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Morning Headlines 5/22/15

May 21, 2015 News No Comments

Cures Act heads to House floor

The House Energy and Commerce Committee approved the 21st Century Cures Act with a unanimous 51-0 vote, sending the legislation to the House floor for a vote. The new law would require EHR vendors to meet yet to be defined interoperability standards by 2018 or risk being decertified.

“I will not stop until we have the right to see our own information” – Part 2 –2015

Regina Holiday and a group of fellow patient advocates held a “paint-in” protest in front of HHS to protest the decision to reduce the MU2 view/download/transmit requirement from from five percent of discharged patients to just a single patient, calling the deprioritization a “slap in the face to patient rights.”

Lahey Health exec sheds light on reasons for layoffs

Lahey Health (MA) announces that it has laid off 130 people, or one percent of its workforce due to both the unusually brutal winter in New England this year, and also the $160 million Epic implementation, which together resulted in a $21 million operating loss for the first six months of 2015.

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May 21, 2015 News No Comments

News 5/22/15

May 21, 2015 News 1 Comment

Top News

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CareFirst BlueCross BlueShield, which provides insurance to residents in Maryland and Washington DC, becomes the latest victim of a targeted cyberattack. Carried out in June 2014, the attack was discovered during a system-wide security audit. Hackers gained access to a total of 1.1 million patient records. While Social Security numbers, medical claims, and financial information were not compromised, hackers did gain access to member names, birth dates, email addresses, and subscriber identification numbers.


Reader Comments

From: Clinic Maven: “Re: Greenway’s Walgreens business is about to shut down.” Greenway’s relationship with Walgreens began in 2010 when it deployed its PrimeSUITE EHR at subsidiary Take Care Health Employer Solutions pharmacies and clinics. The company has worked with Walgreens over the last several years to finish up a pharmacy-wide roll out of the WellHealth EHR, built on the Greenway platform. Greenway Health CMO Robin Hackney responded to my request for verification: “As you know, Walgreens has announced a strategic and financial review of all of its operations, so even if we did have any insight into its plans we couldn’t share them. Speaking on behalf of Greenway Health, however, we remain extremely excited about the future of retail health as part of the nation’s health ecosystem and our opportunity to serve American healthcare consumers in new, innovative, and cost-effective ways.”

From: Bubble Guy: “Re: Welltok acquisition of Predilytics. It was just an "acquihire.” The investors in the last round did not make money. They just invested nine months ago. There was little cash and just stock in Welltok given. This is the dark side of analytics and digital health. Many companies won’t make it and if one doesn’t know that all acquisitions are not the same, then it may appear this acquisition was actually good news. I suppose it’s good if the alternative was winding down at Predilytics.


HIStalk Announcements and Requests

This week on HIStalk Connect: Stanford University researchers unveil a promising new gene therapy technique that can reprogram retinal cells to behave like rods and cones, potentially restoring vision to a subset of blind patients. MindBody files its SEC forms in preparation of a $100 million IPO. Stride Health, a private health insurance exchange startup, raises a $13 million Series A to expand its platform nationally.

This Week on HIStalk Practice: Aledade opens for ACO business in Florida. AMA President Robert Wah, MD discusses the need to move beyond the EHR as the ERP of healthcare. Modernizing Medicine partners with MLS on new specialty EHR. SpineZone founder looks to posture sensors for better outcomes. Updox secures $3.5 million in credit. Reno Sparks Tribal Health Center opts to consolidate multiple systems into one NextGen platform. New CareCloud CEO shares his vision. Brad Boyd offers strategies from The Consultant’s Corner to integrate patient access and physician compensation initiatives. Thanks for reading.


Webinars

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Announcements and Implementations

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Three Metro Care Connection school-based clinics in Cedar Rapids, IA, go live on Mercy Medical Center’s Epic EHR. Clinic staff are especially excited about the transition from paper to digital, given that the schools lost paper student medical records during a 2008 flood.

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The Autism Center at Hospital for Special Care (CT) becomes the first organization to receive the Patient Centered Specialty Practice recognition for Autism from the National Committee for Quality Assurance. The center attributes the recognition to its Allscripts Sunrise Ambulatory Care solution.

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Graham Hospital (IL), a Meditech shop, achieves Stage 6 of the HIMSS Analytics EMR Adoption Model.

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SSM St. Mary’s Hospital and Medical Group (MO), both part of SSM Health, will launch Epic across their facilities early next month.


Acquisitions, Funding, Business, and Stock

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Lahey Health (MA) plans to lay off 130 employees, with seniors executives taking a voluntary 10-percent pay cut for the rest of the year. Lahey Hospital & Medical Center CEO Joanne Conroy, MD cited the system’s $160 million EHR implementation as a contributing factor to the system’s financial difficulties. It signed an agreement with Epic in 2013, noting that it would create 100 new jobs to handle the roll out. 


Government and Politics

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The House Energy and Commerce Committee unanimously approves the 21st Century Cures bill in a 51-0 vote. Premier was quick to chime in with kudos for the bill’s supporters: “We … wish to thank Committee members Joe Pitts (R-PA), Frank Pallone (D-NJ), Gene Green (D- TX), Michael Burgess (R-TX) and Doris Matsui (D-CA) for their support of interoperability standards in the legislation, and for their efforts to ensure that the technology systems of the future will be built using open source codes that enable applications to seamlessly exchange data/information across disparate systems in healthcare.” Given the speed with which it has flown through committee, it will likely pass in the full House and land in the Senate sometime this fall.

ONC announces that it will sunset the Health IT Standards Committee’s permanent workgroups, replacing them with a series of time-limited task forces that will study and make recommendations on specific issues. The intent is to create a more agile HITSC and to increase public engagement by offering an opportunity to participate in smaller, less time-intensive projects.


Technology

Virtru launches the Virtru Pro HIPAA-compliant email service.

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Time profiles the launch of startup AnalyticsMD’s Web-based efficiency index, which offers consumers an easy way to look up and compare hospital strengths and weaknesses in the areas of ER, patient satisfaction, and cost. The California-based company hopes the index will also offer hospital administrators an easy way to benchmark and compare their efficiencies with peer facilities.


People

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Richard Gibson, MD (Providence Health & Services) joins PeraHealth as physician executive.

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Evangelical Community Hospital (PA) promotes Kendra Aucker to CEO.


Other

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Regina Holliday, members of The Walking Gallery, and a reporter or two gather outside of the HHS building in Washington, D.C. to paint and protest the agency’s step back from patient engagement in Meaningful Use criteria. (Check out Jenn’s interview with Regina for the full story behind her advocacy efforts.) KP MD and spectator/supporter Ted Eytan shares a few interesting details of the “brutalistic” building’s history in his blog about the event: “In other wackiness in the 1970s, by the way, plans for a gym in the building were scrapped as executives were told they ‘would be expected to get their exercise by running upstairs and chasing welfare fathers.’

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Winners of Canada-based William Osler Health System’s student app contest develop the Osler Outpatient app, which the health system will roll out next week. The Android-based app aims to help patients at Brampton Civic Hospital and Etobicoke General Hospital better manage their care after discharge.


Sponsor Updates

  • The Atlanta Journal-Constitution talks with Greenway Health’s Paula Kepes, vice president of talent, about the company’s hiring plans at its locations in Atlanta and Carrollton.
  • PerfectServe hosts its annual Customer Advisory Panel gathering today at the Grand Hyatt Hotel in Dallas.
  • Extension Healthcare offers a new blog entitled, “The Skeptical Biomedical Manager – Is Alarm Middleware Necessary?”
  • Galen Healthcare Solutions posts a new blog entitled, “The Viral Workflow: The Bug That Spreads Within Your Organization’s EHR.”
  • Greythorn previews its participation at the upcoming eHealth 2015 conference in a new blog.
  • Hayes Management Consulting offers a new blog entitled, “Budgeting for EHR Go-Live: Everything You Wanted to Know but Were Afraid to Ask.”
  • HCS team members compete in the New Jersey Family Mud Run in support of client Specialty Hospital of Central New Jersey.
  • The HCI Group offers a new white paper entitled, “Protecting ePHI: 5 Tenets of an Effective Cyber Defense System.”
  • Utah Business magazine names Health Catalyst Executive Vice President and Chief Clinical Officer Holly Rimmasch one of Utah’s top woman executives..
  • Healthfinch offers a new blog entitled, “Supercharge Your Delegation Model.”
  • Impact Advisors COO Todd Hollowell is named to Consulting Magazine’s “Top 25 Consultants” List.
  • Intelligent Medical Objects and Iatric Systems will exhibit at the 2015 International MUSE Conference May 26-29 in Nashville, TN.
  • NTT Data will sponsor Tony Kanaan’s Chevrolet IndyCar in this Sunday’s Indianapolis 500.
  • Peer60 releases a new report on 2015 imaging IT purchases in Europe.
  • PDR CEO Mark Heinold is named one of the 60 most influential people in the healthcare industry by PM360 magazine.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 21, 2015 News 1 Comment

EPtalk by Dr. Jayne 5/21/15

May 21, 2015 News 4 Comments

I received a large number of comments and emails in response to my post about Windows 8. Except for one, all were supportive or empathetic with several offering specific suggestions to improve my user experience. The one that I found most thought-provoking, however, was the response blaming the user:

From Cynical: “This post is indicative of the larger problem in the Health IT space. Users are reluctant to embrace change – why not try peeking your head out from underneath a rock once or twice a decade and change won’t be so hard. I won’t say that Windows 8.1 isn’t without flaws, but the majority of the whining in this post is likely attributable to user error or someone who’s 50+ who is terrified of technology. In an age where I can SMS my coffee maker in the morning to start brewing, start my car from my smart phone and adjust the climate control in my home from half a world away we’re at a point where the internet of things is here, and here to stay. “You can’t do anything without being online” isn’t a new concept and it’s not a bad concept either, but maybe that’s the view in healthcare where there are still attitudes that connectedness and sharing information may blow someone’s competitive advantage. Posts like these remind me why it seems like a losing battle to try and advance tech in the healthcare space. Users who have no desire or aptitude to learn and embrace new tools, a generation of technology leaders who think innovation is implementing Epic. A leading HIT blog like HIStalk should be embarrassed to post this.”

Reading through this, I wondered if my former CIO was stalking me. It was actually pretty funny to read, having been on the bleeding edge of healthcare IT during my time as a CMIO and doing extensive change management work to help a large health system do EHR well before everyone else was doing it (and successfully so). Let’s talk about some of the themes:

Users are reluctant to embrace change. Yes, they are. Most health IT users are concerned about the patient in front of them and the care they need to deliver. If they’re not, then they should be. When technology interrupts that, serious patient harm can result. The point of the piece was illustrating the challenges faced by someone who is reasonably tech savvy (and decidedly younger than 50) but still can’t “get it” and runs into problems executing what should be simple workflows. Having studied change management and usability for a long time, one can attribute user resistance to several things including fear, inadequate training, poor system design, and more.

Over the last several years, I’ve become more aware of the role of learning styles in regards to stalled change processes. Although we hope that systems are intuitive, sometimes they’re just not. Sometimes vendors fail to hire actual healthcare usability experts. Sometimes they hire no usability experts. Sometimes users do not have the capability to learn on their own or intuit how something is supposed to work. Learners process information in many different ways and for us as IT professionals, we need to recognize that and offer solutions that meet their needs. As more people enter the workforce with documented learning disabilities and that may require accommodation under the Americans with Disabilities Act, we’re going to need to adapt. These weren’t diagnosed as often 20 years ago and they’re changing the demographic of the workforce. We also have traditional learners with their own needs, as well as an aging workforce with specific physical requirements (increased contrast, larger fonts, etc.).

I’ve seen the assumption that everyone is keeping up with the relentless push of technology turn into a fatal flaw for multiple implementations. If valuable (but non-tech savvy) staff are to be retained, it might require sending an intern to teach them solitaire so they can develop mouse skills. It might require longer periods of elbow support. It might require a user psychology intervention. We can’t just throw away workers because they can’t pick up the latest and greatest on their own. And we need to understand that people learn differently. Webinars are highly distracting for some, who may do much better in a classroom setting. Some people need 1:1 training. Others need multiple solutions and methodologies to be successful.

Users choose not to keep with the times. Cynical’s premise is that failure to embrace new technology is a result of intentional isolation or resistance. In my situation, I’ve spent the last decade leading a major organization with a specific technology portfolio. While working a full-time CMIO job and a part-time clinical job (as well as writing for HIStalk), I didn’t have the free time to explore new pieces of technology that came out unless they directly impacted my livelihood in one way or another. Although my work situation is unique in that I choose to work multiple jobs, it’s representative of most of my workforce. The majority of our clinical end users are running on the treadmill of life faster than they ever have. In addition to increased work demands, they’re trying to be parents, children of adults that need care, spouses, little league coaches, and volunteers. Some are indeed working multiple jobs due to the part-time-ization of work. Sometimes things have to be prioritized and I can completely understand how someone winds up “under a rock” because they’re just trying to get by every day. Whether my post is agreed with or not, blaming users isn’t a strong position and it’s up to us as IT people to help them through when they’ve gotten behind.

You can’t do anything without being online. Although the Internet of Things is here to stay, it’s not everywhere. Right now, I’m working a locum tenens assignment in a community that does not have universal access to broadband. Yes, you heard me right. No high speed Internet. In 2015. The hospital is connected and a couple of businesses offer free wi-fi, but the community is rural and people can’t afford satellite service or it’s not a priority for them. Non-smart phones abound. I find it hard to criticize hard working people because they don’t message their appliances or tweak their thermostat from afar. There are people out there who use healthcare technology all day, every day, who may never leave the state where they were born. I agree the world is increasingly global, but that’s the reality here.

There’s also the reality of downtime. I’d like to be able to use my computer when I’m on a plane without wi-fi, or somewhere with a poor signal, or when the sewer company cuts Verizon’s line while doing a repair. Although being online is great (as I celebrated with my online shopping), sometimes it’s not available. We’re also in a destabilized world where we don’t just have to worry about natural disasters or weather events. Civil unrest is a real consideration and many organizations can’t afford the redundancy solutions needed for business continuity. That doesn’t make it right, but it’s a reality.

The view in healthcare is that connectedness and sharing information may blow someone’s competitive advantage. I agree this attitude is out there but there are equal numbers of us fighting to open the doors. I stood up the first HIE in my state (although it was a private one – we were tired of waiting for the state to catch up with us) and worked to lobby for legislation protecting physicians from liability around data sharing when it was done for the right reasons. Given the recent breach culture however, more patients are becoming concerned about privacy and security and want to minimize online exposure and sharing. They want to control who receives their data and when. I support that is a key tenet of patient autonomy, but it certainly makes my job as a physician harder when I don’t have all the pieces of the puzzle.

Additionally, our friends in government have solidified some of the problems around competitive advantage. A mere five to seven years ago, I had the autonomy to refer to whoever I wanted to and to whoever I thought would give the best care to the patient in front of me based on their unique situation. Now, thanks to narrow networks and ACOs, I’m forced to refer to a subset of providers who are cost-effective rather than to those that are the best for my patients. As a physician, I know that’s not necessarily the right thing to do for patients but most patients can’t afford to go out of network. The healthcare free-market economy is over and done with, at least until we get payers and government out of the business of dictating clinical care. I could write a month’s worth of blogs on those topics but I have to start rounding on real live patients in a few minutes.

Users don’t have the aptitude to learn and embrace new tools. My thinking as a CMIO is that if my users (who are often smart, college-degreed or highly experienced workers) can’t learn a new tool that maybe there is something wrong with the tool rather than with the user. Assuming that a tool is one size fits all is another fatal mistake. Tools are not always scalable and don’t always fit the user culture and workplace. Following the crowd and selecting a system because everyone else seems to be doing it may not be the right decision for your customers, and I agree with Cynical that the sometimes unthinking adoption of Epic is a problem.

Tools can also be frankly broken (like the sticky “I” key on my keyboard). I’m sure I would have had an entirely different experience getting used to Windows 8 if the keyboard worked. But instead, that particular hardware failure marred the entire experience. Imagine if you were an end user who didn’t understand the statistics (that if you buy 2,000 PCs for your staff, there’s odds that a certain percentage will malfunction) and that faulty one was your PC and you had no recourse. And there we get to the entire point of the post:

Everyone experiences technology changes differently. We all come from different experiences and different places of knowledge. Some of us are just trying to get through the day and others are more contemplative about the big picture. In my case, I researched for months and selected the device I thought would most meet my needs. Money was not a constraint. I’m an experienced IT person who has personally trained hundreds of end users and supervised the training of thousands more. I’m an early adopter for the most part and I understand the psychology about adoption. I understand the risks and benefits of the change and the limitations of my old technology and the benefits of the new. I was ready to make a change, excited about the change, and had a plan to embrace it slowly and in a non-threatening way, yet it still slapped me in the face. I literally had to put the technology aside because I physically could not do my job with it.

The story is indicative of what our end users face every day and I wasn’t embarrassed to share it. I’ve learned in the CMIO trenches that empathy and humility go a long way towards making things better.

Email Dr. Jayne.

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May 21, 2015 News 4 Comments

News 5/20/15

May 19, 2015 News 15 Comments

Top News

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Allscripts layoffs, which HIStalk readers have been reporting for the last several weeks, finally happen, with 250 indeed being the magic number. Several readers chimed in with their opinions just as the company made the cuts. Allscripts Peon pointed out that Allscripts “continues to lie to employees and cut staffing levels. Last month, 250-300 employees were cut so leadership could ‘right size’ the company. At that time, senior leaders told remaining employees that further cuts were not anticipated or being contemplated. Last Friday (5/15), another 250 or more employees got the axe as executives again said they were ‘right sizing’ the company. Apparently Paul Black and his team have no clue what the right size is for Allscripts.” Broadway Joe added that layoffs affected DBMotion, too. In terms of “right sizing,” the layoffs represent 3.5 percent of the company’s global workforce. Spokeswoman Concetta DiFranco explained that, “As a normal course of business, we are rebalancing our teams to ensure we have the right resources allocated to the right projects." I’m wondering how “right” those 250 folks feel right about now.


Webinars

Here’s the video from Tuesday’s webinar with Imprivata, which featured tips on how to prevent phishing attacks at healthcare facilities, as well as lessons learned from Yale New Have Health System.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Acquisitions, Funding, Business, and Stock

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Welltok acquires predictive analytics company Predilytics for an undisclosed sum. The timing is interesting, given that Predilytics secured a $10 million Series C round last December. Welltok will likely incorporate the new company’s tools into its CaféWell health optimization platform.


Announcements and Implementations

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ADP AdvancedMD launches patient and administrative kiosk apps, plus corresponding electronic check-in and consent forms.

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Surescripts announces the processing of 6.5 billion health data transactions last year, surpassing transaction heavyweights American Express and PayPal.

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The Hilo Medical Center’s Hawaii Pacific Oncology Center implements Meditech Oncology 6.0x, making it the ninth and final clinic in the HMC network to migrate from paper to the EHR. The five-year, system-wide project also included implementation of secure patient bill pay through the East Hawaii Regional Patient Portal.

Arkansas Heart Hospital and Arkansas Urology implement Pingmd’s secure text messaging solution across 35 facilities. The app has been in use at each organization’s main facility in Little Rock for over a year.

Stoltenberg Consulting partners with Qlik to offer the visual analytics vendor’s data solutions to its clients.

HealthCare Synergy becomes the first home health EHR vendor to partner with Great Lakes Health Connect, a Michigan-based HIE that connects over 80 percent of hospital beds and 10,000 providers throughout the state.


Government and Politics

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An OIG report finds the Coast Guard sorely lacking when it comes to protecting personnel medical records, citing a lack of instruction and process to periodically review health data security measures. The report also found no evidence of meetings between the Coast Guard’s privacy and HIPAA officers, and noted a lack of leadership as the main barrier to be overcome. The copious amounts of paper files pictured in the report (along with one black-and-white photo of a flooded records room) are also cause for concern.


Privacy and Security

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The IEEE Cybersecurity Initiative releases “Building Code for Medical Device Software Security,” a 23-page set of guidelines that aims to help companies “establish a secure baseline for software development and production practices of medical devices.”


