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October 23, 2014 News 9 Comments

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HHS Secretary Sylvia Burwell transfers National Coordinator Karen DeSalvo, MD, MPH, MSc to the position of acting assistant secretary for health — it oversees public health, including the Office of the Surgeon General — in response to the Ebola threat. DeSalvo replaces Wanda Jones. ONC COO Lisa Lewis (above) is named acting national coordinator, effective immediately. Ms. Lewis’s background is in grant management for ONC and FEMA, so her non-clinical, non-technical experience will contribute to ONC’s identity struggle in a post-Meaningful Use world. I would expect HHS to launch a search for a permanent and well-credentialed national coordinator quickly since its internal personnel stores have been recently depleted (assuming that DeSalvo’s move is permanent, which isn’t the stated case so far, which otherwise means Lewis may be keeping the seat warm for some time).

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Jacob Reider, MD would seem to have been the obvious choice for interim national coordinator since he is deputy national coordinator, but he confirms with me that he has resigned, having promised to his family several weeks ago that three years of commuting to DC was enough. That leaves only Jodi Daniel and Kelly Cronin from Farzad’s 10-member team of a year ago, at least barring any additional announcements.


Reader Comments

From Frank Poggio: “Re: Karen DeSalvo reassigned from ONC. If this does not signal the end is near for the MU fed program, I do not know what would. She was there for maybe six months, came up with the grand revelation that interoperability is a bus, issued a voluminous dissertation on what was wrong, then headed for the hills! Can’t wait to see ONC /DHSS press releases on what a great job she did.” ONC was all over the Ebola issue even though the EHR turned out to be non-contributory at THR, so DeSalvo’s interest and Katrina-related public health background put her in the right place at the right time. Physicians with practice experience and an MPH from a decent school will find many job opportunities as the industry matures from encounter management to population management. I think ONC’s best purpose once they’ve either handed out all the MU money or caused providers to lose interest in receiving it would be to (a) retool EHR certification to encourage interoperability and issue standards accordingly, and (b) run with the idea of the healthcare IT patient safety center if they can get Congress to fund it. They got EHRs out in the field, now it’s time to focus on using them for patient rather than provider benefit.

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From The PACS Designer: “Re: ultrasound emergency wireless app. Samsung has demonstrated an ultrasound wireless application for emergency situations. A test showed that life saving could be achieved through the immediate sending of ultrasound images to emergency departments from ambulances.” That’s a good reminder that sometimes creating new data elements isn’t as important as moving the existing ones around more effectively to increase their value to a wider audience.

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From Barry Black: “Re: Wellogic. Alere has divested the former company that was Alere Accountable Care Solutions.” Alere acquired Wellogic, founded in 1993 in late 2011. I interviewed President and CEO Sumit Nagpal a year ago. Alere ACS offers a PHR, EHR, HIE, decision support, analytics, and wellness and health coaching platforms. The company provided this response:

Based on strategic review by a leading consulting firm, Alere made a decision to refocus its energies on its main business market — diagnostics. As a part of this strategic refocus, Alere chose to divest certain assets, including those in connected health and health management. Alere ACS was the cornerstone of the Alere connected health strategy, and during its Alere tenure, enjoyed great investment that were mutually beneficial to Alere and Alere ACS — including tens of millions of dollars of enhancements to its core HIE platform. Alere ACS has now successfully separated from Alere into a new entity that will operate independently. This new entity has received a significant commitment of support and capital that will ensure continued operations and a sizable R&D investment for short- and long-term success. The new unit will continue to focus on the connected health market, including integrations with various diagnostics, mobile devices, and home monitoring opportunities. The new entity is financially robust and is armed with the necessary resources to achieve and support better healthcare and financial outcomes for the healthcare system. Executive leadership, engineering, and professional services  remain unchanged.

From Lazlo Hollyfeld: “Re: non-competes. No rank-and-file employee should be subject to these agreements, and certainly not for two years.” Jimmy John’s, which is my least-favorite sub chain next to Quizno’s and not in possession of any obvious meat and bread secrets, slips a two-year non-compete clause into its employment agreement that prohibits its $8 per hour sandwich makers and delivery drivers from working not only at competing sub chains, but for any business located near one of its locations that makes 10 percent of its revenue from sandwich sales. Lawyers in a class action suit say the chain’s 2,000 locations mean that an employee who quits can’t work in an area covering 6,000 square miles. It’s like every non-compete that claims to cover non-management employees: a load of repressive corporate crap dreamed up by paranoid management that wouldn’t withstand five minutes of scrutiny in court, existing only because non-management employees don’t have the time and money to challenge it.

From Deanna: “Re: Plato’s Cave. Made me think of you and why your contribution to HIT is so much better than anyone else’s. You have been outside the cave.” The outgoing editor of The Wall Street Journal’s CIO Journal says he left journalism to work for Oracle because “journalists are at least twice removed from the essence of what they write about … I also don’t want to watch technological evolution while imprisoned in a cave, forced to take someone’s word for how it’s made and how it’s used. I want to observe it for myself.” Diligent writers often do a good job covering complicated subjects of which they have zero first-hand experience for experts who live it every day, but I get annoyed when they get lazy and just dutifully reword press releases or stray over that already generous line and start editorializing or delivering podium speeches based entirely on their cheap-seats view, like a couch potato sports fan yelling instructions to a professional football coach or a secluded porn watcher providing relationship advice.

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From Clinic EHR Director: “Re: Epic staff rates. Most of the information out there is overpriced, inaccurate, or both. A friend put together a survey and will publish it free. I would love it if this could be made available to as many people in the industry as possible.” The Epic salary survey is here and the results will be published here.

From P.O. Garth: “Re: HIStalkapalooza. Just curious what night it will be?” This might set the record for the earliest inquiry about an event that’s still almost six months away. HIStalkapalooza will be Monday, April 13, 2015. It will be the best HIStalkapalooza, the last, or both since I’ve decided to take the planning out of a single sponsor’s hands and instead run it myself with the help of Lorre and Jenn and the financial support of five sponsors yet to be chosen (let me know if your company is interested – you’ll get lots of exposure and invitations). Last year was the breaking point for me since ticket demand far exceeded supply and people I wasn’t able to invite got personally rude even though I spend months every year from late summer to spring sweating details for no personal benefit, leading me to swear that I was done with it. For Chicago, the facility, band, and menu are all under contract – it should be pretty great. If it’s the last one, it will at least be legendary.   


HIStalk Announcements and Requests

This Week on HIStalk Practice: the DoD’s DHMSM RFP deadline is pushed back — again. Qualis Health achieves MU goal. Jerry Broderick suggests three questions to ask before joining an employed physician network. Tennessee Primary Care Association implements new pop health/analytics tools. HP interviews Rob Tennant, SVP of government affairs, MGMA. Modernizing Medicine co-founders win leadership award. Check out the HIStalk “Must-See” Exhibitors Guide for MGMA 14. Thanks for reading.

This week on HIStalk Connect: Doctors Without Borders is developing an SMS-based Ebola screening tool to engage with the local West African population. HealthTap announces that it has created a national telehealth platform that will provide virtual visits for $44 per session. XPRIZE announces 11 finalists in the Nokia Health Sensor Challenge.

Listening: new from Cold War Kids, bluesy indie rockers from Long Beach, CA.


Webinars

November 5 (Wednesday) 1:00 ET. Keeping it Clean: How Data Profiling Leads to Trusted Data. Sponsored by Encore, A Quintiles Company. Presenters: Lori Yackanicz, administrator of clinical informatics, Lehigh Valley Health Network; Randy L. Thomas, associate partner of performance analytics, Encore, A Quintiles Company; Joy Ales, MHA, BSN, RN, senior consultant, Encore, A Quintiles Company. Data dictionaries, organizational standards, and pick lists for data entry fields may describe the intent of a particular data field, but don’t guarantee that the data captured in the source system actually reflects that intent. Data profiling is the statistical analysis and assessment of the data values in source systems for consistency, uniqueness, and logic to ensure that the data landing in a data warehouse or analytic application is as expected. Attendees will learn which projects benefit from data profiling and the resources needed to accomplish it.


Acquisitions, Funding, Business, and Stock

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NextGen parent Quality Systems reports Q2 results: revenue up 9 percent, adjusted EPS $0.13 vs. $0.22, beating revenue expectations but missing on earnings. Above is the one-year QSII share price chart (blue, down 39 percent) vs. the Nasdaq (red, up 13 percent).

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Cerner announces Q3 numbers: revenue up 15 percent, adjusted EPS $0.42 vs. 0.35, falling short on revenue expectations but meeting consensus earnings. Above is the one-year CERN share price chart (blue, up 6 percent) vs. the Nasdaq (red, up 13 percent). The breathy reports of $XXX billion of healthcare IT startup investment hide the fact that most of the publicly traded HIT vendors aren’t exactly killing it on Wall Street, which the irrationally exuberant cheerleaders will spin as evidence of the changing of the guard rather than the historically difficult HIT business climate.

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Patient self-service app vendor Phreesia raises $30 million in funding.

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North Bridge Growth Equity becomes a majority stake owner in patient encounter platform vendor Ingenious Med with an undisclosed financial investment.


Sales

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Logicworks will host the Massachusetts Health and Human Services Virtual Gateway portal.

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Wyoming Medical Center (WY) selects Wolters Kluwer’s ProVation MD Cardiology for structured reporting and coding in it catheterization labs.

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DeKalb Medical  (GA) selects Connance’s Patient-Pay Optimization program to improve productivity and improve patient experience.


People

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MModal names Scott MacKenzie (Experian Health) as CEO and board member.

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Health Data Consortium, the group that runs Health Datapalooza, names Chris Boone, PhD (Avalere Health) as executive director.

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HDS hires Bradley Johnson (Caradigm) as senior executive of business development.


Announcements and Implementations

Strata Decision launches cloud-based StrataJazz Continuous Cost Improvement to help providers reduce waste and inefficiency.

Greythorn launches a healthcare IT salary survey and will donate $1 for each survey completed to Autism Speaks Foundation.

Long-term care EHR vendor HealthMEDX announces its iCare POE mobile care management system.

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Valley General Hospital (WA) goes live on Medsphere’s OpenVista.

HSHS Medical Group (IL) launches a pilot that will test the use of Apple Watch, due out next year, in its medical home program.


Government and Politics

HHS announces the four-year, $840 million “Transforming Clinical Practice Initiative” incentive grant program to move providers to value-based, patient-centered, coordinated health services, saying that healthcare IT will be a key component. Among the suggested strategies is daily review of EHR quality and efficiency information. Specifically listed is secure, standards-based, bi-directional communication with other providers.

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Three industry notables (Dean Sittig, David Classen, and Hardeep Singh) propose in a JAMIA article that ONC’s planned HIT Safety Center (a) create a post-marketing HIT patient safety event surveillance system; (b) develop policies and procedures for investigating those events; (c) design random safety assessments of large providers; and (d) advocate HIT safety. The surveillance function would look at system failures, inadequate design, improper user configuration or usage, interface problems, and missing or unimplemented safety-related features. I would be happy if someone would just implement an easy way (on-screen button?) for providers to communicate safety concerns directly to vendors with a CC: to a safety center. Several organizations (some of them governmental) claim to have such a system, but none get significant use because end users don’t know about them or aren’t willing to complete a pile of paperwork that doesn’t benefit them directly.

The Department of Homeland Security is reviewing possible cybersecurity flaws in medical and hospital devices (including IV pumps and cardiac devices) that could make them vulnerable to hackers, stating its intention to work with vendors to correct software problems. 


Other

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HIMSS will move its 2019 convention from Chicago to Orlando in a dispute over hotel room rates, citing its unhappiness that the RSNA conference obtained a “favored nation” clause that guarantees it the lowest room rates for events held from April through November. I surveyed readers in early 2013 about their preferred HIMSS conference cities and Chicago finished near the bottom, with only 6 percent choosing it as their favorite — New Orleans, Atlanta, Dallas, San Antonio, and Boston did as poorly or worse, while San Diego, Las Vegas, and Orlando topped the list. Chicago is easily my least-favorite convention city (even though I like visiting it otherwise) due to overpriced and indifferent hotels, surly union workers, poor public transportation to McCormick Place, and the near-certainty of cold, dreary weather in April (which of course exhibitors love since it keeps attendees inside looking at booths). HIMSS scratched its home city’s back by holding the conference there in 2009 after pushing the usual date back several weeks to avoid blizzards (which didn’t work), pulled the conference out again because of union-driven high costs of exhibiting at McCormick Place, and then ill-advisedly decided to return in 2015. Too bad their squabble comes too late to move HIMSS15 somewhere else.

Interesting: scientists nearly 10 years ago came up with an Ebola vaccine that was 100 percent effective in protecting monkeys, but the $1 billion plus cost of bringing a drug with minimal sales potential to the US market sent it to the shelf, where it remains.

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A Diagnosis article by the aforementioned Dean Sittig and Hardeep Singh, along with Divvy Upadhyay, looks at the treatment of Ebola patient Thomas Duncan at Texas Health Presbyterian Hospital Dallas, reviewing the patient’s record to find several discrepancies in THR’s announcements:

  • The patient presented with a temperature spiking to 103 degrees, dizziness, GI symptoms, headache, and a self-reported pain score of eight on a 10 scale, contradicting hospital reports that his initial symptoms weren’t severe.
  • The nurse documented his recent travel to Liberia.
  • The ED doctor prescribed Tylenol and antibiotics (the article didn’t question why he or she prescribed antibiotics for vague symptoms that could be non-infectious or viral, but antibiotic overuse and resistance is a topic for another day).
  • The authors speculate that the ED physician chose predefined phrases from EHR-suggested drop-downs that misled caregivers who read the notes later.
  • They also speculate that the hospital is located next to a high-immigrant population area that a county commissioner termed “a little Ellis Island” that could have caused employees to miss the red flag of “a black man with a foreign accent who reported he came from Liberia and presented with serious ‘flu-like’ symptoms to an ED which reportedly had received CDC and county health department’s guidance as early as July 28th, 2014.”
  • The article points out that clinicians often misdiagnose or miss common clinical conditions and it’s not the EHR’s job to replace their critical thinking and history-taking skills.
  • It adds that doctors tend to ignore nurse-generated documentation, both on paper and in the EHR. Sad, but true.

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THR previously submitted to Congress a timeline of Thomas Duncan’s ED visit with some interesting items:

  • Triage didn’t start until an hour after the patient’s arrival at 10:37 p.m. – he was sent to the waiting area (in contact with everybody else there) and wasn’t taken to the treatment area for for nearly 90 minutes.
  • The ED physician accessed the triage nurse’s report at 12:27 a.m., but the travel history question hadn’t been asked yet since it wasn’t the triage nurse’s responsibility.
  • The patient first reported his travel history to Liberia in a 12:33 a.m. question from the primary ED nurse, but she didn’t pick up on the importance of his answer and ignored the EHR prompt to verbally relay it to the ED doctor (big-time fail there).
  • Audit logs show that the ED doctor reviewed the Epic sections that included the patient’s travel history several times between 12:52 and 1:10 a.m. Remember that at that point, the EHR should have been basically a single screen of information since all that had been documented  was triage, the primary nurse’s initial workup, and a few vital signs. Specifically in Epic, the authors say, that includes screens for: ED lab results, Visit Navigator, related encounters, flowsheet, allergies, home meds, and ED patient history, all of which should have been pretty much blank.
  • The doctor later reviewed the patient’s history in which he said he was a “local resident,” had not been in contact with sick people, and had not experienced GI symptoms (contradicting the triage nurse’s recording of his chief complaint – in other words, the patient gave incorrect and misleading information for some reason).
  • The ED doctor discharged the patient with a diagnosis of sinusitis (not sure where that came from) and abdominal pain.

My conclusions: (a) Epic worked as it should have although the ED doctor still missed crucial information despite spending a lot of time looking at what should have been minimally populated Epic screens and possibly not the patient himself; (b) the hospital should have been asking travel questions at triage, which THR has since required; (c) the ED nurse missed an obvious red flag and broke hospital policy by documenting in the EHR but not reporting the travel information verbally; (d) the ED doctor either missed what should have been plainly obvious travel information or failed to note its relevance; (e) the patient told the ED doctor a very different story than he had told the nurse previously, eliminating or changing information that would have put the ED doctor on alert. All of this points out how unprepared the hospital was for detecting possible Ebola patients despite public health warnings, along with their lack of urgency to put new policies in place. My bigger conclusion: hospitals are not good at all with issues related to public health, and public health departments don’t seem to have the influence to drive sound infectious disease policy out of their ivory towers to the front lines.

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BIDMC CIO John Halamka, MD proposes that clinical documentation, which was designed for billing rather than care coordination, be redesigned around a team-based, story-oriented structure that eliminates redundancy, inaccuracy, and copied-pasted text that doesn’t convey (or even hides) the patient’s story. It resonates with me because I’m getting increasingly frustrated that EHRs are superior to paper in every way except that one – the tendency to generate a lot of worthless but structured information that masks the sometimes obvious issues, meaning those EHRs make care worse instead of better. It’s time to reclaim the EHR from administrators, bureaucrats, CMS, and malpractice attorneys and give it back to patients and clinicians. Halamka writes on his blog:

Imagine if the team at Texas Health Presbyterian jointly authored a single note each day, forcing them to read and consider all the observations made by each clinician involved in a patient’s care. There would be no cut/paste, multiple eyes would confirm the facts, and redundancy would be eliminated. As team members jointly crafted a common set of observations and a single care plan, the note would evolve into a refined consensus. There would be a single daily narrative that told the patient story. The accountable attending (there must be someone named as the team captain for treatment) would sign the jointly authored Wikipedia entry, attesting that is accurate and applying a time/date stamp for it to be added to the legal record.

After that note is authored each day, there will be key events — lab results, variation in vital signs, new patient/family care preferences, decision support alerts/reminders, and changes in condition.

Those will appear on the Facebook wall for each patient each day, showing the salient issues that occurred after the jointly authored note was signed.

With such an approach, every member of the Texas care team would have known that the patient traveled to Dallas from West Africa. Every member of the care team would understand the alerts/reminders that appeared when CDC or hospital guidelines evolved. Everyone would know the protocols for isolation and adhere to them. Of course, the patient would be a part of the Wikipedia and Facebook process, adding their own entries in real time.

A study of ICU patient alarms finds that each occupied bed generates 187 audible alarms per day, many of them false alarms related to arrhythmia. It suggests that hospitals reduce alarm fatigue by reviewing their alarm settings and consider changing some alarms from audible to text messages.

A woman who tried to kill herself by gouging out her eyes with a pencil sues LA-USC Medical Center, saying that one of its nurses took a picture of her and shared it with a friend who then posted it on a shock website.

Weird News Andy fiddles around with this story, in which a concert violinist plays his instrument on the operating room table as neurosurgeons implant a “brain pacemaker” to correct his otherwise career-ending tremors. The surgery team monitored the patient’s movements via a three-axis accelerometer as he played and they inserted electrodes into his brain to make sure they hit the right spot. It worked: three weeks later, he was back on stage with the Minnesota Orchestra.  


Sponsor Updates

  • Yale New Haven Health System (CT) implements SSI Group’s end-to-end revenue cycle management solutions.
  • Predixion Software CEO Simon Arkell is named “Outstanding CEO” for a mid-sized company by the Orange County Technology Alliance.
  • PerfectServe President and CEO Terry Edwards writes a blog post called “Prioritizing Communications to Improve Care Coordination.”
  • AOD Software and Imprivata partner to provide a secure communication platform for the senior healthcare market.
  • Medical Economics names ADP AdvancedMD, Allscripts, Aprima, CompuGroup Medical, e-MDs, eClinicalWorks, GE Healthcare, Greenway, Kareo, McKesson Specialty Health, NextGen, Optum, Quest Diagnostics, and RazorInsights to its “Top 50 EHRs” list.
  • MedAptus will integrate Entrada’s dictation recording technology with its Pro Charge Capture solution.
  • Truven Health Analytics introduces Interactive Reporting, which helps health plans analyze account-specific cost, use, and quality.
  • Perceptive Software will introduce Medical Content Management at RSNA 2014.

EPtalk by Dr. Jayne

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I’m always excited to receive reader mail, although I’m terribly behind on answering it. I have a couple of blogger / author friends and am convinced HIStalk has the best readers out there. That was proven this week when several of you wrote offering advice for my friend’s oncology RFP conundrum. I appreciate the input and have forwarded your thoughts.

Weird News Andy weighed in on last week’s discussion of mood-altering wearables, sharing that it “depends on who is wearing them and what else they are wearing. Mrs. Weird has an effect on my mood no matter the other variables.” I hadn’t thought of wearables in that context when I was writing last week, but that’s an important point. Despite the mass integration of technology in all facets of our lives, I still don’t understand people who wear Bluetooth headsets constantly, let alone people wandering around with Google Glass in social situations. I wonder how much we miss of the world around us because of our devices.

Reader Foie Gras wrote about this year’s Clinical Informatics board certification exam: “Thanks for your description of last year’s experience. I took the exam this past week and I want a do-over! I feel like I studied very very hard, reviewed the AMIA course, took lots of notes, and am experienced in the field, but there were definitely questions on the test with terms I did NOT know and even on some of the topics I’d studied up on. I felt they asked a very nuanced question that I just couldn’t feel comfortable with. A bit frustrating after quite the marathon and sprint of studying. Here comes the two-month wait. I really don’t want to have to study for that thing again (although yes, I learned a ton studying for it and it was really enjoyable at times.)”

