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News 2/12/16

February 11, 2016 News No Comments

Top News

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CommonWell Health Alliance announces new members EClinicalWorks, HIMSS, ImageTrend, LifeImage, Mana Health, MediPortal, and Modernizing Medicine. I’m not clear why HIMSS joined or how some of its own high-paying members who haven’t joined CommonWell (like Epic) will feel about its implicit endorsement.


Reader Comments

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From Skinny Little B-Word: “Re: Grey Bruce Health Services in Canada. CIO Rob Croft and Manager Peggy Millar are gone.” Unverified. There’s nothing new on their LinkedIn or on Grey Bruce’s executive page.

From Dy-No-Mite: “Re: Mr. H. I don’t understand that name.” I needed an anonymous email address when I first started writing HIStalk in 2003 since my employer at that time was threatening me for writing ill of a vendor who richly deserved it (we were there customer, although I wasn’t writing anything I had learned from that experience). My creativity was limited, as it often is, so I chose mr_histalk@yahoo.com, attaching no particular significance to it. Readers started calling me Mr. HIStalk and that got shortened to Mr. H over the years. I never call myself “Mr.” anything in real life, so the reference was really more like someone who is privately dubbed “Mr. Happy Meal” for frequenting McDonald’s or “Mr. Upbeat” for exuding perpetual grumpiness.

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From Identity Thief: “Re: FL Senate bill 1299. It says hospitals must confirm Medicaid patient identities using both biometrics and a positive match with the DMV’s database. Does that mean beneficiaries must have a driver’s license? I also don’t see where funds have been set aside to cover the cost.” The idea probably taps into annoyance taxpayers feel for those who take advantage of Medicaid, a situation that bugs me as well, but medical and insurance fraud isn’t limited to Medicaid patients. Biometrics aren’t perfect and pose security risks of their own (the “stolen electronic fingerprint” scenario) and I don’t get the DMV connection, which must require Medicaid patients who don’t drive to obtain a Florida DMV-issued state ID card. I’m sure this will raise some red-faced debate among people with strong opinions about illegal immigrants and discrimination. It’s a nice idea to positively ID patients for even better reasons (like patient safety) but our lack of political will for something as simple as a national patient identifier makes it unlikely that this bill will withstand the inevitable legal challenges even if it beats the odds of getting that far. 

From Bernie: “Re: Jonathan Bush. It’s ironic that Bush talks down Epic. Try being a vendor that wants to integrate with Athena. They make it very difficult, even when there is customer demand. Bush is no knight in shining armor and their MDP program is a sham.” Unverified.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request from Mrs. Heinrich from California, who asked for headphones, lapboards, privacy petitions, paper, and glue.

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Also checking in was Mrs. Sutton from Illinois, who says her fourth grade students had been making their own  fraction strips from paper and colored pencils before receiving the 25 sets of fraction, decimal, and percent tiles we provided. She’s now having the students teach fraction concepts to second graders to “encourage my fourth grade students to be peer leaders as well as master fraction builders.”

Listening: new from Nothing But Thieves, hard-rocking Brit pop that sounds a bit like Muse with guitars instead of keyboards. They’re on a US tour now with upcoming stops in the southern US, including gigs at legendary clubs like Cat’s Cradle, 40 Watt Club, even the Orlando House of Blues where we had HIStalkapalooza not long ago. It’s a refreshing blast of melodic rock surrounded by a sea of formulaic hip-hop, emotive singer-songwriter warblings, and heavily technically augmented songs better suited for dancing than listening.

This week on HIStalk Practice: Some physicians didn’t get the memo about ICD-10. Washington State Medical Association Executive Director and CEO Jennifer Hanscom shares the successes – and frustrations – members have had with health IT. First Stop Health raises $2.1 million. HIEs invest in new patient-matching technology, plus there’s FINALLY a way to summon your Tesla from your Apple Watch. Navicure CEO Jim Denny advises physicians to use ICD-10 momentum to meet 2016 revenue cycle goals. The California Health Care Foundation highlights digital health technologies making a difference in safety net populations. Escape from paperwork and Big Brother become big drivers of direct care.


HIStalkapalooza

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I created this page so you can check to see if you should have received an emailed HIStalkapalooza invitation but didn’t because of spam filters. My interest is doing so is self-serving since I’m getting an absurd number of party-related emails that I really don’t have the time to mess with. Please don’t email me or Lorre if you weren’t invited or you’ve decided you want to bring a guest you didn’t previously register – we aren’t inviting anyone else and there’s no wait list. Every year otherwise smart people express righteous indignation that we didn’t invite them even though they didn’t even bother to sign up, apparently relying on our staff psychic to detect their interest (and email address).

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Use Twitter hashtag #HIStalkapalooza if you want to get fired up pre-party in the remaining couple of weeks. 


Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.


Acquisitions, Funding, Business, and Stock

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Wipro will acquire Tampa-based insurance company BPO and exchange services vendor HealthPlan Services for $460 million in cash.

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The founder of Pristine, which initially offered a healthcare Google Glass app and then changed business models at some point into visual collaboration for field inspectors, sues an Austin-based venture capital firm for stealing his business. Kyle Samani’s suit claims the real goal of S3 Ventures LLC is “to invest in newly formed companies in order to ultimately take the companies from their founders just as the company becomes successful.” He alleges that Pristine, which raised $6.2 million but has not received funding since September 2014, sold 700,000 of his unvested shares. The real lesson learned might be to avoid creating an enterprise-focused business whose platform is a beta-status consumer gadget.


Sales

Health Partners New England chooses Medsphere’s OpenVista EHR.

Cormac contracts with Premier to provide a cloud-based registry to support CMS’s Oncology Care Model.

The American College of Radiology and the University of Florida choose the Visage 7 Enterprise Imaging Platform as enterprise diagnostic viewer for training diagnostic radiology residents.


Announcements and Implementations

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McKesson partners with HealthQX, which offers a claims analysis system, to offer software to help payers design and run bundled payment programs.

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Bottomline Technologies announces that its Healthcare Privacy and Data Security solution learns normal user behavior and reports exceptions.

First Databank releases OrderKnowledge Canada, a pre-built CPOE drug knowledge base.

A tiny study finds that use of Glytec’s Glucommander IV glycemic control system reduced diabetic ketoacidosis admissions by 45 percent.


Government and Politics

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The President’s $4.1 trillion budget, already rejected by Congress, would have boosted ONC’s budget by $22 million for interoperability work. HHS would have received a mind-boggling $1.14 trillion, up 11 percent since 2015, also increasing its FTE headcount to nearly 80,000.


Privacy and Security

The CPA firm of a Nebraska hospital warns it that a laptop stolen from one of its employees had encryption software installed that wasn’t working, exposing the information of 4,200 of the hospital’s patients.

Magazine publisher Time Inc. buys the faded Internet star MySpace to get data on its 1 billion registered users, with Time’s CEO saying the deal “is all about the marriage of first-party data and premium content.” The seller was Viant, which has gone through three names since it bought Myspace in 2011 for $35 million with Justin Timberlake as a partner, hoping to make it a music hub.

Insurance company Centene says it found the six PHI-containing hard drives it reported losing a few weeks ago. They had been placed in a locked storage box awaiting destruction. It’s puzzling why they wouldn’t have looked there first, or why their employee wouldn’t have logged them as being held for disposal. I would bet at least one person will be fired because of the embarrassment caused and cost expended.


Innovation and Research

An AHRQ-funded study finds that higher levels of hospital EHR usage is associated with a lower rate of adverse events for patients with cardiovascular disease, pneumonia, or conditions requiring surgery.


Other

US News withdraws its Best Children’s Hospitals specialty rankings for two hospitals that had submitted erroneous survey data, adding that it “will implement additional data integrity processes to help identify potentially inaccurate data prior to publication.”

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University of North Carolina Health Care signs a partnership agreement with Mercy in which Mercy Virtual Care Center will monitor patients in a 28-bed UNCHC ICU.

The Chicago Tribune proudly describes its collaboration with scientists to mine data from the FDA’s adverse event reporting system and Columbia University Medical Center’s EHR to find four new drug-drug interactions that can prolong cardiac QT interval and potentially cause arrhythmias. Thank goodness the actual journal article is concise and factual rather than a crappy Trib attempt at long-form journalism, meaning it’s do long and hammily dramatic that you just want to wring the writer’s neck to make them get to the point. Obviously the study found apparent correlation with one hospital’s information – the real work now begins in proving causation, a challenging project that drug companies aren’t likely to underwrite since the result could reduce sales.

ZDoggMD might be venturing into Weird Al territory with a never-ending barrage of parody videos that threaten overexposure, but here’s his latest that lab people will enjoy, “In Da Lab.”  Watch for the Theranos reference. Pop red tops, homeys.


Sponsor Updates

  • Marketing firm Image.works will offer its healthcare clients CRM capabilities from Influence health.
  • Rep. Bob Dold (R-IL) visits Intelligent Medical Objects to learn about IMO Terminology.
  • The local paper covers LifeImage’s acquisition of Mammosphere.
  • Netsmart will exhibit at the MHCA Winter Conference and Annual Meeting February 16 in Clearwater Beach, FL.
  • EClinicalWorks releases a new podcast, “What’s Ahead for 2016.”
  • Healthfinch co-founder Lyle Berkowitz, MD keynotes the AMA/MGMA Collaborate in Practice Conference March 20-22 in Colorado Springs, CO.
  • Park Place International’s Erick Marshall is named a VMware 2016 Vexpert.

Blog Posts


Contacts

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

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February 11, 2016 News No Comments

Morning Headlines 2/11/16

February 10, 2016 News No Comments

Obama budget would lift HHS spending to $1.1 trillion, entice Medicaid expansion

The President’s 2017 budget includes $82 million for ONC with $5 million earmarked for use on interoperability efforts.

Walgreens Threatens to End Theranos Agreement

As lab vendor Theranos works to resolve inspection issues discovered by CMS auditors, its primary customer, Walgreens, threatens to end the business relationship altogether.

What’s a $4.5B campus look like? Get a sneak peek

Cerner streams a live tour of the Kansas City campus is its currently constructing.  The project will add 4.7 million square feet of new office space at a cost of $4.5 billion.

HIMSS Submits Comments on NIST Cybersecurity Framework RFI

HIMSS responds to NIST’s recently published cybersecurity framework FRI, in which it applauds the effort, but calls for the framework to be a voluntary, private-sector led initiative that could be used as a tool to develop best practices around cybersecurity.

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February 10, 2016 News No Comments

Epic’s Remote Hosting Resurgence

February 10, 2016 News No Comments

Epic gets back to its roots – and attempts to keep up with the competition – with another foray into remote hosting services.
By @JennHIStalk

Rumors began swirling earlier this year when Epic purchased Mayo Clinic’s data center in Rochester, MN. The reportedly $46 million deal will see Mayo, which is scheduled to go live on Epic in 2017, lease back the 62,000 square-foot facility to Epic for at least the next four years. It’s a somewhat unconventional arrangement that signals that the company is ready to take hold of the remote hosting market.

It’s Identical to Self-Hosting

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Epic Senior Vice President Stirling Martin explains that, “In terms of the capability of the hosted systems, it’s identical to what a self-hosted organization would have. Our mission in hosting is to allow organizations to retain all of the same flexibility and configuration they would have if they were running the systems themselves. They still have a highly open platform for interfacing and integrating with third-party systems that they’re running in their own data centers or in third-party data centers.”

Remote hosting is not a new endeavor for Epic, which started out in that very field back in 1979. “About four years ago,” Martin explains, “we embarked on building a data center both for our own purposes and with an eye towards eventually doing hosting. We made the decision about 18 months ago to move forward and get back into remote hosting. Since that point, we’ve been building up infrastructure and working with early customers to get them onto the platform.”

Understanding the Options

Epic offers two hosting options. Full hosting — which includes the production systems, training, testing, and a disaster recovery copy in a geographically separate data center –  has so far been the most common request.

Standalone disaster recovery is another option. Martin notes that, “This is a great opportunity for organizations that may not have a second data center and yet want to ensure that they have a copy of their system up and running in a data center that’s geographically separate enough to be away from a natural disaster.”

He declined to give specific pricing numbers, though he did stress that pricing ultimately comes down to the size of the organization. “The number of concurrent users is the metric we talk about most,” he explains. “We factor lots of data points into the overall sizing equation – the different products they’re going to be using, if they have one hospital and a very large ambulatory practice or many hospitals and a smaller ambulatory practice.”

Clarifying the Customer Base

In making the initial announcement about its re-entry into remote hosting, the company said it would first offer the service to its medical group and small-hospital clients, potentially opening it up to large-hospital users later.

Martin says that the remote hosting service is open to all “members” of the Epic community. “Our mission in doing this was to provide our members with an additional hosting option,” he says. “We’ve probably got a little over 250,000 end users that will be hosted by Epic as these organizations roll out their systems. We have three healthcare organizations that are live in production with a couple more lined up in the coming months. All of the members that had signed up for Epic hosting are live in a non-production way, in that they’re building up the systems as part of their implementation activities. We’re preparing them for go-lives over the next six to 12 months.”

Martin adds that no customer is too small, at least from an Epic hosting standpoint. “The mission here is to provide a very scalable infrastructure that has both the capability to flex up to the very large organizations that we work with, as well as the ability to flex down to the very smaller organizations that we work with.”

He couldn’t comment as to the number of customers that will ultimately switch to Epic for their hosting services, though he did stress that, “feedback from sites that are live on it today is very positive.”

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Data Center Details

The data center’s infrastructure includes 100,000 square feet of space, buried under a nondescript hill above the floodplain on Epic’s campus and ready to accommodate added capacity as the need arises. Power generation capabilities are also underground, as is the infrastructure necessary to run critical systems.

The company is currently using a co-location facility as its secondary site until the Mayo data center can be brought up to speed. “With the purchase of that state-of-the-art data center,” says Martin, “we will migrate the existing disaster recovery systems up to the Rochester data center and then start using that as our secondary facility going forward.”

He adds that there is “tremendous redundancy falls in terms of the conductivity in the data centers to the Internet, as well as tremendous redundancy in the connections that we provision from the primary and secondary data centers to an individual health organization. We provision two diverse paths for the conductivity to ensure that there’s redundancy from each of the data centers to the health organization to make sure that no single fiber caught or telecom outage can take out all of the links at once.”

Catching Up with the Competition

Some industry insiders see Epic’s remote hosting resurgence as an attempt to keep up with Cerner, which has offered those services since 1999. Its winning DHMSM bid (with primary contractor Leidos) and the DoD’s $51 million decision to move the project’s hosting to Cerner headquarters makes the notion seem that much more valid.

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“Both vendors are investing heavily in this capability,” says Impact Advisors Vice President Lydon Neumann, “which will be difficult for other competitors to match in performance and breadth of service offerings. As for Cerner, they will continue to be a strong competitor and Epic’s entry into this market segment validates Cerner’s value proposition for this increasingly attractive hosting option. Epic and Cerner are creating a significant barrier for the other vendors in the market.”

Neumann adds that remote hosting is already bolstering Epic’s long-term prospects. “The market appears to be responding favorably to Epic’s entry into this segment. As a result, more customers and a broader segment of the market are now likely to consider Epic in order to leverage external capabilities and expertise, while gaining access to more technical services to properly maintain and enhance Epic’s enterprise solutions. Customers and prospects will also be increasingly proactive in aggressively reducing costs and will look to remote hosting to solve long-term challenges of managing and sustaining their technology infrastructure.”

The Customer Perspective

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FirstHealth of the Carolinas Vice President of Information Systems David Dillehunt took a look at Epic’s remote hosting service as part of the health system’s overall evaluation of replacement vendors. (The North Carolina-based health system is scheduled to go live on Epic on July 1, 2017.) “It didn’t impact our decision to leave McKesson. We were forced to make a change when McKesson decided to sunset the Horizon platform. Epic had not yet gone live with their first remote-hosting customer, so we elected to do the traditional on premise implementation. However, I would bet that, like most things Epic chooses to do, it will do this well and be able to deliver a solid, reliable hosting platform,” Dillehunt explains.

“I do think this will be very interesting to many potential new clients, and possibly to some older clients as well,” he adds, “particularly where there may be issues with space, power, off-site backup availability, etc. I for one do not feel that remote hosting is the magic answer, but I do believe it is one of many and should be evaluated just like any other major choice.”

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February 10, 2016 News No Comments

News 2/10/16

February 9, 2016 News 4 Comments

Top News

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The Navy awards Leidos an additional $50.7 million for Cerner-provided hosting services for the DoD’s EHR as I reported here earlier, overriding the objections of IBM, CSC, Amazon, and General Dynamics. The announcement says the Cerner system can operate regardless of who hosts it, but its functionality would have been limited “to utilizing only DoD data, which greatly impacts the accuracy of analytics given the  much smaller population of data which, in turn, could negatively impact patient outcomes” and that Cerner refused to allow connection to its managed services. The document adds that third-party hosting “could adversely impact Cerner’s financial viability and competitive market advantage.” The DoD says the new award won’t increase the overall contract spending limit of $4.3 billion.


Reader Comments

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From Ickey Shuffle: “Re: Sandlot Solutions. Massive layoffs and the entire sales team was fired. They barely made payroll. Rumor is that ICW may buy the customer base.” Unverified. I reached out to board chair Rich Helppie but haven’t heard back.


