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News 12/13/17

December 12, 2017 News 4 Comments

Top News

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CliniComp, fresh off its failed legal challenge of the VA’s choice of Cerner in a no-bid contract, sues Cerner for patent violation.

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CliniComp says Cerner violated its 2003 patent for a remote hosted hospital system.


Reader Comments

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From Dirty Dirge: “Re: big health system mergers. Who wins, Epic or Cerner?” I would instead ask whether the potential benefits of standardizing systems justify ripping and replacing existing EHRs when their sites cover a big swath of geography without much service area overlap. Maybe it’s OK to limit patient information exchange to the basics, like CCDs, since patients rarely seek care outside their local area. The most compelling argument would be populating a single database that can support analytics, operational analysis, research, and best practices, but that could theoretically be done on the back end with a lot of semantic data translation. The only comparably sized  model is the Kaiser’s use of Epic, but their implementation happened a long time ago; they have more focused corporate control than I would expect of newly merged health systems that can’t even name a single CEO; and Kaiser controls more of the patient experience as an insurer as well as a provider. Perhaps most at risk are Allscripts ambulatory or Meditech in sites included in the merger plans. My guess would be that the highest-priority system projects would involve administrative systems to allow executives to get a handle on their sprawling enterprises. We are really entering uncharted territory since most “huge” health systems have revenue of $2-5 billion vs. the dozens of billions that the proposed mega-mergers would create. Lower-tier vendors should take note – as hard as it already is to sell systems, it’s about to get a lot harder when you have to earn face time with a CIO who controls the IT strategy and budget of more than 100 hospitals (in comparison, Kaiser has only 39 hospitals).

Associate CIO provides these merger-related figures from Definitive Healthcare:

  • Dignity Health’s 48 hospitals run Cerner Millennium.
  • Catholic Health Initiative’s 153 hospitals use Cerner (61), Epic (65), and Meditech (27), also on the ambulatory side running McKesson (4) and Allscripts (21).
  • Ascension Health’s 132 hospitals use Cerner except for Providence and Wheaton Franciscan, which use Epic.
  • Providence St. Joseph’s 58 hospitals use Epic (37), Meditech (19), and Allscripts (3).

In terms of dominant vendor in the two proposed mega-mergers, it’s obviously Cerner over Epic (109 vs. 65 and 130 vs. 39, respectively). Here’s a fun opportunity for Definitive or HIMSS Analytics to list the major systems (beyond just the EHR) used by these health systems that are contemplating merging.

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From Comprn: “Re: Lifepoint Health. RIF including multiple VPs, about 25 FTEs, due to lower-than-expected earnings.” Unverified. The 72-hospital company cut its revenue and profit forecasts in late October due to fewer-than-expected admissions for the fiscal year. LPNT shares are down 15 percent over the past year vs. the Nasdaq’s gain of 27 percent, valuing the company at $2 billion. It’s probably tough competing with systems bigger than yours that don’t pay taxes and that are equally profit-motivated.

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From Trust but Verify: “Re: White House EHR meeting. A news site says [publication name omitted] broke the story but I saw it two days before on HIStalk.” Correct. An anonymous reader sent me the agenda via my Rumor Report online form and I posted the information in Sunday night’s post. Nobody else ran anything that I saw until at least Monday morning, so I’m pretty sure all mentions were triggered by reading it on HIStalk. One site that emailed me late Sunday ran their item (with the agenda that I sent them) Monday morning, but didn’t give credit. I’m also surprised at news organizations that cite one particular health IT website as a source when it’s pretty much like Wikipedia, with no original content.


HIStalk Announcements and Requests

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Cumberland Consulting Group’s employee volunteer and community action group donated $1,000 to my DonorsChoose project, which with matching funds from my anonymous vendor executive and other sources funded the entire cost of these projects for high-need classrooms:

  • Take-home family math activities for Ms. D’s elementary school class in Houston, TX.
  • Hands-on math games for Ms. K’s first-grade class in Indianapolis, IN.
  • Games for science game night for Mrs. S’s elementary school in Gautier, MS.
  • Microscopes, telescopes, and science kits for Mrs. B’s elementary school class in Gulfport, MS.
  • Take-home science activity kits for Mrs. M’s elementary school class in Chattanooga, TN.
  • STEM kits for Mrs. M’s elementary school class in Paterson, NJ.
  • STEM books and activity kits for Mrs. H’s elementary school class in Sugar Creek, MO.
  • Programmable robots for Mrs. G’s elementary school class in Brownsville, TX.
  • After-school science kits and supplies for Mrs. P’s elementary school class in Pocatello, ID.
  • 200 sets of headphones for Ms. C’s elementary school class in Provo, UT.
  • STEM project kits for family game nights for Ms. M’s elementary school class in Fayetteville, NC.
  • Programmable robots and a Chromebook for Mrs. G’s elementary school class in Miami Gardens, FL.
  • STEM kits for Ms. T’s elementary school class in Bronx, NY.
  • STEM project kits for family game nights for Mrs. H’s elementary school class in Canyon, TX.
  • Programmable robots for Mrs. F’s high school class in Glen Dale, WV.
  • STEM activity kits for a student-led STEM gender and ethnic diversity project of Mrs. I’s high school class in Orangeburg, SC.
  • Math and science resources for Ms. S’s first-grade class in Dayton, OH.
  • Headphones for the technology lab of Ms. W’s elementary school class in Memphis, TN.

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Can you please take 3-5 minutes to complete my once-yearly, one-page HIStalk reader survey? I’ll use the results to plan for 2018, but if you need even more motivation, I’ll be randomly drawing respondents to win a $50 Amazon gift card. Thank you.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Population health management systems vendor SymphonyCare acquires Influence Health’s Empower patient portal business.

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Physician scheduling system vendor QGenda acquires ED physician scheduling software vendor Tangier.

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Aetna CEO Mark Bertolini tells investors that he envisions that a merger with CVS would allow placing health hubs in pharmacies that would serve as health system navigators, especially for the 60 percent of people who don’t have a regular doctor. He says it could work like the Genius Bar in Apple Stores.

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Nashville-based health IT staffing firm ALKU acquires Holland Square Group, a health IT consulting firm also based in the Nashville area. Holland Square Group is a DoD MHS Genesis subcontractor under Leidos.


Sales

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OhioHealth (OH) chooses Casechek’s implant supply chain automation.


People

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Hans Morefield (Experian) joins substance use disorder technology vendor Chess Health as CEO. The company’s executive chair is industry long-timer John Holton.

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CTG hires Jeff Gerkin (Manpower Group) as EVP of sales.

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Brett Jarvis (LinkedIn) will join Solutionreach as SVP of customer success.


Announcements and Implementations

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Mental and behavioral screening software vendor AssessURhealth offers its app on the Athenahealth Marketplace.

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New Jersey’s state medical society brings its OneHealth New Jersey HIE live.

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Legacy Data Access will offer its 800 hospital customers a hosted, AI-powered clinical data service in partnership with Life2.

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Firelands Regional Medical Center (OH) goes live on Meditech’s Web EHR.

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New York – Presbyterian installs telemedicine kiosks in some of its New York-based Duane Read drugstores, making its ED doctors available to review problems that are not life-threatening.

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Ground was broken this week on what would have been Cerner CEO Neal Patterson’s 68th birthday on the Patterson Health Center, a $41 million critical access hospital on the Kansas-Oklahoma border that is mostly funded by the Patterson Foundation. The facility, which combines two existing hospitals that merged on November 1, will offer a 15-bed hospital, health clinic, rehab services, a wellness center, and public green space. The family was represented by Neal’s nephew Alan Patterson:

Uncle Neal never really left the farm. He came back to Harper County just about any chance he had. Even after he was a big shot on the cover of Forbes Magazine, he came home at harvest to drive a combine, bring meals to the field, and hang out with the guys when the work was done. If you drove by the farm, you would often see him running the company from a laptop while sitting on the front porch of the farmhouse where he grew up. To me, he was a big kid who was 30 years older than me but enjoyed doing the same things I did. He was like another high school buddy would come back to visit his parents and hang out …  Neal traveled the world and he saw something troubling that most of us don’t see. He saw that small towns were in a healthcare crisis and they were being left behind. He saw that people in rural areas had poorer overall health compared to people in bigger communities. Little hospitals were not the most profitable areas of the business, nor the ones that would help ensure his company made quarterly earnings… but he did not care. He knew that good healthcare facilities and technology were important to rural communities


Government and Politics

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A Wisconsin judge dismisses the revenue cycle system lawsuit that Agnesian Healthcare filed against Cerner, noting that Agnesian’s contract requires it to submit to arbitration in Cerner’s home state of Missouri instead of suing. Anesian claimed in the now-dismissed September 2017 lawsuit that a botched RCM conversion from McKesson to Cerner in 2015 cost it $16 million in revenue and $200,000 per month due to coding and billing errors, while Cerner insists that it fixed the problems in 2016.

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CDC Director Brenda Fitzgerald is recusing herself from issues related to health IT and oncology because she is legally required to keep her illiquid investments in LLCs involving Greenway Health (EHRs) and Isommune (cancer detection). Fitzgerald – a former OB-GYN, Air Force major, and commissioner of Georgia’s Department of Public Health – and her ED physician husband reported assets valued at up to $16 million.

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The New Yorker profiles “Estonia, the Digital Republic,” describing how the post-Soviet republic of 1.3 million people transformed itself into a digital society that embraces robots, a personalized chip ID, making nearly all business and personal information available online, giving every person ownership of data recorded about them, and a “once only” policy that pulls in existing information for everything from buying a house to seeing a doctor.  The country is reconsidering the definition of “population” by connecting virtual talent in an “e-residency” program that allows citizens of other countries to become residents of Estonia with access to digital services without ever setting foot in the country. Some snips from the fascinating article:

“I’ll show you a digital health record,” she said, to explain. “A doctor from here”—a file from one clinic—“can see the research that this doctor”—she pointed to another—“does.” She’d locked a third record, from a female-medicine practice, so that no other doctor would be able to see it …  E-ambulance is keyed onto X-Road, and allows paramedics to access patients’ medical records, meaning that the team that arrives for your chest pains will have access to your latest cardiology report and ECG. Since 2011, the hospital has also run a telemedicine system … Rita Beljuskina, a nurse anesthetist, led me through a wide hallway lined with steel doors leading to the eighteen operating theatres. Screens above us showed eighteen columns, each marked out with 24 hours. Surgeons book their patients into the queue, Beljuskina explained, along with urgency levels and any machinery or personnel they might need. An on-call anesthesiologist schedules them in order to optimize the theatres and the equipment … She logged on with her own ID. If she were to glance at any patient’s data, she explained, the access would be tagged to her name, and she would get a call inquiring why it was necessary. The system also scans for drug interactions, so if your otolaryngologist prescribes something that clashes with the pills your cardiologist told you to take, the computer will put up a red flag.


Privacy and Security

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An Accenture-conducted, AMA-sponsored survey of 1,300 physicians survey finds that 83 percent have experienced cyberattacks and want cyber hygiene tips, a guide on conducting a risk assessment, and easy-to-understand HIPAA instructions. The survey’s methodology isn’t the best, however:

  • Respondents were apparently self-selected and only completed an online survey.
  • If only AMA members were polled (the report doesn’t say), that would be only a tiny, non-representative subset of all US doctors.
  • Respondent demographics were not provided, such as the size of their practice site or whether they work for a health system.
  • Half of respondents say they have an in-house security official, although the question wasn’t asked about that person’s time allocation and credentials.
  • More than one-fourth of responding physicians say they have outsourced security management, but the survey didn’t ask what that means.
  • More than half of respondents say someone clicked on a phishing link, which doesn’t really seem like a cyberattack unless it resulted in downtime.
  • Only 37 percent reported that an employee inappropriately accessed PHI, which is surely low.

Technology

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Apple will launch the IMac Pro this week at an entry price of $5,000 for 32 GB of memory and 1 TB of storage and up to $17K for a fully loaded machine, testing the limits of just how much of an Apple tax even professional users are willing to pay. It’s not an Apples-to-apples comparison, but my Acer laptop has 16 GB, 1 TB (along with a 128 GB SSDD for running Windows 10) and cheap available upgrades and I only paid a bit more than $500. Even that capacity is excessive since nearly everything I use is on the Web.


Other

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Two-thirds of the few dozen interviewed patients who got their lab results via a clinic’s patient portal weren’t given further explanation, sending most of them to Google to try to figure out what the results mean. The article concludes that just displaying lab numbers on a portal isn’t enough, especially for patients with abnormal results.

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In Canada, all-digital Humber River Hospital opens a Meditech-powered, 4,500-square-foot Command Centre in which staff monitor real-time incidents such as delayed care and provider workload issues. It also contains a 26-panel GE Wall of Analytics with live video feeds from patient care areas.

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A just-published review of a 2016 Netherlands bake-off of 32 algorithms that analyze tissue slides to detect breast cancer metastasis finds that seven performed better than a panel of 11 pathologists when limited by typical workflow time constraints. The best algorithms performed equal to the pathologist panel when time constraints were removed. 

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A review of 1,300 clinic visits finds that patients asked their doctors for specific lab tests, referrals, pain meds, other medication an average of once per visit; the doctor agreed to write the order for what they wanted 85 percent of the time; and those patients who were turned down gave the doctor lower satisfaction scores.

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Javon Bea, CEO of five-hospital Mercyhealth (WI), was paid $8.38 million in 2016, far more than basically any charity or health system. The newest tax form I found was from 2014 and even then the CIO made over $750,000. Maybe nobody wants to live in Janesville, WI or work for Mercyhealth if they have to pay that much. Axios notes that even under his previously slightly lower pay, Bea earned $72 per patient day, although he told the local paper that his then-$3 million paycheck had no impact on healthcare costs even as he increased the system’s revenue from $33 million to $1 billion. 


Sponsor Updates

  • Spok launches a library of stories illustrating the ROI of clinical communication technology.
  • Optimum Healthcare IT completes its work as primary partner for UCI Health in its Epic Connect strategic partnership with UC San Diego Health.
  • Change Healthcare SVP of Product Development and Technology Michael Wood joins the 2018 Class of the Nashville Health Care Council Fellows.
  • AssesURHealth raises $2,700 for the American Foundation for Suicide Prevention as part of the Out of the Darkness Tampa Bay Walk.
  • Change Healthcare will integrate Tibco’s Connected Intelligence product line with its products.
  • Besler Consulting releases a new podcast, “S10 changes you should know about.”
  • Glassdoor includes CoverMyMeds in its list of Best Places to Work in 2018.
  • Diameter Health achieves NCQA Certification for all 2017 e-measures.
  • Vyne’s Trace and FastAttach solutions earn HITRUST CSF certification.
  • EClinicalWorks will exhibit at the New York Society for Gastrointestinal Endoscopy 41st Annual New York Course December 14-15 in New York City.
  • The “I Love Madison Podcast” features Healthfinch VP of Finance and Operations Leah Roe.
  • Technology Headlines Magazine names Intelligent Medical Objects CEO Frank Naeymi-Rad one of the 50 Most Admired CEOs of 2017.
  • ConnectiveRx publishes a new white paper, “Boost prescriber knowledge and confidence using in-EHR formulary-status messaging.”

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 12/11/17

December 10, 2017 News 16 Comments

Top News

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The White House’s Office of American Innovation will host a half-day meeting Tuesday on EHR interoperability, led by Jared Kushner and CMS Administrator Seema Verma. Thanks to the reader who forwarded the agenda, which did not include a list of invitees. Working groups will address four topics:

  • How CMS, ONC, and HHS can encourage interoperability and accelerate its timeframe.
  • The methods of authentication that could be used and how can the industry can be aligned to support them.
  • How patients and physicians can be engaged in interoperability and how and any HIPAA issues can be addressed.
  • How can the private sector can become engaged and their participation jump-started by the government’s release of claims or other data.

HIStalk Announcements and Requests

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Fairly few male readers are worried that incidents in their past could result in new claims of sexual harassment. HarassedMan was pursued by a male superior and urges employers to provide clear training, policies, and enforcement procedures. HISJunkie wonders whatever happened to innocent until proven guilty and also suggests that a man who is terminating a female employee for cause think carefully about the situation.

New poll to your right or here, continuing last week’s poll: women, what kind of sexual harassment have you experienced? I found my inquiry limited by the format of a poll, so perhaps I’ll follow up with a survey to answer questions such as:

  • Did you rebuff the advances, and if so, did it hurt your career?
  • Did you report it to HR, and if so, was the issue resolved to your satisfaction?
  • If you didn’t rebuff or report, why not?
  • Have you ever provided sexual favors or accepted sexual situations — or worked with someone who did — to get hired or to improve job prospects? This is hard to ask, but it happens and encourages bad situations for others. I feel sorry for a man or woman who successfully stops an uncomfortable situation but sees their job suffer because co-workers accept it as quid pro quo.
  • Are you considering taking any legal action or going public with incidents from your past?

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Three dozen clinician respondents are mixed on whether hospital VIP patients have better clinical outcomes. Nearly half say yes, while around one-fourth each say the outcomes are the same or worse as in the cheap seats. I was appalled at my first hospital job in learning that my for-profit employer – whose outcomes were universally terrible, as you would expect when bean counters oversee all the clinical decisions of a badly educated medical staff recruited for obedience and volume rather than quality –cleared an entire hallway to house the hypochondriac mother of our very profitable eye surgeon. Our profit-obsessed executives convened emergency department head meetings to make sure everybody figuratively genuflected to meet her every need (I got stuck running out to get the kind of wine she preferred since our nutritional services people could barely open cans and heat up food service frozen entrees) and made rare appearances in patient care areas only because she was propped up back there like a queen. At least working for a for-profit hospital shortened the path to my disillusionment with hospitals and maybe humanity in general.

Listening: new from Bully, Nashville-based grunge rockers who sound like Hole mixed with the Breeders. The tiny female singer, who has a rather chirpy conversational voice but can really belt it out cathartically when singing, looks quite a bit like Lucy in the original “Twin Peaks.” 

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Friend at Impact generously donated $1,000 to my DonorsChoose project, asking that I focus on elementary school STEM materials (which I’m quite happy to do since I usually seek those out). I applied a dollar-for-dollar match from my anonymous vendor executive plus other matching (the $1,000 donation ended up fully funding a stunning $8,200 worth of grants) for these projects in schools whose students are almost all from low-income households:

  • Lab coats, goggles, science journals, and activity kits for Ms. G’s fourth-grade class in Los Angeles, CA.
  • An IPad for running programmable robot kits for Ms. S’s elementary school technology club in Los Angeles, CA.
  • Three video cameras for home science experiments for Mrs. S’s third-grade class in Philadelphia, PA.
  • STEAM activity kits for the after-school elementary school program of Mrs. M in Springdale, AR.
  • Math activity kits and games for Mrs. H’s elementary school class for the deaf and blind in Mobile, AL.
  • Programmable robots for Mrs. W’s elementary school class in Cartersville, GA.
  • Programmable robots for Mrs. O’s elementary school class in Garland, TX.
  • STEM kits and experiment books for Mrs. A’s elementary school class in Detroit, MI.
  • Six electronic note pads for Mrs. N’s elementary school class in Farmville, MI.
  • Take-home math and STEM games for Mrs. F’s elementary school class in Mescalero, NM.
  • A STEM bundle for Mrs. T’s kindergarten class in Dallas, TX.
  • Take-home math game bags for Ms. M’s elementary school class in Bronx, NY.
  • STEM games for Mr. M’s elementary school class in Milwaukee, WI.
  • Weekly take-home science projects for Ms. I’s elementary school class in Oxnard, CA.

This Week in Health IT History

One year ago:

  • President Obama signs the 21st Century Cures Act into law.
  • The Wireless-Life Sciences Alliance trade group and the HIMSS-owned Personal Connected Health Alliance merge.
  • CommonWell Health Alliance and Sequoia Project’s Carequality announce plans to connect their respective systems.
  • The American Heart Association, AMA, DHX Group, and HIMSS launch the non-profit Xcertia to establish best practices for mobile health apps.
  • SocialWellth brings back the Happtique app certification program.
  • MD Anderson considers layoffs and research cutbacks after losing $102 million in the first two months of its fiscal year, with the cost of its Epic implementation being one of four factors hurting its bottom line.

Five years ago:

  • Mediware acquires inpatient rehabilitation and respiratory services documentation systems vendor MediServe.
  • Allscripts sues NYC Health + Hospitals for choosing Epic at what the company says is a $535 million premium to its own bid, to which the health system responds that Allscripts lacks an integrated EHR and that the company is suing to try to prop up its sagging share price.
  • McKesson Paragon beats out Cerner as the #2 product suite behind Epic in Best in KLAS, while Agfa, McKesson, and Allscripts were ranked as the worst vendors overall.