Innovation and Research

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New York-Presbyterian Hospital launches InnovateNYP, a 10-week technology competition in which contestants will develop working prototypes that improve patient engagement or provider collaboration. Entries are due July 24, with a top prize of $15,000.

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A study of over 300,000 free-text machine-readable documents in the Stanford Health Care EHR finds that text-mining tools can be used to detect unplanned care episodes documented in clinician notes or in coded encounter data. Researchers believe their methods could be used for quality improvement efforts in which “events of interest occur outside of a network that allows for patient data sharing.”

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MD Anderson Cancer Center at Cooper (NJ) and behavioral health technology company Polaris Health Directions will launch a breast cancer behavioral health pilot project incorporating the Apple Watch. Wearable data on treatment side effects, sleep patterns, activity levels, and mood will be combined with patient EHR and population health data from within the Cooper health system to provide researchers with greater insight into engagement, feedback, and intervention.


Technology

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Flatiron Health will incorporate National Comprehensive Cancer Network Chemotherapy Order Templates into its OncoEMR, beginning with breast, colon, and non-small cell lung cancers. The EHR will also link to NCCN’s website to provide oncologists with additional resources.

Fruit Street Health taps Validic to integrate wearable devices and applications into its telehealth software, PHR, and video-conferencing platform.

Proxsys partners with mobile technology developer Catavolt to create a bedside discharge delivery app for tablets. The new app will be deployed throughout the Proxsys Rx Integrated Outpatient Pharmacy Provider network.


People

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Jonathan Scholl (Texas Health Resources) joins Leidos as health and engineering sector president.

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Hai Tran (BioScrip) joins Specialists on Call as CFO.

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Recondo Technology appoints Eldon Richards (PatientPoint) CTO and Perry Sweet (Allscripts) as chief client officer.

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Mark Reed, MD (Seattle Children’s Hospital) joins JWA Consulting, a part of Truven Health Analytics, as medical director.


Other

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This article highlights the decade-long collaboration between physicians at the Uganda Cancer Institute and Fred Hutchinson Cancer Research Center (Seattle). The two organizations are preparing to open a new research, training, and outpatient facility in Uganda. It will be the first comprehensive cancer center jointly built by U.S. and African cancer institutions in sub-Saharan Africa.

HIMSS issues a call for members of its new Health Business Solutions Technology Task Force. The group will facilitate discussion between health IT vendors and end-users, review legislative and administrative initiatives, and educate policymakers on aligning regulatory requirements with business needs.


Sponsor Updates

  • ADP AdvancedMD explains “What the Meaningful Use deadline means for your practice” in a new blog.
  • The San Antonio Express-News covers AirStrip’s expansion into home health.
  • AirWatch recaps its first annual employee hackathon in a new blog.
  • AtHoc recaps its annual user conference in its latest blog.
  • Besler Consulting explains “The Role of Discharge Disposition in Preventing Hospital Readmissions” in a new blog.
  • Bottomline Technologies and Cornerstone Advisors Group will exhibit at the MUSE conference May 26-29 in Nashville, TN.
  • CapsuleTech offers a new blog entitled, “Are you aware that your patient’s ventilator has just disconnected?”
  • Caradigm outlines “How Population Health Enriches the Patient Record” in a new blog.
  • CareTech Solutions offers a new video explaining the benefits of cloud services in today’s healthcare environment.
  • Clinical Architecture recaps its HIMSS15 fundraising efforts for the Music Empowers Foundation, Illinois Tornado Relief Effort, and St. Joseph the Worker School
  • CommVault adds several new cloud solutions to its line of enterprise products.
  • Connance’s Patient-Pay optimization solution receives HFMA Peer Review designation.
  • CoverMyMeds Vice President of Customer Relations Michelle Brown discusses how to scale up a company’s culture during a Startup Week event in Columbus, OH.
  • Culbert Healthcare Solutions offers a new blog on “Improving Population Health using Epic’s Healthy Planet.”
  • Divurgent offers a new white paper entitled, “Population Health: Laying the Foundation of Healthcare’s Next Generation of Care.”
  • Medecision offers a new blog entitled, “From Patients to People: Leveraging Analytics to Improve Population Health.”
  • Burwood Group posts a new blog entitled, “ED Caregivers, Tech – Let’s Get Together.”
  • Practice Unite offers a new blog entitled, “[Checklist] Evaluating Mobile Patient Engagement Apps.”
  • SyTrue offers a new visual blog focusing on industry response to its Radiology NLP offering. 
  • Microsoft blogs about its experience demonstrating nVoq’s SayIt speech-recognition solution on Surface Pro 3 tablets at HIMSS.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 19, 2015 News 15 Comments

Curbside Consult with Dr. Jayne 5/18/15

May 18, 2015 News 15 Comments

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Dr. Jayne Adapts to New IT (and Lives to Tell the Tale)

Sometimes it’s important for those of us in healthcare IT to eat our own proverbial dog food. This week was one of those times, when I decided to buy a new laptop before heading out on a locum tenens gig. Although I did plenty of research and thought about it for several months before I took the plunge, I had some unexpected surprises. Much like EHRs, it had plenty of “undocumented functionality” to keep me guessing.

At my previous employer, we had three choices for end-user devices: standardized desktop PC, standardized laptop, or standardized convertible tablet PC. Regardless of which you selected, the desktop images were pretty much the same. I’ve always opted for the latter because it worked well for me in clinical settings. I liked to use it basically as a touch-screen laptop, so I could free text easily while navigating through EHR screens. Our hardware refresh cycle was typically 4+ years, so it had been a while since I had anything new. Additionally, we were still using Windows 7 and I had not yet had the adventure that is Windows 8.

While shopping for my new hardware, I worried that I had become out of touch with consumer electronics because I had been insulated in the IT silo of Big Health System. That became a reality when it finally arrived on Friday afternoon. I have to say, Dell does a snazzy job with their packaging. The new laptop came in a glossy box with full-color photographic images on it. I was worried that my new device was heavier than anticipated, but discovered that a good chunk of the weight was the decorator-quality box. The real shock, though, came when I tried to start setting it up.

First, I guess you can’t do anything anymore without being online. Despite having purchased full versions of several applications along with the PC, it wanted me to go online to download updates before I could do anything. I had heard a lot about the Windows 8 interface so I was prepared to not have my familiar landmarks. I was not prepared, though for how clicky it is just to navigate to items that previously lived in the start menu. Rumor has it that Microsoft is bringing back the start menu with Windows 10, and I daresay I’ll probably be looking forward to it.

I spent a good hour downloading non-Internet Explorer browsers and configuring links and bookmarks just the way I like them, not to mention the general appearance and settings items. The new keyboard has a totally different feel than what I am used to and I knew there would be a learning curve, so I decided to start slowly with some online shopping. Running skirts on sale, y’all. Get ‘em while they’re hot! I placed my order and felt I was doing well getting used to the new touchpad when I had a big surprise – apparently this model is now touch screen! When I originally researched it a few months ago, they offered it in two versions – with and without. Now, apparently, they only offer it with the touch screen and I didn’t notice when I bought it since it was the same price as what I had researched before.

Although cool, it made me wonder whether the privacy filter I purchased would work with it. Especially now that I travel a fair amount, I don’t need people reading my work on the plane. I wanted to get things organized before I had to leave town, so I left that as a project for another day. I started moving files over from my old machine. I was feeling pretty good on the new keyboard and only typing gibberish now and then, so decided to do some real work. I’ve been working on a textbook chapter for a couple of months and emailing back and forth with a collaborator. We’ve had some bad experiences with Google Docs (which everyone and their cousin seems to use for collaboration), so we do our revisions old-school, emailing them back and forth after each update. I couldn’t open the most recent document from my partner and the laptop threw some ridiculous out of memory error at me despite the fact that Chrome was the only thing running.

I ended up having to download the document on another laptop and move it via USB, so I was already aggravated and distracted. Then, while I was trying to write, I kept getting emails from Gmail alerting me that my various accounts had been signed into from new IP addresses and new browsers. I plowed through some edits then got ready to save. Unfortunately, it stuck my draft not in the good old Documents folder as I had specified, but in some AppData/Roaming folder, which apparently is a hidden folder in file explorer. Not cool.

The last straw was when I got the email from Dropbox announcing that it had somehow (and seemingly without my permission) mated with Microsoft Office Online. Seriously? By this point I was ready to go online to my local school district and start looking for community education courses to help me navigate this mess. I’m really a pretty basic user at home – word processing, email, Internet, accounting software, spreadsheets, Twitter, and the occasional Facebook. I don’t do any multimedia or gaming and don’t like storing data in the cloud unless I really have to, hence the Dropbox account. (Yes, I’m a bit of a curmudgeon that way.)

But here I was with my applications melding in a way I didn’t understand or know how to control without doing a bunch of research or calling the teenager across the street. I decided to give up on the textbook and start writing Curbside Consult. Mind you, I’ve had this computer less than 72 hours and have barely used it. I was looking forward to some straightforward word processing and what happens next? The “I” key decides to stick. The screen instantly fills with the letter I and I’m prying it up with my fingernails to get it to stop. I tried for a good 15 minutes to get it to work right and no luck. Apparently the key has three modes: stick and type a thousand letters, stick and type nothing, or depress and type nothing.

By this point I was ready to throw in the towel and returned to my lowly HP with 2 GB of RAM that I bought in 2009. It’s slow and cantankerous, but has all its vowels and consonants in fine order. As for the new one, it’ll have to wait until I get back in town and am ready to deal with it. If nothing else though, I have a new appreciation for what physicians feel like when we throw new hardware or a new operating system at them without adequate orientation and training.

What’s your take on Windows 8? Email me.

Email Dr. Jayne

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May 18, 2015 News 15 Comments

Monday Morning Update 5/18/15

May 17, 2015 News 5 Comments

Top News

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The AMA writes a letter to Rep. Ted Poe to support his bill that would delay ICD-10. The AMA says ICD-10 should be skipped in favor of ICD-11, the first draft of which isn’t due until 2017, explaining that EHR implementation work and introduction of new payment models make 2015 a bad time (hint: it’s never a good time). Failing getting ICD-10 overturned, incoming President Steven Stack says providers should be “held harmless,” presumably meaning getting paid by Medicare no matter what they’ve done in failing to prepare themselves despite years of advance notice. Doctors are vendors and I can’t imagine any other vendor angrily telling its customer how it demands to be paid. That’s like telling your employer it’s their problem to pay you correctly even if you refuse to turn in your timesheet or fill it out incorrectly. Or, me calling up the IRS and making snooty demands about my refund check. On the other hand, CMS and both state and federal governments have proven themselves to be predictably inept at health IT and claims payment rollouts, so I’d be worried too. I’m surprised an insurance company hasn’t offered ICD-10 interruption insurance to practices, although that might indicate that the risk is too high for underwriting.


Reader Comments

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From Faraway: “Re: Allscripts layoffs. Two since the first of the year. On May 15, they started tapping people on the shoulder, with 40 well-seasoned support analysts terminated from the US help desk. The heck with quality service to the thousands of customers who pay software maintenance every month – they will have to fend for themselves and deal with the language barriers that come with offshore support. Many employees feel other departments will be hit Monday morning.” Several folks have emailed about Allscripts layoffs last week, with the number most often mentioned being 250 people. Regular Reader says it was mostly Touchworks people but also some working on Sunrise. The writing was on the wall given last week’s executive comments during the quarterly earnings call, in which professional services revenue was announced as down and not expected to fully recover anytime soon, the company sold only two new Sunrise accounts and those were 50-bed hospitals, and stock analysts were told that the $6 million in Q1 severance payments won’t end there. You made a big mistake if you bought MDRX shares five years ago – they’ve dropped 27 percent while the Nasdaq was jumping 127 percent. A $10,000 investment in MDRX shares in May 2010 would be worth $7,342 today while the same money spent on Cerner shares would have yielded $32,173.

From Make: “Re: Weird News Andy’s snippets. Am I the only one who wonders whether Andy has a real job or how he finds time to track down these crazy nuggets? Keep ‘em coming, Andy — the news links and your color commentary always make my day!!” WNA’s stories and pithy commentary are a highlight for me, too. He’s been sending them in for years without recognition or reward of any kind. Every year I suggest that he take a bow at HIStalkapalooza and he always declines.


HIStalk Announcements and Requests

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Quite a few provider readers work for employers who don’t impress them too much with their service delivery, with half of poll respondents giving them an A or B and the rest going with lower grades. At least there weren’t too many F scores given. New poll to your right or here: which company’s shares would you buy?

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We had all better be interested in population health management, so that being the case, check out Jenn’s weekly wrap-up that runs every Friday. You’ll be up to speed in just a handful of minutes each week.

April 2015 appears to have been the busiest HIStalk month ever because of the HIMSS conference, with 220,000 page views from around 30,000 unique readers in 42,000 unique visits. I don’t check numbers often, but I’m always happy to see that I’m not just talking to myself like I was in those first HIStalk days of June 2003.

Here’s DrFirst’s video of HIStalkapalooza. They got a lot of good crowd shots, so you might see yourself if you were there.

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Our DonorsChoose project bought a Surface Pro for math practice by deaf middle schoolers in Washington. Mrs. Burns sent over a photo, adding that our contribution as an “anonymous donor” gave the students new vocabulary words to review as they  “get to imagine our mysterious benefactor.” Every time I get photos like these I remember my early education in a very poor school and wonder which of these kids will, 30 years from now, still remember the excitement of opening that box or using a new tool that got them engaged in a subject that lit the path to their adult lives. I guarantee it will happen.


Last Week’s Most Interesting News

  • Publicly traded medical group Mednax acquires radiology services vendor Virtual Radiologic for $500 million.
  • McKesson’s Technology Services business reports lower hospital sales, declining revenue, and the upcoming divestiture of an unspecified product line.
  • Cerner says in its earnings call that its acquired Siemens Health Services business had minimal sales and lower revenue than expected for the quarter, adding that Cerner has set aside $35 million for Q2 voluntary separations that involve 2 percent of its workforce.
  • Allscripts attributed its lackluster quarterly performance to lower professional services revenue, a trend it expects to continue, and says it expects to make additional severance payments in Q2.

Webinars

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Acquisitions, Funding, Business, and Stock

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Paragon Development Systems (PDS) will consolidate two offices into a newly named headquarters location in Brookfield, WI. Its offices in Madison, WI; Minneapolis, MN; and Wichita, KS won’t be affected.

Optum, which in 2013 rescued Healthcare.gov from the mess CMS created with the help of contractor CGI, won’t bid to continue the $40 million per year contract. The company says its job is done and that the experience it gained will “leverage our ability to develop and operate large transactional systems that advance healthcare.”

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Shareable Ink raises $3 million and plans to bring in another $1 million in funding.

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Private equity investor Thoma Bravo will sell Mediware Information Systems, according to a financial report that says the company has engaged William Blair to seek a buyer. The author tossed out a rough price of $400 million. Thoma Bravo’s other healthcare IT-related holdings are Hyland Software and SRSsoft.


Government and Politics

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Hillary Clinton’s financial disclosure forms filed Friday show that she was paid $225,500 to deliver her HIMSS14 speech. Quite a few healthcare and drug companies retained her pricey oratorical services as well, with the Clintons banking $30 million in just over a year in total income from speeches and books.

Connecticut legislators express interest in developing a state HIE that would replace the work of HITE-CT, which burned through $4.3 million in federal money before it was put out of its misery in 2014 having accomplished basically nothing.

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Hawaii state officials say speculation that its  $205 million health insurance exchange will shut down in the next few months is premature, although they admit having to make “hard choices” since the site is losing money, CMS audit problems the found IT and sustainability problems have restricted its federal grant money and state lawmakers gave it only $2 million of the $10 million it requested. Like other states that stubbornly built their own insurance exchanges that have since failed, Hawaii is considering shutting down Hawaii Health Connector and instead piggybacking on Healthcare.gov.


Technology

It’s a shameless marketing gimmick that is delivering the obligatory YouTube viral response in pitching a questionably cost-effective healthcare product, but this video of a da Vinci surgical robot suturing the skin back onto a grape while chipper music plays in the background is pretty cute.


Other

Doctors in India question why medical school education doesn’t cover telemedicine even as the country sets up telemedicine centers for rural medicine. A medical school physician says it’s tough to remove the inertia and create telemedicine champions when students haven’t been exposed to it, while a private physician says, “We have an ethnographer who observes doctors and the way they deal with patients in terms of technologies and otherwise. Sometimes, even after training for two weeks, it is so hard to sensitize doctors and make them get used to technologies.”

Newly released tax documents reveal that UPMC paid CEO Jeffrey Romoff $6.4 million in 2013, one of 31 UPMC executives who made more than $1 million. CIO Dan Drawnbaugh, who left in September 2014, made $1.6 million.

I bet Weird News Andy would make a pun about “piece of mind.” A patient sues Norton Cancer Institute (KY), claiming that a surgeon extracted tissue from his brain for an experimental cancer treatment but then lost it.


Sponsor Updates

  • Verisk Health takes a cue from HIStalkapalooza and holds a pie-in-the-face event, giving employees the chance to throw pies at their managers.
  • Huron Consulting partners with 60 charitable and nonprofit organizations during its fourth Annual Day of Service.
  • Patientco offers “Thoughts on PwC’s Patient Payments Report.”
  • TeleTracking client Royal Wolverhampton Hospitals NHS Trust reports that monitoring of hand hygiene increased by 1,000 percent in a single month.
  • Qpid Health offers “Clinical Registries Still the ‘Wild West.’”
  • Oneview Healthcare outlines the “Eight Principles of Patient-Centered Care.”
  • The SSI Group will exhibit at the HFMA Region 1 Annual Conference May 20-21 in Uncasville, CT.
  • NVoq offers a new blog focusing on industry response to its new SayIt Code Fast service.
  • MedData offers “Our People Make the Difference.”
  • ZeOmega posts the final installment of “The Five Pillars of Population Health Management.”
  • Imprivata wins a strategy and delivery award for its customer experience accomplishments.
  • Netsmart will exhibit at the Ohio Public Health Combined Conference May 19 in Columbus.
  • Nordic offers a new edition of its HIT Breakdown podcast, focusing on new revenue opportunities via the CCM CPT code.
  • Orion Health explains why nurses are a healthy population’s biggest ally.
  • PatientSafe Solutions offers insight into “Easing Cognitive Workload for Clinicians.”
  • PMD outlines “The Cloud Confusion.”
  • Sandlot Solutions outlines its support for the Institute of Medicine’s proposed streamlined set of standardized measures and recommendations for their application.
  • Clinical support expert Deon Melton, RN shares how he got into healthcare in the latest T-System blog.
  • Valence Health introduces the results of its pediatric care reimbursement model survey.
  • Voalte offers “Nurses Taking Care of Nurses.”
  • ZirMed offers “Patient Portal A/B Testing.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 17, 2015 News 5 Comments

News 5/15/15

May 14, 2015 News 2 Comments

Top News

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Mednax, a publicly traded provider of specialty physician services including maternal and anesthesia, will acquire outsourced radiology service vendor Virtual Radiologic (vRad) for $500 million. Mednax CEO Roger Medel, MD says teleradiology is “an economic and clinical necessity for customers” and that it can cross-sell to its customers and improve care using vRad’s IT and analytics technology. Mednax shares, which have increased in price by around 20 percent in the past year, value the company at $6.7 billion, with the aforementioned CEO holding $82 million worth.  


HIStalk Announcements and Requests

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Ms. Mundy sent over photos of her South Carolina K-5 class of profoundly mentally disabled students, for which our DonorsChoose project bought hand sanitizer and tissues that they use throughout the day. Also, Ms. Ensor reports that her Maryland third graders were so excited to hear that they would be receiving math manipulatives that they wanted to write thank you cards right away, and three days later when the box arrived, she immediately used the fraction pieces with students who needed some extra help with equivalent fractions.

Listening: new from Melanie Fiona, smooth and sultry rhythm and blues from the Canada-born 31-year-old Grammy nominee who somehow still flies a bit under the radar.

