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Monday Morning Update 11/7/16

November 6, 2016 News 2 Comments

Top News

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The Gordon and Betty Moore Foundation awards the non-profit ECRI Institute and its Partnership for Health IT Patient Safety a $3 million, three-year grant to study ways to optimize EHRs while avoiding patient harm.

The foundation said in the announcement, “With the increasing presence of health IT in all aspects of health care, we need to remain mindful of safety issues that are unintended consequences of this new technology. We are happy to see the Partnership advising health IT developers, users, and policymakers on how to optimize technology and avoid patient harm.”

The Partnership previously analyzed patient safety incidents that were reported to ECRI’s patient safety organization and issued recommendations for using copy-and-paste in EHRs. Its advisory panel includes experts such as David Bates, MD, MSc; Peter Pronovost, MD, PhD; Hardeep Singh, MD, PhD; Dean Sittig, PhD; and Paul Tang, MD, MS.


HIStalk Announcements and Requests

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Only 20 percent of poll respondents think FHIR will have a lot of impact on interoperability. Cosmos, who works for an EHR vendor, says APIs are like wall sockets in that you can plug in anything and it just works even if you don’t know anything about electricity, with the potential that FHIR can power a new generation of plug-and-play connected health tools. Mobile Man says interoperability has never been a technology problem and ManAboutTown agrees that interoperability will occur only as healthcare’s business models change. Furydelobongo suspects he or she won’t live long enough to see true interoperability where information flows to the point an entry in System A shows up in System B as though it were natively entered there, opining that a unified view isn’t enough. HIT Geek provided a thoughtful response:

FHIR is an API specification. It does not specify how data gets to the API, nor what happens after a corresponding API receives it. Being stateless, it does not support a workflow with state transitions, nor coordination of multiple related actors. The data vocabularies referenced in FHIR, such as clinical code sets, are not controlled within the FHIR standard. The underlying RESTful transport specifications for FHIR are also not controlled within FHIR. The corresponding EMRs, IHRs, and PHRs are outside of the standard, And it says nothing about the end-user interfaces needed to create, read, and update data. The policies and regulations envelope for FHIR is a political and organizational crazy quilt, inhibiting interoperability even if FHIR supports it. Similar things could be said about HL7 v2 and v3, including CDA. While FHIR promises to resolve some technical issues, and that’s certainly a necessary piece of the puzzle, we still have a lot else to do. The referenced and supporting standards for FHIR are relatively easy to coordinate, but will require ongoing effort. FHIR itself will need to evolve to incorporate changes in health care data, also with ongoing effort. Permanent sources of funding for the work, and willing participants, are needed. Volunteerism needs to be obtained from a wider set of sources and disciplines, including patients. Dealing the crazy quilt is the most difficult problem. It’s a whack-a-mole with more moles than whackers.

New poll to your right or here: how well managed did the medical practice where you most recently seen appear to be? Dr. Jayne loves hearing first-person stories, so click Comments after voting and describe what you experienced. 

Jenn is working on a story about telemedicine and would like to hear from doctors who have provided those services. Let me know if you have time for a quick chat (anonymously if you’d rather). We know what a video or telephone visit is like for a patient, but what’s involved on the other side?

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Thanks to Optimum Healthcare IT, Validic, and Healthwise for signing up as sponsors of HIStalkapalooza on Monday of HIMSS week. Contact Lorre to join them – I appreciate the help in covering the cost and we can accommodate most any budget.

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Mrs. W says her South Carolina fifth graders used the math games we providing in funding her DonorsChoose grant request to prepare for state testing, adding, “This was by far the most fun and pumped up math review that I have ever been able to lead thanks to your generous donation … Every day they would ask as they walked into class if we were going to get to play the math games that we received thanks to our donor on DonorsChoose.”

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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Listening: new from Deap Vally, all-female grunge that sounds sort of like Janis Joplin covering Black Sabbath in Courtney Love’s basement. Also: new from Nick Cave & The Bad Seeds.  