Ten years ago:

  • MedAssets conducts its IPO.
  • Dairyland Healthcare brings in a new executive team following its acquisition by Francisco Partners.
  • NextGen creates a revenue cycle management division for physician practices.
  • Philips acquires ICU monitoring technology vendor Visicu for $430 million, paying 12 times Visicu’s annual revenue.

Last Week’s Most Interesting News

  • FDA releases three sets of digital health guidance: clinical decision support (draft), reassertion that lifestyle apps will not be treated as medical devices (draft), and how software will be assessed as a medical device (final).
  • Dignity Health and Catholic Health Initiatives announce plans to merge in creating the country’s largest health system in terms of revenue.
  • Advocate Health Care announces plans to merge with Aurora Health Care.
  • The Sequoia Project announces that its Carequality initiative connects more than half of all US healthcare providers, with 1,000 hospitals, 25,000 clinics, and 580,000 providers exchanging 1.7 million clinical documents monthly.
  • CVS announces an agreement to buy Aetna for $69 billion.
  • Former GE CEO Jeff Immelt says the company tried to buy Epic but was immediately rebuffed and also considered acquiring Cerner but thought the $2 billion price was too high.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Philips acquires Netherlands-based, 200-employee population health management software vendor VitalHealth Software, co-founded by Mayo Clinic and Noaber Foundation in 2006. The company expands the informatics work Philips started with its acquisition of Wellcentive in 2016. Philips acquired Netherlands-based interoperability software vendor Forcare last week.

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Patient payments technology vendor Cedar raises $13 million in a Series A funding round. Co-founder Florian Otto, DDS, MD, PhD was sales VP for ZocDoc before starting Cedar in April 2016.

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The urge to merge reaches manic levels as Ascension and Providence St. Joseph Health are reportedly talking about combining to create a 191-hospital system with $45 billion in annual revenue, eclipsing last week’s signed agreement between Dignity Health and Catholic Health Initiatives that set the short-lived annual revenue record of $28 billion. Ascension is a Cerner shop, while Providence St. Joseph Health – formed in a July 2016 merger — uses Epic, Meditech, and Allscripts.


Decisions

  • Albion Family Practice (PA) will switch from Allscripts to Epic ambulatory EHR in 2018.
  • Saratoga Hospital Medical Group (NY) went live with Athenahealth ambulatory EHR in Q4 of 2017.
  • Munroe Regional Medical Center (FL) switched from Medhost to Cerner in 2017.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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Atlantic Health System promotes Ben Bordonaro to chief administrative information officer.


Government and Politics

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A GAO report finds that the VA spent $1.1 billion on four failed efforts to modernize VistA – HealtheVet, iEHR, VistA Evolution, and EHRM. GAO also notes that the VA has requested $4.1 billion for IT in 2018. Among the 15 key VA contractors on the failed projects was Cerner, who will sell the VA its VistA replacement system. An interesting tidbit from the report is that two of the VA’s systems are over 50 years old, both of them COBOL-based mainframe systems.


Privacy and Security

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UNC Health Care (NC) notifies 24,000 patients that their PHI was contained on an unencrypted laptop stolen from a dermatology practice it had acquired in 2015. The health system pledges in the announcement to do a better job of reviewing the security of practices it acquires.


Other

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In England, Royal Surrey County Hospital goes back to paper scheduling after an upgrade to its Allscripts system fails. I think they are using the Oasis Medical Solutions PAS, acquired by Allscripts in mid-2014.

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I ran across Medsender, a company I hadn’t heard of that promises to end 100 percent of medical record faxing or else there’s no cost to the customer. The company claims the product can be installed in 60 seconds and works with any EHR. Founder/CEO Zain Qayyum developed the product in 2014 while attending Marist College full time. 

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The operating income of UMass Memorial Health Care (MA) declined 74 percent in the fiscal year that ended September 30, with executives noting a modest increase in insurer payments, its $200 million in capital projects, and a $700 million Epic implementation that has taken doctors away from their revenue-generating clinic work as they build the system.


Sponsor Updates

  • Sunquest Information Systems hosts its 19th annual holiday toy drive for Aviva Children’s Services.
  • Surescripts will exhibit at the Health Care Law Institute 2017 December 14 in New York City.
  • A national IDN upgrades to ZeOmega’s Jiva 6.1 population health management platform.
  • LogicStream Health will exhibit at the IHI National Forum December 10-13 in Orlando, and will host a poolside party December 11 from 6:30-8:30pm ET.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 12/8/17

December 7, 2017 News No Comments

Top News

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FDA releases three sets of digital health guidance: clinical decision support (draft), reassertion that lifestyle apps will not be treated as medical devices (draft), and how software will be assessed as a medical device (final).

FDA will focus its attention and medical device status on software that analyzes medical images, physiological monitoring data, sound waves, sleep apnea monitor data, spectroscopy data, and slide pathology, as well as software that uses undisclosed algorithms.

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FDA says software isn’t a medical device just because it:

  • Uses patient information to present treatment guidelines and drug interaction / allergy alerts.
  • Offers prioritized alternatives to orders and drugs using generally accepted practices.
  • Suggests an intervention or a test consistent with clinical guidelines or drug labeling.
  • Makes suggestions for chemotherapy.
  • Uses rule-based tools to compare patient data to practice guidelines.
  • Provides tools, calculators, or protocols for TPN or enteral nutrition. 
  • Provides patients with prescription reminders and instructions that are consistent with FDA labeling.
  • Helps patients choose a non-prescription drug based on their symptoms.
  • Is intended only for healthcare facility use.
  • Allows patients to document or illustrate their conditions with their providers.

FDA also says it will not enforce its own requirement that electronic patient software be classified as a medical device if it isn’t certified by ONC.

Software that stores, converts, or displays medical images will also be moved to non-device status, but software that analyzes the images will be treated as a medical device.

Software that flags patient results based on specific parameters (such as out-of-range results or opportunities for complementary tests) will not be regulated as a medical device as long as it only performs the same interpretation that the practitioner could do themselves.


HIStalk Announcements and Requests

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CompuGroup Medical and its US CEO Benedikt Brueckle donated $500 to my DonorsChoose project, which when matched with funds from my anonymous vendor executive and other sources (I found some GREAT matching, as you’ll see, $5 for each $1 in some cases) fully paid for these classroom projects:

  • STEM games for Mrs. S’s fourth-grade class in Columbus, OH.
  • A mobile science lab for Mrs. N’s middle school class in Bay Shore, NY.
  • Ten sets of headphones for Ms. M’s elementary school class in Philadelphia, PA.
  • A library of 30 fiction and non-fiction books for Ms. E’s elementary school class in Bronx, NY.
  • A carbon dioxide meter and air quality mapping supplies for Mrs. E’s elementary school class in Detroit, MI.
  • A STEM activity table for Mrs. S’s elementary school class in Malden, MA.
  • STEM activity centers for Ms. Z’s pre-kindergarten class in Fort Worth, TX.
  • Air quality meters for Mrs. A’s fifth-grade class in Greenville, PA.
  • A three-day environmental science mountain camping trip for Mrs. V’s fifth-grade class in Los Angeles, CA.

Several teachers, including Ms. E, responded almost immediately: “We want to thank you for your warm heart and generosity. I can’t begin to tell you what it means to these kids to have information at their fingertips! They are kind-hearted, sweet, intelligent kids who sometimes just need a little boost and you are a part of them. Again, thank you, and we will send pictures after we get the books. Our classroom is a better place because of your awesome contribution.”

This week on HIStalk Practice: Burke Pediatrics (VA) partners with Food for Others as part of a new food prescription program aimed at ensuring patients can put healthy food on their tables. The Y builds out health IT infrastructure with HIPAA compliance, cybersecurity services. Teladoc drops lawsuit against Texas Medical Board. AJC investigation highlights physician contributions to opioid epidemic. CyberKnife Center of Miami selects Identillect. Aprima integrates DocBuddy voice recognition. HealthiPass raises $7.2 million. UnitedHealth buys DaVita Medical Group in multi-billion dollar deal.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Dignity Health and Catholic Health Initiatives sign a merger agreement that will create the country’s largest health system as measured by operating revenue. The new Catholic health system will have $28 billion in revenue, 139 hospitals, and 159,000 employees, operating in 28 states. The CEOs of each organization will become co-CEOs of the new system. Dignity uses Cerner, while I believe CHI runs a mix of Meditech, Allscripts, Cerner, and Epic.

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I’m interested that the asset management company co-owned by Nobel-winning economist Richard Thaler – which focuses on shares that are mispriced due to irrational investor psychology – holds 2.8 percent of the outstanding shares of Allscripts, worth around $72 million. MDRX shares are up around 12 percent over the past 12 months (vs. the Nasdaq’s 48 percent) and 30 percent over the past five years (vs. the Nasdaq’s 129 percent). It’s Thaler’s theories rather than his investing acumen that earned him a Nobel — the Fuller & Thaler Behavioral Small-Cap Equity fund has performed consistently worse over several years than the Dow, Nasdaq, and S&P 500.

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A Huffington Post article profiles ReHAP, an algorithm-driven system for hospitals to help hospital rehab therapists identify and prioritize patients who need their services. The co-founder is Krishnaj Gourab, MBBS, who is chair and medical director of rehab informatics and analytics at Johns Hopkins Bayview Medical Center (MD).

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An Axios financial analysis of 84 large health systems finds that while their patient care margins are slim, they’re making a fortune with their Wall Street investments and M&A activity in raising their overall average profit margin to 6.7 percent on their huge revenue volumes, with the article concluding, “Large not-for-profit hospital systems now resemble and act like Fortune 500 companies instead of the charities they were often built as. They consequently hold immense financial and political power.” The analysis unfortunately and rather obviously mixes up “millions” with “billions” in the pop-up graph legends, but commendably provides the raw data as Google Docs spreadsheet. The most profitable health system is Kaiser Permanente at $3.1 billion in FY2016-27 profit, of which 38 percent was generated by its investments. To take the counterpoint, one contributing factor in the success of any charity is to accumulate enough assets to iron out the operational cash flow challenges, although people often get suspicious when those war chests swell and executives take home multi-million dollar salaries. Not to mention that the stock market won’t always perform as well as it has lately.

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Anil Sethi, MS – who became director of Apple Health in 2016 after the company acquired his personal health record company Gliimpse — will leave Apple to focus on his new startup Ciitizen. Former ONC Chief Privacy Officer Deven McGraw, JD, MPH also works for Ciitizen, which helps people obtain and share information and health-related legal documents.  


Sales

Medical Society of Delaware chooses HealthEC’s population health management system and services for its 900-doctor clinically integrated network.


Announcements and Implementations

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Solutionreach announces SR Schedule, which allows physician practices to offer the patients easy self-scheduling. 

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Aprima integrates its EHR with DocBuddy voice-powered physician workflow for mobile devices. A hand surgeon early adopter says it saves him 45 minutes per day.

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EBroselow will integrate ASHP’s AHFS DI Essentials database into its SafeDose bedside dosing application.


Government and Politics

The rate of growth of US healthcare spending slowed in 2016, but still increased by $354 per capita to $10,348 in consuming 17.9 percent of the gross domestic product.


Other

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A report from public health grant-making organization De Beaumont Foundation and Johns Hopkins University presents use cases describing how public health agencies could use provider EHR data without running afoul of HIPAA.

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A TransUnion report on Millennials finds that 60 percent don’t understand their health insurance benefits. They also also pay their medical bills more slowly than other generations, mostly because they entered the workforce as lower-income employees just as employers shifted more healthcare payments onto consumers and thus they don’t have the money. The report suggests that providers educate Millennial patients at the point of service, give them an upfront cost estimate when possible, and encourage them to pay at the time of service.

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The Indianapolis paper profiles Chuck Dietzen, MD, medical director for pediatric rehabilitation at Riley Children’s Health (IN); founder of the non-profit Timmy Global Health; and co-founder and chief medical officer of EHR/PM vendor ISalus Healthcare.

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St. Joseph Healthcare (ME) will eliminate 24 jobs as parent organization Covenant Health centralizes billing after completing its Cerner implementation.

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Fun from The Onion.


Sponsor Updates

  • LogicStream Health launches clinical process modules for sepsis, CAUTI, and VTE.
  • Nordic releases a new podcast, “Consolidating your EHR after a merger or acquisition.”

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 12/6/17

December 5, 2017 News 16 Comments

Top News

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Advocate Health Care will merge with Aurora Health Care pending regulatory approval, creating the country’s tenth-largest non-profit health system.

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The CEOs would serve as co-CEOs of the new organization (Advocate Aurora Health) as a result of a “50-50 merger,” with naming two equal leaders appearing either indecisive or ego-stroking but unlikely to prove successful regardless.

There’s also the EHR challenge. Aurora uses Epic, while Advocate runs Cerner and Allscripts.


Reader Comments

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From Not From Monterey: “Re: hospital luxury floors. I’m reading a book by written a doctor (Jacob Appel) in which the suicidal psychiatrist main character says that in his hospital, the posh floor where the wealthy people stay is unsafe compared to the rest of the hospital since it lacks residents and med students asking questions. Would you find this character’s statement to be plausible, or better yet, backed up by data?” I’ve written before that, amenities aside, I wouldn’t want to be housed in a hospital’s VIP unit. Personalized medicine is overrated in this regard – the nurses assigned are the most deferential rather than the most skilled; they are under the thumb of hospital executives whose suck-up meddling may negatively impact care; those annoying middle-of-the-night room rounds and always-beeping monitors sometimes detect real problems; and wandering off the cookie cutter center line of care is always dangerous (like asking the kid at McDonald’s to make you a steak dinner). Hospitals are well-intentioned but dangerous places where the last thing you want is extra attention. I created a poll for clinicians with firsthand experience to weigh in and hopefully offer comments. My only first-hand experience is when my colleague, the health system’s chief medical officer, mobilized the Big House’s trauma team to address a family member’s ruptured appendix, which I declined and instead chose one of our community hospitals with no VIP attention expected or desired. 

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From Ty Dolla Cosine: “Re: Aetna’s CEO. Will get $500 million if the CVS deal goes through. It’s good for at least one consumer, anyway.” CEO and HIMSS14 keynoter Mark Bertolini will leave with a $500 million parting gift, consisting of the inevitable executive golden parachute plus his appreciated stock. His net worth already approached $200 million, so the only thing standing between him and near-billionaire status is the Trump Administration’s anti-trust people in the DOJ and/or FTC, which probably means he’s fine to book the truck to haul away his loot.

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Had you wisely (given 20-20 hindsight) invested your money in Aetna shares (dark blue) five years ago, you would have realized a 292 percent gain vs. the Dow’s (light blue) 84 percent. You would also be singing the praises of Mark Bertolini for making you rich as he did the same for himself.


HIStalk Announcements and Requests

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I finished my initial playing around with my Black Friday-priced Google Chromecast and Home Mini. They featured Apple-like slick packaging and no-instructions setup that had me running in minutes. Chromecast can display anything from your phone that can be cast onto your TV (photo albums, browser pages, YouTube videos, Netflix, etc.)  with just a WiFi connection and the provided HDMI cable into your TV. The Home Mini has an Alexa-like conversational interface that can provide weather, news, your daily schedule,  flight departure time, time to drive to a location given current traffic, and the usual smorgasbord of jokes, games, list-making, song-singing, and music-playing with pretty good audio quality. Both gadgets offer a lot of smooth technology at a price low enough to be impulse-purchased as a toy or stocking-stuffer. I’m happy with both.

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Ben and Michelle from ST Advisors supported my DonorsChoose project with a $500 donation, to which I applied matching funds from my anonymous vendor executive as well as other sources to fully fund these teacher-requested projects:

  • 30 sets of headphones for Ms. B’s second-grade class in Chicago, IL.
  • 35 calculators for Ms. T’s all-girls elementary academy in Houston, TX.
  • STEAM supplies for Ms. C’s middle school class in Provo, UT.
  • A programmable robot kit for Ms. G’s elementary school class in W. Valley City, UT.
  • Science experiment kits for Ms. M’s pre-kindergarten class in New York City.
  • Hats and gloves for Ms. H’s elementary school class in Omaha, NE.
  • STEM activities for Ms. D’s elementary school class in Hialeah, FL.
  • An interactive whiteboard for Mr. T’s elementary school class in Houston, TX.
  • A document camera and speakers for Ms. K’s middle school class in New York City.

I’ve already received thank you notes from most of the teachers, including from Ms. D, who says, “As a first-year teacher, I am absolutely ecstatic! My students are going to be so excited to learn about all these new tools. I am extremely thankful for your donation towards my little learners and I’m positive that they will be too. Thank you for our early Christmas gift! HAPPY HOLIDAYS!”

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Mike also sent a $500 donation, saying that he’s been out of the industry for 10 years but still reads HIStalk every day. Merry Christmas to (and from) Mike, whose donation with matching funds has made these classroom projects a reality:

  • Programming books, posters, and whiteboards for Mr. C’s middle school class in New York City.
  • Lap desks to replace those lost in Hurricane Harvey for Mrs. A’s fifth grade class in La Marque, TX.
  • STEM activity kits for Mrs. C’s elementary school class in Havelock, NC.
  • Programmable robots for Mr. V’s elementary school student-driven programming class in Cherryfield, ME.
  • Five virtual reality headsets for Mrs. B’s high school class in Norfolk, VA.
  • A math and science library for Ms. G’s elementary school class in Houston, TX.
  • Two Bee-Bot programmable robots for Mrs. F’s kindergarten class in Los Angeles, CA.
  • Puzzles, books, and glue for the after-school clubs of Ms. B’s elementary school in Camden, NJ.

Want to donate, especially if your company is willing to pony up $500 in return for a mention of their largesse? Instructions:

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

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Philips acquires Netherlands-based interoperability software vendor Forcare.

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Population health management software vendor VirtualHealth raises $7 million in a Series B funding round.

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Genetic sequencing vendor Human Longevity dismisses its CEO after 11 months on the job, along with the COO, chief medical officer, and head of oncology. Co-founder and executive chairman Craig Venter returns to the CEO role. HIStalk reader Informatician tipped me off in a mid-November rumor report that the company had laid off its chief medical officer and his team of 15, at which time I noted that eight of 18 executives listed on a cached copy of its executive page from June 2017 had been removed (the number now stands at 11 of 18).

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Patient education software vendor Mytonomy raises $7 million in a Series A funding round in which Philips and MedStar Health participated. The company previously pivoted from its original business of offering college preparation videos for high school students. The founders are CEO Anjali Kataria (who co-founded a drug company software vendor and then worked for HHS and FDA) and her husband Vinay Bhargava (Google).


Sales

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Chesapeake Regional Healthcare (VA) will implement Glytec’s EGlycemic Management System.

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Memorial Hermann Health System (TX) signs an enterprise agreement for PerfectServe’s communication and collaboration platform.

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Steward Health Care will convert eight more of its hospitals to Meditech’s Web EHR.

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Singing River Health System (MS) chooses FormFast Capture and ESignature, while Medical University of South Carolina (SC) will implement FormFast Capture and Mobile App. 


People

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Brookfield, WI-based Insurance enrollment technology vendor Connecture hires Brian Lindstrom (Datica) as CFO. Industry long-timer Jeff Surges is the company’s CEO.

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Tom Zajac (Philips) joins the executive-in-residence programs of Summit Partners and Noro-Moseley Partners.

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The Chartis Group hires Tonya Edwards, MD, MMM (Impact Advisors) as principal.

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Marc Andiel (Iatric Systems) joins HealthGrid as EVP of corporate business development.

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Regenstrief Institute hires Jeremy Harper (The Ohio State University Wexner Medical Center) as chief research information officer.

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SCL Health (CO) hires Louis Capponi, MD (Cleveland Clinic) as VP/CMIO.


Announcements and Implementations

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Ability Network streamlines the Triple Check process — for skilled nursing facilities to review Medicare Part A claims prior to submission —  via new functionality in its UBwatch platform.

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The Children’s Center Rehabilitation Hospital (OK) goes live on Harris Healthcare’s Novus ClinDoc linked to its QCPR EHR.

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ISpecimen releases data connectors that allow organizations to integrate their LIS and EHR systems to the company’s marketplace, where those organizations can offer their biospecimens to researchers.

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The Sequoia Project announces that its Carequality initiative connects more than half of all US healthcare providers, with 1,000 hospitals, 25,000 clinics, and 580,000 providers exchanging 1.7 million clinical documents monthly.


Government and Politics

Hector Ramos, the former $200,000 per year IT director of North County Health Services (CA), pleads not guilty to stealing $800,000 from the organization. Prosecutors say he submitted and approved phony invoices from two fraudulent companies he created, telling employees the invoices needed to be paid quickly to avoid a computer system shutdown. They probably should have paid more attention to his resume, which boasts of advanced degrees “earned” from known diploma mills.  