I had my annual physical yesterday and noticed that in the year since my last visit, the glassed-in check-in area at the family practice office now has a huge, echoey expanse of rust-squared carpet and nothing else. I asked the rep why she was sitting in what looked like an empty hotel ballroom and she said implementing Epic had allowed them to remove the sea of file cabinets that formerly took up most of the space. I commented that it sounded like a good thing, which earned me an eye-roll and laughing comment something to the effect of, “Well, I guess if you look at it that way.” My PCP used Epic brilliantly – he walked me through what’s on the as we sat side by side, Epic recommended a couple of new items to discuss, and it caught a near-miss in suggesting he reconsider giving me a vaccine he was touting because of a conflict with another med. It also allowed him to look at trends in my vitals and labs in assuring me that I’m just fine, which is comforting knowing he had the full, historical picture in front of him and not just the one-visit snapshot. My blood pressure prescription refill was shot off electronically, he handed over a printed visit summary, and I was set. He’s a very good doctor, and using the EHR optimally left me with the feeling that I actively participated in my care and that we jointly validated the electronic information used to do it. The thing is, he did pretty much the same thing when the practice was using an undeniably crappy EHR, leading me to repeat my mantra that an EHR amplifies a provider’s skill and empathy regardless of whether it’s good or bad. It’s like giving a singer a robust PA system – it’s easier to tell whether they’re good or not.

I keep getting a Twitter ad from some hipster company that refers to social media (which in itself is a pretty annoying term) as “sosh.” That’s as gratingly obnoxious as people who try to make up cool SoHo type names for every wannabe part of their fly-over burg hoping for trendy restaurants and bars to open in abandoned storefronts, like strenuously coining NoSewPla for “north of the sewage plant.”

This week on HIStalk Practice: CareWell Urgent Care CEO Shaun Ginter discusses EHR transitions. Grove Medical Associates wins HIMSS award. Physician preparedness for ICD-10 leaves one guest author uneasy. MinuteClinic passes the 25 million patient mark. Delaware Health Net signs on for new technology to help its FQHCs with MU. Physicians show Twitter savvy when it comes to cancer. California’s Open Data Portal preps for a hack with the best of intentions.

This week on HIStalk Connect: Fitbit files for a $100 million IPO and in doing so discloses its impressive financial history. IBM signs 14 new customers for its Watson-based cancer treatment analytics platform. Healthbox unveils its next class, which will occupy its new Miami campus. 


Webinars

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.


Acquisitions, Funding, Business, and Stock

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Fuji Medical Systems USA acquires Milwaukee-based vendor neutral archive vendor TeraMedica. I interviewed TeraMedica CEO Jim Prekop a year ago.

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Cave Consulting Group, which recently won a patent infringement lawsuit against OptumInsight, requests a permanent federal injunction to prevent OptumInsight from continuing to sell its Impact Intelligence physician efficiency scoring product.

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Mediware acquires behaviorial and mental health software vendor AlphaCM. The announcement didn’t mention whether the website’s stock photo model will continue in her role.

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McKesson Chairman and CEO John Hammergren said in the earnings call that Technology Solutions revenue and profit dropped 8 percent for the year on lower hospital software sales, a trend he expects to continue but that will be partially offset by contributions from RelayHealth and Payer Solutions. He also mentioned “pending sale of another business line.” He amplified on that by saying that MCK is constantly tweaking its Technology Solutions portfolio as “an aggregation of many companies” and that’s why revenue dropped. Hammergren said McKesson’s only opportunity with CommonWell is that it uses services from RelayHealth as one of an eventual many service providers, adding that, “I’m more excited about what it’s going to do for healthcare in this country than I am necessarily for the revenues of Relay, which will follow over the years.” It seemed that the only positive talking point about Technology Solutions is always RelayHealth, which is obviously a business Hammergren likes a lot, so that seems to send a signal that the rarely mentioned rest of the lineup is less strategic.

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Informatics Corporation of America reduces headcount, with reports stating that 20 employees (20 percent of its workforce) have been let go.


Sales

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Catholic Medical Center (NH) chooses Voalte for caregiver communication, including Voalte Me for personal smartphones.


Announcements and Implementations

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Skywriter MD launches an on-demand virtual scribe service in which doctors wear a microphone and share their EHR screen with a remotely located scribe who navigates the EHR and enters information into it. Founder/CEO Tracy Rue previously worked for Sandlot Solutions and CORHIO.

Scripps Health and Sharp HealthCare will join the San Diego Health Connect HIE, which must be a relief given that their absence made its premise otherwise questionable.


Government and Politics

A old but unsettled Vermont lawsuit questions whether states can require self-insured companies to send them their claims data. Vermont wants Liberty Mutual and its third-party administrator to submit its claims data for its all-payer claims database, but federal law gives states no authority over employer-sponsored plans. The national implication is that employer-sponsored plans are growing, especially among young and healthy people,  and restricting states from overseeing them limits their ability to monitor healthcare costs for payment reform.

A North Carolina auditor’s report finds that the state’s Medicaid IT group, which oversees the troubled NCTracks claim processing system, “wasted” $1.7 million in payroll costs when the former director hired 11 family members and six members of her church, of which at least six were deemed unqualified for their jobs and seven were overpaid based on their credentials. The director also received thousands of hours of unauthorized comp time.

Rep. Diane Black (R-TN) introduces HR2247, which would require HHS to test the ICD-10 transition and to support a phase-in period.


Privacy and Security

In Ghana, a journalist, two musicians, and a hospital’s records officer are charged with trying to blackmail the CEO of the fantastically named Peace and Love Hospital (I’m picturing tie-dyed doctors flashing each other peace signs and holding love-ins in the chapel), having stolen patient records to bolster their claim that the hospital is operating fraudulently.

IBM’s X-Force Exchange allows companies to anonymously share cyberthreat information and to research IBM’s hacking attempt database.


Innovation and Research

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An non-governmental organization run by two doctors from South Africa develops Mobile Triage, an ED app that replaces the paper version of the South Africa Triage Scale. The group also offers apps for Doctors Without Borders Guidance, HIV management, and TB diagnosis and management.


Technology

A Fast Company article describes a Louisville, KY air quality monitoring program that combines data generated by Propeller Health’s smart asthma inhalers with EPA’s air sensors to determine the impact of pollution and other environmental factors on asthmatics.


Other

A New Jersey couple pleads guilty for paying doctors up to $2,000 per month — several million dollars in total — to refer patients to their 10 imaging centers for tests that weren’t always medically necessary. Rehan Zuberi had already settled a 1998 Medicaid fraud charge in which he allegedly paid $300,000 in kickbacks to generate $8 million worth of business.

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UK’s NHS will implement the US-Canada program Choosing Wisely that tries to get doctors to stop performing unnecessary and unproven interventions, including those involving duplicate tests and procedures. It cites statistics suggesting that physicians have “health illiteracy” in misapplying statistics to practice, such as the one-third of gynecologists who thought a 25 percent risk reduction in mammography means that 25 percent fewer screened women will die of breast cancer when the real number is less than one in 2,000, which also doesn’t take into account risks of the mammography itself. Despite the potential benefits of the program, surveys indicate that few US doctors are aware of it.

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NPR Shots profiles benefits consulting firm ELAP Services, which tells its employer clients to refuse to pay ridiculous employee hospital bills and instead offer to pay what’s reasonable based on an analysis of the specific hospital’s in-depth financials. A car dealership CFO customer says, “This is the best form of true healthcare reform that I’ve come across.” A hospital billed the dealership $600,000 for a three-day back surgery stay, ELAP calculated the hospital’s actual cost plus a small profit and told the company to pay only $28,900, and the hospital took the money without complaint.

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Strange: a new website offers fake, customizable doctor notes for taking unwarranted sick days, including a phony phone number with a doctor-sounding voicemail. You get a refund if someone pegs them as fake, although that probably won’t offset the sting of getting fired for lying to your employer. The site features testimonials if you’re gullible enough to believe kudos from a site whose mission is abetting liars and whose disclaimer says its products are “meant to be used as novelty items and not for any illegal purpose.” Among the notes offered: a hospital release form that includes barcodes, an oncology note that suggests something serious, an English-Spanish pregnancy note that the company helpfully suggests is “usable by most women between the ages of 18 and 50,” and a urology excuse with a target audience of “if you take frequent bathroom breaks, this note will work fantastic for you.” I haven’t worked for an employer who provided a fixed number of sick days each year for a long time since most have moved to the PTO system, but I remember one who changed to PTO after reviewing the significant number of employees who took the maximum number of sick days and not one day more unpaid, making their lack of well-being questionable.

A patient who was surprised to find that her hospital’s outpatient surgery center billed her insurance company $39,000 for a one-hour eyelift surgery that had been estimated at $3,500 is even more surprised when Blue Cross Blue Shield of Minnesota pays the entire allowable amount of $29,000. She complained to both the hospital and the insurance company that the charges were absurd, but neither seemed too interested.

Weird News Andy says he couldn’t find an ICD-10 code for this story, in which an Oklahoma man kills his stepfather with an “atomic wedgie” during a drinking binge, suffocating him by pulling the elastic band of his underwear over his head. That sounds like the kind of unfortunate demise that is, like being crushed under a truckload of ice cream bars or trampled to death by a bestialic partner, best tersely glossed over in the obituary as “a brief illness.”


Sponsor Updates

  • Logicworks offers “5 Ways to Monitor and Control AWS Cloud Costs.”
  • Visage Imaging will exhibit its Visage 7 Enterprise Imaging Platform at the upcoming ACR and SIIM conferences in the Washington, DC area.
  • Galen Healthcare Solutions offers “10 Tips and Tricks to Make Mirth Connect Work for You.”
  • Ingenious Med reports that 93 percent of clinicians submitting registry-based data through its One by Ingenious Med patient encounter platform reached the PQRS reporting threshold.
  • HDS will exhibit at the Amerinet Member Conference May 17-20 in Orlando.
  • Healthwise will exhibit at the TriZetto Annual Healthcare Conference May 17-20 in Orlando.
  • Iatric Solutions will exhibit at the iHT2 Health IT Summit May 19-20 in Boston.
  • InterSystems offers the second part of its series on “The Patient Education Chasm.”
  • Impact Advisors COO Todd Hollowell is named one of “Top 25 Consultants” in the “Excellence in Healthcare” category of Consulting Magazine.
  • Liaison Technologies offers “How to Enable Shadow IT Through a Data-Centric Approach to Integration.”
  • LifeImage posts “Fast, Efficient Medical Image Exchange Within ‘The Golden Hour.’”
  • Healthfinch offers “Back to the Future: A 2008 Presentation is Still Super Relevant.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 14, 2015 News 2 Comments

News 5/13/15

May 12, 2015 News 1 Comment

Top News

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Health information management vendors HealthPort and IOD will merge, creating a company with $450 million in annual revenue that offers release-of-information services, audit management, coding and abstracting, and document conversion.


Reader Comments

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From Robert Lafsky, MD: “Re: typo. You could use this. I’ll take plaque instead of plague, I think.” You would need to choose dental, dermal, or arterial, of which Door #1 is the obvious preference.

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From Spaulding Smails: “Re: news items back story. Newsletters sometimes include a ‘why this is interesting’ explanation that your readers might find useful.” I did that in the snarky, weekly HIStalk Brev+IT email newsletter that I wrote 100 or so years ago. Above is a sample from those innocent, pre-HITECH days of early 2008 just in case you weren’t one of the eight people reading it back then. I added some history, perspective, and smart-alecky editorial comments to each news item. I don’t think I’d want to do that for every item I include in HIStalk (which is far more than the three items I ran in each Brev+IT), but I’m open to suggestions if anyone wants to see that commentary added. Some headlines I noticed as I reviewed them for the first time in seven years: “Is That Your iPhone In Your Pocket Or Are You Just Glad To See Me, Doctor?,” “Looking Up Britney’s Dress Was Free, But 13 Pay Dearly For Ogling Her EMR,” “Allscripts and Misys Consummate Desperate Lust: Shareholders Hose Them Down,” and “Survey: Old People Don’t Want to Pay for Health IT or Any Damned Thing Else.” Those newsletters were a lot of fun to write even though I had the equivalent of about three full-time jobs at the time.


HIStalk Announcements and Requests

Elsevier put together this video of their sponsorship of HIStalkapalooza.

It’s the annual post-HIMSS lull where I can finally catch my breath. I’m always on the lookout for brilliant guest writers and interview subjects who work for providers rather than vendors and who want to share their expertise and opinions with the industry. Let me know if that describes you.


Webinars

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making

Here’s the video from Tuesday’s interview with Regina Holliday, which is really mostly just audio but still a good introduction to what she does and is doing.


Acquisitions, Funding, Business, and Stock

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Practo, which offers a doctor-finding website for Asia, will double its India-based headcount to 2,000 in 2015 following a $30 million investment earlier this year. The gray-on-white website theme made me think I was losing my eyesight.

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Premier announces Q3 results: revenue up 16 percent, adjusted EPS $0.38 vs. $0.34, beating expectations for both and raising guidance for the year. The company announced in the earnings call that Catholic Health Initiatives has purchased PremierConnect Enterprise. President and CEO Susan DeVore says “acquisitions play an important role in our future” and adds that IBM’s acquisition of Premier population health management partner Phytel won’t change the existing relationship with either company. The CFO says the recent TheraDoc and Aperek acquisitions are on track to meet the $20 million in annual revenue contribution that was expected. PINC shares are up 35 percent on the year and are 24 percent higher than at the September 2013 IPO. The company’s market capitalization is $1.4 billion, with Susan DeVore holding shares worth $8 million.

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PerfectServe opens an office in Knoxville, TN to handle the 50 percent headcount growth the company has experienced in the past 10 months. The new space adheres to the open floor concept and provides sit/stand desks, collaboration rooms, and a health food micro-market. The hospital I worked for had a temporary open office concept when they were ripping up carpet and had to take down the IT area’s cube walls, which I initially hated but liked at least a little bit as I got used to having everybody inadvertently making eye contact and quickly looking away from the shame of sitting in what looked like a 1950s secretarial pool. The entertainment factor was reduced as employees had to leave the area to make personal phone calls instead of being comforted by the illusion of privacy from the thin cube walls, through which everybody could clearly overhear symptomatic details of their need to schedule a doctor’s appointment and the sometimes shocking manner in which they spoke to their family members.

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McKesson announces Q4 results: revenue up 19 percent, adjusted EPS $2.94 vs. $2.71, beating expectations for both.


Sales

UC Irvine Health (CA) chooses Strata Decision’s StrataJazz for decision support, cost accounting, contract analytics, budgeting, and management reporting.

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National Institutes of Health selects Connexient’s MediNav smartphone wayfinding product for its Bethesda, MD campus.


People

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The Hospital for Sick Children (Toronto, CA) names Sarah Muttitt, MD, MBA (Alberta Health Services) as VP/CIO.

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CTG announces the resignation of SVP Ted Reynolds, who took over the company’s healthcare business and earned the SVP title six months ago.  

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TriHealth (OH) promotes John Ward to CIO. He had held the job as interim.


Announcements and Implementations

NVoq announces GA of its Code Fast service that offers real-time conversion of spoken narratives to standards such as ICD-9, ICD-10, SNOMED, and LOINC in a partnership with SyTrue.

Lexmark launches Perceptive Checklist Capture, which automates the gathering of data and documents from PCs, mobile devices, and multi-function devices into a project or case folder.

Greencastle Associates Consulting receives its fourth Pro Patria Award from the Pennsylvania Employer Support of the Guard and Reserve for supporting reservists and National Guardsmen who are called to service. Veteran-owned Greencastle, which has veterans as 96 percent of its employees, has also earned Patriotic Employer, Above and Beyond, and Seven Seals awards. The company’s management team is Senior Partner Celwyn Evans (retired US Army Ranger), Director Joe Crandall (US Naval Academy graduate and former naval special warfare officer), and Director Will Woldenberg (former Army communications officer deployed to Iraq).


Privacy and Security

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A California woman claims she was fired for uninstalling an employer-required iPhone app that tracked her location 24 hours a day. Her lawsuit claims her boss bragged to co-workers that he was monitoring her GPS location, driving speed, and time spent everywhere she went.


Innovation and Research

A Washington Post report reviews FDA-approved, software-powered, personalized anesthesia machines that may at some point replace anesthesiologists, who lobbied hard to prevent their introduction. Anesthesiologist fees for a colonoscopy sedation run up to $2,000 while the machine costs less than $200, while faster sedation and recovery allow more procedures to be performed in the same suite.

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A small Cincinnati Children’s Hospital Medical Center (OH) study finds that analyzing free-text clinical notes and discharge medication lists using machine language and natural language processing can increase accuracy with less work than manual medication reconciliation.

ONC names six winners of its HHS Competes challenge that will receive $50,000 each to fund pilot projects that begin in August:

  • ClinicalBox (Lowell General Hospital), care coordination critical task visualization.
  • CreateIT Healthcare Solutions (MHP Salud), patient engagement and messaging by SMS, email, and voice.
  • Gecko Health Innovations (Boston Children’s Hospital), respiratory disease management with medication sensors, reminders, and symptom tracking.
  • Optima Integrated Health (UCSF), real-time blood pressure monitoring.
  • PhysIQ (Henry Ford Health System), biosensors and analytical tools to monitor CHF and COPD patients.
  • Vital Care Telehealth Services (Dominican Sisters Family Health Service), telehealth care coordination.

Technology

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A clinical review of 46 insulin dosage calculators finds that only one was free of problems such as lack of edits for missing or clearly incorrect information. Two-thirds of the apps were poorly designed to the point that they gave recommendations that violated clinical assumptions, did not use their stated formulas correctly, or didn’t update properly when users changed information. I can say from experience that hospitals know you can’t let programmers develop stuff like this without a lot of oversight, including design and testing, because they just don’t see the big picture and fail to appreciate the risk of missing a corner case. App developers don’t have that level of oversight and attempt to reduce complex medical rules into a simple algorithm just because they can.

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I went to a restaurant this week that uses the NoWait iPad-powered wait list and seating tool for restaurants that don’t want to go the OpenTable route since they don’t take reservations. The hostess took my name and phone number and said I’d get a text message when the table was ready. The message also included a link to download the app, which when connected via just my phone number, showed me my place on the wait list, and gave me the option to cancel or change the size of my party. It seems something like this could be used for healthcare purposes since the patient wouldn’t have to do anything in advance. The worst waiting rooms I’ve been in were LabCorp or Quest (even worse than EDs) and most folks there are cranky walk-ins who have fasted for hours, so I’d definitely sign up to avoid being overdosed on unemployment TV while waiting for an hour to get my 60-second blood draw.


Other

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The local paper highlights the use of Nuance’s Dragon Medical speech recognition by St. Joseph Warren Hospital (OH) in a pilot project of 70 users. Doctors say Dragon is easy to use, saves them a lot of time, and “is a great way to get our true voice heard and down on paper, so to speak” (I assume the pun was unintentional).

The HIEs of Dallas and San Antonio, TX will merge.

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A KQED Science article covers patients accessing their own data, the MUS3 dial-back of view / download / transmit requirements, the cost of obtaining copies of medical information, and the lack of provider incentive to provide it. Patient advocate Regina Holliday is featured prominently.

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A survey of clinicians who participate in the Meaningful Use program and who work for practices that have earned patient-centered medical home status finds that only half of them receive timely notification of hospital discharges, a capability they believe is “very important.” One-fourth of the respondents actually worked for hospital-owned practices, so the percentage of independent practices that receive hospital discharge alerts for their patients is pretty abysmal.

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The New York Post features Brooklyn’s Brookdale Hospital as one of the worst in the country, one of only 20 US hospitals to fail Leapfrog Group’s hospital safety analysis. It recently received $68 million in taxpayer money to allow it to remain open as a safety net hospital despite the fact that locals would be better off hopping into a taxi to ambulate the few blocks to a safer hospital. The paper says that an “unholy alliance of unions, trade associations, and government officials” make excuses for dangerous hospitals like Brookdale in claiming that care is too complex to measure (note that it’s never the good hospitals that say that). We might create a better healthcare system by focusing on inter-facility transportation (instead of turfing that function off to ridiculously overpriced taxis posing as ambulance services) and moving patients to the facility best equipped to give them a good outcome rather than sticking them with whatever hospital they were closest to at their initial time of need.