HIStalk Announcements and Requests

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We funded Mr. Beeler’s DonorsChoose grant request for 13 environmental and science books for his high school class. He says many of the students at his Texas school go to work immediately after school and don’t get home until their work’s closing time, with only 14 percent of graduates going on to college, so he’s trying to motivate them. Mr. Chen’s class from Massachusetts also checked in to say they’re using the digital drawing tablet we provided to do sketches in Photoshop, then convert their ideas to CAD and then print them using donated 3D printers.

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Iatric Systems included a question about my HIMSS exhibit hall pet peeve (booth people playing with their phones) in their employee role-playing training for the upcoming conference In return, they donated $500 to my DonorsChoose project, which funded these requests:

  • 3D history and engineering puzzles for the STEM-focused high school class of Ms. Hayes in Charlotte, NC.
  • 26 sets of headphones for the elementary school computer lab of Mrs. Schmidt in Vero Beach, FL.
  • Three Kindle Fires and cases for the elementary school class of Mrs. Jones in Knoxville, TN.
  • Math manipulatives for Ms. VanZanten’s elementary school class in W. Valley City, UT.
  • Light experiment kits for Ms. Feeley’s elementary school class in Flushing, NY.

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I have zero interest in sports but had the Super Bowl turned on for background noise. It caught my attention when I heard an ad pitching a prescription drug for treating opioid-induced constipation. We must have one heck of a doped-up population if the constipation of long-term narcotics users justifies running a multi-million dollar 60-second Super Bowl ad. The drug industry estimates that it’s a $2 billion market as Americans seek a second pill to fix the problems caused by the first. The commercial didn’t mention the drug Movantik at all, probably to avoid the FDA’s requirements that it rattle off a long list of side effects (third pill, anyone?) Movantik costs $300 for a month’s supply. I wonder how many patients will seek a prescription for it because they’re having side effects from illegally obtained narcotics? A lot of what you need to know about what’s wrong with American healthcare is contained in this one paragraph.

On the jobs board: clinical software project manager, sales executive, interface engineer.

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The celebrity guest in our microscopic HIMSS conference booth Tuesday afternoon March 1 will be David Schoolcraft, an attorney with Ogden Murphy Wallace PLLC of Seattle, WA. Our “HIT Lawyer in the House” will be happy to say hello, talk about lawyerly HIT issues, or “just chat about how great HIStalkapalooza was.” Email Lorre if you are unnaturally funny, smart, or famous and want to prove it at our booth — it’s not like we’re drawing for Vespas or running a golf simulator on our $5,000 little patch of carpet, so about all we’ll have is a table to stand behind.


HIStalkapalooza

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HIStalkapalooza invitation emails have gone out from Eventbrite. That service provides some nice benefits: you’ll be able to check in quickly via a barcode scan, it will send reminders that you signed up, and it will allow those whose plans change to let me know so I can give House of Blues a better estimated headcount. I’ll also know who took up a spot without attending so I can invite someone else in their place next year (the no-show rate is always at least 40 percent).

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I wasn’t able to invite everyone to attend HIStalkapalooza since we needed one more sponsor to cover the cost for all the 1,700 or so people who wanted to come. I’m sorry if you didn’t receive an invitation. As usual, I invited all providers who expressed interest, then did the best I could with the people left on the list.

I had a mini-brainstorm this afternoon – since Eventbrite supports collecting online payment for tickets, next year I should simply charge the incremental price of attendance instead of just shutting down invitations once I hit the number covered by sponsors. Anyone who didn’t bother to sign up themselves or their guest who desperately wants to attend could buy a ticket for $150 or something like that instead of just being told they can’t come. My constraint is sponsor funding, not capacity, so we could handle a lot more people who are willing to pay their own way. I’ll consider that for next time.

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Just as a reminder:

  • Each attendee must have an emailed ticket to get through security. Walk-up registration will not be available (that’s a screen shot of my own ticket, which I signed up for just like everyone else).
  • Attendees cannot bring guests. I explained clearly that any guests needed to be signed up individually, just like when you buy any other kind of ticket.
  • I’m not keeping a waitlist since no-show rates were already built into attendance estimates. No additional invitations will be sent.
  • I can’t control your company’s spam filters or do the legwork to tell you while your email system didn’t allow the invitation to pass through. I’ll put up a page shortly that works like an airline’s standby list –  the truncated first and last names of each invitee will appears so you’ll know you were invited even though you won’t be easily identifiable to anyone else.

Like last year, the House of Blues doors will open at 6:30 and we’ll close the check-in table by 8:30. The event costs about $200 for each attendee who passes the House of Blues guy with the people-clicker, so swinging by after someone else’s party for a quick beer can wreck the already-stretched budget. Be there on time and you won’t have to listen to a muffled Party on the Moon from the casino outside the HOB’s walls.

You can follow along with whatever it is that people will tweet about the event using #HIStalkapalooza. I’m surprised that nobody has Twitter-bragged about getting an invitation.

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Several readers emailed to ask if we’ll have Longo Lemonade at HIStalkapalooza. I hadn’t heard of it, but figured industry long-timer Peter Longo would know (duh) so I asked him. It’s a game where you ask for a Longo Lemonade and then show the bartender how to make it if they’re stumped – apparently word has spread and many will need no further instruction. But for those bartenders who haven’t heard of it, here’s the recipe that will probably result in sugar-sticky bar surfaces all over the House of Blues:

Shake straight vodka with ice and pour into a shot class. Sprinkle a packet of sugar onto a napkin and dip a slice of lemon in the sugar to cover each side. Drink the shot and then eat the lemon slice.


Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.


Acquisitions, Funding, Business, and Stock

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Premier reports Q2 results: revenue up 17 percent, adjusted EPS $0.42 vs. $0.36, beating expectations for both but recording a GAAP loss of $54 million for the quarter.

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Mobile consumer payments vendor SwervePay raises $10 million in funding, increasing its total to $11.6 million. The company focuses on healthcare and auto-related services, which for appointment-setting and payments are not all that different now that I think of it.

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Cognizant announces Q4 results: revenue up 18 percent, EPS $0.69 vs. $0.59, falling short of revenue expectations but beating on earnings. Shares dropped on lower revenue guidance due to expected reduced technology spending. The company’s healthcare division, its second-largest in contributing 30 percent of total revenue, had a 23 percent revenue increase, still a slowdown from previous quarters. Cognizant acquired TriZetto for $2.7 billion in 2014.

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Human resources software vendor Zenefits fires founder and CEO Parker Conrad, informing employees that, “Many of our internal processes, controls, and actions around compliance have been inadequate, and some decisions have just been plain wrong.” Forbes estimates the net worth of 35-year-old Conrad at $900 million. The company, valued at $4.5 billion, has been accused of allowing unlicensed salespeople to sell medical insurance. Zenefits hired as its new CEO David Sacks, who co-founded Yammer (purchased by Microsoft for $1.2 billion) and who used the fortune he made as pre-IPO COO of PayPal to produce the movie “Thank You For Smoking.”


Sales

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Spartanburg Regional Healthcare System selects Strata Decision’s StrataJazz financial system.


People

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Leidos Health names Chris Freer (SPH Analytics) as sales VP.


Announcements and Implementations

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Skagit Regional Health (WA) posts 53 new IT positions with up 20 more coming in 2016 as it implements Epic, on which it expects to spend $72 million over the next five years.

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Phynd CEO Tom White attended a recent White House roundtable on technology jobs in rural America, including Phynd’s “Silicon Prairie” home of Kearney, NE. The session with 10 business leaders was hosted by Secretary of Labor Tom Perez and Secretary of Agriculture Tom Vilsack.


Government and Politics

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The Senate health committee unanimously passes S.2511, the Improving Health Information Technology Act. Some of what the bill contains:

  • Reduce documentation burdens and allow non-physicians to document on their behalf.
  • Encourage EHR certification for technology used by specialty providers.
  • Create a health IT rating system reflecting security, usability, interoperability, and certification testing results that also incorporates user feedback.
  • Empower HHS OIG to investigate and punish data blocking.
  • Enlist data sharing networks to develop a voluntary model framework and agreement for information exchange.
  • Create a digital provider directory.
  • Require certified software to exchange information with registries that follow standards.
  • Directs the GAO to conduct a patient matching study within one year.
  • Require HHS to defer to standards created by Standards Development Organizations and consensus-based bodies.
  • Require HHS OCR to clarify provider misunderstanding about giving patients access to their own information and to publish best practices for patients to request the information. 

More details: the HELP committee’s revised summary and the Senate’s bill.

The President sends Congress a $4.1 trillion 2017 budget that would raise taxes by $2.6 trillion in the next 10 years. It includes HHS funding for the “cancer moonshot” and programs to address opioid addiction, but the big jump in federal red ink would come from Medicare and Social Security entitlement programs that are being overwhelmed with retiring Baby Boomers. The budget includes $19 billion for improving the cybersecurity of government IT systems. It doesn’t address the economic elephant in the room: that even a tiny increase in increase rates could add $1 trillion in annual costs just to service the cost of the existing massive federal debt.


Privacy and Security

A medical school professor says doctors need to stop complaining about EHRs patients shouldn’t obsess over medical records confidentiality because EHR-created databases will change the way medicine is practiced and lead to new cures. He says that simple data mining can find information “lying in plain sight, no invasive procedures or testing required. We could have found it years earlier if we had had the date.”


Technology

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Cerner launches the Cerner Open Developer Experience to allow developers to work with Cerner’s sandbox using SMART on FHIR.


Other

The British government will give NHS $6 billion to fund technology projects that will eliminate fax machines and paper, improve cyber security, create a new NHS website, and provide free wi-fi. Patients will gain online tools to schedule appointments, request prescription refills, and communicate electronically with their physicians. NHS hopes to monitor 25 percent of patients with chronic conditions remotely by 2020.

A tiny study finds that pediatricians who remotely evaluate children with fever or respiratory distress using FaceTime on an iPad perform just as well as those who conduct their examination in person.

A well-designed study of discharged heart failure patients finds that telemonitoring combined with health coaching didn’t reduce 180-day readmissions.

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Athenahealth’s Jonathan Bush, in a short interview, says that his aunt, Barbara Bush, donated $4 million in Athenahealth profits to the Barbara Bush Children’s Hospital at Maine Medical Center. He says:

The irony is the Barbara Bush Hospital just bought Epic with that money and is building a monopoly to capture referrals that they don’t have the volume to do well. A lot of the stuff they do probably should be done somewhere else. I didn’t say all this to Bar. I said, “That’s just great,” pinching my fingernails under the table.

Weird News Andy says, “I expect it to be in ICD-11” after failing to find an ICD-10 code for the claim that a man in India was killed by a meteorite. WNA codes the encounter as, “W20.8XXA Other cause of strike by thrown, projected or falling object, initial encounter.”


Sponsor Updates

  • AdvancedMD makes its patient engagement solution available to users of its AdvancedPM technology.
  • The Nashville Post covers Cumberland Consulting Group’s move into performance improvement and revenue cycle.
  • Bernoulli participated in the IHE North American Connectathon Week in Cleveland.
  • ZeOmega launches a series of whiteboard videos about its population health management software.
  • Vital Images offers a zero-cost data migration service.

Blog Posts


Contacts

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

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February 9, 2016 News 4 Comments

Morning Headlines 2/9/16

February 8, 2016 News No Comments

£4.2 billion investment to bring the NHS into the digital age

NHS Health Secretary Jeremy Hunt announces a new $6 billion initiative to fund the health system’s push toward a paperless care delivery environment.

Theranos has a week to respond to the searing report about its business

Theranos is granted a one week extension to address inspection deficiencies found by CMS auditors during a routine inspection of its California lab.

Give Up Your Data to Cure Disease

A New York Times opinion piece weighs the trade off between patient privacy and  the research value that EHR data sets offer, arguing “We need to get over it. These digital databases offer an incredible opportunity to examine trends that will fundamentally change how doctors treat patients.”

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February 8, 2016 News No Comments

Morning Headlines 2/8/16

February 7, 2016 News 2 Comments

One Medical Buys Virtual Nutritionist App Rise

Concierge medicine provider One Medical acquires digital health startup Rise for $20 million. Rise markets an app that provides one-on-one nutrition and diet coaching, and has raised $4 million since its 2013 launch.

Obamacare’s Low Enrollment Numbers Also Show Why Exchange Coverage Will Get Worse

A Forbes opinion piece argues that public insurance exchange coverage options will continue to get worse.

JHU launches new healthcare engineering center

Johns Hopkins University launches The Malone Center for Engineering in Healthcare, a research center focused on data analytics, system design and analysis, and technology and devices.

athenahealth Jonathan S. Bush on Q4 2015 Results – Earnings Call Transcript

On its quarterly earnings call, Athenahealth CEO Jon Bush noted that its recently announced partnership with University of Toledo will help it develop a system suitable for larger academic health systems.

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February 7, 2016 News 2 Comments

Monday Morning Update 2/8/16

February 7, 2016 News 7 Comments

Top News

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National medical practice operator One Medical Group pays $20 million to acquire nine-employee Rise, whose app connects users with nutritionists for meal planning and diet advice. The company had raised $4 million. One founder was previously with Groupon while the other worked for Mozilla.

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San Francisco-based One Medical Group, which has raised $182 million and runs practices in seven cities, was founded by former Epocrates CMO Tom X. Lee, MD.


Reader Comments

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From Lib B Z: “Re: NYU’s Langone Medical Center. Doctors are unhappy with the new EMR added because the changes are confusing and time wasting. The new system supplied by Optum is supposed to work alongside Epic. Langone is reportedly looking at dismantling the recent additions that were hurriedly bolted on.” Unverified.

From Curly Endive: “Re: Epic hosting. We’re also concerned about scanning with McKesson. There seem to be mixed opinions among us whether Epic really gets what a big problem this is. I understand keeping a competitor’s product off their hardware, but my sense is they got caught with their pants down in anticipating that hosting customers would need a solution. They don’t seem to have a fast solution in the works.” Unverified.

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From Ex-Epic: “Re: Epic customers in Canada. Children’s Hospital of Eastern Ontario: Beaker (I think), MyChart, Ambulatory and I think inpatient as well.  Women’s College Hospital: scheduling/registration, Ambulatory only. Alberta Health Services: Mychart/Amb and there was rumor when I was at Epic that they were expanding to enterprise (they already have the license). Mackenzie is full enterprise. I think you covered this in the past, but Epic lost out on University Health Network in Toronto, which is the largest hospital network in Canada.”


HIStalk Announcements and Requests

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More than 80 percent of poll respondents say their reaction to recent CMS statements about Meaningful Use is negative. New poll to your right or here: if you’re going to the HIMSS conference, what is your primary reason for attending?

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Welcome to new HIStalk Gold Sponsor Carevive Systems. The Philadelphia-based company offers an oncology care planning system that combines electronic patient-reported outcomes with clinical data and evidence-based content authored by thousands of oncologists to generate initial, supportive, and survivorship care patient care plans and to link patients to clinical trials. Its rules engine auto-populates the 13 elements of the IOM care management plan required for the Oncology Care Model. As a client reports, “What I really like about the platform is the patient’s ability to report his or her own symptoms, and then we can generate evidence-based practice data to manage those symptoms. Subsequently, we provide an intensive care plan for them … we’re able to see what patients are truly experiencing and help them manage their symptoms more effectively.” Thanks to Carevive Systems for supporting HIStalk.

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Mrs. Brunetti says her rural Arkansas students are able to remember math concepts better by using the books and manipulatives we provided in funding her DonorsChoose grant request.

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Also checking in is Mr. Garcia, who needed speakers for the six computer workstations he built himself for students of his inner city Dallas school (he’s an Army veteran and computer engineering graduate). We also provided a weatherproof Bluetooth speaker whose use he describes as, “The portable speaker was a hit. We took it to the hallway for the Sphero robotic ball to draw 2D figures. Every time there was a sound it was deep, loud and catchy — our principal came to see us and was very impressed with my students listening to instructions from Sphero. Teaching coordinates X and Y for ordered pairs was very memorable for them. My plan is now to take Sphero, the tablet, and the portable speaker to the basketball court and teach angles, time to distance ratio, problem solving, and critical thinking.”

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I’ve been surprised at the number of people who are shocked and indignant at Martin Shkreli’s 50-fold price increase for Daraprim, sputtering that his company should behave “fairly.” That’s the most ridiculous thing I’ve heard lately, that anyone would expect a former hedge fund trader and drug company CEO to take any action that doesn’t best serve him or his shareholders, or for that matter that less-annoying healthcare overlords are working selflessly for the good of their customers in some manner everybody else might consider “fair.” Shkreli is working the system that we all created where we made healthcare a capitalistic, obscenely profitable business, no different than everybody else lapping at the sick people’s trough (McKesson doesn’t pay John Hammergren $150 million per year for being “fair.”) The politicians he refused to answer last week seem to think it’s Shkreli’s job and not their own to fix our healthcare mess. As the New Yorker observes with apparent tongue in cheek,

Nancy Retzlaff, Turing’s chief commercial officer, told the committee about her company’s efforts to get the drug to people who can’t afford it. The arrangement she described sounded like a hodge-podge, an ungainly combination of dizzyingly high prices, mysterious corporate bargaining, and occasional charitable acts—which is to say, it sounded not so much different from the rest of our medical system … True, he has those indictments to worry about. But he is also a self-made celebrity, thanks to a business plan that makes it harder for us to ignore the incoherence and inefficiency of our medical industry. He rolls his eyes at members of Congress, he carries on thoughtful conversations with random Internet commenters, and, unlike most of our public figures, he may never learn the arts of pandering and grovelling. He is the American Dream, a rude reminder of the spirit that makes this country great, or at any rate exceptional.