Last Week’s Most Interesting News

  • McKesson, Allscripts, and Cerner post disappointing quarterly results.
  • NTT Data completes its acquisition of Dell Services.
  • CMS publishes changes to the EHR Incentive Program that will allow returning participants to use a 90-day reporting period.
  • Athenahealth lays off nearly 150 employees.
  • A hospital in Canada pays doctors extra to keep using its Cerner system after they voice patient safety and productivity concerns.
  • CompuGroup Medical announces its interest in acquiring Agfa.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call:

  • Sales dropped off unexpectedly as clients held off purchases and upgrades in waiting for CMS to publish its final MACRA rule, although the company does not expect MACRA itself to drive incremental software sales.
  • Netsmart’s bookings were down from the previous quarter, which the company attributes to seasonality and deal delays.
  • RCM services bookings were up 90 percent quarter over quarter.
  • The company sees big opportunity in selling RCM services to its ambulatory EHR customers.

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Meal planning app vendor Zipongo raises $18 million in a Series B funding round, increasing its total to $28 million. The founder and CEO is Jason Langheier, MD, MPH.

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Leidos posts Q3 results: revenue up 44 percent, adjusted EPS $1.25 vs. $0.74, beating earnings expectations but falling short on revenue. Chairman and CEO Roger Krone mentioned the DoD’s MHS Genesis project in explaining that it will contribute lower revenue next year:

I want to make sure that you understand what we said is that relative to revenue, we don’t see the program being delayed. What we’re doing is we’re actually maturing some of the software, we’re conducting some more tests, we’re doing some cyber scans. And so the installation at the first facility will be a few months later than we had anticipated, but the level of activity is essentially the same. And the entire program if you think about deployment to all of the facilities within the Department of Defense will essentially remain on track. So we’ll be a little bit later on the first couple facilities, but we expect to pick that back up as we go into the implementation phase.


Sales

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The Joint Commission chooses Clinical Architecture’s Symedical terminology management platform for semantic normalization, mapping, and value set creation.

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Get Real Health will use technology from Validic to add patient-generated health data to its patient engagement offerings.


Decisions

  • Missouri Delta Medical Center (MO() will replace Infor with Premier for supply chain management in March 2017.
  • UMass Memorial Medical Center (MA) is underway with a PACS change from Philips to Agfa.
  • Throckmorton County Hospital (TX) changed EHR and revenue cycle systems from CSS Health Technologies to CPSI Evident in January 2016.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.


People

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Lisa Stump is promoted to SVP/CIO of Yale New Haven Health System after holding the interim role since November 2015.


Government and Politics

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CMS Acting Administrator Andy Slavitt in a Friday speech to a pharma group expresses his candid opinion about drug prices:

You know, last year when I spoke here, the price increases at Turing were making news, and I told you I didn’t want this industry to be defined by its worst actors. I defended the industry then, but the more data that’s revealed, the more bad actors you find, and I’m telling you now: it’s too many … Drug costs have become the health policy issue Americans are most anxious to see us act on, and we have a responsibility to them to explore all the options available us to make their medications more affordable. I hear occasionally from some that life sciences needs to tell its “value story” better. Perhaps. But it also needs to do the math. If something is growing by 11 percent, unless it’s causing something else to decrease by 12 percent, it’s not going to last forever. The reality is that in the next few years these costs will put unsustainable pressure on the Medicare program and action is going to be necessary to address them.

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China-based laboratories are feeding America’s drug addiction by creating new designer opioids faster than the Drug Enforcement Administration can declare them illegal, allowing addicts to buy them semi-legally and inexpensively over the Internet without seeking out street dealers. Several hundred people have died from known popular drugs like U-47700 and various forms of fentanyl. The labs get their recipes from old drug company research papers that describe painkillers that were never marketed. Ironically, U-47700 was studied by drug company Upjohn as a less-addictive painkiller but was never developed because it had the same addictive properties and side effects as other opioids, exactly what the copycat chemists want.