I’m wary of polls that ask people what they “would” do instead of what they “actually” do or have done recently. A HIMSS Analytics nurse survey finds that 71 percent say they wouldn’t go back to paper-based medical records. My question would have been: if your employer decided to go back to paper, what hourly salary increase would keep you from leaving your job? (with “$0” being a poll choice that would have been chosen often, no doubt). The question as submitted reflects the poll sponsor’s bias, which respondents are quick to pick up on in choosing the most virtuous-sounding answer. Consumer polls always find that Americans want digital health records, smartphone access, and all kinds of nifty-sounding features they don’t really understand, but when asked if they would change doctors or pay extra to get them, they almost always say “no,” meaning their original answer was a shallow attempt to sound nobler. It’s nearly always a mistake to judge people by what they say they’ll do instead of what they’ve actually done.

Apparently salaries are discussed more openly in India than here. An “elated official” of a state-owned technical school proudly announces that two of the college’s seniors have received “plum job offers” that are the highest-paying placement packages in the school’s history, $105K annually from Epic.

Weird News Andy calls this “#2 with a Bullet.” A New Jersey criminal frequent flyer whose bathroom urges raised the suspicion of arresting officers pulls a stolen, loaded .25 caliber pistol from “between his butt cheeks” during the resulting strip search, which WNA says “is a pretty crappy holster if you ask me.”


Sponsor Updates

  • The HCI Group is named a finalist in the Entrepreneur of the Year award in the healthcare category.
  • CareSync posts a new blog about its preparations for AARP’s Life@50+ event May 14-16 in Miami.
  • ADP AdvancedMD offers a sneak peek of its solution for any browser.
  • AirWatch will exhibit at the Gartner Digital Workplace Summit May 18-19 in Orlando.
  • Impact Advisors VP Lydon Neumann will serve on the panel of “Evidence-Based Approaches and Practical Tools for the Never Ending Implementation Journey”at the AHIMA iHealth Conference May 28-29 in Boston.
  • Cumberland Consulting Group recaps its HIMSS15 experience in an interview excerpt.
  • XG Health Solutions features an interview with Janet Tomcavage, RN, SVP of Geisinger Health Plan.
  • Aventura will exhibit at the iHT2 Health IT Summit May 19-20 in Boston.
  • Besler Consulting asks, “Is it too early to prepare for Modifier -59 Billing Changes?”
  • Capsule Tech offers “Not All Superheroes Wear Capes.”
  • Medecision offers “For Population Health Tech to Work, You Need Data.”
  • CoverMyMeds offers “Electronic Prior Authorization: Sustainable Solutions and the Road Ahead.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 12, 2015 News 1 Comment

Monday Morning Update 5/11/15

May 10, 2015 News 4 Comments

Top News

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Cerner shares fell 4.5 percent Friday after the company reported lower-than-expected revenue for the quarter and also warned of slightly reduced revenue expectations for full-year 2015. From the earnings call, the acquired Siemens Health Services business contributed $176 million in the quarter of the company’s overall revenue, about 18 percent of the total, with “minimal bookings contribution from Health Services” and minimal sales expected for the year. HS is now on track for $1 billion in annual revenue vs. the originally expected $1.1 billion, but Cerner wants to stop talking about that business separately since it now isn’t.

Cerner has set aside $35 million in Q2 for a voluntary separation program that will affect 2 percent of the workforce, which works out to around 400-500 people from both the Cerner and Siemens sides. Cerner also called out its Business Office Services for physician practices, which the company says can display an unnamed cloud-based competitor (presumably Athenahealth) because Cerner’s lower staffing requirements cost 20 percent less and “many of these larger and more sophisticated clients are facing several challenges with our competitor’s solution, such as having 50 to 60 percent of the claims requiring manual intervention because they don’t fit the cloud configuration.” Cerner says three former Siemens clients committed to Millennium in Q1, although it admits that those decisions had probably already been made before the acquisition announcement just sped them up.

Speaking of the Cerner earnings call, a Morgan Stanley stock analyst set a world record by sprinkling the maddeningly meaningless “kind of like” liberally throughout questions that were buried somewhere under an avalanche of verbal crutchery:

You talk about the contract with Intermountain and really kind of like a new way of doing business , so when you think about kind of like other health system that are similar in size, can you just kind of like share with us how kind of like that pipeline is looking and do you need to kind of like first implement all the 22 hospitals of Intermountain or should we expect to see a deal, kind of like that looks at that type of intelligent systems before that? … When we look at kind of like your new contracts, what percent of your new contracts have kind of like a Population Health feature to them? And how should we think about kind of like what is an average Population Health deal in terms of revenue contribution?


Reader Comments

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From Interesting: “Re: John Hammergren. He gets a lot of negative press, but this story (which doesn’t identify Kayla Hammergren as his daughter) gives a different perspective on the family life of America’s highest-paid CEO.” A Boston College newspaper article notes the meeting of senior Kayla Hammergren with the four-year-old boy to whom she donated bone marrow in 2013 after she signed up for a donor registry at a campus recruitment drive. Her donation of bone marrow (and later blood) led to the boy’s being declared free of leukemia a year later.

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From Greg Marmalard: “Re: Castlight Health. Our company just rolled it out to employees this week. I searched on a common surgery for glaucoma and it came up empty. Then I searched just on glaucoma and got information on eyeglass exams, low back pain, acne surgery, culture bacteria, and vaccines. A teammate looked up follow-up visit costs for PCPs in his area (including his own) and there was some range shown although it wasn’t large. Then he checked out hip replacement surgery and it came back with over 50 hospitals and surgical centers in a 25-mile radius showing the same cost for all of them. It asked for my email address so they can send me endless emails, so I unsubscribed.”

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From Barb Dwyer: “Re: MyChart on Apple Watch. Photos attached.”


HIStalk Announcements and Requests

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Forty percent of poll respondents say a medical bill has caused them financial hardship within the past two years. Two readers (one Canadian, one on Medicare) said no, while two others said that high-deductible plans put them much more at risk than before. New poll to your right or here, for those who work for a health system: how would you grade your most recent encounter with your employer’s service offerings? I would, of course, love to get more details if you’d leave a comment after voting.

Listening: new from Mikal Cronin, summery but sometimes growly power pop on the trustworthy Merge Records label. Also: addictive melodic ballads from James Blunt, a former British Army captain and current Doctors Without Borders supporter who cranks out pretty amazing music.  One more from a reader: jangly, tied-dyed psychedelic prog from Temples, young English guys who sound like like old English guys did in 1972.

I was thinking about how consumers created a huge but questionable market for herbal and vitamin products whose manufacturers make medical claims without FDA oversight. That happened largely because doctors ignored the demand and refused to educate themselves and their patients about those products, so consumers sensed that traditional medicine was stonewalling them and bypassed the medical system entirely in favor of “alternative medicine” (some of which actually works) and created a great business for chiropractors and other non-physicians who jumped all over the new income source. The same thing happened with weight loss, sexually related products, acupuncture, etc. My conclusion: clinicians need to educate themselves on wearables and health apps because consumers will just sidestep them if they don’t. Unfortunately, short and brusque PCP encounters don’t leave much time for discussions about general health and doctors are often ill prepared to participate in those discussions anyway since their focus is often myopic, standardized, and focused on symptom alleviation via drugs or procedures. For me at least, the ideal team would be a generalist health coach (whose knowledge is broad but not necessarily deep) who is supported when needed by a physician. Many patients don’t believe doctors have the time, objectivity, or economic incentive to serve as their ongoing health partner.


Last Week’s Most Interesting News

  • Cerner and Allscripts turn in unimpressive quarterly results.
  • President Obama nominates National Coordinator Karen DeSalvo, MD to the post of HHS assistant secretary for health, in which she has served in an interim capacity for several months.
  • Harris Corporation restructuring suggests that the company may be planning to divest its healthcare business.
  • Cognizant reports impressive quarterly financial results that were significantly driven by the former TriZetto business it acquired in November 2014 for $2.7 billion.

Webinars

May 12 (Tuesday) 1:00 ET. “HIStalk Interviews Regina Holliday.” Catch up with Regina Holliday and her recent patient advocacy efforts as she chats with HIStalk’s Lorre and Jenn about the HIMSS conference, The Walking Gallery, her upcoming advocacy events, and her new book. Regina will talk about how providers and vendors are working to make the patient voice heard.

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call:

  • The company added 200 clients even as revenue declined due to lower professional services sales, a trend the company expects to continue given the lack of new government mandates.
  • Gross margin was “disappointing” because of the decline in client services margin, some of that due to the one-year delay in New York’s mandatory e-prescribing program.
  • The company sold two new Sunrise clients: 51-bed Palo Verde Hospital (CA) and 53-bed Grand Lake Health System (OH).
  • No new international sales were made in the quarter.
  • The company reported severance payments of $6 million during the quarter and told analysts to expect more severance payouts in Q2.
  • The company hopes to have one or two referenceable clients running the full suite of Allscripts products, including Sunrise Financial Manager, by the end of the year.
  • On the possibility of acquiring population health management companies, CFO Richard Poulton said, “That’s definitely an area that is high on our list of areas to invest in. Whether it’s purely an acquisition, though, is a different question. I don’t have to tell you that some of the companies that are out there, fairly immature companies, are with advertised capabilities are trading at crazy valuations. We’ve looked at a bunch and we’ll continue to look at a bunch, but right now, we have a pretty good plan that is not heavily dependent on acquisitions.”

People

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Vince Roach, founder of Technology Management, Inc. and later an executive with Daou Systems, died May 8 in Indianapolis. He was 71.


Announcements and Implementations

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A Web petition at GetMyHealthData.org urges politicians, providers, and insurance companies to ensure that patients have access to their own health data.


Innovation and Research

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India-based Tata Memorial Hospital works with a for-profit company to offer free, evidence-based online second opinions for cancer treatments. Patients submit their medical records online and receive expert opinions within a few days. Commercial partner Navya offers a patented “analysis engine” that reviews best practices, expert opinion, and patient preferences to provide treatment options. Navya co-founder Naresh Ramarajan, MD has a Harvard undergrad, Stanford MD with community health emphasis, and is completing a critical care and pulmonology fellowship at UCLA along with a PhD in medical informatics.


Technology

An in-depth Washington Post piece says wearables have become big business, but questions the value of the data they create, especially by “life loggers” who obsessively try to quantify their every move in a quest for “self-perfectability” in the “narcissism of the technological age.” A professor says it’s a lot easier to collect information than to do something useful with it, while the article also points out possible privacy concerns, such as in 2011 when Fitbit users realized that their publicly shared data made it easy to determine the frequency, duration, and vigor of their sexual activity. My most recent pet peeve is people who have their fitness apps set to proudly tweet out their latest run or bike ride, which I can personally guarantee no fellow earthling cares about.

An Esquire writer who tried the Apple Watch says it “seems to be designed to be a thing you can’t get overly excited about” and is mostly useful for ignoring unimportant text messages and for the all-important fanboy bragging rights, adding that the watch itself  has decent battery life but it sucks the iPhone battery dry quickly since it’s conversing via Bluetooth. It will, he says in stating the obvious, become obsolete quickly and will require buying it all over again, also stating the obvious that Apple zealots never seem to mind.


Other

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Half the ophthalmologists working for Indiana University School of Medicine have quit since construction of a $30 million eye institute began in 2008, with key issues apparently being a forced practice integration, disputes over their share of the $12 million the eye clinical brings in each year, and aggressive fundraising in which doctors were sent lists of their upcoming appointments by the fundraising director (who is also the wife of the department chair) who flagged high net worth people so they could be given extra attention and hit up for donations. One of the doctors filed a HIPAA complaint over that practice, which the medical school says it has since fixed.

Idiotic lawsuit: a Raleigh, NC police officer who spilled his coffee in his lap is suing Starbucks for the maximum allowed $750,000, saying the emotional damage aggravated his Crohn’s disease and that he was served a large cup without an insulating sleeve as required by the chain’s policy. He told the jury that he really should get $10 million. He didn’t even pay for the coffee since officers in uniform aren’t charged, a benefit he had taken advantage of 50 times in two months. The officer admitted under questioning that after the spill, he went back to the police station to get his truck, drove home, had his wife take pictures of his burn, and finally sought medical attention 2.5 hours later. He says, “I knew it was hot, but not that hot,” indicating his prime candidacy for a Frappucino.

Weird News Andy calls this story “Doctors Acting Badly.” In England, an OB-GYN and his RN wife are charged with slavery after a Nigerian man claims the couple hired him 24 years ago at age 12, but then altered his passport so he couldn’t leave and then forced him to be their unpaid and beaten babysitter and butler.


Sponsor Updates

  • Medicity’s Brian Ahier contributes “5 things we have to do to make health IT work.”
  • Nordic focuses on pharmacy in the sixth installment of its “Making the Cut” video series on Epic conversion planning.
  • MedData offers “Go All In on Early Out.”
  • Versus Technology offers “Nursing’s Impact on Patient Care Transcends the Bedside.”
  • West Corp. offers a Storify tweet recap of its time at ATA 2015.
  • PMD outlines the benefits of “The Developer Carpool.”
  • Netsmart wins the Smile for Team Spirit Award as part of its annual Kansas City Corporate Challenge.
  • Voalte offers “Have faith in nurses.”
  • New York eHealth Collaborative’s Anuj Desai and David Jacobowitz contribute to the third edition of “Medical Informatics: An Executive Primer” from HIMSS.
  • Orion Health offers “The Importance of Chronic Care Management (CCM).”
  • PeriGen offers an interactive history of labor and delivery nursing in honor of National Nurses Week.
  • QPID Health offers “3 Key Insights From Dr. Robert Wachter, Author of ‘The Digital Doctor.”
  • Sandlot Solutions will exhibit at the SoCal HIMSS 7th Annual Clinical Informatics Summit May 15 in Irvine, CA.
  • Shareable Ink and The SSI Group will exhibit at the Ambulatory Surgery Center Association Annual Meeting May 13-16 in Orlando.
  • TeleTracking offers a new blog on “National Nurses Week 2015.”
  • TransUnion hosts Philippine President Benigno Aquino III at its corporate headquarters.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 10, 2015 News 4 Comments

News 5/8/15

May 7, 2015 News 8 Comments

Top News

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President Obama nominates National Coordinator Karen DeSalvo, MD to become HHS assistant secretary for health, a role she has held as interim (in addition to her ONC duties) since last year. The appointed position, which involves Senate confirmation and a four-year term, is the nation’s highest-ranking public health officer. Howard Koh, MD, the previous assistant secretary, resigned in July 2014 to rejoin the Harvard School of Public Health. DeSalvo will leave ONC if confirmed, which is nearly certain since both she and her HHS boss Sylvia Burwell have widespread political support that crosses party lines. Her nomination was entirely predictable from the moment she was named as interim.


Reader Comments

From Code Jockey: “Re: Siemens. As a Siemens/Cerner HS employee I’d like to gauge the community’s thoughts. Unofficially, 200-300 people took the voluntary separation package, so where does that leave the rest? Should they look elsewhere given the probably layoffs or stick it out?” I’ll open the floor, but if it were me, I’d stick it out. Layoffs are certain but strategic, so the first wave will be in areas of obvious generic corporate redundancy such as marketing, finance, sales, and HR. Second-worst is if you work on a clearly doomed product line but even then someone has to keep the lights on until customers are prodded to move elsewhere. Otherwise, the need for technical experts for existing Siemens products isn’t just going to go away overnight. You’re working for a much more successful and US-based, healthcare-focused company now, and while I would always be keeping my ear to the ground for new opportunities as a general policy, I wouldn’t assume the worst.  Speaking of Siemens, I hadn’t checked lately, but our November 2014 webinar, “Cerner Takeover of Siemens: Are You Ready?” with Vince Ciotti and Frank Poggio has been viewed over 4,000 times on YouTube.

From Ex-McK: “Re: layoffs. Heard more layoffs at McKesson and RelayHealth. How many employees are left on the technology side? Someone told me as many as 500 were let go last week. It’s definitely not the company when Pam was running the company.” Unverified. Another reader reported hearing that 300 were laid off, but I haven’t heard from any of them directly.

From Rumor Mill: “Re: MUS2 attestation date. I’m hearing it may be moved to January 2017. Any idea if this is true?”


HIStalk Announcements and Requests

This week on HIStalk Connect: Apple, in collaboration with UCSF and Mount Sinai, will update ResearchKit to support genome data collection, storage, and sharing. American Well launches a new telehealth app designed to let practices offer remote consultations to their patients. Stanford University researchers have improved on recently developed retinal implant technology and are developing a new prototype that should provide some blind patients with 20/250 restored sight. Online glasses retailer Warby Parker raises a $100 million Series D to expand its physical footprint and to develop an online eye exam that its ophthalmologists can use to prescribe lenses.

This week on HIStalk Practice: Harrington Family Health Center goes live on Athenahealth. AHRQ recommends several areas where pediatric EHRs can improve. HHS announces $101 million in funding for health centers, and prepares for artists and health data activists to converge at its headquarters. CareMore Medical Group goes with Allscripts, while Tandigm Health opts for NaviNet referral tool. Harbin Clinic welcomes a new CIO. Apple Watch users bring new meaning to the phrase "lonely hearts club." Calypso, cowbell, and Jonathan Bush converge. Dr. Gregg shares the HIT challenges of being independent (i.e., non-Borgian).

A reader asks if I listen to any Icelandic music. I do sometimes: Sigur Ros, Of Monsters and Men, and of course Bjork. The reader likes indie pop band Seabear, and having checked them out, so do I. A lot of good music comes out of a country whose population is just 300,000.

It occurred to me that just about everybody who’s salivating at the prospect of never-ending streams of real-time, sensor-powered patient data are businesspeople and technologists rather than hands-on doctors and nurses. The diagnostic value of the information is questionable, the cost of follow-up is significant, and the effect on outcomes and cost is unknown. You often can’t even get an appointment when calling in with an acute condition, so who’s going to jump on an unusual iPhone heart rate sensor value? It makes me uneasy to see the further polarization of healthcare haves and have-nots since it’s already easy to find previously undiagnosed and untreated people without using apps – it’s just that their demographics make them unprofitable and our healthcare delivery system doesn’t get excited about unprofitable public health.


DonorsChoose Project Update

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I fully funded these DonorsChoose projects from the generous donations of Cerner and Epic, which I’m listing here so those companies (and Centura SVP/CIO Dana Moore since it was his idea and effort) know where their money went:

  • Books and math flash cards for fourth grade classes in Indianapolis, IN.
  • An iPad Mini for literacy and math stations for an elementary school class in Baltimore, MD.
  • A Common Core math manipulatives set for grades 3-5 in Baltimore, MD.
  • A laptop computer for programming Lego EV3 robots for grades 6-8 in Hartford, KY.
  • Two programmable rover robots for a fifth grade class in Clarendon, TX.
  • Six Makey Makey computer invention kits for K-5 classes in Hull, GA.
  • A Lego EV3 programmable robot and reference books for a middle school robotics competition team in New York, NY.
  • A STEM bundle, three STEM kits, and four engineering centers for first grade recess learning at a bilingual learning school in Columbus, OH.
  • A portable air conditioner for an elementary school classroom in Paterson, NJ.
  • Two iPad Minis for a third grade technology workstation in Tulsa, OK.
  • A math manipulatives library for grades 3-5 in King City, CA.
  • Two Kindle Fires for technology learning for a kindergarten class in Indianapolis, IN.
  • 25 scientific calculators and clipboards for a high school chemistry class in Indianapolis, IN.
  • An iPad Air for reading and math practice for an elementary school in Henderson, NV.
  • Summer school supplies for an elementary school in Norfolk, VA.
  • Educational computer games for a class of pre-K through second grade students with autism in Indianapolis, IN.
  • A library of math books for an elementary school class in Indianapolis, IN.
  • A STEM bundle for grades 4-5 at an elementary school in Fairfield, CA.
  • Two STEM bundles for an elementary school class in Tulsa, OK.
  • An iPad Mini, case, and earphones for a kindergarten class in Aloha, OR.
  • A set of Rekenreks math learning tools for an elementary school class in Indianapolis, IN.
  • Interactive math tools for an elementary school class in Wilder, ID.
  • Math games for first graders at a Spanish immersion school in Minneapolis, MN.
  • Macbook accessories for programming courses at a college prep school in Chicago, IL.
  • Four Kindle Fires for a grade 5-6 math classroom in New York, NY
  • A STEM bundle for a second grade class in Fort Walton Beach, FL.
  • A listening center for grades 3-5 at a Bureau of Indian Affairs school in Hayward, WI.
  • A Bluetooth speaker to play music during gym class at a middle school in Milwaukee, WI.
  • A Samsung tablet and case for reading work at an elementary school in Middleton, WI.
  • Scientific calculators and learning supplies for an at-risk middle school class in Cottage Grove, WI.
  • 20 STEM professional resource books and an iPad Mini for an elementary school teacher in Green Bay, WI

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Mrs. Anderson from Colorado sent over photos of the TV and flash drive paid for by our donations. She placed it in the library as the first thing students see when entering or leaving as it runs new book advertisements and school announcements. She reports that students gave it a lot of “oohs and ahhhs” and checked out three new books the first day by 10:30 a.m. even though the books had been sitting untouched on the new book display for the three weeks before the TV went up. Meanwhile, Mrs. McDermott of Brooklyn sent a note about the four Kindle Fires for her math class: “Thank you so much for your incredibly generous donation. I can’t even believe it! I’m currently on Spring Break, and I woke up thinking of all the things I need to do in order to prepare for when the kids come back, and then I see this wonderful email! I appreciate it from the bottom of my heart! Thank you, thank you, thank you! These Kindles are going to be so helpful in my classroom, and the kids are going to be so excited to have some technology JUST for math class. You are an AMAZING human being!” (it’s actually amazing companies donating, so I’ll accept on their behalf).