Meanwhile, a fascinating video interview shows Shkreli casually slurping from a $5,000 bottle of wine while playing chess with the interviewer, describing that he’s a hero among dishonorable drug companies and explaining why hospitals and doctors are healthcare’s real cost problem. We’re still trying to convince him to hang out at our HIMSS booth. I told Lorre to bribe him by offering to buy one full-priced Daraprim tablet.


Last Week’s Most Interesting News

  • Practice Fusion lays off 74 employees as it struggles to reach profitability.
  • The White House asks Congress to fund a $1 billion “cancer moonshot.”
  • Theranos declines to fulfill its promise to allow partner Cleveland Clinic to verify its technology and says it won’t publish FDA testing data until all of its tests are approved.
  • A Surescripts survey finds that few New York doctors have the technology required to send all prescriptions electronically by March 27, 2016 as state law requires.
  • The Hurley Medical Center pediatrician credits her use of EHR-mined data in proving Flint, Michigan’s water crisis to skeptical state officials.
  • A bipartisan Senate bill calls for expanding Medicare coverage of telemedicine.

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.


Acquisitions, Funding, Business, and Stock

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From Friday’s Athenahealth earnings call:

  • The company has 4,600 employees.
  • The recently announced development partnership with University of Toledo Medical center will help the company move from its “sub-50 bed hospitals” to larger facilities that need “chemotherapy or more advanced pharmacy and lab or surgery, pre-op, post-op, more sophisticated discharge planning.”
  • When pressed on University of Toledo’s  timeline to replace its sunsetting systems, Bush said, “There are a very large number of older inpatient systems that are turning into a pumpkin in 2018. And, yes, we would like to be able to gobble up as much of that as possible. The number one feedback that we get in focus groups with health system executives around Athena is, they don’t do inpatient … they think they need that one throat to choke. So, we’ve got to be there with inpatient and outpatient. And it’s true — 2018 is a bellwether year for us if we’re ready.”
  • Jonathan Bush says of practices taking risk, “The awkward truth is that not many doctors, not many lives are truly, truly at risk. They are part of ACOs and other things where the government takes the first two cents and then they spend the year figuring out what the savings might be and then they give you half the savings. Then if you created savings in past years, they rebate you at a later year.”
  • The company is working on mapping all providers and AthenaNet patients individually into master directories in creating an instant-on experience so that new clients can instantly receive information about their patients and referral patterns.
  • Bush describes the company’s horizontal expansion as, “If you just imagine that the doctor is the guy who launches that pinball up into the pinball machine, the most important guy to get is that ball launcher at the bottom … We are loved more than anyone else. We are the only likeable cafeteria food in all of undergraduate education. That ball is the patient. They shoot up and bounce against labs, pharmacies, clinics, hospitals, surgery centers. We’ve been starting with the most frequent bumpers.”
  • Bush says of McKesson Horizon customers who will be forced to make a replacement system decision soon, “We don’t want these beautiful animals to bolt off the cliff in panic and go enter themselves into another 10-year amortization and another nightmare of capital encumberment for their balance sheet and a nightmare of administrative complexity for their IT teams. We want them to believe. Some will bolt, but the partnership with Toledo, the partnership with Beth Israel, the progress through larger and larger hospitals, and the fact that we have a pretty darned good reputation as an entity that delivers in this space, we’re hoping will save some people from unfortunate decisions.”

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Above is the one-year share price of ATHN ((blue, down 9 percent) vs. the Nasdaq (red, down 7.7 percent). The company is worth nearly $5 billion.

Meanwhile, Bush weighs in on Turing Pharmaceuticals Founder Martin Shkreli, saying he would “fight and die for Shkreli’s right to be a douche,” adding that drug companies should be able to charge whatever they want for drugs that keep people out of expensive hospitals. 

MMRGlobal, the purported personal health record vendor whose real focus is shaking down EHR vendors by filing nuisance patent infringement lawsuits against them in forcing licensing agreements, conducts a reverse stock split. The company’s one billion plus shares were worth less than a fifth of a penny, valuing it at $2.5 million. The company lost $490,000 on sales of $80,000 in the most recent quarter.


Sales

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In Australia, Bendigo Health chooses InterSystems TrakCare as the EHR for its new hospital that opens next year.


Announcements and Implementations

The Ann Arbor, MI VA hospital goes live on LiveData PeriOp Manager in its operating rooms, where it will synchronize perioperative workflow.


Government and Politics

A Forbes editorial says exchange-sold medical insurance will get worse, evidenced not only by enrollment numbers that are 40 percent less than originally estimated, but also by the “adverse selection” of high plan-switching rates indicating that healthy enrollees are trying to minimize the implicit tax in subsidizing sick enrollees who are seeking out the most comprehensive coverage. It concludes that insurance companies that offer the best coverage will be forced out of the marketplaces as federal subsidies run out for their overly sick risk pool.

A proposed Florida bill would require hospitals to verify the identity of Medicaid recipients using biometrics and a link to the state’s driver’s license database.


Privacy and Security

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Above is a nice quote from Ministry Health Care CIO Will Weider.

Jackson Memorial Hospital (FL) fires two employees who provided an ESPN reporter with photos of the medical information of NFL player Jason Pierre-Paul, who blew off his right index finger in a July 4 fireworks accident.


Technology

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Pebble releases its first health-related smartwatch updates, including a Pebble Health watch face. It’s seems to be purely a step counter and sleep tracker so far. The company’s Valentine’s Day special offers two of its Pebble Time Round Black and Silver for $360, much cheaper than the Apple Watch but equally pointless for me personally. 


Other

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Johns Hopkins University launches the Malone Center for Engineering in Healthcare, which will link engineers with clinicians to focus on data analytics, systems design and analysis, and technology and devices. It is funded by cable TV billionaire John Malone, who earned a MS and PhD from Hopkins.

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Actress Selma Hayek posts a photo of her posing with the ED doctors who were treating her after an on-set head injury, apologizing for her interesting shirt in saying, “Unfortunately, my wardrobe for the scene was completely inappropriate for the hospital.” She didn’t name the facility, but the doctors appear to work for Northwell Health (the former North Shore-LIJ). I found the Halloween costume shirt she’s wearing for sale here, although I’m torn between that and the company’s mullet wig for my HIMSS attire.

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The CEO of Union General Hospital (GA) and four members of his family are arrested for distributing narcotics after an investigation finds that a local doctor had written him 15,000 painkiller prescriptions in three years. The CEO’s brother, who is an ED doctor and former hospital board member, was also arrested, as was their sister, a nurse practitioner. The private practice doctor, who is also a board member of the hospital, was arrested and charged with 41 counts of unauthorized distribution of a controlled substance. It’s fascinating that America’s profitable self-doping has reached such epidemic levels that a hospital’s board apparently conspired to cash in on it. That doesn’t even count the cost of locking up our prisoners of war (on drugs) that has long since been lost in trying to limit supply rather than demand and driving up prices, crime, and overdose deaths as a result.

Yet another study finds that high-deductible medical insurance doesn’t encourage Americans to seek better healthcare services deals – it just causes them to skip getting the care they need. I bet there’s a newly occurring “seasonality” in doctor visits during the first half of the year when patients are paying out of their own pockets again, followed by a surge later once they have – expectedly or unexpectedly – met their deductibles that run nearly $7,000 on exchange-sold plans.

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A reader dug up a copy of Epic’s comic book from HIMSS 2000 as produced by “editor in chief Judith R. Faulkner.” The page on the right describes the “unsupported hyperbole decoder ring” that has translated the competitor’s sales pitch as, “We will go public, make gazillions, and retire to an island paradise.” Another page references publicly traded health IT vendors with, “You know what people are saying about the whole Internet stock craze.” That was the year the HIMSS conference in Dallas was pushed back to April to give hospital IT people time to fix unexpected Y2K problems, rocketing attendance to a then-lofty 17,000 (it was 43,000 last year).

Weird News Andy calls the story of the doctor convicted of murder for overprescribing drugs “Rx Wrecks,” with his favorite line being that the perp “sometimes made up medical records” of patients that she described as “druggies.”


Sponsor Updates

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  • Vital Images employees wear red for National Wear Red Day in support of heart health.
  • Reminder and patient engagement service vendor Talksoft announces integration with Greenway Intergy.
  • Versus Technology becomes a founding member of the Electronic Hand Hygiene Compliance Organization.
  • VitalWare publishes a client success interview with Liz Knisel from ProMedica.
  • Huron Consulting Group will exhibit at the Annual AHA Rural Healthcare Leadership Conference February 7-10 in Phoenix.

Blog Posts


Contacts

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

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February 7, 2016 News 7 Comments

News 2/5/16

February 4, 2016 News No Comments

Top News

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Free practice EHR vendor Practice Fusion lays off 74 employees – around 25 percent of its workforce – in the face of ongoing losses.


Reader Comments

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From Bottled Lightning: “Re: Practice Fusion layoffs. Its IPO has been off the table since Ryan Howard left. I’m not sure why the press keeps propagating that fantasy when the company hasn’t been pitching IPO. They’ve been trying to find a buyer with no luck. Now they’re hunkering down and will try to survive with a much smaller team, filling functionality gaps in the product and trying to make it viable in a real market. You get what you pay for, and since most of its customers pay nothing, the product has some pretty deep gaps.” Unverified. Other readers have said the IPO story was floated as an excuse for dismissing founder and CEO Ryan Howard in August 2015. Investors have poured $155 million into the free EHR vendor in the past seven years. Companies yearning to IPO don’t usually fire the CEO, replace him with someone with no CEO experience, and conduct mass layoffs. It’s a tough time to be in the post-Meaningful Use EHR business.

From Boom Goes the Dynamite: “Re: Practice Fusion layoffs. The CEO is nice but unqualified – the board seems to think he can sell the company so they can get their $300 million (or more) back. Steve Filler quit his Oliver Wyman consulting job to become PF’s COO with much internal fanfare in November 2015 and he’s already gone. The CFO was let go and the chief marketing guy from Google didn’t take long to run away. The company’s 2015 revenue was $15 million, all of it from pharma, and its burn rate is $3 million per month. The board just forked over another $30 million to keep the lights on. Tom the new CEO predicts that they will become revenue positive by Q3 2017, but I don’t see a path to the top of that mountain.” Of the 13 executives listed on Practice Fusion’s website a year ago, only six are still there. If that $15 million annual revenue estimate is accurate, then Practice Fusion is a tiny, struggling company in a shrinking market segment in which it’s not among the top 10 companies (based on Meaningful Use attestation numbers). I don’t see even one attribute that would make me want to buy shares if indeed the company survives long enough to do a Hail Mary IPO.

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From Karen Green: “Re: lack of technology vs. lack of adoption. We have plenty of technologies that have begun to interoperate – DSM and HIE messages from acute care partners to post-acute specialists. MU attestation? Check! Not so on the continuum of care, where we are getting care summaries 1-3 days after discharge, rendering them useless for transitions of care. Why? Because the discharge and admissions planners on the front line are still using phone calls and fax to refer the patient. We have to enable the ‘intoperators’ on the front line and within the clinical practice so they can be informed about their patients in a timely way. Gartner suggests that CIOs have to be ‘digital humanists’ to lead the design of systems and technology to ‘enable people to achieve things they never thought possible.’ We must provide solutions that make it easy to give up proven convention for something that goes beyond the automation of processes.” Karen is CIO at Brooks Rehabilitation (FL).

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From Brass Ones: “Re: Mackenzie Health in Ontario. Going Epic.” Verified from their job postings. I don’t know of any other hospitals in Canada that run Epic inpatient.

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From The PACS Designer: “Re: augmented reality in healthcare. There’s a new term that created a buzz at the recent Consumer Electronics Show and that’s augmented reality. AR works differently than virtual reality (VR) in that the viewing device can be worn while doing other activities like walking or at work.” The mock-up above is from Microsoft’s HoloLens, which will start shipping soon. The company offers a $3,000 developer edition.


HIStalk Announcements and Requests

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Ms. Johnson from Oklahoma says her students, many of whom begin school speaking only Spanish, are using the five MP3 players we provided via DonorsChoose to listen to the recordings of books she creates. Meanwhile, Ms. Johnson from Pennsylvania reports that her inner-city third graders are using their new Chromebook and accessories to access online reading and math interventions as well as to perform research – they previously had computer access in just one class three times per week.

This week on HIStalk Connect: Doctor on Demand announces that it will offer psychiatry sessions over its telehealth platform, expanding nationwide by mid-year. Pear Therapeutics raises $20 million in funding to roll out its substance abuse recovery support app. The University of Southern California announces eight strategic partners that will support its Virtual Care Clinic initiative.


HIStalkapalooza

HIStalkapalooza Featured Sponsor – NextGen Healthcare

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Visit NextGen Healthcare at HIMSS16 Booth #4421. See for yourself how we help ambulatory organizations achieve real interoperability, improve population health, and transition to value-based care. By focusing less on IT and more on care, our clients are driving the changes you hear about in healthcare. Of course, we’re not all work and no play! We’ll also be taking professional headshot photos in the booth; not to mention Happy Hour the last hour of each day at our booth, #4421!  Stop by after a long day pounding the convention floor for a pick-me-up.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Houston-based Decisio Health raises $2 million as it starts marketing its FDA-approved patient dashboard that uses technology licensed from University of Texas Health Science Center of Houston.

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Health information vendor IMS Health acquires AlphaImpactRx, which apparently pays doctors to provide feedback about drug salespeople via a mobile app and then sells that information to drug companies. The company also surveys oncologists and pathologists about oncology molecular diagnostic testing, pitching itself to drug companies by, “It’s important to understand how testing is impacting the oncologist’s choice of brand.” I like that doctors want consumer drug advertising to stop, but I also wish they would stop giving or selling their own information to companies like IMS that help drug companies sell drugs that might not be the best option. Drug companies target those doctors using the information they themselves provided.

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Athenahealth announces Q4 results: revenue up 21 percent, adjusted EPS $0.45 vs. $0.58, missing revenue estimates but beating on earnings. 


People

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David Crutchfield (Maestro Strategies) joins Conway Medical Center (SC) in the newly created position of VP/CIO.

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Don Soucy (Orion Health) joins Spok as EVP of global sales.

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Leidos names Donald Kosiak, Jr., MD, MBA (Avera Health) as chief medical officer. I’m not sure if he’s trying appear edgy or to hide a bald spot with his head-cropping LinkedIn photo, but kudos for his 18 years of service in the Army National Guard with deployments to Iraq.

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E-MDs names Derek Pickell (Convergent Healthcare) as CEO and board director. He replaces David Winn, who retired with the March 2015 announcement of the company’s acquisition by Marlin Equity Partners.

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Vocera hires Kathy English, RN (Cisco) as VP of marketing.


Announcements and Implementations

Orchestrate Healthcare launches an information security practice.

KLAS announces members of its Interoperability Measurement Advisory Team. The press release’s headline mentions an inaugural meeting that someone forgot to include in the release itself. 

Philips will use Validic’s technology to integrate consumer health data with its HealthSuite connected health products.

CCSI Distributors, a subsidiary of Clinical Computer Systems, Inc., obtains exclusive US distribution rights to the OB-Tools TrueLabor Maternal Fetal Monitor.

VCU Health (VA) used its Spok communications technology to manage its medical coverage of the nine-day UCI Road World Cycling Championships, which attracted 1,000 cyclists and 640,000 spectators to Richmond, VA.

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Healthcare Growth Partners publishes its “2015 Year-End Market Review.” HGP’s reports are brilliant and eloquent and I savor every one of them. Even folks who aren’t interested in business or investing will find them to be concise and insightful, with passages like this:

We urge innovators to approach the market pragmatically and not get carried away by idealism during this transitionary time of policy-based innovation. In health IT, disruption seems to come in increments versus all at once. We find that when health IT companies fail to achieve objectives (or founders get significantly diluted), it’s most often because the product or strategy arrives on the scene too early versus too late.


Government and Politics

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A group of senators and representatives introduces the CONNECT for Health Act, which would promote expanded use of telemedicine in Medicare by removing existing restrictions.

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Pharma bad boy Martin Shkreli pleads the Fifth Amendment in refusing to answer questions posed to him during a House committee hearing on drug pricing.

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A VA care alert warns that its CPRS system rejected an large number of consult/procedure orders, which it discovered while reviewing the system after the October 1, 2015 ICD-10 switch. Clicking the warning’s OK button cancelled the order. The VA says it fixed the problem in a December 29 patch, adding that a few examples were found to have occurred before October 1.

Federal judges reverse the VA’s demotion of two executives who had schemed to force their subordinates to transfer jobs so they could take those lower-level jobs themselves while keeping their executive pay. The judges ruled that the pair’s bosses knew what they were doing and did nothing to stop them. The same two VA executives are being investigated for being reimbursed $400,000 for questionable moving expenses.