I heard similar feedback from other colleagues who sat for the exam this year. Preparing for board certification can be arduous, but being able to find some enjoyment in it says something about the personality traits of those who stay in medicine. I share the frustration about some of the terminology (particularly eponyms) used on board exams. If it walks like a duck and quacks like a duck, and actually is a duck, is the fact that it’s a Baikal Teal vs. a Carolina American Wood Duck really relevant if the question is asking how many feet it has?

I enjoy leisure reading much more than I enjoy reading CMS regulations or (heaven forbid) the Federal Register, so I was excited when a colleague left a copy of “Doctored: The Disillusionment of an American Physician” on my desk. Sandeep Jauhar is a New York cardiologist. I was familiar with his first book, “Intern.” The sequel was a pretty quick read and explores several healthcare dynamics from the last two decades: the fall of fee-for-service reimbursement, providers who order diagnostic testing for their own enrichment, and fragmentation of patient care.

Although I haven’t had to deal with some of the scenarios he encountered after leaving fellowship, I’ve experienced enough of them to share some of his feelings of disillusionment. In addition to being about the “mid-life crisis” facing medicine since the creation of Medicare in the 1960s, it also covers his own mid-life crisis, which makes some sections a little difficult to read. Still, I appreciate his candor and his willingness to stick his neck out as he shares his story.

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I’m used to getting a variety of mailers and postcards from vendors and recruiters, particularly around HIMSS and other conferences. I was surprised this week to get a recruiting postcard from Uncle Sam. I’m sure the mailing was set up weeks ago, but the statement “because of the wide scope of the Army’s activities, you may have the chance to see and study diseases that are not usually encountered in civilian practice” to be very timely. Some of my best friends are currently or have been military physicians. I am grateful for their service and for the sacrifice of everyone serving in all branches of the military. Veterans Day is approaching, so make plans to thank your colleagues, neighbors, and family members who have served.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 23, 2014 News 9 Comments

Morning Headlines 10/22/14

October 21, 2014 News No Comments

Obama’s Ebola czar declines to testify

Newly appointed Ebola czar Ron Klain declines a request to testify before the House Oversight Committee over the government’s Ebola response thus far. The hearing, scheduled for Friday, will be just his third day on the job.

NCCN Chemotherapy Order Templates to be Integrated into Epic’s Electronic Health Record

Epic will integrate the evidence-based chemotherapy order templates from the National Comprehensive Cancer Network into its Beacon oncology product.

Athenahealth to expand at Ponce City Market

Athenahealth will expand its Atlanta, GA offices, adding 20,000 square feet immediately, with plans to add an additional 40,000 square feet in 2016.

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October 21, 2014 News No Comments

News 10/22/14

October 21, 2014 News 5 Comments

Top News

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California Republican Darrell Issa, chairman of the House Oversight and Government Reform Committee, plans a hearing Friday to look into the Obama administration’s handling of the Ebola crisis. Newly appointed Ebola response coordinator Ron Klain has declined to testify, likely given that it will be only his third day on the job.


Webinars

November 5 (Wednesday) 1:00 ET. Keeping it Clean: How Data Profiling Leads to Trusted Data. Sponsored by Encore, A Quintiles Company. Presenters: Lori Yackanicz, administrator of clinical informatics, Lehigh Valley Health Network; Randy L. Thomas, associate partner of performance analytics, Encore, A Quintiles Company; Joy Ales, MHA, BSN, RN, senior consultant, Encore, A Quintiles Company. Data dictionaries, organizational standards, and pick lists for data entry fields may describe the intent of a particular data field, but don’t guarantee that the data captured in the source system actually reflects that intent. Data profiling is the statistical analysis and assessment of the data values in source systems for consistency, uniqueness, and logic to ensure that the data landing in a data warehouse or analytic application is as expected. Attendees will learn which projects benefit from data profiling and the resources needed to accomplish it.


Acquisitions, Funding, Business, and Stock

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Care coordination platform developer CareSync secures $4.25 million in Series A financing led by Founder and CEO Travis Bond, Tullis Health Investors, CDH Solutions, and Clearwell Group. You can read my recent interview with Bond here.

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Athenahealth makes plans to expand its brand-new Ponce City Market office in Atlanta. Filings suggest the company could expand by another 40,000 square feet by July 2016.

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HealthStream reports Q3 results: revenue up 32 percent, EPS $0.12 vs. $0.08, and announcement of a new patient interview center in Nashville, TN that is expected to create 200 jobs.

TeamHealth Holdings acquires PhysAssist Scribes for an undisclosed sum. PhysAssist will operate as a separate division of TeamHealth under its current leadership.


Announcements and Implementations

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National Comprehensive Cancer Network will integrate its chemotherapy order templates into Epic’s Beacon Oncology Information System. The templates will link to NCCN.org, affording end users access to relevant NCCN guidelines.

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Cleveland Clinic (OH) and Mayo Clinic (MN) are the latest providers to deploy HealthSpot telemedicine booths. Cleveland Clinic has installed two at Marc’s retail pharmacies in Ohio. Mayo Clinic has placed one at its Austin, MN campus, and anticipates deploying more at private employers next year.

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Children’s Specialized Hospital (NJ) and BluePrint Healthcare IT launch the first implementation phase of a new patient-centered medical home model with corresponding software. CSH will use BluePrint’s Care Navigator technology as its main communication and education tool during the process.

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Tufts Medical Center and Specialists On Call partner to establish the Tufts Medical Center TeleNeurology program, which will provide community hospitals in Massachusetts with new neurology support options.


Sales

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Lahey Health (MA) selects supply chain, performance, advisory, and analytics services from Premier Inc. and Yankee Alliance Supply Chain Solutions.

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HealthInfoNet, the State of Maine’s HIE, selects the Symedical system from Clinical Architecture to enhance terminology management and data normalization. HealthInfoNet will also use the system to manage access to mental health- and HIV-related information, which requires additional legal protections in that state.


People

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Senator William Frist, MD and David Snow, Jr. (Medco Health Solutions) join TelaDoc’s Board of Directors.

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Baptist Health (KY) promotes Polly Bechtold, RN to regional director for clinical IT at its Paducah and Madisonville hospitals. Sharon Freyer, RN will serve as Baptist Health Paducah’s interim CNO.

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Jennifer Anderson (Tenet Practice Resources) joins the North Carolina Healthcare Information and Communications Alliance as executive director. She succeeds Holt Anderson, who will retire at the end of this month.

GNS Healthcare names Bill Thornburg vice president of product management, Jim Dutton vice president of product development, and Lance Stewart vice president of payer business development.


Research and Innovation

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A study of 142 cardiac patients equipped with C3 Nexus heart rate monitors at Bon Secours St. Francis Medical Center (VA) finds that just 4 percent of those patients were readmitted to the hospital within 90 days. The company is looking to expand its customer base with hospitals and payers in Texas and Arizona.

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Clinical Genome Resource launches the Genome Connect patient portal as part of a NIH genetic research initiative. The portal, developed by a team of Geisinger Health System (PA) investigators, serves as a repository for lab data and patient-entered health information to assist providers and researchers in better understanding genetic variants and their impact on health.

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A new study finds that participants who used Castlight Health’s Enterprise Healthcare Cloud Software platform to search for healthcare services saw lower costs for laboratory tests and advanced imaging services compared to those participants that did not.


Other

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The local paper profiles Resolution Care, which aims to improve in-home palliative care in rural areas via house calls or virtual visits. Michael Fratkin, MD founder of the project and St. Joseph Hospital’s (CA) Palliative Care Program, will launch an Indiegogo campaign next month to raise $100,00 for the project.

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Local radio profiles the Kentucky HIE’s progress in rolling out a statewide patient portal developed by NoMoreClipboard. Five facilities are participating in the pilot phase of the myhealthnow portal, which is expected to go statewide by the end of the year.

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Kenneth Mandl, MD of Boston Children’s Hospital and Harvard Medical School, points out in a JAMA article that EHRs and workflow aren’t the only problems when it comes to screening for Ebola: “Compounding the problem is that public health, largely absent from the table in defining requirements, remains mostly locked out of the point of care, barely able to exploit the newly deployed health information technology infrastructure. Five years after the enactment of Meaningful Use, public health officials still reach clinicians and hospitals through traditional dispatches and media alerts.”

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The mock @CzarOfEbola Twitter account spotlights the frustration many Washington insiders have expressed with the continued leadership of Tom Frieden, MD at the CDC, and appointment of “Ebola Czar” Ron Klain.

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The local business paper details the somewhat strange trip a group of Nashville, TN healthcare leaders took to Cuba. Scott Mertie, president of Kraft Healthcare Consulting, noted that, “even though the technology is a little bit behind, they’re still doing advanced medicine. I think in general the population seems very happy with their health care,” adding that may be because they "just don’t know what else is out there."


Sponsor Updates

  • Nuance partners with eClinicalWorks to offer cloud-based speech recognition with eClinicalTouch for the iPad, and eClinicalMobile for iPhone and Android.
  • Health Catalyst shares “factoids” from its Summit due to a high volume of requests.
  • NextGen Healthcare and InterSystems enable Missouri Health Connection to provide on-demand bidirectional data exchange with clients.
  • Medicity shares a video of CORHIO’s providers discussing how their HIE has helped improve patient care and streamline workflows.
  • Elsevier releases the first multidisciplinary, general medical reference digest of from its new Clinics Collections series.
  • Health Catalyst introduces a white paper for a systematic approach to transform healthcare.
  • Gartner names the Cache’ data platform from InterSystems a Leader in the Gartner Magic Quadrant for Operational Database Management Systems.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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October 21, 2014 News 5 Comments

Monday Morning Update 10/20/14

October 18, 2014 News 7 Comments

Top News

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Texas Health Resources takes out full-page ads in local newspapers to bolster its community image, with CEO Barclay Berdan admitting that “we made mistakes” and adding that Thomas Duncan’s travel history was documented in the EHR but “not communicated effectively among the care team.” 

Meanwhile, the cruise ship passenger that triggered an Ebola scare at sea (for questionable reasons) that resulted in the ship’s return to port has been identified as the lab director of Texas Health Presbyterian Hospital Dallas where Thomas Duncan died. The lab director voluntarily quarantined herself in her ship’s cabin and has since been found to be free of the virus.

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In the aftermath of its mistakes (of both clinical and public relations varieties), Texas Health Presbyterian Hospital Dallas  is reported to be a “ghost town” with two-thirds of its 900 beds empty and its average 52-minute ED wait time down to zero. THR spokesperson Dan Varga, MD states that doctors whose offices are near the hospital are having up to 60 percent of their appointments cancelled as patients refuse to get close to hospital property, treating it as though it were Chernobyl instead of the building that previously housed a contagiously sick patient as it does 365 days per year. The economic impact will probably be significant.


Reader Comments

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From British Bulldog: “Re: Ascribe. The UK-based company’s CEO and founder, Stephen Critchlow, has resigned, almost a year since Ascribe was acquired by EMIS. Rumour has it that this could spell the end for Ascribe’s Health Application Platform, its flagship software platform.” The company announced Critchlow’s departure to devote “more of his time to his other business interests” on September 29, 2014, while the rest of the statement is unverified.

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From Government Mule: “Re: ONC chief medical officer. Jon White from AHRQ took the job according to his LinkedIn profile.” Actually he lists his position as interim CMO (at least in the current version of his profile), which was announced early this month as a part-time commitment while the search is underway.

From GoVols: “Re: [company name omitted]. The CTO resigns, then gets talked out of it by board member. Sales, marketing, and BD team, once 15 strong, is now down to just a few and more layoffs are rumored. No significant sales this year and the fourth sales VP was recently fired. Everyone still here wonders what the BOD is thinking.” I’ve removed company and executive names since no company is going to confirm statements like these, but I’ll keep an eye on what happens there.

From Insidehr: “Re: athenahealth’s Ebola screening tool. Good to hear the athena clients are ready to treat those Ebola patients when they show up for the primary care visit. Sometimes that group would benefit from the concept of less is more.” It’s interesting that everybody is rushing to cobble together electronic tools that perform the most basic function – display a warning if a feverish patient says they’ve been to Africa lately. I think we can assume that even the least-competent nurse in America would go on alert in that case even without an EHR prompt, so its main value isn’t evaluating the patient’s response, it’s reminding someone to ask them the question in the first place, which is also probably not really necessary.

Additionally, the value of crude tools like online questionnaires will be eliminated if the virus starts spreading from people who haven’t traveled but instead were exposed to someone else who has, perhaps unknowingly. It’s like those early HIV/AIDS questions that asked about same-sex contact, blood transfusions, or exposure to prostitutes –  they helped make a few diagnoses in the absence of anything more accurate, but the real accomplishment was developing specific lab tests since patient reports aren’t always reliable, symptoms are vague, and other transmission methods may be involved. A lab person can jump in, but I think the ELISA test works for both HIV and Ebola, the main difference being that a two-day wait time for positive diagnosis is OK for HIV but potentially disastrous for Ebola. When it comes to stopping pandemics, it’s at least equally important to develop diagnostic as well as therapeutic technologies.


HIStalk Announcements and Requests

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More than two-thirds of poll respondents don’t like idea of an ONC-run health IT safety center. Reader lgro said in a comment that ONC struggles with the logistics of its current areas of responsibility and worries about another HIPAA-like program that doesn’t add value, while Doug points out that the health IT safety center was proposed as a public-private partnership rather than an ONC-controlled body and may provide value in preventing FDA from stepping in due to lack of progress. New poll to your right or here: should the names and medical details of Ebola patients be divulged publicly?


Last Week’s Most Interesting News

  • The American Medical Association sends CMS a blueprint for a redesigned Meaningful use program, adding its criticism of document-based interoperability protocols such as C-CDA.
  • Several groups add to the drumbeat urging CMS to slow down the Meaningful Use program and to refocus certification on interoperability, privacy and security, and quality reporting.
  • Texas Health Resources executive Daniel Varga, MD says the organization modified its Epic setup and workflow after Ebola patient Thomas Duncan was discharged from one of its EDs, adding little clarity to the original report and subsequent denial that the nurse’s documentation was missed because of an EHR setup problem.
  • A paper from the National Bureau of Economic Research says that HITECH was largely ineffective for spurring hospital EHR adoption since most hospitals were already using them.
  • HITPC agrees that current document-based interoperability approaches should be replaced by programming APIs provided by vendors of certified EHRs. That would be a dramatic shift, especially if ONC requires such access for EHR certification.
  • California HealthCare Foundation releases a report covering health accelerators, find that they are excessive in number, unproven in benefit, and potentially harmful in hyping startups that have a minimal chance of market success.
  • Alameda Health System (CA) says a disastrous $77 million Siemens Soarian-NextGen implementation has exhausted its cash and available credit.

Webinars

October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CTO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.

November 5 (Wednesday) 1:00 Eastern. Keeping it Clean: How Data Profiling Leads to Trusted Data. Sponsored by Encore, A Quintiles Company. Presenters: Lori Yackanicz, administrator of clinical informatics, Lehigh Valley Health Network; Randy L. Thomas, associate partner of performance analytics, Encore, A Quintiles Company; Joy Ales, MHA, BSN, RN, senior consultant, Encore, A Quintiles Company. Data dictionaries, organizational standards, and pick lists for data entry fields may describe the intent of a particular data field, but don’t guarantee that the data captured in the source system actually reflects that intent. Data profiling is the statistical analysis and assessment of the data values in source systems for consistency, uniqueness, and logic to ensure that the data landing in a data warehouse or analytic application is as expected. Attendees will learn which projects benefit from data profiling and the resources needed to accomplish it.


Acquisitions, Funding, Business, and Stock

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From the athenahealth earnings call:

  • Jonathan Bush says the company is growing, but with growing pains.
  • Epocrates is a turnaround in progress and it’s taking longer than the company expected to improve the situation due to major cultural and technical issues.
  • Epocrates is moving toward “more of an edutainment relationship where we’re constantly rotating through a set of FDA-approved and clinically appropriate messages for doctors that makes a business act more like a recurring venue business and one-off.”
  • The company added 2,800 athenaClinicals physician users, but at a high expense.
  • Bush says the challenge of the Enterprise business – which he calls “bipolar” since the company never knows when a big organization will finally sign up – is that internal hospital departments aren’t nearly as interested as the outpatient areas in opening up patient access.
  • Bush says it’s hard to sell to academic medical centers: “Nobody gets fired in academic medical. There is no financial mandate. They have got many, many revenue sources, many, many reasons for revenue — the research, the teaching. So that clarity of bottom line is not there. There is somebody in charge of the bottom line who is very clear, but they have grown up an institution that is used to money showing up … an open healthcare network doesn’t help you if you happen to have the highest rates in town … You are not thrill that the doctor and the patient can see the other ones, click on it and rob you of that high-margin encounter … the guys who resist us the most are institutions like Partners, Mass General, where they have historically high rates … and they are terrified of being picked apart.”
  • “We are right now in the midst of trying to seed a couple of the major national consulting firms with the idea that its time to change lily pads. That you don’t want to be the last strategic consultant that advise the board of directors to plump down $0.5 billion on a closed system. The problem is there’s a lot of revenue that goes to those firms that way and so we have been working it.”
  • Bush expresses frustration in working with (and ultimately bypassing) hospital CIOs, declaring, “Typically the CIO has worked very hard to build board-level access and a great huge budget surrounding the idea of his own data center and his own servers and his own programmers. He is sort of craft brewing milky beer and doesn’t want anybody to compare him with the pros from Dover.”

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Above is the one-year share price chart for ATHN (blue) vs. the Nasdaq (green).


People

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University of Virginia Health System hires Michael Williams, MD (North Shore-LIJ Health System) as its first CMIO.

HealthMEDX names Chris Dollar (Henry Schein) as COO.


Government and Politics

A HIMSS response to NIST’s cybersecurity RFI says healthcare providers are too focused on HIPAA compliance and should evaluate their overall security instead, adding that NIST should publish a target state for providers to measure themselves against.

Former National Coordinator David Blumenthal, MD says that Texas Health Resources, in first stating but then denying that an EHR flaw caused it to discharged Ebola patient Thomas Duncan, is part of an “inglorious pattern in human behavior” that causes providers to seek scapegoats when something goes wrong. He also says EHRs are the lightning rod for provider challenges because they use them constantly in daily work while other problems seem to be “distant thunder,” but he adds that users are justifiably frustrated with EHR usability and interoperability.


Other

I don’t automatically believe reports from Black Book Rankings, especially when they don’t itemize their methodology, but their survey of 14,000 RNs who use hospital EHRs claims the following results that I don’t doubt a bit:

  1. Hospital nurse EHR dissatisfaction stands at 92 percent.
  2. EHR workflow disruption reduces job satisfaction, according to 84 percent of respondents.
  3. Nine of 10 nurses say CIO and their executive peers choose EHRs based on price or Meaningful Use performance rather than their usefulness to nurses.
  4. Nine of 10 nurses say the EHR interferes with nurse-patient interaction and 94 percent say it hasn’t helped nurses communicate with other clinicians.
  5. Three-quarters say the EHR has failed to improve the quality of patient communication.
  6. More than two-thirds of RN respondents label their IT departments as “incompetent” in their EHR knowledge.
  7. A hospital’s EHR is one of the top three criteria for choosing a workplace according to 79 percent of respondents, with top-rated systems being Cerner, McKesson, NextGen, and Epic. The lowest satisfaction scores were for Meditech, Allscripts, eClinicalWorks, and HCARE. This statement alone raises a red flag given that eCW doesn’t offer an inpatient EHR, HCARE is (I believe) HCA’s implementation of Meditech, NextGen’s EHR is used mostly by very small hospitals and isn’t likely to have had enough respondents to be judged on inpatient use alone, and McKesson’s users weren’t broken out among Horizon, Paragon, and its other products. The survey’s biggest flaw is not breaking out practice site – ED, ICU, surgery, ambulatory, general med-surg nursing, etc., all of which use broadly (and often incorrectly) labeled “EHR” systems differently.

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An interesting article by Clinovations SVP Steve Merahn, MD says that “unstructured” is a bad term when referring to data because it contains the built-in bias that all data should be structured, when in fact the only reason “structuring” data into convenient pigeonholes is necessary is because our ability to analyze information is otherwise limited. He draws a parallel to earlier observations about Internet content vs. data, which is similar to EHR-contained checkbox results vs. useful clinical information:

  • Content has a voice. It is written to communicate ideas, make a point, convince. It is personal.
  • Content has ownership. Someone created the note from their perspective of authorship as defined by their levels of authority and responsibility.
  • Content is intended for a human audience, for human senses to process.
  • Content has context. Even the most objective content contains lexical, syntactic, and semantic clues about where the reader should focus their attention — what was important and what was not.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 18, 2014 News 7 Comments

News 10/17/14

October 16, 2014 News 1 Comment

Top News

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Dan Varga, MD, chief clinical officer of Texas Health Resources, testifies to a House subcommittee inquiring into its handling of Ebola patient Thomas Duncan that THR has changed its screening procedures to ask travel-related questions first thing in the ED and to make the patient’s travel history available to all caregivers. THR modified its Epic configuration to (a) make the Ebola screening tool more visible; (b) to ask more Ebola-related screening questions; and (c) to display pop-up instructions if any of the screening questions are answered positively. The wording of his statement suggests (in my interpretation, anyway) that the original problem wasn’t because the ED doctor couldn’t see the patient’s nurse-captured travel history, but that the questions weren’t asked at the proper time.


