stuffing, but I noticed that most of the Epic-based respondents chose “no.” New poll to your right or here, as suggested by a reader’s comment: is HIPAA’s impact on privacy positive or negative? It seems like an obvious “positive” on first glance, but as the reader points out, HHS gave providers complete control to use patient information without consent and with minimal disclosure requirements, pretty much killing the idea that patients own their data (not to mention that the full law failed to accomplish the “P” of insurance portability that didn’t happen until ACA). Rampant misinterpretation of HIPAA, where providers conveniently claim that anything they don’t want to do is prohibited by HIPAA, is a different issue.

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Need consulting help? Consider using the RFI Blaster, which lets you send a brief description of your project to one or several consulting firms via one simple online form, also allowing you to choose your desired method of contact (phone number is optional, in other words). The CIO of a large health system suggested I create it and he’s had success using it since it puts him in control while requiring little of his time or energy.

I’m on a pet peeve streak, apparently. For those who latched onto the trite phrase “not so much,” it’s as eye-rollingly out of touch as a leisure suit. I’m also annoyed at the traffic-desperate “news” sites that repeatedly tweet out old stories like “Epic CEO to donate 99 percent of fortune” over and over again for many days (the actual story was published 12 days ago and they’re still tweeting about it, while another just-tweeted story was posted 22 days ago) hoping to eventually con followers into clicking. It’s also like CNN, which keeps old stories high on the page hoping bored passers-by will click out of instinct, which at least isn’t as bad as milking minimal impact stories (still-missing flights or still-fleeing prisoners) while ignoring less entertaining but far more important topics, such as whether Greece will default or the impact of terrorist attacks in Tunisia.

It’s going to be an easy read today because nearly nothing is happening in healthcare IT this holiday week. I won’t waste your time passing off junk as news.


Last Week’s Most Interesting News

  • The Supreme Court upholds the legality of the Affordable Care Act’s subsidies for residents of states that don’t run their own health insurance exchanges, leaving ACA intact and sending shares of insurance companies and for-profit hospital companies soaring.
  • Google confirms that it is developing an industrial-grade, prescription-only wristband that will collect patient and environmental information for clinical studies.
  • Aurora Health Care (WI) takes a lead investor role in StartUp Health.
  • A Federal Aviation Administration RFI discloses its intentions to connect its pilot medical exam system to government EHRs, hoping to detect safety-endangering medical conditions such as depression.
  • Video visit provider MDLive raises $50 million in funding.

Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.


Announcements and Implementations

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Private equity firm co-founder Joshua Harris donates $5 million to create a precision wellness center at Mount Sinai Hospital (NY).


Privacy and Security

Google is caught secretly installing audio listening software as part of its Chrome browser extension that allows it to respond to audio commands.

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A Veracode report finds that healthcare implements security poorly, with 80 percent of applications having cryptographic issues such as weak algorithms and  only 43 percent of known vulnerabilities being fixed. Still, healthcare scored much higher than the bottom-dwelling government. The numbers aren’t necessarily relevant, however, since they include only those self-selected organizations that engaged Veracode to assess their software risk.


Other

A grand jury finds that Ventura County, CA prepared poorly for its $50 million Cerner implementation, with frequent downtime causing care delays. The agency defended itself by questioning why their project required a third review, with the jury foreman explaining, “We had complaints from the public concerning what happened after the system was live. There were still an awful lot of complaints.”

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Bristol Hospital (CT) lays off 5 percent of its workforce in four areas, one of them the IT department.

The City of Pittsburgh drops its lawsuit challenging UPMC’s tax-exempt status and UPMC does the same with its countersuit, with the cash-strapped city hoping that more cordial relations will save legal costs and possibly convince UPMC (as well as Highmark, the University of Pittsburgh, and Carnegie Mellon University) to chip in some of the $20 million the city wants non-profits to pay toward their consumption of city services.

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A former executive of Blue Shield of California files a wrongful termination lawsuit claiming that he was fired for trying to reduce its use of outsourcer Cognizant. He claims that a Cognizant VP tried to bribe him by offering, “You can join me for a party at a sex club in Sacramento. We have some very beautiful women there.” The company fired him for sexual harassment of women, saying his homosexuality was irrelevant.

Weird News Andy says this was an easily made termination, although firing isn’t enough. The Detroit Fire Department terminates an EMT who refused to respond to the house of an eight-month-old baby whose mother called 911 to report that she wasn’t breathing, with the EMT providing as an excuse to the dispatcher, “I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”


Sponsor Updates

  • Valence Health announces Penn professor and author Ezekiel Emanuel, MD, PhD a keynote speaker for its value-based care conference in Chicago September 30 – October 2.
  • Aventura describes implementation of its Roaming Aware Desktop at Republic County Hospital (KS).
  • Surgical Information Systems announces that motivational speaker Denise Ryan will keynote its Go!2015 User Meeting August 23-26 in Atlanta.
  • T-System will exhibit at TxHIMA June 28-30 in San Marcos, TX.
  • Zynx Health posts “Going Beyond the Web and Mobile Tech: Enhancing the Patient Experience Through the Next Wave of Digital Innovation.”
  • Valence Health will exhibit at the Health Technology Research Alliance & Council Summit June 28-30 in Gettysburg, PA.
  • ZirMed offers “How to reduce time spent working denials by 66%, streamlining front-end tasks to spend more time on patient care, and ANI news.”
  • Voalte offers “With Humility Comes Many Blessings.”
  • West Corp.’s Laura Bramschreiber offers “Helping patients graduate to good health” on the HIMSS Future Care blog.
  • ZeOmega offers “Payer/Provider Collaboration: What Works?”
  • Xerox Healthcare offers “Data Science That Simplifies Healthcare Delivery Analytics.”
  • Verisk Health partners with the Association for Community Affiliated Plans to provide its members with healthcare analytics education and results-driven programs.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 27, 2015 News 2 Comments

News 6/26/15

June 25, 2015 News 3 Comments

Top News

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The Supreme Court upholds the legality of  federal medical insurance subsidies for consumers in all states — including those 34 that don’t run their own health insurance exchanges — in a 6-3 decision that preserves the Affordable Care Act.  Shares of publicly traded insurance companies and for-profit hospital operators jumped sharply on news of the decision.


Reader Comments

From Blue Eyes: “Re: 12 years of HIStalk. Seriously? I often think of what it would be like without HIStalk.” I calculate that since I started writing HIStalk in 2003, I’ve posted maybe 5,000 times and done around 500 interviews in writing many millions of words each year. I still can’t wait to start filling the blank screen every day.

From LaToya: “Re: [vendor name omitted.] Aren’t they HIStalk sponsors any more?” I sometimes get remarkably frank comments from company employees who explain why they aren’t continuing their sponsorship, most often: (a) we don’t have money in the budget since we’re cutting back all over the place; (b) we are thinking about pulling out of healthcare; (c) we have changed focus to work through resellers or partnerships instead of trying to sell directly to hospitals; and (d) the only person who knew anything about marketing quit, nobody’s really in charge, and we don’t know what HIStalk is. Some of the statements would make juicy gossip items were I inclined to kiss and tell, which I am not.


HIStalk Announcements and Requests

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My latest annoyance: people who email me and then email again when I don’t respond quickly enough to suit them. Nothing is more vexing than a company’s PR person emailing everybody they can think of demanding to know why I haven’t run their news item when (a) they didn’t read HIStalk to see that I already mentioned the item since I’m perfectly capable of finding my own news, or (b) they’re unfamiliar with HIStalk and don’t know that I write news posts only on Tuesday and Thursday nights and over the weekend, so it stands to reason that their Monday announcement won’t have run here by Tuesday morning no matter how newsworthy. I’ll also observe that companies invariably think that all their announcements are stop-the-presses critical when 99 percent of them aren’t even close.

A note to the industry: “population health” isn’t the same as “population health management” which isn’t the same as “population health management technology.”

This week on HIStalk Practice: AMA President Steven Stack, MD shares his healthcare IT goals for the coming year. Physician willingness to offer telemedicine reflects an untapped market. Atlantic Dialysis Management Services goes with BridgeFront Web resources. Community Health Partnership joins the CORHIO HIE. CVS Health announces new clinical affiliations with emphasis on EHRs. Zen Charts zeroes in on addiction treatment centers.

This week on HIStalk Connect: Telehealth vendor MDLive continues the telehealth funding spree with a $50 million private equity investment. The FDA approves a new medical device that helps the blind "see" by delivering information about their surroundings through a vibrating array held in the mouth. Sano Intelligence raises a $10 million seed round to launch its non-invasive glucose monitoring wearable device. Engineering students at Johns Hopkins invent a tamper-proof pill bottle that it hopes will help curb the rise in prescription-related drug overdoses.


Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.


Acquisitions, Funding, Business, and Stock

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EHR data aggregation and analytics vendor Arcadia Healthcare Solutions acquires Sage Technologies, which offers services to providers transitioning to value-based care.

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Mobile care coordination solutions vendor Cureatr raises $13 million in a Series B funding round, which the company will use to expand its Care Transition Notification network. 

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Video visit provider MDLive raises $50 million, increasing its total to $74 million.

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Non-profit Healtheway, which operates the eHealth Exchange and Carequality interoperability initiatives, renames itself The Sequoia Project. The announcement includes a convoluted, marketing-created rationale for the “rebranding process” and “new tagline” that were apparently vital for future success in choosing a name that sounds like a tree-hugging protest group instead of the perfectly good (and easier to spell) name it was already using. Founding members are AMA, Epic, ICA, Kaiser Permanente, MedVirginia, MiHIN, Mirth, New York eHealth Collaborative, Orion Health, and WEDI.

Castlight Health invests $3.1 million in new startup Lyra Health — which offers screening tools, patient-provider matching, and care navigators for behavioral health – and will sell its products with its own. 


Sales

OSS Health (PA) chooses Strata Decision’s StrataJazz for decision support and financial planning.


People

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Alex Popowycz (Fidelity Investments) joins Health First (FL) as SVP/CIO. At least one site reported that he’s Health First’s first CIO, somehow forgetting Rich Rogers and then Lori DeLone, which takes us all the way back to 1995.

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Huron Healthcare hires managing directors Linda Generotti (Siemens Healthcare) and Lynn Grennan (University of Arizona Health Network), focused respectively on clinical operations and physician organizations.

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Greencastle Senior Management Consultant Troy Beane is promoted to Major in the Army National Guard. He earned the Bronze Star in 2009 as commander of Delta Company, 112th Infantry Division, while deployed in Iraq.


Announcements and Implementations

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Philips announces a tablet-based, subscription-priced ultrasound solution called Lumify, although its transducer isn’t available in the US yet.

CVS announces affiliations with Sutter Health and three physician groups that will receive patient visit and prescription information from CVS’s Epic EHR.

In Scotland, three life sciences companies – including revenue cycle solutions vendor Craneware – sign the Scottish Business Pledge partnership between government and business.

Health-related companies making Computerworld’s “Best Places to Work in IT” for 2015 are Lafayette General Health, Sharp HealthCare, Nicklaus Children’s Hospital, CHG Healthcare Services, Halifax Health, Kaiser Permanente, Medtronic, Children’s Hospital of Philadelphia, Genesis HealthCare, Humana, Adventist Health System, Cerner, OhioHealth, Cancer Treatment Centers of America, Palmetto Health, Intermountain Healthcare, McKesson, Carolinas HealthCare, and Cook Children’s Health Care System.

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Patient satisfaction scores at HealthAlliance of the Hudson Valley (NY) rose after its implementation of CipherHealth’s Orchid tablet-based nurse rounding application.

GetWellNetwork names the first two family engagement nurse scholar fellows supported by its O’Neil Center at the University of Pittsburgh School of Nursing.


Government and Politics

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Florida’s Agency for Health Care Administration will host a half-day symposium on healthcare IT on Friday, June 26, at 8 a.m. in Tallahassee. Speakers include folks from Tallahassee Memorial Hospital, Baptist Healthcare, the Department of Health, and HIMSS. The organizers tell me that interest is good (90 registrations vs. the original 75 cap) so it may turn into a full HIT Summit later this year.

The Department of Justice sues four Michigan hospitals (Hillsdale, Branch, ProMedica, and Allegiance) for illegally agreeing not to compete in each other’s territories.


Privacy and Security

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US healthcare organizations seem to be hardest hit by the password-stealing, difficult-to-detect Stegoloader trojan, which embeds much of its execution code inside photos. Security experts think hackers may be targeting healthcare, but my suspicion is that health systems just have a lot more people with limited technology skills using computers (and inadvertently launching malware) than do other industries.


Technology

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The New York Times ponders the questionable business motivation behind precision medicine and gene testing, highlighting a company that paid doctors $75 for each patient they enrolled and took in $130 million in Medicare money before CMS launched a review of the company’s billing practices, effectively shutting down the 800-employee Renaissance RX. The founders ran an earlier company that also earned Medicare’s death penalty for fraud. Critics say “enthusiasm outpaces evidence” as Medicare was paying for experiments rather than proven treatments. Healthcare wouldn’t get such a bad fraud rap if Medicare was better at performing due diligence before mailing out big checks – couldn’t they have figured out that the people already accused of fraud were involved in the new company?


Other

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Jenn interviewed newly installed AMA President Steven Stack, MD on HIStalk Practice. A snip:

Physicians are very frustrated with these systems, and then we’re very frustrated that the Meaningful Use program that we’re all subject to is overly prescriptive. It lacks flexibility where needed and has compelled us to purchase non-functioning tools to use them in ways that degrade our practice. Let’s not forget that more than half of Medicare physicians are being penalized by Medicare with a one-percent reduction in  compensation because the tools that we are given are so poor and the program the government created so rigid. Now we’re being punished for our inability to achieve what I think, if we really discuss it very openly, is a program that isn’t well designed and sets us up for failure. Needless to say, EHRs continue to be a challenge, and physicians are very frustrated that their input has been disregarded in ways that are injurious to the work we’re trying to do …  Health IT has been helpful and will be far more helpful when these records are actually interoperable. We’ve created digital silos that don’t share information any better than the old system where we had to have people send information via fax machine. If the federal government and software vendors would work much more attentively on making these things interoperable for those things that are of high use to us, I think that physicians would find a lot more joy from the tool than just the current reality where they contribute more misery than joy.

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Radiologist Dr. Dalai says radiologist leadership shouldn’t be pushing them to get closer to patients “as part of the team” in order to prove their value, adding that he’s not comfortable in showing up out of the blue to explain his findings when the patient expects to receive that news from their own doctor. He also wonders whether radiologists will “be told we killed Grandma” in trying to serve as gatekeepers in restricting medically questionable exams. He adds,

When a study comes through on my PACS, I could come running out of the reading room; seek out the patient; act like I’m his or her new best friend, playing a warm, fuzzy Marcus Welby (a TV doc from way back, sort of the opposite of House); and discuss the results of the test. Instant gratification! If you knew me personally, you would realize that I really am a warm, fuzzy, caring kind of guy. But when those radiographs come though on my PACS screen, I don’t know anything about the patient other than the two- or three-word history the physician has lowered himself to give me. If I should happen to have a functioning electronic medical record (a contradiction in terms), I might be able to get some lab values and maybe some additional history. But … I still don’t know the patients like the clinical doctors do. I haven’t talked to them, I haven’t touched them, and I haven’t examined them. So would I be doing them a favor by indulging the itch for an immediate answer? … My solution probably comes too late: Avoid joining anything resembling an ACO. You see, we radiologists do add value — with every single exam. Even a normal chest radiograph adds value, but it isn’t "sexy" and doesn’t increase our self-aggrandizement.

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Weird News Andy labels this widely reported story as “Smart Phone, Dumb Doctor.” A man hits “record” on his smart phone just before his colonoscopy begins so he can capture his doctor’s instructions. The playback reveals a “while you were sleeping” view of what anesthesiologist Tiffany Ingham, MD really thinks as she tells her sleeping patient, “I wanted to punch you in the face and man you up a little bit;” calls him a “retard;”makes fun of a rash on his penis; agrees to falsify the medical record in claiming the team provided post-procedure instructions; speculates whether the man is gay because he attended a previously all-women’s school; and tells staff she’s adding a diagnosis of hemorrhoids even though she saw no evidence of them. She suggests to the gastroenterologist that he pretend to receive an urgent page to avoid having to speak to the patient after the procedure, saying that she has done it before herself and adding, “Round and round we go, wheel of annoying patients we go, where it will land, nobody knows.” The man sued the anesthesiologist for defamation and malpractice and won, with the jury ordering her and her practice to pay $500,000. It wasn’t her lack of credentials – she is dual boarded (anesthesiology and internal medicine) and is a major in the Air Force Reserve, having been deployed short term to Afghanistan as a flight surgeon.