Honduran officials arrest Eric Conn, the on-the-run Kentucky lawyer who conspired with doctors and judges to earn $550 million in fraudulent Social Security disability benefits for his clients. 


Technology

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Google announces the open source release of its DeepVariant genomic analysis tool.


Other

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A Vox reports looks at ED facility fees, as hospitals are increasingly using higher-intensity codes to bill higher rates. The prices charged for those fees jumped 89 percent from 2009 to 2015 in raising ED costs by billions even as the number of ED visits dropped. The article profiles a man whose lifting-induced back spasms were treated by a hospital ED – the only place open — in 20 minutes at a cost of $3.50 for a muscle relaxant and over $2,400 in facility fees.

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The owner of a New Jersey lab that was paid $150 million by Medicare and private insurers over eight years says he couldn’t compete against the national lab companies without bribing doctors to send him patients. His lab offered fake consulting agreements, prostitutes, sports cars, vacations taken on private jets, and Super Bowl tickets. The owner says the lab’s biggest expense was a New York strip club, where he spent $10,000 in one night to entertain a pediatrician who bragged about how many tests he was ordering on young patients. The owner spent $800,000 – less than one month’s profit from the lab — to build a pool shaped like Mickey Mouse’s ears. 


Sponsor Updates

  • Healthcare Growth Partners advised Russell Phillips & Associates on its sale to Jensen Hughes.
  • CenTrak donates RTLS equipment to students at Drexel University in Philadelphia.
  • Dental practice management company Dentisoft selects patient relationship management technology and services from Solutionreach.
  • Access partner The Last Well advances its clean water initiative in Liberia with matching grants through December 31.
  • Audacious Inquiry’s CALiPR earns ONC Health IT Certification.
  • Change Healthcare’s Stuart Hanson speaks at the AHIP Health Forum in Nashville.
  • Elsevier Clinical Solutions will exhibit at the North Carolina Council of Community Programs Conference December 6 in Pinehurst.
  • FormFast will exhibit at the 2017 IHI National Forum December 10-13 in Orlando.
  • Definitive Healthcare hires its 200th employee.
  • Impact Advisors publishes a new report, “Constructing an Analytics Strategy.”
  • Kyruus will exhibit at the Diabetes Innovation Summit December 7 in Boston.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 12/4/17

December 3, 2017 News 3 Comments

Top News

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CVS will buy Aetna for $69 billion.

Unanswered questions:

  • Will the federal government approve the deal given its reluctance to allow big insurers to buy each other, especially since CVS has a strong pharmacy benefits management business in CVS Caremark and both companies have specialty pharmacy operations?
  • How will CVS structure the combined companies to use its newfound vertically integrated clout?
  • How will CVS’s pharmacy relationships with competing insurers be affected?
  • What actions will diehard competitor Walgreens take or what acquisitions might it consider?
  • Was the proposed acquisition driven by Amazon’s interest in the prescription drug and/or durable medical equipment business or will this transaction increase that interest?

HIStalk Announcements and Requests

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Black Friday shoppers hit Amazon hard for electronics, with Best Buy landing an anemic second and the other online retailers sucking wind.

New poll to your right or here, for male readers: do you fear that past incidents could result in a new sexual harassment claim being made against you? The poll is anonymous, as always, and your comments are welcome. Recent headlines triggered me to review my past to make sure I wasn’t forgetting something that could have been misconstrued, leading me to think that others are similarly hoping they surface no repressed memories of previous impropriety.

Next week’s poll will ask women if they’ve experienced work-related sexual harassment or assault. Note: I considered making both of these polls gender-nonspecific, but my assumption is that most of the examples are male-on-female and I didn’t want to dilute the denominator.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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This Week in Health IT History

One year ago:

  • The House passes the 21st Century Cures Act.
  • A CDC study finds that the number of families struggling to pay their medical bills dropped 22 percent in five years due to an improving economy and those newly insured via the Affordable Care Act.
  • Allscripts acquires Australia-based Core Medical Solutions.
  • China-based investors finalize their acquisition of Lexmark and announce plans to quickly sell off its software business, including the former Perceptive Software.

Five years ago:

  • “Tricorder” company Scanadu announces plans to release consumer tools for vital signs, urinalysis, and saliva testing by the end of 2013.
  • Reuters reports that several private equity firms have submitted revised takeover offers for Merge Healthcare.
  • Constellation Software acquires Salar from Transcend Services, which had itself been acquired by Nuance.
  • Vitera closes its hardware support business.
  • Athenahealth announces plans to acquire Harvard’s Arsenal on the Charles complex in Watertown, MA for $169 million.
  • CDC reports that 40 percent of office-based physicians use an EHR with at least basic functionality.

Ten years ago:

  • Philips announces plans to acquire medical alarm and notification vendor Emergin.
  • Dennis Quaid and his wife sue Baxter Healthcare for the Cedars-Sinai heparin overdose of their newborn twins.
  • Siemens announces Invision 27.
  • An entrepreneur offers a $10 million prize for developing software that can map the genetic codes of 100 people in 10 days for $10,000 or less per genome.

Last Week’s Most Interesting News

  • Caring Voice Coalition, a drug co-pay charity, says it will likely shut down after HHS OIG finds that it sent patient data to its drug company supporters.
  • Nuance turns in better than expected quarterly results as the actual financial impact of its June malware attack was less than it projected.
  • Siemens Healthineers announces plans to go public on the German market in the country’s largest IPO in 20 years.
  • Athenahealh names its third CFO of 2017.
  • A newly unsealed lawsuit claims that Indiana hospitals falsely attested for $300 million in Meaningful Use money by failing to promptly provide patients with copies of their medical records.

Webinars

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

 

Here’s the recording of last week’s webinar titled “Making Clinical Communications Work in Your Complex Environment,” sponsored by PatientSafe Solutions.


Acquisitions, Funding, Business, and Stock

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Nashville-based data management vendor Trinisys acquires Mica Health, which offers ambulatory EHR decommissioning services. Former Mica President Mike Justice will apparently stay on as Trinisys VP of business development.

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Former GE CEO Jeff Immelt made some interesting comments on a conference stage last week:

  • Companies offering healthcare point solutions are in for a rough ride since door-to-door sales in healthcare take 10-15 years.
  • Immelt thinks AI will influence radiology practice, but says no great companies will focus exclusively on that.
  • His shortest meeting ever (at five minutes) was driving to Epic and pitching the idea of GE buying part of Epic to Judy Faulkner, who simply replied, “No. No interest.” I can’t imagine a CEO in any industry who would have the brass to tell the CEO of GE to hit the bricks.
  • GE considered acquiring Cerner, but didn’t think it was worth the $2 billion figure being bandied about (the company’s market cap has since risen to $23 billion). CERN’s market cap hasn’t been that low since early 2005, so GE’s acquisition interest must have been before then but after Immelt took the CEO job upon Jack Welch’s retirement in 2000.
  • Hospital CEOs are still clueless about health IT and aren’t generating ROI, with the original goal being connectivity rather than value creation. He thinks they’ll gain interest in improving patient outcomes and value.
  • Immelt said companies that started venture funds “have stunk at it,” admitting that they have been “company killers.” In healthcare, of course, GE’s direct acquisitions – which weren’t usually top-rated companies in the first place – gave it the “elephants’ graveyard” moniker as the place where previously good companies go to die.

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The average healthcare CEO who lost their job due to a merger or acquisition received a golden parachute of $25 million, much less than the $37 million average from a 2015 version of the same report. Dismissed trench warriors presumably were paid basically nothing for being cut loose through no fault of their own even though their need for income was probably much more acute than that of the aristocracy. 


Decisions

  • WellStar West Georgia Medical Center (GA) will switch from Meditech to Epic in 2018.
  • St. Luke’s Hospital Cardiothoracic Surgery (MO) will switch from EClinicalWorks to Cerner Ambulatory EHR in July 2018.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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New York Health + Hospitals hires Kevin Lynch (LA County Department of Health Services) as SVP/CIO.


Other

Here’s Vince’s look back 30 years at what was going on in health IT in December 1987, when George Michael’s “Faith” topped the charts and “Three Men and a Baby” foretold an epidemic of poor taste.

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Weird News Andy titles this article “DNR, R, DNR, EXP.” A 70-year-old diabetic man with “Do Not Resuscitate” (emphasis his) tattooed on his chest shows up at a hospital ED with an elevated blood alcohol level. Doctors considered his tattooed instructions invalid and started an IV, but covered themselves by also conferring with an ethics consultant, who told them they should honor the man’s request. The doctors wrote a DNR order and eventually also located a copy he had filed with the state’s health department. Meanwhile, the man died without further intervention.


Sponsor Updates

  • Deloitte names Definitive Healthcare to its Technology Fast 500 list of fastest-growing companies.
  • Logicworks announces support for AWS Guard Duty, a new machine learning-based security service.
  • Reaction Data publishes “Ideal Medical Imaging Trends 2017.”
  • Surescripts will exhibit at the AHIP Consumer Experience & Digital Health Forum December 5-7 in Nashville.
  • T-System President and CEO Roger Davis receives Dallas Magazine’s Excellence in Healthcare Award for achievement in medical technology.
  • Huron releases a new video, “Transparency Empowers Healthcare Consumers.”
  • Mazars USA expands its New York office with the addition of Elliot Horowitz & Company.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 12/1/17

November 30, 2017 News 2 Comments

Top News

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HHS OIG cracks down on drug co-pay charity Caring Voice Coalition, removing its seal of approval after finding that the charity shares data with the drug companies that provide its support.

CVC, which has received hundreds of millions of dollars from drug companies earmarked for paying patient prescription co-pays, had been exposed by several former employees as fast-tracking assistance for patients that use a donor company’s drug while wait-listing those who are prescribed drugs sold by non-donors.

OIG says the information sent to the drug companies could help them raise Medicare prices by accumulating anecdotal patient-reported successes.

CVC told OIG that it will probably shut down following the ruling.

I found CVC’s 2015 federal tax forms, in which it reported $132 million in 2014 revenue (vs. $83 million in 2013), giving it a $30 million surplus for the year.

The Justice Department had previously sent subpoenas to a handful of drug companies in its investigation of patient assistance programs, after which United Therapeutics set aside $210 million in case it gets caught up in a False Claims Act lawsuit over its donations.

The Internal Revenue Service is reviewing the tax-exempt status of another patient assistance program, Chronic Disease Fund (now known as Good Days), which took in more than $1 billion of drug company money over six years, of which the charity used $35 million to pay for data processing services provided by a company owned by the charity’s founder. Good Days has filed eight lawsuits so far this year to fight IRS subpoenas.


Reader Comments

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From Dollar Bill: “Re: [site name omitted.] Who finds actionable information there?” I can’t say, but the above is from Reaction Data’s independent C-level survey that asked about which sites influenced their decisions. I’ve blurred the names, but the one you’re asking about finished poorly in this and the other four categories (most-read, most-influential, most interest-generating, most positively affecting job performance, and most recommended). I immodestly note that the winner in all categories was a spare-bedroom, one-author one.


HIStalk Announcements and Requests

This week on HIStalk Practice: DaVita preps to sell its $4 billion medical group. South Carolina’s PDMP helps slash opioid prescriptions. Elderly New Hampshire MD faces non-license renewal over lack of computer skills. Google researchers develop gaze-detection software to deter snooping smartphone bystanders. Senate HELP Committee questions HHS Secretary nominee Alex Azar on drug prices. VillageMD New Hampshire selects Geneia predictive analytics for PHM efforts. CareCloud’s Polly Friend offers three key things practices should do to prep for MIPS.


Webinars

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Nuance announces Q4 results: revenue down 8 percent, adjusted EPS $0.20 vs. $0.31, beating analyst estimates for both and sending shares up to extend a run that started in mid-November. The company says its June malware attack cost it $53 million in revenue for the quarter. NUAN shares have risen 4 percent in the past year vs. the Nasdaq’s 30 percent. From the earnings call:

  • The total impact of the malware incident was just over $60 million vs. the originally expected $85 million.
  • The healthcare business delivered its best net new bookings quarter in history in Q4 despite the malware attack.
  • Nuance’s strategic focus will be conversational AI and analytics-based solutions.
  • The company expects Dragon Medical to replace transcription as its largest healthcare revenue contributor as its HIM business continues to decline.

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Siemens will take its Siemens Healthineers healthcare business public in Germany at a valuation of $47 billion, the country’s largest IPO in 20 years. The company chose the German exchange after ruling out London due to Brexit and the US markets because it wants to appeal to investors from Asia.

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AI-supported diagnostic software vendor Prognos closes a $21 million Series C funding round, increasing its total to $43 million. Its target audience is drug companies, insurers, and labs. Co-founder Jason Bhan, MD used to work for Clinovations, while Sundeep Bhan co-founded Medsite.

Bizarre: three-employee medical translation training vendor MiTio files for a $10 million IPO despite having only ever enrolled 1,000 students, naming as its CFO/CIO/CTO the founder’s 16-year-old son who is “a rising star in the coding community.” The company says it won’t sell shares publicly,  but had to file for an IPO because it will give investors cryptocurrency tokens. That’s the second company I’ve seen today offering that form of investment (see the Health Wizz item below). I admit that I don’t understand that concept.


Sales

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Artesia General Hospital (NM) chooses FormFast’s FastPrint, Capture, FastFlow, Content Manager, and Connect.

The Ministry of Health of the Republic of Kazakhstan will implement Elsevier’s ClinicalKey reference solution in 200 locations.


People

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Nuance hires Tom Beaudoin (SimpliVity) as EVP of business transformation. He was EVP/CFO for Nuance from 2008 to 2015.

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Laure Kreofsky, MHA, MBA (MedSys Group) joins Pivot Point Consulting, A Vaco Company as VP of advisory services.

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Hurley Medical Center (MI) promotes Casey Bryson to CIO from the interim role.


Government and Politics

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The VA misses its target date to sign with Cerner, which it originally vowed to get done in November in responding to a lawsuit protesting its no-bid selection. A VA source says the contract is ready to sign as soon as Congress approves moving the money to the correct accounts.


Announcements and Implementations

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Elsevier will offer WiserCare’s Shared Decision Making solution as part of its patient engagement suite.

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Glytec’s Glucommander Outpatient will be integrated with the virtual diabetes clinic of Onduo, whose parent companies are drug manufacturer Sanofi and Alphabet’s Verily.

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MemorialCare (CA) opens a technology testing and training center in conjunction with systems integrator Sirius Computer Solutions. It includes the technologies need to run a 2,000-bed hospital, an isolated data center, and a simulation lab.

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Health Wizz launches a blockchain-powered consumer tool for managing and sharing their medical data with research organizations and drug companies that can offer to pay them. The company is recruiting investors who will receive digital tokens.

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GE launches blood collection firm Drawbridge Health, which will allow physician offices and clinics that don’t have a blood draw technician to easily draw small-volume blood samples and send them to third-party labs. I like the idea of going back to the good old days when you could get your blood drawn during your office visit instead of starting over with the DMV-level indifferent employees of Quest or LabCorp and then listening to your NPO stomach grumble while watching the Unemployment TV Network of fake judges, on-cue fistfights over infidelity, and ambulance-chaser commercials.

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Tahoe Forest Health System (CA) goes live on Epic, implemented and hosted by Mercy Technology Services. 

GetWellNetwork adds Elsevier’s patient education videos to its content library.

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QuadraMed and Harris Healthcare launch individual websites that cover their respective products, with QuadraMed offering its EMPI solutions and Harris Healthcare covering Affinity Patient Self-Service, Affinity ERP, AcuityPlus staffing, Team Notes, the QCPR EHR, and Affinity RCM. The Harris Health Group brands are listed above, although it should be noted that it acquired only the hospital division of NextGen and not the entire NextGen Healthcare product line or its parent company Quality Systems, whose logos appear on the page.

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Deborah Heart and Lung Center (NJ) will go live on Meditech 6.1.5 today (Friday). I believe they’re upgrading from Meditech Magic.


Privacy and Security

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A cybersecurity publication asks three healthcare security experts to assess the recent hospital ransomware episode of “Grey’s Anatomy,” who conclude:

  • It didn’t make sense for the hacker to take down patient monitors since the hacker’s objective is to make money and the on-screen ransom note would accomplish that less dramatically.
  • The attack took down phones, computers, and medical devices, which the experts say could actually happen since hospital networks are often “one big, flat, happy family” instead of being segmented or protected by internal firewalls. Still, the variety of operating systems and versions used in a typical hospital make it unlikely that everything could be taken offline by the same malware.
  • Medical uncertainty due to lack of a paper backup may be realistic, although more hospitals are keeping electronic snapshots of important clinical information.
  • The demanded ransom – $20 million in bitcoin at the time of the airing and $50 million today – is not realistic because nobody would pay that much.
  • It’s not likely that a cyberattack could take down access control systems, as shown on the show when nobody could open the door to the blood bank.
  • It’s unrealistic that the FBI would arrive in minutes and take charge as the show depicted.
  • It’s not necessarily advisable to just shut all systems down, but rather to control the malware’s spread while forensically trying to learn more about the hacker.
  • The TV chief of surgery made the decision to pay the ransom, which is unrealistic not only because that’s a CEO-level decision, but also because hospitals usually follow the FBI’s advice and refuse to pay.

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Security researchers find that the installation script of free, web-based OpenEMR does not automatically remove itself upon completion and that the instructions don’t tell users to delete it, allowing hackers to gain administrative access and to execute PHP scripts of their own. Kudos to the developers, who released a patch within four days, made a community announcement about the vulnerability, and updated its instructions to include removing unnecessary files after installation. The system is used by thousands of healthcare facilities and users in supporting an estimated 90 million patients.

In England, a financial administrator who was worried that she was being out-earned by co-workers hacks into the hospital’s systems, looks up salaries, collects data on celebrity mental health patients, and deletes key files. The judge let her off with a suspended sentence since she argued that her deeds were to “ease her mind” rather than for financial gain.

A federal court drops child pornography charges against a California oncologist after his attorney argues that the warrant used to search his home – in which child pornography was apparently found – was invalid because the FBI’s tip from a Best Buy technician was triggered by a photo of a naked girl that was not pornography but rather “child erotica,” which is not illegal but may not be the kind of image you hope your oncologist is studying intently.


Other

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Family medicine doctors from the University of Missouri School of Medicine design a prototype of collapsible accordion physician notes, comparing four models that also emphasize abnormal items.

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FDA approves AliveCor’s EKG watchband replacement for the Apple Watch to warn users of possible atrial fibrillation. The KardiaBand use what it claims is AI on the smart watch to determine a specific user’s normal heart rate based on activity, then issue a warning to run the EKG function if the rate goes outside the normal range. The band costs $199 plus a $100 per year subscription. Like other “advances” that find previously undetected conditions that require expensive treatment, we’re all going to be paying for it. Going problem fishing by using data for bait isn’t usually as good for patients as it seems.

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IHI/NPSF publishes “Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era.” Recommendations include developing better interoperability among EHRs used by PCPs and specialists; conducting a risk assessment of the electronic referral process using the SAFER guidelines; creating collaborative care agreements for PCPs and specialists that include how patients will be managed and communications etiquette; and developing easy ways to track referral status by patient. The impressively credentialed expert panel notes that 24 percent of malpractice claims are caused by missed or delayed diagnosis; the volume of referrals has skyrocketed and more frequently involves multiple specialists; and that patients don’t follow through on up to half of referrals. The study also observes that while EHRs have potential to improve the referral situation, they generate a lot of ignored noise and a lack of evidence-based guidelines makes it tougher.

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Australia’s My Health Record – rollout of which cost up to $1.5 billion with annual costs of up to $300 million — is being roundly ignored by both providers and consumers, according to the government’s dashboard that shows few new voluntary registrations and that only 200 doctor-entered patient summaries were viewed by hospitals in August.

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This is a fun tweet.

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Here’s another great tweet I found via @healthblawg.

Big health systems keep moaning about how financially strapped they are and brag about how they’re moving away from the lucrative “heads in the beds” financial model, but Ohio State University joins a bunch of other health systems that have recently announcing huge construction projects. The cost of their much-anticipated erection – which includes an impressive 840-bed tower – has not been determined.

A study estimates that healthcare illiteracy – which includes half of Americans, according to the CDC – costs the country up to $175 billion per year.

Snapchat CEO Evan Spiegel says the factors that have driven social media – more friends, more likes, and more free content – will undermine it. He says that automated, personalized newsfeeds based on what friends are consuming — like Facebook’s — “came at a huge cost to facts, our minds, and the entire media industry.”

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Weird News Andy will love this. A startup that raised millions to develop its $40-a-bottle “cognitive enhancement” concentration pill (aka “nootropics”) tries to bury the results of its own study, which conclude that the expensive product is less effective than just drinking a cup of coffee.