Reader Comments

From Kaiser’s Role: “Re: Kaiser’s Georgia Region. Being taken over by the Southern California Region and presumably not doing so well. They did this several years ago with the Mid-Atlantic region, sending all kind of docs there to take over.” Verified, according to an internal Kaiser email from Chairman and CEO Bernard J. Tyson. 

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From Spock’s Beard: “Re: Greenway’s Meaningful Use dashboard. Has been down for weeks, meaning clients can’t run Stage 1 or Stage 2 reports even though we’re two weeks into the final 2014 reporting period. As of yesterday, support says it will be another 2-4 weeks before the dashboard is ready.” Greenway Health SVP of Product Management Mark Janiszewski provided this response:

Due to a high volume of Greenway PrimeSUITE customers using the new cloud-based reporting / dashboard solution through our PrimeDATACLOUD, we’ve seen dashboard service disruptions that have impacted a small number of our customers. To meet customer requirements for Q3 attestation, the cross-function Greenway Meaningful Use Service Team worked with customers and supplied them with the information needed to attest for the Q3 90-day attestation period. To prepare for a higher volume of customers planning to attest in Q4 and in 2015, we’re currently making enhancements and performance improvements to the PrimeDATACLOUD environment. This maintenance window is expected to last until the end of October. During the maintenance period, we’re making the MU Dashboards available on a regular basis to all customers using the system, enabling them to track their progress towards attestation goals. In addition, we continue to on-board customers who need to attest for Q4 as well as 2015. The Greenway MU Service team continues to engage directly with all affected customers to provide updates as well as help guide them through the MU process. Greenway Health is committed to ensuring that all eligible providers using our solutions who are planning for MU attestation have the required information in time.
 
From Mr. Drummond: “Re: Ebola patients. Are we getting close to HIPAA violations in going public about patient identities, photos, condition, and travel patterns?” It would seem like a clear-cut violation if the information is disclosed by a provider without the patient’s consent  but that wasn’t the case with the first Texas patient, whose information apparently came from the family. Still, just because the family has disclosed a patient’s information wouldn’t seem to give a hospital the green light to repeat it. HIPAA allows providers to disclose PHI to public health agencies, but not as a warning to the general public – there’s no HIPAA clause that allows disclosing PHI for the perceived public good, at least as I interpret it. However, CDC is also not a covered entity, so it can presumably release whatever information hospitals give it without running afoul of HIPAA, although it could still be sued for general privacy reasons. Going public with patient-specific details might bring forth more people who have been exposed, but it also might discourage exposed patients from stepping forward into the media (not just medical) limelight. My overall opinion is that the public has an unnaturally keen interest in salacious details that media will find a way (legal or otherwise) to feed using public health interest as an excuse. It’s also fishy to me that the first infected nurse spoke glowingly about Texas Health Resources via the THR media people – she may well be expressing her feelings honestly (albeit unnecessarily), but having her employer’s handlers issuing the statements encourages skepticism.

HIStalk Announcements and Requests

This week on HIStalk Practice: athenahealth creates an Ebola risk assessment algorithm for its EHR. Palmetto Primary Care Physicians taps eGroup to help it install IT in South Carolina’s first gigabit community. ONC adds a dozen primary care physicians and administrators to its Health IT Fellows Program. Ability Network acquires MD On-Line Inc. See our Must-See Exhibitors Guide for MGMA 2014. Thanks for reading.

This week on HIStalk Connect: Dr. Travis explores the potential ROI that can be generated from implementing online self-scheduling tools for patients. Patient engagement startup Welltok raises $25 million of a planned $37 million Series D. The NIH announces $32 million in grant awards that will be used to further big data research in healthcare.

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Welcome to new HIStalk Platinum Sponsor FormFast, the leading provider of process automation solutions for hospitals (electronic forms and signatures, workflow, and content management) that integrate with existing systems to add functionality and streamline processes. FormFast has been providing electronic workflow solutions since 1992 with 1,000 hospital customers that are gaining efficiency, improving task coordination, reducing supply costs, and eliminating errors (webcasts and case studies are here). Thanks to FormFast for supporting HIStalk.


Webinars

October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CTO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.


Acquisitions, Funding, Business, and Stock

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Revenue cycle solutions vendor Ability Network will acquire competitor MD On-Line.

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Athenahealth reports Q3 results: revenue up 26 percent, adjusted EPS $0.27 vs. $0.29, meeting expectations for both. The company’s $293 million Epocrates acquisition from January 2013 continues to drag down the bottom line as the unit’s quarterly revenue dropped 27 percent to less than $10 million.

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Analytics vendor Viewics raises $8 million in funding.

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Telepharmary kiosk vendor MedAvail completes $30 million in Series C funding.

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Consumer rewards-based wellness platform vendor Welltok raises $25 million of a planned $37 million funding round.


Sales

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Marin General Hospital (CA) chooses MModal for clinical documentation software and services.


People

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James R. Boldt, chairman and CEO of Computer Task Group, died unexpectedly on October 13 at 62. He led CTG into the healthcare IT provider services market after taking the role in 2001.

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Just-resigned GE Healthcare CEO John Dineen is named fund advisor to private equity operator Clayton, Dubilier & Rice.

Paul LaVerdiere (Iron Mountain) joins ESD as regional VP.


Announcements and Implementations

Elsevier launches Mosby’s Home Health Care, which provides content for home health nurses. The company also announces that it will provide free access to its ClinicalKey reference site to healthcare and disaster aid workers battling the Ebola outbreak in Liberia, Nigeria, Sierra Leone, and Guinea

Regional Medical Imaging (MI) goes live with Merge Notifi for patient appointment reminders.

Predixion Software releases Predixion Insight 4.0.

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Evangelical Community Hospital (PA) goes live with Nursenav Oncology’s patient navigation workflow system. The company offers patient tracking, assessments, reporting, and a patient portal.

HIPAA compliance platform vendor Catalyze puts its 25 model HIPAA policies for “a modern cloud healthcare company” online as open source.

DrFirst announces October 28 availability of its electronic prior authorization service Patient Advisor ePA+SM, which will integrate multiple sources starting with CoverMyMeds.


Government and Politics

A paper from the National Bureau of Economic Research says that HITECH was largely ineffective for spurring hospital EHR adoption, having fast-forwarded usage by only two years at a cost to taxpayers of $48 million per new EHR-using hospital (as opposed to the majority of hospitals that earned HITECH payouts for just using what they already owned). I wasn’t willing to pay $5 to read the full paper, especially since it’s a draft version, but I suspect I would have issues with its methodology even though its conclusions seem reasonable. Paying hospitals  (and doctors, which the report didn’t cover) to keep using systems they had already purchased was of questionable taxpayer value, but then again much of the $787 billion ARRA program was equally iffy from a value perspective.

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Organizations including the AMA, MGMA, and Premier urge HHS to refocus Meaningful Use certification on interoperability, quality reporting, and privacy and security. The groups also want HHS to slow the Meaningful Use program down and to encourage innovation and the development of new clinically-focused healthcare technology.  

The Treasury Department is trying to fix an HHS-created technical mistake that allows employers to offer employee health insurance that doesn’t cover hospitalization.


Technology

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Apple announces that OS X 10.10, also known as Yosemite, is available as a free upgrade to MacBook users.  


Other

The Robert Wood Johnson Foundation launches “Data for Health,” which will convene public meetings in five cities (Philadelphia, Phoenix, Des Moines, San Francisco, and Charleston, SC) to learn how data can improve health.

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Rob Lamberts, MD writes on his site that the Epic-created transition of care documents the local hospital keeps sending are 12-14 pages of “computer vomit” that don’t indicate the primary diagnosis or an indication of who ordered newly resulted lab tests or why. He concludes:

The purpose of these documents is, instead, to document that they have performed a vital function of the "ACO" (accountable care organization): performed transition of care to the PCP.  Hospitals are rewarded for doing this kind of thing … My job is to include this vomit in my computer system for posterity, confusing future generations of people who look at these records. This brings me back to my belief that computerizing an idiotic system does not help anyone; rather, it simply allows idiocy to be performed with much greater efficiency, at a greater volume, and dissipating it to more unsuspecting victims. This is what you get when care is about checking boxes or submitting codes. You get information that is useful only for the sender, not the receiver.

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The web domain dealer who bought Ebola.com in 2008 will put it on the market for at least $150,000, saying the site is drawing 5,000 page views per day from people who just type the address into their browser to see what’s there. The site contains unrelated Ebola news items cribbed from other sites, a “donate”link to Doctors Without Borders, and a notice that “Ebola.com Is For Sale.”

Navy doctors treat what may be the first known case of Google Glass addiction, in which a serviceman who was being treated for alcoholism was found to be using the device for 18 hours per day. He suffered from involuntary movements, cravings, memory problems, and dreams that he saw as though he was watching them through Glass. The head of the Navy’s addiction program says always-on wearables such as Glass allow users with psychological problems to escape from reality and to seek frequent neurologic rewards.

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Weird News Andy says she makes Nurse Ratched look good. A nurse in Italy is suspected of killing 38 patients by injecting them with potassium because she found them or their relatives annoying. Co-workers say she also gave patients laxatives at the end of her shift so that next-shift nurses would be stuck with the effects, while a newspaper reported that she took smartphone pictures of herself standing next to a deceased patient she is suspected of killing.


Sponsor Updates

  • HCS is sponsoring and exhibiting at the LeadingAge Annual Meeting in Nashville October 19-22.
  • SCI Solutions launches a company blog with an introductory post by CEO Joel French.
  • HIMSS Analytics says in its latest “Essentials of the US Hospital IT Market” that computer-assisted coding applications will experience increased hospital growth.
  • Vishal Agrawal, MD, president of Harris Healthcare Solutions, will participate as a panelist on “innovations in Access and Population Health” during the Scottsdale Institute 2014 Fall Forum.
  • Clinovations interviews Will Hodges regarding service line management vs. physician employment.
  • BlueTree Network challenges Vonlay-Huron to a food drive challenge to see who can raise the most meals or funds for meals from November 5 through December 3.
  • Levi, Ray & Shoup will participate in the 2014 SAP TechEd && d-Code event in Las Vegas October 21-23.
  • Imprivata reports that 100 European organizations have confirmed rapid adoption of virtual desktop infrastructure for single sign-on.
  • NoteSwift announces availability for Allscripts TouchWorks EHR.
  • NTT Data is named to the Winner’s Circle in the 2014 SAP Services Blueprint Report.
  • The Advisory Board Company discusses the threat of Ebola to healthcare workers in a recent blog.
  • Lifepoint Informatics unveils its patient access portal this week at G2 Lab Institute 2014.
  • HTMS, an Emdeon Company, launches Coverage Scout to assist in calculating health plan rates and federal subsidies.
  • Ingenious Med announces that three members of its mobile development team took first place in the Mobility Live Hack-Back Invitational.
  • The keynote address of eClinicalWorks CEO Girish Navani will be streamed live from the 2014 National Conference on October 17.
  • Louis Stokes VA Medical Center (OH), Orange City Area Health System, (IA) and Mercy Hospital Fairfield (OH) are live with Extension Engage to manage clinical alarms, alerts, and patient-centric text messaging.

EPtalk by Dr. Jayne

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My apologies for not mentioning eClinicalWorks in my recent shout-out of fall conferences. Their National Users Conference kicks off October 17 in Orlando. From the pictures of last year’s event, it looks to be a lot of fun. If you’re attending, we love a good party, so do tell how it’s going and share your photos.

I received a fair amount of reader response (and a handful of vendor solicitations) after this week’s Curbside Consult on transitioning to mandatory e-learning as part of EHR implementation. We already went live, so I’m not looking for a vendor (although you can bet I’m going to file your contact information away in case our system tanks and we need a replacement). Others wrote about their own experiences. The general consensus is that short segments with focused content are best and that unless mandated, user adoption can be less than stellar. E-learning seems to be most popular for workflows that aren’t overly complex but require more than a PDF to explain. So far we haven’t had any major glitches and people are logging on and completing the curriculum, so I’ll remain cautiously optimistic.

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The most intriguing healthcare IT tool I’ve seen recently is called The NNT. For readers who are not statisticians, NNT is the “number needed to treat” and represents the number of patients who would have to use a treatment for one person to benefit. If the NNT is low, that means you don’t have to treat a broad population to deliver benefit. If it’s high, the likelihood of the patient in front of you benefiting is low. In addition to providing NNT data, the website also uses a color-coded header bar to indicate treatments that make sense and those that don’t. Thanks to Wired for profiling the site.

It’s not exactly healthcare IT, but it does involve health care and IT giants. Several colleagues asked my opinion of Facebook and Apple offering egg-freezing as part of their benefits plans. Having cared for many women during their pregnancies, I can tell you that freezing eggs and using them later doesn’t change the other risks that pregnant women face when they’re older. Regardless of their motives, I’m glad it’s available for people who need it for medical reasons, such as young women undergoing cancer treatments. On the other hand, I’m still waiting for my own company to cover services many people take for granted, so I’m a little jealous.

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A shout-out to Dr. Travis and his recent mention of startup Thync, which aims to develop a device that can aid in shifting the wearer’s mood. Since it is worn on the head and uses ultrasound waves to trigger brain changes, I’m not sure I’d be a fan. For mood-altering wearables, I prefer the sparkly kind.

What kind of wearables alter your mood? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 16, 2014 News 1 Comment

News 10/15/14

October 14, 2014 News 5 Comments

Top News

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The AMA issues a Meaningful Use blueprint that calls for CMS to:

  • Waive penalties for providers that hit a 50 percent threshold.
  • Pay incentives for meeting a 75 percent threshold.
  • Make three unpopular measures optional: View/Download/Transmit, Transitions of Care, and Secure Messaging (or as an alternative, set thresholds at less than 100 percent).
  • Eliminate thresholds and menu vs. core requirements.
  • Add Stage 3 measures that are more appropriate for specialists.
  • Continue hardship exceptions for anesthesiologists, pathologists, and radiologists given their tiny attestation numbers and their use of systems provided by hospitals that don’t care all that much whether they can attest or not. AMA also wants a hospitalist exemption for those who treat large numbers of observation patients since they don’t qualify as hospital-based EPs in that setting.
  • Leave the measures in place that HITPC suggested removing, but allow providers to qualify by meeting any 10 measures.
  • Loosen the hardship exception requirements by expanding the definition of “unforeseen circumstances” and exempt hospitalists and physicians who are eligible for Social Security by the end of 2015.
  • Revamp EHR certification to cover only interoperability, quality reporting, and privacy and security.
  • Eliminate the requirement that only licensed clinicians can enter orders.
  • Create standards for electronically passing data between EHRs and registries in a standard format, eliminating the need for middleware.
  • Focus Stage 3 standards on coordination of care and new payment models rather than on data collection.

The AMA’s document also calls out C-CDA as causing interoperability problems, saying that ONC mandates its use in Stage 2 even though it has had “very little real world testing, nor was it balloted or approved for standardization by HL7” and therefore is still a draft standard with “wild variation in technology versioning.”  It urges that ONC not repeat the same process of jumping on untested standards starting with Stage 3.


Reader Comments

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From Media Horse: “Re: Abraham Vergese, MD’s comments about EHRs interfering with patient care. He was the keynote speaker at athenahealth’s user conference a few years ago. It was a good speech about preserving the patient-doctor relationship, but it’s interesting that he spoke for a company that’s in essence a billing company with an attached EHR. I’m not suggesting that he’s a hypocrite, but I’m sure he was paid well.”

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From Number Six: “Re: Health Data Warehousing Association conference in Portland, ME last week. I was impressed by the all-volunteer organization’s conference and the low registration fee of under $500 for 2.5 days. It was held in MaineHealth’s really nice conference center and had about 170 attendees. No vendors, just data people giving concrete details of what they’re working on in their institutions. Utah presented how they incorporate PROs into Epic and Altrius had a talk on predictive modeling, which was then covered in a ‘Sharing’ session on Day 2 since it was obvious that their specs could be implemented at other places. I highly recommend the conference HIStalk readers. Next year’s meeting is in Grand Rapids.”

From Always Be Closing (Offices): “Re: CompuGroup Medical. Closing the Boston office and terminated the sales VP and several sales reps.” Unverified, but the report is from a non-anonymous insider.


Webinars

October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CEO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.


Acquisitions, Funding, Business, and Stock

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Lifestyle healthcare technology vendor Alphaeon Corp. acquires Utah-based TouchMD for $22 million. TouchMD’s apps allow plastic surgery and OB-GYN practices to educate patients on their services to “increase consultation closings at the time of service and added procedures beyond the consultation, resulting in increased practice revenue.”


Sales

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Beaver Dam Community Hospitals (WI) will deploy eClinicalWorks across its eight locations.


People

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Andrew Gelman, JD will step down as SVP of corporate development for PDR Network to run a family business, but says he will keep his hand in healthcare with occasional consulting.

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Facebook CEO Mark Zuckerberg and his physician wife donate $25 million to the CDC for Ebola control.

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University of Arkansas for Medical Sciences promotes Rhonda Jorden to vice chancellor for IT and CIO.

ONC names Lucia Savage, JD (UnitedHealthcare) as chief privacy officer, replacing Joy Pritts, who resigned in July.


Announcements and Implementations

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Mobile Heartbeat will integrate EMR and waveform data from AirStrip’s One platform into its care team smartphone app.

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Eskenazi Health (IN) will use technology from Indianapolis-based Diagnotes to alert its brain center coordinators when patients are admitted, discharged, or transferred from hospitals as reported to the state HIE.

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Personal health records management app vendor Hello Doctor claims it has “gained access to an API” that gives it “access to 52 percent of clinics and hospitals in the US.” That sounds suspicious since there’s no single API out there that covers multiple vendors, leading me to believe that perhaps they’ve connected to Epic in some manner and are using the “52 percent” statement incorrectly to refer to organizations rather than patients.  

Allscripts will offer Shareable Ink’s documentation solution for surgical and clinical documentation for Sunrise.


Government and Politics

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Rep. Renee Ellmers, RN (R-NC) issues a statement saying she’s pleased that CMS extended the Meaningful Use hardship exception after admitting that its submissions website wasn’t working correctly, but repeats her request (made via her proposed Flex-IT Act) that CMS reduce its 2015 Meaningful Use Stage 2 reporting period from 365 days to 90 days.

Beth Israel Deaconess Medical CenterCenter John Halamka, MD says the White House should choose someone from DC rather than Silicon Valley in replacing departed US CIO Steven VanRoekel:

I always support the federal government, but bold new ideas get lost in the complexity of procurement, contract management, and getting stakeholders to agree. Navigating the US government is difficult and complicated, and an outsider from Google or Facebook is likely to be eaten alive. Only an insider can navigate the process while offering new ideas and approaches.

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HITPC’s JASON Report Task Force will deliver its conclusions today (Wednesday), proposing that current interoperability approaches should be replaced with an API-driven model starting with Meaningful Use Stage 3. It disagrees with the JASON report’s conclusions that such an approach requires new clinical and financial systems, that the market has failed in its failure to advance interoperability, or that a newly mandated software architecture is required. The task force advocates that ONC create a public interoperability API and encourage its use via the Meaningful Use program. 

ONC names 12 providers as health IT fellows. 

Executives of California’s health insurance exchange are questioned about its contracting practices as a state senator claims the organization practiced cronyism in awarding dozens of no-bid contracts, some of them to a company whose owner has close ties to Covered California’s executive director.

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The chief of staff of New York City’s medical examiner’s office quits following a $10.9 million no-bid, sole-source contract award to a ICRA Sapphire, whose software has cause bodies to be mishandled or lost. The city has been paying for the system using Homeland Security grants, having awarded what one lawyer called a “lifetime contract with constantly increasing costs and poor results” and hiring the India-based company’s rep as the ME office’s CIO. The previous CIO and his girlfriend were arrested for embezzling $9 million in FEMA grants intended for tracking the remains of 9/11 victims. The just-resigned chief of staff had been promoted to the position even after getting caught stealing an airplane’s exit handle from the 9/11 debris to take home as a coffee table souvenir.


Technology

Philips Healthcare begins Netherlands hospital trials of a wearable COPD monitoring sensor that collects information on physical activity, respiratory indicators, and sleep disturbances.

A reader called my attention to Xenex, whose xenon-powered pulsed UV devices (“Germ-Zapping Robots”) can disinfect hospital rooms in a few minutes, a timely topic given Ebola. Two of the company’s executives hold doctorates from the Bloomberg School of Public Health at Johns Hopkins University, while the other two were involved with Rackspace Hosting.

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Google is testing a search feature that would allow people who are Googling medical symptoms to click a “talk with a doctor now” link.

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Breathometer integrates its $100 Breeze personal breathalyzer with Apple’s HealthKit.