Sponsor Updates

  • Medicity offers “New survey identifies the state of cost control in hospitals, health systems and physician organizations.”
  • DocuSign offers “Yes, this crazy scribble is my signature. And I’m proud of it!”
  • Extension Healthcare offers “Market Trends: Survey Examines Nurse Call Communication Preferences.”
  • Galen Healthcare publishes “ICD-10 Clinical Documentation Improvement (CDI) – Now is the Time!”
  • Greenway Health offers a transparent and collective approach to politics.
  • Healthcare Data Solutions offers “Email Marketing Roundup: Which Metrics Should You Use?”
  • Healthfinch posts “AMA STEPS Forward to Address Provider Burnout.”
  • Impact Advisors offers “Healthcare CIOs Discuss Top Healthcare IT Optimization Strategies.”
  • HealthMedx will exhibit at the New York State Health Facilities Association Conference June 28-July 1 in Saratoga Springs.
  • EClinicalWorks will exhibit at the NATA 2015 66th Clinical Symposia & AT Expo June 24-26 in St. Louis.
  • Healthwise offers “Helping our employees be ‘healthy, happy, and wise.’”
  • Holon Solutions will exhibit at the TORCH Critical Access Hospital Conference & Tradeshow June 25-26 in San Antonio.
  • Iatric Solutions offers “Making Your EMPI solution work for you.”
  • MedData is named a 2015 Top Workplace by the Cleveland Plain Dealer.
  • NextGen parent company Quality Systems Inc. is recognized in eight categories of the 13th Annual American Business Awards program.
  • Navicure offers “How Can You Collect More From Your Patients?”
  • New York eHealth Collaborative will exhibit at Wearable Tech + Digital Health NYC 2015 June 30 in New York City.
  • Oneview Healthcare offers “Digital health revolution? Perhaps evolution better describes what’s actually going on.”
  • Experian/Passport Health will exhibit at the HIMSS Privacy & Security Forum June 30-July 1 in Chicago.
  • PDS IT offers “A Roles-Based Approach to Epic Security.”
  • PeriGen offers slides and materials from its AWOHNN presentation on “A New Way to Handle Checklists.”
  • PMD offers “Health Exchange Video: Style Boards.”
  • Qpid Health posts “Is NLP-Enabled Data Mining the Digital Breakthrough We’ve Been Waiting For?”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 25, 2015 News 3 Comments

News 6/24/15

June 23, 2015 News 4 Comments

Top News

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Google’s research division creates a prescription-only vital signs tracking wristband that will provide research-quality data for clinical trials. Testing of the device — which monitors heart rhythm, skin temperature, and environmental factors — will begin this summer and the company hopes to earn FDA approval.


Reader Comments

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From The PACS Designer: “Re: USB computer. The Intel Compute Stick can be used anywhere with a wireless keyboard and could be used in wireless more via the HDTV USB port.” The $150 USB gadget turns an HDMI-ready TV or monitor into a computer, with the Atom-powered Windows 8.1 version including 2 GB of memory and 32 GB of storage. Intel suggests such use as digital signage, home entertainment, or as a thin client. User reviews on Amazon are mixed, mostly complaining about slow performance, iffy Wi-Fi, the single USB port, and the limited storage capacity. You could get a Chromebook, Android tablet, or almost a low-end laptop (certainly a refurb) for about the same money and then you’d have the keyboard, monitor, and USB ports.

From Graham: “Re: your comment about the healthcare status quo stifling innovation with political influence and financial clout. Regulatory capture will deepen for the next five years. It’s going to be a very rough ride, particularly in the USA where money is so influential in government. But eventually the stink will become too great for the treasure to ignore and change will happen.” My theory is that no matter what change begrudgingly occurs, the same companies and people will end up with all the money, just like that economic theory that you redistribute the wealth of the world’s 100 richest people and they would have it back within 10 years. That’s OK as long as overall healthcare cost and quality is improved – we’re wasting untold fortunes on US healthcare,  so at least we should perform better or spend less.

From James: “Re: Cache database. InterSystems claims it’s the fastest object database. I’d like to substantiate that claim by trying out their benchmark, but have made an inquiry with no response. Do your readers have insights?”


HIStalk Announcements and Requests

I always forgot to observe HIStalk’s birthday, which I believe was June 6. I started writing it in 2003, so that makes it 12 years old.

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The folks at FormFast made a generous $1,000 donation to my DonorsChoose project, which was even more effective because of the matching funds provided by an anonymous health IT vendor executive (your company’s donation is welcome as well). I put the total $2,000 donation on the educational street quickly, as follows:

  • iPad Minis, math manipulatives, and write and wipe boards for a K-2 class in Lake Charles, LA.
  • Two Kindle Fires for small group math exercises in a Grades 5-6 class in New York, NY
  • A STEM bundle for a Grade 4-5 class in Glasford, IL.
  • A STEM bundle for a Grade 2-3 class in Knoxville, TN.
  • Electronics kits for STEM lessons for Grade 6-8 intellectually disabled and autistic students in New York, NY.
  • Wireless math manipulatives for a Grades 6-8 class in Shreveport, LA.
  • A STEM bundle for a Grade 5 class in Little Falls, MN.
  • Math games for an 8th grade class in Niagara Falls, NY.

Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

I’m running a summer special on both produced and promoted webinars since the industry is like a snoozing man in hammock for the next few weeks and I get antsy when it’s quiet. Sign up by July 31 and get a sizeable discount. Contact Lorre. We get good turnout — especially when companies take our advice about content, title, and presentation – and the ones we produce keep getting hundreds of views well after the fact from our YouTube channel. The record is held by the one Vince and Frank did on the Cerner takeover of Siemens, which has been viewed over 5,000 times.


Acquisitions, Funding, Business, and Stock

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Fantastically named Myelin Communications acquires Dodge Communications, which does quite a bit of public relations work for health IT vendors. That also pairs Dodge with an odd sibling – Duet Health, which sells patient engagement technology.

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Accretive Health, which has been on a financial rollercoaster and executive merry-go-round since its strong-arm patient collection techniques got the attention of Minnesota’s attorney general in 2011, lost $80 million in 2014 as net services revenue dropped nearly 60 percent.

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Aurora Health Care (W) takes a lead investor role in StartUp Health, giving it early access to digital health investment opportunities and technologies.

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Heal, which desperately wants to be Uber in offering $99 doctor house calls in Los Angeles in San Francisco, raises $5 million in funding for expansion. The company uses technology such as AliveCor ECG, CellScope otoscope, and electronic medical records.


Sales

St. Barnabas Hospital (NY) chooses Strata Decision’s StrataJazz for decision support.

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Dublin-based Beacon Hospital signs for Slainte Healthcare’s EHR, hoping to become Ireland’s first digital, paperless hospital. Hint: as in US “paperless” hospitals, the folks making the proclamation aren’t watching the pallets of paper coming in via the loading dock, the elimination of which would send the hospital into immediate chaos.


People

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McKesson names Kathy McElligott (Emerson) as CIO/CTO.

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Ed Kopetsky, CIO of Stanford Children’s Health, is presented with a lifetime achievement award from a Bay Area business publication group.

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Staff scheduling system vendor OpenTempo names Andy Comeau (Cerner) as CEO, with former President, CEO, and Co-Founder Rich Miller moving to chief strategy officer. Andy’s LinkedIn profile has an artistic but news-worthless long shot of him standing unrecognizably in front of a mountain (which I’m using above anyway to make a point), so perhaps it’s a good time to recite the LinkedIn photo rules: (a) use a professional head shot only, not one cropped out of a frat party group photo or police lineup; (b) post the photo in large size and high resolution so that news sites can use it without excessive graininess – LinkedIn will automatically thumbnail it so that clicking brings up the high-res version; (c) don’t get artsy-craftsy with a picture taken at a weird angle, with head or chin cropped out, or with a mountain in the background. LinkedIn is for business and profiles should include an appropriate photo, although mine doesn’t because the LinkedIn police made me take by Carl Spackler photo down (kudos to them for recognizing it, though).

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EXL names Scott McFarland (McFarland & Associates) as SVP/GM of its healthcare business.


Announcements and Implementations

McKesson releases Paragon Clinician Hub, a Web-based navigation and workflow tool, as part of Release 13.0. Also included in Release 13.0 is integration with Zynx Health’s ZynxOrder order set management.

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Peer60’s revenue cycle management report finds that CFOs are worried about value-based payment models and are anxious to reduce capital spending and IT costs. A pessimistic 14 percent of respondents say value-based payments will “bankrupt us,” while the roll-up-our-sleeves types are focusing on ICD-10 migration, improving the patient experience, and improving point-of-sale collection.

ZirMed announces a Denial and Appeals Management solution.

Nuance will include data analytics from Jvion in its Advance Practice Clinical Documentation Improvement to compare clinical documentation to payments and quality scores.

T-System joins the CommonWell Health Alliance.

A statistically lacking HIMSS survey of health information organizations (75 responses) finds that Direct messaging is popular for care coordination, but connectivity to EHRs isn’t great.


Other

Orange County (CA) Health Care Agency requests double its original estimate of $796,000 to complete the second phase of its Cerner behavioral EHR project for mental health patients, with the total project cost increased to $8.8 million.

The Providence, RI newspaper observes that less than 15 percent of the state’s physicians use the state’s HIE, which cost $25 million in federal money plus the state’s cost. A representative from the state medical society says, “It will make docs’ lives easier eventually, but so far, it’s only made insurance companies and EHR companies happy.”

The American Society of Clinical Oncology publishes a formula to assess the cost vs. benefit of new cancer drugs, the first step in developing software that can be used by oncologists at the point of care. One drug that costs nearly $10,000 per month in generating $2.8 billion per year for its manufacturer scored a zero in net health benefit.

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Weird News Andy says, “You CAN handle the truth” in describing the $13 bacteria-killing door handle invented by two Hong Kong high school students. WNA also proclaims “strangling her legs” in describing a case study of a woman with temporary leg nerve and tissue damage caused by squatting too much in her skinny jeans, which were so tight doctors had to cut them off.


Sponsor Updates

  • ZeOmega posts “Payer/Provider Collaboration: What Works?”
  • Coalfire Systems analyzes the security of InstaMed’s healthcare payment solutions and concludes that they “have the most effective data security controls available in healthcare today.”
  • Experian Health partners with two companies to offer healthcare organizations a credit card processing device that meets the October 1 deadline for implementing EMV chip-authenticated credit card standards.
  • AirStrip offers “Shifting Our Thinking to Prepare for the Future.”
  • Besler Consulting offers a podcast on the “QualityNet Hospital-Specific Report.”
  • Clinical Architecture offers “Understanding ICD-10-CM – Part III – A Terminology by the Book.”
  • Atlanta public radio highlights Clockwise.MD in “Local App Reduces Time Spent in Urgent Care Waiting Rooms.”
  • Gartner positions Commvault in the Leaders quadrant of the Magic Quadrant for Enterprise Backup Software and Integrated Appliances.
  • CoverMyMeds offers “Proactive, Analytical and Interoperable Trends Affecting Today’s EHR Systems.”
  • Culbert Healthcare Solutions offers tips for “Allscripts Upgrade Services.”
  • AirWatch offers “Virtual Training Experience available with AirWatch Labs.”
  • Burwood Group is named one of “Chicago’s Best and Brightest Companies to Work For.”
  • Anthelio Healthcare Solutions will exhibit at the 2015 TxHIMA Convention June 28-30 in San Marcos, TX.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 23, 2015 News 4 Comments

Monday Morning Update 6/22/15

June 21, 2015 News 5 Comments

Top News

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The Federal Aviation Administration wants to connect its Amsis pilot medical certification tracking system to government EHRs via NHIN and HIE connectivity, hoping to detect safety-endangering medical conditions such as the depression of the Germanwings pilot who deliberately crashed his plane into the French Alps. The privacy considerations would be extensive.


HIStalk Announcements and Requests

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More than half of poll respondents don’t use any smartphone health apps other than fitness trackers, although 17 percent say they use five or more. New poll to your right or here: do Sittig and Wright’s EXTREME criteria (defined here) accurately define EHR openness and interoperability? If you vote no, it’s only fair that you click the poll’s Comments link to describe what they missed.

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Welcome to new HIStalk Gold Sponsor Dbtech. The Edison, NJ based document management, electronic forms, and document imaging company offers solutions for document and data archive, paperless registration, patient portal, reporting standardization, and no-silo storage of images. Dbtech’s Ras document management is installed in 350 community hospitals and works with all applications (Cerner, Epic, Meditech, etc.) regardless of hardware, OS, or database and contains workflow automation for SmartLinks, data extraction, AutoPrint, forms, email workflow, and HL7 and other integration standards. Case studies include Saint Michael’s Medical Center, Greenwood Leflore Hospital, Palisades Medical Center, and Mount St. Mary’s & Evangelical. Thanks to Dbtech for supporting HIStalk.

Listening: The Struts, British 1970s-style hard rockers that sound to me like Queen genetically spliced to The Hives and Quiet Riot.

My latest grammar gripes: Yelp restaurant reviewers who talk about their “palette” when referring to their “palate,” almost as annoying as those who didn’t realize the 15-minute shelf life of the trite phrase “to die for” ended years ago. People who needlessly insert “very” in front of words or phrases. Unskilled writers who ask their imaginary readers questions and then answer them instead of just making an authoritative statement in the first place, such as “Do we need ICD-10? Yes.” instead of saying “We need ICD-10.” Starting a sentence with “know,” in a pompous attempt at conveying sincerity, as in “Know that we will support our employees” instead of simply saying, “We will support our employees.” It also bugs me that people still think “the reason why” is somehow better than the correct “the reason.”


Last Week’s Most Interesting News

  • England’s NHS announces ambitious health IT plans that include making real-time medical records available to patients by 2018 and issuing wearables for inpatient monitoring. NHS also goes live on its new e-referral service and then shuts it down almost immediately for an undetermined time due to known problems.
  • Dean Sittig and Adam Wright propose EXTREME, five criteria that define whether a given EHR is open and interoperable.
  • The draft budget submitted by the House Appropriations Committee holds ONC’s funding flat, does not include money for ONC’s proposed Patient Safety Center, and calls for AHRQ to be shut down immediately.
  • CVS opens a Boston digital innovation center that will eventually house 100 employees, while the company also announces that it will acquire Target’s pharmacy business for $1.9 billion.
  • HHS OIG finds that the federal government is paying many billions of dollars in insurance subsidies based purely on estimates since CMS still hasn’t finished the software modules that are needed to calculate the amounts correctly.
  • The VA announces a three-hospital pilot of its open source, open system eHMP integration tool that allows VA clinicians to view context-aware information from non-VA systems such as the DoD’s EHR. Meanwhile, a GAO report that details the delays and cost overruns of high-risk federal government IT projects points out the repeated, expensive failure of the VA and DoD to integrate their EHRs.
  • CHIME co-founder Rich Correll announces his retirement.

Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.


Acquisitions, Funding, Business, and Stock

Virtual nurse technology vendor Sense.ly raises $2.2 million in a Series A funding round.

Investors who invested $50 million in preferred shares of Merge Healthcare to finance its February 2015 acquisition of DR Systems waive their right to have Merge redeem their shares by August 25, 2015, a vote of confidence that their hastily made investment is still attractive post-acquisition.


Sales

Fairview Health Services (MN) chooses Paragon Development Systems (PDS) for IT end user device asset management.

HealthShare Exchange of Southeastern Pennsylvania chooses Mirth solutions for Direct messaging, integration, MPI, and CDR.


Announcements and Implementations

SSI Group will resell Recondo Technology’s automated claims status solution as part of its revenue cycle solution suite.


Government and Politics

The State of Virginia notifies providers that not only must they be ready for the October 1, 2015 switchover to ICD-10, but also that the state will simultaneously stop using of the similar but separate DSM codes for mental disorders.

CMS awards Data Computer Corporation of America a $24 million contract to support the IT system that supports payout of Meaningful Use money.

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A union representing the Pittsburgh VA, trying to gain bargaining power, says implementation of an inventory management system from Shipcom Wireless is stressing out its members. The system, which is being rolled out to all 152 VA hospitals in a contract worth up to $275 million signed in September 2013, is already live in 12 VA hospitals.


Privacy and Security

A clerk at Montefiore Medical Center (NY) is charged with selling 12,000 patient records for $3 each to co-conspirators who used the information printouts to go on luxury shopping sprees. It’s interesting that hospitals always seem to be involved in this kind of breach while retailers aren’t – maybe hospitals are different in their security precautions, hiring practices, breadth of information collected, or employee oversight.


Technology

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NTT Data not only sponsors Chip Ganassi’s IndyCar racing team, but provides it with technology ranging from inventory tracking to a wearables device being created by the company’s healthcare division that will monitor the driver’s physiology. I’m suddenly struck by yet another fantastic business idea, of which surely one of mine will pan out one day: sell ad space on the white coats of doctors like NASCAR does its driver fire suits, where every available inch features the emblem of a paying sponsor. Uber could do the same, paying contract drivers to turn their cars into rolling ad space.

Mechanical engineering students at Johns Hopkins University develop a tamper-resistant, biometric-secured, one-at-a-time pill dispenser, which assures that pharmacy-dispensed drugs like oxycodone are used only by the intended patient.


Other

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Nebraska Medicine announces its use of Epic’s MyChart on Apple Watch, allow its patients to receive provider messages, appointment reminders, medication information, new results availability, and notification that earlier appointments are available so the patient can accept the proposed time directly from the watch.

I think Vince Ciotti misses writing his HIS-tory series that I ran for a couple of years, as evidenced by this new episode that looks back on the buyer seminars his company has been putting on since the good old days.

A Harvard Business Review article says personalized technology such as wearables and apps that provide continuous monitoring will transform healthcare in the next 10 years, with help from telemedicine, home diagnostics, and retail clinics. The authors say the two business models will be (a) gold miners (insurers, and health systems) that will dig deep in successfully managing patients with expensive chronic conditions via care coordination and monitoring, and (b) bartenders (new healthcare entrants) that will empower consumers with advice and information that bypasses the doctor-patient relationship. Goldminers might approach an atrial fibrillation patient with an app-driven monitoring program administered by a clinical care team, while Bartenders would sell tracking apps that suggest interventions, provide reminders, and let the user retain and interpret their own data.