The head of California’s insurance marketplace says UnitedHealth Group is “driving me bonkers” for blaming the Affordable Care Act for its losses from selling individual policies. He says the company’s competitors participated and learned from the beginning while UHG initially stayed on the sidelines, then set its rates higher than everyone else and offered broad networks that attract sicker people to sign up.


Privacy and Security

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A second former Tampa General Hospital (FL) employee is charged with stealing patient information used to file fraudulent tax forms.


Other

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Melissa Memorial Hospital (CO) brings self-pay billing back in house and goes back to separate inpatient and ambulatory statements following problems with First Party Receivable Solutions and its “OK, but not stellar” NextGen billing system.

Glassdoor places Epic as #16 on its list of “Top 20 Employee Benefits & Perks,” scoring the company four spots ahead of Google for offering a paid four-week sabbatical after five years.

The Charlotte newspaper notes that Carolinas HealthCare paid its retiring CEO $6.6 million in 2015, with all of the health system’s top 10 executives earning more than $1 million in total compensation. Even the chief HR officer made $1.3 million.

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I like this graphic, available here. The only problem I see is that it seems to be aimed at providers who probably either won’t see it or will ignore what it says. A patient-focused version would be nice if there was a way to blast it to the masses.

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OpenNotes sponsor Robert Wood Johnson Foundation lists its three-year goals for the project: (a) expand OpenNotes to 50 million people; (b) conduct pilot projects to see how clinical notes are being used to engage patients and families; and (c) measure the value of sharing notes.


Sponsor Updates

  • PharmaPoint incorporates the Surescripts Medication History for Panel Management solution into Xchange Point 5.0.
  • InterSystems is listed among the top 25 privately held companies in Massachusetts in the 2016 Boston Business Journal Book of Lists.
  • Premier awards Versus Technology a group purchasing agreement for its RTLS/RFID products.
  • Leidos Health will exhibit at McKesson Southeast February 10-11 in Charlotte, NC.
  • Outsourcing Gazette names MedData one of its Top 25 Most Promising Healthcare Services Providers of 2016.
  • Medicomp Systems will host Quipstar at HIMSS16.
  • Orion Health will present with CAL Index on March 1 at HIMSS16.
  • Sunquest announces UPMC, BSA Health Systems, and Carolinas HealthCare as winners of its client innovation awards.
  • PeriGen announces a new online training tool for its Patterns systems.
  • Red Hat releases a now viral employee rap video paying homage to its hometown of Raleigh, NC.
  • RelayHealth shares a video interview with VP Arien Malec.
  • The SSI Group opens registration for its 2016 user group events.
  • Streamline Health will exhibit at the 2016 Florida HFMA Regional – Space Coast event on February 5 in Titusville.

Blog Posts


Contacts

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

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February 4, 2016 News No Comments

News 2/3/16

February 2, 2016 News 1 Comment

Top News

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The White House will ask Congress to approve $1 billion for President Obama’s so-called “cancer moonshot.” Some of the areas to be funded within HHS are early detection via genomics, enhanced data sharing among institutions, and a virtual FDA Oncology Center of Excellence to review new combination products.


Reader Comments

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From Judo Chop: “Re: Florida Hospital and Athenahealth. This is part of the December announcement by its parent company Adventist Health System selecting Athenahealth. Florida Hospital will replace a combination of Epic ambulatory EHR that’s used in a handful of clinics, Cerner ambulatory EHR, and Allscripts (the old Misys product) PM. Most of the rest of AHS is using NextGen’s EHR/PM.“ Adventist announced in December that it will be deploying Athenahealth’s PM/EHR to 1,600 employed physicians.

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From Polecat: “Re: Meaningful Use hardship exception. The new form doesn’t even ask the EP or EH to submit documentation of their claimed reason.” Correct. I think we can assume that this wink-wink form means CMS will allow anyone to avoid EHR penalties. MU is an embarrassment to everyone involved at this point and even the government is trying to distance itself from it. Just check “EHR Certification/Vendor Issues” and you’re done.


HIStalk Announcements and Requests

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Mrs. Haley from Georgia couldn’t wait to send photos of her special education and gifted students using the three tablets we provided in funding her DonorsChoose grant request. She took these photos the day they arrived, where she had already installed reading and testing apps.

Also checking in was Mrs. B from North Carolina, who just got word that we had funded her request for science activity tubs. She says, “I couldn’t believe the email I received with information about my project … I yelled out loud and other staff members came to my classroom to see what was going on … I try to purchase what I can, but it seems as if my money is not going very far these days. Thank you very much from the bottom of my heart. You have made one teacher very happy … You will never know if a future mineralogist, petrologist, or geologist will be inspired by these kits!”

I was thinking today: has anyone actually ever heeded the warning to, “If this is a medical emergency, hang up and dial 911” after hearing those boring, time-wasting phone tree warnings when calling everyone from a dermatologist to a drugstore?


HIStalkapalooza

HIStalkapalooza Sponsor Profile – Fujifilm

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With 16 years of industry-leading experience, our TeraMedica division remains independently focused on advancing VNA technology and healthcare interoperability while now leveraging Fujifilm‘s clinical capabilities. As the centerpiece of Fujifilm’s comprehensive medical informatics portfolio, Synapse VNA provides the industry’s leading image management solution. Fujifilm is proud to sponsor HIStalkapalooza. Visit us during HIMSS16 for all your medical informatics requirements, Booth #1024.

HIStalkapalooza Sponsor Profile – PatientSafe Solutions

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PatientSafe Solutions has mobilized clinicians and redefined clinical workflows for more than a decade. Meet our team in Booth #4257 to learn how our Clinical Communications platform improves patient care and satisfaction while decreasing costs. Meet us at HIMSS. Our team can’t wait for HIStalkapalooza this year. Look for us at the event to get your picture taken for the 2016 HIStalkapalooza video!


Webinars

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


Acquisitions, Funding, Business, and Stock

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Huron Consulting Group acquires 25-employee, Denver-based MyRounding, which offers a mobile rounding and survey tool for hospitals.

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Aetna announces that its profit jumped 38 percent in the most recent quarter, mostly due to its Medicare and Medicaid business, but says it lost money on its exchange-issued policies and warns that it has “serious concerns about the sustainability of the public exchanges.”

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Alphabet, the recently formed parent company of Google, surpasses Apple as the world’s most valuable company after reporting impressive numbers in its first detailed report. Alphabet made $4.9 billion in profit on $21.3 billion in revenue for the quarter. Share price jumped 8 percent on the news, raising the company’s market capitalization to $559 billion.

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Sunquest parent Roper Technologies reports Q4 results: revenue flat, EPS $1.82 vs. $1.85, missing estimates for both and issuing 2016 guidance below expectations. The CEO said in the earnings call, “We think we will have mid-single digit organic growth in Medical throughout 2016 and we think that will get stronger as the year goes on. Sunquest has a number of version changes and software release updates that are rolling out in the second half that will be quite beneficial. And then Strata, Data Innovations, and SoftWriters which are growing rapidly, will become organic in the second half. Verathon and Northern Digital are going to continue to grow at a relatively high rate in 2016. And then we closed on January 7 the CliniSys acquisition in the UK, which is a European hospital laboratory software provider, and it will add to our acquisition sales growth in 2016.”

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Machine learning vendor Digital Reasoning, which acquired Shareable on January 8 to create its healthcare business, raises $18.6 million, increasing its total to $53 million.

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A New York Times article questions whether it was wise for the struggling Theranos to hire star litigator and company director David Boies as its legal representative, given that he would be representing Theranos management as a lawyer while his responsibility as a director is to the company’s shareholders. It concludes,

The potential for conflict is particularly great. What if Ms. Holmes resists changes that would be in the interest of shareholders? What if the board decides that it is time for her to go — and she stands her ground? The board could do little more than throw up its collective hands under the current governance structure. Mr. Boies and the other outside directors could resign in protest. But why would anyone, particularly Mr. Boies, be a director on a board that lacked the power to make fundamental changes? Indeed, what is Mr. Boies thinking? He may be paid lots of money for his roles, but for someone so successful and savvy to put himself in a position that is bound to be problematic is puzzling.

Meanwhile, Theranos finds another foot to shoot in indefinitely delaying its October promise to allow Cleveland Clinic to validate its technologies and insisting that it won’t publish anything about those technologies in peer-reviewed journals until it receives FDA approval for all 120 of its tests.


Sales

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Joseph Brant Hospital (Ontario) chooses FDB MedsTracker MedRec for medication reconciliation.

Craneware signs a $7.5 million contract with an unnamed hospital operator.


People

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Seattle Children’s Hospital (WA) names interim SVP/CIO Jeff Brown (Lawrence General Hospital) to the permanent role. He holds three master’s degrees in business administration, executive management, and health informatics.

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Allscripts names Melinda Whittington (Kraft Foods Group) as CFO.

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CareSync hires Russell Dumas (Napier HealthCare) as VP of clinical operations, David Antle (BobCAD-CAM) as VP of client services, and Teri Spencer (GTE Financial) as VP of human resources.

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Cumberland Consulting Group hires Terrell Warnberg (QHR) as partner over its new performance improvement practice.

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The Health Information Trust Alliance (HITRUST) appoints Epic President Carl Dvorak to its board and names David Muntz (GetWellNetwork) as senior advisor of public policy.

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Athenahealh hires Prakash Khot (Kaseya) as CTO.

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Laura Momplet, RN (Dignity Health) joins CTG as chief operations officer and chief clinical officer.

Employee health platform vendor Healthcare Interactive names John Capobianco (KickStart Partners) as president and chief marketing officer.


Announcements and Implementations

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Craneware will offer patient payment plan technology from VestaCare with its medical necessity and price estimation products.

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Premier announces that it will conduct Innovator Research using Medicare data from CMS’s Virtual Research Data Center. Premier’s research division will analyze episodes of care to identify best clinical practices for care improvement and cost reduction.

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A Surescripts study of New York providers finds that 93 percent of pharmacies can receive electronic prescriptions for controlled substances while only 27 percent of prescribers have the technology to issue them. It also finds that 58 percent of prescribers are issuing electronic prescriptions in general. New York’s I-STOP law requires that all prescriptions be transmitted electronically by March 27, 2016, meaning a huge number of prescribers need to take action in the next seven weeks.


Government and Politics

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New York Mayor Bill de Blasio hires a consulting firm to figure out what to do about the city’s 11-hospital Health + Hospitals Corporation, which despite extensive city support is expected to run a deficit of $2 billion within the next three years. The health system hopes to convince more patients with commercial insurance to use its facilities than those of its competitors, all of which have similar ambitions.


Privacy and Security

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Australia’s Royal Melbourne Hospital says it hasn’t completely eradicated the Qbot malware that infected its Windows XP computers two weeks ago. The hospital says the virus mutated six times in a single day. The keystroke-capturing malware penetrated the hospital’s pathology computers via a Windows XP exploit, managing to evade detection by the hospital’s updated antivirus product.


Other

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A study finds that mobile text messaging increases medication adherence rates in chronic disease patients from an assumed baseline of 50 percent to 68 percent, although the sites that are screaming this out as big news failed to note that:

  • It’s a meta-analysis, meaning that instead of doing new research it just combines information from previously published studies.
  • The studies it reviewed involved fewer than 3,000 patients combined.
  • Texting results were measured only for a short duration.
  • The studies relied on what patients said they did rather than measuring what they actually did.
  • The text messaging in each study was not consistent as to frequency and style.

This is not newsworthy other than the fact that it was published in JAMA Internal Medicine, where it will reach a wide audience. It’s also surprising that the journal misspelled the name of the Johns Hopkins Bloomberg School of Public Health in its author affiliation section.

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Duke University Health System (NC) reports making a record profit of $355 million for 2015, explaining that, “For the three or four years leading up to this past year, we had made a series of investments in facilities and information systems that helped to relieve capacity constraints limiting growth … With our new IT capabilities, we are able to better manage care across the spectrum and become more efficient in that way.” The system said it made a lot of money by buying up oncology practices to increase inpatient volume.

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I received a survey link from HIMSS about its Learning Center, which sells thinly disguised advertising via its HIMSS Media business. Being a member of HIMSS means being inundated with its vendor-sponsored pitches, in this case disguised as “education,” where high-paying vendor members pay dearly to be hooked up with low-paying provider members in the “ladies drink free” business model. 

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The Virginia Tech professor who led the study proving that the water in Flint, MI contains dangerous levels of lead says public science is broken as university faculty members are pressured to get funding and to become famous. He explains, “Where were we as academics for all this time before it became financially in our interest to help? … Science should be about pursuing the truth and helping people. If you’re doing it for any other reason, you really ought to question your motives … Everyone’s invested in just cranking out more crap papers … when you reach out to them, as I did with the Centers for Disease Control and Prevention, and they do not return your phone calls, they do not share data, they do not respond to FOIA … every single rock you turn over, something slimy comes out.”

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A Congressional investigation finds that despite the patient-focused claims of since-fired Turing Pharmaceuticals CEO Martin Shkreli, the company was gloating with delight at the profits it would make by jacking up the price of ancient drug Daraprim by 50-fold.

Weird News Andy titles this sad story “Out of the frying pan and into the fryer.” A patient with mental illness jumps out of a moving ambulance while being transported from a hospital and is struck and killed by a driver who then fled the scene.


Sponsor Updates

  • Catalyze co-founder and CEO Travis Good, MD will speak on “Excitement in Healthcare Regulation” at the 2016 Hosting Milestone Summit Series on February 4 in Las Vegas.
  • Divurgent will attend the South Carolina HIMSS Networking Reception & Dinner February 4 in Columbia.
  • FormFast gears up for HIMSS16.

Blog Posts


Contacts

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

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February 2, 2016 News 1 Comment

Monday Morning Update 2/1/16

January 31, 2016 News 9 Comments

Top News

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CMS proposes a rule that would allow qualified entities – of which 13 have been approved so far — to provide or sell Medicare and private claims data to providers to support quality improvement. Only two of the qualified entities report provider performance nationally — Health Care Cost Institute and Amino. Physician practices (or employers paying for their services) would be able to review all-payer data for their patients.


Reader Comments

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From Eddie T. Head: “Re: CHIME’s patient identifier challenge. A 100 percent match is unrealistic. Even in countries with a national medical identifier the accuracy is about 95 percent. The 100 percent goal will get in the way of creating a real solution nationwide.”

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From AthenaAscending: “Re: Florida Hospital. Is replacing Epic’s PM/EHR with Athenahealth.” Unverified.

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From Unintended Consequences: “Re: AGH in Pittsburgh. Its Epic acute go-live has created medical care havoc in peripheral LTAC and SNF facilities that had relied on Allscripts Sunrise for order entry and results retrieval. They are not on Epic and have resorted to a 1980s paper requisition and lab retrieval system. Doctors cannot see a list of their patients. AGH’s command team has informed doctors that stat orders must be called in and cases ordered as consultations won’t appear on the consultant’s patient list.” Unverified. 


HIStalk Announcements and Requests

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A reader asked me to post a single summary of my unsuccessful quest to obtain an electronic copy of my hospital stay information, which I’ve done here.

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A surprising 80 percent of poll respondents aren’t fans of the idea of the ONC-published EHR star rating that Congress is considering. Jacob Reider commented that it’s a terrible idea and is outside of the government’s role. Ross Koppel says summarizing complex systems with a single star rating is simplistic. Barbara Hillock thinks such ratings would be misleading since they would be driven by the expectations of customers who don’t always follow the vendor’s implementation recommendations. Meltoots commented that ONC and CMS need to stop getting in the way of patient care with new programs.

New poll to your right or here: how have recent statements from CMS affected your perception of HHS/CMS/ONC?

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

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Mrs. Johnson from Illinois sent photos of her kindergarten class using the math tools we providing in funding her DonorsChoose grant request. She says, “It was so generous of you to help us succeed in getting some of the tools we need to make learning math engaging and fun! The look in these kids’ eyes when I tell them we have something new that will help us learn is motivation for me. I couldn’t have provided these materials on my own and appreciate the support you have given.”

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Epic consulting firm BlueTree Network donated $1,000 to secure a spot at my CIO lunch at the HIMSS conference, which allowed me to fully fund these DonorsChoose teacher grant requests with the help of matching funds:

  • Science activity tubs for Mrs. B’s first grade class in Richfield, NC.
  • Three iPad Minis, cases, and a document camera for the second grade class of Mrs. Mann of West Newton, PA.
  • Electricity and magnetism activity tubs for Ms. Anderson’s fourth grade class in Phoenix, AZ.
  • Two Osmo gaming systems for Mrs. Boyd’s elementary school class in Chocowinity, NC.
  • Three programmable robots and engineering components for the new middle school robotics club started by Mr. Rector in Beebe, AR.
  • STEM challenge kits and for Mrs. May’s special education classes in Edgewater, FL.