Sponsor Updates

  • ZeOmega achieves Oracle Validated Integration of Jiva 6.1 with Oracle Healthcare Foundation 7.1.1.
  • The HCI Group partners with the Dubai Health Authority as part of its Transformation Forum.
  • The local paper features Healthlink Advisors consultant Claude Younger’s health-prompted feat of running marathons in all 50 states.
  • Optimum Healthcare IT publishes an infographic titled “The ROI of Interface Error Management.”
  • Meditech posts a video featuring ancillary department directors of Colquitt Regional Medical Center (GA) discussing their time savings from using its Web EHR.
  • Bill  Spooner, founding advisor at Next Wave Health Advisors – a Huntzinger Management Company, leads sessions at the Millenium Alliance’s Assembly on healthcare provider transformation.

Blog Posts


Contacts

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Contact us.

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News 11/29/17

November 28, 2017 News 11 Comments

Top News

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A newly unsealed state court lawsuit claims that 62 Indiana hospitals fraudulently attested for $300 million in Meaningful Use money because they don’t give patients copies of their medical records within three business days 50 percent of the time as required.

Two lawyers filed the suit after testing four Indiana Hospitals with a records request. They say that none of the hospitals delivered their records promptly even though all the hospitals reported that they had done so.

Their statistics were extrapolated to other state hospitals to assume that they, too are not following through on patient records requests in a timely manner.

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Also named in the lawsuit is records release vendor Ciox Health, which the plaintiffs say illegally profited from overcharging patients for their records in violation of anti-kickback laws.  


Reader Comments

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From Uncle Douger: “Re: HIStalk reporting bias. Have you looked at who is making those claims as article comments? I would be suspicious.” I will only say that those commenters claiming that I’m biased against any given company often use IP addresses owned by that same company. Today’s anti-journalism environment encourages anyone who doesn’t like particular facts to accuse those who present them of bias. There’s nothing I like more, however, than having my own opinion — when I actually state one — challenged and occasionally changed by rational and well-considered facts.

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From Apple Alar: “Re: billion-dollar lawsuit against ECW. It’s interesting that it was filed as a class action suit rather than wrongful death / malpractice. The implications for setting a legal liability precedent for a vendor involving the content of the electronic health record would be game-changing. What about systems that send information to the EHR that is improperly presented there?” I don’t really know what to make of the lawsuit since the plaintiff made vague claims that her husband’s cancer wasn’t diagnosed because of EHR issues, but she wasn’t specific and didn’t name any doctors or hospitals as defendants. It also copied and pasted a lot of information from the DOJ’s settlement with ECW, which I took as an indication that it was a me-too claim hoping for a quick settlement from a company trying to distance itself from its $155 million payout. Attorney readers, what do you think?

From ExEpic: “Re: HIMSS compensation survey. They don’t even list Washington, DC as an option for the state or territory of residence.” I checked the survey and it asks, “In which state do you work?” in omitting DC but including an “Other US Territory” option.


HIStalk Announcements and Requests

I was reviewing the rehearsal of Thursday’s excellent webinar by PatientSafe Solutions and took note of the “wireless wellness” problem mentioned by both CIO presenters. It was a key lesson learned – every new application that would use the wireless network must be tested because some of them are poorly designed and could mess up other apps.

I like this brilliant quote as tweeted from a conference: “Palliative care is what all care would be like if we started over with healthcare.”


Webinars

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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The Boston business paper reports that while Athenahealth is selling its Bombardier Challenger 300 jet in a cost-cutting move, it will keep its second aircraft, a propeller-driven Pilatus PC-12. I was curious about the cost of the Challenger – $24 million new with an operating cost of $7,250 per hour.

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UnitedHealth Group’s Optum launches a $250 million fund to invest in early-stage healthcare startups, including digital health. If you’ve started a crappy company that everybody else’s digital health fund has passed on, here’s your chance.

Bloomberg predicts a wave of bankruptcies involving hospitals and healthcare vendors in 2018, especially for disproportionate share hospitals whose funding has been cut.


Sales

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The Clinical Radiologists radiology group chooses MModal for radiologist documentation, real-time physician documentation, business intelligence, critical test results management, and peer review and learning.


People

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Athenahealth names Marc Levine (JDA Software Group) as CFO.

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University Hospitals (OH) rehires Robert Eardley (Houston Methodist Hospitals) as CIO.

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Vice-Admiral Raquel Bono, MD, MBA, director of the Defense Health Agency, accepts the HIMSS Federal Health IT Award.

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John Halamka, MD will serve as editor-in-chief of the new open access, online journal Blockchain in Healthcare Today. Another site run by the same company runs ads, so I assume this one will, too.

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Health coaching app vendor Farewell names former US Surgeon General Richard Carmona, MD, MPH to its board. He’s also a combat-decorated Vietnam veteran and a Special Forces medic who also earned an AA degree in nursing and accumulated many awards as a deputy sheriff and SWAT leader.

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Patient engagement software vendor Relatient hires board director and venture capital operating partner Michele Perry as CEO.


Announcements and Implementations

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TigerText announces TigerFlow Enterprise, a clinical communication and collaboration platform.

Unified clinical communications platform vendor Telmediq integrates the IPhone X’s Face ID authentication.


Privacy and Security

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The University of Chicago student newspaper reviews the network log scans of its hospital, finding unsecured network printers that are being used to print PHI-containing forms that any hacker could theoretically access. They found Epic-issued print jobs containing organ donor information, diagnostic procedure reports, and prescription forms. The reporters also found Internet of Things devices such as cameras and sensors were accessible and sometimes controllable. In the all-too-common shoot the messenger scenario, the person who initially tipped off the reporters was identified during the university’s ensuing investigation and was “formally summoned to the Office of the Dean of Students.”

Precision medicine platform vendor LifeOmic offers customers a $1 million ransomware guarantee that covers “any financial extortion payment or service reimbursement.”


Other

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A Medscape survey of 4,000 physicians finds that half have been sued for malpractice, noting that New York OB/GYNs pay nearly $200,000 per year in malpractice premiums. Sixty percent of doctors said they were either encouraged or required by their insurer to settle their case, with two-thirds of those resulting in payouts of less than $500,000. A surprising 62 percent of doctors said the outcome of the lawsuit against them was fair, but one-third of those sued said they no longer trust patients, treat them differently, or left the practice setting after the lawsuit. Three-fourths of doctors in general say the threat of malpractice influences their actions. Doctors say the best ways to discourage lawsuits include communicating more effectively with patients, screening cases for merit by a medical panel, capping non-economic damages, making the plaintiff responsible for paying the legal fees of both sides if they lose, and banning lawyers from taking cases on contingency. 

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An interesting graphic (click to enlarge) shows that Walmart is the largest private employer in 22 states, but also unintentionally illustrates that 12 states have a health system as their largest employer. Unlike Walmart, those systems are tax-exempt and create profits that often involve less-direct societal costs in the form of Medicare and Medicaid.

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Facebook upgrades its AI tools to identify users who are expressing suicidal thoughts so they can be connected to first responders.

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A Google Research Blog post says the company will work with Stanford researchers to understand how automatic speech recognition models can be used to transcribe physician notes, with a patient-consented pilot study looking at ways to reduce EHR interaction in capturing clinical information from conversations. It will use voice recognition technology from Google Assistant, Home, and Translate. A Google team just published “Speech Recognition for Medical Conversations.”

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CNBC profiles Cedars-Sinai testing of AbStats, a stomach-attached wearable that analyzes bowel sounds to alert doctors that their post-op patients are capable of eating. The hospital is also testing the device to alert users that their stomach is empty so they eat only when it’s time. The inventor of AbStats is Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai.

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A JAMIA-reported study finds that hospital Meaningful Use performance is associated with the EHR they use, with Epic users scoring higher in five of six criteria. The article – which is of the “let’s merge some government databases and see if we can find something to publish” type — duly notes that correlation does not necessarily indicate causation, as hospitals that use Epic, for example, might well have different resources and motivations than those that don’t. It also correctly notes that MU criteria have little to do with patient outcomes. In that regard, I don’t see one iota of usefulness in the study, especially since the information is hardly actionable even if valid. It also fails to note that presence of EHR functionality (as measured by certification) doesn’t do anything to meet hospital MU requirements — the hospital creates and actively enforces policies on EHR use (maybe Epic-using shops just press their doctors harder to chase MU targets). I’ve seen sites pushing sensationalistic headlines around this article and interpreting it wildly incorrectly, making it even worse and more like an Epic commercial.

A JAMA op-ed piece proposes – not very convincingly – the creation of a “medical virtualist” specialty, with the proposed required training including “webside manner,” competency in conducting virtual examinations, and including families in virtual visit. It’s not clear why those specific competencies should not be included in regular medical education or as a certificate (no different than learning to use a particular EHR) rather than carving out yet another self-serving, expensively maintained medical specialty.

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The local paper notes that the CEO of Novant Health (NC) has had a 93 percent salary increase since 2012, with total 2016 compensation of $3.4 million. SVP/CIO Dave Garrett was paid $990,000.

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Microsoft CEO Satya Nadella says in his new book that he learned empathy after the 1996 birth of his son, who has cerebral palsy:

On one of his son’s hospital ICU stays shortly after Satya Nadella became CEO, the Microsoft executive noticed how many devices in the room were running Windows and were connected to the cloud: “It was a stark reminder that our work at Microsoft transcended business, that it made life possible for a fragile young boy. It also brought a new level of gravity to the looming decisions back at the office on our cloud and Windows 10 upgrades. We’d better get this right, I remember thinking to myself.”

The surgeon treating the minor tongue condition of a five-year-old asks the mother if she wants her daughter’s ears pierced while she’s under anesthesia, so she says OK. The daughter leaves with a repaired tongue, a pair of earrings installed, and an extra $1,900 bill for “operating room services” that her insurer refused to pay. Children’s Hospital Colorado demanded that she either write a check or deal with its collections agency, but eventually waived the charge. Meanwhile, one of the piercings was off center and had to be redone at a mall kiosk, which set her back another $30. 


Sponsor Updates

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  • Netsmart recognizes its employees in honor of Giving Tuesday.
  • Ivenix will demonstrate its infusion system at the ASHP meeting in Orlando December 3-7.
  • The Washington Stat Health Care Authority certifies consumer decision aids from Healthwise for knee osteoarthritis and hip arthritis.
  • Nuance launches its AI Marketplace for Diagnostic Imaging.
  • Change Healthcare will work with healthcare AI vendor Zebra Medical Vision to apply AI to radiology solutions
  • Endpoint management software vendor Igel will integrate its product with Imprivata’s OneSign SSO after joint work at Parkview Medical Center (CO). 
  • AdvancedMD Cares makes 600 quilts for three Nashville charities during its Evo17 conference.
  • The Boston Globe includes Definitive Healthcare in its list of Top Places to Work in Massachusetts for 2017.
  • MModal extends its Speech Understanding technology to the PACS desktop in a unified workflow.
  • Conduent Health publishes a new e-book, “Patients’ Attitudes Regarding Healthcare.”
  • Forbes features Kyruus co-founder and CEO Graham Gardner, MD in its look at how AI and digital will shape the future.
  • Arcadia Healthcare Solutions sponsors the Millenium Alliance Healthcare Payers Transformation December 7-8 in Nashville.
  • Besler Consulting publishes an analysis of the 2018 OPPS Final Rule.
  • Change Healthcare announces a strategic relationship with Google Cloud.
  • ChartLogic publishes a new white paper, “Evaluating Your Next EHR’s Support.”
  • CoverMyMeds will exhibit at the American Society of Health System Pharmacists Midyear Conference December 3-7 in Orlando.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 11/27/17

November 26, 2017 News 12 Comments

Top News

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CNBC reports that Amazon Web Services and Cerner will announce an agreement this week involving Cerner’s HealtheIntent population health management system, which is already hosted on AWS.

The new deal may involve allowing researchers to analyze HealtheIntent data using AI technology.

CERN shares led the S&P 500 in gaining 5 percent Wednesday afternoon after the article ran.


Reader Comments

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From Dr. Scripps: “Re: Eric Topol, MD. Has been pushed out of his position as chief academic officer at the Scripps Healthcare System, where he reported to CEO Chris Van Gorder. He still practices cardiology at Scripps Clinic one day a week, but is no longer a member of the executive leadership team. He has joined The Scripps Research Institute (TSRI), which shares the Scripps moniker, but is not part of the health system, which never adopted the ideas Eric has been evangelizing for years.” Eric’s LinkedIn shows that he left the CAO position in August 2017, moving into the role of EVP and professor of molecular medicine at the Research Institute.

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From A Little BIrdie Told Me: “Re: Iraan General Hospital. They were implementing Athenahealth because of the cost model in the clinics and decided to put it into the acute side. I’m working on what the specific drivers were to go back to CPSI.” Unverified. The trend of CPSI customers going to Athenahealth and then returning quickly to the fold is close to astonishing, although it would be interesting to see what if any inducements CPSI gave them.


HIStalk Announcements and Requests

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Just over half of poll respondents think the VA’s Cerner system will allow it to exchange information with providers outside the VA. Commenters note, however, that being able to exchange information doesn’t necessarily mean that the VA will actually make it happen.

New poll to your right or here: where did you do your online electronics shopping last week, if anywhere?

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I limited my Black Friday shopping to getting a Google Home Mini and Chromecast to play around with, unable to resist the great deal Google was offering. I was tempted by an $800 Mac Air, but that device is so long in the tooth (especially the display) that it seemed like an unwise investment, especially since I recently paid less for a much better equipped Windows 10 laptop and my only interest was learning Mac stuff and running a couple of Mac-only apps. Actually, I went back Saturday for one more Black Friday weekend special – Amazon-owned Woot! has fantastic deals on Diamondback bicycles (inexpensive, but plenty good for someone like me who hasn’t ridden in years) that beat every price available plus $5 shipping, so the his-and-hers models are on their way.

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A minimally Spanish-speaking friend is traveling in South America, so I checked out the much-improved, still-free Google Translate app. It can now be used with the mobile device’s microphone both ways – you set the to/from language (like English to Spanish), speak into it (“Where is the nearest bar?”) and it puts the translated text on the screen with an option to play it aloud with a natural-sounding voice for the other person to hear in their language. Then, you flip the languages and let the other person speak in Spanish, which you then see on-screen or hear in English. Google has improve the translation engine a lot, apparently, so it’s more conversational than before. A cool new option (via a Google acquisition) is the ability to translate written words on the screen by pointing the device’s camera at road signs, menus, etc. that then displays the English translation as an image overlay in real time. You can also download the language package so it can be used while offline.


This Week in Health IT History

One year ago:

  • President-elect Trump nominates Tom Price, MD as HHS secretary and Seema Verma as CMS administrator.
  • Constellation Software subsidiary Harris acquires IMDsoft.
  • Orion Health shares drop to a post-IPO low following poor quarterly results and its announced post-election US sales concerns.

Five years ago:

  • KLAS lists its top radiology PACS innovators as Infinitt, Intelerad, DR Systems, McKesson, Novarad, and Sectra.
  • Cleveland Medical Mart signs Cleveland Clinic and GE Healthcare as tenants.
  • OIG warns that CMS is not adequately auditing Meaningful Use attestation submissions, recommending that CMS conduct random audits, issue guidance of the types of documentation it expects providers to have available, and require certified EHRs to issue verification reports.

Ten years ago:

  • UPMC CIO Mark Hopkins dies of cancer at 47.
  • A nursing professor creates simulation training on Second Life.
  • Experts at Penn’s Wharton School predict that personal health records such as Microsoft HealthVault could serve as the bridge between incompatible hospital EHRs.
  • Athenahealth buys a 130,000 square foot office facility in Belfast, ME as its second site.
  • Carestream Health announces plans to integrate its radiology solutions with IBM’s Lotus Sametime messaging.

Last Week’s Most Interesting News

  • The AMA severs its relationship with Outcome Health following fraud allegations that also caused the company to offer buyouts that were accepted by one-third of its staff.
  • The VA announces that it is considering merging its Choice program with the DoD’s Tricare following discussions about their planned joint EHR.
  • Banner Health confirms that its Tucson-based hospitals are experiencing patient delays following its October 1 Cerner go-live.
  • Advisory Board closes the sale of its healthcare business to Optum.

Webinars

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Behavioral app vendor Ginger.io pivots its business to become a technology-focused national medical practice that will provide therapists. The company, which had raised $28 million with its most recent funding round in late 2014, had struggled to get hospital customers in its previous model.

Philips acquires Analytical Informatics to enhance its PerformanceBridge Practice imaging department management system. The company offers applications for quality analysis, productivity, dictated report search, scanner utilization, peer review, undictated studies lists, image quality problem reporting, and real-time alerts.


Announcements and Implementations

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Children’s Healthcare of Atlanta (GA) will spend $1 billion to build a replacement 446-bed hospital on a new campus on North Druid Hills.

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University of Pennsylvania Health System (PA) will spend $3.9 billion on construction in the next five years, including $1.5 billion for a 17-story patient tower, updating other buildings, and adding a new Center for Health Care Technology that will house IT and other corporate functions.

UMass Memorial Medical Center (MA) goes live on Agfa HealthCare’s enterprise imaging platform.

Memorial Hospital (IL) goes live on Epic.


Privacy and Security

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Cottage Hospital (CA) pays $2 million to settle state charges regarding two incidents between 2011 and 2013 in which patient information was freely discoverable in Internet searches. The hospital, which faced up to $275 million in penalties, has agreed to upgrade its security infrastructure and to hire a chief privacy officer.


Other

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Researchers find that only 21 percent of Florida physicians have registered for the state’s prescription drug monitoring program database, with lack of EHR integration being found as one significant factor. Use of the database to check patient opiate histories is voluntary, but submission of opiate prescription and dispensing data is mandatory.

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A designer creates a virtual reality system to reduce death anxiety in terminally ill hospital patients by creating a sensation of leaving the body. He says,

The fear and experience of death is a neglected topic. If we began treating our anxieties surrounding death, it might mean the process of dying could become more comfortable. In the developed world, the majority of people die in hospital or a care home, turning deaths into medical experiences. But doctors are trained to save and prolong lives, not tend to our demise. They simply lack the tools.

China, following through on its ambition to lead the world in AI by 2030, announces plans to build an unmanned, AI-powered police station that can handle DMV-type issues such as administering driver exams and vehicle registration.

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I wrote last week about the dedication of a new e-health center in India that admitted afterward that it had no actual doctors or staff, with outside workers brought in for the ceremony as pretend employees to impress the locals and the governor of Punjab. The center has closed four days after it opened after the lone doctor at the dispensary where it was housed “was found missing” (is that an oxymoron?) and even the dispensary itself has closed until a replacement is found.


Sponsor Updates

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 11/22/17

November 21, 2017 News No Comments

Top News

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The AMA asks to have its content removed from the platforms of waiting room advertising technology firm Outcome Health “in light of recent unfavorable reports in the media” that involve fraud accusations against the company.

Another publisher, Harvard Health Publishing, says it is “reviewing the situation” in determining the future of its relationship with Outcome Health.

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Outcome Health offered voluntary buyouts to most of its employees late last week because of “challenging times.” More than one-third of its employees – about 200 – took the company up on its offer of a 90-day severance payment to quit. That will reduce the company’s headcount to just over 300, based on previous estimates. The company laid off employees in late September just after pledging to add 2,000 Chicago jobs by 2022 when it dedicated Outcome Tower on Chicago’s North State Street.

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Meanwhile, a Chicago Tribune investigation finds that the company has struggled for years with salespeople making false and misleading statements to medical practices in trying to get them to replace a competitor’s system with that of Outcome Health. Examples include one salesperson describing drug company advertisers as “diabetes advocacy organizations;” using a drug company rep’s conference badge to obtain material from a competitor’s trade show booth; telling practices using a competitor’s system that the competitor had approved replacing its product with that of Outcome Health; and lying to prospects about how many of the competitor’s systems it had replaced.

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Outcome Health also twice sued competitor AccentHealth for making misleading statements to prospects in the same manner it has been accused, but then bought that same company months later in November 2016.


Reader Comments

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From Lee Carmen: “Re: UI Health Care’s Epic Community Connect program. The Community Connect program is currently part of UI Health Ventures. UI Health Ventures is going through a reorganization process and our Community Connect program will transition into UI Health Care in the coming months. Operations will continue as usual for our current clients, but we are putting a hold on new contracts for now as we complete the transition.” Thanks to UIHC CIO Lee, who provided this response to a reader rumor I ran earlier this week.

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From PreviousGen: “Re: NextGen. Looks like someone sent their patient safety problem alert to the wrong list!” I give them credit for notifying users of potentially patient-endangering software problems, which amazingly is still not done by some vendors.

From Itchy Scratchy: “Re: HIMSS social medial ambassadors. Can you explain the point?” The précis: HIMSS likes to get mentioned in tweets by folks it can bribe with free conference registration and the chance to mug with each other for Twitter selfies. My admittedly cynical observation is that for some of those chosen,  their social media volume is inversely proportional to their relevant education and real-world accomplishments.