I’m not sure I see things quite that way since app-empowered healthcare consumers will still make up a tiny percentage as quantified selfers. I expect health systems to use their market share and profits to chase away nimbler competitors and steer consumers away from them in creating fear, uncertainty, and doubt that those upstarts aren’t proven or local like the impressive, comfortingly bureaucratic edifice down the street. Consumers will exercise choice only where they discern little differentiation,using convenient retail clinics and video visits for obvious and self-limiting conditions where all that’s really needed is reassurance and possibly a prescription. Health systems will create narrow networks and manipulate quality and satisfaction metrics so that confused, low-expectation consumers will simply keep going to whatever provider they’re told. Chronic conditions will be much better managed by technology because providers will be paid specifically for outcomes, which is one bright spot, and while companies may well do an end-run around the doctor-patient relationship (which is rapidly eroding anyway), they won’t be able to crack the health system-patient relationship. Any effort to upend the status quo will be squelched via lobbyist influence and deep war chests unless health systems, doctors, drug companies, insurers, and device manufacturers are somehow turned on each other, which is less likely now that employers are bowing out of the healthcare war and leaving their employees to fend for themselves. There’s no equivalent to “changing healthcare” except perhaps “changing government” and the folks running both aren’t going to just step aside.

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The San Diego paper profiles 20-employee Humetrix, which along with iBlueButton has developed Tensio, a blood pressure management app that uses information from Apple HealthKit-attached devices.

A New York Times article examines more rapid treatment of heart attacks, with technology earning modest credit: ambulances that can send EKGs to hospital EDs and hospitals using paging systems to assemble response teams quickly. The article seems to confuse heart attack deaths with deaths from heart diseases, however.

The local paper, skeptical of Hartford HealthCare’s (CT) claim of financial distress that requires it to eliminate over 300 positions, notes that the health system paid it top 18 executives $12.8 million in 2013, with bonuses averaging $135K each. The CEO made $2.1 million, while the CIO took home $630K.

Bizarre: Chinese citizens anxious to unload shares as the country’s stock market plunged last week include a woman who crashed her car while executing trades on her smartphone and another who sold her portfolio from her iPad while medicated and laboring in a hospital’s delivery room.

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Weird News Andy is happy to hear that AIDS, SARS, MERS, and Ebola have been cured thanks to North Korea’s Great Leader Kim Jong-un, who claims to have created a miracle drug from ginseng and other ingredients he declines to name, to which WNA adds, “It’s a floor wax AND a dessert topping!”


Sponsor Updates

  • Experian posts “Using Data to Manage the Cost of Healthcare” and a video titled “Healthcare Data Diagnosis: Using Data to Manage the Cost of Healthcare.”
  • Nordic offers a new episode focusing on technical cutover in its “Making the Cut” video series.
  • Orion Health publishes an “AHIP 2015 Recap: It’s all about the Consumer, Transparency, Interoperability and Data Exchange.”
  • Experian / Passport Health offers “Using Data to Manage the Cost of Healthcare.”
  • Patientco explains “Where to Find Patientco at HFMA ANI 2015.”
  • PatientPay offers “How Many More Reasons Do You Need?”
  • Washington Hospital Services will offer ZeOmega’s Jiva HIE-enabled population health management solution to its members.
  • NVoq offers “The EMR Journey to Optimization and Innovation.”
  • Phynd will exhibit at the 2015 Annual Physician-Computer Connection Symposium June 23-25 in Ojai, CA.
  • PMD offers “Three Lessons Your Baby Will Teach You About Software Implementations.”
  • Streamline Health will exhibit at the 2015 AMDIS Physician-Computer Connection Symposium June 24-26 in Ojai, CA.
  • Greenway Health highlights its partnership with Talksoft.
  • TeleTracking offers “From Patient Flow to Real-Time Operational Management.”
  • Verisk Health publishes “Gearing Up for VHC2015.”
  • Voalte discusses digital health and wearables in “Let’s pick up the pace.”
  • Huron Consulting posts pictures of its work with Sea Island Habitat for Humanity.
  • Xerox Healthcare offers “Three Ideas That Will Make Healthcare Work Better.”
  • Zynx Health comments on the Medicare Shared Savings Plan ACO final rule.

The following HIStalk sponsors are exhibiting at HFMA ANI June 22-25 in Orlando:

  • ADP AdvancedMD
  • Allscripts
  • Besler Consulting
  • Billian’s HealthDATA
  • Craneware
  • Experian/Passport Health
  • GE Healthcare
  • Greenway Health
  • Health Catalyst
  • Ingenious Med
  • InstaMed
  • Legacy Data Access
  • Leidos Health
  • MModal
  • McKesson
  • Medecision
  • Medhost
  • Navicure
  • NextGen
  • NTT Data
  • Nuance
  • Patientco
  • Peer60
  • Recondo Technology
  • Relay Health
  • Sagacious Consultants
  • SSI Group
  • Strata Decision Technology
  • TransUnion
  • TriZetto
  • T-System
  • Valence Health
  • VitalWare
  • Wellcentive
  • Xerox
  • ZeOmega
  • Zynx Health

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 21, 2015 News 5 Comments

News 6/19/15

June 18, 2015 News 9 Comments

Top News

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England’s NHS makes tech announcements: commits to giving patients real-time access to their entire electronic medical record by 2018, ambulance services will also be connected electronically to hospital EDs. NHS is also looking into the possibility of making all of its facilities free Wi-Fi zones and rolling out wearables to patients for in-hospital monitoring. Other proposed projects include endorsement of third-party health apps, providing technology training to citizens, and adding learning disability and dementia status flags to the Summary Care Record. Patient digital services will be delivered via the NHS Choices website. The announcements were made at the National Information Board meeting, taking place at Kings Fund Digital Health Congress 2015 in London (if you are attending, HIStalk sponsors TeleTracking and  Orion Health are exhibiting).


Reader Comments

From Not in Monterey: “Re: 3M’s coding product. Our hospital system was told they will update their product just weeks before the ICD-10 implementation date. I find this to be insane. I would be interested to hear if users of large EHR systems are receiving endless dribbles of code fixes for ICD-10 even now since we are experience this with Cerner.”


HIStalk Announcements and Requests

It’s that time of year when schools are out and health IT news is slow, so we can all enjoy a slight break until September.

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Response has been excellent to “What makes an EHR ‘open’ or interoperable?” as published in JAMIA and summarized by the authors on HIStalk. Dean Sittig and Adam Wright wrote the original article after I challenged someone other than vendors to define what “open” and “interoperable” really mean since vendors have turned those terms into meaningless marketing froth (former Allscripts CEO Glen Tullman was easily the worst offender for repeatedly stating that all of the company’s mixed-ancestry EHRs are open and interoperable by definition since they all run on Microsoft SQL databases). Most notable to me is that nobody has challenged the definition proposed by Sittig and Wright, so they seem to have captured consensus. I have ideas about where it could go from here:

  • Assess the three DoD EHR bidders – Epic, Cerner, and Allscripts – on just how open and interoperable their systems are since DoD claims it wants an EHR with those characteristics for our $11 billion taxpayer investment.
  • Ask the top EHR vendors, hospital and ambulatory, to provide a live customer example of being able to perform each of the five items in a real-world environment (extract information in an understandable form, send information to another EHR, accept real-time information requests and return structured information, move all of a customer’s patient records to a new EHR along with metadata and a data dictionary, and open up access to its systems using programmatic, secure APIs).
  • Athenahealth complains and/or brags the most about openness among EHR vendors. Let’s see the company throw down against its competitors using these measurable criteria. That should raise visibility and give Jonathan Bush something fun to talk about.
  • Ask the top EHR vendors to state in writing that they don’t limit openness and interoperability via contract terms that require developer certification, non-disclosure terms, license fees for outside access, custom programing, or documentation fees. As proof, let’s see their most recent signed customer contract.
  • Challenge vendors to publish where they stand on each item or their plans to achieve all five.
  • Turn the list into a layperson-friendly version that could be used by Congress and other interested political bodies, perhaps inviting the authors to testify at the HELP subcommittee hearings.
  • Add the criteria to EHR certification.
  • Further expose the criteria and how prospective EHR customers can evaluate vendor performance against them via ONC’s publicity and informational offerings, including ONC-produced contract boilerplate that prospect customers can insist vendors include.

The industry tends to get too deep into semantics when it comes to the technologies that can support openness and interoperability. These criteria leave the technology out of the picture and instead focus on outcomes – systems can either do these things or they can’t no matter what the marketing people say.

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I mentioned the other day that Twitter is expanding the character limit on direct messages from 140 to 10,000, which several readers (including Dr. Jayne) misread that to mean that all Twitter messages can now be that length. Direct Messages are the ones where you tweet someone privately using the Direct Message option, which is possible only if they follow you (although I remember joking years ago that if Twitter ran into revenue problems, which seemed inevitable, they could offer a premium membership that expands the tweet box to more characters, knowing that the verbose among us wouldn’t be able to resist). Expanded Direct Messages give Twitter at least a theoretical messaging tool to compete with similar offerings by Facebook and LinkedIn, although the limitation of all three is that unlike email, you can’t message anyone who hasn’t already connected with you, which is often the reason you want to contact them in the first place.

This week on HIStalk Practice: ThoughtWorks partners with Save the Children to develop EHR for infectious-disease outbreaks. ONC releases massive data set on every meaningful user. Quest Diagnostics Care360 EHR ranks high with small physician practices. MyIdealDoctor announces new funding. PAA survey reveals physician frustration with EHR charting and loss of productivity. Young female PCPs show the ACA some love. Federation of State Medical Boards CEO Humayun Chaudhry, DO discusses next steps for the Interstate Medical Licensure Compact.

This week on HIStalk Connect: the FDA partners with online support group vendor PatientsLikeMe to use its database of patient-reported adverse drug events to improve the FDA’s post-market surveillance programs. Telehealth vendor Doctor On Demand raises a $50 million Series B, while Aledade, Farzad Mostashari’s new startup, raises a $30 million Series B. Apple patents a new approach to calculating resting heart rate that should solve many of the problems users are experiencing with the Apple Watch.


Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.


Acquisitions, Funding, Business, and Stock

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Hospital bed maker Hill-Rom will acquire point-of-care device manufacturer Welch Allyn for $2 billion. Both companies offer technology products, with Hill-Rom selling tools for asset tracking, hand hygiene, staff locating, nurse call, fetal monitoring, and patient safety.

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Xconomy profiles Madison, WI-based prescription refill management platform vendor Healthfinch, which has raised $3 million in funding since 2011 and has grown from four employees to 21 in the past 18 months.

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Allscripts, which in November 2014 was ordered to pay $9.7 million to Etransmedia for deceptive trade practices after a failed business relationship, petitions North Carolina to deny Etransmedia’s request for further litigation that Allscripts says would cover issues that have already been resolved in arbitration. The November arbitration panel ruled that Allscripts convinced Etransmedia to buy MyWay EHR licenses for resale via a Costco Wholesale program but then “deliberately sabotaged” Etransmedia’s sales by retiring MyWay in October 2012, sticking Etransmedia with millions of dollars in unsold licenses.

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In an “only in America” major medical advance, Botox maker Allergan will pay $2.1 billion to buy Kythera Biopharmaceuticals, which just won FDA approval to sell an injection that eliminates double chins, which the company previously estimated as a $500 million per year US business. Allergan offers a number of cosmetic drugs and hopes Kybella will bring women into doctors’ offices for cross-selling opportunities. As a bonus, the money-losing Kythera is also developing a baldness drug. The smart money (like Allergan’s) is that doctors will ignore Kybella’s specific indications and start shooting it indiscriminately into cellulite-laden thighs and butts. KYTH shares are up 91 percent on the year and 209 percent in five years.

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Video visit provider Doctors On Demand, which offers $40 medical consultations, closes $50 million in a Series B funding round.


Sales

Recondo Technology announces sales of its patient access and business office solutions to University of Virginia Health System (VA), Northside Hospital (GA), and Hannibal Regional Healthcare System (MO).

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Dayton Children’s Hospital (OH) chooses Phynd to manage 7,000 providers across its EHR and other systems.

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Legacy Health (OR) selects GetWellNetwork’s interactive patient care system.


People

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Health Data Specialists names David Astles, PhD (Encore Health Resources) as VP of revenue cycle.

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Regional Medical Center (AL) promotes Pete Furlow to CIO.

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Deven Mcraw (Manatt, Phelps & Phillips) joins HHS’s Office for Civil Rights as deputy director for health information privacy.

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Healthline hires Paul Clip (RelayHealth) as SVP of engineering for its health IT group.

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The HCI Group promotes Cynthia Petrone-Hudock to president of international business. I interviewed her a few months ago.

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CHIIME co-founder Rich Correll announces his retirement, with accolades from industry long-timers that include John Glaser, Bill Spooner, Rich Rydell, and Larry Grandia. His LinkedIn profile lists his occupation as “senior old guy.”


Announcements and Implementations

Premier introduces Quality Cycle Management, a SaaS and services offering that helps health systems recognize areas of clinical outcomes that are reducing their CMS payments under value-based purchasing.

Huntzinger Management Group launches a big data consulting service called V6 Data Analytics.

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Practice Fusion releases native iOS and Android tablet versions of its free EHR.

Grant-funded and volunteer-led Games for Health will co-locate its annual conference with HIMSS’s mHealth Summit in December. 

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Planned Parenthood pilots an app that lets California users order a $149 at-home urine test for chlamydia and gonorrhea, and if the mailed-in urine samples are positive, the user is notified via the app and is issued either an electronic prescription or an appointment prompt, respectively. The organization already offers residents of Minnesota and Washington app-based video consultation by which users can receive birth control and sexually transmitted disease test kits.

@Cascadia notes that Providence Home Health (WA) is offering Seattle-area house calls for $99, scheduled online and prepaid by credit card.

GE Healthcare will move customers of its patient flow solutions to those offered by TeleTracking in a newly signed collaboration agreement that also includes shared analytics.


Government and Politics

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A draft budget by the House Appropriations Committee would fund ONC at $60.4 million, the same as it received in FY2014 versus the $75 million requested by the White House. No funding is proposed for ONC’s Patient Safety Center. The draft also calls for AHRQ to be shut down immediately. The Republication-majority committee’s first bullet point in announcing the funding bill is to “stop the implementation of ObamaCare.”

Joe White, the former CFO of Shelby Regional Medical Center (TX), is sentenced to 23 months in federal prison and is ordered to replay $4.5 million to CMS for falsely attesting to Meaningful Use for his for-profit hospital owner employer, whose facilities received $16 million in total MU payments.

The Department of Justice conducts what it says is the largest Medicare fraud take-down in history, with charges of $712 million in false billing filed against 243 people, of which 46 are licensed professionals. Among the charges: paying and receiving kickbacks, coaching patients to appear eligible for services, a physician home visit company that billed $43 million for a single doctor, providing medically unnecessary wheelchairs, billing for services not performed, and mailing $38 million worth of talking glucose monitors to people who didn’t ask for them. The splashy announcement is probably intended to make criminals think twice before committing Medicare fraud, but I can’t imagine a more compelling incentive than the agency happily writing a single doctor $43 million in checks before finally catching on that something wasn’t quite right.


Innovation and Research

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CVS, fresh off this week’s announcement that it will buy Target’s pharmacy business, opens a digital innovation office in Boston’s Back Bay to increase access to tech talent and to foster collaboration with local providers and startups. CVS already has 40 people working from the new office and expects to top out at 100 employees. VP of Digital Strategy and Innovation Andrew Macey says the projects will always be prototyped and marketed within one year, adding that CVS is opening up its systems with APIs and is also studying how streams of wearables data can be used to help people get healthier.


Technology

Sprint is forced by new net neutrality laws to stop throttling back customer cellular data bandwidth during busy periods, quickly reacting to the news that FCC will fine AT&T $100 million for misleading customers by selling unlimited data packages but capping their data speeds after 5 gigabytes in a billing period.


Other

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In England, hospital executives admit that they should have paid more attention to the concerns of a 19-year-old cancer survivor instead of telling her to stop Googling her symptoms. She died of cancer 10 days after being admitted, with her family complaining that during her stay, she was not given pain relief, referrals were delayed, and doctors were “evasive and aloof” when the family tried to gather information. The hospital has enlisted her mother to help it improve (or at least to improve its image).

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Also in England, the NHS’s new e-referral system has been taken offline “until further notice” days after its launch after several of its known problems were deemed to be unfixable on the fly.

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The former pharmacy director of Beth Israel Hospital (NY) pleads guilty to stealing 200,000 oxycodone tablets worth $5.6 million on the street by falsifying entries in the hospital’s electronic narcotics inventory system.

What’s ugly about US healthcare in a nutshell: lawmakers argue over the decision by Yale New Haven Health System to close two clinics, with the hospital blaming lower Medicaid payments and higher state taxes, while opponents say the health systems uses anti-competitive practices and opportunistically timed state budget political pressure to support its huge profits and million-dollar executives.  It’s fascinating to me that Connecticut in 2012 starting charging hospitals a new tax worth $350 million, which earned it an extra $200 million from the federal government, and then the state gave the hospitals back their $350 million plus another $50 million in vig, keeping $150 million for itself by beating federal taxpayers in a financial shell game.

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Two labor unions sling arrows at each other in trying to gain power over Kaiser Permanente workers, with upstart union NUHW claiming that SEIU-UHW gained Kaiser concessions by blocking whistleblower protections and agreeing to drop ballot measures that would have capped hospital prices and executive paychecks. Consumers lose just about any way you look at it.

Bizarre: hearings continue in the negligence lawsuit brought by a fan of the Kansas City Royals, who claims that in 2009 he was permanently impaired when the baseball team’s former mascot threw a foil-wrapped hot dog while the man was looking at the scoreboard, striking him in the eye and detaching his retina. The lawsuit is in its fourth inning, having already been heard with inconsistent verdicts in three rounds of courts.

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Weird News Andy says DNR might stand for “Do No Rong” as nurses in England allow an inpatient to die because someone forgot to remove a previous bed occupant’s “do not resuscitate” sign.