Webinars

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May 12 (Tuesday) 1:00 ET. “HIStalk Interviews Regina Holliday.” Catch up with Regina Holliday and her recent patient advocacy efforts as she chats with HIStalk’s Lorre and Jenn about the HIMSS conference, The Walking Gallery, her upcoming advocacy events, and her new book. Regina will talk about how providers and vendors are working to make the patient voice heard.

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making.


Acquisitions, Funding, Business, and Stock

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Harris Corp. eliminates the headquarters function of its Herndon, VA-based Integrated Network Solutions business, which includes Healthcare Solutions, as it plans for the integration of defense contractor Excelis, which Harris is acquiring for $4.5 billion. SEC filings suggest that the company may be considering divesting the INS businesses, which in addition to healthcare, include IT services and telecommunications. Harris Healthcare Solutions offers the FusionFX care collaboration suite, FusionIQ analytics, and FusionOS middleware, acquired with its $155 million acquisition of Carefx in 2011.

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IMS Health acquires England-based Dataline Software, which offers healthcare cost analytics and develops custom hospital software.

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Castlight Heath reports Q1 results: revenue up 90 percent, adjusted EPS –$0.17 vs. –$0.72, beating expectations for both. Shares jumped on the news but are still down 31 percent on the year, valuing the company at $739 million.

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The Advisory Board Company announces Q4 results: revenue up 30 percent, adjusted EPS $0.31 vs. $0.34, missing expectations for both. ABCO acquired educational enrollment vendor Royall & Company for $850 million in December 2014 and most of the analyst questions in the earnings call involved that topic.

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DrFirst raises $3.5 million in new financing.

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Cerner reports Q1 results: revenue up 27 percent, adjusted EPS $0.45 vs. $0.37, falling short of revenue expectations due to “a combination of lower-than-expected revenue from the recently closed acquisition of Siemens Health Services and lower revenue in our existing business.” It’s a rare and somewhat shocking miss for CERN.

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Allscripts announces Q1 results: revenue down 2 percent, adjusted EPS $0.08 vs. $0.07, falling short of expectations for both by quite a bit.

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Fitbit earns $142 million profit on $745 million in revenue in 2014 and announces plans to IPO after raising $100 million, having valued itself previously at $1.2 billion.  The company also disclosed that its product recall in response to consumer complaints about band-induced rashes cost it $107 million plus settlements for lawsuits both settled and open. Fitbit says less than half of the total devices it has sold are being actively used.

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Private equity firm ABRY Partners will acquire pharmacy 340B systems vendor Sentry Data Systems, with an unannounced price that one banker says is more than $200 million.

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Population health management vendor Evolent Health files for a $100 million IPO.


Sales

England-based urgent care provider Coordinate My care selects InterSystems for care coordination.


People

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Andrew Rhinehart, MD (Johnston Memorial Center for Comprehensive Wound Care) joins Glytec as chief medical officer.

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Harbin Clinic (GA) names Andrew Goodwin (Georgia Hospital Association) as CIO.


Announcements and Implementations

Zynx Health announces the annual Clinical Improvement Through Evidence (CITE) Award for nurses leading a clinical decision support team. Nominations are due June 15.

The Indiana Rural Health Association announces that the tobacco referral application by Holon Solutions is being used by 11 clinics and three hospitals, replacing faxed referrals with one-click electronic access.


Government and Politics

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The fired head of the Phoenix VA hospital that falsified wait times sues to get her job back, saying she was a scapegoat. In response, Rep. Kyrsten Sinema (D-AZ, above), annoyed that the VA pays terminated employees for months to years of appeals and that it lied about the number of employees it fired related to the scandal, has introduced legislation to hold the VA and its employees more accountable, explaining, “It’s now been over a year and these two are on paid administrative leave. That’s ridiculous. They’ve been sitting at home eating bonbons getting paid and they’ve done jack. Every time I talk to the secretary, I’m like, ‘Why have you not fired more people?’ And the secretary says, ‘Well, the process is very long and there’s due process, there’s all these steps, blah, blah, blah’… This is precisely the type of situation that makes the average citizen lose faith in their government.” The Congresswoman’s bio is fascinating.


Privacy and Security

A Ponemon Institute report (which you ironically can’t read without divulging private information) finds that the number one cause of healthcare data breaches is now criminal attacks, with a 125 percent uptick over five years.

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Two unnamed hospitals will test PowerGuard, a medical device malware detection system that looks for unusual power consumption without touching the underlying FDA-regulated hardware and software. The PhDs that started the company found that they could recognize when a computer accessed a particularly website by analyzing its power frequency footprints.


Innovation and Research

Brigham and Women’s Hospital (MA) will validate the offerings of startups in which Rock Health invests.

A UC Berkeley engineering team develops CellScope, a smartphone video blood microscope that can diagnose parasitic worm diseases that are common in Africa. Their work was funded by the Bill and Melinda Gates Foundation.


Other

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Here’s a reader-sent photo of folks representing most of the lab middleware vendors (including Liaison Healthcare Informatics, Lifepoint, CareEvolve, and Atlas Healthcare) taken at a recent conference. They talked about issues of mutual concern, including how to get more value from conferences and trade shows.

An employee of the Broward County, FL sheriff’s office faces 15 years in prison for attempting to extort $7,000 from a doctor she met on “married but dating” site AshleyMadison.com.

Weird News Andy titles this, “Not Exactly Wearable.” University students design seat-based airplane heart rate sensors that could allow flight attendants to identify passengers who are anxious or ill.  


Report from the American Telemedicine Association Conference
By Bill Rieger, CIO, Flagler Hospital

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The ATA conference, held this week in Los Angeles, was the largest in the 20-year history of the association. What is the ATA? American Telemedicine Association, of course. Did you know that association existed? Sadly, until last year, I wasn’t aware of it. Historically, unless you were dealing with the challenges of rural healthcare, you may not have had the desire or need to think about telemedicine. A couple of industry dynamics are changing that.

First, some definitions for those of you like me who are just awakening to the world of telemedicine. Telemedicine refers to the use of video or telephone technology used to reach those who would not normally have easy access to healthcare. Telehealth, a newer term that is more personal, is the use of technology to deliver healthcare. This can be wearables, remote monitoring, or even going to Dr. Oz’s website to get health tips that can impact your life. The terms are not really interchangeable, although they are commonly used that way. The conference was full of education and vendor booths that supported both concepts.

I went this year because we are trying to leverage both telehealth and telemedicine within the construct of our ACO. We have plans to use telemedicine to both reduce readmission rates and provide additional benefits to employers as we look to contract directly with them in our community. This is now common in most cities as the use of clinically integrated networks grows . In addition to ACOs driving use of telemedicine, the change in technology itself makes a case for increased use. Remote monitoring of patients in the least-expensive setting of care is just plain smart. Monitoring at home was a huge focus at the conference and the technology used to do this is exploding.

There were two main issues discussed in the keynote panel discussion and they were both excellent topics. The first one was interoperability. That’s right, that $10 word thrown around at HIMSS for the last few years. Well, that word did not even make  it to the showroom floor at ATA. When I walked around and talked to vendors, their technology was great, but the data resided in their individual cloud servers that could only be accessed through their proprietary Web-based or mobile application. Ugh!

Frustration filtered through me as I walked around and heard this repeatedly. Some of them mumbled something about HL7, but it clearly wasn’t a focus or priority. This is problematic for the industry as we look to consolidate data through the increasing use of private and public HIE strategies. It will be left to the health systems leveraging these technologies to assimilate the data into their EMR and HIE systems.

The other issue debated was standards of care. I was happy to hear about the new partnership between the ATA and the AMA. The AMA is starting to understand the potential of telemedicine and has determined that they needed to partner with this rapidly growing initiative and ensure there is a focus on patient safety, quality, and coordination of care. I look forward to seeing this relationship grow.

Eventually, I anticipate Joint Commission-like standards being put in place for the use of telemedicine. That will have to be done for the physician office and the hospital. Sprinkle some MU-like regulations for vendors that focus on interoperability and you will have just what we need — more innovation stifled by bureaucracy. Personal feelings aside, it seems too loose and Wild West right now, especially in the telehealth arena. Maybe I have been a part of the establishment too long to recognize the strength in loosely managed innovation. At the end of the day, a patient is involved, so no matter how cool or innovative, patient safety, quality, and coordinated care has to be addressed in some fashion.

The trip was well worth it. The conference was well run, although there were some minor hotel issues. There were minimal booth babes there, mostly telemedicine techno geeks that loved to talk. I learned a lot about telemedicine and telehealth and how different organizations are leveraging these technologies across the globe to improve access of care. I definitely recommend attending next year in Minnesota.


Sponsor Updates

  • DocuSign will exhibit at Microsoft Ignite through May 8 in Chicago.
  • Extension Healthcare celebrates National Nurses week with a #NursesRock Twitter contest.
  • ZirMed’s ZUG 15 user conference will be held August 17-18 in Chicago.
  • Galen Healthcare offers “eRX Refills – Just Click the Button, Right?”
  • Hayes Management Consulting offers five things to know after EHR implementation.
  • SyTrue CEO Kyle Silvestro is quoted in an article titled “Unlocking Unstructured, Qualitative Data Is Key to Analytics.”
  • HealthMEDX will host its user group meeting May 12-14 in St. Louis.
  • Healthwise offers “Apps and APIs: A Positive Step for Patients.”
  • Access customer Hilo Medical Center says the company’s electronic patient signature helped it attain HIMSS EMRAM Stage 7 and saved it $200,000 annually on consent forms.
  • Holon Solutions will exhibit at the New England Regional MGMA Meeting May 13-15 in Rockport, ME.
  • Impact Advisors offers “Revenue Cycle Management – What Does it Encompass?”
  • Aspen Advisors publishes “Transforming Care Delivery: The Power of Clinical Variation Management.”
  • Ivenix offers a new white paper entitled, “Improving Intravenous Therapy: Opportunities for Designing the Next Generation Infusion System, Part 1: Supporting Medication Safety.”
  • Logicworks publishes “Managing Hybrid Clouds: What Team Do IT Leaders Need?”
  • Medecision’s Aerial InCircle mobile application is named a finalist for Dorland Health’s 6th Annual Case in Point Platinum Awards in the patient engagement category.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 7, 2015 News 8 Comments

News 5/6/15

May 5, 2015 News 3 Comments

Top News

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Cognizant reports Q1 results: revenue up 20 percent, EPS $0.62 vs. $0.57, beating expectations for both and boosting the stock to a record high Monday. The company’s healthcare unit, which includes its November 2014 TriZetto acquisition for which it paid $2.7 billion, increased revenue by 43 percent year over year. CTSH shares are up 32 percent in the past year. Cognizant says it has added 500 consultants and 300 developers to the former TriZetto business and was selected for $200 million worth of synergy deals, which it says proves its expectations of $1.5 billion in post-acquisition revenue synergies. TriZetto had closed 2014 at $729 million in revenue with single-digit growth rates before the acquisition. Cognizant CEO Frank D’Souza added that while the TriZetto integration continues, the company would consider another acquisition of similar size.


Reader Comments

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From Compadre: “Re: Athenahealth. Its core offering is data entry, not software. They have thousands of people scanning, typing, and following up on claims. The actual software is just a Web front end that drives little profit margin. Let’s do some math. One MD internist collects $25K per month. Athena charges 7 percent ($1,750) to perform billing services, allowing it to book annual revenue of $1,750 x 12 months so the top line revenue looks like it’s growing. However, the cost is $1,500, leaving $250 per month for busy work. That’s not cloud computing. The street has caught on to this and it’s starting to show in investor sentiment. Finance rule 101: not all revenue is created equal.” A Forbes analysis says Athenahealth, like Allscripts, is facing low and declining ambulatory EHR margins compared to Cerner and says ATHN struggles with “evaporating profits, competitive struggles, and fading tailwinds” even as its share price climbs, making it ripe for implosion.

From BestBets33: “Re: Dr. Jayne’s report on her friend’s hospitalization. I often wonder why discharge planning and education is so disorganized. They do these things every single day, yet everywhere I’ve been it is such a cluster. Think about confused patients and nurses chasing things that should have been taken care of with a short checklist.” It is ridiculous that award-bragging hospitals can’t drive their policies and technologies down to frontline staff, meaning patients are at the mercy of whatever the individual nurse or doctor decides to do given their other priorities. Any other high-volume, high-revenue business would collapse from the lack of standardization and consistency – can you imagine shopping at a Walmart or eating at a McDonald’s that is run like a hospital? I suggested to Dr. Jayne that she ask her friend to request a copy of her medical record to see how closely it matches reality, not to mention finding out the cost and time required to get it. The hospital has a $200 million EHR, but from Dr. Jayne’s account, they’re using it poorly. Here’s my theory: hospital executives all over the country have fooled themselves into thinking they offer great care because they’ve walled themselves off from reality. They don’t eat their own dog food — when they themselves are forced into the patient role, they either go elsewhere due to privacy concerns or they get the swanky suite treatment far away from the huddled masses who pay their huge salaries. I would bet that every one of us who has been hospitalized was appalled at the inefficiency, clinical errors, and lack of consistent humanity. We ought to be embarrassed as an industry at what we’ve let ourselves become while pretending otherwise, but on the other hand, just acknowledging the opportunity for improvement is the first step.

From Picky Eater: “Re: Jeremy Bikman’s comments about KLAS. One report I saw recently costs $16,000 and it surveyed only a few dozen people. That’s not sustainable, especially considering that its methods are not statistically valid.” KLAS’s business model is brilliant – by ranking vendors, it creates a profitable maelstrom as the higher-ranked ones pay it fees to brag on their accomplishment (no matter what its statistical validity) and the lower-ranked ones pay the company for whatever insight it can offer to help them move up the food chain. I contributed to KLAS as a provider almost from the day they opened and my summary is that I rarely quibble at their best- and worst-ranked vendors – it’s the ones in between that are always duking it out. It was most useful when I was looking at a product I knew nothing about because otherwise the reports only validated what I already knew. I wasn’t as interested in the rankings or even the scores as much as I wanted to read customer comments, but even then you can’t put too much stock in them since you don’t know either the organization or the background of the commenter.

From Sam: “Re: Ed Marx. I like reading his submissions because he seems like a CIO with a philosophy. I’m curious if he resigned to work for a new organization and which one it might be.” I’ve heard indirectly that he has a new job, but I’ll leave it up to him to announce it when he’s ready.


HIStalk Announcements and Requests

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This is Ms. Sheppard’s Texas third-grade class using the drawing tablet, response buzzers, and iPad projector adapter bought with our DonorsChoose donation. She says the students now want to do all of their work using the response system since they enjoy competing. Maybe the buzzers should be used at some of the HIMSS snoozer sessions, or perhaps at executive meetings after being wired to provide an electrical shock to the presenter if the majority of attendees are bored.

I also got a fun thank-you card from a high school student who is happy with the algebra calculators we purchased for the class. It reads, “You’re my hero. You’re like the Superman of my math class today. For years now my brain has had one thought … I hate math. But now it is a lot easier for me to do basic and hard math because of the technology you have donated. I still don’t like math, but it’s not the worst thing in the world.” It apparently isn’t, because the student ended with a PS that included a complicated math problem and the challenge, “See if you can solve this.” It’s great seeing the benefit of donations firsthand, knowing that the impact wasn’t diluted by middlemen salaries and wasteful corporate overhead (which is why I would never donate to a hospital).

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Meanwhile, Epic has generously donated $4,500 towards our classroom projects, so I’ll be funding quite a few new ones this week. I have to look at our total donated, but I think it’s $20,500, and that funds a lot of important activities. Thanks to Epic for helping a bunch of kids  – I will make it a point to look for Wisconsin teachers in need.

Listening: reader-recommended Tame Impala, a one-man band from Australia that sounds like Sergeant Pepper-era John Lennon jamming with the children of Pink Floyd at the home of Tears for Fears.

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

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Webinars

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making.


Acquisitions, Funding, Business, and Stock

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Imprivata announces Q1 results: revenue up 32 percent, EPS –$0.28 vs. –$2.29, beating expectations for both.


Sales

Visiting Nurse Service of New York chooses Cureatr for secure messaging and care coordination.

CareMore Medical Group of Nevada signs up for the chronic care management program of Allscripts.

Grady Health System (GA) selects Strata Decision’s StrataJazz Continuous Cost Improvement.


People

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Penny Wheeler, MD, president and CEO of Allina Health, joins the board of Health Catalyst, replacing Larry Grandia.

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Kathleen Brenk (Trust Company of America) joins Recondo Technology as chief human resources officer.

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Former HHS Innovation Fellow Zac Jiwa joins healthcare API vendor MI7 as CEO. He had been an advisor to the company.


Announcements and Implementations

Raintree Systems will offer its customers patient billing solutions from PatientPay.

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Telehealth service vendor American Well releases a telehealth app for providers who want to see non-urgent patients via high definition video visits and Apple HealthKit connectivity. It also allows patients to choose a particular doctor or to take first-available and for doctors to invite their patients to a telehealth visit.

IBM, Epic, and Mayo Clinic will collaborate in using IBM’s Watson to analyze EHR information.

CompuGroup Medical announces CGM Analytics, a data aggregation and analytics solution.


Government and Politics

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Rep. Ted Poe (R-TX) introduces a bill that would prohibit HHS from implementing ICD-10. He’s been a hater from the beginning (mostly of anything Democrats favor), but his previous legislative attempts to stop ICD-10 haven’t gained traction and probably won’t this time either since he doesn’t have much Congressional clout. At least he’s apparently given up on his repeated attempts to prove that President Obama isn’t a US citizen.


Other

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Beth Israel Deaconess Hospital – Plymouth (MA) declares “Email Free Fridays,” urging employees to stop emailing each other for a least one day per week, get out from behind their desks, do real work, and communicate with co-workers face to face.

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Atul Gawande says in a New Yorker article that performing unnecessary tests and procedures is expensive and risky to patients, but it’s hard hit the sweet spot between doing too little and doing too much, especially in an environment that pays doctors for unnecessary care and penalizes them (via satisfaction scores and lawsuits) for lapsing into inadequate care territory. My interest is something he doesn’t emphasize much – what voice does the patient have in those decisions? We always assume patients want their doctors and hospitals to be aggressive with their procedures and prescriptions, but I suspect doctors aren’t always good at explaining the long-term benefit or recommending only those treatments that they themselves would choose.

A three-hospital study finds that while physicians often blame demanding patients for running up healthcare costs, less than 9 percent of oncology patients ask for specific tests or treatments, nearly all of those are clinically appropriate, and physicians very rarely comply with the inappropriate ones.

An MIT Technology Review article says Apple will recommend genetic testing to certain iPhone users, arrange for the tests to be run by academic partners, and then allow people to share their results with each other or with researchers via ResearchKit. UCSF and Mount Sinai Hospital are planning studies that will involve DNA collection.

The family of deceased Ebola patient Thomas Duncan says the donation of $125,000 by Texas Health Resources as part of its settlement with the family is “not nearly enough,” expressing shock that THR didn’t provide the $5 million the family asked for to build a hospital in Liberia.