Webinars

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Change Healthcare acquires Docufill’s dental provider credentialing technology.


Sales

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Yale New Haven Health (CT) chooses the Visage 7 enterprise imaging platform.

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Iraan General Hospital (TX) goes back to CPSI’s Evident Thrive EHR, saying it had previously switched to an unnamed system that caused billing problems and couldn’t handle its service lines.


People

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Smartphone wound image analysis app vendor Tissue Analytics hires Mark Becker (Cerner) as VP of sales.

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Jonathan Teich, MD, PhD  (Brigham and Women’s Hospital) joins InterSystems in a role he didn’t specifically name in his Facebook update. UPDATE: Jonathan report that his new job title is CMIO/director of product management.

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Patrick Conway, MD, MSc, former CMS administrator for innovation and quality, joins BCBS of North Carolina as president and CEO.

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Continuous monitoring vendor EarlySense hires Karissa Price-Rico, PhD (Healthways) as COO.


Government and Politics

FCC Chairman Ajit Pai announces his plan to “stop micromanaging the Internet” in ending net neutrality regulations that prevent broadband providers from selectively throttling back or blocking traffic from specific sites and apps and from charging cable-like a la carte pricing for accessing specific websites, expected to be approved at FCC’s mid-December meeting in a straight party line vote. Internet service providers would be free to do whatever they want as long as they disclose their policies to users, making Internet service less like a public utility in transferring most oversight of consumer protections to the Federal Trade Commission.


Other

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The AI-powered robot of a China-based company passes the country’s national medical exam with an above-average score. IFlytek will launch the robot in March 2018 to improve cancer care and to train PCPs. A reported 500 million people in China use its voice product that translates between English and Chinese, which also powers business functions such as transcription, automated call center replies, and sending voice instructions to ride-hailing app drivers. The 10 robotic greeters in the lobby of one hospital in China give directions to departments based on what symptoms the patient says they have, while clinicians use it to input voiceprint-verified information into the EHR.

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A report on the use of technology by the “death industry” cheerily projects a big increase in sales of equipment to private morgues that correlates to the number of US hospitals. Refrigeration units are the big seller for which business is “booming,” driven by North American Christian burials that require holding bodies for long periods.

In India, a governor performs the dedication of a new pharmacy-based telemedicine center, although its head later admitted to the press that it has no doctors or other staff, adding that the busy technicians conducting tests in the background were just brought in for the photo opportunity. According to the local paper’s account, “The centre has been set up by converting a courier container, which was lying unused at the Dhanas dispensary for nearly a decade.” Meanwhile, another paper reports that dispensary patients were told to come back the next day since its only doctor was hosting the festivities.


Sponsor Updates

  • Visage Imaging will demonstrate the AI-powered research and diagnostic capabilities of Visage 7 at RSNA.
  • The Minnesota High Tech Association names Ability Network the software category winner of its Tekne Awards for its cloud-based revenue cycle management application.
  • Nuance will showcase AI enhancements for radiologist effectiveness at RSNA.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 11/20/17

November 19, 2017 News 3 Comments

Top News

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The VA is considering merging its Choice program – which allows veterans who can’t get timely VA appointments to see private doctors — with the military’s Tricare, which offers health insurance to active service members.

A VA statement says that work on the planned VA-DoD single EHR platform led VA Secretary David Shulkin to have conversations with the White House about merging the programs to “provide better care for veterans at a lower cost to taxpayers.”

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Some large veteran groups immediately expressed concern with the plan, fearing that it could turn the VA’s direct care model into a DoD Tricare-like insurance program in which private providers deliver services and insured members pay premiums, deductibles, and co-pays.

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Shulkin said in a May 2017 White House briefing:

In terms of our Choice Program, we still today only have three Department of Defense facilities that participate in the Choice network. We need to get the Department of Defense and VA to make all their facilities and our facilities open to veterans and to active service members. We certainly have to work with Congress and our veteran service organizations to redesign this Choice Program. It will expire essentially at the end of the year, and we need new legislation — this Congress — to make sure that veterans don’t go back to waiting longer than they need to wait to get care in the community. So we have to pass legislation this year.


Reader Comments

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From Logic Pretzel: “Re: MHS Genesis. Deployment can’t continue beyond the four completed pilot sites until an independent assessment of cost and suitability is performed, which may not be finished until a year or more from now. That piles more risk on the VA’s piggyback decision and undercuts the credibility of their rationale that there’s no time to do a proper competitive search.” The DoD says the review will continue through late 2018, meaning that the VA is rushing into its no-bid contract with Cerner without even knowing whether DoD will continue its own Cerner rollout.

From Short Attn: “Re: HIStalk. It’s too long for me to read. I’m glad you at least run headlines to save me time.” I spend many hours each week extracting the health IT news and information that I think is most relevant and interesting, condensing it massively and dividing it into categories for easy skipping. You are free to consume as little or as much of what I write, but someone out there is poring over every word to gain an edge to allow them to steal your job or your customer. It’s good to have all the knowledge you can get when you’re a knowledge worker.

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From Chalky Aftertaste: “Re: patient-preferred by whom? Check out this bizarre vanity press release.” A horribly written announcement published on a free press release service – I’d bet a stack of non-American currency that it wasn’t written by a native English speaker – lauds the medical accomplishments of an Indiana neurosurgeon, indisputably proven by a single fawning Facebook quote from an alleged patient and a short list of educational qualifications that includes “CMS Meaningful Use Stage 1 Certification from Epic Care Ambulatory EMR” (has he tapped into an unmet consumer demand for Epic-certified neurosurgeons?) The conferrer of the award is Patient Preferred Physicians and Practitioners, an “exclusive medical society” whose corporate address is a Boca Raton mail drop. Most of its honorees seem to be in late in their careers and I’m guessing their modest social media skills misled them into thinking that buying a vanity award would make them seem hipper.

From Pernicious: “Re: diagnostic apps and sites. Don’t you think these will revolutionize healthcare and that you should mention them more often?” No. Non-clinicians think patients are undiagnosed or misdiagnosed a lot more than happens in real life. We don’t have a diagnosis problem – we’re getting killed (literally) by conditions that have been perfectly diagnosed but are either untreated or expensively held in check at best. From a public health perspective, the last thing we need is wiring up millions of Americans, testing their genes, or poring over images of their innards to detect theoretical problems. That’s why experienced doctors roll their eyes at greenhorns who order tons of lab and imaging studies, with the near-certainty of finding something out of range requiring Whac-A-Mole action that’s not good for anyone except the companies making money off unnecessary tests and treatments. Western culture and medicine looks at illness and death much differently than most of the world, and our fascination with gadgetry and medical heroics that prop up the comforting illusion of immortality instead of taking on less-decisive public health issues has left us with a society that’s #1 by far in healthcare costs, but that barely beats Cuba in WHO’s health rankings.

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From IA Taxpayer: “Re: University of Iowa Hospitals and Clinics. Shutting down its Epic Community Connect program. Team members were told on Friday, November 17. The business unit will be integrated into UIHC IT, UIHC is not seeking new Community Connect business, services to existing clients will be cut off, and layoff of 50 percent of the staff (more than 30 FTEs) will happen by July 1, 2018. The message is that the program has a financially flawed business model that provides only a fraction of the ongoing revenue needed to support existing staff. UIHC has negative margins, but within increased focus on patient-centered care, referral patterns from those hospitals that joined the program will be negatively impacted.” Unverified. I’ve emailed a contact there for a comment.


HIStalk Announcements and Requests

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The vast majority of poll respondents think the federal government should review whether the AMA-owned CPT procedure code system constitutes a monopoly. An anonymous reader says rather insightfully that it’s not illegal to BE a monopoly, but rather to ACT like one, while John recalls an early copyright misuse claim in which the ruling was that while the federal government may have created a monopoly by mandating the use of CPT codes, AMA didn’t seek that monopoly. Another anonymous reader wonders whether AMA perpetuates the use of E&M codes, which he or she blames on note bloat and lack of usability of clinical documentation functions.

New poll to your right or here: will Cerner’s EHR allow the VA to exchange electronic information with non-VA providers?

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I’m fascinated by the small number responses to my poll in which I asked HIStalkapalooza attendees what aspects drew them to the event. #1 by far was the hosts, stage show, and HISsies, which is surprising because the in-person feedback is usually that they couldn’t hear or didn’t care. Only 10 percent of respondents ranked “free food and drinks” as their motivator. Based on that, the ideal event would be open to everyone, feature a less-expensive dance band, let everyone buy their own food and drinks, and carry on the stage show as always. The only aspect I’ll miss (since I’m still not inclined to do it again) is the interesting roster of attendees, which as far as I know is unmatched since it included providers, vendors, professors, government officials, equities analysts, and even people from competing websites and publications.

It seems as though many members of the Greatest Musical generation of the 1960s and 1970s are dying lately as that cohort starts to hit the mortality wall. The latest: AC/DC co-founder, guitarist, and songwriter Malcolm Young, who died of dementia this weekend at 64 in leaving the band with one original member, his schoolboy-uniformed brother Angus Young. A third brother, AC/DC producer George Young, died last month at 70. Meanwhile, David Cassidy (aka Keith Partridge) is apparently also close to death from dementia and organ failure. Life is a (hopefully) long line to the cliff where it will eventually be your turn to be pushed off.


This Week in Health IT History

One year ago:

  • The Gates Foundation issues a grant to create a blockchain-powered medical record.
  • HIMSS and CHIME create an international group to manage programs outside of North America.
  • HHS Secretary Sylvia Burwell warns that a “repeal and replace” approach to the ACA will cause the program to collapse due to insurers pulling out because of uncertainty, leaving 20 million more people uninsured.

Five years ago:

  • HP writes down $9 billion after finding that its recent acquisition Autonomy misstated earnings.
  • The CEO of Quest Diagnostics says the company is “redirecting” its EHR business (ChartMaxx, Care360) to work with enterprise EHR vendors like Cerner, Epic, and McKesson.
  • The National Football League signs a contract with EClinicalWorks to provide an EHR that can support the research and treatment of player head injuries.
  • New sales were announced by Acuo, Merge, 3M, and Humedica.

Ten years ago:

  • A UK survey finds that GP support for the NPfIT project is down to 23 percent.
  • Sunquest, fresh off its acquisition by Vista Equity Partners, announces that it will increase investment in its radiology information system and begin actively marketing it again.
  • Wheaton Franciscan Healthcare VP of IT Tim Belec is shot by a 17-year-old robber in the organization’s parking lot as he leaves work.
  • Dennis Quaid’s newborn twins are given a heparin overdose at Cedars Sinai due to improper stocking of a medication dispensing cabinet.

Last Week’s Most Interesting News

  • VA Secretary David Shulkin asks a House appropriations subcommittee to approve using $782 million of the VA’s budget to kick off its Cerner project while sidestepping member questions about how Cerner will exchange information with community-based providers.
  • A multi-day system downtime leaves CVS Pharmacy unable to fill prescriptions.
  • Meditech announces a cloud-based, subscription-priced version of its EHR.
  • A Black Book survey finds that only 19 percent of post-acute care providers have any degree of EHR capability and that 90 percent of long-term care providers don’t exchange information with referring doctors or hospitals.
  • In England, a migrant rights group challenges an agreement by which NHS makes patient data available to the Home Office for immigration enforcement.

Webinars

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Drug company Roche will acquire laboratory-focused health analytics technology vendor Viewics. Roche Diagnostics offers laboratory analyzers, inventory software, and middleware and will deploy the Viewics solution to help labs improve profitability and care.

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Madison, WI-based image sharing app vendor ImageMoverMD separates from its CEO, hires a former drug rep as president, and brings on a COO (who comes from Epic) and a sales director in hopes of boosting sales. The two physician co-founders are UW radiologists who are also board-certified in clinical informatics.

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Eric Topol apparently isn’t convinced that radiologists will be replaced by artificial intelligence, based on the lack of peer-reviewed publications of the companies that offer imaging AI.

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Advisory Board closes the sale of its healthcare business to Optum, with CEO Robert Musslewhite staying on.


People

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Glenn Galloway (Children’s Health Network) joins Center for Diagnostic Imaging as CIO. He previously worked as CIO of Children’s Hospitals and Clinics of Minnesota and co-founded Healthia Consulting in 1998, spending several years as SVP of Ingenix Consulting after it acquired Healthia in 2007. Long-time readers will recall that Healthia (and thus Glenn) sponsored the first-ever HIStalkapalooza at HIMSS08 in Orlando, a two-hour cocktail party for around 200 attendees at what was then the Peabody Hotel.

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ZappRx hires Rich Cramer (Upfront Healthcare Services) as VP of commercial operations and names James Cornicelli (UCB) as VP of corporate strategy. 


Announcements and Implementations

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Sunquest will integrate its Mitogen laboratory information management system for molecular diagnostics and precision medicine with oncology molecular decision support technology vendor N-of-One. Private pathology lab CellNetix will be the first customer.

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South Georgia Medical Center (GA) goes live on Epic, saying that within the first two weeks it had exchanged information with 20 or more facilities.


Government and Politics

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The controversial president of the Fresno, CA school board attacks a Center for Health Journalism writer for her newspaper series on sex education and high birth rates. He launches a Twitter tirade, compares her on talk radio to a “child sex predator,” and publishes her work phone number on Facebook in urging others to contact her.

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A California state judge rules that Sutter Health intentionally destroyed 192 boxes of documents that were being sought by employers and labor unions who had charged Sutter with market power abuse and charging inflated prices.

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Florida’s Agency for Healthcare Administration takes the next step after heavily redacting nursing home inspection records in claiming threats to the privacy of residents – removing the records from its website completely. Florida newspapers mentioned the censored inspection reports in their coverage of the deaths of 13 seniors in a rehabilitation center after September’s Hurricane Irma, after which the AHCA took all nursing home records offline without notice. Some South Florida counties have also refused to release the emergency management plans they approved for nursing homes – including the all-important sections of how they would keep residents comfortable during power outages –even though they had previously said they were public record.


Other

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The local paper says patient appointments at Banner Health’s Tucson hospitals and clinics are being delayed due to its October 1 go-live of Cerner, with Banner’s chief clinical officer admitting that it has been a “painful period.” The health system expects the situation to be resolved by December 31. The Arizona Department of Health Services is investigating complaints about the impact of the new system but won’t provide details. Banner acquired the former money-losing University of Arizona Health Network in 2015, which had  gone live (and well over budget) with its $115 million Epic project less than a year before. Banner’s corporate standard is Cerner.

A JAMA research letter questions whether hospitals are gaming the federal government’s Hospital Readmission Reduction Program in avoiding financial penalties by upcoding severity of illness instead of actually improving care.

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County officials question the auditor and CEO of Blount Memorial Hospital (TN) about why they weren’t told that the hospital foundation’s since-fired executive director had embezzled $187,000 over nine years. The employee issued checks to herself using QuickBooks accounting software, then modified the QuickBooks entry to make it appear that the payee was a foundation business partner. The foundation did not require checks to bear a second signature and did not conduct yearly audits. 

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In England, a man who proposed to his girlfriend last New Year’s Eve —  the day before he suffered from sepsis-induced brain damage that nearly killed him — proposes again from the rehab hospital, using eye-tracking technology to communicate. His girlfriend said “yes” a second and his therapists and caregivers prepared him to make his way down the aisle in a wheelchair and to place the ring on her finger. The eye-tracking technology is from Eye Gaze, which offers assistive technology and eye tracking human cognition research.


Sponsor Updates

  • Medicity publishes a new report, “HIE Preparedness: Learning from Recent Health Care Disasters.”
  • MedData and Experian Health will exhibit at the Illinois AAHAM Annual State Institute November 29-December 1 in East Peoria.
  • Meditech will exhibit at the West Virginia HIMSS 2017 Fall Event November 30-December 1 in Morgantown.
  • PatientPing announces that its ACO customers achieved $120 million in cost savings in 2016.
  • Navicure will exhibit at HFMA Maine’s Revenue Cycle Workshop November 30-December 1 in Portland.
  • A large health plan upgrades to ZeOmega’s Jiva 6.1 population health management solution.
  • The Technology Association of Georgia recognizes Patientco’s Jason Kuo as 2017 TAG Product Manager of the Year.
  • TransUnion partners with Mercy Home for Boys & Girls to launch the Friends First mentoring program.
  • Verscend Technologies publishes a new white paper, “Thinking inside the box with a provider decision quadrant.”
  • Visage Imaging previews its Visage 7 Enterprise Imaging Platform in a new video.
  • Vocera Communications will present at the Piper Jaffray Healthcare Conference November 28 in November 28.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 11/17/17

November 16, 2017 News 4 Comments

Top News

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VA Secretary David Shulkin, MD asks Congress to move $782 million from its 2018 appropriations to get its Cerner implementation underway, starting with an immediate $374 million in reprogramming since that’s the maximum that can be moved in the short term.

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Committee chair Charlie Dent (R-PA) and ranking member Deborah Wasserman Schultz (D-FL) opened the session by expressing their frustration with previous VA-DoD interoperability efforts, the failure of the VA and DoD to follow the previous directives of Congress to create a single system, and their skepticism that the Cerner project will run as smoothly as the VA is assuring.

Some comments from Wednesday’s session:

  • The committee declined to discuss cost issues in the open session because the Cerner contract has not been signed and the VA is worried about bid protests. Cost was discussed Wednesday in a closed session that followed the public one.
  • Shulkin said that modernizing VistA would have cost $19 billion and would only say that the Cerner project will cost billions less.
  • The VA said it will save 5 percent of the project’s cost if the money is approved quickly so that the VA can align its project with the DoD’s.
  • Wasserman Schultz referred to the VA’s EHR history as, “The unbelievably lengthy process this has been, even for government,“ adding that, “This issue could have and should have been resolved years ago,” and, “It’s no wonder our constituents get incredibly frustrated with the insanity of the bureaucracy of many federal agencies. This is a textbook case.”
  • Wasserman Schultz called the DoD’s selection of Cerner as “problematic” with regard to VA-DoD interoperability given that the VA had committed to modernizing VistA, adding that “the patchwork of the Joint Legacy Viewer has left much to be desired.”
  • Wasserman Schultz said, “I was not thrilled at getting a $782 million reprogramming at the end of October that needed to be acted on by November with no real details. I’m also concerned about how this new system will work with the private sector providers .. I’m concerned that the VA’s foot-dragging and missteps have become our emergency because DoD has gone forward and jumped ahead to what we should have been doing in parallel … that’s not really the fiscally responsible way to do things.”
  • Shulkin reminded the committee that VistA is not a single system, but rather 130 separate systems that cannot continue to function. Those will be shut down one at a time as the Cerner implementation progresses over eight years.
  • Shulkin admitted that previous VA IT projects have not been delivered on time and on cost, but said the Cerner project will be overseen directly by the deputy secretary and the DoD’s lessons learned will be invaluable.
  • Shulkin said, “We’re taking advantage of the private sector CIOs. Mr. Blackburn’s going to be on a call with five of the leading CIOs in the country, getting their advice, asking what mistakes are likely to happen, and essentially using private sector input. I’ve been a private sector CEO. I’ve done EHR implementations.” Specifically named as being consulted in response to a later question were the CIOs of Mayo Clinic, Partners, Johns Hopkins, and Kaiser Permanente, all of which interestingly use Epic rather than the VA’s no-bid choice of Cerner.
  • Shulkin talked up what seems to be CommonWell along with HIEs in response to a committee question about community interoperability, a subject brought up several times by committee members. He added that the VA has just issued an RFI for the Digital Health Platform that will address that issue.
  • The VA’s EHR modernization executive director, John Windom, guaranteed 100 percent interoperability with the DoD in response to a committee member’s rather pointed question.

Reader Comments

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From Winter Rye: “Re: Medent sale. I’ve never understood its reach despite the apparently success of its family and 8,000 reported deployments. The resignation of the son-of-the-father CEO may be telling that other family members want to sell after the father / founder died earlier this year. Potential buyers?” The family seems to be angrily split on selling the 260-employee EHR/PM vendor, which is based in Auburn, NY. It claims 8,000 physician users, with ONC placing it at #13 on the Medicare EHR Incentive Program most-attested vendor list with just under 4,000 EPs. It’s not the best environment to be selling an ambulatory EHR vendor given that segment’s consolidation, but it’s all about the asking price and the acquirer’s confidence of either maintaining the revenue stream or converting users to their own product (the former is much more likely than the latter). The worst thing that could happen is that the family members can’t agree whether to sell and the product languishes amidst the bickering.