Sponsor Updates

  • DocuSign CFO Mike Dinsdale is recognized as the 2015 Bay Area CFO of the Year for Emerging Business.
  • Healthgrades releases a white paper on robotic-assisted surgery clinical outcomes in women’s care.
  • Extension Healthcare will exhibit at the 15th Annual Healthcare Summit Disruptive Forces in Healthcare June 22-23 in British Columbia.
  • FormFast offers “4 ways to improve efficiency in multi-facility hospitals.”
  • Galen Healthcare offers “Successfully Attest for Meaningful Use While Simultaneously Converting to a New EHR.”
  • GE Healthcare General Manager of Monitoring Solutions Didier Deltort explains how the demand for digital talent will change the healthcare job market.
  • Hayes Management Consulting offers “It’s Almost October 1. Do You Know Where Your Documentation Is?”
  • HCS will exhibit at the 2015 Long-Term and Post-Acute Care Health IT Summit June 21-23 in Baltimore.
  • The HCI Group offers a new white paper, “ICD-10 Health Plans: Essential Elements for Effective Testing Strategies.”
  • Healthcare Data Solutions publishes “Health System Pharmacists: 4 Ways to Solve Ethical Dilemmas.”
  • HealthMedx will exhibit at the New York State Health Facilities Association Conference June 28-July 1 in Saratoga Springs.
  • Iatric Systems will exhibit at the NCHICA AMC Conference on Securely Connecting Communities for Improved Health June 22-24 in Chapel Hill, NC.
  • Influence Health offers “Why Mobile Should be the Greatest Priority in Your Online Marketing Strategy.”
  • Healthfinch offers “Mission is Great, but Execution Matters.”
  • Intellect Resources offers “Resume Writing Secrets from a Recruiter.”
  • InterSystems and Intelligent Medical Objects will exhibit at the AMDIS 2015 Physician-Computer Connection Symposium June 24-26 in Ojai, CA.
  • Legacy Data Access helps over 175 hospital systems comprising 1,100 facilities retire their healthcare data.
  • Healthwise will exhibit at the CMSA 25th Annual Conference & Expo June 23-26 in Orlando.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 18, 2015 News 9 Comments

News 6/17/15

June 16, 2015 News 2 Comments

Top News

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An HHIS OIG report finds that the federal government has paid Healthcare.gov insurance subsidies since January 2014 even though CMS hasn’t finished the software module that verifies the payments owed. Insurers are still submitting estimated claims that the government pays even though it can’t verify their accuracy or whether the enrollees have paid their share of the premiums. CMS sent checks for $2.8 billion in just the first four months of 2014, the period OIG audited.  


Reader Comments

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From Levi Kittycat: “Re: University of Virginia. Leaving Sunquest and going with Epic Beaker for lab over the next 2-3 years.” UVA posted a Beaker trainer job a few weeks back, so I assume they are indeed going in that direction. I did a quick search and found Beaker analyst positions recently listed at ThedaCare, Stanford, Duke, University of Colorado, PeaceHealth, Sanford Health, UTMB, Thomas Jefferson, OhioHealth, Wellmont, and others. The best-of-breed LIS vendors had better jump quickly onto genomics and personalized medicine before the customer demand for integrated systems shuts them out despite the complaints of the lab people who like having their own systems.

From Ed Hocken: “Re: MModal. Announced in an internal email that chief scientist and co-founder Juergen Fritsch will leave to pursue ‘personal interests.’” Unverified.

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From Willow: “Re: Xerox Midas+. Developers have been ordered to work weekends for no extra pay to try to finish development of the in-house replacement for 3M’s APR-DRG coding, which has been dropped to save $3 million per year and must be finished by August.” Mandatory overtime indicates a management failure in overcommitting and underfunding resources assigned to unprofitable work (if it was profitable, they would happily bring in more help). My short stint with a failing vendor many years ago involved the occasional mandatory work weekends, with our clueless leadership exhibiting complete indifference to the family and religious activities they were disrupting through their ineptitude. However, the free market works – if the employees have better options, they are free to seek them (as did quite a few of the best folks at the vendor I worked for). You would hope that the work flexibility extends in both directions so that employees don’t have to burn PTO for occasionally leaving early or taking a long lunch for an appointment (such as a job interview with a better company). I wouldn’t be thrilled with working every Saturday for a few weeks, but it could be worse – at least it’s for a finite product delivery event rather than just offsetting ongoing inadequate staffing.

From NewHavenNighthawk: “Re: Yale New Haven. Big IT management shakeup – Ed Fisher is out and Jimmy Weeks is in.” Former YNHH VP/CTO Ed lists his current LinkedIn position as of May as being in that “between-jobs limbo” of freelance consultant.

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From Ben Dover: “Re: Providence Health & Services IT. The former COO and chief of technology and service operations is leaving and his position eliminated after a number of failed projects and clinical system outages. IT has struggled to execute on the system’s affiliations and acquisitions, leading to rumors that it will revert back to the regional model.”


HIStalk Announcements and Requests

My latest gripe: sites that headline stories with Batman-like verbs (Kapow! Powie!) in describing companies that “snag” funding or hackers that “swipe” data. They probably get their coveted clicks for their low-expectation advertisers, although from readers who quickly abandon the story (and possibly the site) after realizing they’ve been baited one time too many by inexpertly written, non-clickworthy stories that were all sizzle and no steak.

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Mr. S sent photos of his South Carolina classroom of profoundly mentally disabled K-5 students, for which we provided (via DonorsChoose and matching funds from Publix) baby wipes, diapers, a blender for preparing food (some of his students can’t eat otherwise), and insect repellent so the kids can participate safely in Special Olympics. 


Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.


Acquisitions, Funding, Business, and Stock

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CVS buys Target’s money-losing pharmacy business – which includes 1,660 drugstores and 80 in-store clinics – for $1.9 billion. CVS will rebrand the departments as CVS/pharmacy and MinuteClinic. CVS and Walgreens are pulling away from the drugstore chain pack in footprint, technology, and revenue as they diversify traditional drugstore offerings into providing extensive health services in convenient locations. I would expect grocery stores that operate in-store pharmacies (Kroger, Safeway, Publix, and possibly even Sam’s Club and Costco) to pay attention since running increasingly complicated pharmacy businesses isn’t their core competency. 

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Forward Health Group moves to a new headquarters location in Madison, WI.

Big insurance companies take acquisition aim at their smaller competitors that are still worth dozens of billions of dollars, with UnitedHealth hoping to acquire Aetna, Aetna eyeing Humana, and Anthem and Cigna performing a mating ritual. Reasons: (a) declining employer-provided insurance in favor of exchange and government plans; (b) the need to improve bargaining position with big and expensive market-dominating health systems; and (c) the rise in value-based care.

Former National Coordinator Farzhad Mostshari, MD’s ACO startup Aledade raises $30 million in a Series B round. It will be interesting to watch as heavier investments and the mandatory outsider board seats they require set up a potential clash between idealism and capitalism and the ongoing need for the founder to keep investors and the board happy. The industry rags are covering the story like it’s breaking health IT news, but other than Farzhad’s former job and Aledade’s somewhat related need to assemble information from its physician EHRs, it’s not all that relevant to healthcare IT in general.

CTG will take a $0.09 Q2 earnings charge after failing to convince payers to buy its end-stage renal disease management system that cost over $1 million to develop. CTG will also lay off the non-billable employees working on the product and has revised its Q2 and full-year earnings guidance down sharply. CTG is also considering selling its Buffalo, NY headquarters building. CTG shares are down 48 percent in the past year, valuing the company at $147 million.


Sales

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Millinocket Regional Hospital chooses Medhost’s emergency department information system.

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Florida Hospital Physician Group (FL) chooses Smartlink Mobile for its Medicare Chronic Care Management services, billing for which at $40 per patient per month requires clinical information exchange, management of care transitions, creation of a patient-centered care plan, and patient access to electronic communication.

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Westchester Medical Center Health Network (NY) signs a $500 million deal with Philips for consulting services and medical technologies that “gives us access to the latest in connected digital health technologies, it will be allow us to collaborate on proactive health management and co-create new patient-centered models of care for the Hudson Valley area.” It would be fascinating to see how the actual agreement matches up to the lofty statements in the announcement, and even more fascinating to look back in five years to see how much of the deal was hype.

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Weill Cornell Medical College and New York-Presbyterian Hospital sign up for electronic informed consent from Mytrus for clinical trial enrollment in their oncology clinics.


People

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Spok promotes COO Hemant Goel to president. He replaces Colin Balmforth, who will “pursue other opportunities.”

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Boston Children’s Hospital (MA) promotes John Brownstein, PhD of the Children Hospital Informatics Program to the newly created role of chief innovation officer.

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CTG names Alfred Hamilton, PhD (George Washington University) as VP/GM of CTG Healthcare and Life Sciences. He is retired lieutenant colonel in the US Army Medical Department, where he served as a military CMIO and CIO and was deployed to Iraq to support the IT needs of two mobile trauma units.

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Don Kemper, who founded Healthwise in 1975 and still serves as its CEO 40 years later, will retire in 2016.


Announcements and Implementations

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Imprivata joins App Configuration for Enterprise, which is developing open standards for managing and securing enterprise mobile apps.

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Patientco announces the launch of a redesigned PatientWallet, which allows patients to pay bills from any device. The announcement says, without apparent irony, that the product uses “new-and-improved technology.”

Cerner and the Commission on Accreditation of Healthcare Management education announce an awards program and scholarships that will recognize graduate programs that focus on the use of information for healthcare performance improvement.

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Incident training in Elgin, IL includes the use of a cellphone app by Augusta, GA-based Global Emergency Resources that allows first responders and hospital personnel to log patient information, including photos and driver license images, so that hospital employees and other emergency teams can monitor progress.


Government and Politics

HHS seeks software developers to become Entrepreneurs in Residence for two development projects: an FDA cancer and hematology data aggregation analysis platform and a CMS system that connects providers to their Medicare interactions.

In England, NHS alerts users that its newly live e-referral service, which replaces the problematic Choose and Book system, has 33 known problems, including system delays, search problems, and reporting capabilities.

The government’s top seven contractors are, in order, Lockheed Martin, Boeing, General Dynamics, Raytheon, Northrop Grumman, and McKesson, which slipped into the defense-heavy list with its $6 billion in drug contracts.

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The Senate’s HELP committee convened its second hearing Tuesday, this time on EHR user experience. Vindell Washington, MD, CMIO of Franciscan Missionaries of Our Lady Health System (LA) testified that EHR workflow and documentation requirements are based on outdated paper models and providers should instead be rewarded for patient outcomes. Tim Pletcher, executive director of the Michigan Health Information Network Shared Services, said that health plans and payers have been conspicuously absent from Meaningful Use and patients are still forced to use their portals as are providers who are asked to submit additional documentation, suggesting that health plans be encouraged by HHS to use direct secure messaging. Meryl Moss, COO of the Coastal Medical ACO, urged the government to harmonize quality measures and add data analytics criteria to EHR certification. 


Privacy and Security

The FBI is investigating reports that the St. Louis Cardinals hacked into the player performance and scouting databases of the Houston Astros, which had hired the head of its “Moneyball”-type operation who apparently reused his Cardinals password on the network of the Astros, thereby inadvertently enabling the alleged unauthorized access.


Technology

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A JAMIA article by Dean Sittig and Adam Wright proposes use cases of exactly what determines whether a given EHR is “open” or “interoperable,” which hopefully will squelch the bleating of robotic vendor CEOs who insist on abusing the term to mean “whatever we’re selling at the moment.” The authors also question whether a system is open if its vendor requires those who need access to its system to be certified, to sign a non-disclosure agreement, to pay a license fee, to pay the vendor for custom programming, or to buy documentation. The EXTREME (Extract, Transmit, Exchange, Move, Embed) use cases require the EHR to:

  1. Export patient records in a format that can be discretely imported into another system that includes enough metadata to make the information usable, with a published dictionary describing how the information is stored and what it means.
  2. Support the ability for users to send some or all of a patient’s information to another EHR or PHR system via a standard format, allowing the user to choose which information to send and maintaining a usable data structure.
  3. Respond to data queries 24×7, use a record locator service, send information in a structured format, and send its data dictionary to the receiving EHR.
  4. Allow a customer to move all of their patient information to a new EHR, preserving metadata and maintaining the existing transaction history.
  5. Provide read and write API access to clinical and administrative information, such as by using SMART or FHIR services, and store new values provided by the external application.

For more information, see the summary Dean and Adam wrote as a HIStalk Readers Write article.

Here’s a challenge to EHR vendors: is your system open and interoperable based on the definition above?

An interesting article in Wired debates whether “apps” as we know them are obsolete, with both Google and Apple developing technologies that allow apps to be accessed more like services, so that users don’t even need to open one of many apps that reside in their “bag of hammers.” A developer says companies might be forced to sell “powers” rather than “things,” explaining, “There’s a lot of startups that are features masquerading as companies, and they’ll find a better home in this world. For some transactions, it’s ideal. If you can write a perfect API, there’s no longer a need to wrap it up in an app or UI.” The downside is that big companies like Google and Apple will control the entire user experience and compete to lure users into their competitive ecosystems. The author concludes that users may not care since they want results, not services.


Other

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A Cerner spokesperson tells me that the Leidos tweet and infographic claiming that “40%+ of healthcare facilities worldwide use Cerner’s EHR system” was, as HIStalk readers pointed out, incorrect (which was pretty clear given that 40 percent of the world’s healthcare facilities don’t have an EHR at all, much less Cerner’s specifically). Cerner says someone probably misinterpreted an analyst’s “global” report title as indicating that it covers the entire world. They’ve asked Leidos to correct the statement. Cerner responded quickly and apologized for the misstatement, which was nice considering they didn’t make the claim in the first place.

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Hartford Hospital (CT) says proposed state budget cuts will force it to cut jobs and eliminate programs, with the health system’s CEO calling on residents to demand that Medicaid funding be restored. The most recent tax return I found for the hospital (2012) showed that it earned a $110 million profit, paid the quoted CEO $2.1 million, and had at the top of its one-year compensation list a VP who took home nearly $4 million.

It’s all about perspective: a research article addresses how states are “protecting consumers from unexpected charges,” specifically when they are billed the balance not covered by insurance, such as when they are referred to an out-of-network specialist. That’s something the federal government could address – requiring providers who aren’t covered by a patient’s insurance to state that fact and to provide an estimate of their charges. It’s infuriating to be treated in an ED, where you have no choice in the hospital’s choice of contracted service providers, and to receive out-of-network bills weeks or months later that charge non-negotiated list prices from the ED doctor or even the lab. That’s much more egregious than predatory lending practices if you ask me, especially since the providers dump the responsibility on patients who are usually, by definition, not prepared to sort it all out on the spot.

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Dilbert takes on wearables.

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Weird News Andy says you have to pay extra for this service at some places. A 21-year-old home health nurse in Florida is arrested after she “decided to take off her clothes and not act normally” in stripping off her uniform and attacking the elderly patient under her care. The local TV station predictably made the non-news item its breathless lead, sending a reporter to report live from the jail’s driveway. Providing competitive snark to WNA this week is @JennHIStalk, who provided the heads-up that a neurosurgeon in Italy plans to lead a team of 100 technicians in transplanting a human head in 2017, with the ailing Russian patient saying, “I hope it will be OK.”


Sponsor Updates

  • Culbert Healthcare Solutions becomes a CHIME Foundation Affiliate.
  • Frost & Sullivan names Validic a “Healthcare Disruptor.”
  • Ricky Caplin, CEO of The HCI Group, is named EY Entrepreneur of the Year in the Florida Health Care & Life Sciences category.
  • ADP AdvancedMD offers “ICD-10 billing & coding help – just in the nick of time.”
  • AirStrip will exhibit at Connected Healthcare 2015 June 18-19 in San Diego.
  • AirWatch by VMware is recognized as a leader in the 2015 Gartner Magic Quadrant for Enterprise Mobility Management for the fifth consecutive year.
  • Practice Unite offers “Is your mHealth app HIPAA compliant?”
  • Besler Consulting offers an “Update regarding HIPAA Eligibility Transaction System (HETS).”
  • Bottomline Technologies will exhibit at ACE June 17-19 in Austin, TX.
  • XG Health outlines “XGlearn – Care Management Training.”
  • Craneware kicks off a new “value cycle” initiative at HFMA ANI 2015 next week.
  • Caradigm offers “The Cultural Shift to Population Health.”
  • Commvault offers “Backup-as-a-Service (BaaS) Just Became Easier with Cisco and Commvault.”
  • TechOhio discusses startup success with CoverMyMeds VP of Engineering Alan Gilbert.
  • Divurgent team members race to support the Children’s Hospital of the King’s Daughters.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 16, 2015 News 2 Comments

Monday Morning Update 6/15/15

June 14, 2015 News 2 Comments

Top News

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The VA will launch a three-hospital pilot of its self-developed Enterprise Health Management Platform, which allows clinicians to view non-VA patient information such as that stored in the DoD’s systems. The VA says the new system uses coded, discrete data that can be used for clinical decision support across all systems and to provide a “veteran-specific” rather than “local-specific” view. The VA developed the product using open source programming and will release a software development kit that will allow others to create add-on applications. Rollout of eHMP to the entire VA will continue through December 2017.


Reader Comments

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From LearnHealthTech: “Re: 50 hospitals gouging uninsured patients. Any surprise that so many are in Florida under Governor Rick ‘why isn’t he in jail’ Scott?” I’m not surprised a bit, but not because of Rick Scott, who seems to have turned his previous wildly capitalistic healthcare opportunism into a zeal for financial responsibility and transparency, at least among Florida’s non-profit health systems. Florida has always been ground zero for healthcare fraud, with international criminals, known hucksters, and immoral providers flocking there as predictably as snowbirds with harsh accents and pale skin. My theory is that everybody there is from somewhere else, lured by an implied lack of responsibility in a vacation-like lifestyle and no state income tax, so there’s little social stigma associated with scandalous behavior, which in addition to brazen healthcare fraud includes transplanted Midwesterners wearing black dress socks with sandals and aging Canadian expats hitting the beach in tiny Speedos obscured by pendulous, sun-leathered stomachs sprouting a scorched forest of gray hairs.