Other

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The Brookings Institution presumably publishes intelligently written and authoritative articles on occasion, but this lame piece called “Could Better Electronic Health Records Have Prevented the First American Ebola Case?” isn’t one of them (maybe Farzad was the only person there who knew anything about healthcare IT). Its insight is zero, its valid points are few, and its flaws are many:

  • It doesn’t answer the question its sensationalistic headline asks.
  • It is based on a preliminary report that an EHR setup decision caused Texas Health Presbyterian Hospital Dallas to discharge the Ebola patient from its ED, which turned out not to be the case according to the hospital.
  • It gets the hospital name wrong even though it’s right there on the page to which the article links.
  • It wanders all over the place about EHR privacy, cost, and “voluminous files,” then meanders into healthcare policy issues, health IT competition, and a proclamation that an undefined “many”are skeptical about EHR value and the government should therefore fund outcomes research (which is already underway).

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Anna McCollister-Slipp, the co-founder of an analytics company and Tricorder Xprize judge who also has Type 1 diabetes says she’s tired of waiting for digital health to flourish, pointing out that:

  • Even hospitals that took Meaningful Use money won’t allow patient-sourced data to be imported into their EHRs.
  • Most of the health apps were designed for people who are already healthy.
  • Her academic medical center does not offer online EHR access, doesn’t allow electronic communication with its physicians, and won’t provide her endocrinologist with the software that would allow him to load her glucose monitoring data to his computer.
  • None of her doctors use electronic scheduling, none offer online lab results retrieval, and only one accepts electronic refill requests.

A Pennsylvania legislator questions UPMC (PA) about its ability to send records of Highmark insurance patients to new providers when they lose access to UPMC’s hospitals on January 1. UPMC CIO Steven Shapiro says they can transfer records electronically within 24 hours, but Highmark claims UPMC will be sending faxed documents instead. UPMC uses Cerner among its variety of systems, while Highmark-owned Allegheny Health Network is moving to Epic.

Reuters covers the growing telemedicine market in China, which the government is supporting to overcome the rural-urban medical expertise gap. A report says doctors in China spend 13 hours per week online, with 80 percent of them using mobile phones.

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CDC and ONC will present a webinar on Thursday, October 16 at 1:00 – 2:30 p.m. Eastern to encourage providers and EHR vendors to work together to develop Ebola screening tools. CDC’s Ebola team will present its detection algorithms and travel history / medical signs checklists.

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NBC medical correspondent Nancy Snyderman, MD admits that some of her crew members broke a voluntary Ebola quarantine in going out for takeout food after returning from Liberia, where the group had been in contact with an Ebola-infected freelancer. New Jersey health officials reacted to her admission by making the quarantine mandatory.  She declined to say whether she herself was one of those involved as several locals who spotted her indicated.


Sponsor Updates

  • Predixion Software joins the Salesforce Analytics Cloud ecosystem.
  • Greenway Health’s SuccessEHS is prevalidated by NCQA to receive 27 points in auto credit toward PCMH 2011 scoring.
  • Frost & Sullivan names Validic to its 2014 Best Practices Award for Customer Value Leadership.
  • First Databank’s collaborative research paper is selected as a finalist in the Best Paper Competition by the American College of Clinical Pharmacy.
  • The Jacksonville Daily News discusses the history of military healthcare IT solutions and calls RelayHealth a “pearl.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 14, 2014 News 5 Comments

Monday Morning Update 10/13/14

October 11, 2014 News 3 Comments

Top News 

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Opponents of California’s Proposition 46 – which would quadruple the maximum allowed pain and suffering medical practice award, mandate drug and alcohol testing of physicians, and require that physicians and pharmacists look up controlled substance prescription patients in the little-used CURES drug abuser database – launch a voter campaign suggesting that the CURES database would be vulnerable to hacking. Many of the coalition’s members are healthcare providers and member organizations.


Reader Comments

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From Bob Loblaw: “Re: Stanley Healthcare. The complete incongruity of this reputable firm flirting in the healthcare arena was probably the need for one or more of its executives to have something to say at the cocktail circuit. None of the senior managers has healthcare experience and many of the clinical experts were jettisoned in the inevitable rightsizing. Their attempt to force the amalgamation of security organizations, furniture companies, a cart company, and a grossly overpromised acquisition of an Israeli company have resulted in a monster of Frankenstein proportions. RIFs have begun and Stanley Healthcare will be absorbed into Stanley Security.” Unverified.


HIStalk Announcements and Requests

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It’s a 53-47 “no” vote on President George W. Bush as HIMSS15 keynote speaker. New poll to your right or here: should ONC create and run a national health IT safety center? The Comments link on the poll allows you to expound further.


Last Week’s Most Interesting News

  • NantHealth raises another $250 million in funding from the government of Kuwait and rounds out its executive team with several new hires.
  • GE Healthcare CEO John Dineen resigns, replaced by John Flannery, whose extensive GE experience includes none related to healthcare.
  • Ochsner Health System (LA) says it is the first of Apple’s beta sites to go live with HealthKit-Epic integration.
  • CMS reopens the EHR hardship exception period through November 30, 2014.
  • Walmart announces plans to sell health insurance in its stores and its ambition to become “the number one healthcare provider in the industry.”
  • Facebook may create online health support groups and supporting health-related apps.
  • Texas Health Resources reverses its statement that its Epic setup allowed Thomas Duncan to be discharged from its hospital without being recognized as a potential Ebola patient despite his statement that he had just arrived in the US from Liberia.

Webinars

October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CEO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.


Acquisitions, Funding, Business, and Stock

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Shares of Streamline Health hit a 52-week low as the company’s market capitalization drops to under $70 million. Above is the one-year performance of STRM shares (blue) vs. the Nasdaq (green).


Government and Politics 

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Internal documents suggest the overall cost of the Massachusetts health insurance exchange is much higher than the figure provided last week by Governor Dev Patrick. Temporary Medicaid plans for citizens who were unable to use the failed website will cost state and federal taxpayers $700 million, raising the exchange’s total cost to nearly $1 billion. 


Innovation and Research

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California HealthCare Foundation creates a downloadable healthcare accelerator database, saying that demand for accelerators is increasing even though evidence is skimpy that their members will be successful or that the accelerators add value. An expert says the accelerator success rate is about one out of every 7-10 companies. The report adds that while entrepreneurs like joining one or more accelerators,  the need to join a second highlights the failure of the first, and that anyone with “ loft-like space, an unlimited electrical supply, some former entrepreneurs, and a good network of local supporters” can start their own accelerator. It concludes that the recent rash of newly announced accelerators may end up doing more harm than good this early in the hype cycle and many of them will not survive. The report lists six accelerator models:

  1. Independent companies, profit or non-profit, that take equity from participants (Rock Health, Healthbox).
  2. Enterprise-based, where companies provide help only to startups building a product that they themselves might want to use (Microsoft, Boston Children’s Hospital, Optum).
  3. Product-specific to expand use of a particular platform (athenahealth’s More Disruption Please).
  4. Economic development funded by governments or organizations to promote local job growth (100health, DreamIt Health, New York Digital Health Accelerator).
  5. University-affiliated programs that may primarily involve technology transfer (UCSF’s Catalyst, Boston’ Center for Integration of Medicine and Innovative Technology).
  6. Collaboration programs that connect large corporate partner sponsors to startups (Health XL, Avia).

Other

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Daughters of Charity announces that it will sell all six of its California hospitals to for-profit Prime Healthcare.

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An infectious disease physician who with a colleague treated the third Ebola-infected patient in the US says that only one of the doctors entered the patient’s room to minimize contact, while the other observed via two-way video and documented in the EHR. She adds, “We joked about who had the easier job, since writing notes and orders in an electronic medical record can be a formidable task.”

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Alameda Health System (CA) says it has run out of cash and used up all of its credit trying to recover from a $77 million Siemens Soarian and NextGen implementation that “did not go as well as planned.” The system’s new CFO says, “The system makes it difficult to collect the right information that you need to bill a claim and makes it hard to identify what kinds of errors are occurring. …. It’s very disjointed right now. A lot of mistakes are being made.” A physician adds, “There’s not a single part of the hospital — inpatient, outpatient, ER — that has fully functional (electronic health records).”

Kaiser Permanente is working on supply chain redesign, hoping to reduce duplicate inventory, increase patient care time of nurses, and manage expired and recalled items. They are also scanning product ID barcodes into the EHR so that product effectiveness can be reviewed electronically afterward.

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Physician and professor Abraham Vergese says in an interview with Eric Topol, MD that technology is infringing on the patient-physician relationship:

It is taking us away, and society will judge us poorly about 20 years from now. They’ll look back and say, "You were complicit. Why did you let Epic and all these electronic medical records rule your life? You actually signed up to learn the new ICD codes and plug them in. Exactly what did this do for patient care?" And the answer is that it did nothing for patient care. It did everything for billing. I feel like the lone piper saying this, but it is clear that we are all feeling the frustration of being forced to do things that have nothing to do with patient care. They are all about billing.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 11, 2014 News 3 Comments

News 10/10/14

October 9, 2014 News 1 Comment

Top News

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ONC hires RTI International to plan its national health IT safety center. Several lawmakers have questioned ONC’s legal authority to create and run such a center, particularly the part of its original plan that involved charging vendors fees.


HIStalk Announcements and Requests

This week on HIStalk Connect: Facebook investigates new healthcare-focused services, including disease-specific social media groups and Facebook-connected health apps. Healthcare billionaire Patrick Soon-Shiong’s startup NantHealth raises a $320 million Series B led by the Kuwait Investment Authority. Startup Health welcomes 13 new digital health companies to its three-year incubator program.

This week on HIStalk Practice: Virginia Women’s Center implements Keona Health tech. NHS patients are assigned non-muggle names at check-in. United Physicians rolls out Wellcentive solutions. DHMSM bidders get two more weeks. Community Health Centers of Arkansas goes with eClinicalWorks. The artist formerly known as Dr. Gregg pens a new tune. Thanks for reading.

Listening: new from Hozier, a creative Irish musician who tells lyrical stories in a variety of genres. I like it.


Webinars

October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CEO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.

Acquisitions, Funding, Business, and Stock

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Box acquires medical imaging collaboration platform startup MedXT. Meanwhile, healthcare startup investor and Box CEO Aaron Levie (centimillionaire; college dropout; healthcare background or previous interest zero) posts a self-congratulatory USA Today opinion piece (it’s not very well edited with quite a few misspelled words, so it may be a paid promotion) extolling the virtues of the companies in which he holds a financial interest, saying, “There’s already an explosion of start-ups in Silicon Valley and beyond tackling healthcare, ready to transform the industry from the outside in … The Obama administration has taken the lead on pushing through legislation to increase access to care, and there’s far more that can be done on the policy side. But there’s a major role for the technology sector to play in transforming our health care system from one that lags behind its peers, to one that defines the future of health care innovation worldwide.” That’s what Google thought, too.

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NantHealth raises $250 million from Kuwait’s sovereign wealth fund, adding to the $100 million the fund invested earlier this year. The company also announced that Steve Curd (CareInSync) has joined as COO and KLAS co-founder Scott Holbrook has been named to the company’s board.

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HIMSS and the Avia provider-driven accelerator announce HX360, which will facilitate adoption of next-generation technologies. I don’t really understand what the buzzword-laden announcement is saying the new organization will actually do. Or, for that matter, why HIMSS would partner with a for-profit that collects dues and invests directly in companies that may compete with the vendors that provide HIMSS with most of its income.


Sales

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Maury Regional Medical Center (TN) selects VisionWare’s MultiVue platform.

University of Virginia Health System selects Strata Decision’s StrataJazz for decision support and cost accounting.

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Hugh Chatham Memorial Hospital (NC) chooses Medhost’s Advanced Perioperative Information Management System with Anesthesia Information Management System.


People

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Hearst Corporation promotes Charles Tuchinda, MD to president of First Databank.

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Anthony J. Principi (US Department of Veterans Affairs) joins GetWellNetwork’s board.

Vince Ciotti reports that former SMS VP Jim Carter, who he profiled in the above HIS-tory segment a few years ago, has passed away. Vince adds, “I’m sure his hundreds of friends at SMS share my sad feelings tonight at this news. The good things we all share are the many memories of his ever-smiling face, infectious laugh, and always positive attitude. He will be sorely missed.” 


Announcements and Implementations

Allscripts announces GA of the FollowMyHealth Achieve care management solution for Touchworks and Sunrise users.

Visage Imaging announces a new release of its Enterprise Imaging Platform, which includes increased scalability to tens of millions of images and Epic integration. The company will exhibit at ACR’s Imaging Informatics Summit on October 29-30.


Government and Politics

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HHS Secretary Sylvia Burwell says in a interview question about the Meaningful Use program, “Once we get these systems interoperable, that’s when we get the real value. You get the real value as a practicing physician, you get the real value as a consumer, and that’s the next step. At the same time, as we’re trying to move forward, we’re receiving comments and pressure to slow the implementation. This is a push-pull as we’re going through change.”


Technology

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Wearables vendor Fitbit says it has no plans to integrate with Apple’s HealthKit.

Gartner identifies its “Top 10 Strategic Technology Trends for 2015”:

  1. Computing everywhere
  2. Internet of Things
  3. 3D printing
  4. Advanced, pervasive, and invisible analytics
  5. Context-rich systems
  6. Smart machines
  7. Cloud/client computing
  8. Software-defined applications and infrastructure
  9. Web-scale IT
  10. Risk-based security and self-protection

Other

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An eHealth Initiative survey of HIEs finds them concerned about the cost and challenges involved with interfacing with EHRs, but happy that Meaningful Use and regulatory requirements have sent providers their way. Nearly half of the HIEs that charge membership fees say that income doesn’t cover their expenses.

Weird News Andy titles this story “Fallopian Tubers.” Doctors investigating a woman’s abdominal pain remove a germinating potato from her reproductive tract, which she explained as, “My mom told me that if I didn’t want to get pregnant, I should put a potato up there, and I believed her.” 


Sponsor Updates

  • Beckie Cosentino, director of privacy and compliance at Etransmedia, discusses HIPAA-compliant email.
  • Orchestrate Healthcare posts “Strategies for Effective Healthcare Systems Integration Are Changing”
  • Clinovations shares a Q&A with Brian Morton discussing the business side of medical practices.
  • CitiusTech will participate in the NAHC Annual Exposition, MGMA, and the IBM Insight in October.
  • Connance and the University of Rochester Medical Center will discuss how the medical center was able to increase charity care dollars and reduce bad debt during HFMA Region 2 Fall Annual Institute October 22-24.
  • Innovative Healthcare Solutions shares how PeaceHealth (AL/WA/OR) was able to alleviate challenges and meet expectations for its Epic implementation by engaging IHS for support.
  • Sunquest announces its November anatomic pathology summit agenda.
  • Craneware will sponsor the Hospital 100 Leadership and Strategy Conference October 19-21 in California.
  • CoverMyMeds partners with Prodigy Data System to provide faster prior authorization approvals within long-term care facilities.
  • ShareCor selects Sandlot Solutions’ Sandlot Dimensions for its Louisiana Health Information Network.
  • Imprivata will showcase its single sign-on and authentication management solutions during VMworld 2014 in Europe October 14-16.
  • Premier shares a video overview by Stacey Counts at Heartland Health/Mosaic life Care (MO) of the PACT Collaborative and Premier’s PopulationFocus after participating in the first Medicare Shared Savings Program by CMS.
  • Orion Health launches eReferral province-wide in Alberta, Canada for lung cancer, breast cancer, and hip and knee joint replacement surgery referrals.
  • Besler Consulting explores the implications of the elimination of the Common Working File for acute care hospitals in a recently published issue brief.
  • The Nova Scotia Department of Health and Wellness PHR project, powered by RelayHealth, receives second place in the 2014 Canada Health Infoway Accelerate Challenge.
  • ScImage achieves DIACAP accreditation for its hybrid cloud medical imaging solution PicomEnterprise 3.x.
  • ZeOmega CEO Sam Rangaswamy is named to Dallas Business Journal’s “Who’s Who in Health Care.”
  • Strata Decision publishes the agenda for its summit and leadership symposium October 21 in Chicago.

EPtalk by Dr. Jayne

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ONC opens a public comment period on the Draft 2014 Edition Release 2 Test Procedures. I can confidently say that most of the public has no idea what this is, let alone a comment on it. I imagine most comments will come from individuals associated with a vendor or who have a vested interest in the testing process. Anything that takes my vendors’ time and effort away from improving usability and ensuring patient safety is a problem, so I hope people who have more free time than me add some helpful comments.

In other news, CMS is reopening the hardship exception application process with a new deadline of November 30. We submitted a number of applications prior to the original July 1 deadline and still have not received determinations on about half of those providers, despite their reason for hardship all being identical. I’m not sure why the rest are delayed, but I hope CMS addresses the backlog before they start processing new applications.

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I’m continuously entertained by the emails I receive as a result of being on LinkedIn. This week I’ve had no fewer than 10 requests to connect with international medical students with whom I have no connections in common. The pick of the week is one from a recruiting firm searching for a CMIO with experience using a particular vendor. Had she bothered to look at my profile, she would have seen that vendor listed exactly nowhere.

Additionally, she states that the client requires the new CMIO spend 70 percent of his or her time in clinical pursuits “to establish credibility with the medical staff and garner Physician respect.” Anyone who thinks that you can do the non-clinical work of a CMIO in 12 hours a week doesn’t understand at all what it is that we do.

The email goes on to say that eventually the role will transition to 20 percent, but doesn’t list a time period. From experience, it doesn’t matter how much time the CMIO spends in clinical pursuits, it will never be enough for some physicians. Unless you’re seeing as many patients who are as sick as their patients (who are undoubtedly the sickest patients on the planet), you are inferior.

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The end of the month really heats up with healthcare IT events. First MGMA kicks off in Las Vegas on the 26th, with the CHIME Fall Forum starting the next day. The Cerner Health Conference starts November 2 along with NextGen’s One User Group Meeting. Las Vegas, San Antonio, Kansas City, Las Vegas. If you’re a best of breed CIO (and I can think of a few), you could really rack up some frequent flyer miles. If you’re attending any of them, we love to have reader feedback.

Got photos? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 9, 2014 News 1 Comment

News 10/8/14

October 7, 2014 News 14 Comments

Top News

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CMS will reopen the submission period for EHR hardship exceptions through November 30, 2014. Valid circumstances are vendor delays in providing 2014 Edition CEHRT and the inability to attest via the 2014 CEHRT Flexibility Rule. They didn’t give a reason, but it’s probably because their attestation system wasn’t working and providers were going to be penalized for another CMS technology screw-up.


Reader Comments

From Zephyr: “Re: Ebola. Epic is hosting a conference call Wednesday to allow users to share strategies for screening, notification, and management of communicable diseases.” Unverified, but I think all ED system vendors should consider doing this. Epic has a vested interest since it was called out (correctly or not, depending on which hospital press release you believe) by Texas Health Resources, which owns the hospital that discharged an Ebola patient from its ED due to poor communication of his stated recent visit to Liberia.

From Doppelganger: “Re: MU. We are an EH trying to attest since July for Stage 1 Year 2 for the period April-June 2014. We first attested under Medicaid for 2012, then Medicaid and Medicare in 2013. There’s a bug in the CMS website – they think we’re in our third year of attestation, so we must be on Stage 2. I’ve heard this is happening to everyone who attested under Medicaid for 2012 only. CMS said the bug would be fixed on October 1. It still isn’t and my CFO wants his ‘free’ money!” CMS seems to be struggling with its websites these days, so I’m sure others are having the same problem.


Webinars

October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CEO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.


Acquisitions, Funding, Business, and Stock

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Cognizant, which bought TriZetto two weeks ago for $2.7 billion, acquires healthcare digital marketing company Cadient Group.  

Rock Health runs an interesting interview with a Goldman Sachs healthcare IT guy on doing IPOs. A good quote: “Being public—not just going public—can put you in a very powerful position as you continue to build your toolset and maximize its importance in the world. But the process is time intensive and distracting, so always be objective and sober about it. Maintain control and don’t let the euphoria and momentum of the IPO process carry you away such that you later wish you had spent time continuing to innovate and build the business rather than focusing on the IPO.”

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Hewlett-Packard will split into separate companies, one (Hewlett-Packard Enterprise) focusing on enterprise hardware and services and the other (HP) on PCs and printers. 

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Medical supply manufacturer Becton Dickinson will acquire CareFusion for $12 billion in cash and stock. CareFusion’s health IT-related product lines include Alaris (smart IV pumps), MedMined (infection surveillance), and Pyxis (medication and supply dispensing). The company was a 2009 Cardinal Health spinoff. The Department of Justice fined CareFusion $40 million earlier this year for paying high-profile patient safety advocate Charles Denham, MD nearly $12 million to recommend the company’s skin prep cleanser via the National Quality Forum.

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Alteryx, which offers software that allows minimally technical users to create workflow-driven applications from data sources, raises $60 million in a Series B round. The company, which partners with Tableau and QlikView, offers a 14-day free trial download.


Sales

United Physicians (MI) will roll out Wellcentive’s population health and risk management solutions to cover all its patients.

Community Health Centers of Arkansas will implement eClinicalWorks Care Coordination Medical Records across 10 practices and 58 locations.


People

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GE Healthcare President and CEO John Dineen resigns effective immediately to “look at new leadership opportunities outside GE.” He will be replaced by SVP of business development John Flannery.

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Sheryl Bushman, MD (NYU Langone Medical Center) joins Optimum Healthcare IT as CMIO.