HIStalkapalooza

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I have received over 1,200 requests to attend HIStalkapalooza, so I’m closing signups Monday. Sign up now or never. I’ll be able to invite most of the people who signed up. We’ll be handling invitations, RSVPs, reminders, and electronic check-in through Eventbrite this time and I expect the invitation emails will go out this week. This is where the annoying part of throwing a free party begins as it does every year when I vow that this year’s event will be the last because of the time and energy it requires:

  • People will email me asking if they can bring a guest. If you didn’t sign up your guest like the form clearly states, then they can’t come – it’s like going to an Adele concert or traveling on American Airlines –everybody needs a ticket, with the only difference being that HIStalkapalooza tickets are free.
  • I’ll hear from folks who claim to be the most loyal and careful readers who swear they mysteriously missed the dozens of times I’ve provided signup instructions and wanted to be added after the fact. Sorry, no, it’s only a party and your life won’t be ruined if you miss it because you couldn’t follow the rules everybody else figured out.
  • Vendor administrative assistants who don’t read HIStalk and who signed up bunches of their executives (who rarely actually show up) will start bugging us about why they haven’t received invitations. That’s actually already happened as the admin of one company keeps asking why her 23 executives haven’t been invited yet. This isn’t a company outing and we have more important things to do than swap party-related emails, so I’m hitting “delete” on those.

Last Week’s Most Interesting News

  • CMS warns Theranos that its California lab practices are dangerous to patients and that it has 10 days to fix the problems or face suspension from Medicare.
  • Leidos announces that it will acquire the IT business of Lockheed Martin for $5 billion.
  • Cerner Chairman and CEO Neal Patterson notifies shareholders that he is being treated for soft tissue cancer.
  • A Texas hospital regains access to its EHR after being locked out for more than a week by ransomware.
  • Flint, MI-based Hurley Medical Center says it was hit by a cyberattack by hacker group Anonymous, which is protesting the city’s water crisis.
  • Big Bucks Equals Big Interest in CHIME’s National Patient ID Challenge.
  • McKesson’s Paragon Dilemma.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Capital BlueCross orders Theranos to stop performing blood draws in Capital’s storefront in Hampden Township, PA following a CMS investigation that found deficiencies in the California lab of Theranos that “pose immediate jeopardy to patient health and safety.”

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Xerox will split itself into two companies, responding to pressure from activist investor Carl Icahn to separate its $11 billion document imaging business from its $7 billion business process outsourcing. Xerox, which acquired Affiliated Computer Services for $5.6 billion in 2010 and will now basically spin it back off, has 104,000 employees who will be part of the new BPO company. Xerox announced Q4 results with the announcement: revenue down 8 percent (its 15th consecutive quarter of declining sales), adjusted EPS $0.32 vs. $0.31, beating earnings expectations.

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WeiserMazars acquires Lion & Company CPAs, which includes healthcare consulting among its offerings.

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Quality Systems (NextGen) announces Q3 results: revenue down 1.7 percent, EPS $0.16 vs. $0.16, missing on revenue but beating on earnings. Shares dropped nearly 20 percent Friday on the news. Above is the one-year share price of QSII (blue, down 20.7 percent) vs. the Nasdaq (red, down 1.34 percent). Five-year performance looks a lot worse, as Quality Systems shares dropped 67 percent as the Nasdaq gained 67 percent.

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The HCI Group acquires Houston-based Expert Technical Advisors.

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Philadelphia-based orthopedic practice The Rothman Institute and the University of Virginia Health System participate in a $4 million funding round for Locus Health, a remote care management company of which both organizations are customers.

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Meditech publishes its FY2015 annual report. Revenue was down 8 percent for the year (“primarily due to lower product bookings”) and net income dropped from $124 million to $70 million. Neil Pappalardo owns about $450 million worth of shares.  


Announcements and Implementations

Recondo Technology launches MySurePayHealth, which allows patients to estimate their out-of-pocket cost for a given procedure.

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An emerging technology site profiles Valdic co-founder and CTO Drew Schiller as part of its “Today’s Entrepreneur” series, in which he lists his top three lessons learned:  (a) if someone isn’t interested in paying for your product, ask them what they would pay for; (b) reputations follow you, so treat everyone well; and (c) we are so fortunate to be living in an era where it is this easy to start a new company and iterate on ideas.


Government and Politics

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Ashkan Soltani, senior advisor to White House CTO Megan Smith on loan from the Federal Trade Commission, announces that he has effectively been fired after just six weeks on the job when the Office of Personnel Security denies his security clearance. Soltani, whose White House assignment involved privacy, data ethics, and recruiting technologists for government service, previously won a Pulitzer prize as part of the Washington Post investigative team that revealed the extent to which the National Security Agency spies on American citizens.

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This might be the highest-profile bungling of the HIMSS acronym. Pedantic grammarians such as myself smugly note that HIMSS and HIPAA are “acronyms” as opposed to “initialisms” (acronyms are sounded out as words, while initialisms are pronounced as their individual letters, as in “CIA” or “IBM”).


Privacy and Security

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Scientific American’s “How Data Brokers Make Money Off Your Medical Records” contains no new information, but gives the public a glimpse at how companies are buying and selling their de-identified medical information. It mentions IMS Health, which takes in $2.6 billion per year by combining and repackaging information on 500 million people worldwide and then selling insights to drug companies and other to help them target sales. It repeats the now-obvious concept that it’s not hard to re-identify people by linking multiple databases. Drug company Pfizer spends $12 million per year to buy health data, but even its own analytics director says patients own their data, should be told how it’s being used, and should be given the ability to opt out of data that’s being collected for purely commercial purposes.


Technology

A Fast Company article describes the use of robots in long-term care, giving as an example Luvozo’s SAM “robotic concierge” that uses remote care staff. 


Other

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A good interview with WebMD’s dethroned founder Jeff Arnold, now CEO of Atlanta-based Sharecare, describes how the company uses individual results from its acquired RealAge health questionnaire to push content to users. Sharecare also offers personal health consultations via its AskMD app and publishes a voice-analyzing app to detect stress. On the downside, the company’s co-founder is the pseudo-medical huckster Dr. Oz.

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Kaiser Health News describes the enthusiasm patients of Newport Orthopedic Institute are expressing for the empathetic, automated post-surgery daily emails they receive from the practice’s HealthLoop system. The article provides an example of a knee surgery patient who responded to a system-generated, emailed question about calf pain, which triggered his doctor to see him immediately and diagnosis his dangerous blood clot.

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The Hurley Medical Center pediatrician who uncovered the human effects of the Flint, MI water crisis credits the hospital’s Epic system and EHRs in general for allowing her to quickly discover the increasing number of children with high levels of lead in their bloodstream. “If we did not have Epic, if we did not have (electronic medical records), if we were still on paper, it would have taken forever to get these results,” says Mona Hanna-Attisha, MD, MPH. She cross-referenced the abnormal blood levels to home addresses using geographic information system software to prove what was happening despite the denials of state officials. She is also adding an Epic flag to allow doctors to track those children for lead poisoning symptoms that can take years to emerge. Note once again the key involvement of a doctor trained in public health when discovering and responding to a regional crisis.

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Chester County, PA commissioners proclaim January 29 as R. James Macaleer Day, honoring the recently deceased local charitable benefactor and founder of Shared Medical Systems on his birthday.

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The US Army Reserve highlights the actions of three members of the 345th Combat Support Hospital of Jacksonville, FL who are deployed to Kosovo and who saved the life of a motorcycle accident victim while on leave in Greece. Those involved were Major David Whaley, who is a doctor of pharmacy; Colonel Edward Perez-Conde, brigade surgeon; and Major Kirk Shimamoto, a doctor of dental surgery. Perez-Conde says he considered using a pocketknife and ball point pen to relieve the victim’s pneumothorax, but, “we didn’t know how the police would react to a medical procedure using a pocketknife and we certainly didn’t want to go to jail.”

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Flint-based McLaren Health Care (MI) will centralize its 13 billing and collections offices, saying it lags in standardizing its revenue cycle processes but hopes it can increase revenue by $30 million by reducing denials and increasing collections. The health system also says it is working on integrating Cerner’s EHR and patient billing systems.

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An article describing how ad-supported publishers are “freaking out” over their readers using ad-blocking software provides an example in Modern Healthcare. The Interactive Advertising Bureau calls AdBlock Plus, which has been downloaded 500 million times, “unethical” and “immoral,” declining to note that publishers are producing content that few people are willing to pay for in any form, including by the viewing of ads.

A New Hampshire jury awards $32 million to a former Walmart pharmacist who claims she suffered gender discrimination in being wrongfully terminated for notifying the state’s board of pharmacy about the large number of errors the pharmacy was making, some of which the store manager inappropriately blamed on her. Mauren McPadden, who had worked for the company for 18 years, also says Walmart violated her HIPAA rights by accessing her PHI and telling co-workers that she had suffered a nervous breakdown. Walmart claims it fired her because she lost her pharmacy keys.


Sponsor Updates

  • T-System offers free tool to providers for documentation and diagnosis of influenza patients.
  • Valence Health will exhibit at the HFMA First Illinois Managed Care Meeting February 4 in Chicago.
  • Huron Consulting Group releases a new clinical research management briefing.
  • ZirMed will exhibit at the AAPAN Annual Forum February 1-2 in Laguna Niguel, CA.
  • Aprima launches its redesigned website. 
  • Caradigm completes the ConCert by HIMSS interoperability testing and certification program.
  • Sandlot Solutions will exhibit at the Louisiana Hospital Association’s Winter Leadership Symposium February 2-3 in Baton Rouge.
  • Surescripts will exhibit at the EHealth Initiative 2016 Annual Conference February 3-4 in Washington, DC.

Blog Posts


Contacts

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

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January 31, 2016 News 9 Comments

Why I Still Don’t Have an Electronic Copy of My Medical Records Six Months After Asking

January 30, 2016 News 12 Comments

I decided in June 2015 to go through the exercise of requesting an electronic copy of my medical records. They’re from an Epic-using, Most Wired-winning, EMRAM Stage 7 academic medical center at which my only encounter was an unplanned, uneventful one-night stay while traveling. I wanted to see how the records request process might work for the average patient.

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I also tried using the hospital’s MyChart portal to look up my own records as a second experiment. That’s a different process managed by the hospital’s MyChart support team. I was not successful since my visit was not listed and the polite but baffled technician couldn’t figure out why. The technician did not offer to research the problem further.

Day 1

The records request page on the hospital’s website offers two options: dropping by personally to the hospital’s health information management department (which they clearly prefer) or downloading, completing, and faxing a form. Scanning and emailing the signed form was not possible, they said – it has to be faxed. Requests for images must be made separately by calling a different telephone number.

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The form is complicated since it was primarily designed for patients who want to give someone else access to their records, such as for a workers compensation claim. The hospital really should create separate forms to avoid awkward references to “the patient” when it’s the patient making the request. It also asked for “patient medical record number or other identifiers” which hospitals frustratingly and somewhat arrogantly expect patients to learn and remember.

I completed the paper form as best I could, but it was not easy to figure out what they were looking for. Then I had to scan the signed form and find an online fax service to send it to the HIM department’s release of information fax machine.

The paper form did not provide an option for how I wanted to receive the information, stating flatly that paper copies would be mailed and that an unstated per-page fee would be charged by its contracted release of information vendor (it’s scary to agree to pay the fee upfront without knowing how many pages are involved or what the per-page charge is). It didn’t ask how I preferred to be contacted (not that it mattered since they never contacted me), but it did ask for a telephone number and physical address, again oddly worded since the multi-purpose form isn’t intended for patients only, with fields such as, “Phone (if known)” as though the patient might not know their own telephone number.

Day 11

I called the hospital’s HIM department since I hadn’t heard back from my request. They said they hadn’t taken any action because I hadn’t provided dates of service for my one and only encounter with the health system (since I couldn’t remember the date – it was more than a year before). They looked it up and said they would mail the records. I told them I wanted them in electronic form.

The HIM person said they don’t provide electronic information to patients, only to physicians. I said they were obligated to give me an electronic copy if I wanted it. She said she would get back with me after she talked to her supervisor.

Day 13

I hadn’t heard back from HIM, so I called them again. The supervisor repeated that they are not obligated to give patients electronic copies of their records and would provide only mailed paper copies. I repeated that they are indeed obligated to provide electronic copies. I said I would file a Office for Civil Rights complaint if they refused. Which they did, again.

I filed the OCR complaint. It was an easy online form to complete and I received quick email confirmation that it had been received.

Day 39

A letter-sized envelope arrived in the mail from the hospital. My name and address were scrawled nearly illegibly on the front with no indication of what was inside. I opened it up and there was my visit summary, contained on two pages front and back as printed off from the hospital’s Epic system. The hospital didn’t include a greeting or explanation or anything to indicate why they had sent the copies – it was just two Epic-generated pages that I finally figured out. I can’t imagine the average patient receiving the same document and making sense of it. At least they didn’t charge me for the two pages.

Day 211

I received a letter from the Office for Civil Rights informing me that my complaint was being closed without formal investigation. Instead, OCR said it had decided to “resolve this matter informally through the provision of technical assistance to the hospital.”

I haven’t heard from the hospital. I still don’t have an electronic copy of my records. My visit still doesn’t display in MyChart.

I invite readers to try this same process with their hospital or physician practice and let me know how it goes.

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January 30, 2016 News 12 Comments

News 1/29/16

January 28, 2016 News 2 Comments

Top News

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CMS warns lab company Theranos that its December inspection of the company’s California laboratory found deficient practices that “pose immediate jeopardy to patient health and safety.” CMS has given the company 10 days to prove that it has corrected the problems, threatening to revoke its Medicare certification otherwise. Theranos respondes that 90 percent of its lab work is done in its Arizona facility and says it has already fixed some of its California lab problems, including hiring a qualified lab director.

Walgreens, which seems anxious to wangle out of its deal with Theranos, has told Theranos it doesn’t want its samples processed in the California lab and has closed its Theranos Wellness Center in Palo Alto, CA. Walgreens admits only that it is “currently in discussions about the next phase of our relationship.”


Reader Comments

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From The PACS Designer: “Re: better cancer detection. Researchers at the University of Tokyo Graduate School of Engineering have developed haptic gloves that can more easily detect potential types of breast cancer lumps through a new type of bendable sensor. The gloves cling more tightly to your fingers, thus improving the feel aspect of detection.”

From Pale Imitator: “Re: KLAS report on Soarian. You didn’t mention how Soarian is seen as an orphan product.” KLAS has stopped sending me anything about their reports, so I don’t mention them since I don’t even have a summary to review like other sites apparently get. For example, I noticed KLAS’s tweet that talked up Medicity’s “most improved vendor” performance in its year-end awards and clicked the link, but goes to a sign-up page that doesn’t even mention Medicity’s award, so I’m left with nothing. Back to your original comment, Soarian is an orphan product, of course, with only the timeline in question.


HIStalk Announcements and Requests

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FlexPrint donated $1,000 to attend my CIO lunch at HIMSS, which funded these DonorsChoose teacher grant requests:

  • A programmable robot for Mr. Fess’s elementary school class in Port St. Lucie, FL.
  • A programmable robot for Mr. Jewell’s  sixth grade engineering class in Beebe, AR.
  • Headphones for Ms. Garris’s elementary school class in Fayetteville, NC.
  • Math tools for Ms. Reynolds’s elementary school class in Springfield, MO.
  • Electronic circuitry kits for Mr. Shawver’s career pathways high school class in Taos, NM, in a project led by sophomore Zack, who wants to earn a Harvard doctorate in math and engineering.
  • Math games for Mrs. Dlouhy’s elementary school class in Las Vegas, NV.
  • STEM activities for Mrs. Newman’s second grade class in Indianapolis, IN.
  • A document camera and wireless printer for Mrs. Garcia’s elementary school class in New Haven, CT.
  • Dry erase boards and markers for Ms. Hughes’s elementary school class in Marietta, SC.

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QPID Health also donated $1,000, which funded these requests:

  • A Chromebook, mouse, and case for Mrs. Williamson’s English language learner class in Rentz, GA.
  • Science reading books for Mr. Beeler’s high school class in Houston, TX.
  • Two trumpets for the area’s first band program led by Ms. A in Dallas, TX.
  • Science learning centers for the kindergarten class of Ms. Estes in Franklin, TN.

This week on HIStalk Practice: Mississippi taps Teladoc for virtual firefighter care. Emerge Urgent Care opens as the "first telemedicine-based urgent care center in the US." Amazing Charts President John Squire lays out his vision for the problem-oriented medical record. RetraceHealth raises $500,000. AMA convenes disgruntled physicians for a town hall vent session in Seattle. PCPSs in Arkansas, South Dakota, and Iowa have it made – unless they’re female. Riverside Medical Group opts for an "always-open" model.

This week on HIStalk Connect: In England, the NHS partners with IBM, GE, Phillips, Google, and others to roll out several digital health pilot projects designed to objectively evaluate the benefit of introducing new technologies to care delivery. CMS sends a public letter to Theranos after discovering deficiencies during a routine lab inspection that could put patient safety in "immediate jeopardy." Texas Medical Center welcomes 13 startups to its TMCx accelerator program. Neurotrack raises a $6.5 million Series B to roll out an Alzheimer’s disease diagnostic tool that can detect cognitive impairment six years before symptoms present.


HIStalkapalooza

HIStalkapalooza Sponsor Profile – Clinical Path Consulting

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Clinical Path Consulting is dedicated to optimizing the benefits of digital healthcare. Our team of industry experts help healthcare providers take advantage of technology to make operations more efficient, meet regulatory requirements, and improve the overall quality of patient care. Our professionals have extensive experience with, and an in-depth understanding of, healthcare business processes and industry technologies. Our services range from EMR implementation, optimization, upgrades, and training to specialized services, including our Healthcare Reporting Lab and our Clinical Concierge Program.