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From Imelda Roxas: “Re: Medical Center Health System, Odessa, TX. I saw this article saying they are replacing their McKesson Horizon system. The selected vendor is not named. Any idea of who it is?” I asked CIO Gary Barnes, who says they will implement Cerner in a $55 million, three-year project.


HIStalk Announcements and Requests

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Most poll respondents think overall health IT vendor revenue will grow over the next five years. New poll to your right or here: how many smartphone-based, non-fitness health apps do you use at least weekly other than those required by work? I’m curious what they are, of course, so click Comments after voting to tell me.

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Mrs. D says her New York second graders are enjoying the STEM science kits we provided via DonorsChoose donations, giving them exposure to group communication and project planning. I have matching funds available (courtesy of an anonymous vendor executive) to companies willing to donate $1,000 or more, which I will acknowledge on HIStalk as well.


Last Week’s Most Interesting News

  • The Senate’s HELP committee on Wednesday kicked off the first of a series of hearings that will review the Meaningful Use program, with the testimony of industry experts focusing mostly on interoperability.
  • Walgreens announces that it will roll out MDLive-powered virtual doctor visits to users of its app in 25 states by the end of 2015.
  • PHR vendor NoMoreClipboard announces that the information of its customers has been exposed to hackers.
  • Epic CEO Judy Faulkner signs The Giving Pledge in which she will donate 99 percent of her estimated $2.3 billion in assets to a charitable foundation.
  • Telemedicine provider American Well sues competitor Teladoc for patent infringement.
  • CSC agrees to pay $190 million to settle SEC fraud charges over falsifying financial results to hide losses from shareholders related to its participation in the UK’s defunct NPfIT program.
  • Hawaii announces that it will shut down its $130 million health insurance exchange because of low usage.

Webinars

June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.


Acquisitions, Funding, Business, and Stock

Health Catalyst will expand its Salt Lake City, UT headquarters, planning to add 300 jobs over the next five years. The Utah Governor’s Office of Economic Development is providing $700,000 in incentives.

Cerner will co-market a video analysis-powered musculoskeletal health screening tool from Kansas City-area startup DARI that Cerner is using in its Motion Health employee program to reduce the employer cost of mobility problems.


People

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Nordic Consulting promotes Abby Polich to VP of affiliate solutions.


Announcements and Implementations

Aventura announces Sympatica, which will present clinicians with real-time, context-aware information from predictive analytics and performance management applications along with their EHR content. The application integration solution, which will be released in Q3 2015, has already been chosen by three healthcare organizations that includes Wise Regional Health System (TX), which will use it to present users with context-aware patient care checklists and reminders. The company will provide APIs for partner integration.

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A Peer60 healthcare data security report finds that 95 percent of hospitals place data security as either their highest-priority project (29 percent) or as one of a few major priorities (66 percent). Budget limitations and lack of employee compliance are the biggest security barriers. The top provider priority is securing mobile devices, with smaller hospitals also focusing on intrusion protection.

Billian’s HealthData offers an Essentials licensing tier of its market intelligence database that includes key hospital and health system executives.

Children’s Healthcare of Atlanta goes live with Clockwise.MD in its urgent care centers, allowing patients to reserve their spot in line and receive wait time updates.


Government and Politics

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GAO testimony criticizes high-risk federal IT project cost overruns, schedule delays, and questionable achievements, calling out ineffective management and lack of follow-up on the GAO’s recommendations. Among the massively expensive and ultimately cancelled projects mentioned are the DoD’s CoreFLS  and the VA’s scheduling system replacement, which cost at least $750 million. The GAO also notes that the VA and DoD have failed to modernize and integrate their EHRs over many year and questions the likelihood that their new focus on integrating their separate systems will succeed. The federal government spends $80 billion per year on IT.


Privacy and Security

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The Texas Department of Aging and Disability Services announces that the medical information of 6,600 Medicaid recipients was exposed when data from an internal software application was accidentally opened up to the Internet.

Symantec reports that hackers are spreading malware by sending emails about MERS outbreaks in South Korea that contain an attachment named “MERS_List of hospital and infected patients.docx.exe.” that launches a Trojan. The company reports that malware creators often use current news headlines, including last year’s Ebola scare, to get email recipients to open attachments.


Other

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Harvard Medical School’s Center for Biomedical Informatics will convene a free, two-day program titled “Precision Medicine 2015: Patient Driven” June 24-25 at the medical school’s campus in Boston. Presenters include the center’s Zak Kohane and Ken Mandl, 23andMe co-founder Linda Avey, and Cloudera founder Jeff Hammerbacher.

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The American Medical Association passes a proposal from its resident and fellow members that calls for the AMA to create ethical and professional guidelines for media doctors such as Dr. Oz, whose evidence-lacking snake oil claims reach millions of TV viewers who aren’t aware of his paid endorser status and his wildly off-center positions on scientific topics. The AMA will also issue guidelines disciplining unethical media doctors through existing channels such as state licensing boards and medical societies.

Weird News Andy says it was, “Tats, not cancer.” Surgeons remove a woman’s uterus, cervix, Fallopian tubes, and pelvic lymph notes after a PET scan showed spreading of her cervical cancer, only to find that the bright spots on the image were caused by migration of ink from her many tattoos rather than the radioactive tracer that would have indicated lymphatic metastasis. The surgeons had planned to remove the organs anyway; the woman is recovering and cancer free.


Sponsor Updates

  • Medicity recaps its HIStalk webinar, “Successful HIEs DO Exist: Best Practices for Care Coordination.”
  • Brad Levine of Visage Imaging is interviewed about imaging industry trends during SIIM 2015, including the movement to make radiology processes and technologies more relevant to referring physicians.
  • Versus Technology offers “How Your Hospital can Easily Track Nurse-to-Patient Ratios.”
  • Cumberland Consulting Group reports that since its June 2014 acquisition of Cipe Consulting Group, 16 new and 10 existing clients have used the services of its specialist consultants, the company now supports the applications of all leading vendors, and its recruiters have expanded their network to 2,500 contacts for responding quickly to customer requests for specific skill sets.
  • Summit Healthcare honors non-profit Hands on Nashville at the International Muse conference.
  • SyTrue will exhibit at the Healthcare Innovation Conference on NexGen Data, Analytics, and Technology-Enabled Services June 16 in Palo Alto, CA.
  • Verisk Health will offer analytics education to members of the Association for Community-Affiliated Plans.
  • SyTrue publishes use cases for its Smart Data Platform including conversion of physician narrative into structured data, real-time transformation of clinical documentation into diagnosis and procedure codes, conversion of radiology information into evidence-based insight, and translating pathology terminology and codes to improve billing accuracy.
  • T-System offers “Nurse Debate: The Value of Electronic Alerts in ED Documentation.”
  • PMD blogs about “Hotel Room Hacking” to push client-requested updates through while on the road.
  • Greenway Health chooses Talksoft as Partner of the Month for June 2015.
  • VisionWare will exhibit at the Big Data & Healthcare Analytics Forum June 18-19 in New York City.
  • TeleTracking will exhibit at the Digital Health and Care Congress 2015 June 16-17 in London.
  • TransUnion offers “Uncompensated Care: Hospitals’ Billion-Dollar Challenge.”
  • Validic will exhibit at Connected Healthcare USA June 18-19 in San Diego.
  • Verisk Health offers “Improving Medical Cost Containment with Pre-Payment Claim Review.”
  • Nearly 100 PatientKeeper employees donate time, goods, and money to Massachusetts charity Cradles to Crayons on the company’s volunteerism day.
  • PerfectServe client Orange Coast Memorial Medical Center (CA) is featured on the American Medical Group Association’s premiere of online news program High Performing Health.
  • VitalWare’s VitalCoder receives HFMA peer review designation.
  • Voalte previews its Mobile Communication Strategy eBook.
  • Huron Consulting sponsors Loyola University Medical Center’s Health, Hope, and Heroes 5K Run/Walk June 14 in Maywood, IL.
  • Close to 450 WeiserMazars employees volunteer at over 30 community organizations in four states for its first annual “Days of Service.”
  • Zynx Health offers “Let’s Keep Nurse Recognition Going!”
  • Leidos Health VP/ Health Information Privacy and Security Officer Sean Murphy will speak on a panel cybersecurity at the iHT2 Summit June 16-17 in Washington, DC.
  • MEA/NEA offers an article series taking a closer look at HIPAA.
  • JAG Products will offer its ClinicTracker users revenue cycle products from Navicure.
  • Sandlot Solutions will exhibit at the Minnesota e-Health Summit June 16-17 in St. Louis Park.
  • Netsmart announces its support for the Helping Families in Mental Health Crisis Act, which aims to bring Meaningful Use parity for behavioral health and addiction treatment providers.
  • The New York eHealth Collaborative will exhibit at the NY MiniHIMSS Conference June 17 in New York City.
  • Nordic Consulting focuses on intervention in the latest episode of The HIT Breakdown podcast series.
  • Oneview Healthcare recaps its experience at the Cleveland Clinic’s Patient Experience & Empathy Summit.
  • Orion Health’s David Hay talks with Radio New Zealand about FHIR’s impact on population health.
  • Patientco offers, “3 Reasons Why Insourcing the Patient Revenue Cycle is Easier Than Ever.”
  • Phynd offers an “Introduction to Phynd’s Single Provider Profiles.”
  • Qpid Health offers “Human-Digestible Documentation Tops AMIA EHR 2020 Task Force Recommendations.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 14, 2015 News 2 Comments

News 6/12/15

June 11, 2015 News 1 Comment

Top News

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Senator Lamar Alexander (R-TN), who chairs the Senate’s HELP committee that is reviewing the Meaningful Use program in a series of hearings this summer, says physicians are “terrified” of MU Stage 3 and he wants to change it before it is implemented so that “hospitals and physicians can look forward to using it to help their patients instead of something they dread.” Testimony from Wednesday’s first hearing was as follows (video of the hearing is here):

  • AMIA Board Chair-Elect Tom Payne, MD says Congress should provide regulatory guidance on who is allowed to enter EHR information and should publish standards by which external data such as patient-provided information and medical devices can be incorporated into the EHR. He also suggests that Congress eventually consider revamping the Medicare payment system to focus on value-based purchasing rather than paying from code-driven documentation requirements. He adds that it is “unconscionable” that patients can’t get their full medical record in a standard, machine-readable format and says fixing that situation is the most important thing Congress can do.
  • Cerner CEO Neal Patterson says health IT vendors must sell systems that are open (supporting externally built apps and extensions) and interoperable. He defines interoperability as being when a doctor seeing a patient for the first time can click an EHR button that immediately displays all relevant patient-approved information from the lifetime record from many sources, adding that we’re close to realizing that vision and the remaining problems don’t involve technology. He says a national patient identifier is essential. He admits that EHR vendors, including Cerner, “were out conquering the map” and competitive pressure led them to create technology silos, while full interoperability will require vendors to cooperate with the understanding that they will then need to compete based on innovation, quality, and cost. He talked up CommonWell and said Congress should act immediately to challenge behaviors that restrict patient choice, limit interoperability, or use captive data to increase market share.
  • Consultant Christine Bechtel says consumers need to force the issue of having their data spread across multiple provider systems that can’t talk to each other so that none of them have a complete health picture. She reported her own experience on trying to get her electronic data from her PCP, who told her their portal was broken and they don’t plan to fix it. She then invoked the HITECH-HIPAA requirements that require providers to give her an electronic copy and the practice refused. She finally got them to provide an electronic copy (via a CD she had to pick up at the front desk) and found that the only way she could make sense of the CCR text file was to download an app that presented it more clearly. She recommends that the government provide consumer information and tools that make it easier for them to obtain and understand their medical information, require EHRs to incorporate consumer-generated data via the certification program, require EHRs to offer API access to earn certification, retain the Meaningful Use threshold for patients to view/download/transmit their information, publish privacy and security best practices for developers, and require providers to give patients their electronic data quickly and with a single, ongoing request.
  • Carolinas HealthCare SVP/CIO Craig Richardville, representing the health system and Premier, says the market doesn’t reward information sharing, which is expensive. He wants Congress to encourage private-public interoperability governance, establish data and transport standards, and prohibit EHR vendors from charging fees for exporting information or accessing it via APIs.

Reader Comments

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From Plyometric: “Re: Ministry Health Care. Eliminating positions due to its breakup with Marshfield Clinic and the loss of revenue that followed. Looks like a 5 percent RIF. At least they’re giving six months’ severance.” Unverified.  

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From Flush the Money: “Re: Leidos. Is a renamed SAIC. Around 1994, Arlen Specter of PA – home of the then-owner of Sunquest — got funding passed to have a pilot program  for an anatomic pathology system for DoD hospitals. The privately owned CoPath system was chosen, to the surprise of the then-leading lab vendors Sunquest and Cerner. This was the first time a commercial system was integrated with CHCS. $10 million was allocated for the pilot, of which CoPath got $1.6 million and the rest went to and through SAIC for overseeing the process and interfacing CoPath to CHCS. One more reason I am rooting for Epic.” I took a trip down memory lane in reassembling cobwebby nuggets from anatomic pathology systems ancient history:

  1. CoPath developer CoMed sold itself to Dynamic Healthcare Technologies (DHTI).
  2. Sunquest wanted CoPath but couldn’t convince DHTI to sell the company so instead Sunquest signed a VAR agreement to resell it.
  3. Publicly traded DHTI went down in flames and sold out to Cerner, meaning the two leading lab vendors (Sunquest and Cerner) were both selling the same CoPath product.
  4. Legal disputes cut off Sunquest’s access to ongoing updates from Cerner (where the original CoPath developers remained), so then each company starting doing their own development in creating different products that were both called CoPath.
  5. AP vendor Tamtron sold itself to Elekta, which eventually sold the PowerPath AP product to Sunquest, giving Sunquest two AP products that it still offers today.

You might correctly assume that all of these corporate gyrations and convoluted family trees have confused laboratory customers for years, while Epic’s Beaker genealogy (including anatomic pathology) is a short but straight line. 


HIStalk Announcements and Requests

From the jobs board: director of provider solutions, western region (VisionWare).

This week on HIStalk Practice: MyIdealDoctor partners with Zest Health. Physicians seem dead set against sharing data with patients. Mountain River Physical Therapy implements Clinicient tech. Kareo, Greenway Health, ADP AdvancedMD, and McKesson rank high for physician practice IT. Delaware and North Dakota adopt new HIE technologies. Cactus Clinic moves to Athenahealth.

This week on HIStalk Connect: an artificial intelligence-based algorithm developed at Tufts University solves a 120-year-old biological mystery with no human aid. The VA pilots a program that captures patient’s life story as told by them. Walgreens expands its telehealth platform to residents of Colorado, Illinois, and Washington. Google X Labs launches a ResearchKit-like app that it designed to support its Baseline Study project.


Webinars

None scheduled soon. Contact Lorre for information about webinar services.


Acquisitions, Funding, Business, and Stock

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British medical equipment vendor Smith & Nephew acquires two orthopedics supply chain software applications developed by Memphis-based S2 Interactive, a visual OR preference app and a central processing management system.

Twitter, desperate to boost usage and revenue that have been constrained by new users who can’t figure out how it works, will increase the character count allowed in direct messages from 140 to 10,000 in hopes of making it a desirable messaging app.


Sales

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Mount Sinai Medical Center (FL) chooses Phynd for creating and maintaining a single provider profile for its 10,000 referring and credentialed physicians across multiple systems that include Epic.


People

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Care coordination software vendor TEAM of Care Solutions hires Thomas McCarter, MD (Executive Health Resources, An Optum company) as chief medical officer.


Announcements and Implementations

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Ireland-based claims processing and procurement software vendor SoftCo reports several recent US hospital sales that include Providence Hospital (SC) and UPMC Cancer Center (PA).

National Billing Center will offer its customer nVoq’s SayIt Transcription Assist service to customers who want to dictate notes that are routed to US-based transcription company and that can then be sent to the EHR.

Software vendor Kolkin offers physicians a free download of its SOS real-time patient list and handoff tool through July 31.

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Walgreens will expand its MDLive-powered $49 virtual doctor visit service to 25 states by the end of 2015 now that testing in California and Michigan has been completed.

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Terebonne General Medical Center (LA) goes live on RightPatient biometric patient ID management throughout the hospital.

Meditech’s UK dealer, Centennial-MIT, is listed on the NHS Shared Business Services procurement framework.


Government and Politics

HHS warns physicians to carefully review the terms of medical directorship agreements they may sign, suggesting they make sure their compensation reflects the market value of their services to avoid any hint of being paid kickbacks for their Medicare referrals.

The VA and National Institute of Mental Health develop a suicide risk algorithm that, when applied to the VA’s EHR data, identifies high-risk suicide patients that have been missed by clinicians.

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National Coordinator Karen DeSalvo, MD posts her #HealthySelfie and challenges her 6,180 Twitter followers to do the same.


Privacy and Security

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PHR vendor NoMoreClipboard, operated by Indiana-based Medical Informatics Engineering, reports that the information of an undetermined number of its users was exposed in a breach discovered on May 26, 2015. It apparently collected and stored Social Security numbers that were contained in the breached information.

The South Korean government is enforcing the quarantine of citizens exposed to Middle East respiratory syndrome by tracking their cell phone locations.

The government of Ontario, Canada proposes to double the fines (to $100,000) for people who inappropriately access patient medical records and also eliminate the requirement that prosecution starts within six months of the breach.


Technology

Mayo Clinic launches its Periscope account to provide Twitter-owned, real-time video streaming from smartphones. As with most new technologies, they’re trying to figure out what to do with it, while also being careful of the possible patient privacy implications of streaming live, unedited video from one person’s mobile phone.