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Sean McDonald, who founded the Pittsburgh-based hospital pharmacy robotics vendor Automated Healthcare and sold it to McKesson in 1996, leaves his CEO job at Precision Therapeutics.

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Jim Cato, EdD, RN, MSN, CRNA (Christus Spohn Health System) joins GetWellNetwork as SVP of clinical integration and operations.


Announcements and Implementations

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XIFIN will use SyTrue’s terminology as a service to improve pathology services billing and to ease the conversion to ICD-10.

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A local newspaper article by Lee Memorial Health System (FL) CIO Mike Smith describes its go-live with Epic MyChart.

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Caradigm releases a population health applications bundle that includes its Intelligence Platform plus modules for patient knowledge aggregation, risk management, quality improvement, and care management. 

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Surescripts integrates its CompleteEPA medication prior authorization system with Epic.

T-System releases system-agnostic Ebola patient screening tools that are free to all providers.

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Premier adds real-time predictive analytics from Predixion Software to its PremierConnect data management and decision-making platform.

Merge Healthcare adds electronic referral and order management to its iConnect image sharing network.


Government and Politics

Medicare will change its five-star rating system for nursing homes after news organizations questioned the validity of self-reported data. Among the changes will be mandatory quarterly electronic submission of payroll data to verify staffing levels and an auditing program to validate quality measures ratings.

The VA, following up on its investigation of long wait times, fires three health system directors and its chief procurement officer. One of the fired directors announced his retirement four days before his termination was made public, which the chairman of the House Veterans’ Affairs Committee called, “semantic sleights of hand.” The procurement officer was fired for inappropriately influencing a contract award and then trying to block the resulting investigation.

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Massachusetts Governor Deval Patrick says the state’s health insurance exchange has been fixed for $26 million and a total cost of $254 million, far les than the $600 million total that a think tank had estimated last month.  

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A Texas Senate committee is holding hearings into how Ebola patient Thomas Duncan ended up at Texas Health Presbyterian Hospital and why the hospital’s ED discharged him even though he was feverish and told the nurse just came back from liberia.  


Innovation and Research

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Orlando Portale, president of Health Innovation Partners, mocks up an Ebola early warning app for hospital EDs that would connect to the system in which the US Department of Customs & Border Protection records the itineraries of travelers entering the US. if the government authorized access its system, doctors could review the patient’s travel history by entering the patient’s last name, gender, and date of birth. Sounds like a great idea other than the inevitable privacy objections that would arise from having the visit plans of foreign travelers available outside of the government.

A Brigham and Women’s Hospital EHR review finds that doctors experience “experience fatigue” later in the day and are 25 percent more likely to inappropriately prescribe antibiotics late in their shifts. As if that’s not bad enough, the study found that doctors often ordered antibiotics questionably even when they weren’t tired, about 30 percent of the time.


Technology

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Ochsner Health System (LA) announces that it is the first site to integrate Apple HealthKit with Epic, bringing in weight from wireless scales to monitor home patients for congestive heart failure. I cringed when I typed “weight” since I recall my physics professor adamantly declaring that the correct term is “mass.”

An Exconomy review says there’s not much evidence proving that digital health improves outcomes, but it’s not reasonable to withhold clearly beneficial technologies while waiting for the perfect study to be performed. The best quote is from Joe Kvedar, MD of Partners Healthcare’s Center for Connected Health, who says its tough to get insurance companies to pay for apps for conditions such as smoking cessation where the medical cost benefit won’t be realized for years, possibly after the patient has moved on to another insurer. “That’s why so many companies say they’d rather make a cute thing to put on your wrist, make some money, sell it, and move on to the next thing.”


Other

University of Michigan gets a $1.6 million AHRQ grant to study how clinicians use EHRs, email, and pagers and how those systems can be set up to reduce communications failures.

Several high-end restaurants in Los Angeles are tacking on a 3 percent dinner tab surcharge line item to cover the cost of providing health insurance to their employees. Some patrons are complaining that, like other costs of running a business, the extra fee should be built into menu prices, but the restaurants argue that their leases and insurance are priced based on gross revenue and 3 percent wouldn’t cover it by that method. Some of the restaurants agree that it doesn’t make sense to pay servers nearly nothing and force them to live on tips, so they’re considering adding an all-inclusive service fee. 

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Masimo Corporation, which flashily launched a patient safety foundation last year with an on-stage appearance by President Bill Clinton, is found in a ProPublica investigative report to have been reprimanded by the FDA for failing to respond adequately about complaints about the safety of its own medical devices. An expert who reviewed the agency’s findings found it troublesome that the company challenged a complaint about a device’s alarm system involving a patient death, adding, “When a company refuses to respond in any way to the FDA other than to say that the FDA is wrong on every issue, that’s not very credible.”  

Health Catalyst puts out a good video called, “If Restaurants Were Run Like Hospitals.”

Researchers looking at Beth Israel Deaconess Medical Center’s patient portal usage through 2010 found that patients sent an average of about one email every other month per patient, with about a fourth of all patients signing up for the portal and a third of those (8 percent of all patients overall) sending at least one message to their doctor. Physicians received about one email per day. The authors conclude that physicians should be required by their job descriptions to respond to patient emails. That’s interesting, but the information is awfully old and the conclusions are questionable as a result.

Walmart will allow in-store shoppers to compare and select health insurance plans, adding that the company’s goal is “to be the number one healthcare provider in the industry” and that the foot traffic will allow it to sell customers prescriptions, non-prescription medications, optical services, and retail clinic services. The company also announces that it will stop offering health insurance to the 30,000 of its employees who work fewer than 30 hours per week, meaning those employees will lose their 75 percent Walmart premium subsidy.

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Weird News Andy is amused by PitPat, a Bluetooth-enabled exercise tracker for dogs. WNA adds that the cat version would be locked on 99 percent sleep.


Sponsor Updates

  • Sanford Health (ND) VP of clinical operations Jeff Hoss describes the use of an RTLS from Intelligent InSites and Sonitor to improve ambulatory patient processes in a video presentation.
  • Medicity earns HISP certification from DirectTrust and EHNAC.
  • Streamline Health will begin work on a $7.5 million, five-year deal for its abstracting solution with a new channel partner.
  • Georgia West Imaging and Outpatient Imaging (GA/AL) select McKesson Business Performance Services for its RCM.
  • Netsmart announces that over 1,000 attendees are participating in its CONNECTIONS2014 client conference through October 9.
  • GetWellNetwork CEO Michael O’Neil, Jr. is speaking at the US News Hospital of Tomorrow summit October 6-8 in Washington, DC.
  • CTG Health Solutions’ Joseph Eberle will share his experience identifying improvement opportunities for chronic kidney disease patients at the National Association of Health Data Organizations Annual Conference October 8.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 7, 2014 News 14 Comments

Monday Morning Update 10/6/14

October 3, 2014 News 42 Comments

Top News

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A Reuters report says Facebook is working on healthcare tools that include chronic disease support communities and health apps. It adds that the company has been meeting with healthcare experts and entrepreneurs and is setting up a health app R&D unit. Mark Zuckerberg’s wife is a doctor, so maybe it will do more than just the usual privacy invading and ad serving. Meanwhile, the company apologizes that it performed mood manipulation experiments on unwitting users by tweaking their news feeds to show extra-cheery or extra-depressing items to see how they reacted.


Reader Comments

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From David: “Re: CMS Open Payments. ProPublica has downloaded the database and made it searchable as Dollars for Docs. They’ve also done a great job with Treatment Tracker, which breaks out Medicare payments to doctors.” It’s pretty funny (or sad if you’re a taxpayer) that the non-profit newsroom quickly whipped up a perfectly fine consumer-friendly version of the mess that CMS and its army of highly paid contractors created.

From WhoopsInVA: “Re: Anthem BCBS in Virginia. Forgot that ICD-10 wasn’t actually going live this month and are rejecting all incoming claims because of diagnosis. Our athena rep just emailed us about this.”

From The PACS Designer: “Re: new iPad Air and Mini. Apple will be holding its next event on October 16 for the new versions of its iPad Air and Mini devices. It will interesting to see the changes they are making with the its iOS 8 system installed.” Maybe it’s just me, but I’m losing interest in Apple’s overly dramatic announcements of incremental product tweaks. The fanboys still achieve mandatory technical arousal and obediently line up outside the Apple Store as they’ve always done (ironically resembling the Big Brother-obeying monochromatic drones from Apple’s famous “1984” commercial), but Apple is a lot less interesting without Steve Jobs. I’m pretty sure I’ll do the same in eventually replacing my phone as I did with my iPad: buy a more innovative product for a less money even though it won’t come with the self-congratulatory hipster delusions in hanging around the Apple store pretending to be artsy and cool.  


HIStalk Announcements and Requests

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Most readers say it’s not OK for an EHR vendor to deny a hospital or practice access to its patient information in a billing dispute. New poll to your right or here: What’s your reaction to HIMSS announcing President George W. Bush as a keynote speaker for HIMSS15?

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Here’s my opinion on Bush as a HIMSS keynote: he wasn’t interesting as President, so I don’t really care what he has to say now that he’s cashing in on his pitiful legacy (unless he’s announcing that he finally turned up those pesky WMDs.) The HIMSS strategery is probably to scratch his back in return for his industry-enriching 2004 declaration that every US citizen would have an electronic medical record by 2014, so perhaps he will strut out in a flight suit and yet again prematurely declare “Mission Accomplished.”

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We’re putting together our MGMA guide featuring sponsors of HIStalk, HIStalk Practice, and HIStalk Connect that will he exhibiting or will be available to meet with interested attendees. Contact Jenn by Monday evening if your company sponsors and hasn’t already provided information.  

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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Last Week’s Most Interesting News

  • The CMS Open Payments database goes live with inaccurate physician payments information and usability criticism.
  • CMS announces that it will miss its date to move Healthcare.gov’s hosting to HP, with its only option to leave it running on the previously problematic Verizon infrastructure through the open enrollment period.
  • UnitedHealth Group’s Optum division acquires MedSynergies, which offers physician practice billing and quality services.
  • Informatics pioneer Morris Collen, MD of Kaiser Permanente dies at 100 years old.
  • Experts warn health systems to test for the newly discovered Shellshock Unix vulnerability.
  • Epic CEO Judy Faulkner says in a rare interview that the company developed its own interoperability tools only when it became clear that the federal government wasn’t going to set clear standards.
  • Apple restores its HealthKit health data aggregation system and third-party apps that use it in an iOS 8 update.

People

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Spok names Hemant Goel (Siemens Health Services) as COO.

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Jim Dwyer (Santa Rosa Consulting) joins RCG Global Services as SVP and healthcare practice leader.


Government and Politics

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ONC loses another of its leadership team as Chief Nursing Officer Judy Murphy will resign to take the same position with IBM Healthcare Global Business Services. To quantify the turnover, I looked back at the ONC leaders who presented at HIMSS13: Farzad Mostashari (gone), Judy Murphy (gone), Doug Fridsma (gone), David Muntz (gone), Jacob Reider (still there), Jodi Daniel (still there), Lygeia Ricciardi (gone), Mat Kendall (gone), Joy Pritts (gone), and Kelly Cronin (still there).


Technology

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The FCC fines Marriott for blocking personal hot spots in its conference center to force attendees to buy its overpriced Wi-Fi services. Marriott issued a lame statement of protest, claiming that its actions were intended to protect guests from “rogue wireless hot spots” (at a larcenous price, of course) and blaming the FCC for “ongoing confusion.” The FCC took action after a Gaylord Opryland attendee claimed the hotel was “jamming mobile hot spots so that you can’t use them in the convention space.” Let’s see how this plays out at the HIMSS conference. Since my ATT wireless plan includes free tethering and 10GB of data transfer, I don’t even bother with airport Wi-Fi any more and I will quickly switch to my hotspot in a hotel if their Internet service is poor or expensive (or, as is often the case, both). Rumors abound that convention centers play games with cellular and Wi-Fi coverage in the exhibit hall to force exhibitors to buy their expensive network access.


Other

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This is bizarre. Texas Health Presbyterian Hospital (part of Texas Health Resources) initially said it discharged Ebola patient Thomas Duncan from its ED because of an EHR setup problem, explaining in considerable detail that the patient’s travel history was located only in the nursing workflow part of Epic where the physician didn’t see it. News media were all over that statement, leading THR to issue a a hurried retraction at 9 p.m. local time Friday evening saying it was correcting the previous day’s release and the EHR was fine after all. My speculation is that Epic complained vigorously about being thrown under the bus (but not by name) and threatened legal action, forcing THR to claim that its detailed, carefully explained statement was incorrect. My biggest concern – could the doctor have been so robotized by the EHR that he or she slipped on critical thinking? EHR or not, the patient sitting right there in front of you is telling you a story that you’d better listen to. What about the nurse, who had just been told by a patient with fever that he’d just come from Liberia? That information would seem to suggest a higher level of response than just dutifully entering the information in Epic and moving on. Computers sometimes fail, but not nearly as often as people. At least THR’s problem raised an industry red flag that had clinicians and programmers all over the country working this weekend to evaluate their processes and systems to make sure it doesn’t happen to them.

Update: a reader’s comment about the use of scribes sent me Googling and it turns out that Texas Health Presbyterian Hospital Dallas uses scribes in its ED. It would be interesting to know whether scribes were involved in this instance.

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Meanwhile, a poorly and smugly written piece in The Atlantic declares that, “The Ebola Patient Was Sent Home Because of Bad Software.” The author collected all of her inexpert healthcare IT opinions into one unfocused article, proclaiming the “atrociousness” of many EHRs and their “gaping loopholes,” complaining that the hospital was blaming “the robots,” opining that “a flawed EHR might have lead to the spread of an incurable virus,” and then veering off into a rant about interoperability, which has zero to do with anything. Author credentials are fair game if you’re going to editorialize, so let’s check hers: an intern until 2010, moved down from global editor to staff writer after 10 months in the higher position, wrote about home design and architecture, and listed her most recent accomplishment on LinkedIn as, “Talk about beards on the radio.” Nothing makes me angrier than people who’ve never spent a day working in either IT or healthcare blasting out their entirely unqualified opinions in passing themselves off as authoritative. The Atlantic should be ashamed for letting this dreck hit the airwaves just to get something reactionary up quickly. HIStalk Reader Tom called her piece “more than ridiculous,” observing that “highly configurable EMR software was used to ensure a medical mistake in clinician workflow never happens again.”

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Athenahealth’s Jonathan Bush, using his limelight-seeking power to ride the Ebola story in touting his company at Epic’s expense (while claiming he’s not) from his second home on the set of CNBC, trots out his stump speech to easily charmed reporters about “pre-Internet software” with no “network effect,” wrapping up with his company commercial in saying, “I hope soon that nobody will be on enterprise software and these things will be managed by people across thousands of hospitals.” He omitted the obvious rest of the sentence, “ … and instead will be running the sort-of cloud system and offshore-powered mailroom I sell that allows ATHN shares to trade at 1,220 times earnings.”

The government of India announces plans to make e-prescribing mandatory for all doctors to reduce corruption and inefficiency.

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Attorneys consider a plea deal for a third-year medical student who is accused of stealing a breast cancer patient’s iPad during a Code Blue in which the patient died at UCLA Medical Center. The patient’s family is most upset by the fact that the student allegedly wiped off the patient’s information before re-registering it to herself, depriving them of the chance to see the thoughts the patient had left for them.

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A 38-year-old Russian billionaire bank founder releases plans for “the world’s most pleasant hospital” that he will erect in the Dubai-inspired, purpose-built Tunisian Economic City. The hospital will sit on a man-made lake, look like a cruise ship, and require employees to dress (but not swear) like sailors.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 3, 2014 News 42 Comments

News 10/3/14

October 2, 2014 News 4 Comments

Top News

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CMS will miss its planned dates to move Healthcare.gov’s hosting to HP and instead will leave the site on Verizon’s infrastructure through the November to February enrollment season. CMS signed a contract last year to move off Verizon after a series of outages. Verizon has upgraded its servers and will offload some of the processing to Amazon Web Services, but testing suggests that users will still be forced into “waiting rooms” during peak use times.


Reader Comments

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From Disruptured: “Re: athenahealth’s More Disruption Please annual conference. This is my first time attending the conference. I’m here as a newly established partner in athena’s MDP program. Didn’t know what to expect when I signed up. The meeting has turned out to be a great blend of athena folks, customers, investors, and CEOs from young companies. Helpful sessions and a great opportunity to connect with investors, customers, and possible partners in a small, intimate environment. Athena has been a pleasure to work with, especially compared to other big PM/EMR companies.” 

From LND Generis: “Re: Allscripts. This is being emailed to clients. ‘Yesterday we communicated that there was a potential for affected data between FollowMyHealth and Allscripts EHRs. This would affect the Stage 2 View / Download / Transmit measure by indicating that some patients had viewed their chart, when in fact they had not.’” The purported support email says the information has been fixed but an urgent report update needs to be applied for those who are applying for MU Stage 2 for the first time.


HIStalk Announcements and Requests

This week on HIStalk Practice: WRS Health introduces new products for pediatric practices. Philips gains FDA clearance for new digital health applications. Quillen ETSU Physicians goes live on Allscripts. The Hutchinson Clinic implements a new telemedicine program. Code for America makes open-source health data a priority. Thanks for reading.

This week on HIStalk Connect: Rock Health reports that the digital health sector has raised $3 billion in VC funding so far in 2014. Basis unveils its next-generation activity tracker, called the Basis Peak. WiserTogether, a consumer health startup focused on pricing transparency, raises a $9 million Series B.


Acquisitions, Funding, Business, and Stock

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Cohealo raises $9 million in financing. The Boston-based company allows hospitals to share medical technology among multiple locations with online resource booking and equipment transportation.   

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Specialty EHR vendor Nextech acquires ophthalmology EHR vendor MDIntelleSys.

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Silicion Valley-based precision medicine data platform vendor Synapse will open a Philadelphia office.

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Israel-based MedAware, which offers machine learning-powered CPOE drug warnings, raises $1 million in Series A financing. Its self-learning product (“a spell-checker for medical prescriptions”) analyzes prescription databases to identify deviations from normal treatments prescribed for similar patients, although it’s not clear to me how it connects to the prescribing system.

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Athenahealth unveils its 60,000-square-foot Atlanta office that will house 200 employees initially and hundreds more later.

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A poorly sourced rumor, resurrected from a few months ago, suggests that Samsung may be talking to Nuance about acquiring the company, which would give Samsung control of the speech recognition technology used by Apple’s Siri.


Sales

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Scottsdale Lincoln Health Network (AZ) chooses Premier’s solutions for supply chain, performance, and technology solutions.

Greater Baltimore Medical Center (MD) selects Access web-based forms and patient signature capture.


People

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Nick Bonvino (CTG) is named CEO of Greater Houston Healthconnect.

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Peter Witonsky, formerly president of iSirona, is now president of the Ionic Division of St. Louis-based Asynchrony. The company seeks 100 engineers who know Ruby, Scala, C#.NET, Java, and mobile programming.

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Huffington Post profiles Laurie McGraw, president and CEO of Shareable Ink, in its “Women in Business” Q&A series.

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Consulting firm ICF Internation names John Guda (CSC) as SVP/GM of its commercial healthcare business.

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I missed this from the new Forbes 400 list of richest Americans: Terry Ragon, founder of InterSystems, is #390 on the list with an estimated net worth of $1.58 billion.


Announcements and Implementations

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The Memphis business paper profiles S2 Interactive, which sells software that optimizes tray setup and instrument sterilization in the OR. The company was founded by Larry Foster, RN.

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NextGen will offer its customers the Plexus IS Anesthesia Touch anesthesia documentation system.

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Two Philips chronic care management telehealth applications developed with Salesforce.com (care coordination and a patient portal) receive FDA 510(k) marketing approval.


Government and Politics

The VA says it will go live on a new commercial patient scheduling system by 2017 – originally announced as 2020 — and will choose a vendor that can meet its aggressive deadlines.

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CMS’s Open Payments database is live, but doctors are finding errors in the information submitted by drug companies. Glaxo admits that incorrectly assigned huge payments made to the National Cancer Institute to a single physician who says he is “shocked by the enormity of this mistake.” Glaxo says it fixed its error in September 2013, but CMS chose to bring Open Payments live with data (including corrections) covering only the first five months of the year. Critics also observe that the system is slow, doesn’t provide total payments, has no search function, doesn’t group corporate entities within a single drug or device manufacturer, and requires a lot of scrolling since the on-screen spreadsheets aren’t sized correctly for a browser. Commenting about the traditional tendency for CMS to make a mess of just about any technology project it undertakes, a former aide to Sen. Chuck Grassley whose bill created the database said, “It’s so complicated that it’s almost useless. It looks like data bombing and I don’t think the average American will find it useful. It’s disappointing.” I’ll go out on a fairly sturdy limb in stating that CMS might be the least competent of many incompetent federal agencies in putting in-house career bureaucrats in charge of opportunistic contractors (Healthcare.gov comes to mind).

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FDA releases a cybersecurity guidance document for medical device manufacturers.

Walgreens announces a partnership with the VA in which it it will immunize veterans and share its Greenway EHR information with the VA.