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Legacy Health System (OR) goes to an emergency operations plan when an apparent power surge takes its systems down for 12 hours.

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A New York Times article covers the rise of air ambulance services that are raising their rates dramatically and pressing harder for patient payment even as insurance companies reduce coverage. A glut of medical helicopters has caused usage to drop and an industry trade group is trying to convince the federal government to increase their Medicare payments, warning that “it’s about access to healthcare.” Billion-dollar operator Air Methods, which operates 450 helicopters and airplanes in 300 locations, charges an average of $40,000 per flight. It’s another of those healthcare things that sounds like a fairly good idea to doctors and patients until everybody finally realizes what it costs.

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Weird News Andy offers a thumbs-up on the just-published “The Thrilling Adventures of Lovelace and Babbage: The (Mostly) True Story of the First Computer,” which he describes as “fun, smart, and very entertaining / informative.” It’s a mix of fact and fiction for “the whimsical intelligentsia,” a group to which we all surely aspire to belong.


Sponsor Updates

  • Extension Healthcare wins the Health Tech Award from Indiana’s TechPoint.
  • A team from Nordic will ride in the Madison Tour de Cure benefit for the American Diabetes Association on May 16.
  • PatientSafe Solutions CEO Joe Condurso is interviewed by The Wall Street Journal about health app development.
  • Ingenious Med is named as one of Atlanta’s 100 fastest-growing companies.
  • Medecision asks, “Who is Responsible for Patient Engagement?”
  • Cumberland Consulting Group Managing Partner Jeff Lee is featured in a PharmaVoice article on technology.
  • Culbert Healthcare Solutions offers “3 Strategies for Retaining and Attracting Top-Notch Physicians.”
  • Capsule Tech offers “Are your medical devices configured to reduce alarm fatigue?”
  • ADP AdvancedMD offers “Spring Cleaning for ICD-10” tips.
  • TransUnion Healthcare President Gerry McCarthy is quoted in an article that addresses uncompensated care.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 5, 2015 News 3 Comments

Monday Morning Update 5/4/15

May 3, 2015 News 3 Comments

Top News

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Henry Chao, the CMS CIO and deputy director who led the rollout of Healthcare.gov, has retired. He was little noticed until a September 2014 House report on the site’s failure, which quoted emails from former HHS CTO Bryan Sivak that characterized Chao as being in way over his head to the point that HHS plotted to hijack the project to try to salvage it. Chao reported to CMS CIO Tony Trenkle, who hightailed it for an IBM federal IT executive job just a handful of weeks after the site went down in flames (of taxpayer money).


Reader Comments

From Not So Lucky: “Re: McKesson EIS division. Big layoffs Friday.” Unverified.


HIStalk Announcements and Requests

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Around 17 percent of poll respondents think that HIT vendors intentionally stack the executive deck against women and unstated minorities, but most of them feel that companies have simply chosen the best people for the job and possibly only need ongoing reminders of the desirability of diversity. Some readers commented that perhaps companies can’t even see the benefit of executive diversity because they’ve never practiced it, while others commented that the “mommy track” may present a more attractive option for women who aren’t very interested in the never-ending hours, travel, and relocation required to move up the executive ladder. Cerner Europe GM Emil Peters referenced the poll on Twitter, saying, “Personally I think it’s a travesty. And I’m going to do what I can to fix it. However, I don’t think it’s by design.” New poll to your right or here: within the past two years, have you had to pay a medically related bill that created at least a modest degree of personal financial hardship?

Here another poll that interests me since I see a lot of people playing around with media in ways I don’t quite get: which would be the most attractive way to catch up on a weekly health IT news summary? I personally have never listened to a podcast and don’t anticipate a time that I ever will, so the results will help me figure out if I’m in the Bell curve hinterlands.

Check HIStalk Practice for the Population Health Management Weekly Roundup.

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I bought Regina Holliday’s brand new book “The Writing on the Wall” from Amazon and became so engrossed that I read it nearly straight through this weekend. My expectations are modest for healthcare IT-related books given some fairly lame ones, but this one is among the most moving things I’ve ever read, more of a story about love and family, overcoming adversity, and standing up for what’s right than the usual preachy, recycled facts about technology coming from someone who thinks of patients as people and/or customers different from themselves (the big secret: we’re all frightened, marginalized patients at one time or another). If your blood runs above room temperature, I predict you’ll laugh, cry, and get fighting mad at the very system you work within as you read about her life and the untimely death of her husband, but you’ll also find it uplifting and empowering. It would be a great read even without the IT connection. I’ll most likely write a full review shortly since to do less would be a disservice to people who either want or need to peruse it, but here are some excerpts that got me as I learned that Regina’s art is not limited to the visual variety:

We come into this world screaming and owning nothing. We grow and change. The years pass by and we fill with life experience as our homes fill with possessions. Time rolls on and on, but for all of us there is an end. Some will meet their end on highways and some in hospitals, but for most of us the end is the same. We are patients in the end. We pluck at cloth hospital gowns, left with only a few possessions: our watches, rings, and wallets … Hospitals can deconstruct a person as assuredly as I could lay bare a jewelry box. Take any professional adult and remove their clothes and their accessories. Dress them in a threadbare gown that is faded by thousands of wash cycles. Give them a number rather than a name. Confuse them with jargon while applying copious amounts of medication. Then watch them try to navigate the maze of care … I felt like a bright blue inconsequential bird in my Easter dress as I fluttered among the forests of polo shirts, hoodies, and business suits. Conference attendees in the world of medicine have a uniform look. You were welcomed if you wore a suit, tolerated if you wore a hoodie, and ostracized in a church dress. I was not wearing the correct uniform, but I took a deep breath and introduced myself. I would say, “Hello, my name is Regina Holliday. I want to paint about healthcare to improve health policy for patients.” I’d then say that I was inspired to paint by my late husband who very recently died of kidney cancer. I would give them my slip of paper masquerading as a business card. Then tell them to reach out to me via social media or email. Then I’d share the horrific things we had experienced during my husband’s 11-week hospitalization at five different facilities. I would see them step back from me with a brief condolence. A nervous half-laugh would often escape their lips. I was a widow fresh from the graveside asking questions that affect the lives of us all. I was not supposed to be there. They were having a ball and I was death walking among them.

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I’ll have more DonorsChoose project updates later, but here’s a photo from Ms. Classen’s intervention algebra class using the calculators we provided. She says, “What we’re able to do now with these calculators is amazing. Many more students are going to get the practice they need to graduate high school and learn to solve difficult problems thanks to you all.” 

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Here’s a photo of Mrs. Rowe’s third graders using the six iPad Minis we bought them for math study.

I was thinking about how hospital patient rooms often resemble hotel rooms in being littered with previously popular but now-useless technology components, which in the hotel’s case often includes iPod docking stations and dial-up ports that get used rarely and never, respectively.


Last Week’s Most Interesting News

  • CMS releases a gigantic Medicare Part D prescribing database for 2013 that includes details on $103 billion of drug spending.
  • Teladoc announces IPO plans and files an antitrust lawsuit against the medical board of its home state of Texas for requiring prescribers to see a patient at least once in person before issuing a prescription.
  • Anthem books $865 million in Q1 profit, up 25 percent despite its massive data breach during the quarter.
  • Imprivata acquires palm vein scanning biometric vendor HT Systems.
  • The chair and ranking member of the Senate’s HELP committee follow through on HHS Secretary Sylvia Burwell’s request for help identifying pressing but easily solved EHR-related issues.
  • A Brookings Institution report questions why patients are charged significant and inconsistent prices to receive copies of their own electronic medical records from providers.
  • CareCloud announces $15 million in additional funding and a new CEO.
  • Validic receives another $12.5 million in funding.
  • Vanderbilt University Medical Center announces that it will replace McKesson Horizon, some of which was developed internally by Vanderbilt, with either Cerner or Epic.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Startup MORE Health receives $3 million in Series A funding for its multi-language EHR that connects doctors and patients in China with US specialists.

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From the Athenahealth earnings call, which followed Friday’s expectations-beating earnings report that for some reason triggered a 7.4 percent share price drop:

  • The company added 2,300 providers in the quarter, raising its total to 64,000.
  • The RazorInsights team has been moved into the Atlanta office and the company has made RazorInsights sales, cross-sold AthenaOne to a RazorInsights client, and sold both products to a new client.
  • Jonathan Bush says the urgent and convenient care market is the most important to him because it’s growing fast and is managing “worried well” lives.
  • Bush says of big, non-academic health systems buying Athenahealth, “These guys have done their homework, gotten out their protractors and done the math on the arc of their flight, and they see it not clearing the tree tops. Not clearing the tree tops due to lack of profit is a great way to make you for-profit … They know that they can’t put the kind of obscene amounts of capital against or manage internal IT systems in the way that the fancy pants universities can afford to do and they’re slowly coming around to us and it’s exciting.”
  • The company says it won’t talk about individual hospitals or sales of RazorInsights, but “When we look at our growth, first of all, we’re starting with a very new company with a small base, so it’s relatively easier to grow a lot on the small base. We don’t intend to talk specifically about the number of individual Razor deals or that sort of thing. We really bought RazorInsights as a strategic asset along with WebOMR to build out our full inpatient solution over time.” Bush added that RazorInsights got its clients to Meaningful Use but “the billing needs a lot of work, like a lot” and says by year-end Athenahealth will offer a full-service revenue cycle program to RazorInsights users.
  • In justifying the $40 million paid for RazorInsights, Bush says Athenahealth got the best deal it could since the VCs who owned the company were either going to re-fund it or step out, so he sees it as an “acqui-hire” play in buying a product, a founding team, and brave early customers, adding that he’d like to do more of that.
  • Bush responded to an analyst who asked how bookings revenue drove operating income improvement, “If you’ve been following us for a while, you’re following a caterpillar, right? There’s sometimes where the nose of the caterpillar doesn’t appear to be moving at all, but back in the ass, it’s building up potential energy which will turn into a great nose stretch. ”
  • Bush said of ICD-10, “Never has a Bush felt so longing for more federal mandates as I have felt since the dying down of Meaningful Use and ICD-10 and PQR and ABC and do-re-mi. It is so easy when some fearful group of federal apparatchik are going to come for your prospect if they don’t buy. We are currently in a period where there are no apparatchiks coming … if ICD-10 tightens up and actually looks real later in the year it will help our close rate. I will feel sheepish about it because it seems a silly reason to make a free market move. But it’s true that right now our close rates are lower and that the specific reason we can attributed to it is no urgent federal mandate to buy.”
  • Bush said that Athenahealth’s connection to CommonWell is in beta and that he’s OK with making EHRs interoperable via other methods because “otherwise we’re all going to be on some federally mandated ridiculous EHR.” He adds, “CommonWell could have been perceived as sort of a PR smite against Epic, which I assure you I would never want … I want to be anything that Epic’s in as well, even if we have to double pay. This is not the solution for interoperability by any stretch. This is just a service so that a patient can get their freaking chart and have the same patient match to all the different systems that their chart is in. So I don’t think you guys should think of CommonWell as some sort of silver bullet that fixes everything … I don’t think it’s a solution to the real challenge, which is the B2B interoperability … that’s kind of the new frontier that we’re doing most of our work on.”

Sales

Erlanger Health System (TN) chooses Epic in what the local paper says is a $100 million deal.

CoverMyMeds will use state-specific electronic prior authorization requirements information from Point-of-Care Partners.


People

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Valence Health hires Michael McMillan (Cleveland Clinic) as SVP of strategic solutions.


Announcements and Implementations

CVS says in its earnings call that its Epic rollout is on schedule and will be completed by mid-year.


Government and Politics

A Washington Post review finds that nearly half of the 17 health insurance exchanges created as alternatives to Healthcare.gov are struggling with high technology and call center costs along with less-than-expected enrollment numbers. They’re considering raising fees charged to insurance companies, sharing costs with other states, asking for state money, or shutting down and using Healthcare.gov instead.


Technology

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Consumer personal health record vendor LMG 3 Marketing and Development Corp. sues Apple, claiming that its Health and HealthKit apps violate its patents for technologies that it claims to have licensed to retailers such as Target. I found the original 2012 patent, which is a vague and seemingly unrelated description of a personal health record on a thumb drive. The primary inventor is Mike Lubell of Raleigh, NC, who developed MyPMR in 2000 while creating an EMR/PM business unit  for Canon Business Solutions. LMG 3 apparently still offers MyPMR for $34.95.


Other

Former National Coordinator David Brailer, MD, PhD says in a Wall Street Journal opinion piece titled “They’re Your Vital Signs, Not Your Medical Records” that Congress should ensure that individuals have unqualified ownership of their health information and be given legal control over who sees it. He adds that patients should be allowed to designate an “infomediary” who can manage their information on their behalf. He warns that EHR vendors and providers block interoperability to gain a competitive edge and because “whoever controls health information will dominate the healthcare marketplace and its vast profit pool.”

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Intermountain Healthcare CHIO Sameer Badlani, MD lists his favorite apps for reference guides (DynaMed, UpToDate, ACP Smart Medicine); drug reference (Epocrates, Lexicomp, and one listed as Medimex that I assume is supposed to be Micromedex); clinical calculators (MediMath, MDCalc, and one I haven’t heard of, OxCalc); and antibiotic guides (Johns Hopkins Antibiotics Guide, Sanford Guide).

UnitedHealthcare will offer 24×7 video-based virtual physician visits to members enrolled in self-funded employer health plans, expanding availability to employer-sponsored and individual plan participants in 2016. It’s working with Doctor On Demand, Optum’s NowClinic, and American Well, with access through its Health4Me app. 

A Phoenix TV station profiles the local neurosurgeon who in 2008 developed The Medical Memory, which provides doctors with video recording equipment for recording patient encounters and posting them securely online for reference and sharing. I checked out the video link from the site showing his overview, but was kind of turned off that he got rather curt with whoever was running his slides (he’s a neurosurgeon, after all). It’s fascinating to me that on at least half a dozen occasions recently, I’ve had email or telephone conversations with healthcare IT people who came across as rude and clueless, leading me to question: could they possibly be that unlikeable in real life, or do they just come across poorly online without realizing it?

I’ll go out on a limb with this story: a Florida man sues a hospital for discarding his amputated leg in the trash, which he discovered when homicide detectives knocked on his door to inquire about what it was doing there.


Sponsor Updates

  • The SSI Group will exhibit at the Louisiana HFMA meeting May 3-5 in Lafayette.
  • Streamline Health will host the 2015 NEXT Summit Client Conference May 3-5 in Atlantic Beach, FL.
  • VitalWare shares “Five More Facts about ICD-10.”
  • Versus Technology recaps its HIMSS15 presentation on “Transforming Process Improvement through RTLS Data.”
  • Huron Consulting Group will sponsor the 2015 Cristo Rey Viva Event on May 7 to support the students of Cristo Rey Jesuit High School in Chicago.
  • Verisk Health offers“How Dollars Flow to Fight Medicaid Fraud.”
  • Sunquest Information Systems will exhibit at the Pathology Informatics Summit May 5-8 in Pittsburgh.
  • T-System President and CEO Roger Davis weighs in on EHR interoperability.
  • Team Hackasaurus Rex wins TransUnion’s first Hackathon, held at California Polytechnic State University.
  • Truven Health Analytics will host its Advantage Conference May 4-7 in Boca Raton, FL.
  • Valence Health will exhibit at Becker’s Review and Annual Meeting May 7-9 in Chicago.
  • ZirMed CEO Tom Butts shares his thoughts on IT trends and challenges, hospital CFOs on preventing claim denials before they happen, and ICD-10.
  • MedData exhibits at the MGMA Anesthesia Administration Assembly through May 1 in Chicago.
  • MediQuant President Tony Paparella is interviewed as part of the #TalkHITwithCTG podcast series.
  • Navicure exhibits at Centricity Live through May 2 in Orlando.
  • New York eHealth Collaborative will exhibit at the Crain’s Health Care Summit May 5 in New York City.
  • Nordic Consulting releases the fifth episode of its “Making the Cut” video series on Epic conversion planning.
  • NTT Data offers “It’s Beginning to Look a Lot Like Christmas … Thoughts on the Apple Watch.”
  • Oneview Healthcare will exhibit at Digital Health Live 2015 May 5-7 in Dubai, UAE.
  • Orion Health, Patientco, and PDS reflect on their HIMSS15 experiences.
  • PMD offers “There’s More to Health Than Being Happy: What a Patient Satisfaction Score Really Means.”
  • Qpid Health will exhibit at the Medical Informatics World Conference May 5 in Boston.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 3, 2015 News 3 Comments

News 5/1/15

April 30, 2015 News No Comments

Top News

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CMS releases a Medicare Part D prescription database for 2013 that includes details down to the individual prescriber for $103 billion in drug costs.


Reader Comments

From Ortho Doc: “Re: Meaningful Use. The ‘we can’t tell what the numbers mean yet’ for MU2 rear their ugly head in an Advisory Board report. Only 38,472 EPs have attested for MU2 to date. My guess is that only about half actually did Stage 2 as there was the Stage 1 reprieve. Even so, only 18 percent have successfully attested, which is a complete failure of MU. Someone ask CMS and ONC the tough questions, please. Now what are they going to do?” I’ve lost what little interest I had in MU – it’s a distraction to the real work that needs to be done, it encouraged providers to impulsively buy the same old EHRs they wouldn’t spend their own money on, and it put the federal government’s fingers in what should be private business practices and the patient-physician relationship. I’m actually encouraged that providers are bailing out since maybe they will refocus on what’s important.

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From Dan: “Re: DonorsChoose. We’ve noticed the recent activity on HIStalk and would like to participate. Your effort is very well aligned with our philanthropy and community involvement objectives, especially around STEM (science, technology, engineering, and mathematics). It’s great that you’ve topped $10,000 towards the effort and we’d love to make a $5,000 contribution. We’d also like to keep the contribution confidential – I’m simply reaching out on behalf of others who feel strongly about this topic and have worked to approve the funding.” I never disclose sources, but I’m making an exception this time because Cerner’s generous donation should be acknowledged (I warned Dan that I would probably name the company). I also suggested an interview with one of Cerner’s female engineers who mentors local girls about technical careers, so that’s coming soon. Thanks to Cerner, I’ll be funding another $5,000 worth of DonorsChoose projects with an emphasis on those related to STEM, which is vital to our global future as we fall behind countries that emphasize those subjects more than we do. Kudos to Cerner for stepping up with no expectation of recognition. 

Speaking of the DonorsChoose project, donating $500 for some time with Centura SVP/CIO Dana Moore is Holland Square Group, which provides contract help to Centura.  

From Ockham: “Re: Judy Faulkner. A rare panel appearance at the World Medical Innovation Forum put on by Partners HealthCare. I attended Day 1 and I was very impressed with the speakers. I also found it fascinating that even though the conference was on neurology, every panel and speaker ended up talking about genomics and how it is going to transform medicine. Unfortunately, I couldn’t be there for Judy. Epic clinicals and everything go live at Brigham and Women’s in 30 days. Boston should feel like a home town to Judy with almost all but BIDMC soon to be live on Epic.”

From Soul Survivor: “Re: Medfusion. 20 percent payroll downsize.” Unverified.


HIStalk Announcements and Requests

This week on HIStalk Connect: Teladoc files IPO paperwork, and simultaneously sues the Texas Medical Board for antitrust violations. Scanadu raises a $35 million Series B to fund clinical trials of its Tricorder-like Scanadu Scout. Validic reports strong Q1 results and raises a $12.5 million Series B that will be used to ramp up operations and meet growing demand for its personal health data interface engine. White coat hackers demonstrate a number of security vulnerabilities found in tele-operated surgical robots.

This week on HIStalk Practice: CareWell Urgent Care goes with Athenahealth. PatientlySpeaking integrates with Aprima. Iora Health CEO details the delight of developing a homegrown EHR for primary care. IOM rebrands. ICD-10 study shows physicians have their heads stuck in the sand. North Florida Women’s Care goes with Keona Health. Telemedicine price wars escalate. Tattooed community up in arms over Apple Watch’s heart rate sensor sensitivity. Sherpaa bypasses "old school" video for more effective text message consults. Thanks for reading.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Dallas-based video doctor consultation vendor Teladoc will file an IPO. The company also files an antitrust lawsuit against the Texas medical board for passing a new rule that requires doctors to meet a patient face to face before prescribing medication.