Other

A recap of Canada’s largest e-health conference by the Canadian Medical Association Journal says the country has seen limited progress after spending $2 billion on EHRs because each province developed their own technical standards and chose their own systems without considering interoperability. A researcher says Canada Health Infoway has spent $220 million on salaries and administrative costs in handing out $2 billion in federal grants, but doesn’t manage those investments with interoperability in mind. A physician who helped create Alberta’s EHR says the government should encourage provider interoperability by using pay-for-performance measures as the carrot and financial penalties as the stick.

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Epic CEO Judy Faulkner signs The Giving Pledge, launched by Warren Buffet and Bill and Melinda Gates in 2010 to encourage the world’s wealthiest people to give most of their fortunes to philanthropy. Faulkner, who says in her pledge letter that she “never had any personal desire to be a wealthy billionaire living lavishly,” will direct 99 percent of her estimated $2.3 billion in assets to a charitable foundation upon her death or direction.

In a brilliant motivational and engagement practice, blood donors in Sweden receive a thank-you text message when their donated blood is administered to a patient.

Stanford University researchers discover a possible link between the use of proton pump inhibitor drugs like Prilosec and heart attacks by mining Stanford’s own EHR databases as well as those stored by free EHR vendor Practice Fusion. The authors acknowledge that their work is not definitive, suggesting that a large, prospective clinical study be performed to prove causality rather than correlation.

Here’s a fun sepsis awareness video from Kern Medical Center (CA).

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Weird News Andy says, “He’s bean curd” in summarizing the removal of a patient’s 420 kidney stones that doctors blame on his excessive consumption of tofu.


Sponsor Updates

  • Extension Healthcare offers a new blog on standardizing hospital sounds with alarm management middleware.
  • Galen Healthcare asks, “Quality Incentive Programs Reporting – Which Opportunities are Right for You?”
  • Hayes Management Consulting posts “Why Your Front Desk Needs to Understand Coding.”
  • The HCI Group offers “5 Steps to Harness Healthcare Innovation.”
  • SVP of Marketing Sarah Swidron of Healthcare Data Solutions is profiled in the Pharmaceutical Marketers Directory Refresh newsletter.
  • Healthfinch offers “Physicians: Ready to Give up Your Lunch Time Now Too?”
  • Healthwise offers “Decision aid reduced men’s interest in PSA screening and helped shape patient-clinician conversations.”
  • Impact Advisors is named to The Channel Company’s 2015 CRN Solution Provider 500.
  • Influence Health recaps its Annual Client Congress.
  • Ingenious Med will exhibit at the 2015 National Health Leadership Conference June 15-16 in Charlottetown, PEI.
  • InstaMed looks at “Trends in Consumer Healthcare Payments.”
  • Holon Solutions will exhibit at the Indiana Rural Health Association meeting June 16-17 in French Lick.
  • InterSystems will exhibit at the 2015 NYS Mini-HIMSS Conference June 17 in New York City.
  • Ivenix releases a new white paper entitled, “Improving Intravenous Therapy: Opportunities for Designing the Next Generation Infusion System, Part 2: Infusion Pump Alarms Management.”
  • PDR will exhibit at Pioneer Rx June 12-14 in Nashville, TN.
  • HealthMedx will exhibit at the LeadingAge PA Annual Convention June 16-17 in Hershey, PA.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 11, 2015 News 1 Comment

Morning Headlines 6/11/15

June 10, 2015 News No Comments

Walgreens and MDLIVE Expand Telehealth Platform to Three New States, Add Desktop and Tablet Functionality

Walgreens expands its telehealth service to users in Colorado, Illinois and Washington, and promises to make the service available to 25 states by the end of the year.

Kentucky Physician Named AMA President-elect

AMA announces that its next president will be Steven Stack, MD, an emergency medicine physician from Kentucky. Stack served as the chair of the AMA’s Health Information Technology Advisory Group from 2007 to 2013 and has served on multiple ONC advisory groups.

Reducing Alert Fatigue Prevents Pharmacy Medication Errors

Hospital Sisters Health System (IL) reduces the number of alerts being presented to physicians by 40 percent, while improving its rate of catching preventable medication errors by analyzing and optimizing its alerts.

Growth Of New York Physician Participation In Meaningful Use Of Electronic Health Records Was Variable, 2011–12

Health Affairs publishes an analysis of the Meaningful Use program, finding that providers that had adopted EHR systems prior to MU were more likely to be “early and consistent participants” in the program.

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June 10, 2015 News No Comments

News 6/10/15

June 9, 2015 News 15 Comments

Top News

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Video visit provider American Well sues competitor Teladoc for patent infringement, claiming that Teladoc continues to use American Well’s patented doctor-patient visit matching and queuing technology even after American Well turned down its request for a license.


Reader Comments

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From Stickler: “Re: Epic. It is NOT an acronym. MEDITECH is an acronym. I have personally heard a CIO say he automatically deletes any vendor email that spells Epic as EPIC. Anyone who does it immediately loses any credibility they might have otherwise had – it shows they don’t know or don’t care and neither does a positive impression make.” Vendors let their marketing people run amok in peppering company names with bizarre extra capitalization, non-capitalization, conjoined words with capitalization in the middle, extraneous symbols, and other heinous and overly attention-seeking insults to the English language in trying to create a memorable company brand. The important distinction in Epic’s case is that they spell their own name correctly – it is clueless others who spell it EPIC. I agree with your CIO friend that I would hesitate to do business with a company claiming Epic expertise that doesn’t include knowing how to spell the company’s name. MEDITECH, by the way, is not an acronym, which is defined as an abbreviation made up of the first letters of several words that can be pronounced as a single word (IBM is not an acronym since it can’t be pronounced – it is instead an initialism, while NASA is an acronym). For that reason, Meditech’s name should not be capitalized even though the company does it – it’s an artificially, informally shortened version of the company’s real name, Medical Information Technology, Inc. The AP Stylebook for publications is clear that all-caps company names are not to be used unless the letters are individually pronounced, such as IBM or BMW, no matter how the company registered its legal name or trademarks.

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From Richard Head: “Re: Leidos tweet. Is there a possible interpretation that could make this true?” I’ll challenge the Leidos and/or Cerner folks to provide details, especially since “healthcare facilities” seems like a pretty broad group given the large number of “healthcare facilities” in non-Cerner parts of the world such as China and Russia, for example.

From Bud Fox: “Re: DoD EHR bid. A private recruiting firm contracted by the DoD has been contacting my health system’s Epic analysts to recruit them for its EHR project, with starting salaries of over $100,000. Perhaps the DoD has already quietly selected Epic?” My sources say that no decision has been made and won’t be for at least another month. If there’s a frontrunner, DoD is keeping quiet about it even among the bidders.

From Dusty Wind: “Re: DoD EHR bid. Leidos will say or do anything to keep the business, which is supposedly contributes 20 percent of their revenue in maintaining CHCS.” Unverified, but Leidos wins under two scenarios – (a) DoD chooses Cerner, or (b) DoD decides to do nothing. Either way Leidos gets the lucrative operations and change orders business for many years. They will take significant revenue a hit if DoD chooses Epic or Allscripts.

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From Point Taker: “Re: grammatical errors. And you worry about the small ones!” The Twitterverse loves this gaffe by a headline writer who confused “ambidextrous” with “amphibious,” with wags adding comments as “Faces Aquaman in next outing” and “He loves rain delays.”


Webinars

None scheduled soon. Contact Lorre for information about webinar services.

We had a great turnout for Tuesday’s Medicity-sponsored webinar titled “Successful HIEs DO Exist: Best Practices for Care Coordination.” Participation was so extensive that we ran out of Q&A time, but we’ve sent the remaining questions to speakers Brian Ahier of Medicity and Dan Paoletti of Ohio Health Information Partnership and will provide their answers by email.


Acquisitions, Funding, Business, and Stock

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Cardiac biomarker lab company Health Diagnostic Laboratory files Chapter 11 bankruptcy two months after agreeing to pay $50 million to settle Department of Justice charges of giving kickbacks to doctors to order its tests.

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Medsphere closes a $7.5 million venture-backed loan that the company will use for working capital.


Sales

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Accountable Care Medical Group (FL) chooses HealthEC’s population health management solution.


People

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Pratik Chakraborty (Wipro) joins home care data collection platform vendor CellTrak as VP of R&D.


Announcements and Implementations

Orion Health incorporates the image exchange system of eHealth Technologies into its HIE platform for the North Dakota Health Information Network.

EClinicalWorks will offer its users electronic prior authorization services from Surescripts.

Ochsner Health System (LA) launches Healthgrades-powered appointment scheduling that updates its Epic EHR.

Apple’s always-in-June developers’ conference announcements: (a) the Apple Music streaming service that will even eventually run on Android devices; (b) iOS 9; (c) OS X 10.11 El Capitan; (d) support for native Apple Watch apps; (e) a smarter Siri; and (f) public transit directions in Maps. 


Government and Politics

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The Senate’s HELP committee will review AMIA’s just-published “EHR 2020” report in a Wednesday morning session available as a live video stream. Witnesses include incoming AMIA chair Tom Payne, MD, Carolinas HealthCare SVP/CIO Craig Richardville, Christine Bechtel, and Cerner CEO Neal Patterson.

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The Madison, WI VA hospital encourages patients to spend an hour telling a trained volunteer their life story, which is written up, edited by the patient, and then added to their electronic chart. Army veteran Jennifer Sluga (above), who served in Kosovo, describes the “My Life, My Story” program, which is expanding to other VA hospitals but unfortunately not to hospitals in general:

“Even if you do get asked about your story, you get tired of telling it over and over. You hold back information. With this interview, I get it out and it’s in the record. I don’t have to talk about the hard stuff if I don’t want to. I don’t have to be strong and put on the soldier face. I know it’s there for the provider to read. There are a lot of younger providers who don’t have the life experience to know what it means. You might be sitting across from an 89-year-old veteran but you don’t know what experiences he has under his belt. If you have his story in the record, you might realize that he isn’t just an old man, but a hero. Anything you can do to make a veteran feel special is worth it. Interviewing them and writing their stories does that.”


Privacy and Security

In England, the NHS’s information center admits that the information of 700,000 patients may have been shared without their permission because technical and workload requirements left the department unable to record opt-out preferences.


Innovation and Research

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The 28 members of the Greater Dayton Area Hospital Association (OH) launch Ascend Innovations, a business to commercialize healthcare technology from hospitals, the Air Force Research Laboratory, and other sources that combine “Dayton’s biggest industries – defense and healthcare.” 


Other

In England, the CIO of a veterans’ support organization says it could provide better service to its clients if it had access to their NHS healthcare records, but it can’t afford the integration and auditing costs involved. He also notes the barrier of outside groups like his being unable to update the NHS records.

Independence Blue Cross applies algorithms to its databases to assign health coaches to coordinate services for high-risk patients, reporting a 40-50 percent reduction in expected CHF admissions. A Harvard law professor questions whether patients should have the right to opt out, but the insurer says their information is used only in its role of improving their care and that should be perfectly fine.

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A study finds that long-term care hospitals seem to time patient discharges for maximum Medicare payment rather than clinical needs.

Industry groups want pathologists to follow standard case review protocols before sending results to referring doctors, hoping to reduce the 10 to 25 percent of cases where experts don’t agree that a growth is either benign or malignant. A possible solution is digital pathology that allows pathologists to share scanned images and to apply biomarker algorithms, although FDA won’t approve it for primary or secondary diagnosis until it’s convinced that the quality of the digital image is as good as that of the original tissue slide.

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A study finds that 50 US hospitals are charging uninsured patients more than 10 times the actual cost of their care vs. the 3.4 times national hospital average, with all but one of those 50 being for-profit hospitals. Researchers say it isn’t just uninsured patients who are getting gouged – it’s also those being treated out of network, using workers’ compensation, and being reimbursed by their auto insurance carrier, adding, “They are price-gouging because they can. They are marking up the prices because no one is telling them they can’t.” Community Health Systems owns 25 of the hospitals, while HCA has 14. The hospital owners predictably disagree with the findings, saying they offer discounts and charity care and need the money to keep their safety net hospitals open.

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Weird News Andy says of this patient who performed “Yesterday” by the Beatles during his brain tumor removal surgery, “All his troubles seemed so far away.”


Sponsor Updates

  • PeriGen will introduce its PeriCALM CheckList OB solution at the AWHONN conference June 13-17 in Long Beach, CA.
  • A Forward Health Group video features the use of its PopulationManager by ARC Community Services to address substance abuse in women.
  • Wellsoft will exhibit at the National Freestanding Emergency Center Conference June 17-18 in Dallas.
  • Health Catalyst’s Dan Burton, Steve Barlow, and Tom Burton are named “EY Entrepreneur of the Year” in the technology category of the Utah region.
  • Accreon client OntarioMD is recognized with the CHIA Innovation Award at the eHealth 15 conference.
  • AirWatch shares its reaction to the Apple Worldwide Developers Conference announcements in a new blog.
  • CareSync highlights National Cancer Survivors Day.
  • ChartMaxx exhibits at NYHIMA through June 10 in Syracuse, NY.
  • E-MDs customer Orlando Heart Specialists (FL) is chosen as one of five sites to pilot the American College of Cardiology SMARTCare ischemic heart disease treatment options program.
  • CommVault advances to preferred solution partner with Cisco.
  • Aventura is named as a 2015 Red Herring Top 100 North America Tech Startup.
  • CoverMyMeds will exhibit at the Next Generation Payers Summit June 10-12 in Miami.
  • Richard Helppie of Santa Rosa Holdings and Sandlot Solutions is interviewed for an article titled “The missing link in interopability: what patients want.”
  • CTG posts a new podcast featuring patient advocates in its #TalkHITwithCTG series.
  • Bottomline Technologies will exhibit at ACE June 17-19 in Austin, TX.
  • Divurgent receives the Small Business Award from the US Chamber of Commerce.
  • Burwood Group is named to the 2015 CRN Solution Provider 500 list.
  • CitiusTech will exhibit at DIA 2015 June 14-18 in Washington, DC.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 9, 2015 News 15 Comments

Monday Morning Update 6/8/15

June 6, 2015 News 2 Comments

Top News

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CSC will pay $190 million to settle SEC charges of accounting fraud related to its money-losing NPfIT contracts with the UK’s National Health Service. Five of eight former CSC executives have settled SEC charges of manipulating financial results, with former CEO Michael Laphen agreeing to return more than $4 million in compensation under the clawback provision of the Sarbanes-Oxley Act. The SEC’s investigation found that CSC lied about earnings after falling short of revenue due to missed NPfIT deadlines and also took out high-interest loans from NHS to hide cash flow problems from investors. A Bloomberg report says HP was close to acquiring CSC last month for $9.3 billion but backed out, with CSC’s new plan being to split itself into two publicly traded companies.


Reader Comments

From ICDelightful: “Re: ICD-10. Why didn’t CMS just do ICD-9 to ICD-10 mapping itself to provide a single standard? Even if 20 percent of the codes don’t directly it seems like CMS is in the best position to determine which are the closest match.” I’ll leave it to more HIM-savvy readers to respond, with my guess being that ICD-10 codes have a mandatory additional level of specificity that can’t be automatically and accurately derived from a given ICD-9 code.

From The PACS Designer: “Re: coining a new term. With the advent of cloud-based solutions, it’s becoming apparent that data stored in the cloud and other database solutions need a better term than big data. With transparency being key to move data more efficiently, it would be better to use the term ‘dataware’ to describe the transparent data sources.”

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From Mountain High: “Re: Boulder Community Hospital. Goes down again, this time for only about a day (eight days of downtime in 2013).” It sounds to me like they were experiencing some kind of denial-of-service or malware attack given that the forwarded internal email suggests that its network was overloaded and the IT security director was assigned to investigate.


HIStalk Announcements and Requests

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Poll respondents are equally split as to whether lack of patient data-sharing should be blamed on health systems or their EHR vendors. Will says the correct answer is none of the above – the fee-for-service system treats interoperability as an unreimbursed cost and data will be shared when there’s a business reason to do so, while Frank blames lack of customer (patient) demand and Mobile Man says the biggest payor (Uncle Sam) could change interoperability overnight by changing reimbursement. New poll to your right or here: how will overall health IT vendor revenue change over the next five years?

My latest grammar peeve: capitalizing relationship names when the word isn’t used as a title, as in, “I visited my Dad” (wrong) vs. “I visited Dad” (right). Sometimes people mysteriously do the same in referring to an occupation, such as “I am a Teacher.” Not new but increasing in frequency is the practice of combining words not used as adjectives, such as, “I brush my teeth everyday” (wrong) vs. “My everyday practice is brushing my teeth” (right). I acknowledge that rampantly incorrect word usage will eventually find its way into dictionaries that see their role as observational rather than authoritative, which would make one fine mess in nearly every other discipline where things are either right or they aren’t despite what the questionably knowledgeable masses believe.

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Mrs. H says the two Chromebooks we bought for her Oregon elementary students via the DonorsChoose project (with matching funds from the Bill & Melinda Gates Foundation) have boosted morale and improved reading scores. I have $10,000 in matching money available (courtesy of an anonymous vendor executive’s personal pledge) for companies donating $1,000 or more, who also get a mention right here on HIStalk for their involvement.


Last Week’s Most Interesting News

  • Quality Systems President and CEO Steven Plochoki resigns.
  • BIDMC CIO John Halamka, MD urges CMS to shut down the Meaningful Use program and instead hold providers accountable for patient outcomes and letting the market determine which technologies they need.
  • A M&A publication states that health IT firms Netsmart, Precyse Solutions, Mediware, Edifecs, Caradigm, and Altegra Health are being shopped for sale.
  • A cybersecurity firm warns that unsecured medical devices provide hackers with a nearly undetectable back door into health system networks.
  • Partners HealthCare (MA) goes live on Epic at a total project cost of $1.2 billion, double its original budget.
  • An insurance company demands that Cottage Healthcare System (CA) repay its $4.1 million breach settlement, saying the hospital lied on its insurance application by claiming it was performing IT security maintenance steps when it really wasn’t.
  • A Texas judge issues an injunction requested by telemedicine vendor Teladoc against the Texas Medical Board for its requirement that physicians conduct an initial face-to-face patient visit before prescribing drugs.