Privacy and Security

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In England, Papworth Hospital describes its near-miss with ransomware infection after an employee clicks on a malicious email link, allowing the malware to spread via file shares. The ransomware started encrypting the hospital’s files just after its midnight backup had completed, allowing it to quickly restore its systems from its fresh copy. The hospital changed to hourly incremental backups using tape since ransomware often encrypts backups digital backups along with everything else.


Technology

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I’m not sure I need to replace my old iPhone 5, but Wired magazine says the Google Pixel is the best smartphone on the market, giving the company perfect timing as Samsung goes up in smoke and Apple putters around with yawn-inducing iPhone tweaks. The Pixel comes with a “Quick Switch Adapter” for moving everything over, includes deep Google integration, charges for seven hours of use in just 15 minutes, offers Google Assistant that sounds smarter than Siri, and provides a best-in-class camera. I may have to check it out at Best Buy since AT&T isn’t selling it yet.


Other

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Medical device manufacturer Medtronic donates $5 million to the Patient Safety Movement Foundation to help the organization pool de-identified patient data collected from the devices sold by several companies to improve patient safety via predictive analytics.

MD Anderson Cancer Center will lose $450 million in FY2017 following a $267 million loss in FY2016, according to an internal report obtained by The Cancer Letter. The report blames four factors, starting with the cost of its Epic implementation.

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Coulee Medical Center (WA) cancels its Meditech upgrade when the project’s cost swells from the budgeted $1.3 million to at least $4 million. The 25-bed hospital says it didn’t understand the extra costs required for third-party software, with the CEO likening the project to buying “a car without an engine, brakes, or exhaust.” The hospital will keep its existing Meditech system even though it’s on the hook to pay licensing fees for the new system it won’t use.

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The local paper says the switch from Hitachi to EMC storage at Fairview Health Services (MN) has caused three crashes of Epic in the past year, the most recent lasting 10 hours.

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A new Peer60 reports finds that 90 percent of hospitals have an analytics strategy, but it ranges from a piecemeal approach with multiple vendors to homegrown systems to a single enterprise approach. The short-term replacement market for data visualization and enterprise analytics is significant, but consulting services and data warehouses have less short-term demand. Health Catalyst and Cerner are the strongest healthcare-specific vendors.

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A researcher develops a tool to identify which drug companies and universities aren’t publishing the results of their clinical trials, which it determined by matching the studies registered on ClinicalTrials.gov with results published there or in PubMed-covered journals.

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The US Marine Corps profiles use of its TMIP-MC battlefield EHR, recently testing during the DoD’s Global Medic joint patient movement and medical field training exercise at Fort McCoy, WI. Information from the training exercise will be used in designing its MHS Genesis replacement.

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Sutter Health notifies San Francisco area employers that it won’t offer in-network prices to their employees unless the companies sign an arbitration clause that waives their right to sue Sutter over pricing issues. Healthcare software vendor Castlight Health received one of the letters from its plan administrator Anthem (above) even through it is self-insured and has no direct relationship with Sutter. Castlight’s general counsel says Sutter is flexing its market dominance with prices that are 25 percent higher than those of other hospitals. Castlight hasn’t decided if it will sign the letter, but says declining to do so would allow it to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”

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Southampton Hospital (NY) bans political conversations in its cardiac rehab gym following an incident in which a treadmill-using patient was stuck between two people arguing over Trump versus Clinton for 15 minutes.


Sponsor Updates

  • Smart Business Magazine includes TeleTracking COO Diane Watson in its “Smart 50” list of executives.
  • TierPoint gains traction in new Gartner DRaaS report.
  • Valence Health will exhibit at the Children’s Hospital Association Annual Leadership Conference November 7-9 in Phoenix.
  • KLAS rates Voalte a top platform vendor for improved care team communication.
  • Huron Consulting Group representatives will present at the Children’s Hospital Association Annual Leadership Conference November 7-9 in Phoenix.