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From Allscripts Curious: “Re: the new Allscripts ambulatory EHR showcased at MGMA. Anyone seen it and have feedback? It claims to offer cloud hosting, usability, interoperability, mobility, and embedded AI, but management was short on details.” I’m interested as well. I assume this is the Allscripts Care Otter project, which after I mentioned it via a reader’s tip in August wondering why it wasn’t ready to be shown at ACE, all online traces of the project were immediately taken down. This reminds me of why I’m skeptical when vendors suddenly claim to have embedded the oh-so-trendy AI in their products, leading me to wonder exactly what that means beyond the usual hard-coded programming logic (the real definition of AI is that the system simulates human intelligence in applying what it learns to complete new tasks, which sounds kind of unlikely for an EHR).

From Nice Hat: “Re: patient access technology. What does that mean, exactly?” It’s less noble than it sounds, usually referring to technology that increases the number of profitable patients that can be cranked through the system.


HIStalk Announcements and Requests

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Thanks to Healthfinch, which has upgraded its HIStalk sponsorship to Platinum level.

At least 50 percent of the usage of the possessive “its” that I’ve seen lately incorrectly spelled the word as “it’s,” raising the near-certain likelihood that dictionaries will start listing the misspelling as acceptable in their self-assigned role of being descriptive rather than prescriptive.

This week on HIStalk Practice: CDC announces Million Hearts Hypertension Control Challenge winners. GE CEO John Flannery announces major restructuring. Mynd Analytics makes telepsychiatry acquisition. Nomad Health adds telemedicine to healthcare jobs marketplace. Pacifica Labs adds therapist directory to popular mental health app. Forward brings high-tech primary care to LA. The Iowa Clinic embarks on population health management with help from Lightbeam Health. PRM Pro Jim Higgins outlines how PRM tools can help physicians treat the person inside the patient.


Webinars

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

 

Here’s the video recording of this week’s webinar titled “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.”


Acquisitions, Funding, Business, and Stock

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Merck-owned Ilum Health Solutions acquires Teqqa — a partner organization that offers analytics for infectious disease analytics — to enhance its antibiotic stewardship offerings with point-of-prescribing decision support.

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Patient adherence message vendor ConnectiveRx acquires Pittsburgh-based Careform, which offers technology for specialty drug access.

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Hospital and infusion center scheduling system vendor LeanTaaS raises $26 million in a Series B funding round, increasing its total to $39 million.

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Banyan Software acquires Atlanta-based student health EHR vendor Medicat. I was puzzled why the company that developed the Vines networking system would buy an EHR vendor, not realizing that Banyan Systems has been defunct for nearly 20 years.

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Fast Company profiles Remedy, a shuttered startup that used technology and human billing experts to help people get their incorrect medical bills fixed. The company says hospitals, practices, and insurers wouldn’t cooperate by giving it access to the billing records of their customers, saying in its goodbye message, “Until the industry begins respecting the rights people have to their own information, it will remain difficult for individuals and their agents to be vigilant against baseless medical bill overcharges.” The article acknowledges that perhaps the company should have done more due diligence before placing investor bets on external data access, but adds that the company’s billing subcontractors were buried in paperwork as hospitals and practices required completing manual forms, lost the submitted forms so they had to be completed again, and incorrectly told them that HIPAA made it illegal to work with the company.

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AI-powered patient engagement platform vendor Catalia Health raises $4 million in a pre-Series A round, increasing its total to $7.75 million. The company offers Mabu, a supposedly human-like conversational companion whose robotic voice is about as un-human as it can be, making that a good place to spend some of the new windfall.


Sales

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Jefferson Health (PA) chooses KyruusOne and ProviderMatch for Access Centers to create and manage a central provider directory that provides visibility into network-wide clinical coverage and provider expertise.

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Griffin Hospital (CT) will implement FormFast’s electronic form and workflow technology along with check printing.

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In Australia, Royal Adelaide Health chooses the anesthesia information system of Florida-based IProcedures as part of its Allscripts contract.

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Allegiance Health Management (LA) selects Medhost’s clinical and financial solutions, EDIS, and YourCareCommunity patient and provider portal for eight of its facilities.

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Banner Health will implement Health Catalyst’s Data Operating System for its outcomes improvement program.


People

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A UCSD announcement of the go-live of UCI Health on a shared instance of UCSD Health’s Epic system quotes UCSD Health CIO Christopher Longhurst, MD, MS and UCI Health CIO Chuck Podesta.

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Protenus hires Megan Emhoff (Curiosity Media) as VP of people operations.


Announcements and Implementations

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Apple co-founder Steve Wozniak will headline InstaMed’s 2018 User Conference April 9-11 in Philadelphia.

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The Iowa Clinic (IA) goes live on the population health management platform of Lightbeam Health Solutions.

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The local paper covers the first US deployment of Netherlands-developed, infection prevention-focused OR Cockpit at Ocean Springs Hospital (MS).

Philips and Nuance will bring AI-based image interpretation and reporting capabilities to radiologists in integrating their respective Illumeo and PowerScribe 360 products.

NextGen adds the IMO Problem IT Terminology diagnosis entry tool by Intelligent Medical Objects to the mobile workflow solution that was part of NextGen’s acquisition of Entrada earlier this year.

Image Stream Medical offers HIStalk readers “Surgery is a Team Sport,” a three-part educational series on improving teamwork, increasing care quality, and expanding efficiency.

In Canada, Canada Health Infoway and OntarioMD will align the privacy and security components of their respective EHR certification programs.


Other

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An “internal network infrastructure issue” leaves CVS Pharmacy unable to process prescription refills. Annoyed Twitter users dispute the company’s claim that new prescriptions are being filled normally, saying that the multi-day outage has disrupted all CVS prescription activity and has caused store personnel to suggest they head over to Walgreens.

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CHIME suspends its highly publicized, $1 million prize National Patient ID Challenge after two years, saying “a new approach is warranted” with no good solutions found and admitting that “we cannot do this alone.” CHIME President and CEO Russ Branzell also notes that Congress may soften its stance on prohibiting HHS from creating a national patient identifier. CHIME says it will bring together key stakeholders to find a national solution that identifies people with 100 percent accuracy (its million dollars would be safe there for sure).

A woman sues EClinicalWorks for $999 million, hoping to attain class action status in claiming that her husband died because ECW’s EHR left him “unable to determine reliably when his first symptoms of cancer appeared in that his medical records failed to accurately display his medical history on progress notes” without really describing what happened. The complaint cites the certification issues that were listed in ECW’s settlement with the Department of Justice.

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In England, a physician’s op-ed piece complains that a private telemedicine provider is advertising itself as a replacement for seeing GPs while excluding more complex patients, thus cherry-picking the easiest ones and threatening GP practices that are paid a fixed $200 per patient per year in which the healthy subsidize the sick. The yearly fees are transferred to telemedicine provider Babylon when a patient signs up for an online visit. The author says his practice can’t provide services to truly ill patients if telemedicine providers skim off the profitable ones:

But while anyone can join its service, the website says it may not be suitable for “complex mental health problems or complex physical, psychological or social needs.” Or if you’re pregnant or older and frail, and as long as you don’t have dementia or learning difficulties or safeguarding issues … We cannot refuse to register patients or advise them to register elsewhere based on age, gender, or disability. If my surgery put a list on its website telling the most ill people in our catchment area we weren’t suitable for them, NHS England would serve us a breach of contract notice and could close us down.

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I mentioned that Thursday night’s “Grey’s Anatomy” winter finale involves a hospital cyberattack, with a sneak preview showing that it’s ransomware. It’s a pretty realistic EHR screen and “Tim from IT” gets a fun line before his day is wrecked in cutting off the nurse’s description of the problem by asking her if she’s tried turning the computer off and back on. Hollywood loves playing sounds when text displays on a screen like a teletype and did so here, which might be desirable for ransomware but not otherwise. The hacker appears to be demanding 4,932 bitcoin, making the ransom at bit steep at $38 million.


Sponsor Updates

  • Elsevier adds an Opioid Epidemic Resource Center to its Connect website.
  • Salesforce offers an e-book titled “How a Mobile CRM Makes You More Successful” and a guided tour of Community Cloud Lightning.
  • Datica CTO Adam Leko and Methodist Le Bonheur Healthcare analytics director David Deas will present a session on eliminating HIPAA compliance as a development barrier at the Amazon Web Services AWS re:Invent conference on November 27 in Las Vegas.  
  • Brava Magazine profiles Healthfinch VP of Finance and Operations Leah Roe.
  • Healthgrades partners with Code.org to bring Hour of Code to schools in Atlanta, Denver, Madison, and Raleigh.
  • Healthwise will exhibit at the Next Generation Patient Experience November 28 in San Diego.
  • Iatric Systems releases a preview of its forthcoming Security Audit Manager.
  • Imprivata customer support wins the 2017 TSIA Star Award.
  • The HCI Group partners with the Dubai Health Authority for the DHA Transformation Forum.
  • Consulting Magazine includes Impact Advisors in its list of fastest-growing firms for 2017.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 11/15/17

November 14, 2017 News 7 Comments

Top News

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American Medical Association EVP/CEO James Madara, MD pitches AMA’s recently announced Integrated Health Model Initiative at the organization’s Interim Meeting. He criticized the poor organization of clinical data sets; the lack of clinical usefulness of EHRs; the need for meaningful interoperability; and “oceans of data, but only puddles of clinical meaning.” His overriding message was that useful information is scattered throughout the EHR, it lacks context, and its needs to include patient-reported data and perceptions.

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Meanwhile, AMA President David Barbe, MD cites AMA’s major wins at the same conference in which he urges attendees to recruit new AMA members. “We successfully fought to postpone a mandate for physicians to upgrade their EHRs … We are fighting to prevent IT vendors from blocking information or making it expensive for physicians to share data, and we are making progress. We are fighting physician burnout and the time crunch by working to improve EHRs, mobile devices, and interoperability, and again, those efforts are showing signs of success.”

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AMA is protective of its membership count – omitting the actual number from its otherwise detailed annual report — but admits that its small growth in the past few years is due to offering low-dues options to groups and for partial-year trial memberships. Some observers estimate that the percentage of American physicians who are members has dropped from 75 percent in the 1960s to as low as 15 percent today. Most of AMA’s $324 million in annual income is from publishing, selling databases such as CPT codes, and profits from its insurance agency.


Reader Comments

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From LinkedOut: “Re: LinkedIn. You said it’s inexcusable not to have a LinkedIn profile. I have found it useful only for networking, primarily to land your next job. Most profiles are outdated. I’m happy in my current position and don’t have a profile. I prefer anonymity and a quiet inbox. If you are in a long-term relationship with someone with an updated EHarmony profile, you’ve got a surprise coming.” I dislike LinkedIn for many reasons: endless spam; slow page load time; user-written vanity pieces; and preening profiles full of questionably accurate credentials. All that aside, I look people up there all the time there for both work and non-work reasons (where did my cousin John Smith ever end up?) My comments specifically referred to executives, where not making a bio and headshot available there is a bad PR move. I also believe that everybody should be open to employment inquiries, which they are free to accept or reject as a business decision unrelated to receiving them in the first place. It’s a lot harder to desperately market yourself after your once-beloved employer has escorted you off their property and your current LinkedIn headline turns into “seeking the next great HIT opportunity” or you declare yourself a first-time, self-employed consultant because nobody’s hiring you. Anonymity and a quiet inbox are great until the paychecks stop, and trust me when I say that your employer’s EHarmony profile is always current even if yours isn’t. 

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From Smoove B: “Re: HIStalkapalooza. Since you aren’t doing it at HIMSS18, you can put your name on our company’s event and we’ll give you some invitations to use.” I don’t really see any point to that, but it reminds me of something I’ve always wondered just in case I ever consider doing it again: why did people attend HIStalkapalooza? If you were there, complete this one-answer poll about why and I’ll report back. So far I’m not feeling nostalgia for the massive personal financial risk, the never-ending search for sponsors to help cover the cost, and the ugliness of the self-impressed who insist that their party presence is mandatory. HIMSS has plenty of parties, so mine shouldn’t be missed much.

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From Hinrika: “Re: UAE. Thought you would be amused at what happened when I tried to read HIStalk in Dubai this morning.” I’m always happy to be blocked, although it’s best when a paranoid vendor tries to hide unflattering news and opinions from their employees. That usually has the opposite effect — they simply read from home or on their phones out of curiosity to see what their employer wishes they wouldn’t. I don’t know what I wrote that got me banned in the UAE, but I’m probably proud of it.

From GoLiveSupport: “Re: [health system name omitted]. [consulting company name omitted] was chosen to help with its Epic go-live and brought in buses of foreign resources who could not speak English. The health system was so unhappy with the inexperienced resources that they made all of them take an assessment and then immediately walked off all 300 of them off the property and kicked the company off the project entirely.” Unverified and likely to stay that way since neither the health system nor the vendor is likely to confirm, so I’ve expunged the names.

From Timothy: “Re: SOAPware. It’s not new news that the EHR vendor is shutting down effective February 2018, but they’ve sent clients a memo suggesting they transition to Athenahealth. Apparently they had established a marketing agreement that I’m sure Athena paid some good $$ for.”


Webinars

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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ED notification technology vendor Collective Medical raises $47.5 million in a Series A funding round. The Salt Lake City company, founded in 2006 by a couple of BYU computer science graduates, is now run by a Bain Capital private equity guy (and BYU grad) in his first CEO job.

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Syapse, which offers an oncology precision medicine and data sharing platform, raises $30 million in Series D financing, increasing its total to $70 million.

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Israel-based Medigate, which offers a cybersecurity platform to inventory and protect connected medical devices, raises $5.4 million in a seed funding round. The three co-founders were all officers in the Israeli Defense Forces Intelligence Corps.

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Coding and compliance services vendor Aviacode acquires an unnamed, India-based medical coding company to extend its coding staff and available hours.

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A state judge denies a request from investors in Outcome Health who had asked the court to freeze $225 million that was due to be paid to the company’s founders. The investors’ lawsuit claims that the doctor waiting room advertising technology company, whose valuation rose to more than $5 billion, defrauded them by falsifying advertiser metrics. The complaint was amended Sunday to note that 22 high-level executives have left Outcome or have been placed on leave so far this year, with the investors also noting that they are receiving Justice Department subpoenas and expect the SEC to get involved. 


People

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Healthcare economist Uwe Reinhardt of Princeton University died Monday at 80. His seminal Health Affairs article, “It’s the prices, stupid: why the United States is so different from other countries” pointed out way back in 2003 that we spend more than any other country on healthcare only because healthcare goods and services cost a lot more here, an issue that remains unaddressed by policy-makers fixated with cutting insurance benefits and reducing the number of people able to buy plans (guess who’s got more lobbyists?) 

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Humana appoints former National Coordinator Karen DeSalvo, MD, MPH, MSc to its board.


Announcements and Implementations

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Meditech announces a cloud-based subscription version of its Web EHR that targets critical access hospitals. The company says hospitals can go live within six months of signing.

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A Black Book survey finds that only 19 percent of inpatient post-acute providers have any kind of EHR capability, with 91 percent of administrators reporting that they have no money budgeted for technology acquisitions and improvements. Nearly 90 percent of long-term care providers are not exchanging information with referring hospitals, doctors, or home health providers, while only three percent of them have analytics capability. Netsmart is Black Book’s top-performing post-acute care technology vendor based on user satisfaction.

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Casenet releases TruCare ProAuth, which allows providers to process prior authorization requests.

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A Change Healthcare study finds that at least 40 states are pursuing value-based payment programs.

UPMC touts its kidney failure detection EHR alert that monitors serum creatinine trends, although the big-picture mortality improvement has been modest.

Mediware adds billing capability to its MediLinks rehab EHR.


Government and Politics

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CliniComp offers to drop the appeal of its dismissed lawsuit against the VA – for choosing Cerner in a no-bid contract — if the VA agrees to test its product head to head with Cerner and let the non-partisan General Services Administration judge which system performs best against existing VistA-to-DoD interoperability benchmarks. They don’t have a chance in this political climate, but its offer throws some justified shade on the VA for declaring that it’s in the best interest of taxpayers to sling no-bid billions at Cerner instead of looking at competitors, of which Epic would be a lot stronger than CliniComp despite the former’s lack of success implementing the Coast Guard and bidding for the DoD.  

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The DoD’s MHS Genesis will celebrate completion of the initial deployment of Cerner in a Facebook Live event from Madigan Army Medical Center (WA) Wednesday at noon ET.

The VA issues a $158 million contract to CSRA to convert the paper health records of 7 million veterans to digital form as part of its conversion to electronic claims.


Technology

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FDA approves the Proteus “digital pill,” a skin patch that will report to doctors when a patient takes a digitally enabled dose of the psychiatric drug Abilify. The system may improve adherence, although no studies have proven that, and it may prevent psychotic episodes if the patient is historically forgetful rather than deliberate in skipping doses. Still, some experts note the irony of giving a “biomedical Big Brother” to delusional patients as well bringing up the privacy implications of being monitored (although patients can opt out). An alternative is already available – once-monthly injectable aripiprazole. 

A London scientist develops a camera that highlights temperature hot spots on the feet of diabetics, allowing early detection of foot ulcers.


Other

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A Boing Boing article that contains no new research (but admirable snark) calls IBM Watson for Oncology “a human-driven engine masquerading as an artificial intelligence” that simply relays the results of a manual case review by Sloan Kettering experts. It notes that IBM hasn’t allowed an independent study of how Watson for Oncology works; its misleads doctors into thinking they will get a data-driven, global recommendation instead of the opinion of a handful of peers; it can’t accurately import patient records; and its outcomes haven’t been studied to see if its recommendations are any good.

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A research article concludes that “psychological mass persuasion” — using an individual’s digital footprints such as Facebook likes or Twitter activity to target social media advertising that pushes their specific hot buttons — is effective in altering their behavior, measurably influencing their purchasing and voting behaviors. That confirms (to me, anyway) that stories about social media influencing elections miss the most important point – that Americans aren’t smart enough to realize when they are being manipulated, are too lazy or too embracing of information that matches their beliefs to vet their information sources, and are too quick to launch personal attacks at anyone whose opinion (or especially factual information) contradicts what they want to hear. American adults of today sometimes seem like American children of yesteryear – self-indulgently watching cartoons, playing with toys, enviously watching what their friends are doing, and throwing temper tantrums, except now it’s all online. Let’s hope we don’t get invaded since the only resistance will be people getting in the way by holding up phones hoping to post the first Facebook selfies.

An interesting public health issue: Colombian “soda cartels” threaten and attack consumer advocates who support a 20 percent tax on sugary drinks that are cheaper than water, convincing the government to threaten supporters with fines. Colombia’s obesity rate has tripled since 1980. 

A hacker breaches the hospital’s computer system in this Thursday’s “Grey’s Anatomy,” forcing the TV doctors “to get creative in their methods to treat the patients.” I’m certain it will be far from realistic, even omitting the standard hospital executive post-incident assurance that the system that was expensively purchased with claims that it would improve patient care puzzlingly didn’t negatively impact that same care when it tanked.


Sponsor Updates

  • PokitDok earns HITRUST CSF certification and accreditation for OSAP-HIE and CEAP.
  • Kern Health Systems (CA) goes live on ZeOmega Jiva 6.1.
  • LogicStream Health moves into a larger Minneapolis office after doubling its FTE count since 2015.
  • Definitive Healthcare is included in Deloitte’s Technology Fast 500 list.
  • Meditech celebrates Canada’s Digital Health Week.
  • Agfa Healthcare publishes a new white paper, “Augmented Intelligence – The Next Frontier.”
  • Black Book’s latest survey ranks Netsmart as the top-rated HIT platform across post-acute settings for the third consecutive year.
  • Arcadia Healthcare Solutions and Cumberland Consulting Group will exhibit at the 2017 HPA Clinical Informatics Value Visit November 15-17 in Kissimmee, FL.
  • Besler Consulting releases a new podcast, “Healthgrades 2018 Report to the Nation.”
  • Carevive will present at the Navigation & Survivorship Conference November 16-19 in Orlando.
  • CoverMyMeds will exhibit at the Norcal HIMSS Annual CXO Summit November 16 in Santa Clara, CA.
  • Diameter Health President John D’Amore presents the the 2017 Digital Quality Summit.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 11/13/17

November 12, 2017 News No Comments

Top News

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In England, the Migrants’ Rights Network challenges a January 2017 NHS data-sharing agreement that allows the Home Office’s immigration enforcement teams to access confidential patient information.

The Home Office has made 8,000 data requests so far this year, using NHS patient information to target 6,000 people.

New regulations also require hospitals to check a patient’s ID and to verify their ability to pay for services.

Migrants’ Rights Network says the data-sharing agreement violates privacy guaranteed by the Human Rights Act, does not justify breaching the doctor-patient relationship, leaves migrants too scared to access healthcare services, and discriminates against non-citizens. Their challenge is supported by Kingsley Manning, former chair of NHS Digital.