Defense Secretary Chuck Hagel gives the military’s underperforming hospitals six weeks to submit improvement plans, adding that military hospitals offer care comparable to the civilian health system but that’s not good enough. Hopkins patient safety expert Peter Pronovost, MD, PhD said hospitals in general are better at managing their bottom lines than patient care: “This is not unique to them. If you miss your budget, within a week you are in someone’s office. We have not applied that kind of rigorous discipline to quality and safety.”

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ONC posts a chief medical officer position. Jacob Reider, MD says in an internal memo that he will remain deputy national coordinator and that hiring a full-time CMO (Reider’s job before he became acting national coordinator and then deputy) is a commitment clinician relevance. People forget that it’s a sacrifice to work for ONC – the job pays a maximum of $157K per year (although there’s a potential unstated extra allowance for physicians), unreimbursed relocation to DC is required, and the application and selection process is tougher than in the private sector. I was thinking last week that I am too critical of government employees and politicians – if they stick with the job I call them career trough-lappers, but if they leave for the private sector I label them as opportunistic sellouts trading their influence for cash. 

ONC also lists the open position of director of the office of consumer ehealth, vacated in July by Lygeia Ricciardi.


Technology

This is bizarre, assuming it’s not a hoax. A company called Pavlok (a nod to the dog-testing Pavlov) will produce the ultimate fitness wearable, a $129 fitness band that delivers an electrical shock when the wearer misses fitness goals. The pain-loving founder’s experience includes hiring a woman off Craigslist to slap his face every time he launched Facebook, admitting that, “I have a weird slapping thing.”

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This is brilliant: a startup is developing an affordable sensor to warn people that food contains items to which they are allergic. It must be terrifying  for people who are highly sensitive to peanuts or other foods to have trust a restaurant waitperson’s assurance that a given menu item is OK for them to eat.


Other

Rock Health tweeted an exuberant message Wednesday that Kleiner Perkins was visiting, proudly observing that “none of these digital health entrepreneurs have a healthcare background.” I can’t decide if it’s sad or just insulting when the techno-weenies brag on their ignorance of the industry into whose face they brashly thrust their VC money and technologies fully confident that they’ve figured it all out from the cheap seats. My consolation is that their contempt will likely turn into humility (or more precisely, a quick redirect to some other seemingly lucrative bright shiny object) when, like their predecessors, they find that healthcare is a lot more complicated than a bunch of arrogant child-entrepreneurs can even begin to understand. I suspect that any of the rumpled CEOs or besuited VC schmoozers would run for the hills when faced with an actual patient or consumer whose medical needs can’t be identified or ameliorated by cute, imitative phone apps that lust to be the Uber or Facebook of healthcare in exploiting some minor niche while dodging the big problems that matter. The healthcare IT burial pit is full of companies both large and small that smugly concluded, “How hard could it be?” and later found out as they ran into one business-killing obstacle after another: insurance companies, the government as both the dominant payer and regulator, privacy, misaligned incentives, and even the most basic question: who is the healthcare customer? Most of us long-timers welcome humble newcomers with fresh ideas that focus on patients, but instead we seem to draw obnoxious brats and their rich uncles who have big iPhone-powered hats but no cattle.

Cedars-Sinai Medical Center (CA) revises its estimate of the number of patients whose medical records were stored on an unencrypted laptop that was stolen in June from 500 to 33,000.

JPMorgan says that a cyberhacking attack this summer exposed the data of 76 million households and 7million small businesses, although the stolen information was mostly benign, such as email addresses. The company had said previously that its increased security efforts would require 1,000 employees and $250 million per year.

Here’s a great Ebola-inspired EHR idea from Linda Pourmassina, MD: when a patient presents with fever, trigger a reminder to ask about travel history. At least Ebola gives otherwise health-indifferent consumers something to obsess over as the latest TV-touted epidemic du jour gains their engagement far more than the daily habits that will likely kill them (see: avian flu, swine flu, H1N1, and Legionnaire’s).

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The CEO of Clark Memorial Hospital (IN) announces that the hospital has no choice but to merge with Norton Healthcare because of huge losses causes by bad debt patients and the cost of unnamed software that I assume is its Allscripts Sunrise system.


Sponsor Updates
  • Voalte will integrate its Voalte One mobile communications solution with Spectralink’s Android-based handset and will sell and support the offering.
  • Impact Advisors is ranked as the top Enterprise Implementation Leadership Epic Partner by KLAS.
  • Verisk Health creates an infographic about the cost of claims errors.
  • Health Catalyst is offering a free PDF copy of its eBook, “Healthcare: A Better Way.”
  • Castro County Healthcare-Plains Memorial Hospital (TX) is implementing Holon’s CollaborNet HIE.
  • Forbes discusses how UnitedHealth’s acquisition of MedSynergies will strengthen its Optum division.
  • Nuance will participate in the Health Connect Partners Hospital & Healthcare IT convention in Chicago October 13-15.
  • Royal Solutions Group announces the integration of its kiosk platform with Merge RIS and OrthoEMR.
  • NoteSwift joins Allscripts developer program with a bridge between Allscripts Pro EHR and Dragon Medical.
  • ICSA Labs certifies HIStalk sponsors Healthtronics, Iatric Systems, Medseek, PatientSafe Solutions. Quest Diagnostics, Shareable Ink, and Wellsoft in September.

EPtalk by Dr. Jayne

October 1 has come and gone, forcing many organizations to make hard decisions about their participation in the Meaningful Use program. Several of our recent acquisitions are planning to attest for Stage 1 and this quarter is their last chance. It’s been quite a battle to even get them live on EHR in the most rudimentary fashion. Saying that we ran out of time to deliver the kind of workflow redesign needed for true clinical transformation is an understatement.

Our organization was a fairly early adopter of EHR. Our original employed practices went through an intense program of workflow analysis, development of policies and procedures to support new workflows and technologies, and continuous process improvement. We were “doing EHR” for all the right reasons and were seeing good outcomes. Practices that weren’t ready for the transition progressed through more slowly or chose to leave the group. Along came Meaningful Use, however, and we were forced to push everyone through the same funnel.

At this point we’re dealing with a subset of physicians who don’t care and aren’t ready, yet our administration has made it clear that we must make them succeed at any cost. Our operations team has responded by “reporting” them to death. They’re delivering a full spread of Meaningful Use reports to each physician, office manager, and practice lead every Friday in the effort to ensure compliance.

Unfortunately, what they’re not delivering is support for operational and practice policies and workflows to actually lead to a successful outcome. It’s the hospital administrator equivalent of yelling at your teenager for having a loud party, but refusing to stay home on Saturday night to ensure it doesn’t happen again.

My favorite nonsensical example of the week is a practice that is documenting in two EHRs as of Wednesday. Their old system isn’t certified and our employer refuses to pay for a data conversion, so they’re continuing to see patients in the old system while documenting the barebones data needed for Meaningful Use in the certified system. Penny wise and pound foolish – discovery alone on a single lawsuit from this patient safety nightmare would easily cost triple the amount we’d have spent on the conversion. Instead, we’re relying on the practice to abstract patient data on its own and transition “when the practice is ready.”

In other CMS-related news, the first round of Open Payments data has been released to the public. By the time I made it to the website, there were over 21,000 hits on the General Payment Data for 2013. I wanted to dig more deeply in the data, but the website was painfully slow and I didn’t have time to download the dataset before I had to run off to meetings. Some weekend entertainment, perhaps?

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As many of you know, my second language is Administralian. I have to admit this reader submission is a puzzler, and not the fun kind heard on Car Talk:

Our recently announced operating model reflects our transformation to an integrated technology company dedicated to building a software-defined network with an engaged, agile workforce whose well-being is a top priority.

I asked the reader what that might mean and received this response: “I wish I knew, because I’m being transformed into it, whatever it is.”

That, dear readers, is what happens when you allow buzzword-happy consultants to write communications snippets. I even tried to use my old-school English class skills to diagram the sentence but couldn’t make a go of it. Is the company using their engaged, agile workforce to build the network, or are they building a network that has the engaged, agile workforce as its members? Whose top priority is the well-being of said workforce and how will it be supported?

I feel bad for the employees at this company. If leadership is willing to economize the use of words to the point where they no longer make sense, leadership is also likely to over-economize in other areas.

Do you have a favorite example of Administralian? Email me.


Lorre’s Healthcare Analytics Summit 14 Report

Being a bit of a data and analytics geek, I looked forward to attending Healthcare Analytics Summit 14. I have attended enough conferences over the years to keep my expectations realistic since I have almost always been disappointed. Admittedly, I have a short attention span and often end up thinking about better uses of my time, but that wasn’t the case at HAS14.

Opening keynote presenter Billy Beane is an excellent speaker and the type of storyteller that I can connect with. He injected humor and anecdotes while taking the audience through formulating his hypothesis about using data and analytics to win baseball games to the outcomes and validation of his theory. He was a brilliant choice by Health Catalyst in creating optimism, a longing for similar outcomes in healthcare IT, and a vision that it is possible.

The next two speakers — Glenn Steele, Jr. MD, PhD, president and CEO of Geisinger Health System, and James Merlino, MD, chief experience officer, Cleveland Clinic — described how their organizations use analytics to transform healthcare and transform the patient experience, respectively. Their case study-like narratives reinforced that not only is it possible to improve outcomes with analytics in healthcare, it is already happening.

Google’s Ray Kurzweil rounded out the day with an enthusiastic discussion about the acceleration of technology is the 21st century and how we can expect that to impact healthcare and medicine.

Day Two brought fresh speakers with more case studies to reinforce the overarching message — data and analytics can transform care and improve outcomes. Breakout sessions were mostly interesting, but I didn’t leave any of them feeling like I learned anything I could use.

Before Health Catalyst CEO Dan Burton delivered the closing keynote, we viewed a 30-minute documentary, From the Heart: Healthcare Transformation from India to The Cayman Islands. It was impressive to see what health systems in other countries have been able to accomplish. It tugged at my heartstrings when one of the Indian cardiologists said, “The first question a mother asks is how much it (open-heart surgery to save her child’s life) is going to cost. The doctors are putting a price on human life.” After learning about how they were able to cut the cost of the surgery in half and maintain it, another physician drove the message home when he said, “The object of technology should be to bring cost down … In healthcare, technology takes the cost up. That can change only by a data-driven, facts-driven medicine where the decision making process itself is driven by technology.”

The logistics of the summit were unlike any I have ever experienced. There were genius bars staffed with technical people to help with everything from installing the custom application to providing directions. My HAS14 app froze and I raised my hand and had a technical person at my side within seconds. Pre-charged chargers the size of playing cards were placed at every seat to keep mobile devices running through the day

Analyst teams were present in every in every session to present real-time data gathered from participants. Attendees voted ahead of time on their seating preference at Wednesday night’s dinner – sitting with similar attendees, sitting with dissimilar attendees, or open seating. Table assignments were pushed out via the app before dinner. It seems like a small thing, but it demonstrated how gathering data could allow for real-time decision making and the ability to create a more desirable outcome based on it.

When Dan Burton took the stage during the opening keynote, he told us we would have the opportunity to learn from innovators in and out of healthcare and he promised there would be no long-winded CEO speeches. That was what Health Catalyst delivered. It was a fun, engaging, and informative summit. I left with a copy of their book, “Healthcare: A Better Way,” a few new connections, and excitement about the future of data and analytics in healthcare.

(Presentations and recordings from the conference are available to all online.)

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 Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 2, 2014 News 4 Comments

Morning Headlines 10/2/14

October 1, 2014 News 1 Comment

‘Data dump’ reveals billions in pharma payments to docs, hospitals

CMS’s Open Payments website goes live, publishing transactional data on $3.5 billion worth of payments made by pharmaceutical and medical device companies to doctors and hospitals over the last five months of 2013.

Information Governance: Principles for Healthcare (IGPHC)

At its annual conference, AHIMA publishes an information governance framework to help health systems establish “an organization-wide framework for managing information throughout its lifecycle and for supporting the organization’s strategy, operations, regulatory, legal, risk, and environmental requirements.”

About 44,000 apply for MU hardship exception

CMS reports that it received 44,000 hardship exception applications from providers prior to the July 1 deadline.

PQRS GPRO Registration Extended Until October 3rd

The Physician Quality Reporting System enrollment window for the Group Practice Enrollment Option will remain open until October 3 due to a software glitch that prevented some provider groups from enrolling by the September 30 deadline.

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October 1, 2014 News 1 Comment

News 10/1/14

September 30, 2014 News 5 Comments

Top News

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UnitedHealth Group’s Optum division acquires MedSynergies, which offers physician practice billing and quality services. MedSynergies was founded in 1996 by a group of Texas ophthalmologists. Its board chair is Joe Boyd, whose history includes being GM of the healthcare practice of Perot Systems, board chair of Healthlink until it was sold to IBM in 2005, and board chair of Encore Health Resources until it was sold to Quintiles earlier this year. I interviewed him in 2012.


Reader Comments

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From CloudedCare: “Re: CareCloud. Recently laid off a number of their implementation team and the senior leader running that department. The venture debt must be creating pain or their onboarding process needs a revamp.” The company provided this response to my inquiry: “CareCloud is increasingly gaining traction among larger medical group clients, and optimizing our organization to best support their needs. This includes an expansion of professional services offerings and realignment of the team to deliver them.”

From Bloomington Onion: “Re: health system bond downgrades following EHR implementation. They always blame billing issues and reduced productivity due to revenue loss. I wonder how many of them expect it going in?” I would imagine most health systems expect a short-term jump in AR days, but not to the extent that would cause bond raters to question their financial outlook. Hospitals can’t seem to survive without constantly borrowing money and downgrades mean they pay higher interest rates.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Zynx Health, healthcare’s pioneer and leader in evidence-based clinical solutions. Solutions include ZynxAnalytics (pinpoints opportunities to reduce care variation), ZynxOrder (evidence-based order sets), ZynxCare (patient-focused plans of care), ZynxAmbulatory (evidence-based order sets for primary care), and ZynxEvidence (online library of clinical evidence guidelines, and quality measures). A brand new product is ZynxCarebook, a mobile platform that connects care team members and guides them to best practices with clinical evidence while making communications more efficient (the “virtual huddle” capability is a cool idea) and eliminating HIPAA concerns related to text messaging. ZynxCarebook stratifies discharge risks and suggests interventions as it supports care transition plan collaboration – clients have experienced a 22 percent reduction in 30-day readmissions, an 18 percent improvement in HCAHPS scores, a LOS decrease of 0.5 days, and a 40 percent increase in referrals of high-risk patients to post-discharge care management. Zynx is part of Hearst Health, which also includes First Databank, MCG, and Homecare Homebase. Learn more by signing up for a demo. Thanks to Zynx Health for supporting HIStalk.

I found this new Zynx Health video on YouTube, which features customer testimonials.

Listening: new from Sloan, an underrated Canada-based power pop band that’s been around for almost 25 years with no lineup changes and with all four members writing hook-heavy songs that sometimes sound like the Beatles (and still sound good even when they don’t).


Acquisitions, Funding, Business, and Stock

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Hospital financial management software vendor Healthcare Insights will merge with NOMISe Systems, which offers hospital cost accounting and analytics software. Business will continue under the Healthcare Insights name.

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Forbes names its 400 richest Americans, with Microsoft’s Bill Gates leading the list at $81 billion of net worth. Facebook’s Mark Zuckerberg jumps to #11 as the company’s share price increase boosts his wealth to $34 billion, while the founder of the GoPro wearable video camera clocks in with $3.9 billion. New to the list is Elizabeth Holmes, the 30-year-old Stanford dropout who founded lab testing company Theranos and owns half of the company, which is valued at $9 billion. Patrick Soon-Shiong of NantHealth is #39 with $12 billion, while Epic’s Judy Faulkner is listed at #261 with an estimated worth of $2.4 billion. Cerner’s Neal Patterson comes in at #395 with $1.55 billion.

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Google Glass healthcare telepresence vendor Pristine raises $5.4 million in Series A financing.

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The state of Ohio offers CoverMyMeds $482,000 in incentives to execute its plans to add 116 jobs, move to a larger Columbus office, and create a $2 million training program for software engineers.


Sales

Christopher Rural Health Planning Corporation (IL) selects eClinicalWorks EHR for its 13 locations.

In England, Wrightington, Wigan and Leigh NHS Foundation Trust chooses Allscripts Sunrise.


People

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Connie D’Argenio, RN, MSN (Philips Healthcare) joins Huron Consulting Group as managing director of its healthcare practice.

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PerfectServe names Travis Hiscutt (CRI) as sales director for the southeast.

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Bimal Shah, MD, MBA (Duke University Health System) joins Premier Research Services as VP.

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Katherine Schneider, MD (Medecision) is named president and CEO of the Delaware Valley ACO (PA).

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The Cal Index HIE announces two new board members: Mark Savage (National Partnership for Women & Families) and Beth Ginzinger, RN, MBA (Anthem Blue Cross – above).

Morris Collen, MD died last week at 100 years old. He was the last of the seven original partners who created Permanente Medical Group, founded its Division of Research more than 40 years ago, and later embraced a second career as an a medical informatics expert after developing a health assessment tool in the 1950s that was automated as a patient screening tool. He said on his 100th birthday that his proudest accomplishment was his involvement with Kaiser’s EHR. AMIA’s annual excellence award is named after him.


Announcements and Implementations

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Cerner announces that its HealthyNow app with newly added Apple HealthKit integration is available to Sharp Health Plan members. It allows users to set health goals, earn rewards, share information with providers, and manage medication schedules.

MModal announces availability of computer-assisted physician documentation for its Fluency Direct speech recognition system. The cloud-based solution gives physicians feedback about possible documentation deficiencies as they type or dictate. 

Beaumont Medical Group (MI) goes live on Wellcentive’s PQRS Enterprise Solution, aggregating information from its Epic EMR.

Nuance expands its consulting services to include coding and abstracting compliance monitoring.

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HCA International will distribute physical therapy and pathology images using Picsara from Sweden-based Mawell. A pilot project found savings of up to an hour per day per clinician when physical therapy sessions were recorded and reviewed using video instead of writing and reading notes.

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Two North Carolina-based HIEs, Carolinas HealthCare System CareConnect and Mission Health Connect, will share their 3.5 million patient records. They will fill a need in the western part of the state since North Carolina’s first HIE, WNC Data Link, will shut down on September 30 after running out of money.

AirWatch debuts AirWatch Video, an enterprise application integrating content delivery network operators to secure companywide video initiatives.


Technology

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Dartmouth College will use a telehealth robot from Dartmouth-Hitchcock’s Center for Telehealth on the sidelines of home football games as part of a remote concussion assessment program.

HITRUST warns that the newly discovered Shellshock Unix shell vulnerability could be even more dangerous than Heartbleed since it gives hackers complete control of a server and thus the network on which it resides.

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Intel introduces the Basis Peak smartwatch that includes step counting, an optical heart rate sensor, sleep tracking, and smart phone notifications. It has a Gorilla Glass touch screen, works with both iOS and Android, is waterproof, claims a four-day battery charge life, and costs $199.

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Bizarre: Microsoft decides to name the new Windows release Windows 10, skipping a number. Every other Windows version is problematic, so maybe it’s hoping to dodge the bullet even though Win 8 was the disappointing follow-up to Win 7. The new version downplays the much-reviled Metro tile interface, brings back the start menu, and finally shows evidence that Microsoft understands that few users have or want touch screen laptops and desktops no matter how convenient it might be for Microsoft to design one OS for all platforms.


Other

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Alabama’s medical association registers its displeasure with ICD-10 with its “Top 10 Craziest ICD-10 Codes” social media campaign.

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The local TV station covers the rollout of the MedaVet app by Washington State University’s veterinary hospital, which allows pet owners to have around-the-clock access and review their care plans. The company’s site says the cloud-based service includes a customized site for the veterinary practice, creation of templates and health plans, incorporation of promotional and wellness information, a calendar of daily tasks with learning material and appointments, a shared health journal that shows task status with an optional photo, and a social support network. It costs $239 for up to three vets. What’s interesting is that the same company – MedaNext – offers care plans for humans, too.

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The local paper highlights the implementation by Floyd Memorial Hospital (IN) of CrossChx, a fingerprint-based biometric solution for spotting patient identity theft. Founder and CEO Sean Lane was an Air Force captain and NSA Fellow, serving five tours of duty in Afghanistan and Iraq before founding Battlefield Telecommunications Systems. CrossChx, which is based in Columbus, OH, says its solution is live in 28 health systems (of 61 signed) and that it has verified 6 million identities. 

The New York Times interviews Epic CEO Judy Faulkner in covering the challenge of EHR interoperability. She says the government should “do some of the things that would be required for everybody to march together,” adding that Epic created Care Everywhere only when it became clear that the government wasn’t going to go far enough.

A Toronto study finds that assigning patients to a post-discharge “virtual ward” (at-home care coordination, visits, care plans, home care, and follow-up) failed to improve the rate of readmission or death compared to just sending the patients home as usual. The authors suggest these issues caused the surprising failure of all that clinical attention to make any difference: (a) it was hard to get in touch with the patient’s PCP and their in-home support workers; (b) the variety of EMRs used made it hard to figure out who was doing what; and (c) the intervention was started after discharge instead of before.
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Amazing Charts apologizes for long customer support wait times, blaming a Meaningful Use services rush. Users unhappy after the company’s 2012 acquisition by Pri-Med are venting their frustration on the company’s discussion boards, with one summarizing, “AC has created these logjams by being unable to prioritize what is important, continuing to partner with NewCrop, releasing buggy new versions, and offering unlimited support for a flat price which may create abuse.” Users are also upset that the company is charging them to watch Meaningful Use webinars.