Blog Posts


Contacts

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

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News 11/4/16

November 3, 2016 News 5 Comments

Top News

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Allscripts posts Q3 results: revenue up 11 percent, adjusted EPS $0.14 vs. $0.13, missing analyst expectations for both. The company also issued disappointing earnings guidance.

Allscripts shares are down 17 percent in the past year and have dropped 44 percent in the past five years. The company’s market value is $2.16 billion.

Netsmart contributed $38 million in revenue for the quarter. Allscripts and a private equity firm acquired the behavioral EHR vendor in April 2016 for $950 million and merged it with the homecare software business of Allscripts with the expectation of generating $250 million in annual revenue and $60 million in annual profit, although the Allscripts ownership stake was not specified. Netsmart acquired LTPAC EHR vendor HealthMEDX on October 27, 2016 for $36.3 million in cash.

Allscripts competitor Cerner also posted disappointing results this week.


Reader Comments

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From JB:Re: data blocking. A Politico piece claims Epic and EClinicalWorks are impeding the sharing of data with public and specialty registries. It’s surprising that EMR suppliers aren’t going full-tilt toward open practices given regulatory pressures and pending VA procurement.” Epic says it has a problem with the for-profit companies behind medical association registries that also sell analytics software and apparently patient data. Epic and Practice Fusion say they will submit CCDs, but registry companies complain that CCDs don’t include all the information they need and a fully automated process would require EHR vendor customization. As is always the case, the patient is excluded from the vendor-vendor bickering even though the data in question (although not necessarily the benefit from its use) is theirs. The largely overlooked open.epic.com lists the public health registries to which Epic offers standard integration. There’s also the question of whether specific EHR vendors don’t allow submission of data at all (which is apparently sometimes true in Epic’s case) or simply charge EHR users extra to do so (like EClinicalWorks). Epic is the crown jewel since its refusal to participate means that large academic and government projects (including the FDA’s planned medical device monitoring program) are missing the information of the largest health systems. A point to note: correctly or not, I’ve never seen Cerner mentioned even once as a problem – it’s nearly always Epic and EClinicalWorks that come up, such as in the AMA’s proposed policies to be discussed in its upcoming meeting that call out those vendors specifically (see above).

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From David Watson: “Re: Memorial Health System in southeastern Ohio. We have deployed Meditech 6.15, including ambulatory, of which we are Meditech’s largest client. Physicians and staff alike have joined together with a small army of technology folks committing hundreds of hours to design, build, test, and validate a comprehensive solution. We appreciate their dedication to delivering a system that enhances MHS’s ability to provide exceptional patient care.” Congratulations to MHS and David, who joined the system in July after coming over from Duke.

From Chatty Kathy: “Re: online chats. I would like to see HIStalk provide scheduled ones for readers to share information.” I’m not a fan of Twitter for that purpose since it’s kind of kludgy, but perhaps other tools exist – YouTube and Facebook Live for video chats, GoToWebinar or conference calls for voice chats, and probably something other than Twitter for text chats. I’m skeptical at the level of demand for something like that since Twitter and Facebook seem to draw mostly people who aren’t decision-makers or influencers who just supportively stroke each other’s egos, but I’m open to ideas. My best one to use a moderated GoToWebinar session (one recognized speaker at a time) with the conversation transcribed afterward.


HIStalk Announcements and Requests

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I admit as a card-carrying curmudgeon that I don’t understand why people identify emotionally with sports teams as though they are more than just their paying customers (except maybe for the community-owned, non-profit Green Bay Packers). The most brilliant marketing strategy in history was to brand companies that hire athlete-entertainers with city names, which profitably confuses locals into mustering misplaced civic pride in saying “we won” instead of the accurate “they won while I watched” (I’ll skip my usual porn analogy). Still, Cubs fans seem pretty excited, so perhaps their lives are now complete and at least Facebook will become nearly tolerable again once the World Series and the election are over. I lost what little interest I had when I heard that Charlie Sheen wouldn’t be allowed to reprise his “Wild Thing” Rick Vaughn character to motivate the Indians, although apparently there were some Jobu sightings.