Reader Comments

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From Jonathan Baran: “Re: Epic. This past week in Madison, Epic held its first App Orchard Conference and it was a great start to the program. The audience was approximately 300 people, split between  health systems and third-party app companies. Epic has been criticized for being ‘closed,’ but based on my experience this past week, Epic was the opposite. As an app company on the App Orchard, we had access to developers, our own technical service representative to answer any questions (similar to customers), and their roadmap spoke to us getting continued support.” Jonathan is co-founder and CEO of Healthfinch. Another reader who provided the graphic above said Epic announced an “FHIR First” strategy.

From LobbyWin: “Re: UnitedHealth Group. Lobbyists may have convinced the Department of Justice to drop the whistle-blower lawsuit claiming that it bilked Medicare of billions. Their DC team was able to score a similar victory with the previous administration’s DOJ.” A federal judge dismissed the Justice Department’s lawsuit in mid-October and the DOJ has elected not to re-file its complaint, which involved up-coding Medicare Advantage claims.

From Informatician: “Re: Craig Venter’s Human Longevity. Didn’t see this on HIStalk (or anywhere else), but on November 1 the company laid off its chief medical officer and his entire department of at least 15, which includes physician informaticists. The chief scientific officer is leaving as well (voluntarily?) The Health Nucleus thing is in trouble.” Unverified. The San Diego company, which has raised $300 million, offers Health Nucleus X, which collects data from whole genome sequencing, MRI, microbiome sequencing, and other tests that claim to allow consumers to “stay ahead of aging and illness.” The bio page of Chief Medical Officer Brad Perkins has been removed from the company’s website although his LinkedIn profile remains unchanged. The cached version of the executive webpage from June 2017 shows that eight of the 18 names listed aren’t included on the current version of the page.


HIStalk Announcements and Requests

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Around half of poll respondents have donated money to a hospital or health system.

New poll to your right or here: should the federal government review AMA’s licensing of CPT procedure codes as a possible monopoly? Vote and then click the poll’s Comments link to weigh in.


This Week in Health IT History

One year ago:

  • Cerner CEO Neal Patterson makes a surprise appearance at the Cerner Health Conference, expressing his frustration with the healthcare system from his experience as a cancer patient.
  • UCSF and GE Healthcare announce plans to work together to develop clinical diagnosis and management algorithms.
  • Cerner says in its earnings call that it expects that its DoD win will give the company a strong competitive advantage if and when the VA decides to replace VistA.
  • NTT Data completes its $3.1 billion acquisition of Dell Services.

Five years ago:

  • Allscripts CEO Glen Tullman admits in the company’s earnings call that its drastically reduced quarterly earnings were caused by rumors that the company is trying to sell itself.
  • PCP usage of EHRs increases to 69 percent.
  • WellStar Health System pays $20,000 for the intellectual property of the bankrupt Center for Health Transformation, the for-profit think tank started by Newt Gingrich.

Ten years ago:

  • Google releases the Android operating system for mobile devices.
  • Mediware retools the company by hiring a new CEO, restructuring, retiring products, and laying off employees.
  • Three Medquist board members quit over concerns about the company’s potential sale.
  • Sutter Health says its Epic project will cost at least $500 million vs. the initial estimate of $150 million.
  • AMIA announces an initiative to establish clinical informatics as a medical specialty.
  • IBM acquires Cognos for $4.9 billion in cash.

Last Week’s Most Interesting News

  • Insiders say the VA will sign its contract with Cerner this month at a total cost of $10 billion, much less than originally estimated.
  • Major investors in Outcome Health sue the company, claiming fraud.
  • Saint Anthony Hospital (IL) sues the Leapfrog Group, saying that the quality organization lowered its patient safety grade based on incorrect data.
  • UPMC (PA) announces plans to spend $2 billion to build three technology-focused specialty hospitals in Pittsburgh.
  • A former employee of WakeMed (NC) files a whistleblower False Claims Act lawsuit claiming that Epic’s software defaults to double billing for anesthesia.

Webinars

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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NantHealth announces Q3 results: revenue up 5 percent, EPS –$0.20 vs. –$0.22, beating earnings expectations but falling short on revenue. The company said in the earnings call that its previous sale of its provider / patient engagement solutions to Allscripts will reduce annual operating losses by $50 million.


Sales

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Memorial Sloan Kettering Cancer Center (NY) chooses Cota to create optimized clinical and genomic datasets from anonymized patient data, allowing it to map EHR data into a structure that can be used for analytics and precision medicine.


People

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Great River Health Systems (IA) names Matt Wenzel (St. Luke’s Health System) as president and CEO. He’s a former Cerner marketing manager with master’s degrees in health administration and healthcare informatics.


Other

In India, a government hospital suspends a doctor who posted on Facebook that the hospital is overwhelmed with dengue fever cases, an outbreak the government has downplayed. The opposition party says the government has asked doctors not to indicate dengue as a cause of death. The 62-year-old doctor says it’s unfortunate that he was suspended since he would have retired at 60 had the government not extended the retirement age of doctors.

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St. Vincent Hospital (IN) will use high-tech, vehicle-mounted cameras to match license plate numbers of cars parked in visitor spots with an employee database to enforce visitor-only parking rules, hoping to improve its patient satisfaction scores.


Sponsor Updates

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  • T-System employees pack over 27,000 meals for North Texas residents while helping out at the North Texas Food Bank.
  • Ernest Health implements Cantata Health’s Optimum Referral Portal to standardize the intake process at 18 of its 25 post-acute care facilities.
  • Cumberland Consulting Group is named to Consulting magazine’s list of fastest-growing firms.
  • TriNetX achieves ISO 27001:2013 certification.
  • Verscend Technologies will exhibit at the NHCAA Annual Training Conference November 14-17 in Orlando.
  • Vocera publishes new research on clinician burnout and care team resilience.
  • ZappRx will exhibit at the Comprehensive Lung and Breathing Summit November 16-18 in Colorado Springs, CO.
  • MDwise upgrades to ZeOmega’s Jiva 6.1 population health management platform.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 11/10/17

November 9, 2017 News 4 Comments

Top News

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An FCW source says Cerner and the VA have agreed on a rough price of $10 billion for implementing Cerner, with the contract still on track to be signed sometime this month. The price is lower than previously suggested. VA Secretary David Shulkin is reportedly lining up Congressional funding this week.

The initial VA launch, planned for mid-2019, will take place at sites in Oregon, Washington, Idaho, and Alaska.

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A federal judge who previously dismissed CliniComp’s lawsuit in which the company claimed it was unfairly eliminated from consideration to replace VistA claims in newly unsealed documents that CliniComp would not have been a credible bidder because it lacks experience with projects of the VA’s scope. CliniComp says it will appeal while seeking an injunction to stop the project.

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The judged also noted that she sees no evidence to support the VA’s no-bid choice of Cerner. Other bidders can protest once the Cerner-VA contract is signed.


Reader Comments

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From Nordic Employee: “Re: Nordic. Laid off over 10 percent of the home office staff yesterday.” Unverified. Another reader reports that around 15-17 employees were escorted out. I asked Nordic and received this response from CEO Bruce Cerullo:

On Tuesday, Nordic initiated its 2018 growth plan, which includes the further expansion of our Managed Services division, a formal move into non-Epic legacy support, a further investment in our revenue cycle and data and analytics capabilities, and the launch of an ERP practice. As part of this plan, we took the difficult step of restructuring our home office. This included the displacement or redeployment of 17 employees. We recently posted 20 new positions and plan to add up to 150 new employees over the next nine months.

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From SoCal Girl: “Re: UC Irvine Medical Center. Went live on Epic on 11/4. Possibly the first site to run out of another’s data center (UCSD) and using a lot of their build. UCI started with TDS in 1983 and stayed through the incarnations (Alltel, Eclipsys, Allscripts) with their own data center until now. Haven’t heard how it’s going.”

From Skippy Trip: “Re: photos. Why do some items in the ‘People’ section not include photos?” I’m always surprised in this day and age how many photo faux pas I see every day when scouting the Internet for headshots since you would think people would want to make it easy to get exposure. Some executives don’t have any Internet-discoverable photos, making me wonder if they have appearance issues or fears of being judged (which they will be anyway, as in, “what’s with the lack of a photo?”) What I sometimes find when I look for headshots:

  • People who don’t have a LinkedIn profile, which is inexcusable.
  • LinkedIn profiles that don’t include a photo, which is bizarre for someone who works in a people-facing role (you must be a crappy salesperson if your LinkedIn doesn’t include a photo so people can find acknowledge that it’s you).
  • Poorly resized LinkedIn photos that are low-resolution or too small, making the pixelated mess unusable even at a small size. LinkedIn shrinks to thumbnails, so there’s no need to downsize the original to their displayed image size.
  • Trying to repurpose a vacation photo or family picture in which the grainy subject is surrounded by the shoulders of cropped-out others; is so far from the camera as to be unrecognizable; is wearing a tuxedo, Santa suit, or a bike helmet; or is proudly displaying something alcoholic.

HIStalk Announcements and Requests

I’ve noticed that Twitterers who were dull, clueless, or eye-rollingly self-promoting in their allotted 140 characters are now four times more so with the limit doubled to 280.

This week on HIStalk Practice: Georgia Partnership for Telehealth achieves school-based milestone. Family Christian Health Center selects Visualutions billing software. State-based physician health programs help addicted doctors recover – successfully. Consumers still prefer phone-based appointment scheduling. The Federation of State Medical Boards tests blockchain for the medical licensure process. Alpine Investors takes over behavioral health EHR vendor. Physician pirate Jay Saux, MD brings healing and whimsy to cancer care. Navicure’s Kermit Randa offers practical steps for practices looking to offer digital payment options.

Listening: new from Chicago throwback indie band Twin Peaks. Then it was off to very Canadian jangle rockers Alvvays with the amazing singer-songwriter Molly Rankin (who kind of looks like Veronica Mars), the best thing I’ve heard lately, with extra points for the bass player rocking a Hofner violin end everybody seeming to be delightfully nerdy. I can’t take my eyes or ears off them. “Archie, Marry Me” is one of the best pop songs ever and their live version is flawless (warning: I couldn’t get it out of my head and have listened to it 25 times today).


Webinars

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

November 30 (Thursday) 1:00 ET. “Making Clinical Communications Work in Your Complex Environment.” Sponsored by: PatientSafe Solutions. Presenters: Steve Shirley, VP/CIO, Parkview Medical Center; Richard Cruthirds, CIO, Peterson Health. Selecting, implementing, and managing a mobile clinical communications platform is a complex and sometimes painful undertaking. With multiple technologies, stakeholders, and disciplines involved, a comprehensive approach is required to ensure success. Hear two hospital CIOs share their first-hand experience, lessons learned, and demonstrated results from deploying an enterprise-wide mobile clinical communications solution.

December 5 (Tuesday) 2:00 ET. “Cornerstones of Order Set Optimization: Trusted Evidence.” Sponsored by: Wolters Kluwer. Updating order sets with new medical evidence is crucial to improving outcomes, but coordinating maintenance for hundreds of order sets with dozens of stakeholders is a huge logistical challenge. For most hospitals, managing order set content is labor intensive and the internal processes supporting it are far too inefficient. Evidence-based order sets are only as good as their content, which is why regular review and updates are essential. This webinar explores the relationship between clinical content and patient care with an eye toward building trust among the clinical staff. Plus, we will demonstrate a new evidence alignment tool that can easily incorporate the most current medical content into your order sets, regardless of format, including Cerner Power Plans and Epic SmartSets.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Here’s the recording of this week’s webinar titled “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.”


Acquisitions, Funding, Business, and Stock

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Investors that include heavyweights like Goldman Sachs and Google sue waiting room advertising company Outcome Health, claiming that the company committed fraud in obtaining $500 million in funding by providing false information. The lawsuit was driven by a Wall Street Journal investigation from last month that concluded that the company was inflating the number of video screens it had installed in practices, allowing it to overcharge drug companies, its primary advertisers. Outcome Health calls the lawsuit “irresponsible” and a “money grab,” which is an interesting approach to investor relations.


Sales

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Goshen Health (IN) chooses CloudWave’s OpSus Live infrastructure-as-a-service to host its Meditech 6.16 system.

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The board of Ector County Hospital (TX) approves implementation of IllumiCare’s EHR-agnostic Smart Ribbon to encourage the appropriate use of tests and drugs. 

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WellStar Health System (GA) chooses Agfa HealthCare Enterprise Imaging.


Announcements and Implementations

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A small study finds that hospitals that use Glytec’s Hospital-to-Home discharge insulin program for poorly-controlled diabetics had zero diabetes-related readmissions or urgent care/ED visits within the first 30 days after discharge.

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Marshall Medical Center (CA) goes live on Epic via a Community Connect agreement with UC Davis Health. The local paper’s article notes that all area health systems use Epic other than Cerner customer Dignity Health.

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Humana sponsors an innovation challenge to make the digital health records of Medicare recipients more useful to those patients, their caregivers, and their doctors. California-based individuals and early-stage startups will assemble Humana-provided complex data sets (claims data, hospital records, and health program participation information) into a solution that targets either providers or patients in improving quality or reducing cost. The winner gets $10,000.

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A West survey finds that more than half of Americans delay paying their medical bills, with the top reason being high insurance deductibles. Other reasons include forgetting to pay, confusion about what charges insurance will cover, and receiving bills for services they don’t think they should have to pay for. Three-quarters of respondents say high deductibles affect how often they see their provider or seek care. Less than 25 percent of providers discuss affordability in advance, send payment reminders, or provide messages explaining what portion of their bill is covered by insurance.

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An Anthem study finds that total joint replacement patients enrolled in HealthLoop’s guidance and monitoring platform cost $656 less and had about half the rate of 90-day surgical complications and readmissions.


Government and Politics

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The federal government awards Apprio a contract to transition the DoD’s MHS Genesis system to the Defense Health Agency’s long-term sustainment office.

An editorial in the St. Louis paper rips into the state’s government for refusing to confirm that its cobbled-together prescription drug monitoring program is actually running. Missouri – the only state without a PDMP – created an odd version of its own that relies on claims data to allow government officials to identify “pill mills” but without allowing prescribers to see individual patient data. The governor said in July that the program would be operational in weeks, but the state hasn’t even signed a contract to create it.

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HHS announces advance care planning technology vendor Vynca as winner of its Patient Matching Algorithm Challenge, with data integration vendor Pic-Sure earning second place along with wins in the “Best Recall” and “Best Precision” categories.

President Trump’s “Putting Our Veterans First” announcement includes technology references:

  • Criminal investigations of the VA’s previous manipulation of wait time data.
  • Expansion of the VA’s telemedicine program to span geographic areas.
  • Greater adoption of VA Video Connect mobile app.
  • Rollout of the VA’s Online Scheduling Tool.
  • The move to Cerner for both the VA and DoD.
  • Launch of an online wait time tool.

Other

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A former employee of Kansas City, MO-based Healthy Plus LLC – run by two locally prominent sports figures – says employees went weeks without pay as the company issued bad checks and closed its accounts. One of those executives previously ran VC Medical, which is the subject of a lawsuit over an unpaid loan. The company is a pilot member of Athenahealth’s More Disruption Please program, offering solutions for chronic care management and Medicare Annual Wellness Visit reminders. A Healthy Plus press release says the business was launched in April 2017.

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An Axios article questions UPMC’s plan to spend $2 billion to build three specialty hospitals without adding new bed count, noting from experts that:

  • Non-profit hospitals spend big money to erect impressive buildings that entrench their market position, often using tax-exempt debt for buildings on which no property tax is paid.
  • The kind of new treatments UPMC aims to discover are revenue-maximizing.
  • UPMC is investing in inpatient bricks and mortar instead of what the market is demanding: community-based care, primary care, and home care.
  • Pittsburgh residents and federal taxpayers will foot the bill in the form of higher premiums for private insurance, Medicare, and Medicaid.
  • Moving patients into a specialty-specific hospital ignores their other conditions and impedes care coordination.

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This is a great graphic from Gartner that shows the level of analytic maturity.

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AnMed Health (SC) lays off 94 employees and eliminates 65 open positions, citing losses due to lower payments, reduced volumes, and the cost of its $85 million Epic implementation.

Here’s rare video snippet of Epic’s Judy Faulkner speaking, this time at a Geisinger symposium. The moderator didn’t ask great questions or press her for deeper answers, eliciting basically that she likes AI and telehealth. Hopefully the conversation was better than this excerpt.

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Pope Francis expresses frustration with people who screw around with their phones when he is celebrating Mass, suggesting they life their hearts instead of their devices. He wrote in 2015, “When media and the digital world become omnipresent, their influence can stop people from learning how to live wisely, to think deeply, and to love generously. In this context, the great sages of the past run the risk of going unheard amid the noise and distractions of an information overload.”


Sponsor Updates

  • MModal supports the migration of FHN (IL) to Meditech’s Web EHR with its Fluency Direct speech recognition solution.
  • MedData’s Pulse intranet wins the EHealthcare Internet Award for Best Intranet.
  • Meditech will present at the Value-Based Care Summit November 16-17 in Boston.
  • Medicomp Systems releases a new e-book, “Clinical Conundrum: Too much data, not enough meaning.”
  • The Metro Atlanta Chamber of Commerce honors Navicure with its Phoenix Award for Emerging Company of the Year.
  • Nordic’s 800 employees and 200 customers are poised for significant growth in 2018.
  • Consulting Magazine names Impact Advisors to its list of fastest-growing firms.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Northwest AHEC conference November 14-15 in Hickory, NC.
  • Experian Health will exhibit at HFMA Southern IL November 16-17 in O’Fallon.
  • Vocera earns Authority to Operate from the DoD.
  • The Tech Tribune includes PatientSafe Solutions in its top 10 list of best tech startups in San Diego.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 11/8/17

November 7, 2017 News 1 Comment

Top News

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Saint Anthony Hospital (IL) sues The Leapfrog Group for defamation after the quality rating organization lowers the hospital’s patient safety score from its previous A grade to a C.

The hospital says Leapfrog gave it a low score for underusing electronic prescribing even though the information it submitted showed that doctors order medications electronically 95 percent of the time.

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Saint Anthony is demanding a temporary restraining order to keep Leapfrog from publishing its score. Leapfrog’s fall 2017 report that was released October 31 does not include the hospital.


Reader Comments

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From CIO Reader: “Re: Citrix maintenance price hikes. I don’t have the details, but our maintenance fees will increase nearly 30 percent.” My rule of thumb for companies selling to hospitals has always been that you shouldn’t raise your prices beyond the average Medicare reimbursement increase, although bigger, richer non-profit health systems spending millions and billions to erect monuments to themselves has converted me to being OK with vendors sticking it to them just like any other business. Hospitals will always find a way to increase volume or reimbursement to cover their ever-swelling expenses.

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From Grammar Guru: “Re: the HIMSS-owned rag. Needs some help with plural vs. possessive.” Apparently the Healthcare IT New’s editor’s have problem’s with apostrophe’s gone astray.

From Bruce Brandes: “Re: Graysky’s comments about Lucro’s ownership interest and my Readers Write articles. Our company is owned by Martin Ventures, HCA, and Heritage Group. The first priority of the health systems in our network is to reduce costs and inefficiencies to find, evaluate, and choose solutions. While our investors are excited for their portfolio companies to leverage Lucro as a targeted, effective alternative to traditional sales and marketing tactics, their companies have no greater advantage over any other company in Lucro beyond the merits of their own value proposition. There is no cost for any vendor or health system to engage in Lucro and premium services are optional.  Our goal is to level the playing field by democratizing access to relevant buying decisions and there is no Lucro-sponsored opinion or recommendation of one company over any other. We provide a platform for the market to make those assessments on their own, with private support from their invited network of trusted peers. Of the 1,200+ vendors currently engaged with Lucro, about 20 are backed by our investors.”

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From Broadcom Insider: “Re: Broadcom’s $130 billion offer to acquire Qualcomm. Last week Broadcom’s CEO promised Trump he would move its headquarters from Singapore to the US. This is an easy way to accomplish that – San Diego, here we come! I wonder what will happen with Qualcomm’s Capsule Tech? Will Broadcom want to get into the healthcare market or remain narrowly focused on semiconductors and chip sets? Attached is a teardown of the new Apple Watch, which contains mostly Broadcom and Qualcomm chips. Clearly the deal makes a great deal of sense.” Experts say the biggest challenge with the blockbuster deal will come from China, which, like the US, looks closely at proposed deals that could shift technology sales offshore. It’s always interesting when a smaller company (Broadcom, $18 billion in annual sales) bids on a larger one (Qualcomm with $22 billion). Qualcomm Life includes Capsule medical device integration (acquired in September 2015 for an undisclosed price) and 2net remote monitoring. Qualcomm Life previously acquired HealthyCircles for data sharing, but that seems to have been either killed off or rolled into 2net. If the acquisition goes through, it would seem both easy and advisable for Broadcom to sell the Qualcomm Life business to a company more focused on healthcare, perhaps Philips or even Nokia.