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MedAssets announces Q1 results: revenue up 9.9 percent, adjusted EPS $0.31 vs. $0.32, beating expectations for both. Chairman and CEO Halsey Wise said in the earnings call that he’s not happy with the company’s financial performance and announces plans for a “data-centric future” as customers ask the company to offer more services than just group purchasing as health system emphasis partially shifts from inpatient to ambulatory where MedAssets has minimal presence. The company plans to combine its supply chain and revenue cycle data with insights from its Sg2 analytics group (acquired in August 2014 for $142 million) to provide customers with deeper analytics. Above is the one-year share price chart of MDAS (blue, down 3.8 percent) vs. the Nasdaq (red, up 20.7 percent).

Care, quality, and compliance software vendor MedHOK acquires Continuum Performance Systems, which offers Medicare process management software.

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Anthem shakes off its January 2015-reported data breach in booking Q1 profits of $865 million, up nearly 25 percent from a year ago, mostly due to increased Medicaid plan membership.

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Athenahealth reports Q1 results: revenue up 27 percent, adjusted EPS $0.24 vs. $0.12, beating estimates for both. ATHN shares are up 20 percent in the past year.

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Imprivata acquires HT Systems, which offers the PatientSecure biometric identification system, for $19.1 million in cash plus performance incentives worth up to $6.9 million. The company’s palm vein scanning patient ID system is used in 324 hospitals.


Sales

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Community Health System (IN) chooses Allscripts dbMotion for its clinically integrated network.


Announcements and Implementations

Surescripts expands its CompletEPA prescription electronic prior authorization coverage to nearly 100 percent of US patients by partnering with PDR.

Boston Scientific will integrate analytics software from TogetherMD into its cardiovascular products.

IBM, Apple, and Japan Post Group will deliver iPads to up to 5 million senior citizens in Japan by 2020. The IBM-developed apps include medication and lifestyle reminders, community services access, and electronic monitoring that extends Japan Post Group’s fee-based home visits.

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Apple revises its App Store review guidelines to require ResearchKit developers to obtain institutional review board approval for studies involving human research. The previous language recommended but did not require IRB approval.

New York-Presbyterian Hospital launches the self-developed NYPConnect staff communication app.

Athenahealth connects the lab hub of Liaison Technologies to its network.


Government and Politics

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Former Texas for-profit hospital chain CFO Joe White is ordered to pay $4.4 million in restitution for filing false Meaningful Use attestation reports, adding to his previous sentence of 11 years in prison for healthcare fraud. He also falsified the entries using another employee’s ID and faces up to seven years in federal prison for identity theft in his May 27 sentencing. Chain owner Tariq Mahmood, MD was sentenced to 11 years in federal prison a couple of weeks ago for Medicare and Medicaid fraud, with the US attorney cheering the decision by saying, “What we do not need is providers like Tariq Mahmood who masquerade as physicians and pretend to care about American healthcare but actually are determined to loot the Medicare Trust Fund.”

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Premier comments on the House’s 21st Century Cures, urging ONC to help liberate data “locked in proprietary software systems” by developing standards (including patient identifiers, security, and APIs) and publicly reporting measures of interoperability via ONC’s certification program. Premier’s comments are valid, but as an organization representing providers, it places the blame on vendors rather than providers who are neither demanding or using interoperability capabilities due to competitive concerns.

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Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) of the Senate’s HELP committee make good on their promise to help HHS Secretary Sylvia Burwell with ideas for EHR improvement by inviting their Senate colleagues to join a working group that will identify ways to improve care, interoperability, and patient access to their own information.


Privacy and Security

A security guard at Mercy Health Saint Mary’s (MI) apologizes for looking up the EHR record of a 19-year-old female patient and then sending her a Facebook friend request.


Innovation and Research

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Sensiotec wins an innovation award from the Technology Association of Georgia and the Southeastern Software Association. The company’s Virtual Medical Assistant offers FDA-approved, non-contact patient monitoring for post-acute care patients, with a monitoring panel placed under a patient’s bed or chair to continuously stream biometric information to the cloud.


Technology

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Ron Kloewer, CIO of Montgomery County Memorial Hospital in Red Oak, IA, sent over a link to a Verizon story about the hospital’s Heartland Mobile Health unit, which connects the mobile exam room by 4G LTE to the hospital’s EHR.

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Microsoft releases a software development kit for its Band smart watch that providers app developers access to its body sensors and notification tiles.


Other

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Sitka Community Hospital (AK) says one of its top priorities in trying to survive financially is to fix its software problems, especially those that are causing delayed billing. Googling suggests that the system they installed last year is Healthland.

Deaconess Health System (IN) will install and maintain Epic for Good Samaritan Hospital (IN) via the OneCare ACO. I believe the system getting replaced is McKesson Horizon, which Good Samaritan bought in 2007.

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Sensationalistic US news sites love crises that keep eyeballs coming back, milking the latest plane crash, natural disaster, or civil unrest for all it’s worth. Good news doesn’t sell in the “if it bleeds, it leads” style, so here’s a counterpoint: the folks at Baltimore-based Salar were at Inner Harbor Wednesday handing out food to whoever was around – National Guard, police, locals, and visitors. Scour the web and you’ll find pictures everywhere of locals helping looted business clean up, protecting police from those intending to harm them, and reminding opportunistic criminals that torching a CVS and stealing lottery tickets hurts rather than helps.


Sponsor Updates

  • Microsoft announces Office plug-ins for DocuSign.
  • Mobile charge capture vendor pMD will become a PQRS registry for 2016.
  • Extension Healthcare offers “Reducing Clinical Noise and Solving the Challenge of Interruption Fatigue – A Nurse’s Perspective.”
  • PatientSafe Solutions hosted a 40-participant HIMSS15 breakfast event discussing smartphone-based clinical communication and collaboration.
  • Galen Healthcare offers part 1 of “Management-friendly policies we’ve taken to improve information security … and why you should too.”
  • The HCI Group interviews ERP Practice Director Lane Tucker in its latest blog.
  • ZeOmega hosts its client conference May 4-6 in Plano, TX.
  • Healthcare Data Solutions unveils a new brand and website.
  • First Databank adds natural health products to FDB MedKnowledge Canada.
  • Holon Solutions will exhibit at the National American Hospital Association Meeting May 3-6 in Washington, DC.
  • Influence Health will hold its Influence Client Congress May 3-6 in St. Louis.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 30, 2015 News No Comments

HIMSS15 Patient Advocate Recap–Melanie Peron

April 29, 2015 News 3 Comments

How do I sum up the HIMSS tornado I lived for three days with my new advocate friends? It is quite difficult, but it’s time that I did it!

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Almost four years ago, I decided to act and founded a social enterprise called l’Effet Papillon (The Butterfly Effect) in my home of France. It is dedicated to bringing a greater welfare to patients and their families. Since September 2011, we have organized 20 shows in patient hospital rooms (oncology services) and over 1,000 patients and family members received visits from musicians and storytellers. With the supportive care we provide to hospitals, charities, and socio-medical structures, 500 patients participated in individual or collective sessions.

It is incredible to see the power of this non-medical approach. Less anxiety, less feeling of social isolation, less consumption of antidepressants, and fewer relapses. This idea was born after being a caregiver for 18 months and after being very shocked by the social isolation of patients and family.

After being in contact with Regina Holliday for three years thanks to social media, I became a proud member of The Walking Gallery when she painted my jacket, “Butterflies.” When she suggested I apply for the patient advocate scholarship she created with HIStalk to attend at HIMSS15 in Chicago, I was surprise because I thought I was too small. I applied, thinking I had nothing to lose and that maybe I could be one of the lucky, happy, few patient advocates.

A few weeks after, I learned that I was one of the five winners. When I discovered the four other winners, I was very honored to be a part of this incredible team of rocking ladies. I also noticed that I was the only non-American patient advocate. Me, little social entrepreneur from France who struggled to provide supportive care and greater wellness to people, I’ll attend this huge event. I was thrilled!

For my trip to Chicago, friends and family wanted to be part of this journey, and in a way, they were with me. A friend of mine, Geraldine, took time to help me with the English version of the website. She also coached me for presenting my project. Another friend, Richard, helped me with the English version of the website of l’Effet Papillon. My friend Sonia lent me a beautiful couture dress of her atelier GLM fashion.

I arrived a few days before because I wanted to acclimate myself to the time zone, to the city, and to the language. I was a little bit worried to take part to this event and not to be able to speak like I did in French. HIStalk and Lorre organized everything very well before my arrival. Thanks to FormFast, I had the chance to stay in a very lovely and nice hotel during the event. Sunday evening I met Lorre for the very first time for real at Maggiano’s Little Italy at the HIStalk sponsor event and we met very nice people from Health Catalyst attending HIMSS as vendors.

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I arrived at McCormick Place on Monday with the shuttle. Even though I heard it was a big event, I was impressed by the crowd. I searched for the HIStalk booth with a great excitation to meet Regina, Lorre, Jennifer, Amanda, Tami, and Carly. I was searching a lot because HIMSS is so big. Even in the biggest stadium when I went to see my favorite rock bands, I never felt so lost!

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Finally, after a little time, I found the HIStalk booth and Regina. She was painting the jacket of Gabriela Wilson, a very nice person who I will meet the day after. Meeting Regina in real life is like meeting someone you waited for a long time. Quickly after this very happy moment, I met Carly, Tami, and Amanda and the team of patient advocates that was there. Sadly at the last minute Kim Witczak, our fifth winner of the scholarship, couldn’t come because of her job.

Monday was the first day of meeting in real with all my Walking Gallery friends and I passed all my day with them. I wanted to take the time to know them, to share our experiences, and to be with them, so I didn’t see a lot of vendors. The Walking Gallery of Healthcare members are so inspiring! You can’t imagine how wonderful and shining they are!

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Regina organized a gathering of the members and I met E-Patient Dave for the very first time. I was so happy! It’s thanks to a talk of Dave that I discovered him and Regina. I had the feeling to meet one of my favorite rock stars! And Dave is so nice! He gave me a badge for the Society for Participatory Medicine and proposed me to be a member of this society because they need of the participation of patients to move forward with the care and the treatments of patients. I would love to have the same kind of organization here in France.

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Monday night was the HIStalkapalooza event, a VIP event that is the place to be during HIMSS. As a fan of music, I was delighted to go to the House of Blues and share this lovely moment of music and happiness with my friends. For this special occasion, I wore my French couture dress and everyone loved it! I even receive the “Mr. H’S Secret Crush” sash. I think I succeeded to make a good representation of my friend’s work and talent!

Tuesday, we went to visit vendors with Tami. They welcomed us well and I think they were a little surprised to discover patient advocates. Finally, they all told us it was a great idea to have patient advocates in this event. I’m deeply convinced that everyone will take advantage asking patients their needs. How can we imagine being efficient toward the users of the healthcare system while ignoring them?

Unfortunately, I didn’t have the time and the chance to meet the cancer centers who were at HIMSS and I came through a lot of trouble with the WiFi. If some of them read this post, I’ll be happy to have a talk with them on Skype!

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Tuesday afternoon was the CGT live interview and I was a little scared about it. As you know, English isn’t my mother tongue. I make a lot of mistakes and it’s very frustrating to not be able to express your thoughts like you can in your native language (French for me). With the help of the two kind interviewers and the support of Tami, I came through safe. I tried to give the voice and the needs of the people who aren’t heard, who are voiceless — the patients. I hope the message is understood and empathized by many.

After the interview, we had another gathering with the walkers. I had the privilege of meeting Kym and Ross Martin, two lovely people who know very well how important support and the well-being are both for patient and caregiver. Kym is a three-time cancer survivor and she is as shiny as the sun. Ross loves music and he founded The American College of Medical Informatimusicology and Ross named me fellow for France! I’m very proud to be part of it when you know how important music in my life and in my work is. That’s how l’Effet Papillon began, with music and the meeting of the French singer Benabar.

When you’re a lucky patient advocate invited thanks to HIStalk patient scholarship, you are invited to very nice events and a lot of people want to talk and share your thoughts about patient’s needs with you. Tuesday evening, we had two events where we were invited. The first was the Speakeasy party organized by Medicity. The second was the social media healthcare leaders in Gino’s. It was very nice and Tami won a Chromebook!

I began Thursday with a session about physician tools for patient engagement and it was very interesting. I learnt that 72 percent of Internet users look online for health information within the past year (2012 survey) and research indicates informed patients are more likely to comply with physician-recommended treatment, more willing to take an active role in their own health, less likely to make unnecessary health visits such as to emergency room, and more likely to have better health outcomes. About the topic patient-centered vs. patient engagement, they told us that patient-centered care is about the actions of the physician and other care providers and patient engagement is about the action of the patient regarding their own care. I have the dream that all physicians share the same goal and so the healthcare system!

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Little after, I did a demo of Bliss in a Starbucks for Tami.

After that I had a nice meeting with Bewatec. This company offers multimedia communication solutions for hospitals. I thought it could be interesting for them to see Bliss, the social network of l’Effet Papillon I imagined and designed to answer to the social isolation of sick people. I have to keep in touch with them because we did not have a tablet version for the moment.

Because of the awful WiFi, I heard very late about Carly and the fact that she was in the emergency room of a Chicago hospital. She did so much for the patient advocacy during the event that her body stopped her with a huge migraine. With my daily headaches and the huge migraines I have quite often, I understand very well this kind of problem. When you give a lot and you don’t rest enough, your body stops you. And Carly, as a chronic patient with Crohn’s disease, knows that much more than me.

On the afternoon, I met Medfusion and they did a demo of their portal of portals for me. I’m not used to applications like that and I was surprised to find it quite easy and user friendly. They told me they asked for patients’ thoughts and needs when they were creating their app. The solution manager gave me an invitation code to download the app and try it, but unfortunately it’s not supported by my HTC One mini 2 so I am unable to review it.

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At the end of the day, we had the last gathering of The Walking Gallery.

Thanks to HIStalk for this scholarship opportunity at HIMSS, I lived one the very best moments of my life. It was one the most incredible experiences I have had since the beginning of l’Effet Papillon. I met amazing and lovely people, people who inspire the change, people who dare, people who try and a lot of DOERS! With Amanda, Tami, Carly, Regina, Lorre, and Kim (you were there in our thoughts), I found incredible new friends.

I have never been so well received and listened to. In 2011, when people asked me, “Why do you want to create something which doesn’t exist? If a structure dedicated to bring a greater welfare for sick people doesn’t exist, it is because it’s not possible,” at that time, I discovered those crazy people like me are called social entrepreneurs. In 2015, thanks to HIStalk and Regina Holliday, I discovered that I was a patient advocate and a change maker.

One day, I’ll hope to bring wellness and happiness in the US too and I think Bliss could be a lovely way. I met so nice people there! The butterfly wants to fly and bring bliss actions everywhere.

I hope I will have the chance to live again those kind of moments and to attend to other events like that with patient advocates. Don’t forget about Carly’s challenge for HIMSS16: bring at least one patient to each booth!

Again, a huge thanks to Regina Holliday with The Walking Gallery of Healthcare and HIStalk who allowed me to be part of this journey.

If you want to stay in touch, feel free to contact me, I’ll be happy to talk with you by website, email, Twitter, Facebook, or LinkedIn.

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April 29, 2015 News 3 Comments

HIMSS15 Patient Advocate Recap–Amanda Greene

April 28, 2015 News 3 Comments

When I first heard about the opportunity to attend the 2015 HIMSS conference in Chicago as a HIStalking patient advocate on Regina Holliday’s blog, I knew I had to apply even if I didn’t earn one of the coveted scholarships. I wanted to be a part of the incredible opportunity that invited patients to be a part of the largest health IT conference of the year. I was thrilled when I found out that I was going to be one of five patient advocates selected by Regina and the HIStalk team.

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"LA Lupus Lady" in The Windy City of Chicago at HIMSS15.

After weeks of planning and preparations, taking a trip when you manage a chronic illness is more than packing your suitcase — it involves strategy and planning for all contingencies. Traveling to Chicago, checking in to the hotel, and adjusting to Chicago time is for most people the extent of travel stress. For me, the seemingly endless walk to the departure gate and retrieving my luggage was a virtual marathon, yet my adrenaline and excitement pushed me with a sense of excitement. I made it to the shuttle and arrived McCormick Place with eagerness and anticipation.

There was a small registration situation, but soon I found myself meeting Colin Hung (@Colin_Hung of #hcldr) for the first time. I love meeting my friends from social media in real life and had been looking forward to hugging Colin at HIMSS. Thankfully Colin had access to an extra HIMSS pass and shared his access with me.      

Strolling the streets of Chicago was one thing but walking the aisles of booths within the exhibit hall of HIMSS was incredibly empowering. I was filled with joy and inspiration with every step. The colorful signage and well-appointed booths were on abundant display as Colin helped me wield the magnificent madness and lead the way to the HIStalk booth to check-in with Regina and the HIStalk team.

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Regina Holliday and Colin Hung show off their "The Walking Gallery" jackets in the HIStalk booth at HIMSS15.

Soon I was on my own and wandered through the exhibition hall, meeting executives and representatives for the largest health IT companies as well as the next big thing and meeting the teams behind the start-ups who strive to create the next big paradigm shift in information technology. After a fabulous first day of HIMSS adventures, it was time to celebrate at the HIStalkapalooza party held at Chicago’s famous House of Blues, where I was proud to participate in judging the HIStalk "Best Dressed" and "Best Shoes" contests. In case you don’t know this about me, let me share that I love it when my passions collide, and being a patient advocate with a new Karen Kane dress on at the HIStalk HIMSS party was a real collision of my passions for health activism, fun, and fashion.

The reason attending HIMSS was such a pleasure for me is that HIMSS is a "global, cause-based, not-for-profit organization focused on better health through information technology." As a healthcare activist, I was happy to be healthy enough to attend the conference and absolutely thrilled to be able to engage and connect with the stakeholders involved with developing the next generation of healthcare devices and apps. More importantly, I was able to be seen and heard as a patient advocate.

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Patient advocate "engaged" with Jan and Jack at HIMSS.

On Tuesday morning, Jan Oldenburg of the HIMSS Connected Patient Initiative shared the value and impact of engaging with patients at the Digital Health Meetup. This meetup was one of the most empowering sessions of HIMSS15. I was already teary from Jan’s passion for the community and retelling of Regina Holliday’s story "73 cents" when she asked if anyone was a member of "The Walking Gallery" and wearing their jacket.  Of course, I was. I stood up and "modeled’ my jacket. Soon after, Jan mentioned that WEGO Health CEO Jack (@healthyjack) Barrette was in the crowd. I was overwhelmed by inspiration and had to talk with Jan about how I could continue my passion for the Connected Patient Initiative and community after the conference was over.

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"Connected Patient" Learning Gallery exhibit at HIMSS.

Imagine the future of healthcare where patients and doctors are able to share EMRs/EHRs with immediate access and are able to create a system of Meaningful Use. (No Meaningful Use "MU" without me.) At the HIMSS conference, the future is not some far off and distant place but "the future is now."

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In addition, to attending HIMSS as a patient advocate, I was interviewed for #TalkHITwithCTG. Thank you to CTG Health Solutions for being a sponsor of the HIStalking patient advocates HIMSS registration passes. CTG Health Solutions was generous and extended their extra passes to HIMSS to HIStalk and that is how the HIStalk patient advocates were able to gain admission to HIMSS. (Thank You!)  

Headlining the HIMSS conference was former POTUS George W. Bush. He was surprisingly jovial and recalled his memories of days during his Presidential administration. I enjoyed his family stories of how his parents and family have taught him the value of family, trust, and love. Though attendees were told not to take pictures during his keynote presentation, as a patient advocate I was also told to be gently and openly "disruptive," so I enjoyed the challenge of sneaking pictures of 43 during the Q&A.

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Former President George W. Bush giving the keynote at HIMSS15! Wowing the crowd.

Immediately after the Presidential keynote, it was time for the HIMSS Block Party, a celebration of the community and regional HIMSS chapters representatives were there to encourage a real sense of community.  It was at the HIMSS Block Party where Regina and the HIMSS attendees who are members of The Walking Gallery gathered for a photo op and hugs. On my way out of the party, I luckily met the California HIMSS chapter representatives, and as luck would have it, I won the Block Party prize of California wine and treats. The HIMSS community made me smile even more (on the last day after the conference) than I thought possible.