Beth Israel Deaconess Medical Center CIO John Halamka tells a local business group that, “The academic medical center is a dying beast,” urging those systems to reinvent themselves in the face of competition from retail clinics and community-based hospitals and practices.

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Walgreens CIO Tim Theriault, speaking at Oracle OpenWorld this week, says the company has distinct IT strategies for the retail and healthcare sides of its business. The retail initiatives are focused on a customer loyalty program, determining what items each store stocks, and using analytics and personalization to connect more closely with customers. For its healthcare business, the company plans to perform in-store lab tests and to exchange information with doctors and hospitals collected through its health cloud.

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Former Kaiser Permanente CEO George Halvorson says in a Health Affairs interview by healthcare expert Jeff Goldsmith that the organization spent $6 billion implementing Epic:

Halvorson: When I got to Kaiser Permanente, one of the things that I told the board was that we were going to do what I did when I helped build health plans in Uganda. We were going to have every single element of the care system connected electronically, so there would be no paper record.

Goldsmith: So you told them you wanted to catch up to Uganda?

Halvorson: I’m not kidding.  I actually learned in Uganda that to strip the whole process down to its most elegant essence was to have no paper anywhere. In Uganda, we couldn’t afford to pay a claim or for patients to show an ID card.

A New York Times article highlights hospitals that use out-of-network ED physicians who stick patients with huge bills even when the patient is careful to use an in-network hospital’s ED in a crisis. Texas lawmakers found that the state’s three largest insurance companies had no in-network ED doctors at all. The article points out that 1980s emergency medicine board certification pushed hospitals to contract out their ED coverage and bill the physician services separately. One patient observes, “It never occurred to me that the first line of defense, the person you have to see in an in-network emergency room, could be out of the network. In-network means we just get the building? I thought the doctor came with the ER.”

Weird News Andy says he plays golf like this, too. A previously profanity-hating grandmother recovering from a stroke finds herself swearing involuntarily when things upset her, including poor performance on the golf course. WNA also notes this story, in which coroners are determining whether high chlorine levels in the water supply of England’s second-largest hospital caused the deaths of two dialysis patients. Meanwhile, an anonymous WNA-wannabe contributes this story, in which surgeons saved a teen whose hair-eating psychological disorder caused her digestive system to be blocked by a world record nine-pound hairball.


Sponsor Updates

  • DataMotion announces that 37 EHR vendors have used its Direct secure messaging service to achieve 2014 ONC-ACB certification.
  • PatientSafe delivers three areas of consideration for bringing contextual communication to clinicians in a follow-up blog regarding clinicians struggling to find the context.
  • PMD announces that its mobile patient status verification is accelerating hospital reimbursements.
  • GetWellNetwork’s O’Neil Center publishes an e-book entitled“Patient Engagement: Beyond the Buzz” including ten interview and articles with provider perspectives and insider insights.
  • HealthEdge partners with NTT DATA to offer a migration program from TriZetto Facets technology due to Cognizant’s acquisition of TriZetto.
  • Judy Starkey (Chamberlin Edmonds & Associates) joins Streamline Health’s board of directors.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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September 30, 2014 News 5 Comments

Monday Morning Update 9/29/14

September 27, 2014 News 3 Comments

Top News

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Apple’s HealthKit health data aggregation system and the apps that use it go live after being pulled previously from the initial iOS 8 rollout due to unspecified bugs. Some HealthKit-powered apps that are back in the App Store after the iOS 8.0.2 update are FitPort, MyFitnessPal, WebMD for iPhone, and Carrot Fit. HealthKit allows iPhone-collected fitness measures to be forwarded to other iPhone apps, brokering the exchange using the phone owner’s permissions of allowable data sources and destinations. That might be the most significant aspect of HealthKit – the consumer-patient is in charge of the collection and movement of information about them.


Reader Comments

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From Ben and Jerry: “Re: Chuck Podesta. Gone from Fletcher Allen, now CIO of UC Irvine Health.” Verified per his LinkedIn profile.

From WisconsinBeerGut: “Re: Epic to Cerner conversions. I’ve worked for Epic and consulting companies and I’m not aware of any clients that have replaced Epic. Some mergers to watch that involved Epic and non-Epic users are NorthShore-Advocate in Illinois and UAHN-Banner in Arizona.” Given Epic’s cost, you’d have to really hate it to contemplate spending money to replace it. That’s not the only reason that it keeps users, but it may be significant one.

From Ex-Epic: “Re: Cernover. Judy prides herself on the fact that Epic has never lost a customer to Cerner or any other vendor. There have been some small scale de-installs for various reasons unrelated to dissatisfaction with Epic and those of course get swept under the rug, but to my knowledge (and according to Judy) there has never been an Epic to Cerner move.”

From AtUGM: “Re: Epic’s app exchange announced at UGM. It envisions that hospitals will sell their self-developed apps. My organization has discussed this with Epic, but Epic hasn’t provided any way to do it other than as a spin-off, which we’re loath to do. Eclipsys had an app exchange and I don’t think it went anywhere. It would be great if you wrote a feature discussing these app development opportunities with the big companies and what it would take to actually be useful to those of us in the industry.” I assume that vendor-specific app stores work like Apple’s – the vendor skims 20-30 percent off the top and sells apps that meet their published requirements. I would be interest in hearing about anyone who’s actually bought an app from a healthcare IT vendor’s store. I would be worried about paying a lot for something that might be poorly supported or that won’t be enhanced regularly.


HIStalk Announcements and Requests

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Most poll respondents like the idea of a 90-day MU reporting period for 2015 instead of the 365-day version that is official for the moment. New poll to your right or here: is it OK for an EHR vendor to block system access to a late-paying practice or hospital? Leave a comment after voting with your thoughts.


Last Week’s Most Interesting News

  • Intermountain Healthcare joins the Cerner-Leidos-Accenture DoD EHR bidding consortium.
  • Hospital operator HCA announces its intent to acquire physician systems vendor PatientKeeper, signaling that it will remain a Meditech clinical system customer.
  • A government report exposes HHS-CMS infighting and incompetence as Healthcare.gov went down in flames at its launch last October.
  • ZirMed acquires predictive analytics vendor MethodCare.
  • ONC Chief Science Officer Doug Fridsma, MD, PhD resigns to become president and CEO of AMIA. 

Acquisitions, Funding, Business, and Stock

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Oncology data vendor COTA closes $3.7 million of a planned $7 million funding round. Most of the folks involved are from Hackensack University Medical Center’s cancer center.

Meditech finally issues its 2013 annual report that was due 11 months ago but was held up following revenue recognition changes. Revenue was down a bit from 2012 at $580 million, but net income rose to $133 million (that’s an enviable margin). Neil Pappalardo owns nearly 41 percent of the company, or about $680 million worth. The directors and officers of the company have been around forever, with the newest hires among their ranks having joined the company 24 years ago.


People

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FCC Director of Health Initiatives Matt Quinn leaves the agency for a job with Intel.


Announcements and Implementations

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CareSync announces version 2.5 of its personal medical records system, which adds the ability to collect and track information from 80 health and fitness apps such as Fitbit and Withings blood pressure cuffs.

CVS Health announces new MinuteClinic affiliations with University of Maryland Medical System, UTMB, and UAB.


Government and Politics

An investigation finds that HHS paid WebMD $14 million to promote the Affordable Care Act.


Other

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Glucose monitor manufacturers and the FDA express concern that the technologically sophisticated family members of diabetes patients are hacking the devices to make them more useful, partially because FDA takes forever to approve manufacturer-requested changes. A group of engineers, many of them parents of diabetic children, modified a glucose monitor to send readings to a website so that parents can monitor their children who are away on sleepovers.

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A Premier study of ACOs finds that while most are improving care using basic internal systems such as EHRs, patient registries, and data warehouses, they struggle with bringing in data from external sources and providing patient-facing technologies. The key obstacles are interoperability problems and cost.

Penn Medicine (PA) has developed 75 apps, including the MedView physician portal and new Connexus patient data display app.

Weird News Andy provides a non-weird item: US hospitals aren’t prepared to handle Ebola-related patient waste since no disposal packaging has been approved, causing waste management companies to refuse to accept it. Emory University Hospital finally convinced Stericycle to accept 40 bags of infectious waste by first autoclaving it, but only after CDC brokered a deal.

Death rates dropped at two English hospitals that moved from paper-based vital signs charting to using the VitalPAC electronic system that provides warnings when patients are deteriorating. The hospitals developed the “early warning score” software with a vendor.

Here’s the more traditionally odd Weird News Andy article, which he titles “Give It a Shot.” The state nurse’s union sues Brigham and Women’s Hospital for requiring employees to get a flu shot after voluntary efforts failed to move the needle (pun intended) above 77 percent participation vs. 90 percent success in peer hospitals. State law prohibits hospitals from requiring employees to get a flu shot even though several hospitals require it as a condition of employment.  


Healthcare Analytics Summit 14 Report 

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I attended Health Catalyst’s Healthcare Analytics Summit 14 last week, my first visit to Salt Lake City. Note: in the interests of disclosure, the company comped my registration fee although I paid my own expenses otherwise. I took the photo above from my room’s balcony, by the way – a very brief rain shower kicked up on a sunny afternoon and created a double rainbow over the City-County Building.

The Health Catalyst folks were hoping for around 100 attendees and ended up with 500. The event was held in a beautiful five-star hotel, the Grand America, which had surprisingly reasonable prices and outstanding service. Rooms, food, and meeting facilities were excellent.

Salt Lake City apparently is not quite as Mormon Church-driven as I naively expected since you can actually get ethnic food and alcoholic beverages, although some odd rules are in place (as explained to me, you can’t order drinks without buying food, so you pay $2 for a bowl of peanuts to allow you to order a beer). Good restaurants were an easy walk away, everything from tapas to tacos (my choices: Green Pig Tavern, Eva, Himalayan Kitchen, Caffe Molise, and Tin Angel Cafe). It’s a lot smaller city than I would have guessed – around 200,000 residents – and the mountains create an attractive backdrop. I checked out a rehearsal of the Mormon Tabernacle Choir that was inspiring. The weather was a lot hotter than I expected. My overall impression of the city was favorable, although since I don’t ski, I’m not sure I would have a non-business reason to return.

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The event logistics were unparalleled. Plenty of Health Catalyst folks were on hand to direct people, answer questions, and even run a Genius Bar-type setup to help attendees use the cool app developed for the conference, which allowed interactive voting, reacting to speakers, and connecting with fellow attendees. I happened to chat with the guy whose company developed the app while walking to a session and he said it was built specifically for this conference. If it can scale, it would be pretty cool for larger conferences as well.

Presenters included Glenn Steele, Jr. MD, PhD, president and CEO of Geisinger Health System; James Merlino, MD, chief experience officer, Cleveland Clinic; Mike Leavitt, former Utah governor and former HHS secretary; Ray Kurzweil, director of engineering, Google; Penny Ann Wheeler, MD, president and chief clinical officer, Allina Health; and Charles Macias, MD, MPH, chief clinical systems integration officer, Texas Children’s Hospital.

A bizarre press restriction prevents me from even mentioning the name of the keynote speaker, although you can see it here. That’s too bad because I would have gushed about how entertaining and surprisingly relevant he was, and my fellow attendees seemed to agree given their highest rating of his keynote from all of the first day’s sessions. It was a bold choice by Health Catalyst. I enjoyed his talk more than any keynote I’ve ever heard. He would make an outstanding HIMSS keynote presenter, much better than the drones they’ve propped up on stage lately.

My least-favorite speaker was Mike Leavitt, who always struck me as a lightweight political journeyman turned opportunistic lobbyist. He rambled and misspoke to the point that I was checking email for most of his presentation. Everybody else did a great job, although I might have dialed back the presence of Health Catalyst people on the podium a bit if the intention was to engage attendees who don’t necessarily have a Health Catalyst connection. It got a bit confusing since three of the folks involved are from the same family (Burton) and were introduced with both past and present titles as the company made changes over the years, so I couldn’t keep track of who’s who as they came and went from the podium over the two days. I didn’t get a whole lot from the three breakout sessions, so for me the value was in the keynotes.

Health Catalyst used information collected from the app to announce some interesting (and sometimes creepy) facts gleaned from audience responses, such as that Android users were most likely to blow off the breakout sessions after attending the keynotes. Every session included several instant poll audience questions and a team of analysts presented the results immediately as the presenter paused. That was pretty cool and a nice touch to connect presenters with the audience.

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I should also note that this was neither a user group meeting nor a selling opportunity. The presenters for the most part were vendor-neutral and talked about using data in general, not Health Catalyst’s products in particular. I also applaud the company for really thorough preparation right down to the minor points of quality of the handouts, stage setup, and food and break logistics. Also a high point was distribution of an internally written book that I’ll be reading cover to cover. They really have a lot of good information to share that transcends their products alone.

Some of the memorable points of the conference from my perspective:

  • It’s clear that the hasty move to electronic medical records and health apps is creating more data than anyone understands. We’re at the exploratory stage, trying to figure out which of thousands of data points are relevant in predicting outcomes or triggering interventions. This is exciting. We are surrounded by data that we don’t yet know what to do with, but the first glimmers of success are coming out.
  • A lot of people, including many of healthcare’s leaders, aren’t convinced that the industry should be data driven. Not only does the “medicine as an art vs. a science” argument arise, but leaders often have personality types that value bold decisions based on emotion, history, gut instinct, leading through relationships, and valuing consensus over facts. As was said several times in the conference, it takes courage to use data, especially when it tells us something we don’t want to hear or that requires unsavory actions.
  • Becoming a data-driven organization requires two attributes. The first is fairly simple from the non-IT point of view – collecting and analyzing the information. The second is having the organizational willpower to do something with it. Facts alone don’t change anything – leadership is required.
  • Better care costs less. Analysis nearly always shows that the highest-cost organizations deliver lower-quality care. The upside of this is that we can improve care and outcomes without spending a penny more than we already do as a society, provided we have the will to do it.
  • As the unnamed keynote speaker pointed out, people mimic those who are having success. The organizations improving care and reducing cost through the use of data will find their competitors raising the bar by doing the same. Nobody wants to be in the higher percentiles of cost or the lower percentiles of quality, so as competitors eye each other warily, it’s likely that they will raise the boats for everyone.
  • Everybody has a data warehouse. Most of them don’t provide useful information.
  • You can’t selectively intervene on individual patients by using claims data. By the time you take action, the high-cost patients have costs trending back down and you’ve missed the opportunity.
  • People seem to love QlikView as a data analysis and presentation tool. I noticed several presenters from provider organizations were using QlikView dashboards.
  • An interesting thought from one presenter: “We don’t take a quality assurance or compliance approach.” In other words, it’s not effective to chase the 2.5 percent of outlier providers. Instead, move the 80 percent even higher since improving the already-good majority has a much greater overall impact.
  • The maturity progressions looks like this: data reporting –> data analysis –> decision support –> predictive analytics.
  • “Predictive analytics without actions an interventions are useless.” You can predict things you don’t care about or are reluctant to act on.
  • The most relevant health factors involve socioeconomics. Healthcare delivery organizations can’t fix those.
  • The wisdom of crowds still has value even in an analytics-driven organization.

I give this conference a high grade. The logistics were superb, the size and scope was just right, the value was significant, and the speakers were well chosen and interesting.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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September 27, 2014 News 3 Comments

DoD EHR Update from Dim-Sum 9/26/14

September 25, 2014 News 2 Comments

 

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Between 2000 and 2003, Harvard Business School published a case study on Toyota industrial engineering processes in a hospital. Toyota collaborated with Beth Israel and LEAN Healthcare was born – now that was a great and interesting collaborative. Well defined and the results were quantifiable!

Collaboratives can add value; even ones that may not sound great at first could prove to define and refine standards, improve care, and actually enable better quality controls for care. If you like collaborative approaches, take a look at what has been done between Deloitte and Northern New England Accountable Care Collaborative (NNEACC). The solution is called Insight. After mentioning that new collaborative, I cannot help but remember a strange and poorly constructed one. How can anyone forget the ill-fated relationship between Philips and Epic that ended in 2006?

I can think of one specific collaborative that has promised the world and delivered almost nothing (see NwHIN). However, after a cursory read of the DHMSM Team Leidos article about a collaborative effort linking Cerner’s mega client Intermountain Health on governance structure, I began to think of what other collaboratives I would want to accentuate and/or at least commoditize so that I might differentiate my team to compete for the DHMSM opportunity. IBM will certainly throw in an Epic-esque client that has provided the groundwork for improvements across the Epic stable of solutions. I even think CSC and Allscripts might find their favorite client pet co-development.  I think I like Collaboratives.

One has to wonder, what was the primary edict for the collaborative, and what measurable outcomes have been reported – indicating value? To what extent have the monies invested into the collaborative been shown to improve profitability or improve PQRS results? I am not against collaboratives so much as I have a real desire to understand how some of them were stood up and made financially viable, why some dissolved, and most evolved with grand entrances into the market only to die a death of irrelevance. I think I like Collaboratives.

I for one like the New York eHealth Collaborative and the Massachusetts eHealth Collaborative, and not just because they have the word collaborative in their name. I think they are practical entities that leveraged historical regional extension centers, where money was initially provided by public funds and, through attrition and maturation of models and adoption challenges, the collaboration actually had to collaborate. They had to collaborate to survive. These collaboratives had to figure out smart ways to make their collaborative viable. Their challenge, unlike Intermountain Health (for Cerner) or Kaiser (for Epic), is that they had to work with disparate and competing entities, clinicians that were not incented by what their crosstown rivals did. The collaborative’s cross regions that did not in and of themselves support huge populations, and yet they wanted to know how their colleagues worked in other parts of the state, in rural, suburban, and urban environments.

Sounds remotely like the military HIT that we have grown to appreciate and fear. I like those collaboratives because they have to work together even though they are in a “coopetition” mode. (They were built to compete, to differentiate their medical specialty, and yet they know that cooperation has to occur for a peaceful co-existence and patient-first mentality. Thus the term “coopetition.”)

Honestly, I wish Team Leidos, Accenture, and Cerner would chat up their HealtheIntent population health tool, and what can be done to improve care coordination, quantify targeted chronic-disease management, improve appropriate care measurements, lower readmissions, and provide dynamic quality measures that actually act as a catalyst for patient engagement. Maybe Team Leidos could express its thoughts on how to turn prescriptive, descriptive, and predictive analytics into actionable analytics – impacting care and quality of life? Why not share its philosophical thoughts on data liquidity and how that could be the conduit for improved EHR and research data mining? Take the time to share their approach to research – we know IBM will reference Judith’s Cogito – so compete.

Maybe I am being harsh. I guess I am all too aware of how collaboration in the federal government has not always worked out very well. The best example of a collaboration was between the VA and DoD to share – or rather to transition – the EHR for a service member en route between active duty into veteran’s care. The best analogy: “Imagine spending the day as a cub scout during a camp out, eating gummy bears, enjoying hot dogs roasted over an open flame and masticating pounds of beef jerky on the three-hour canoe trip!” That was the planning for the debacle between DoD health and VA health – now imagine being stuck in the tent all night with those boys – that is pretty much the result of DoD/VA EHR interoperability – a smelly tent!  Not sure if there is a lesson in that story, but after reading it aloud, I smiled.

The good news is that at least DHMSM competing teams are looking to grab practical experience and applying it to the DoD HIT environment. Any collaboration with organizations that embrace HIT standards is a great thing. Any collaboration that shows that the HIT development vendor actually possesses a veracious understanding of governance structure – bully for them. Any collaboration that can accentuate the divine path to full-on proactive adoption, well then … that is Heaven. I like the move, and expect to see a lot more collaborating.

Inasmuch as I like the collaboration with Intermountain Health, I really would like to hear more about lessons learned from Accenture’s effort in Singapore. Cerner should express lessons learned from its NHS efforts. After all, Cerner had to work with Fujitsu (sort of the equivalent of our service integrators in and about the Beltway). Fujitsu is a less-than-stellar example of HIT consulting talent that was appointed by the NHS to implement, integrate, and manage the regional program. Maybe a white paper on nexus process and data touch points that could improve continuity of care with an eye on improving outcomes and lowering readmissions would be helpful and germane.

DHMSM is about transition and data liquidity. The DoD will not get excited with the commercial version of efforts to move from fee-for-service to value-based care. However, the DoD will perk up and pay attention to care coordination – so focus on the client and similar client experience and their deficits, lessons learned, and what new approaches improved adoption and workflow. One should remember that the DoD has stated on several occasions – mostly during Hill meetings – that the DoD does want to be more innovative like Kaiser (code for Epic). Cerner probably sees Intermountain Health as its Kaiser, so why not leverage that as a collaborative? I just hope Cerner can provide the depth of white papers and analysis of pre- versus post-Cerner in Utah and a lesser extent Idaho. That would be good news for the DoD.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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September 25, 2014 News 2 Comments

News 9/26/14

September 25, 2014 News 1 Comment

Top News

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Intermountain Healthcare (UT) joins Cerner and Leidos in their bid for the DoD’s new EHR system. Intermountain will provide clinical governance of solutions and workflow to be proposed for the $11 billion Defense Healthcare Management Modernization Initiative (DHMSM). Intermountain is in the process of implementing Cerner’s EHR and revenue cycle solutions across its 22 hospitals and 185 clinics. The move is no doubt yet another feather in the cap of Cerner President Zane Burke, interviewed this week in the local paper: “It’s a really interesting time. We have a lot of work left in front of us, but I love the position we’re in and the clients that we have on the journey with us. It’ll be a lot of fun.”