Webinars

June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.


Acquisitions, Funding, Business, and Stock

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Shares of Evolent Health closed Friday up 11 percent to $18.86, valuing the newly NYSE-listed company at $950 million. UPMC’s stake is worth $278 million, while CEO Frank Williams holds $22 million in shares. 


Sales

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Glytec announces that 13 health systems have chosen its eGlycemic Management System for managing glucose levels using evidence-based insulin dosing recommendations. Among the new clients are Kaweah Delta Health Care District (CA), Edward-Elmhurst Healthcare (IL), Mary Hitchcock Memorial Hospital (NH), and Mission Health System (NC).


Government and Politics

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Hawaii will shut down its $130 million health insurance exchange and move to Healthcare.gov. Hawaii’s high percentage of insured citizens, driven by a mandatory state employer insurance law, gave it too few users and too little revenue to sustain itself once it spent all of its federal grant money.


Privacy and Security

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China-based hackers breach the US federal government’s personnel system and steal the information of up to 4 million current and former federal employees in a just-announced December 2014 incident. Investigators say the cybercriminals, who may be working for the Chinese government, are likely the same ones who recently breached health insurers Anthem and Premera Blue Cross. The message is clear – in-depth information about people is more desirable to hackers (or “actors,” as the security people inexplicably say) than credit card files, and the fact that the Anthem and Premera data hasn’t hit the black market would suggest that a bigger and more organized plan is in place that goes beyond simply making a quick buck. Credit cards can be cancelled after a breach, but in-depth personal information can’t.


Other

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St. Louis Children’s Hospital (MO) says CNN misled readers by including it in an article titled “Is your pediatric heart hospital keeping secrets? We have answers.” The hospital says the CardioAccess software it uses doesn’t collect all of the information, leaving the hospital unable to report it.

Reno, MV pediatrician Ron Aryel, MD says syndicated columnist and non-practicing physician Charles Krauthammer is wrong in blaming physician dissatisfaction on EHRs. “My electronic medical record is my most powerful tool in the office. It helps to organize my thinking, prevents mistakes, and helps me spot important trends within my practice. My time ‘entering data’ rewards both me and my patients with better outcomes and more effective medicine. But doctors should focus on what they do best. I am good at getting patients healthy, and Krauthammer is good at being paid to write opinion pieces. I think he should keep doing that.” Krauthammer might not even be all that good at writing opinion pieces – he doesn’t offer one shred of proof to back up his assertion that an “EHR mandate” is causing physicians to quit. Nobody “mandates” that physicians accept insurance, deal with Medicare, sell their practices to health systems, or use EHRs – they voluntarily did all of those things for the money and now have seller’s remorse, leaving them with three basic choices: (a) deal with it while complaining to anyone who will listen; (b) start over in a cash-only concierge practice; or (c) quit and do something else. The problem with (c) is that doctors nearly always find the market value of their non-medical capabilities to be much less than they themselves believe, with the threatened loss of income and status steering them back to (a) in most cases. Actually I don’t have any more data than Krauthammer cites, but I suspect there’s a (d) choice in which doctors take purely transactional 9 to 5 physician jobs, such as working for insurance companies, telemedicine providers, consulting companies, and contracted physician staffing firms, accepting the notion that doctors rarely hang out their own shingles these days and that means becoming a begrudgingly obedient time-selling corporate widget like most everybody else who doesn’t drape a stethoscope around their neck as a status symbol.

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Here’s yet another questionably useful gadget for quantified selfers to embrace: The Lovely, a wearable sex tracker / sex toy (already tagged as the “Fitbit for your penis”) whose app tracks intensity and calories burned and provides suggestions for improvement and experimentation. I’m fearful of a future in which lust-crazed users flood Facebook with their Lovely-generated updates and boastful historical dashboards.

Weird News Andy says this spine transplant wasn’t about politicians, but rather a 35-year-old woman who faked romance with an 86-year-old man and then scammed him into giving her $1.2 million to pay for her “spinal transplant.” WNA’s rim shot conclusion is that “her story really struck a chord with the victim.”


Sponsor Updates

  • Zynx Health offers “Restricting Low-Volume Hobbyists: Translating the Volume-Outcome Relationship Into Health Policy.”
  • Streamline Health will exhibit at the 2015 CHIA Convention & Exhibit June 8-10 in Palm Springs, CA.
  • Sunquest releases the agenda for its 2015 Executive Summit July 13 in Scottsdale, AZ.
  • Xerox Healthcare offers “Healthcare C-Suite Sets Sights on Population Health Management.”
  • SIS COO Doug Rempfer pens an article for HFMA’s magazine entitled, “Using Perioperative Analytics to Reduce Costs and Optimize Performance in the OR.”
  • T-System offers “Leading with Passion: Checking in on Your People.”
  • TeleTracking will exhibit at the Digital Health and Care Congress 2015 June 16-17 in London.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 6, 2015 News 2 Comments

Morning Headlines 6/5/15

June 4, 2015 News 1 Comment

Quality Systems, Inc. Announces Retirement of President and Chief Executive Officer Steven T. Plochocki; Names Rusty Frantz Successor

Quality Systems announces that President and CEO Steven T. Plochocki will retire from the Company, effective June 30, 2015. He will be replaced by Rusty Frantz, former Carefusion SVP/GM.

So What is Interoperability Anyway?

John Halamka, MD and CIO at Beth Israel Deaconess Medical Center, calls for the end of the Meaningful Use program, proposing instead that Congress hold providers accountable for outcomes and let the free market dictate which technologies will work best to pursue those goals.

How hospitals hope to boost ratings on Yelp, HealthGrades, ZocDoc and Vitals

The Washington Post covers the impact patient satisfaction scores are having on clinical economics and the various efforts being undertaken by hospitals and practices to monitor and improve their online reputations.

Former Facebook CFO Ebersman Launches New Health Tech Startup Lyra Health

Former Facebook CFO David Ebersman launches a new business, backed by a seed investment from Venrock, focused on improving population health efforts in the behavioral health space.

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June 4, 2015 News 1 Comment

News 6/5/15

June 4, 2015 News No Comments

Top News

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Quality Systems (NextGen) announces the retirement of President and CEO Steven Plochoki. He will be replaced by Carefusion SVP/GM Rusty Frantz. QSII share price dropped 14.5 percent in Plochoki’s seven-year tenure vs. the Nasdaq’s 111 percent gain. 


Reader Comments

From LearnHealthTech: “Re: Florida Governor Rick Scott. Thanks for the new article on the stunningly corrupt and hypocritical governor. After defrauding taxpayers as a hospital CEO, he wants to go after non-profit hospitals for turning a profit.” Both for-profit and non-profit hospitals have plenty to be ashamed about, but Columbia/HCA’s felony fraud guilty pleas and $2 billion in settlement costs top the list. I suppose I shouldn’t be so critical because: (a) our healthcare system rewards aggressive business tactics, as evidenced by the stock market success of for-profit hospital operators and big healthcare-focused companies like McKesson and any number of insurers; (b) CMS’s “pay and chase” payment methods encourage health systems and companies to interpret its rules favorably in asking forgiveness rather than permission, no different than companies dealing with the IRS; and (c) Scott is right about the non-profit hospitals that still manage to have hundreds of millions of dollars in “excess revenue” that never seems to result in their overpaid CEOs offering to return the money, which usually means they just spend it on outcomes-indifferent activities such as buying up physician practices or erecting fancier buildings.

From Marshall: “Re: Connecticut hospital CEO salaries. Boosted handsomely.” Ten non-profit hospital executives made between $1 million to $3.52 million, with one CEO’s compensation increased 133 percent from $1 million to $2.3 million in just one year, while a second CEO saw his pay bumped by 85 percent to $3.1 million in the same year. The health systems didn’t provide a response to the newspaper’s inquiries, but it’s always the same anyway: (a) we have to pay that to keep him and we’re lucky he hasn’t left for greener pastures; (b) it’s not our fault that the market commands such high salaries and it’s a really hard job; or (c) we’re not really paying that much – it just looks that way because of one-time benefits such as payout of accrued retirement or severance benefits.


HIStalk Announcements and Requests

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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This week on HIStalk Connect: Dallas-based telehealth provider Teladoc enjoys its first victory in its antitrust lawsuit against the Texas Medical Board. The National Cancer Institute announces the start of a multi-arm cancer research project that will attempt to match cancer drugs with cancer-related genetic mutations. Google’s artificial intelligence research team is working on an app that will calculate the total calories in a plate of food by analyzing a picture of it. Rockwood City, CA-based digital health startup BaseHealth launches a genome API that will enable developers to integrate personalized care plans and risk reports into wellness applications.

This week on HIStalk Practice: Persivia CEO Mansoor Khan gives Jenn the scoop on starting up a new population health management company. Northwestern Counseling & Support Services connects to the Vermont HIE. Dr. Gregg describes the “bastardization” of HIT. CVS Health partners with HHS. Hughston Clinic rolls out TrainerRx software. TMA PracticeEdge COO Dave Spalding lays out the vision for ACOs in Texas. CMS opens up data for further research and development, and gives physicians an easy way to rat out information blockers. Solutions Recovery Center goes with ZenCharts. Gastro Health launches virtual support community.

I was thinking about the plethora (and increasing number) of proprietary body sensors tied to specific apps or services. That sensor-app connection is mandatory at the moment, particularly with FDA-approved systems, but at some point the sensor overlap and need for economy of scale would seem to make it desirable for a single universal sensor that all health and fitness apps can talk to. It seems inefficient for every app vendor to develop and maintain yet another heart rate or calories-burned gadget, especially when consumers need or want information that requires more than one of them.


Webinars

June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.


Acquisitions, Funding, Business, and Stock

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Genstar, owner of behavioral EHR vendor Netsmart, has reportedly retained an investment bank to either take the company public or sell it, with a potential price of $750 million. Also on the block, according to insiders, are health IT firms Precyse Solutions, Mediware, Edifecs, Caradigm, and Altegra Health.

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Telemedicine provider Carena receives $13.3 million in funding from Cambia Health Solutions and McKesson Ventures to continue development of its virtual clinic solutions, which it says can be brought live 90 days after signing as a branded virtual clinic.

GE is rumored to be shopping its GE Capital Healthcare Financial Services unit for up to $11 billion as it dismantles GE Capital.

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Shares of value-based care consulting firm Evolent Health begin trading on the New York Stock Exchange Friday at $17, which values the company — formed in 2011 by UPMC Health Plan and The Advisory Board Company — at $800 million.


Sales

East Jefferson General Hospital (LA) signs up for MedCPU’s clinical decision support system. I interviewed EJGH CMIO Beau Raymond, MD a couple of weeks ago.

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Penn State Hershey Medical Center chooses PeraHealth’s clinical surveillance system.


People

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Patient engagement solutions vendor TeleHealth Services names Gary Kolbeck (GK Consulting Services) as VP of business development.

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Ted Reynolds (CTG Health Solutions) joins Impact Advisors as VP.


Announcements and Implementations

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Provide Medical Park (WA) goes live on the Advantages RTLS patient flow system from Versus Technology, which allows patients to skip the waiting room and proceed directly to an available exam room.

CitiusTech launches CQ-IQ, a cloud-hosted quality analytics platform for CQM reporting that includes 250 pre-built quality measures across several care settings. I interviewed CEO Rizwan Koita in January.  

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Former Facebook CFO David Ebersman launches Lyra Health, which offers behavioral health screening tools and care coordination. His co-founder and chief medical officer is Dena Bravata, MD, who left Castlight Health in December 2014 after five years as chief medical officer and head of products.

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Two public relations firms, one of which focuses on sensitive federal government issues, form ATDigitalHealth, which will promote interoperability and telehealth services to lawmakers.


Government and Politics

The opening of the Topeka, KS VA hospital’s ED – closed for almost a year and a half due to staffing shortages — is delayed for at least six more weeks as the VA’s central office requires it to upgrade its EDIS.


Privacy and Security

A report by cyberdefense vendor TrapX finds that most healthcare organizations are vulnerable to Medjack (medical device hijack), where hackers locate unpatched, Internet-connected medical devices and use them as a back door to penetrate the health system’s network. The attacks, which are made easier by FDA restrictions on keeping devices it has approved updated, are hard to detect since security teams can’t view a device console and can’t just disconnect them for maintenance.

Plans by the Federal Employees Health Benefits Program to launch a claims database of federal employees for third-party cost analysis are criticized by privacy advocates, unions, and consumer groups who question the potential privacy exposure.


Technology

A Harvard-developed blood test that costs as little as $25 can detect nearly every virus to which a person has been exposed, potentially allowing epidemiologists to track diseases and to determine optimal vaccination ages.


Other

East Texas Medical Center sues Blue Cross, Aetna, and Cigna for excluding the hospital from their PPO networks in what it says is a violation of Texas insurance code.

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I’m not surprised by Will Weider’s tweet. What we think patients want, as often is the case, isn’t what they really want. It’s smug paternalism to presume either way without actually asking them or letting their actions speak for themselves.

Clint Eastwood will direct a movie version of  US Air pilot Sully Sullenberger’s biography, most likely dramatizing the “Miracle on the Hudson” story of his saving his own life (and in doing so, the lives of his passengers) rather than his later, less-dramatic safety efforts.

A Washington Post article says hospitals struggle to meet unrealistic consumer expectations as they try to manage their social media reputations, with patients rating doctors and nurses on bedside manner and convenience while providers are focused instead on delivering clinical outcomes. It mentions HealthLoop’s tailored follow-up messages and responses that help doctors know when to intervene after an encounter, citing an unnamed hospital whose satisfaction scores jumped 11 percent after implementing HealthLoop.

BIDMC CIO John Halamka, MD says the Meaningful Use program should be shut down and replaced with outcomes-based CMS incentives, with ONC refocusing its work to create a national provider messaging directory, encourage the use of a voluntary national patient identifier, work to streamline state-specific privacy laws, coordinate federal health IT priorities, and support private sector initiatives. He says interoperability demands have changed in a value-based care world and that the private sector is best equipped to meet market needs, urging that the industry “help providers do their job and improve satisfaction to the point that Congress no longer wants to legislate the solution to the problem.”

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Several high-profile health IT bloggers who are patients of One Medical Group call out the supposedly tech-savvy concierge medicine company on Twitter for not providing online bill payments and for being unable to give patients digital copies of their records.  

British Medical Journal reorganizes its software development teams as it moves from publisher to a vendor of point-of-care clinical guidance.

An anesthesiologist says it’s not just OR personnel who are distracted by screwing around with their phones instead of doing their jobs. He provides a first-hand example of a teen struck by a car and awaiting surgery who was taking selfies from his hospital bed while one parent was texting and the other was posting to Facebook, all of them scolding the anesthesiologist for interrupting them as he tried to take a pre-op history. He urges health professionals to educate the public about addiction to texting and social media.


Sponsor Updates

  • Patientco CFO Kurt Lovell is recognized by the Atlanta Business Chronicle as a CFO of the Year finalist.
  • Anthelio’s Engage mobile patient engagement app earns ONC’s 2014 Edition Modular Certification.
  • Impact Advisors is named to Crain’s Chicago “Fast 50 List” as the #21 fastest-growing Chicago company.
  • Healthloop is featured in an Economist article titled “Small data from patients at home will mean big cost savings.”
  • Nordic profiles practice director and cheese carver Joey Vosters, who says he’ll carve the company’s logo for the next work party if Nordic will get him a 45-pound block of cheese.
  • Patientkeeper offers “About Nurses, Patience, and EHRs.”
  • Iatric Systems announces successful integration of Welch Allyn and Nihon Kohden medical devices with the EHR of Halifax Regional Medical Center (NC) using its Accelero Connect solution.
  • MedData will exhibit at the Coastal Emergency Medicine Conference June 5-6 in Kiawah Island, SC.
  • Navicure offers “Setting Goals to Improve Patient Collections and Total RCM.”
  • Nordic hosts a meetup for Houston-area consultants and candidates on June 5.
  • Oneview Healthcare Head of Solutions Niall O’Neill talks to NewJobRadio.
  • Orion Health offers “Why you should be an engaged patient.”
  • Passport Health will hold a Northeast User Group Meeting June 11-12.
  • PatientSafe Solutions offers “Patient Centered Care: Is It Really That New?”
  • PDS publishes “Technology and the Group Purchasing Organization Business Model.”
  • Phynd Technologies offers “My Time at the More Disruption Please Hill Day.”
  • New York eHealth Collaborative will exhibit at NYHIMA’s 2015 Annual Conference June 7-10 in Syracuse, NY.
  • PMD posts “Purpose Build: EHR Mobile Apps vs. PMD Charge Capture.”
  • Qpid Health offers “’Human-Digestible’ Documentation Tops AMIA EHR 2020 Task Force Recommendations.”
  • Extension Healthcare offers “Bridging the Gap Between Clinical Users and Health Tech Managers.”
  • Galen Healthcare Solutions recaps its experience at the 2015 MUSE conference.
  • Beth Israel Deaconess Medical Center CIO John Halamka, MD contributes to the debut of Hayes Management Consulting’s new Healthcare Leaders series.
  • HDS posts “The High Price of Health IT Security Breaches: $6B.”
  • The Atlanta Journal-Constitution profiles entrepreneur Greg Foster’s battle with brain cancer while starting Brightwhistle, which was recently acquired by Influence Health.
  • InstaMed publishes a new white paper entitled, “New Expectations: The Payment Experience Members Want from US Health Plans.”
  • Intellect Resources offers “Healthcare IT Jobs: Carpe Diem.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 4, 2015 News No Comments

News 6/3/15

June 2, 2015 News 7 Comments

Top News

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Partners HealthCare (MA) goes live on Epic at a cost of $1.2 billion, double its original $600 million estimate, making the project the single largest investment the health system has ever made. The Boston Globe article quotes a Tufts professor and Health Policy Commission member as saying, “We will ultimately all pay for it. Will we get dividends back in terms of better care and greater efficiencies? We don’t know yet.”