HIStalk Announcements and Requests

Lorre is running her year-end special for new HIStalk sponsors – avoid the pre-HIMSS rush, sign up now, and get the rest of this year free. She’ll also offer a deal to wayward former sponsors who want to return to the fold.

Listening: new from Kesha, who has matured individually as a singer-songwriter at 30 (even removing the “$” in her name) and, more importantly, musically, with less Auto-Tuned dance pop and more pure rock in her first release since 2013. Her latest album features tracks with Eagles of Death Metal, the horn section of the Dap-Kings, and Dolly Parton, which is a pretty eclectic group.


Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Clinical Architecture will expand its 52-employee Carmel, IN headquarters, more than doubling its square footage and adding 40 jobs by 2021.

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CoverMyMeds will hire “hundreds” of support team employees immediately for its Columbus and Cleveland offices. The 500-employee company, which has annual revenue of more than $100 million, was acquired by McKesson in January for $1.1 billion.

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Salesforce and Google will integrate Google’s analytics and office software with Saleforce’s platform and Salesforce will use Google’s cloud infrastructure for some of its new services. 

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Cardinal Health fires CEO George Barrett after a poor quarterly report due to lower generic drug prices and the Amazon threat, promoting the CFO to the top chair.

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CVS Health, fearing competition from Amazon, announces plans to offer free, next-day prescription delivery nationwide next year, with same-day service available in some urban areas.

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Roman, which offers online diagnosis and treatment of erectile dysfunction, raises $3.1 million in a seed funding round. Customers choose their preferred drug if desired, pay $15 for a five-minute online visit, then receive home delivery of their med. The company serves men in California, Florida, New York, and Pennsylvania. Drug prices range from $2 for a 20 mg generic Viagra tablet to $63 per tablet for brand-name Viagra.

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Kaiser Health News profiles Comprehensive Pain Specialists, a 54-clinic pain treatment practice headquartered in Tennessee that raked in $11 million from Medicare alone in 2014 for urine drug screening. The article notes that Medicare pays tens of millions of dollars for tests that detect drugs that have minimal abuse potential and for screening street drugs that are rarely found in the urine of pain patients. Analysis found that 31 pain practitioners earned 80 percent or more of their Medicare payments just from urine testing, which the government sees as a red flag that perhaps testing is overused, especially as labs increased revenue by moving testing to more expensive machines that earned higher CMS payments. It notes a company that was exposed in a 2011 whistleblower lawsuit as earning $166 million from Medicare for urine screening in a single year, with reps earning up to $700,000 to convince doctors that “drug testing is not about medicine, but about making money.”


Sales

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In Australia, publicly funded health service Gippsland Health Alliance chooses Allscripts Sunrise.

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In the UK, Princess Alexandra Hospital selects Agfa HealthCare’s enterprise imaging platform.

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Amita Health (IL) will implement PerfectServe’s enterprise clinical communication and collaboration system.

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Non-profit health plan AlohaCare (HI) chooses Health Catalyst for population health, accountable care, financial decision support, and operational performance improvement.


People

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Erik Smith (UnitedHealth Group) joins Stanson Health as RVP of sales.

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Former Rent-A-Center CIO Angela Yochem joins Novant Health (NC) in the newly created position of chief digital officer, where she will report to the president and CEO.

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Huntzinger Management Group hires David Tucker (ESD) as VP of business development.

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Richard Walsh (Continuum Health) joins HealthHusk as managing partner.

BetterDoctor hires John Steinhouse (Box) as VP.


Announcements and Implementations

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Surescripts will offer real-time, patient-specific prescription pricing and benefit information to users of EHRs from Allscripts, Aprima, Cerner, Epic, GE Healthcare, and Practice Fusion for patients whose prescription benefits are managed by CVS Health or Express Scripts. Prescribers will also receive therapeutic alternative suggestions within their EHR workflow and can complete any needed prior authorization during the patient’s visit. Surescripts got its start in 2001 as RxHub, formed by three pharmacy benefits managers (Caremark, Express Scripts, and Medco Health) that ended up as CVS and Express Scripts.

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The Tiger Institute Health Alliance HIE (MO) joins the Sequoia Project EHealth Exchange, allowing University of Missouri Health Care to exchange information with St. Louis-based SSM Health. 

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A Kyruus survey finds interesting facts about consumer provider preference:

  • While most consumers search for providers on the Internet, they would rather schedule appointments by telephone.
  • 90 percent of people look up providers to whom they have been referred before scheduling their appointment, most of them preferring to use generic Internet searches rather than checking health system websites.
  • Among the most important factors in choosing a provider are insurance accepted, clinical expertise, and appointment availability.
  • Over 60 percent of consumers will choose a different provider if they can’t get a timely appointment with their first choice.
  • 40 percent of people say they trust online reviews.
  • Millennials are most willing to choose a different provider because of availability and to schedule their appointments online.

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AMIA announces its unspecified collaboration with the OpenNotes initiative.


Government and Politics

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University of Vermont Health Network (VT) files a state certificate of need to spend $150 million to implement Epic. The health system says it would save money because Epic would replace systems that would cost $200 million to maintain over several years. CIO Adam Buckley, MD, MBA says Epic is a good choice because it is widely installed and it completes its projects on-time and on-budget 87 percent of the time, while the health system’s choice of project management firm, Cumberland Consulting Group, has a 100 percent success rate.

The VA retools its provider inbox to strip out low-value clinical alerts and trains its doctors to process their messages optimally, with the changes saving clinicians 90 minutes per week.

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CMS Administrator Seema Verma says the federal government will “reset the federal-state relationship” in proposing Medicaid reforms that allow states to set some rules of their own and to waive the requirement that states report the health outcomes of such changes. The statement’s wording suggests that CMS is happy to consider state-mandated employment, drug testing, and lifetime coverage limits for recipients. Verma said in her prepared remarks that Medicaid consumes 29 percent of state budgets at a cost of $558 billion; that one-third of doctors won’t see Medicaid patients; and that ACA expensively moved many less-vulnerable people – some of them able-bodied and working – into the program, leading to problems with access and quality, adding that “we shouldn’t just celebrate an increase in rolls or more Medicaid cards handed out.” She said the days of a “tragic example of the soft bigotry of low expectations” are over. Verma used the term “able-bodied” four times in her remarks. 

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The owner of a Florida compounding pharmacy pleads guilty to earning $100 million by fraudulently billing insurers $633 million, mostly for pain and scar creams prescribed by doctors who were given kickbacks. The government recovered $7.6 million by seizing the owner’s antique car collection and a 50-foot racing boat. The FBI arrested eight Florida residents in mid-2016 for their role in the scheme.

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NIH buys 10,000 Fitbits — hopefully at a significant quantity discount — for participants in its All of Us project that will gather anonymous health information from up to 1 million Americans.


Other

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The South Australian government spends $38 million to upgrade its Allscripts-powered EPAS system, raising the total cost of the project to $361 million vs. the originally budgeted $312 million.

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IBM proposes that the government of British Columbia use a blockchain system to protect consumers by monitoring the legal distribution of cannabis from seed to sale.

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The American Psychological Association’s “Stress in America” survey finds that more than half of respondents – even those who remember World War II, the Vietnam War, and the September 11 terrorist attacks – say the US is at “the lowest point in our nation’s history.” The #1 stressor by a considerable margin is healthcare. APA says a key problem is that people check news sites and social media nearly constantly even though they don’t trust the media and aren’t encouraged by what they see. Perhaps this directly contradicts the “broadband as a social determinant of health” technology fanboys.

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A JAMA report creates a healthcare “Affordability Index” that divides the mean cost of an employer-provided family insurance plan by the median household income, which finds that families spend nearly one-third of their income just to pay health insurance premiums. The situation is likely far worse since the income used in the index appears to be pre-tax, high deductibles mean that total healthcare expense is a lot higher, the index looks only at people who buy employer-sponsored insurance, and many people don’t even bother buying insurance since they can’t afford the premiums or deductibles. I remember doing a similar calculation in predicting that the housing bubble had to burst – more homes were being sold (mostly on speculation, as it turned out) than there were people to live in them and the average cost was many multiples of the average household income in the areas that were experiencing the biggest construction boom, strongly suggesting that the music would eventually stop and somebody would be left holding the bill (taxpayers, as it nearly always turns out).

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Several hospitals in drug-ravaged West Virginia file a class action lawsuit against the Joint Commission, claiming that its “fifth vital sign” pain management standards downplayed addiction risk and were biased because opioid-selling drug companies helped create them and also supported the Joint Commission financially.

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A digital health report reviews the “evidence and impact” of digital health tools, but looks at questionable metrics such as the number of available apps, app store ratings, and the number of downloads. More relevantly, it notes that 571 studies have proved some degree of clinical evidence, 860 clinical trials that use digital health tools are underway, and emphasis is shifting to chronic condition management. It attempts some faith-leaping extrapolation in throwing out a potential $46 billion US cost savings figure if apps were used more widely. The study’s publisher is IQVia, the newly renamed (as of Monday) QuintilesIMS. 

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Ambulatory EHR vendor DrChrono enables its app to use the iPhone X’s Face ID facial recognition technology for user log-on.


Sponsor Updates

  • AdvancedMD will exhibit at the American Academy of Ophthalmology conference November 11-14 in New Orleans.
  • Arcadia Healthcare Solutions will exhibit at the Millennium Alliance Summit November 13-14 in Dallas.
  • Besler Consulting releases a new podcast, “Enterprise risk management during healthcare change.”
  • Hyland Healthcare — fresh off its acquisition of Lexmark’s Perceptive VNA, content management, and imaging business — will demonstrate its PACS, VNA, diagnostic imaging viewer, and unstructured data viewer at RSNA.
  • CoverMyMeds will exhibit at the NG Healthcare Summit November 8-10 in Braselton, GA.
  • Forward Health Group founder and CEO Michael Barbouche will present “What Technology means to the BioHealth and Healthcare Industry in Wisconsin and Beyond”at the HHS SMIR/STTR conference in Milwaukee, WI on November 9.
  • Visage Imaging will demonstrate its enterprise imaging platform at RSNA.
  • Dimensional Insight will exhibit at the HIMSS NE Northern Maine Day Conference November 9 in Brewer.
  • Elsevier Clinical Solutions nursing executive Tiffany Mccauley, RN discusses the role of technology in the patient experience during the US News Healthcare of Tomorrow conference in Washington, DC.
  • EClinicalWorks will exhibit at the Kentucky Primary Care Association Conference November 8-10 in Lexington.
  • The HCI Group becomes a CHIME Global Partner.
  • HealthCast will exhibit at the Idaho Chapter HIMSS Conference November 13 in Boise.
  • Madison Magazine recognizes Healthfinch as a trailblazer in the field of healthcare innovation.
  • InterSystems will exhibit at the Millenium Healthcare Providers Transformation conference November 13-14 in Dallas.
  • ConnectiveRx publishes a new white paper, “Optimizing brand access strategies with wrap-around prescriber messaging.”

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 11/6/17

November 5, 2017 News 5 Comments

Top News

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UPMC will spend $2 billion to build three new Pittsburgh specialty hospitals for heart and transplant, cancer, and vision restoration and rehabilitation.

UPMC calls the new facilities “digitally-based specialty hospitals.” Microsoft is also working on the project in an unstated capacity, with a goal of changing “what today is often a disjointed and needlessly complex experience for patients and clinicians.”

UPMC says it will reallocate existing beds to the new facilities. The Pittsburgh market has an excess of inpatient beds.

UPMC declared itself as “the global destination for outstanding healthcare” in its announcement, in which it also states its aspiration to become “the Amazon of healthcare.” The 39-hospital, 80,000-employee UPMC also predicts it will double in size within five years. Its annual revenue is $17 billion.


Reader Comments

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From Jingle Pockets: “Re: the JP Morgan Healthcare Investor Conference in January in SF. What are the best digital health parties?” I’ve never been invited or attended that conference since it’s for JP Morgan clients only as I understand it, so I can’t help. However, I’m sure some readers have been there and might offer suggestions.

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From Skilly Litigator: “Re: Citrix. Do you think most hospitals are aware of the software pieces-parts on which they rely daily or do they believe vendor claims that they wrote everything in-house? Do contracts require the big vendors to disclose the third parties whose solution their products require? Do customers ask for specific details about their rights as a sub-licensee? At least one vendor had their reliance on previously undisclosed third-party components disclosed in a lawsuit relating to sublicensing agreements. What happens if the parties go their separate ways or if a once-removed sublicensor retires their product?” Most clients would be aware of expensive third-party components like Citrix, Cache, or drug databases, but probably less so of free and possibly invisible components. Vendor developers use a lot of tools that could be sunsetted, while products that run on servers (web or otherwise) assume that the components they require will be around forever. Perhaps readers would be interested in a webinar on the topic – I’m open to suggestions. I don’t want to be an alarmist if few problems have cropped up related to third-party software components, but maybe it’s a bigger exposure than I assume. I haven’t received confirmation that Citrix hiked their license fees significantly as one hospital executive reported here previously. 

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From Graysky: “Re: Lucro. Consider asking Bruce to disclose ownership interests to your readers when he’s publishing Readers Write articles. Several of the Nashville hospital operators have direct equity in Lucro, which is nothing more than a way for these hospital operator executives to advertise vendors that they have a personal ownership interest in through Lucro. CHS and Lifepoint contribute to the Heritage Innovation Fund, which provides VC funding to many of the vendors that advertise on Lucro. Lucro has already raised a round of funding with Heritage.”

From Cherokee People: “Re: Columbus Regional Health Physicians (IN). Went live on Epic at most of its affiliated and owned physicians offices Wednesday. The hospital is a Cerner shop and has been for a few years now. I’m not aware of any practices affiliated with or owned by Columbus Regional Health that implemented Cerner’s ambulatory solutions.”


HIStalk Announcements and Requests

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Poll respondents say GE Healthcare has taken the biggest ambulatory EHR fall, although the other vendors listed aren’t far behind.

New poll to your right or here: Have you ever donated money to a hospital or health system without being pressured and without expecting a personal benefit? Those of us with health system management experience know that feeling of dread when the calendar invitation arrives for the upbeat meeting in which we will be collectively pressured to donate to hospital projects or to the United Way, with the clear but carefully unstated hint that our strong-armed magnanimity could affect the “team player” portion of our performance reviews. I would rather flush money down the toilet literally than to give it to hospitals to flush figuratively, but that’s just jaded and cynical me.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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We provided STEM activity kits for Ms. P’s elementary school class in Florida in funding her DonorsChoose teacher grant request. She convenes STEM creation periods 2-3 times per week in which the students choose which materials they want to use, concluding, “The creativity and collaboration going on at this time is priceless. I also love watching how they take each other’s ideas into consideration and work together to make the best end result possible.”


This Week in Health IT History

One year ago:

  • An MD Anderson Cancer Center internal report warns that the organization will lose $450 million in FY17, with the cost of its Epic implementation named as one of the four contributing factors.
  • McKesson lays off 60 employees of its Enterprise Information Solutions business.
  • Walgreens files a $140 million lawsuit against former partner Theranos.
  • Siemens announces that it will take its Healthineers division public.

Five years ago:

  • Hearst acquires Milliman Care Guidelines.
  • Kaiser Permanente promotes President and COO Bernard Tyson to chairman and CEO, replacing George Halvorson.
  • Allscripts CEO Glen Tullman confirms reports that the company is seeking strategic alternatives.

Ten years ago:

  • CCHIT announces the first six inpatient EHRs to earn its permanent or conditional certification: CPSI, Eclipsys, Epic, HMS, Prognosis Health, and Siemens Soarian.
  • A House bill supports independent health record trusts.
  • Cerner says KU hospital let Kansas City down by choosing Epic, leading the hospital CIO to counter that it was happy to pay more for Epic than Cerner because its doctors like it a lot better.
  • Cerner wins a nine-year contract to install PathNet in the VA.

Last Week’s Most Interesting News

  • Allscripts turns in decent quarterly results.
  • Documents filed with the state of Georgia indicate that Athenahealth will close its Atlanta support center and lay off 61 employees the week before Christmas.
  • Meditech announces a big quarterly product revenue jump even as earnings slid 31 percent.
  • Cerner blames its quarterly revenue and earnings expectation shortfall on big deals that didn’t close and less-than-expected performance from its IT outsourcing business.

Webinars

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

November 15 (Wednesday) 1:00 ET. “How Hospitals and Practices Can Respond to Consumerism by Better Engaging Patients Through Price Transparency and Payment Options.” Sponsored by: Change Healthcare. Presenters: Kathy Moore, president, Moore Martini Medical; Linda Glidewell, VP of business development, consumer payment solutions, Change Healthcare. Healthcare consumerism and high-deductible health plans require providers to offer upfront estimates and payment options throughout all points of service. In his webinar, we’ll discuss consumerism as a critical area of opportunity in revenue cycle management and review numerous areas across the revenue cycle where your staff interacts with patients and leaves lasting impressions. From your first interaction with patients on the phone to discuss financial responsibility; to collecting payments at all points of service; to offering payment plans and various payment options — these are all areas that can be game-changing. With the right approach to consumerism, you can improve patient collections and optimize revenue from the start while also improving the overall patient experience.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call:

  • The company says it is approaching $2 billion in annual revenue, making it the second-largest publicly traded pure health IT vendor.
  • Allscripts will continue to support the former McKesson Star and HealthQuest revenue cycle solutions.
  • The company confirmed that it cut headcount among the former McKesson employees almost immediately after the acquisition and did the same within the Allscripts group in Q3. It also shut down an Allscripts office in Atlanta in consolidating employees into the former McKesson office in Alpharetta.
  • Allscripts plans to quickly integrate the former McKesson EIS into its operations, eliminating its separate identity within two quarters.
  • The move of Horizon Clinicals into discontinued operations will be complete by Q1 of next year. As McKesson had previously announced, Horizon support will end in March 2018, although the company suggests that outside companies may provide some level of customer support.
  • The company says it has not yet obtained customer feedback on McKesson’s laboratory information system but is interested in doing that.
  • Allscripts plans to GA its new, cloud-based ambulatory EHR next year, touting its strengths as usability, interoperability, mobility, and inclusion of embedded AI tools.

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Politico reports that Patrick Soon-Shiong publicly bragged to investors about sales of NantHealth’s GPS Cancer genetic test to hospitals without telling them that some of the ordering doctors are or were on his payroll as consultants.


People

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Medical second opinion vendor More Health hires Jeffrey Lasker, MD, MMM (Vision Healthcare Consulting) as chief physician officer.

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Heather Haugen, PhD, MS (Xerox) joins Atos as chief science officer.

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Press Ganey hires Jason Erdell (Change Healthcare) as president and chief client officer.


Announcements and Implementations

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Southeastern Health (NC) will go live on Epic this month under its shared services agreement with Carolinas HealthCare.


Government and Politics

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A former compliance team member of Epic customer WakeMed (NC) files a whistleblower False Claims Act lawsuit claiming that Epic defaults its software to bill both anesthesia base units and procure time in surgical cases, resulting in double billing that totals hundreds of millions of dollars across all Epic clients. Epic says the whistle-blower apparently doesn’t understand how claims software works and notes that the Department of Justice has already declined to get involved.

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Four members of Congress who serve on the House Committee on Veterans Affairs introduce legislation that would compel VA Secretary David Shulkin to provide the committee with documents covering timelines and costs of its planned Cerner implementation.

New FDA guidance tells medical device vendors that it’s OK to share the information that those devices collect directly with the patients using them with seeking additional FDA marketing approval, as long as those manufacturers provide no further interpretation than they already offer to physicians. FDA also acknowledges that some devices don’t collect information in a patient-friendly or shareable format and suggests that manufacturers tell patients to contact their doctors with any questions.  


Other

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Craig Joseph, MD notes the awkward signage required to tout Epic as an AMIA 2017 sponsor despite the absence of a company Twitter account.

Drug overdose deaths jumped 21 percent last year, a bigger increase than that of the previous four years combined. Gun-related deaths also took a turn upward from 9,600 to 11,000, with two-thirds of the total involving suicide. The biggest killers – cancer and heart disease – are on the decline, although drugs and guns more than offset those as the death rate actually increased.

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An apparently intoxicated cardiologist in Russia takes sick leave after being captured on video rambling incoherently and trying unsuccessfully to enter his computer password.


Sponsor Updates

  • QuadraMed, a Harris Healthcare company, will exhibit at HealthAchieve November 6-7 in Toronto.
  • Salesforce will host its annual Dreamforce conference November 6-9 in San Francisco.
  • Surescripts will exhibit at the 2017 NextGen One User Group Meeting November 5-9 in Las Vegas.
  • Huron will exhibit at Salesforce’s Dreamforce event November 6-9 in San Francisco.

Blog Posts


Contacts

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