The next day, I spent more than a few hours napping and recouping from the conference, but I forced myself to get out and explore the city. In addition, to visiting the famous Bean sculpture, I went to Tribune Plaza for a special "photo op" with my favorite football team’s helmet. Despite being in Chicago, I had to pose with the New York Jets helmet, a part of the city’s preparation for the NFL draft. 

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Passions collide in Chicago… #LHandSign in the New York Jets helmet in front of the Chicago Tribune. Raising Lupus Awareness in the city after HIMSS15 wrapped.

It was an honor and pleasure to join the HIMSS community. I feel so lucky to have had the opportunity to participate as a HIStalk patient advocate. I will never be able to show my deep gratitude and appreciation to everyone who made my journey to Chicago such a wonderful adventure.  Lorre, Jennifer, and of course the entire HIStalk team, I am so grateful. How can I begin to thank Regina Holliday for creating the environment where patients are included?  

I am proud to share my adventures in Chicago and hope that this post was able to give you a glimpse into my HIMSS journey. Patient advocacy is my path and I feel that my trip to Chicago was a delightful turning point in empowering me to "level up” my activism and share my enthusiasm for advocacy. In case you are wondering, yes, I am still smiling.

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April 28, 2015 News 3 Comments

News 4/29/15

April 28, 2015 News 3 Comments

Top News

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Vanderbilt University Medical Center (TN) will replace its McKesson Horizon system — the CPOE portion of which it developed in-house as WizOrder starting in 1995 — with either Cerner or Epic. That’s one of the last homegrown systems to bite the dust, both at Vanderbilt and everywhere else as McKesson puts its commercialized version out to pasture after a 12-year run. It’s also interesting that Vanderbilt is echoing the general market trend of considering only Cerner and Epic to be viable choices, showing no interest in looking at Allscripts, Meditech, or McKesson Paragon.


Reader Comments

From Willow: “Re: Xerox Midas+ layoffs. Four laid off so far, apparently prompted by the first poor quarterly earnings report in the company’s history, which appear to have been caused by the high consulting and infrastructure costs spent on its Juvo product.” Unverified.

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From Concerned CC Client: “Re: new CEO at CareCloud. Positioned as great new, but in reality not. Since they were founded in 2009, under Santalo’s direction, they have gone through $80.5 million, are not making money, and now need $15 million to stay afloat.” EHR/PM vendor CareCloud announces Ken Comee as CEO, replacing Albert Santalo, who will remain as chairman and chief strategy officer. The company also announced $15 million in additional funding from existing investors. Technology executive Comee has been on CareCloud’s board since 2012, and according to his LinkedIn profile (which features the overly arty “more chest, less head” look above), he has no other healthcare-related experience.


HIStalk Announcements and Requests

We’ll have HIStalk Practice posts Monday through Thursday going forward (instead of just twice weekly) and Jenn will also write a Friday summary of population health management news. Sign up for short, fun, and informative updates and see what’s new in ambulatory, practice, and PHM.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Private equity firm Francisco Partners will acquire healthcare talent management solutions vendor HealthcareSource from majority owner Insight Venture Partners.

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Merge Healthcare announces Q1 results: revenue up 6.9 percent, adjusted EPS $0.05 vs. $0.04, beating earnings estimates but falling short on revenue.

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Validic raises $12.5 million in Series B funding from investors that include the venture arm of Validic customer Kaiser Permanente.

The Raleigh, NC business paper says Allscripts will build a new 18-story building for its 1,260 local employees, although the company hasn’t confirmed. The article mentions that Allscripts recently “rebalanced” 3 percent of its workforce.

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The Chicago business paper profiles referral management software vendor Fibroblast.

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Scanadu raises $35 million in a Series B round to further develop its Scout tricorder-like body scanner.

CTG announces Q1 results: revenue flat, EPS $0.08 vs. $0.19. The company blames soft healthcare IT services demand as providers delay projects or staff them internally.

Aetna announces Q1 results: revenue up 8 percent, EPS $2.20 vs. $1.82. Chairman and CEO Mark Bertolini said in the earnings call that its Medicity business is “seeing a lot of growth.”

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Roper Industries, which owns many companies that in healthcare IT include Sunquest and Strata Decision Technologies, reports Q1 results: revenue up 4 percent, adjusted EPS $1.55 vs. $1.46, falling short on analysts’ revenue expectations but beating on earnings. The company announced in the earnings call that it has changed its name to Roper Technologies to emphasize that it isn’t just an industrial company but rather a collection of businesses that deliver 60 percent gross margins. Above is the one-year share price chart of ROP (blue, up 24 percent) vs. the Dow (red, up 9 percent).


Sales

Consolidated Laboratory Services chooses McKesson Business Performance Services for billing.

Star Medical Center (TX) contracts with Anthelio Healthcare Solutions for revenue cycle optimization.


People

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Medical kiosk vendor HealthSpot hires Gail Croall, MD (Anthem) as chief medical officer; Eric Eichensehr (Levitate Technologies) as CTO; and Bruce Roberts (RxEngage Partners) as COO.


Announcements and Implementations

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In Qatar, Al Khor Hospital goes live on Cerner Clairvia for nursing staff management.

The CEO of Henry Ford Health System (MI) says that while the system took an initial financial hit in 2013 after its $353 million Epic implementation, using Epic helped it save $65 million in 2014 and HFHS will cut $300 million in cost by 2016 as its financial turnaround continues. Meanwhile, UNC Health Care (NC) also credits Epic with its stronger-than-expected operating income.

Wellcentive, SpectraMedix, and eClinicalWorks are pilot testing NCQA’s eMeasure electronic clinical quality measure program for Meaningful Use and HEDIS reporting.

T-System announces its tablet-based T Sheets Digital for Urgent care that includes 45 chief complaint-based templates.

MedAptus releases Premium Analytics for its charge capture suite.  

QPID Health is named a Gartner “Cool Vendor.”


Government and Politics

The Institute of Medicine will rename itself to National Academy of Medicine effective July 1, 2015.

National Coordinator Karen DeSalvo, MD says in a Health Affairs blog post (which appears to have been taken verbatim from her HIMSS conference presentation) that ONC will use Medicare payments and the DoD’s EHR contract bid to push interoperability.


Privacy and Security

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A security researcher finds data from Hilton Head Hospital (SC) for sale on a hacker marketplace, apparently exposed during a 2014 breach caused by PST Services, a McKesson subsidiary that provided billing services to Tenet’s hospitalist contractor and inadvertently opened up its billing records to Internet searches.

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Seton Family of Hospitals becomes the latest organization to expose patient information via employee-targeted email phishing attacks. Hackers accessed the information of 39,000 Seton patients in the December 4 breach.


Other

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Pella Regional Health Center (IA) opens a 24×7 nurse hotline as part of its patient-centered medical home efforts. Anyone can call the hotline to discuss concerns or make appointments with nurses who have access to the EHR.

Partners HealthCare expects to double the $80 million in annual revenue it receives from licensing and spinoffs.

Former National Coordinator David Blumenthal, MD says in a Wall Street Journal editorial that healthcare IT will fall short of its potential unless security and interoperability are improved.

A Brookings article highlights the maximum “reasonable cost” providers can charge patients for providing 75 copied pages of their records, which ranges from $19 in California to $101 in Georgia. It mentions that providers in many states can charge patients the same per-page amount for copies of their digital records even though the provider cost is essentially zero.


Sponsor Updates

  • Amerinet extends through 2018 its member discounts to revenue integrity products from Craneware, also adding the company’s InSight Medical Necessity tool.
  • Zynx Health and Meritage ACO will present “Using a Mobile Tool to Create a Virtual Caregiver Huddle” at the NPSF Congress April 29 – May 1 in Austin, TX.
  • Cueatr posts a photo slideshow of its experience at the HIMSS conference.
  • ADP AdvancedMD announces the launch of its SmartPractice e-letter for independent practices.
  • AtHoc details its integration with Apple Watch.
  • Besler Consulting outlines how “CMS-1498-R2 gives hospitals option to have their SSI Factor recalculated.”
  • CareSync offers “Here’s How CareSync Changes Lives for the Better.”
  • CareTech Solutions takes a look at how The Metro HealthSystem used the company’s solutions to realize SEO advantages and budget benefits.
  • The local paper looks at how several HIStalk sponsors — CenterX, Forward Health Group, Healthfinch, and Nordic Consulting – are making an impact in their native Madison, WI.
  • Team CoverMyMeds shares personal highlights of HIMSS15 in its latest blog.
  • MedCPU looks back on its HIMSS15 experience.
  • Health Care Improvements Institute announces its partnership with xG Health and interviews xG Health CEO Earl Steinberg, MD and President/COO Ray Herschman.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 28, 2015 News 3 Comments

Monday Morning Update 4/27/15

April 26, 2015 News 14 Comments

Top News

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HHS Secretary Sylvia Burwell, testifying on the department’s $84 billion 2016 budget request, is challenged by Sen. Lamar Alexander (R-TN) who stated that half of doctors don’t like their EHRs to the point that they’ll accept Medicare penalties rather than deal with workflow disruption, adding that the AMA found that 70 percent of doctors say their EHRs weren’t worth the cost and that EHRs are the leading cause of physician dissatisfaction. Burwell responded that HHS will work with Congress on a list of administrative action items related to EHRs, which seems to refer to the work of the HELP committee that most recently talked about interoperability and interviewed Epic’s Peter DeVault. What worries me most about the entire exchange is that nobody questioned whether HHS or Congress have any business involving themselves with how doctors use EHRs, where Burwell’s response might have logically been, “Respectfully, our job is making taxpayer payments to providers who choose to participate in Medicare and HITECH, but otherwise the EHRs that providers buy, use, and complain about really aren’t under the government’s purview. We should be monitoring the outcomes, not prescribing the process, which is how government works with all other industries.”


HIStalk Announcements and Requests

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Poll respondents grade the HIMSS conference with somewhere in the C-plus range. A consulting company vendor says it was successful in meeting with clients and networking with peers, while a CIO observes that the HIMSS conference is all sizzle and no steak as it keeps growing and ratio of vendors to providers seems to be going up as well. New poll to your right or here: what do you think about the fact that most health IT vendor executives are white men? (“I’m not thinking about it at all” is a poll option as well). Add a comment to support your position if you like.

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We were signing up for our microscopic booth for HIMSS in Las Vegas and were surprised to find that nearly all of the exhibit spaces have already been taken in the booth signup frenzy that occurs even before the previous conference is over. I don’t have the money or HIMSS points to play with the big boys, but even the 10×10 spaces in weird locations were mostly booked up. The tiniest parcels run around $5,500 and I declined the $2,500 extra HIMSS wanted for a corner space (they didn’t charge extra for our corner spot the past two years). We’ll be in #5069, with our presence probably annoying our next door neighbors Varian Medical Systems and Patient Prompt even though we’ll keep their area busier than it would be otherwise as we have a fun cast of characters running around. At least we don’t have much stuff to stick in there – we brought everything we used in our McCormick Place booth in one large duffel bag and set it up in maybe 20 minutes. There’s no ROI since we don’t have anything to sell, but we like just saying hello and giving our boothless friends a place to hang out.

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Speaking of our McCormick Place booth, patient advocate Regina Holliday wrote a nice summary of the time she spent there and her HIMSS experience in general.

I forgot to mention an unpleasant encounter Lorre had with the “HIMSS police,” who were a little bit snippy in confronting her at our booth and demanding that we stop using the name “HIMSS Bingo” in referring to a contest that we had nothing to do with other than allowing winners to pick up their prizes there. The HIMSS person was too busy scolding to hear that she had the wrong scoldee.

Most people think of Epic first on the list of Madison-connected companies. Here’s another that just came to me: John Holton, who graduated from UW in 1975, founded Atwork in 1983 and then Scheduling.com (now SCI Solutions) in 1999, although both operated out of California rather than Wisconsin.


DonorsChoose Project Updates

Feel free to skip this section if you aren’t following our project as it winds down – the normal stuff follows.

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Thanks to new participant The Breakaway Group, who donated $500 to get on Centura SVP/CIO Dana Moore’s dance card. I’ve funded $10,478.21 in projects, including these new ones, including some I chose in Colorado since that’s where Dana lives:

  • A printer, tablet supplies, and early literacy books for an elementary school teacher’s graduate courses in education, Los Angeles, CA.
  • A camera and photo printing equipment for creating a time capsule for a high school in Atlanta, GA.
  • Math games and learning activities for a second grade class in Garland, TX.
  • An iPad case and AV adapter for English language learners at an elementary school in Las Vegas, NV.
  • A TV and flash drive to promote newly arrived books in the library of a high school in Walden, CO.
  • Drums for rhythm and movement activities for special needs students at an elementary school in Centennial, CO.
  • Six iPad keyboard cases for a fourth grade class in Lone Tree, CO.
  • Globes, maps, and books for a K-2 class in Denver, CO.
  • A tablet with keyboard for English as a second language students at an elementary school in Fort Lupton, CO.
  • A Chromebook for an earth sciences class at a high school that can’t be accredited due to lack of hands-on learning tools in Norfolk, VA.
  • A complete library of high-interest, low-readability books for a class of severely intellectually disabled students at a middle school in Conway, SC.
  • Four boom boxes and 12 sets of headphones to create a literature listening station in the reading area of an elementary school in Seattle, WA.
  • A library of classic books for a third grade class in Clarksdale, MS.
  • Hand sanitizer and tissues for profoundly mentally disabled K-5 classroom in North Charleston, SC.
  • Baby wipes, diapers, a food blender, wheelchair supplies, and insect repellent for a handicapped K-2 students at an elementary school in North Charleston, SC.

Webinars

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


Last Week’s Most Interesting News

  • Infor signs an agreement to distribute its hospital data integration products in Cuba.
  • A RWJF study of personal health records finds that consumers value their own subjective narrative entries more than anything else, while doctors rarely even look at them.
  • Seven disabled veterans sue the VA for failing to deliver copies of their disability-related medical records for up to 25 months after their requests.
  • LabCorp announces a direct-to-consumer testing program.
  • Kaiser Permanente announces plans to open a 900-job healthcare IT campus in Atlanta.
  • A judge orders MyMedicalRecords to pay the legal defense costs of Allscripts and WebMD after those companies prevailed in two of a nearly endless number of questionable MMR patent infringement lawsuits.

Acquisitions, Funding, Business, and Stock

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Business Insider runs the first skeptical article I’ve seen about Silicon Valley lab darling Theranos and its $4.5 billion net worth, 31-year-old founder Elizabeth Holmes. Experts say they have no idea how the company’s technology works because Theranos won’t publish peer-reviewed studies about its tests, won’t let independent experts review its labs, and doesn’t acknowledge whether it’s actually using the same analytical machines as other labs in addition to its small-sample size equipment that other labs use as well. The article also questions whether can scale given its plans to perform 1 million tests in 2016, less than 0.2 percent of the number performed by Quest. Quest and other competitors are questioning whether tests performed by Theranos using capillary blood (microfluidics) are accurate.   


Sales

Children’s Hospital Association chooses Clinical Architecture’s Symedical for global terminology management for analyzing comparative data.

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Avera Health System (SD) selects Meditech 6.1 Web EHR for 33 hospitals and 208 clinics. The press release isn’t clear as to whether this is an all-new product and Googling the term “Meditech Web EHR” brings up a non-specific mention on the company’s website, which used to be a no-nonsense list of information but is now maddeningly glossy and detail-free, with artsy scrolling pages and oversized type crying for Internet attention without providing much value in return. Click “EHR Solutions” and you won’t see a list of them. I don’t fully understand how a product can be “groundbreaking” if it’s in version 6.1 or whether this is just a new Web front end for the same old products.


People

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Mark Young (StayWell Health Management) joins PatientSafe Solutions as COO.


Announcements and Implementations

Phynd Technologies will analyze the cost to Nebraska hospitals of managing their provider information manually vs. using its provider information management platform in a project funded by the state.


Government and Politics

The VA forms an 11-member medical advisory group to advise it on healthcare delivery issues.

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Here’s a pretty funny tweet from CMS Chief Data Officer Niall Brennan.


Technology

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Healthcare is always a lagging chaser of consumer technologies, so I’m not quite sure what to make of the just-announced Amazon Dash, a WiFi-connected, product-specific stick-on electronic button that lets users restock a particular product with a single press. It’s either a brilliant time-saver that creates even more loyalty to Amazon and the products it sells or, as The New Yorker opines, “an uneasy image of our homes as giant Skinner boxes, and of us as rats pressing pleasure levers until we pass out from exhaustion” that bypasses the brief thinking moment of “Why am I using all this stuff?” while driving to the store. I didn’t realize that Amazon already offers a speech recognition and barcode scanning version of Dash for users of its expensive AmazonFresh grocery delivery service in Seattle, California, and New York metro areas.


Other

USA Today profiles the involvement of patients in the EHR selection of Partners HealthCare (MA), which invited a patient who sits on its advisory board to help choose its $700 million system. I like the approach, although I can’t help but think of the economic strong-arming and brand name-brandishing Partners does to squeeze out competitors and force insurers to pay its exorbitant rates, which isn’t really in the best interests of patients or the healthcare economy in general.

An investigation has been underway in Texas to review the state’s issuance of a no-bid Medicaid anti-fraud system contract to a local bidder with zero experience. The Houston newspaper points out that the state was already using a similar system that had recovered $56 million against its original cost of $16 million, while the new $20 million system (with a pending $90 million extension) has recovered zero dollars. Nearly all of the funds came from all of us who pay federal taxes. State government was asleep at the wheel, with a prime example being that the contractor (21CT) billed it the full price of a $452,000 project the day after the purchase order was signed and the state paid it immediately. A few state employees have been fired and a criminal investigation is underway. The state’s HHS inspector general who arranged the deal lied to CMS by claiming that a competitive bidding process had been conducted and then resigned after local newspapers exposed the scandal.


Sponsor Updates

  • Nordic offers a recap of #HIMSS15 through its Twitter feed.
  • PatientKeeper offers thoughts on “HIMSS and hEHRs.”
  • MBA HealthGroup offers “Skin in the Game: Keys to Success in a Private Dermatology Practice”
  • MedData breaks down the 2015 PQRS payment adjustment statistics.
  • Wellsoft will exhibit at the EDPMA Solutions Summit April 26-29 in Amelia Island, FL.
  • Sandlot Solutions will exhibit at the Big Data in Healthcare Summit April 28-30 in Boston.
  • Netsmart’s e-prescribing solution attains certification for controlled substances.
  • TeleTracking asks, “Who’s Looking Out For Nurses?”
  • PDS offers “Five Tips for a Trend-Setting Healthcare IT Strategy.”
  • NTT Data offers “Wearables in the Enterprise – What are Industries Saying?”
  • Patientco adds 2.4 million patients to its patient revenue cycle platform.
  • PeriGen recaps last fiscal year in “Another 48,611 births powered by PeriGen.”
  • PMD offers “Keeping Priorities Straight and Scaling Support.”
  • QPID Health CMO Michael Zalis, MD is featured in “Diagnosing Imaging: Maximizing Appropriate Use with Smart Decision Support.”
  • Sagacious Consultants offers “ICD-10 Training for Providers, Coders, and CDI Specialists.”
  • New York eHealth Collaborative offers “The Healing Power of Your Own Medical Records and SHIN-NY.”
  • Stella Technology offers “HIMSS15 Conference Highlights and Takeaways.”
  • Summit Healthcare declares that “HIMSS 2015 Did Not Disappoint!”
  • T-System will exhibit at the UCAOA National Urgent Care Spring Convention April 27-30 in Chicago.
  • Truven Health Analytics offers “Appealing the CMS Risk Adjustment and Reinsurance Calculations: Making Sense of the Discrepancy Regulations.”
  • Versus Technology publishes “Reflections on the Oklahoma City Bombing, from a Nurse Who Was There.”
  • Huron Consulting Group is named one of America’s best employers by Forbes.
  • Winthrop Resources will exhibit at Interop Las Vegas 2015 April 27-May 1.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 26, 2015 News 14 Comments

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