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Dim-Sum, HIStalk’s intrepid DHMSM insider, shares always entertaining and thought-provoking insight into the Intermountain “collaborative.” A snippet:

“After a cursory read of the DHMSM Team Leidos article about a collaborative effort linking Cerner’s mega client Intermountain Health on governance structure, I thought of what other collaboratives I would want to accentuate and/or at least commoditize so that I might differentiate my team to compete for the DHMSM opportunity. IBM will certainly throw in an Epic-esque client that has provided the groundwork for improvements across the Epic stable of solutions. I even think CSC and Allscripts might find their favorite client pet co-development. I think I like collaboratives.”


Reader Comments

From Chris Jaeger, MD: “Re: Sutter Health’s HIE discussions with Orion Health. As Sutter Health’s CMIO and executive sponsor of its HIE efforts, I can state without a doubt that the following post is false:
From Deal Breaker: “Re: Sutter Health. Stops discussion with Orion Health after its HIE project goes on for nine months. …”
Our collaborative relationship with Orion and related HIE efforts have never stopped – to the contrary, we continue to make great progress while also actively planning the next phases of establishing robust data exchange with those that share in the care of our patients.”


HIStalk Announcements and Requests

This week on HIStalk Practice: Athenahealth looks for the next great startup. TekLinks partners with Greenway. Doximity goes live in Utah. Physician practices in Texas take home quality improvement award for use of HIT. Physicians feel slighted by CMS thanks to attestation "glitch." Healthcare.gov costs more than originally thought. Physician executives have options when it comes to standing desks. Thanks for reading.

This week on HIStalk Connect: Dr. Travis analyzes the non-traditional roles that cloud-based computing has found in healthcare thus far, and speculates on its future. Researchers in Paris are working with 3-D video cameras to create virtual reality-based surgical training aids. Virtual visit provider Teladoc raises a $50 million Series C.


Acquisitions, Funding, Business, and Stock

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Allscripts and Citra Health Solutions (formerly Orange/MZI) announce a partnership to make their services available to each other’s customers. Citra, which provides consulting services and technologies for providers and payers, unveiled its new name and branding at the Allscripts user group meeting last month.

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ZirMed acquires predictive analytics vendor MethodCare and announces plans for a Chicago-based Healthcare Analytics Center of Excellence led by MethodCare staff. Moving forward, MethodCare will operate under the ZirMed name.

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Conifer Health Solutions agrees to acquire physician practice business solutions vendor SPi Healthcare for $235 million. SPi CEO John O’Donnell will join Conifer’s senior management team, reporting to President and CEO Stephen Mooney. The transaction is expected to close in Q4 2014.


Sales

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North Philadelphia Health System (PA) selects Medhost’s inpatient EHR for implementation at St. Joseph’s Hospital and Girard Medical Center.

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Beaufort Memorial Hospital (SC) selects the Access Passport online forms solution to take its paper-based accounts payable, human resources, and administrative documentation processes digital.


Announcements and Implementations

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Community Hospital (NE) goes live on a patient portal from Relay Health.

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Children’s Healthcare of Atlanta joins the Georgia Health Information Network. CHOA has integrated GaHIN’s Georgia ConnectedCare product into its Care Everywhere HIE application, which it launched earlier this year to facilitate data sharing with other providers using Epic.

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Kennedy Health System (NJ) adopts the MedAptus Professional Charge Capture Solution for hospitalists at its three acute-care facilities.

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Sightseeing.com announces the availability of the MyMedicalRecords PHR to its customers. The PHR will offer travelers access to their medical records and such documents as passports, birth certificates, immunization records, and insurance policies.

Practice Fusion announces that its customers will soon be able to order, manage, and receive lab test results within its EHR through Quest Diagnostics. Physicians will also have the option to share test results with patients through the Patient Fusion portal.


Research and Innovation

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A survey of 62 ACOs reveals that poor interoperability between organizations remains a big barrier to improving clinical quality. Additional findings include:

  • 100 percent of respondents find access to data from external organizations challenging.
  • 95 percent find interoperability of disparate systems to be a significant challenge.
  • 90 percent feel the cost and ROI of HIT has become a key barrier to further HIT implementation.
  • 88 percent face significant obstacles in integrating data from disparate sources.
  • 83 percent report challenges integrating technology analytics into workflow.

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WEDI releases the results of its ICD-10 Industry Readiness Survey, which finds that vendors, payers, and providers have made some progress in preparing for the October 1, 2015, transition, but not nearly as much as likely needed for a glitch-free switch.


People

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Jim Dowling (QuadraMed) joins Qpid Health as vice president of sales.

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Michael McDermott, MD (Radiologic Associates of Fredericksburg) takes on the role of CEO at Mary Washington Healthcare (VA) beginning January 1, 2015.

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Bob Taylor, DO (Greenway) joins Clinical Architecture as CMIO.

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Ryan Witt (Juniper Networks) joins ClearDATA Networks as vice president of growth and innovation.

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Steven Steinhubl, MD (Scripps Translational Science Institute) joins Vantage Health as chairman of the board.


Technology

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This article covers the debut of Spruce, an app that lets users privately share photos and medical information with dermatologists, and then receive in-app treatment. Baseline, Cowboy Ventures, and Kleiner Perkins Caufield & Byers contributed $2 million to the launch in initial seed round financing.


Other

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Samsung, the Children’s Fund, and Columbia University announce at the 2014 Clinton Global Initiative Annual Meeting a two-year partnership to develop the Samsung Innovation Center at the Children’s Health Fund. The center will focus on advancing access to and quality of healthcare for medically underserved children through telehealth and other strategies.


Sponsor Updates

  • Intellect Resources describes Ochsner Health System’s (LA) challenges and results of its Epic implementation.
  • Connance will share how the University of Rochester Medical Center increased its charity care dollars while reducing bad debt during the HFMA Region 2 Fall Annual Institute October 22-24 in New York.
  • ReadyDock discusses the vulnerability of mobile devices to virtual and pathogenic attacks in a recent blog post.
  • Aprima and First Databank offer electronic prior authorization through Surescripts connection.
  • Etransmedia shares how a pediatric cardiology practice was able to reallocate resources after working with Etransmedia’s RCM team to automate its front office.
  • Billian’s HealthDATA shares 10 recent healthcare CIO placements.
  • CareSync rolls out V2.5, which combines wearables data with medical records using integrations through Validic partnership.
  • Craneware will host its first Revenue Integrity Summit October 14-16 in Las Vegas.
  • Greenway becomes the first ambulatory information provider to have a solution recognized as a Validated System by Healtheway’s eHealth Exchange Product Testing Program.

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EPtalk by Dr. Jayne

Our hospital recently hosted a healthcare career day for middle school students. We’re in an economically depressed part of town with some serious socioeconomic issues, yet fully realize we’re going to need dedicated and well-educated healthcare workers to deal with the challenges we’ll continue to face. The goal of the day was to expose them to various opportunities either directly in or supporting healthcare. They were able to visit various areas of the hospital, including sterile processing, the laundry, patient care floors, engineering, and an operating room.

Some students were grossed-out by the idea of direct patient care, but were interested in engineering or IT, which is a good thing. It takes an army of people to keep an institution of our size going and often those jobs are independent of patient census or case mix, which is a good thing for job security. The highlight of the day for many was being able to see one of the air ambulances land and speak with the flight crew.

As a member of hospital administration, my role was to shepherd a group of students through various stations set up throughout the hospital, where they could talk directly to staff and learn about their jobs and how they contribute to the healthcare team. As is predictable with students in that age group, frequent questions included: “What’s the grossest thing you’ve ever seen? What’s the worst injury you’ve ever seen?” My favorite question was, “Is the stuff that happens on Grey’s Anatomy really true?” which made me wonder why a parent was letting a 10-year-old watch a show about sex-crazed doctors.

At one point, the air ambulance pilot received a question about emergency situations. He told the student his question was in the top 10 list of things he didn’t want to experience, to which the student responded “What’s number one?” I had to give him full credit for that one. I kind of tuned out after that because I was thinking about what I’d put on my own top 10 list of things of things I never want to happen.

I’ve experienced some things in my IT and practice careers that would definitely make that list:

  • Someone accidentally activated the fire suppression system at our corporate data center. Because we were using Halon, the building had to be vented by the local fire department with their positive-pressure ventilation equipment. This took about eight hours for a building the size of our data center. Unfortunately, our “hot backup” failed due to a defective network switch, requiring all practices to go to paper.
  • A local road crew cut the T1 line to my office. Luckily, we equipped key staff with wireless cards and network hot spots, so it wasn’t that big of a deal.
  • With my first EHR, the clinical documentation workflow went through a “locking” process as the provider finalized the note. This was after the provider reviewed the documentation on screen. Unfortunately, during the locking process some kind of character limit went into effect, causing the documents to truncate. When patients returned for their follow-up visits, their plans (at the bottom of the documents) were missing critical elements. Nothing makes your blood run cold like reading “Counseled patient on…” and having that be all that remains of your highly detailed patient plan.
  • Vendor sunsets a product that actually supports your workflow and that your staff likes, transitioning you to a product that is not yet ready for prime time. This has now happened to me twice.

None of these are quite as scary as having rotor failure on your helicopter or having the landing pad collapse underneath you, but in our world they’re pretty unnerving. What’s on your top 10 list of things you never want to happen? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
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September 25, 2014 News 1 Comment

News 9/24/14

September 23, 2014 News 1 Comment

Top News

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Hospital operator HCA announces that it will acquire privately held physician systems vendor PatientKeeper. Terms were not disclosed. I spoke to PatientKeeper President and CEO Paul Brient ahead of the announcement. “HCA is a longstanding customer of our view-only portal, our clinical review tool,” he said. “Now HCA will deploy all of our software – CPOE, clinical documentation, and medication reconciliation – over top of their Meditech systems. They will invest to make it even more useful to their doctors.” Brient will serve as CEO of PatientKeeper, which will be operated as a wholly-owned subsidiary of HCA. Its 160 employees will continue to work from company headquarters in Waltham, MA, supporting the company’s 58,000 physician users. The acquisition is expected to close by the end of the year.


Reader Comments

From Garbanzo Being: “Re: HCA. Will remain on Meditech and not transitioning to Epic or Cerner as has been rumored. PatientKeeper helps extend the life of Meditech for HCA.” HCA didn’t say that specifically, but PatientKeeper President and CEO Paul Brient hinted to me that HCA likes PatientKeeper over Meditech better than Epic, suggesting that its Epic experiments have concluded and the go-forward platform will be Meditech. He didn’t mention whether HCA will do a Meditech 6.0 upgrade, the challenge of which sent them sniffing around Epic in the first place.

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From King Biscuit: “Re: Office Practicum. Announced to clients that they acquired EHR/PM vendor Workflow.com. Odd since OP is a small company and it’s a competing product. The email suggests a move away from a pediatrics-specialty product and possibly a wholesale platform change.” I don’t know anything about Workflow.com except that it founded by Packy Hyland, who also founded Hyland Software (now Onbase by Hyland).

From Shannon: “Re: 3M’s CAC 360 Encompass R2 (Release2). Has numerous major problems. Coders not happy using it. 3M is currently merging their 2 NLP platforms — will this be too late for ICD-10 implementation date? Will the other CAC vendors be able to capitalize on this weakness?” Unverified.

From Deal Breaker: “Re: Sutter Health. Stops discussion with Orion Health after it HIE project goes on for nine months. Is this the reason there are not any US reference sites for Orion all accounts travel to Canada and New Zealand?” Unverified. I think a site visit to New Zealand would be pretty great since I’ve heard it’s spectacular there and they (unlike much of the world) love Americans.

From All Hat No Cattle: “Re: Cernover. Don’t forget that Integris in Oklahoma (12 hospitals) is moving to Epic, too. Care New England in RI now Epic outpatient. How long until CHI moves across to Epic for their remaining sites on Cerner like KentuckyOne?” I tried to muster an argument that at least some sites have moved from Epic to Cerner, but I was just speculating since I couldn’t name any. The Cernover list is a bit one sided, so chime in if you know if an Epic-to-Cerner move that wasn’t triggered by a health system acquisition and standardization.

From Bob White: “Health 2.0. Lots of innovative companies there, although they all start to sound alike after a while.” The conference gets lots of people excited even though 95 percent of the startups there will sink without a trace because they aren’t that sharp, are underfunded, are poorly managed, or let their technology arrogance override their healthcare ignorance. I wish them all well, but I don’t have the patience to watch Darwinism in action as they desperately try to find pilot sites, customers, or acquirers before they run out of runway. My interest picks up once they hit $5 million in annual revenue because once they get that big they probably won’t disappear entirely.


HIStalk Announcements and Requests 

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Welcome to new HIStalk Platinum Sponsor ZeOmega. The Plano, TX-based company, founded in 2001, offers the Jiva population health management platform to payers, providers, and value-based care organizations. A recent client success is Indiana health plan MDwise, which reduced readmissions by 66 percent and length-of-stay by 65 percent, saving $6.5 million per year with Jiva. Jiva is scalable and stable with redundancy and recovery built in and the new release adds more capabilities to support accountable care and value-based health delivery models in integrating workflow, analytics, content, and communication capabilities. The folks there would be happy to do a demo for you. Thanks to ZeOmega for supporting HIStalk.


Webinars

September 25 (Thursday) 1:00 ET. Using BI Maturity Models to Tap the Power of Analytics. Presented by Siemens Healthcare. Presenters: James Gaston, senior director of maturity models, HIMSS Analytics; Christopher Bocchino, principal consultant, Siemens Healthcare. Business intelligence capabilities are becoming critical for healthcare organizations as ACOs and population health management initiatives evolve in the new healthcare marketplace. The presenters will explain how BI maturity models can help optimize clinical, financial, and operational decisions and how organizations can measure and mature their analytics capabilities.

September 26 (Friday) 1:00 ET. Data Governance – Why You Can’t Put It Off. Presented by Encore, A Quintiles Company. Presenters: Steve Morgan, MD, SVP for IT and data analytics and CMIO, Carilion Clinic; Randy Thomas, associate partner, Encore, A Quintiles Company. In this second webinar in a series, “It’s All About the Data,” the presenters will review the pressing need for data governance and smart strategies for implementing it using strained resources.


Acquisitions, Funding, Business, and Stock

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Royal Philips NV announces plans to split into two companies – one devoted to lighting, the other to healthcare and consumer goods that will operate under the HealthTech name. The announcement follows in the footsteps of similar moves made by rival Siemens last year.


Sales

Community Health Center of Southeast Kansas and Health Partnership Clinic (KS) select eClinicalWorks EHR and RCM for their 12 combined clinics.

Catholic Health Services of Long Island (NY) chooses Connance predictive analytics and vendor management technology.

Sheltering Arms Rehabilitation Center (VA) deploys Strata Decision’s StrataJazz as its financial platform.


Announcements and Implementations

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North Country Hospital becomes the first in Vermont to go live on the state HIE. Larger hospitals like Fletcher Allen Health Care will be online by the end of the year.

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Waterbury Hospital (CT) integrates TigerText secure messaging into its Cerner EHR. The hospital has also been in the news due to rumors of a possible takeover by Tenet Healthcare Corp.

Surescripts announces the addition of four pharmacies and three EHR vendors to its Immunization Registry Reporting service.

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The Bronx RHIO selects Direct secure messaging services from DataMotion for its affiliated healthcare organizations. The Visiting Nurse Service of New York and SBH Health System (NY) are among the first to use the service.

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Zynx Health launches the ZynxCarebook mobile platform to help streamline coordinated care efforts between inpatient and after-care providers.


Government and Politics

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White hat hackers from the HHS inspector general’s office report that their attempts to break into Healthcare.gov earlier this year alerted them to a “critical vulnerability.” Their attempts to exploit it were thwarted due to defenses already in place.

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Representatives Diane Black (R-TN) and Peter Welch (D-VT) introduce the ACO Improvement Act. If passed, the act would permit ACOs to use remote-patient monitoring and store-and-forward technologies for delivery of images to providers far away.

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Alaska’s Department of Health and Social Services files a lawsuit against Xerox for "failing to timely and adequately implement the [Medicaid payments] system and failing to timely and accurately pay Alaska providers." The state is seeking $46.7 million in damages, and has already shelled out $154 million in advance payments to providers to help see them through the Xerox delay.


Research and Innovation

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Ali Parsa, MD creator of the UK-based Babylon subscription health service, announces that he is prepared to take the Babylon app to the Middle East and Africa to reach populations with little reliable access to healthcare, but high adoption of smartphones. "We are now looking at parties who have a large customer base, such as supermarkets, big public institutions, mobile phone companies, and newspapers,” he says. "If people can go into Tesco and by an iTunes card, why can’t they buy a Babylon access card?"


People

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Mark Hyman, MD (The UltraWellness Center) joins the Cleveland Clinic as director of its new Center for Functional Medicine. Patrick Hanaway, MD (Institute for Functional Medicine) will serve as the center’s medical director.

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Jeff Pate (W Squared) joins Aegis Health Group as executive vice president of business development.

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White House CIO Steve VanRoekel resigns to join the USAID, where he will work as a senior adviser in the fight to halt the Ebola outbreak.

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Doximity hires Emily Peters (Uncommon Bold) as VP of marketing communications and Peter Alperin, MD (Kelvin) as VP/GM of connectivity solutions.  

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Bruce Brandes (Valence Health) is named managing director of Martin Ventures. 

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ONC Chief Science Officer Doug Fridsma, MD, PhD resigns to become president and CEO of AMIA.


Announcements and Implementations

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Billings Clinic (MT) is implementing just-released Caradigm Quality Improvement to identify gaps in care and make improvements in clinical workflow at point of care.


Other

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Construction company DIRTT makes news for using open-source software from the classic video game Doom to design hospital wings and office spaces. CEO Scott Jenkins says the system will help hospitals that want to reconfigure a room’s wall panel quickly for patients with different needs, or to accommodate new technology.

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Apple CEO Tim Cook announces that the company’s new “spaceship” headquarters in Cupertino, CA, will be the “greenest building on the planet.” Scheduled to open by the end of 2016, the new HQ will be powered exclusively by wind and solar energy.

CompuGroup Medical locks Full Circle Health Care (ME) out of its EHR system in a billing dispute. The financially struggling practice admits that it stopped paying its maintenance fees 10 months ago after CompuGroup bought its original vendor HealthPort and increased monthly fees from $300 to $2,000. The practice has moved to a new EHR and wants access to its old system for 48 hours to copy patient records that will otherwise be unavailable, putting patients in danger, but says CompuGroup installed a “phone home” kill switch without its knowledge that won’t let the practice log on even in read-only mode. CompuGroup makes the analogy that people who don’t pay their electric bill have their power shut off eventually. Meanwhile, the patients get to enjoy being used as human shields as the vendor and customer bicker. Someone should have read their contract more closely before signing it, I suspect.

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Weird News Andy summarizes this story as “Three’s a Crowd.” A Florida woman pays $20,000 to have a third breast added, saying she wants to make herself unattractive to men so she wouldn’t have to date any more (as WNA says, hasn’t she heard of just turning men down?) The real reason is likely her stated dream of starring in an MTV reality show, with possible titles being rich in punning opportunities. WNA notes that the story has been declared a hoax (not surprising given the obviously ‘shopped picture), but that shouldn’t stand in the way of its entertainment value.


Sponsor Updates

  • Arcadia Healthcare Solutions will demonstrate a new version of its Arcadia Analytics solution at Health 2.0 this week. It uses Informatica technology to integrate information from 20 EHR and claims systems to report on reporting for performance management, cost and utilization analysis, and patient outreach and care planning.
  • Amerinet signs a new agreement to offer VitalWare revenue cycle technology to its members at negotiated pricing.
  • Alan Rosenstein, MD, an expert in disruptive physician behavior, posts a PerfectServe article titled “Emotional Intelligence – Understanding Patient, Staff, and Physician Needs.”
  • DocuSign publishes a blog post titled “BAAs and Beyond: Meeting the September 22 HIPAA Deadline.
  • Shareable Ink will work with students from Bentley University on user interface design.
  • Park Place International achieves SSAE 16 Type II standards compliance for OpSus Cloud Services.
  • EClinicalWorks CEO Girish Navani joins a panel discussion at Health 2.0’s annual conference to discuss how technology is improving the patient experience.
  • US News and World Report indicates that 96 percent of Honor Roll hospitals in its “Best Hospitals and Best Children’s Hospital’s 2014-2015” use Wolters Kluwer Clinical Drug Information.
  • Gritman Medical Center (ID) is live on AtHoc’s emergency communication solution.
  • Validic announces a 20 percent increase in its digital health ecosystem with new integrations including hospitals, health systems, payers, pharma, and wellness companies.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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September 23, 2014 News 1 Comment

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