Webinars

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


Acquisitions, Funding, Business, and Stock

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McKesson reports Q3 results: revenue up 3 percent, EPS $2.71 vs. $2.04, missing revenue expectations but beating on earnings. Revenue in its Technology Solutions business dropped 8 percent on the sale of its nurse triage service and “anticipated revenue softness” in Horizon Clinicals. From the earnings call, John Hammergren says he’s pleased with the operating margin trends in the Technology Solutions business, citing the company’s focus on peer solutions, transactional offerings, imaging, and revenue cycle management. The transcript makes it seem that stock analysts tremble in Hammergren’s telephonic presence since they can’t seem to string together coherent sentences without Tourette’s-like verbal crutches. The Morgan Stanley analyst said “kind of like” a record 16 times in just three questions, such as, “It’s kind of like up 7 percent in the last kind of like 18 months, we’ve seen this growth in kind of like low to mid and even high teens,” while the ISI Group’s analyst, not to be outdone, used “sort of like” five times in his two questions.

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HCA announces Q4 results: revenue up 6.4 percent, EPS $1.40 vs. $1.19. The hospital operator made over $2 billion in profit in FY15.

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Anthem announces Q4 results: revenue up 7 percent, EPS $0.68 vs. $1.80, missing earnings expectations. The company says its insurance exchange policy volume ran 30 percent lower than it planned.

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CPSI announces Q4 results: revenue down 4.5 percent, EPS $0.30 vs. $0.60, falling short of expectations for both. 

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Telemedicine technology vendor SnapMD raises $5.3 million in Series A funding.


Sales

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The Ohio Department of Mental Health and Addiction Services expands its use of Netsmart’s clinical and financial systems across its six psychiatric hospitals.

Orion Health signs two pilot project contracts with the French Ministry of Health.

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MidMichigan Health chooses Epic in a $55 million project that it says will pay for itself within six years. They went live on Cerner in early 2011 and choose Allscripts for ambulatory that same year. The change was most likely due to its 2013 affiliation with University of Michigan Health System, which invested in the Midland-based system with plans to undertake joint projects in telemedicine, clinical data analysis, and IT.

The Cal INDEX HIE selects Wolters Kluwer’s Health Language for terminology management.

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Steward Health Care Network (MA) expands its use of behavioral health access technology from Quartet Health, which has former US Representative Patrick Kennedy on its board.


People

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Joshua Lee, MD (Keck Medical Center) joins Loyola University Health System (IL) as VP/chief health information officer.


Announcements and Implementations

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Oracle announces Oracle Healthcare Precision Medicine, which it says connects genetic testing information to EHRs “for seamless clinical workflow and adoption.”

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Continuous wearable vital signs monitoring technology vendor Sotera Wireless’s database of de-identified monitoring data reaches 1 million hours, supporting evidence-based alarm management.

University of Michigan launches MS and PhD degrees in Health Infrastructures and Learning Systems, which will focus on IT-driven innovation and continuous improvement.

DrFirst releases a new version of its Rcopia system for e-prescribing, controlled substance e-prescribing, electronic prior authorization, medication history, and medication adherence.


Government and Politics

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ONC has a proposed rule in front of the White House that is described only as, “ONC Health IT Certification Program: Enhanced Oversight and Accountability.”


Privacy and Security

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NCH Healthcare System (FL) notifies employees that two of its servers hosted at Cerner’s data center have been breached, exposing employee and medical staff credentialing information. 

Fitbit will add security measures to its fitness trackers after hackers brag openly about stealing user account information that they use to scam the company. The hackers sell Fitbit login credentials online for between 50 cents and $5, explaining to buyers how to convince Fitbit support reps to send them a replacement for a claimed defective device they never actually bought using a Photoshopped Amazon receipt as proof of purchase. They then sell the devices.

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A short report by cloud security vendor Bitglass reminds us that one in three Americans were affected by a healthcare breach in 2015, with hacking and IT incidents making up 98 percent of the total. The big problem last year was loss of employee devices, but that was before the huge Anthem and Premera insurance company breaches that represented 80 percent of the affected individuals.


Other

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A doctor in Canada warns the public of physician rating site RateMD, claiming the company’s salespeople offered him extra-cost options to hide up to three suspicious reviews and display his banner on the pages of other doctors. To be fair, the company is straightforward about that (and its business in general) on its FAQ page. The real challenge for ratings sites is that the small number of self-selected people who post have had either a great or terrible experience that may not be representative. That plus the fact that anonymous posts can’t be verified, allowing anyone to post a review.

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KLAS announces its Best in KLAS winners for 2015/16. Epic won best Overall Software Suite, Impact Advisors won Overall IT Services Firm, and Medicity earned most-improved recognition. Some notable category winners:

  • Acute care EMR: Epic
  • Ambulatory EMR small practice: CureMD
  • Ambulatory EMR medium practice: Athenahealth
  • Ambulatory EMR large practice: Epic
  • Business intelligence/analytics: Dimensional Insight
  • Community EHR: Cerner
  • Community HIS: Meditech
  • ED: Wellsoft
  • HIE: Epic
  • Laboratory: McKesson
  • Patient accounting/patient management: Epic
  • Patient portal: Epic
  • Population health: IBM (Phytel)
  • Surgery management: Epic

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Dear Healthcare IT News: your ad-filled junk email pitches for HIMSS16 are using a “from” email of “Destination HIMSS15.” Thank you in advance for your prompt attention in this matter.

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The crack investigative team of a Louisiana AM radio station smugly discloses photographic evidence that doctors are wasting time using computers with an “absurd number of diagnoses and codes that total more than 18,000,” adding expert editorial comment opining that, “Remember that our tax dollars are going to buildings filled with bureaucrats who spend their days making rules and regulations that run our lives!” My question is this: does AM radio still exist?

A survey of doctors in Canada finds that 73 percent use office-based EHRs vs. 23 percent in 2006.

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The Orlando paper notes the swelling but untaxed annual profits of Florida Hospital ($330 million) and Orlando Health ($247 million) as “the hospital chains gobbled up what were once taxpaying businesses and property and brought them into the non-profit, tax-exempt fold.” The systems would have paid $50 million in property taxes alone if they weren’t non-profits. Both organizations not only avoid state income tax, federal income tax, and sales tax, but they also receive taxpayer money in the form of taxing districts in three counties. The article notes that Florida Hospital parent Adventist Health System “trades $4.5 billion in securities, mostly through bonds, hedge funds, and money market funds.”

Hospitals in China require non-emergent patients take next-number type tickets, providing a lucrative market for ticket scalpers. A woman who complained on state TV about offers to sell places in the hospital line for $700 says she was harassed afterward by the scalpers and is afraid to take her mother back to the hospital. Her summary would work equally well here even in the absence of scalpers: “My God, for average people to see a doctor takes so much money, so much energy.” 


Sponsor Updates

  • Ingenious Med’s Scott Pierce describes the company’s new consulting practice.
  • NTT Data is sponsoring the Northern California Chapter of HIMSS reception at HIMSS16 on March 1.
  • Iatric Systems takes the Best in KLAS top spot for patient privacy monitoring.
  • MedData will exhibit at the American Society for Anesthesiologists Practice Management Meeting January 29-31 in San Diego.
  • Premier recognizes Inova (VA) with its 2016 Premier Excellence Award.
  • InterSystems TrakCare wins Best in KLAS for Global (Non-US) Acute Care EMR.

Best in KLAS 2015/2016 Winners

Segment Leaders: Software
Cardiology: Merge
Claims and Clearinghouse: ZirMed
Emergency Department: Wellsoft
Global (Non-US) Acute Care EMR: InterSystems
Patient Access: Experian Health
Radiology: Merge
VNA/Image Archive: Merge

Segment Leaders: Professional Services
HIT Implementation Support & Staffing: Galen Healthcare
IT Advisory Services: Impact Advisors
Technical Services: Galen Healthcare
Value-Based Care Advisory Services: Premier

Category Leaders: Software
Cardiology Hemodynamics: Merge
Charge Master Management: Craneware
Clinical Decision Support – Care Plans: Zynx Health
Clinical Decision Support – Order Sets: Zynx Health
Clinical Decision Support – Surveillance: Wolters Kluwer
Decision Support – Business: Strata Decision
Enterprise Scheduling: Streamline Health
Labor and Delivery: Clinical Computer Systems/Obix
Medical Device Integration Systems: Capsule
Patient Flow: TeleTracking
Patient Privacy Monitoring: Iatric Systems
Quality Management: Nuance
Secure Messaging: Imprivata
Single Sign-On: Imprivata
Staff/Nurse Scheduling: GE Healthcare

Category Leaders: Services
Business Solutions Implementation Services: Xerox

Blog Posts


Contacts

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

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January 28, 2016 News 2 Comments

Big Bucks Equals Big Interest in CHIME’s National Patient ID Challenge

January 28, 2016 News No Comments

A $1 million CHIME prize attempts to position the industry for patient identification success.
By @JennHIStalk

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A perfect storm of healthcare concerns around near-ubiquitous EHR adoption, a resultant need for interoperability, patient safety and privacy, and federal stonewalling have swirled into an industry-wide conversation around the need for a national patient identifier.

Such an ID would, in theory, offer all providers a safe, accurate, and private way to identify patients no matter where they receive care. Correctly matching the right patient record to the right patient across care locations has the potential to save the US healthcare system money and lives.

The Implications

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Intermountain Healthcare CIO Marc Probst estimates that his Salt Lake City-based organization spends as much as $5 million each year on administrative and technology costs related to accurately matching patients with all of their medical records. Minnesota-based Mayo Clinic has faced similar financial fallout, paying out up to $1,200 per misidentification, according to a 2014 ONC report.

Probst puts Intermountain’s patient-matching accuracy at 95 percent, above the industry norm of 85 percent. Similar rates show up at Kaiser Permanente, though that number falls to the mid-50s when records are shared between its regions and outside of its Epic system. Some estimates put identity errors in medical records at 14 percent, accruing to an annual estimated spend of almost $9 billion.

But wait, there’s more. A 2012 CHIME survey found that nearly 20 percent of its members could attribute at least one adverse medical event to incorrect patient matching.

That’s where the rubber hits the road. Adverse medical events equate to administering the wrong medication to the wrong patient, performing unnecessary procedures on misidentified patients, and burdening incorrectly identified patients with the hospital bills of someone else. Access to another patient’s health data is also of concern, as the steady stream of healthcare hacks over the last few years shows no signs of slowing down.

The Backstory

While the 2012 CHIME data might be dated, the statistic strongly shouts that the healthcare industry has a moral obligation to roll out an accurate national patient ID. While such an ID has never been developed, it’s not for lack of trying. There was talk of a federal patient identifier initiative when Congress passed HIPAA in 1996, but that was ultimately shot down by the industry’s privacy contingent, resulting in a 1999 law prohibiting federal funding to create the identifier.

What’s an industry in dire need of a solution to do? While there’s talk of removing the federal prohibition within the next year or two, industry stakeholders have taken the matter into their own hands and turned to the private sector for a solution – one fueled by cold, hard cash.

The CHIME Challenge

The CHIME National Patient ID Challenge, originally announced last fall, made its formal debut earlier this month, exciting just about everyone who has ever taken part in the national patient ID debate. The association, which has partnered with crowdsourcing company HeroX, is looking for innovators from around the world to develop a patient ID solution that:

  • Easily and quickly identifies patients.
  • Achieves 100 percent accuracy in patient identification.
  • Protects patient privacy.
  • Protects patient identity.
  • Achieves adoption by the vast majority of patients, providers, insurers, and other stakeholders.
  • Scales to handle all patients in the US.

ONC, National Patient Safety Foundation, AHIMA, and the AMA have endorsed the contest, which will award the winning solution $1 million. Over 80 entrants in seven countries have already signed up. With submissions due April 8, the clock is ticking for entrepreneurs and established companies to finalize their ID innovations. The winner will be announced February 19, 2017 at the CHIME/HIMSS CIO Forum in Orlando.

“We recognized that this is a real challenge,” says Intermountain’s Probst, who is also chair of the CHIME Board of Trustees. “We can’t identify people as well as we’d like to and there’s security issues around that. We’ve become well aware of this over the years, and talked significantly about it for probably the last five.”

Probst attributes the timing of the competition to learning about HeroX. “We discovered there was this creative way of looking at a problem – a much broader strategy than the healthcare industry has traditionally employed. When we heard from HeroX and XPrize founder Peter Diamandis and got aligned with the HeroX team, we thought this is something we could create a challenge around, and CHIME could really get behind.”

“We’ve come to understand that it’s more difficult to model a challenge like this than any of us realized,” he adds, “and I don’t think that’s necessarily unique to patient identifiers. You’re going to throw a million dollars on the table, so you hope that the winning solution is going to be really effective.”

The $1 million prize has obviously set a fire under the healthcare community. Some wonder where the winnings will come from. “CHIME will be looking for people to partner with to help fund this – organizations that would like to have their name associated with it,” Probst explains. “That’s actively going on. The CHIME board will make sure it gets funded one way or another.”

Competition Heats Up

With so many entrants — from credit bureaus to startups to clinicians to big business — committing to the contest in just over a week, competition will surely be stiff once submissions are reviewed and the chosen few move on to the “Concept Blitz” round in May.

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“We’ve been working on this since 1995,” says Barry Hieb, chief scientist at not-for-profit Global Patient Identifiers. “There’s been a long pause on this issue, but now there is renewed focus due to the race for interoperability. There’s a desperate need to identify patients correctly. Between 100,000 and 400,000 people die each year due to medical misidentification. That’s what keeps me awake at night. That’s not acceptable.”

Hieb, who anticipates signing GPI up for the challenge, envisions rolling out the winning solution at several pilot sites for a year or two, and then making it publicly available. “It could be a card, an app, a USB drive … the key is determining what information is accessible,” he says, adding that his other big concern is management of the solution once its 15 minutes of fame have worn off. “We’ll need to sit down with CHIME and other stakeholders to determine who is trustworthy enough to run this capability in perpetuity.”

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Michael Trader, CEO of biometric patient ID platform vendor and contestant RightPatient, echoes many of Hieb’s concerns. “Meaningful Use has been a big impetus for this. Now we’re at a stage where the next goal is interoperability. Combine that with the new influx of covered consumers and you’ve got to help providers avoid sharing dirty data.”

“We feel strongly that our current technology is the ultimate solution for this problem,” he adds. “The winning solution will be strong on the technical side, but will be practical, too. Providers will ultimately drive the adoption, which will in turn drive patient adoption. When all’s said and done, it’s got to be scalable and focus on multiple touch points.”

May the Best – Most Accurate – Solution Win

Probst seems confident that this competition will bring a viable solution to market. “We need these participants to figure this out,” he says. “I don’t know that it will be an algorithm. It could be a biometric, or a combination. Whatever it ends up being, we’d like to get 100 percent accurate identification. It has to be something that makes economic sense and can be reasonably introduced into the industry and afforded. All those are aspects of the challenge.”

“To the patient, this solution will enable your provider to access your medical records when you walk up to the registration desk. You won’t have to clarify. They’ll know it’s you when they create a bill or record or test or referral. We’re going to get it right.”

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January 28, 2016 News No Comments

News 1/27/16

January 26, 2016 News 5 Comments

Top News

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Leidos Holdings will acquire Lockheed Martin’s Information Systems & Global Solutions business — which includes its health IT offerings — for $5 billion, confirming earlier rumors.

Lockheed Martin is known in health IT circles as having created the first CPOE system in the early 1970s when the company was operating as Lockheed (it merged with Martin Marietta in 1995 and changed its name to Lockheed Martin) but the company sold the product to Technicon in 1971, when it was named TDS. Lockheed Martin recently won the VA’s appointment scheduling system contract, bidding Epic through its recently acquired Systems Made Simple subsidiary.

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With the acquisition, Leidos will become the #1 government IT contractor by revenue, with annual sales of more than $10 billion.


Reader Comments

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From Smartfood99: “Re: Frisbie Memorial Hospital (NH). Cerner couldn’t flip a MedSeries4 hospital – they are going with Meditech 6.1.” Frisbie’s CEO says they wanted a system that would work for their 112-bed hospital sold by “a vendor we could trust.”

From Eddie T. Head: “Re: integration with Epic’s hosted systems. I would be surprised if Epic ever agrees to host third-party products. As far as I know they have always maintained that they will host the Epic infrastructure of servers, but they will not take on the role of a customer’s IT department for anything else. If the server-to-server integration comment is correct, then it sounds like sabotage (either by malice, or by incompetence) on the part of McKesson.”


RxNorm Follow-Up

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A reader asked us to find out what’s going on with RxNorm updates and code changes, which they say is causing quality measures to fail because CMS has not updated its eCQM value sets with the new codes. Jenn asked the NIH/National Library of Medicine what happens with VSAC and quality measures when RxNorm is updated:

The short answer is, nothing. But it really has nothing to do with RxNorm or any other code system. ONC/CMS (back in 2012) statically bound all of the CQM value sets to their respective code systems, so the content of those value sets is legally locked to whatever versions of code systems specified by an update. So for example, the last CQM update back in 2015 used Feb 2015 RxNorm I believe. Thus, the problem for implementers who want to use the newer, better content (Lovenox as injectable heparin) to meet the treatment criteria for a measure, but are bound to use an earlier version of RxNorm. This has been a known problem for years. The real issue is providers vs. implementers. Providers, of course, want the new content as it benefits them meeting the care goals. Implementers see too much risk in updating/floating value sets dynamically, especially those that are authored as list (extensional) to begin with rather than as rules (intentional).