Reader Comments

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From Around St. Louis: “Re: SLU Hospital. The university is buying their hospital back and conjoining with SSM to run it. SLU Hospital was the only Tenet hospital with Epic – all others are on Cerner.” The 356-bed hospital wasn’t happy that buyer Tenet, which paid $300 million for the hospital, failed to establish a regional network. The city will lose $6 million in annual tax revenue that for-profit Tenet was paying that SSM won’t, although the mayor’s office say it’s happy with the hospital providing “quality healthcare, jobs, and expansion,” thus neatly illustrating that it’s tough to control healthcare costs when everybody likes the huge employment it creates at public expense.


HIStalk Announcements and Requests

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Mr. K sent a photo of students with the Bluetooth speaker we provided to his Wisconsin PE class via DonorsChoose, which apparently was a great student motivator for our $178 donation. Mrs. F’s Ohio first graders are using their STEM kits in summer school sessions where they learn “while they think they are playing,” she reports. Meanwhile, companies donating $1,000 or more to our DonorsChoose project get mentioned and double their impact via matching funds provided by an anonymous HIT vendor executive – contact me.

I was thinking about complaints that providers don’t make EHR data available to patients vs. the tiny percentage of patients who actually request it. Someone should perform a study to determine the level of demand and the reasons people aren’t requesting their information. I haven’t seen anything to suggest that providers are denying those requests, so targeting them as the villain doesn’t make sense. Proponents should be taking their case to the public, not to providers and EHR vendors. I’ve never requested my own information or changed providers just because I couldn’t get it easily – have you?

I was also thinking that among all the unrealistic expectations placed on health IT to improve health, a big one is caused by consumers who think a huge problem is misdiagnosis. That’s a minor issue compared to lack of consistent, evidence-based treatment of easily diagnosed conditions in which the patient accepts full responsibility for their outcome. Improving outcomes and cost for obvious conditions such as COPD, diabetes, and heart disease unfortunately isn’t as sexy as uncovering a gene for an obscure disease or using Watson to suggest treatments. The transition to a public health mindset is slow and patients don’t like hearing that the answer to their problems is willpower, moderation, and acceptance rather than a decisive, inconvenience-free prescription or procedure.


Webinars

June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.


Acquisitions, Funding, Business, and Stock

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Post-hospital care coordination systems vendor Careport Health closes $3.8 million in financing.

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McKesson sells its Care Management business, which offers case and disease management services to payers, to investors who will rename it AxisPoint Health.

Premier acquires CommunityFocus, a community health needs assessment management solution jointly developed by UNC-Charlotte and Premier that will be incorporated into PremierConnect.


Sales

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Kingsbrook Jewish Medical Center (NY) will use CipherHealth’s Echo to provide secure, online audio recordings of verbal discharge instructions to visually impaired patients.

Kentucky Medical Services Foundation chooses MedAptus Enroll for managing provider credentialing.


People

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Payor platform vendor Healthx names Sean Downs (Enclarity) as CEO.


Government and Politics

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Vermont Governor Peter Shumlin says a successful software upgrade to the state’s troubled health insurance exchange system this week will reduce the time required for “change in circumstance” updates, but adds that consumers will still need personal staff help until more changes are made in the fall and that warns that it will take time to catch up on the 10,000 changes that have been backlogged. Optum met the May 31 deadline for applying the update but must clear the backlog by October 1 to keep the state from considering shutting down the exchange and moving to Healthcare.gov.


Privacy and Security

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Cottage Healthcare System’s (CA) cybersecurity insurer demands that the hospital repay $4.1 million it provided in settlement costs following a 32,500-patient data breach in 2013, saying the health system lied on its application in saying that it was applying patches, performing annual audits, and verifying the security capabilities of its outsourcers. The hospital failed to update the default FTP settings of servers, allowing patient information to display on Google searches.


Other

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County-operated 439-bed Riverside County Regional Medical Center (CA) requests $53 million to convert to Loma Linda University Health’s Epic system, which I believe would replace Siemens Soarian for inpatient and NextGen for ambulatory.

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A Northwestern University study finds that 84 percent of teens have looked up health information online (mostly by Googling a topic and clicking on the first link presented) and 21 percent have download health-related mobile apps, although two-thirds of them say they didn’t change their behaviors based on health information or tools. Three-fourths of teens were at least moderately satisfied with the information they found, but a significant percentage also ran across negative information such as how to manufacture drugs, play drinking games, or create eating disorders. Only seven percent had ever used a fitness tracker. 

A New York Times analysis finds that hospitals are jacking up their list prices (paid only by uninsured and out-of-network patients) at double the rate of inflation, while their Medicare payments remain flat.

A study finds that 8.2 percent of ED patients returned within three days, with a third of them choosing a different ED and the second visit often costing a lot more than the first. The highest revisit rate involved skin infections that probably shouldn’t have required an ED visit in the first place, but of course most doctors in private practice work banker’s hours in rarely being available without an appointment and nearly never between 5 p.m. and 8 a.m., leaving the ED as the only medical “open now” sign on for well more than half the day unless you count urgent care clinics that actually expect patients to pay upfront instead of if and when they get around to it.

Your cutting edge, contemporary, and fresh HIMSS16 presentation proposal is due June 15, a mere 8.5 months before you’ll actually present it.

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AOL founder Steve Case, now an investor, says healthcare is one of the big economic sectors that will be disrupted by startups, for which he advises perseverance, partnerships, and policy. On the other hand, Steve’s one hit was dumping AOL on the clueless and Internet-terrified Time Warner in a disastrous and scandal-driven 2001 dot-bomb merger, with his follow-up Revolution Health sinking without a trace and his current healthcare IT investments being companies I’ve never heard of. He spoke at HIMSS08 back when it still looked like he might disrupt healthcare.

Weird News Andy flipped over this story that he titles “spatuvula.” A woman tries to clear her allergy-swollen throat using a foot-long kitchen spatula handle, removal of which (and part of her esophagus)required emergency surgery. WNA loves the bonus story at the end that describes a doctor removing a fish from a boy’s throat on camera, leading WNA to question whether he was paid scale.


Sponsor Updates

  • Valence Health is named as one of Chicago’s fastest-growing companies with its 50 percent annual growth rate and 800 employees.
  • Cumberland Consulting Group’s Annamarie Lee will present “Navigate Complexities of Contracting and Government Compliance” at CBI’s Medicaid and Government Pricing Congress this week in Orlando.
  • Health Catalyst is named as one of the best places for millennials to work.
  • Forward Health Group CEO Michael Barbouche is interviewed by a Madison newspaper.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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June 2, 2015 News 7 Comments

Monday Morning Update 6/1/15

May 31, 2015 News 9 Comments

Top News

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A judge approves an injunction requested by Dallas-based telemedicine provider Teladoc against the Texas Medical Board for its new rule that requires doctors to conduct a face-to-face patient visit before issuing a prescription.


Reader Comments

From Talking About BS: “Re: Athenahealth. Has spent almost $1 million on lobbying so far in 2014-15 and VP Dan Haley is listed in OpenSecrets.org as a ‘revolving door’ lobbyist, described as federal employees turned lobbyists and vice versa. Athena’s cloud vapor simply isn’t selling to real customers and instead is being sold to Wall Street and Congress. Einhorn has this company pegged.”

From Travlinman: “Re: Epic. Guarantees ongoing interoperability with TeleTracking. Are they going to start playing nice with other vendors?”


HIStalk Announcements and Requests

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More than half of poll respondents think Cerner is the HIT stock to buy. New poll to your right or here: who is most to blame for lack of patient data sharing among providers? Vote and then click the poll’s comments link to make your case.

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I have no idea what a Rekenrek is, but Ms. S says her Indiana first graders are using the ones we bought via our DonorsChoose project daily for Math Warm-Up, adding that, “We had been using Rekenreks that we made on our own that are falling apart, so to see professionally made ones is wonderful!”

I seem to be especially cranky about grammar these days, so add these to my already long list: (a) starting sentences with the word “So” like a drunken bar patron launching into a long, dull anecdote; (b) sloppy use of geographic terms such as “a German doctor” that could mean a doctor from Germany, a doctor in Germany, or both; (c) using “less” rather than “fewer” in describing a collection of individual items, as in erroneously stating, “The event had less people than before”; (d) confusing “I” with “me” as in incorrectly proclaiming, “My brother came to visit Mary and I.” There, now I feel better.

I’m also annoyed by the expression “EHR mandates.” Nobody requires doctors to use EHRs except perhaps their employers – they just pay them extra if they do.


Last Week’s Most Interesting News

  • HHS names Susannah Fox as its new CTO.
  • Two entrepreneurs who sold DiagnosisOne to Alere in 2012 buy back the business – now known as Alere Analyics – to form Persivia. 
  • Athenahealth VP of Government and Regulatory Affairs Dan Haley said in a New York Times article titled “Tech Rivalries Impede Digital Medical Record Sharing” that customers typically pay EHR vendors $1 million upfront, $500,000 per year, and $2 per patient record to exchange information with other systems.
  • Forbes names Epic CEO Judy Faulkner as the wealthiest women in all of technology with an estimated $2.6 billion net worth.
  • Cerner told shareholders that it recorded $4.25 billion in sales for 2014.

Webinars

June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.


People

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Tim Theriault, global CIO of Walgreens Boots Alliance (the former Walgreen), resigns for personal reasons. He will be replaced by Anthony Roberts, SVP/international CIO. Roberts came on board with the December 2014 Boots acquisition.

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Former Meriter CIO Peter Strombom died May 18 at his home in Costa Rica. He was 75.

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Jeremy Delinsky, chief product officer at Athenahealth, resigns after five months in the position to take a CTO position with an online furniture company. ATHN shares dropped more than 5 percent Friday following the announcement.  His interim replacement will be VP Kyle Armbrester. ATHN shares are down 20 percent so far in 2015.


Announcements and Implementations

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Athenahealth offers athenaCommunicator Enterprise to new customers who participate in an ACO for a flat 10 percent of their MSSP shared savings payouts.


Government and Politics

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Florida Governor Rick Scott, former CEO of for-profit and fraud-admitting Columbia/HCA, wants to hold the state’s non-profit hospitals more accountable for their huge profits, topped by Lee Memorial Health System’s $230 million.


Technology

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Ashish Jha of Harvard tweeted out rave comments about Doc Stats, an app that shows the approximate number of procedures a doctor performs as derived from CMS data.

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A Bay Area recycling firm is looking for a woman who dropped off garage junk following her husband’s death that included an Apple I computer, one of only 200 that were hand built by Steve Jobs and Steve Wozniak in 1976. The company wants to give the woman $100,000, her half of the amount a private collector paid to buy it from them.


Other

AMIA’s EHR 2020 task force publishes its recommendations. Many of them are observations of the current state or non-specific ideas about long-term changes that I didn’t find especially compelling or novel, but a few actionable items are:

  • Use natural language processing to convert free text notes to discrete data and reduce reliance on documentation templates.
  • Spend government money to study data entry methods and encourage the use of those that improve provider efficiency.
  • Slow down or freeze the Meaningful Use and certification requirements.
  • Eliminate requirements for providers to enter EHR information that isn’t used for direct patient benefit.
  • Eliminate E&M codes and checkbox-driven data entry that fails to capture the patient’s voice.
  • Allow vendors to meet MU certification with less-prescriptive methods and require them to post video recordings of their system so that EHR purchasers can see how they work.
  • Create the national Health IT Safety Center.
  • Require vendors to offer APIs to earn certification.

The board of Erlanger Health System (TN) approves its $91 million Epic contract, which will also require $97 million in maintenance costs over the next 10 years. The CFO says Epic beat Cerner on price and the selection committee preferred Epic 28 votes to two.

The Indianapolis business paper profiles ICUcare, which puzzling offers both a smartcard-based PHR (the company owner says he spent $25 million to develop it) and a telemedicine platform. The owner says the company has 12 employees and $3.5 million in revenue, some of which should probably be directed to updating the website, whish announces plans to release new technology in June 2010 and that lists Windows Vista as the required operating system (those are just the tip of the “ice-burg,” it says).

A Florida hospital tests the Internet lag time in performing telesurgery using the da Vinci surgical robot, finding that surgeons can’t tell the difference whether they are a few feet or a few states away from the patient.

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Influential healthcare IT expert Jess Jacobs of Aetna’s Innovation Labs recounts her recent and current experiences (with photos) as an inpatient of a hospital that can’t do anything right – a bathroom sink clogged for three days with her roommate’s bloody vomit, having to use her own cellphone to coordinate the work of several attending doctors who hadn’t talked to each other, mixing up mouthwash with handwash, a nurse call system that didn’t work, the nursing staff’s disregard of her roommates sickle cell crisis pain, and the barring of her patient advocate (who is a medical student at the same organization) from participating in her care. She complained to hospital administration after an earlier visit and received a halfhearted apology blaming her being housed in a treatment room as due to unplanned admissions, an acknowledgment that it was “unfortunate” that the hospital didn’t allow her friend to serve as her patient advocate (without offering an explanation as to why), and defense of her roommate’s pain management as being appropriate based on medical evidence. She’s back in as an inpatient for intractable vomiting and says nothing has improved – the hospital missed her abnormal lab results, security guards confiscated her prescribed drugs and supplies and threatened to arrest her for objecting, and the hospital assigned a “sitter” who sleeps, talks loudly in the hall, and eats bacon in her room. The scary thing about her story is that it’s not unusual from my experience – everybody who lives through an inpatient stay can relate equally horrifying stories about the incompetence and indifference they encountered.

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A good article in IEEE Spectrum describes how BIDMC CIO (and gentleman farmer) John Halamka, MD helped develop early big data platforms I2B2 and SHRINE that later may have saved his wife’s life as he researched the best treatment options for her newly diagnosed cancer based on historical outcomes. He adds in describing future innovation, “All these big companies are fine, but do we really think the next cool innovation is going to come out of an 8,000-person company? No. It’s probably a two-person garage operation.”

Another interesting IEEE Spectrum article addresses the healthcare uses of IBM’s Watson, which it concludes isn’t ready for prime time and may not be for some time because: (a) it not only has to find existing answers in existing content but also has be trained to think like a doctor; (b) journal articles Watson uses as source material aren’t always current or based on actual medical practice; (c) EHR databases are full of errors and focus more on billing rather than clinical usefulness. The article mentions other companies working on medical artificial intelligence such as QPID, DXplain, and CancerLinQ.

A small study of Facebook users finds that those with low self-esteem post often about their romantic partners, while those who brag about diet, exercise, and achievements are often narcissists who crave “likes” and positive comments from annoyed “friends” just trying to be nice.


Sponsor Updates

  • Medicity posts “ICD-10: Are We There Yet?”
  • MedData will exhibit at the Coastal Emergency Medicine Conference June 5-6 in South Carolina.
  • First Databank customer Joshua Schmees, PharmD of Hospital Sisters Health System describes the organization’s success in reducing alert fatigue by using FDB’s AlertSpace.
  • Quest Diagnostics employees raise over $11,000 in the American Cancer Society’s Relay for Life.
  • WeiserMazars posts pictures from its nationwide community service day.
  • NTT Data offers “Predictive Intelligence Brings Increased Value to Data.”
  • Versus Technology will exhibit at AAMI 2015 June 5-8 in Denver.
  • Truven Health Analytics posts “Understanding Your Exchange Population: Are You Asking the Right Questions?”
  • Microsoft summarizes the origins of Oneview Healthcare as part of its Customer Stories series.
  • Orion Health and Passport Health will exhibit at AHIP Institute 2015 June 3-5 in Nashville.
  • Patientco offers “Out-of-Pocket Costs are Increasing Faster Than Expected.”
  • PatientPay Founder and CEO Tom Furr asks “What Would Steve Jobs Say?”
  • ZirMed posts “Leveraging Data Analytics, Keeping Up with Value-Based Care, and Rev Cycle Success at Stanford Children’s Health.”
  • PMD offers “Reusing Code to Improve Care Coordination.”
  • Wide River will host an educational event, Health IT: Compliance & Innovation, June 4 in Lincoln, NE.
  • Sagacious Consultants posts “What You Don’t Know Can Hurt You: the Importance of Measuring Productivity.”
  • Huron Consulting will sponsor the 2015 Aria Health Golf Classic June 1 in support of Philadelphia-based Aria Health’s ICU renovations.
  • The Nashville Business Journal features Shareable Ink CEO Hal Andrews in its “The Boss” video series.
  • Streamline Health will exhibit at the 2015 CHIA Convention & Exhibit June 8-10 in Palm Springs, CA.
  • T-System will exhibit at NYHIMA’s 2015 Annual Conference June 7-10 in Syracuse, NY.
  • TeleTracking offers “Making Interoperability a Commonplace.”
  • Valence Health Project Manager Jacob Krive will present a session on big data and population health at the University of Illinois College of Medicine Chicago June 3.
  • Verisk Health, West Corp., and ZeOmega will exhibit at the AHIP 2015 Institute June 3-5 in Nashville.
  • Voalte offers a new blog showcasing the successful deployment of its smartphone solution at Massachusetts General Hospital.
  • Winthrop Resources will exhibit at the NY Tech Summit June 4-5 in Verona.
  • Xerox offers “The Best Kept Secret in Healthcare.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 31, 2015 News 9 Comments

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