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I’m looking at tweets and streaming video as Robert Herjavec of “Shark Tank” (and founder of two IT security companies) presents at the CHIME Fall CIO Forum in Phoenix. He’s going to be a winner at HIMSS17, along with his co-star Kevin O’Leary. I watch “Shark Tank” only when traveling since as a cord-cutter I can’t get it, but those guys (and their fellow sharks) are insightful and entertaining. The recently released book by the “nice shark” gets pretty good reviews on Amazon, although the “look inside” preview shows mostly the wide-margin, collaborator-written chattiness that boosts page count without necessarily imparting additional wisdom. The CHIME tweets also make it obvious that, as is the case with HIMSS, vendors get a lot of influence, podium time, and questionably designated awards in return for their financial support. The CHIMErs were set to rock out (air quotes optional) Thursday night to Foreigner, featuring the band’s one remaining 71-year-old member from its late-1970s heyday. The best thing I can say about Foreigner is that at least they aren’t Journey.

This week on HIStalk Practice: AdvancedMD includes telemedicine capabilities in its new technology suite. Humana adds EliteHealth primary care practices to its Medicare network. Navicure’s Jeff Wood believes healthcare consumerism is finally taking off. Frederick Primary Care Associates joins Privia Medical Group. Manna Health Professional Services rebrands. MedStar National Rehabilitation Network selects WebPT tech. CMS figures out a way to pay PCPs for more time spent with patients and better coordinated care.


Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Recondo Technology raises $16 million in debt and capital funding to further develop API-enabled RCM, expanded claims statusing, and authorization automation.

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From the Cerner earnings call:

  • The company’s revenue shortfall was due to lower technology resale and software sales.
  • Cerner expects to spend $30 million on a Q4 voluntary separation plan, estimating that 2 percent of employees will be affected. The company advises that “this should not be viewed as a layoff or a sign that we don’t expect to grow.”
  • The company expects strong contributions from RCM and population health management technology, adding that HealthIntent mostly involves small contracts since most providers aren’t at risk for most of their populations.
  • Cerner says it earned a noteworthy ambulatory win in displacing Athenahealth for ambulatory EHR and business services at what the company believes is Athenahealth’s largest customer, also replacing Athena at two other sites.
  • The company blames lower software sales on the lack of MU-driven urgency among prospects, along with lower contributions from ITWorks and RevWorks.
  • Cerner believes its DoD project gives it a strong competitive advantage if and when the VA decides to replace VistA.
  • The company says its DoD revenue is steady but not significant, but completion of milestones in 2017 will add some modest-sized additional bookings.
  • Cerner says population health represents a “very little piece of bookings growth” and that those deals of $5 million and under don’t change the overall bookings number much.

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Tokyo, Japan-based NTT Data completes its $3.1 billion acquisition of Dell Services, renaming the business NTT Data Services. It was the former Perot Systems, acquired for $3.9 billion in 2009 by Dell, which apparently either overpaid or underperformed in bleeding off a large chunk of its value before offloading it to buy EMC.

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Analytics vendor Inovalon (known as MedAssurant until 2012 and acquirer of Avalere Health) reports Q3 results: revenue flat, adjusted EPS $0.10 vs. $0.09, beating revenue expectations but falling short on earnings. Shares rose sharply on the news, but are still down 24 percent in the past year.

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Israel-based equity crowd-funding organization OurCrowd launches a $50 million digital health fund with Johns Hopkins that will invest in early stage Israel-based companies. Accredited investors can invest as little as $10,000 in each company with pre-emptive rights to future fundraising.


Sales

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Inspira Health Network (NJ) chooses Cerner Millennium, HealtheIntent, and remote hosting, replacing the former Siemens Soarian.