Julia Skapik, MD at the eCQI Resource Center adds:

This topic is known to CMS and ONC—the use of a static value set associated with each measure means that dynamic code system changes post-publication will not be reflected in the value set. To this date, we have provided the guidance that it is permissible to map where appropriate to a similar code. Where there are no similar codes, however, there will be a gap in the measure. Rob McClure, cc’d above, has been working on a proposal with CMS to provide an interim update to the value sets in the middle of the measurement period with additions only that will fill out dynamic code changes (and potentially correct errors) that affect real-world value set and measure performance.

In response to the reader’s example of CMS not updating the code sets for Lovenox as an injectable heparin that causes the VTE measure for anticoagulant therapy to fail, ONC/NLM consultant Robert McClure, MD responded:

Her defining example is confusing. Enoxaparin (Lovenox) has been included in the VTE measure anticoagulant value sets, such as "Anticoagulant Therapy" OID: 2.16.840.1.113883.3.117.1.7.1.200 and "Low Molecular Weight Heparin" OID: 2.16.840.1.113883.3.117.1.7.1.219 (and there others), from the very first release in October 2012. So if this is a good example of what ever her concern is, I’m afraid I don’t get the problem. 

If I was to wildly guess (a dangerous thing to do with you playing man-in-the-middle) perhaps she is not familiar with the expectation that data submitted in support of meeting an eCQM may at times require mapping, say from a code representing a branded drug (like Lovenox) to the “general form” (Enoxaparin) using RxNorm as the submitted code system. Or some entity that she’s relying upon is not getting this job done well.

There is the possibility that Sanofi (they make Lovenox) has come out with a brand new formulation of enoxaparin that did not get into the value set. If that is the problem, then this is exactly the sort of thing we are working to determine a better solution for implementers then simply “mapping to something close that is in the value set." If she is aware of such things then I encourage her to provide very specific evidence of this so we can design solutions that really work. She should do this by participating, like thousands of her colleagues have done, in the CMS/ONC eCQM JIRA site (http://jira.oncprojectracking.org) and report the specific issues so we can get to specifics.


HIStalk Announcements and Requests

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The HCI Group donated $1,000 to participate in my CIO lunch at the HIMSS conference, with which I funded these DonorsChoose grant requests:

  • A document camera, speakers, and dry erase lapboards for Ms. Hardy’s elementary school class in Upper Darby, PA
  • A document camera for Mr. Martinez’s high school math class in Delano, CA
  • Three tablets for Mrs. Haley’s elementary school class in Waycross, GA
  • Model rockets for Mrs. Elliott’s sixth grade class in Indianapolis, IN
  • Electronic circuit kits for Ms. Mills fifth grade science classes in Spring, TX
  • An iPad and gaming system for Mrs. Swords’ fourth grade class in Douglas, GA
  • Machining tools for the robotics team of Mr. R’s high school class in West Covina, CA

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Ms. Osborne says her South Carolina elementary school class is using the math games and materials we provided in their math centers.

I was excited about Black Sabbath’s final tour, but video from their “The End” tour stop in Chicago shows Ozzie singing so wildly off key that he ruins all the songs they otherwise played excellently. I think they’re making the right decision to hang up their inverted crosses after nearly 50 years.


HIStalkapalooza

HIStalkapalooza Sponsor Profile – Healthwise

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Amplify the impact of your patient touch points with Healthwise health education, technology, and services. Easily integrated into episodic care, care coordination, automated programs, and patient portals, Healthwise solutions give you the ability to deliver tailored, meaningful experiences. Since 1975, Healthwise has been driven by our non-profit mission to help people make better health decisions. Visit us on the HIMSS show floor in booth #3617 and at our kiosk in the Population Health Knowledge Center. To find out more about Healthwise or to schedule a one-on-one meeting, visit www.healthwise.org/himss16.


Webinars

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


Acquisitions, Funding, Business, and Stock

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CMS inspectors have found problems at the Northern California laboratory of Theranos, according to unnamed insiders. Meanwhile, a Wall Street Journal investigation finds that not only is Theranos using its fingerstick technology for just one test, it’s also sending some of its samples out to reference labs instead of running the tests itself, apparently losing money on each (Theranos sells patients a test for $7 while paying UCSF $300 to run it). The article also reports that Walgreens has met with the company several times since October to discuss concerns about the Theranos stations in its California and Arizona drugstores and isn’t satisfied by the company’s responses. The since-fired CFO of Walgreens approved a loan of $50 million to Theranos without involving the drug company’s senior clinical executives and signed an agreement that Walgreens can’t easily escape from, although a negative CMS report might give them reason.

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Specialty EHR vendor Nextech acquires SupraMed, which offers a PM/EHR for plastic surgeons.

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Medical image exchange platform vendor LifeImage acquires its mammography-specific competitor Mammosphere.

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Enterprise integration vendor Jitterbit, which offers a platform for developers to build and expose APIs, raises $20 million in a Series B funding round. It lists among its customers Dignity Health, Eisenhower Medical Center, and ZirMed. Prices range from $2,000 to $6,000 per month.

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Kaiser Permanente will open an 800-employee customer service center and a 900-employee IT center in metro Atlanta.

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The Milwaukee paper profiles Epic with a potpourri of recycled facts:

  • The company has 9,500 employees, up from fewer than 400 in 2000.
  • The Verona campus has cost $1 billion and construction continues.
  • The article claims that Epic departments don’t have budgets, there’s little hierarchy and few middle managers, and use of job titles is minimized.
  • The company won 127 contracts in 2014 vs. 19 for Cerner.
  • The article says the company is poorly equipped to deal with the criticism that goes hand in hand with its success, noting that its in-house communications team consists of one person and the company is run by limelight-shunning CEO Judy Faulkner, who has asked reporters not to run photos of her for fear that people will bug her at her favorite Madison ice cream shop.

Sales

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Pikeville Medical Center (KY) chooses Medsphere’s OpenVista EHR.

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Trinity Mother Frances Hospitals and Clinics (TX) chooses Stanson Health’s point-of-care recommendation system for appropriate use of medications, imaging, and lab tests.

Phynd Technologies announces sales of its provider management system to Premier Health (OH), Duke University Health System (NC), and Children’s Health (TX).

University of Iowa Health Care selects Oneview Healthcare’s interactive patient care system.


People

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Cerner Chairman and CEO Neal Patterson notifies shareholders via an SEC filing that he was just diagnosed with a “treatable and curable” soft tissue cancer and will therefore be traveling less and attending fewer meetings as he undergoes treatment.

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For-profit hospital operator Capella Healthcare promotes Vishal Bhatia, MD, MBA to SVP/CMIO.

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Nashville healthcare entrepreneur R. Clayton McWhorter, who served as CEO of HCA in the 1980s, died Saturday at 82.


Announcements and Implementations

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The California HealthCare Foundation will cease publishing its iHealthBeat daily technology news digest as of February 1 because “its exclusive focus on health IT no longer aligns with the programmatic focus of our work.” The newsletter was managed by The Advisory Board Company under contract to CHCF. I’m surprised that HIMSS didn’t buy it and fold it into its vendor-friendly publishing arm.

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EHealth Ireland announces that available funding will allow it to increase its 288 FTE headcount by 47.

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Vermont’s Depart of Labor notifies former and present employees of the South Burlington, VT office of Allscripts that they are eligible to apply for re-employment services if laid off.

Liaison Technologies launches its bone marrow transplant registry that includes one-click CIBMTR reporting.

CareSync joins Athenahealth’s More Disruption Please program, offering CMS Chronic Care Management program support services to providers.

Research software vendor Pulse Infoframe will use InterSystems HealthShare for interoperability.


Government and Politics

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CMS encourages development in state Medicaid claims processing systems by permanently extending a 90 percent federal funding match for those systems. CMS is spending $5 billion per year on state Medicaid IT and estimates that 30 states are redesigning their Medicaid eligibility or claims processing systems. Cedars-Sinai CIO Darren Dworkin tweets that it’s a much bigger vendor opportunity than any population health app although it’s likely open only to large government contractors.

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Blue Cross Blue Shield of Vermont calls for an independent review of the state’s Vermont Health Connect insurance exchange as errors force it to once again turn off the ability to enter “change of circumstance” situations. The state blames original contractor CGI and a consulting firm it hired that has since gone out of business. BCBS says exchange problems have prevented some of its customers from renewing their policies and doesn’t allow the company to reconcile its customer accounts. The exchange cost over $200 million to develop, nearly all of that paid by federal taxpayers.

A New York Times article describes the security-required modifications that are required before government officials (including the President) can bring mobile devices into the White House. A general who bought one of the first iPads in 2010 says DARPA technicians removed the device’s cameras, wireless chips, location sensors, microphones, and on-board storage capabilities, leaving him with “a pretty dumb iPad.” The article recounts a 2013 interview in which former VP Dick Cheney revealed that when his replacement defibrillator was implanted in 2007, his cardiologist insisted on disabling its wireless capability for fear someone might use it to assassinate him.

A Congressional Budget Office report finds that the federal government spend $936 billion last year on Medicare, Medicaid, and ACA subsidies vs. $882 billion on Social Security. The report warns about increased spending on mandatory programs and predicts that the federal deficit will increase.

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CMS posts its 2017 Medicare EHR Incentive hardship exception application, due March 15 if EPs are involved or April 1 for just eligible hospitals, with these allowable reasons:

  • Lack of Internet access.
  • An EHR destroyed by natural disaster.
  • Practice or hospital closure or bankruptcy.
  • Problems with EHR vendor certification delays, decertification, or other vendor-caused delays.
  • Lack of control over locations that fall short of 50 percent of patient encounters.
  • For EPs, a practice that does not offer face-to-face interaction.

Privacy and Security

Insurance company Centene announces that it can’t find six hard drives containing the information of 950,000 members.

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NIST invites companies to provide products and technical expertise to help develop use cases for IV pump security.

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Titus Regional Medical Center (TX) finally regains access to its EHR more than a week after its servers were locked by ransomware. The hospital says it did not pay the money demanded and that the FBI is investigating. The Dallas Area Rapid Transit Authority was also recently infected with ransomware that demanded payment of $63,000 to restore access to encrypted files. DART declined to pay and was able to recover most files from backup copies, but some information was lost and some online services remain unavailable. The FBI stated a few weeks ago that it might make sense for some businesses to pay the ransom demanded, which was the case with at least one police department and a sheriff’s office that have paid to get their files back. The hackers behind the CryptoWall ransomware creation tool recently upgraded their product with a redesign of the ransom note.

Two organizations — New Jersey Cybersecurity and Communications Integration and Cell and National Health Information sharing and Analysis Center — create a third-party reporting and notification system in which the state’s hospitals can share cyberattack information anonymously.


Other

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Apparently the unnamed health IT vendor who ran this ad in the Las Vegas Craigslist values its customers about as much as it does women in seeking a “booth girl” whose primary attribute is appearance.

The inquiring mind of Weird News Andy wonders whether a drug that can cure fear will work in cases of pharmacophobia, iatrophobia, and phagophobia.


Sponsor Updates

  • Burwood Group packs 100 winter coats, hats, and gloves for the Boys & Girls Club of America during its annual company retreat.
  • The local paper features CareSync in its roundup of local entrepreneurial ventures.
  • The local paper features Healthfinch in its feature on “Madison startups to watch in 2016.”
  • Qpid Health’s quality reporting solution achieves ONC HIT 2014 Edition Modular Ambulatory EHR Certification.
  • Huntzinger Management Group hires Jay Boylan and Bill Ehrman as regional sales directors.
  • EClinicalWorks is recognized as having the highest market share among cloud-based EHR vendors.
  • Versus creates a dedicated clinical solutions department of RNs. 
  • Stella Technology is supporting ConCert by HIMSS and conducting demos of the Interoperability Test Tool (ITT) at the IHE NA Connectathon this week in Cleveland, OH.
  • Elsevier Clinical Solutions will host the New England HIMSS Social March 1 at HIMSS16.
  • Frost & Sullivan recognizes the EClinicalWorks cloud-based EHR for highest market share.
  • FormFast will sponsor the HIMSS Midwest Gateway Chapter networking event January 28 in St. Louis.

Blog Posts


Contacts

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

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January 26, 2016 News 5 Comments

Morning Headlines 1/26/16

January 25, 2016 News No Comments

Deficiencies Found at Theranos Lab

The Wall Street Journal reports that a damaging inspection report on Theranos’ California lab testing facility will be made public soon. The article says that investigators found “serious deficiencies” that could compromise its standing with Medicare and existing corporate clients.

Cerner CEO Neal Patterson being treated for cancer

Cerner CEO Neal Patterson files an SEC update announcing that he has been diagnosed with a “treatable and curable” soft tissue cancer. He reports that he will reduce his travel and work schedule while he receives treatment, but notes that “it will not be a big change compared to how we run Cerner day to day already.”

Kaiser Permanente says website woes, now on third day, weren’t caused by cyber attack

Kaiser Permanente’s website, including its patient portal, went down last week due to server issues. Kaiser has confirmed that the outage was not the result of a cyberattack, and has confirmed that all systems are back up.

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January 25, 2016 News No Comments

McKesson’s Paragon Dilemma

January 25, 2016 News 3 Comments

The bumpy road McKesson and its users have found themselves on in the transition from Horizon to Paragon.
By @JennHIStalk

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It’s been four years since Atlanta-based McKesson announced its decision to shift resources away from its Horizon Clinicals product line — known for serving several hundred large facilities of 300 beds and up — and to make Paragon its centerpiece hospital IT system.

The move — part of the company’s broader Better Health 2020 initiative of increased investment, research, and development of Paragon — was seen by the industry as an attempt to streamline McKesson’s technology solutions to better serve a customer base that was becoming increasingly vocal in its need for an integrated offering.

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McKesson has faced an uphill battle in its attempts to convert Horizon customers to Paragon. Changes in leadership, rumored employee discontent, and user push-back have all played their part in McKesson’s attempt to remain competitive with scalable technology that can keep up with federal regulations, evolving payment models, and a customer base that seems to be jumping ship to Cerner and Epic in numbers the company didn’t anticipate.

The Evolution of Industry Reaction

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Initial reactions to McKesson’s decision were tempered, with analysts and industry insiders coupling their wait-and-see attitudes with a healthy dose of skepticism regarding the company’s financial stakes. “On one hand, I laud MPT for coming clean on the challenges it has had with the development and support of the Horizon product,” Aspen Advisors (now part of The Chartis Group) Founder and Managing Principal Dan Herman said in a 2011 year-end assessment. “However, it appears that [McKesson’]s go-forward strategy is ‘déjà vu’ – a poorly thought-out approach to integrate disparate platforms, enhance a product that has experienced success in a focused marketplace (Paragon), and promise to customers that [McKesson] is committed to delivering a ‘fully integrated core clinical and revenue cycle IT system.’”

The situation wasn’t as positive after a few years and a few Horizon to Paragon migrations, both from an end user and company perspective. “As a customer, we have noticed that support and services have steadily declined since the Better Health 2020 announcement …. The average tenure of support employees supporting us has dropped severely with resignations,” noted one HIStalk reader and McKesson Horizon customer in 2013. “We have to run a gauntlet of triage and bottom-tier support before most of our issues are escalated to a rare senior resource. They are exerting pressure for us to migrate to Paragon while failing in their commitment to support us on Horizon. Actions speak louder than words and customers have been left to deal with the fallout.”

Fewer than one-fourth of respondents to an HIStalk reader poll in December 2011 said they had a positive reaction to McKesson’s Better Health 2020 plan. Three-quarters of respondents to a September 2012 reader poll said McKesson’s healthcare IT position had worsened in the past year, with one respondent commenting that the plan to move Horizon users to Paragon was, “Nothing more than puff-piece marketing. There was no tangible follow-up with their closest clients to show them concrete plans. The traditional, ‘Trust us because we’ve worked so hard together all these years’ and the implications of ‘we are too big to fail’ just do not hold water.”

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The corporate side of the story correlated with user frustration, as McKesson leadership shuffled and Horizon employees were urged to take jobs at RelayHealth, which expanded to over 1,000 employees in 2013. McKesson’s February 2015 earnings call offered a slightly rosier picture of the company’s migration attempts. Chairman, President, and CEO John Hammergren mentioned that the Technology Solutions division’s seven percent drop in revenue was in line with expectations of lower Horizon Clinicals revenue, and that the company was “in [the] middle of the game” in trying to migrate customers.

He added that, “As you think out two or three years, the EMR space and the transition away from Horizon will be more complete or complete, and we’ll see more results, we think, in terms of this pay-for-performance priority.”

Fast forward almost a year. Hammergren’s prediction of a transition away from Horizon seems to be coming true, though not necessarily with the outcome he had hoped.

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“The move from Horizon to Paragon has actually been pretty painful for McKesson and for their customers,” says Coray Tate, vice president of clinical research at KLAS Enterprises. “That’s not a secret. It’s a little bit of a perfect storm that Paragon got caught up in.”

Paragon, Tate explains, has suffered not only from a Horizon customer base that was unenthusiastic about switching systems and wary of Paragon’s ability to scale to larger facilities, but also from bad timing. The leader in KLAS customer satisfaction rankings for small community hospitals was caught up in the rollout of Meaningful Use and the prospect of a switch to ICD-10. Toss in high-level leadership changes and the “perennial leader” found itself falling behind.

“They took a product that had really struggled,” says Tate. “They reset expectations and have actually done a really good job of developing on that. But now you’ve got all these external pressures that they haven’t been able to meet. Meaningful Use made EHRs become a physician tool, and so that part has been the biggest gap and they are having a hard time getting to the point where physicians are happy with it. That’s not unique to Paragon, but that is definitely one of Paragon’s struggles and one of the reasons why you’ve seen their scores drop in the small market.”

End-User Fallout

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Tate’s insight into market forces have been playing out in Horizon facilities. Mike Jefferies, a former McKesson technical advisor who is now vice president of IS at McKesson customer Longmont United Hospital (CO), agrees with the Better Health 2020 strategy. However, he questions whether big Horizon customers are comfortable with the idea of migrating to Paragon.

“You’ve seen a huge consolidation in healthcare,” Jefferies explained in a February 2015 HIStalk interview. “That consolidation has favored EHRs that handle a larger scale, which in our market means Cerner or Epic. What a larger organization consolidates smaller hospitals and organizations, they certainly aren’t going to uptake that smaller community EHR.”

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Vanderbilt University Medical Center (TN) is one such customer. It announced its move from Horizon – much of which it had self-developed as WizOrder and then licensed to McKesson in 2001 to create Horizon Expert Orders — to Epic in December 2015, with an anticipated go-live in 2017.

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VUMC Chief Informatics Officer Kevin Johnson, MD, MS, who is spearheading the effort, says that its decision was certainly strategic, though the IT team was understandably disappointed to hear the Horizon/Paragon news. “We realized that McKesson was focusing on a different segment of the healthcare market with the Paragon system,” he explains. “Therefore, we had begun surveying the landscape to be proactive about the move at the same time that McKesson sent us the announcement.”

“We have enjoyed a long history with Epic as one of their first revenue cycle clients, dating back to 1995,“ Johnson adds. “We had made a decision to upgrade our revenue cycle and billing system to a more recent Epic version for inpatient and outpatient billing. We also have Cerner’s lab system. Our decision, therefore, was to migrate our revenue cycle/clinical/lab environment to Epic/Epic/Cerner or Epic/Cerner/Cerner. Paragon is a system constructed with a different size and complexity health system in mind. Both Cerner and Epic were good choices for us, and after a thorough evaluation, we chose Epic for our clinical system.”

The Consultant’s Perspective

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Mike Lucey, founder and president of Paragon consulting firm Community Hospital Advisors, paints a more intimate picture of Horizon end user reaction. ”I work with the IT folks and the doctors, nurses, therapists, and revenue cycle folks that actually use the product. They take it personally. This is their product,” he explains. “It’s very hard for the users to get around the idea that McKesson is taking something away that they like and works for them and giving them something that for years and years has been pitched as not good enough for their needs. They feel like they had the rug pulled out from under them.”

In Lucey’s best estimation, between 50 and 60 Horizon customers are still evaluating their options and  “a couple hundred” are on Paragon, with half of those being migrations.

“It’s important to remember that frustration has a half-life,” he says. “People get frustrated, they get angry, they stomp their feet. They run around and they put out RFPs and they get their responses back. Then the reality of money sets in. I think that’s where we are now. How many phases are there to grief? You know, you have denial. They kind of get stuck on anger for a while. Then somewhere along the way there’s acceptance. I think that’s the phase this market has gotten to. Folks are recognizing that they need to make a rational decision with good information.”

The Positives of Paragon

It’s not all doom and gloom, as Lucey’s current Paragon customer estimates attest. He is quick to emphasize that Paragon works, though the definition of “works” is, as with all IT systems, at the discretion of the implementing organization.

“The underlying technology and the functionality of Paragon is effective. It can get the job done for hospitals and multi-facility organizations, but it has to be put in well. It’s an issue of accountability. You can find many instances of Paragon implementations where the product is working very, very effectively. The difference between where it’s effective and ineffective is ownership. If the hospital owns it, it works well. If they don’t, it usually stinks.”

Paragon’s Success Hinges on McKesson’s Commitment

Both Lucey and Tate believe that product development and overall quality will make or break Paragon. “They’re going to have to be able to get code out to increase the physician experience,” Tate explains. “The code quality of the releases has got to get better. There have been reports of things being buggy as releases have come out. Overall, it’s going to have to mature to more of a clinical solution, meaning that it’s easier and faster for physicians to use.”

Lucey agrees that McKesson needs to show its commitment to Paragon by improving code quality within a few months. He adds that the company will have to deal with employee challenges. “A lot of them are the same people that were previously doing that for Horizon. A lot of them are still upset. Can they change uniforms from Horizon to Paragon, pick up the mantle, and advocate for it? Make it better, support it well, and sell it effectively? I don’t think a lot of them can, quite frankly.”

Lucey’s insight into McKesson’s internal struggles is shored up by several HIStalk reader reports that McKesson has turned to offshore resources to tackle Paragon’s development and that the company has begun pitching its technology division to venture capitalist firms, reported privately to HIStalk by someone who claimed to have been present in one of the meetings. McKesson President Nimesh Shah was unavailable for comment due to the company’s pre-earnings quiet period through April 1.

McKesson’s commitment to Paragon will determine whether it will continue to meet user needs, remain competitive, and capture a significant share of the Horizon customer base that is being forced to seek an alternative from McKesson or its competitors.

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January 25, 2016 News 3 Comments

Monday Morning Update 1/25/16

January 24, 2016 News 14 Comments

Top News

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The hacker group Anonymous is presumed to be behind a cyberattack against Flint, MI-based Hurley Medical Center, with the group apparently following through on its threats from the previous day to take action against those involved in the city’s water crisis. The hospital says its IT team detected the attack and reports no impact on operations.

Meanwhile, Flint-based McLaren Regional Medical Center says the city’s contaminated water probably contributed to a January 2014 Legionnaires’ disease outbreak that occurred right after the city started drawing water from the Flint River. The hospital president says health agencies didn’t inform the public about the outbreak until just a few weeks ago, adding, “It’s a public health issue. There were people in the city of Flint seeing brown water. It would seem logical that there would have been public reporting or public awareness about the Legionella situation.”


Reader Comments

From Caveat Emptor: “Re: Epic hosting. We’re one of the first, scheduled to go live in a few months. The IT department tells us we may not be able to scan documents into Epic due to poor integration with our McKesson document management system. There is some very serious anger at Epic right now. They seem to have been caught flat-footed, which raises questions about what other third-party vendors Epic-hosted solutions can’t accommodate.” Unverified.

From Mark: “Re: CenTrak. Heard it was acquired this week.” I’ve seen no news about the RTLS vendor so far.

From InBetweener: “Re: CHIME. They will award $1 million to anyone that technically solves the national patient identifier problem (underwritten by a vendor contribution, of course). Here we have a classic political failure that needs to be solved by technology. Healthcare is full of these ‘insane’ situations and we wonder why systems overly complex, don’t work as planned, have errors, and cost a bundle? The simple albeit political solution is to allow a opt-in/out NPI, just like TSA does for trusted fliers. Works for TSA, no privacy uproar. Why not for CMS? Why isn’t HIMSS/CHIME spending a million to lobby for that solution?”


HIStalk Announcements and Requests

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A slight majority of poll respondents expect CMS’s changes to the Meaningful Use program to be positive. New poll to your right or here: is an ONC-produced EHR "star rating" a good idea?

Four firms donated $1,000 each to DonorsChoose to attend my HIMSS lunch with 10 or so CIOs. I won’t recite the individual projects I funded as a result since it’s a long list, but I’ll run photos and updates from the teachers when I get them (most of them emailed me their thanks over the snowy weekend). Nearly everything I funded was STEM related – iPad Minis, programmable robots, Chromebooks, math manipulatives, headphones, and science activity kits. Thanks to these companies for helping teachers and students in need.

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Consulting firm Optimum Healthcare IT made a second $1,000 donation following its first one last week.

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Serra Health Consulting donated $1,000.

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Electronic forms and workflow vendor FormFast provided $1,000, which funded six great projects.

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Nordic, which always steps up to support HIStalk, donated $1,000 to fund projects that include two I chose specifically from teachers in their home state of Wisconsin.

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Our budget-minded HIMSS Booth #5069 will by necessity be microscopic, remote, and amateurishly furnished. However, it always overflows with more enthusiastic, fun visitors than those block-spanning monolithic monuments to executive egos. Contact Lorre if you are an industry celebrity (loosely defined) and want to hang out for an hour with her saying hello to readers. I’m hoping she can get Martin Shkreli to sign up. 

We give out “secret crush” beauty queen sashes on stage each year at HIStalkapalooza for whoever submits the most convincing reason they deserve one. I’ve ordered ones indicating Mr. H, Jenn, Lorre, and Dr. Jayne if you want to send your entry to me. My main lesson learned from years of planning the event – other than that people vastly prefer an open bar to drink tickets — is that nearly everyone likes wearing a beauty queen sash.

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Mrs. Twigg from Missouri says the document camera we provided in funding her DonorsChoose grant request has changed her classroom’s dynamic since students can now see everything up close and are able to demonstrate their own work to the class. She says, “There are a few students who are soft-spoken and a little uncomfortable speaking in front of their peers. The document camera has been especially beneficial for these students because the focus is more towards their work, and less on them individually … I have noticed that the document camera has greatly enhanced their oral communication skills …It’s nearly impossible to imagine our classroom without the document camera because it has created endless opportunities for each student and their learning experience as a fourth grader. On behalf of every fourth grader who walks through room 205, thank you.” That’s a really impressive result from our donation of just $100 (I applied matching funds from the Ewing Marion Kauffman Foundation).

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Also checking in is Mrs. C, who says her Texas second graders love using the iPad Mini keyboards and styli we provided.

Here’s an old but funny video of a sketch from Britcom “That Mitchell and Web Look” called “Homeopathic A&E” that amused me when I ran across it this week.

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I’m fascinated by the war that’s heating up between ad-serving websites and their readers. Internet users started it by using ad-blocking software that threatens the sole revenue stream of most online publishers in squelching their increasingly intrusive expanding banner ads, pop-up banners, and obnoxious auto-play video commercials. Some of those sites in turn starting blocking access unless the ad-blockers are turned off. Google gets most of its revenue from displaying ads and thus is obviously not a fan of ad blockers (and in fact prevents Android users from installing them), but just announced that it suppresses some of the more annoying or misleading ads, apparently hoping to convince people they don’t need ad-blocking software that it can’t control. One ad-blocker vendor just accused a big competitor of accepting company bribes to let their ads through its filter, while Firefox creator Mozilla just released a new browser (Brave) that blocks publisher ads but instead inserts its own. I’ve noticed that quite a few sites won’t even load on my tablet due to the mess of advertising junk that’s trying to load in the background or pop up intrusively in ways that don’t work on tablets.

Here’s when hospitals will see the impact of this weekend’s blizzard: early November, in their L&D departments.


HIStalkapalooza

HIStalkapalooza Sponsor Profile – Forward Health Group

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Forward Health Group to unBooth at HIMSS16! A visual extravaganza is rolling into booth #2477. FHG, a leader in value-based population health management solutions, zigs when everyone else zags. The fast-growing company will feature prodigious, on-the-fly artistic talents, generating marvelously whimsical graphic population health management collaborations with HIMSS visitors. Producing giant eight-foot, hand-drawn murals each day, recording booth visitors’ visions of their value-based population health futures, FHG will also provide demonstrations of five new PopulationManager products, including innovative pre-packaged FastForward PopulationManager solutions for chronic care, acute episodes, behavioral health, bundled payments, and national standards reporting. Fresh oranges, too. A splendid time is guaranteed for all.


Last Week’s Most Interesting News

  • Titus Regional Medical Center (TX) remains without its EHR several days after its servers are hit with ransomware.
  • The Senate’s HELP committee releases draft legislation that it will consider on February 9 that includes streamlining government EHR requirements, charging ONC with publishing an EHR star rating system, increasing interoperability efforts, and creating an ONC-led committee to drive creation of a national health IT infrastructure that includes accurate patient identification.
  • An investigative report finds that Practice Fusion originally expected to go public next year with a valuation of $1.5 billion, but plans and expectations have changed with the decline in the stock market.
  • Leidos is rumored to be close to taking over Lockheed Martin’s IT and services businesses.
  • UnitedHealth Group announces that it lost $720 million selling insurance plans on the exchanges in the fiscal year and expects losses to continue, but reports stellar performance from its Optum services business.
  • OCR clarifies the provider requirements for giving patients copies of their medical information, suggesting that it will step up its enforcement efforts.

Webinars

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


Acquisitions, Funding, Business, and Stock

Cloud and managed services vendor TierPoint acquires Midwest competitor Cosentry, expanding its operations to 38 data centers.

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Pre-launch digital medicine vendor Akili raises $30.5 million to continue development of its video game-like cognitive disorder diagnosis and treatment apps.


People

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Hearst Health promotes Kevin Daly to president of its Zynx Health business.


Announcements and Implementations

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Athenahealth customer University of Toledo Medical Center (OH) will help the company develop inpatient capabilities based on its acquired RazorInsights and WebOMR systems, which will be retooled to create an AthenaNet cloud-based hospital system. I’m not certain which systems UTMC uses, but I think it’s McKesson for both ambulatory (HAC) and inpatient (the ancient McKesson Star).


Government and Politics

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I finally heard back from the Office for Civil Rights about the complaint I filed in July 2015 against a large, Epic-using, EMRAM Stage 7 academic medical center that refused to give me an electronic copy of my medical records (they told me, “We only do that for doctors.”) The letter acknowledges the hospital’s responsibility to give me what I requested, but concludes with, “We have determined to resolve this matter informally through the provision of technical assistance to the hospital,” thus closing my complaint. I still don’t have an electronic copy of my information seven months after requesting it and the hospital will apparently see no repercussions for refusing to provide it. OCR’s insistence last week that it will zealously protect patient rights to receive their own medical information seems to be bureaucratic chest-thumping rather than a commitment to actually meting out punishment for intentional non-compliance, at least from this N of one.


Privacy and Security

A patient of an Indianapolis hospital complains about receiving calls demanding that she make payments on her pacemaker, apparently originating from a con artist spoofing the hospital’s caller ID.

A Utah women is arrested for entering narcotics prescriptions for herself by logging as a doctor into an old computer at the Intermountain clinic where she previously worked as an administrative assistant. She wrote 260 prescriptions for 62,000 doses for which insurance paid $26,000. At an average of nearly 250 pills per prescription, you would think the pharmacy might have become suspicious.


Other

A Scripps Translational Science Institute study finds that smartphone-powered biosensor monitoring did not improve outcomes for patients with hypertension, diabetes, or arrhythmias. The study’s methodology was decent although it used data from 2012.

Nabil El Sanadi, MD, president and CEO of Broward Health (FL), commits suicide. 

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A 54-bed hospital in rural Georgia that hired a local car dealer as its turnaround CEO faces closure again after paying big money to the CEO and experts he brought in. The CEO was paid $480,000 per year on contract (quadruple the pay of his predecessor) with checks made out directly to his Ford dealership. He paid millions to bring in employees and contractors with connections to Duke University, where he had studied, including a reported $458,000 over five years for the CIO. Employees claim his hired gun experts were driven by data rather than patient needs. The hospital faces closure if the locals don’t approve a tax increase.

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An editorial in NEJM warns of “research parasites” who “use another group’s data for their own ends” and who might not understand the differences in multiple datasets that they combine. It recommends that researchers start with an original idea rather than a me-too concept and then find collaborators with whom to share data, work together to create new hypotheses, and jointly publish their findings. I can’t decide if this is sound thinking or egotistical data-hoarding by academics more interested in furthering their careers than making patient-contributed datasets available for the public good.

Weird News Andy says this doctor was uber-rude. A fourth-year neurology resident at Jackson Health System (FL) is suspended pending an investigation after a video of her attacking an Uber driver goes viral with several million views. The apparently intoxicated doctor hopped into an Uber car that someone else had called, refused to get out, beat the driver, and threw all of his belongings into the street while cursing at him. Police responded but filed no charges after she told them (while crying) that she would lose her medical license if arrested.


Sponsor Updates

  • T-System and VitalWare will exhibit at the HFMA Region 11 Healthcare Symposium January 24-29 in San Diego.
  • Wolters Kluwer Health publishes an e-book titled Integrated Clinical Decision Support: Accelerating Adoption of Evidence-Based Care for Optimal Outcomes.
  • Valence Health will exhibit at the HFMA Tri-State Institute January 27-29 in Memphis, TN.
  • ZeOmega will exhibit at the Strategic Analytics for Population Health event January 25-26 in Orlando.

Blog Posts


Contacts

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

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January 24, 2016 News 14 Comments

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