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Penn State Health’s Hershey Medical Center (PA) will implement Cerner Millennium Revenue Cycle.

St. Claire Regional Medical Center (KY), Mary Rutan Hospital (OH), and Bella Vista Hospital (PR) will upgrade to Meditech’s Web EHR.

The DoD’s Dental Information Systems Center chooses the Dicom Systems Unifier Archive VNA.

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In England, University College London Hospitals NHS Foundation Trust chooses Epic to replace GE Healthcare Centricity, citing interoperability as a key factor going with Epic instead of Cerner.


Announcements and Implementations

Great Lakes Health Connect will offer researchers access to “remnant specimens” from lab tests by matching them with patients who match their requests and who have consented to make their de-identified information available.

Catalyze participates in the HITRUST CSF Inheritance Program that allows its customers to demonstrate their security measures without doing their own testing.

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Fortified Health Solutions renames itself to Fortified Health Security and launches new offerings of a virtual information security program, managed loss data prevention, and security event monitoring.

Telemedicine provider HealthTap announces an app developer platform that connects to telemedicine, health data exchange, CRM, and content. The company is also working on a blockchain product.

Mount Sinai Health System (NY) launches Rx Universe, a catalog of curated, evidence-proven mobile health apps that physicians can prescribe. The health system has launched a company, Responsive Health, that will license the app prescribing platform to other health systems.


Government and Politics

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I’m really going to miss Acting CMS Administrator Andy Slavitt when he leaves the job in January. His comment above came when he was asked  why the drug industry is the only group complaining about a national test of a YMCA diabetes prevention program. He also describes healthcare cost issues in Thursday remarks to the American Academy of Actuaries:

Transparency into costs is important in a world where more people are paying their own premium. Hospital profits in many cases are double or more what they were before the ACA. Drug costs are growing at record levels. And there are more endemic issues like the costs of untreated chronic diseases like diabetes or the large “tax” the fee-for-service system imposes on us when care isn’t coordinated or when bad quality is delivered. While people may not equate these costs or inefficiencies to the premiums they pay each month, we need to make those connections clear that this is where the real work needs to happen.

ONC names the 10 Phase 1 winners of its Move Health Data Forward Challenge, which calls for using APIs to enable consumers to share their information with providers and family members. I started to list the 10 and what they offer until I realized I had never heard of any of the companies and the products all sounded the same. Anyway, the 10 will be narrowed to five finalists in the next round and then one or two winners of the final phase.


Privacy and Security

From DataBreaches.net:

  • The city of El Paso, TX is scammed out of $3.3 million when officials pay a phishing hacker posing as a vendor.
  • In Canada, Winnipeg Regional Health Authority reports the latest of several incidents in which paper patient records were stolen from locked cars and offices.
  • Victims of Anthem’s 2015 data breach file a class action lawsuit seeking information on the Office of Personnel Management’s security audit, after which Anthem was rumored to have refused to perform the recommended security tests.
  • An employee of the New Zealand Nurses Organisation sends its 47,000-member database to a hacker whose spear phishing email was disguised to look as though it came from its CEO.

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A corporate lawyer sues a Miami, FL hospital for allowing its telemarketing company MedAssist to call his mother with recorded marketing messages every seven days following her hospital visit. MedAssist says its messages are informational and that the hospital’s patient waiver includes their consent to receive robocalls. The lawyer is seeking class action status.


Technology

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The New York Times covers end-of-life tech startups that are trying to bring technology into the tech-resistant “death care” industry. Investor-funded companies are offering TurboTax-like products for estate planning, online funeral home directories, post-death task automation for families, and online advance directives.

Forbes profiles Magic Leap, a secretive startup valued at $4.5 billion that is developing a next-generation computer interface, a head-mounted display that projects directly onto a user’s retina to create a mixed-reality environment. They’re targeting the consumer market, but possible healthcare uses are extensive (the founder earned a master’s in biomedical engineering). The video above – recorded directly from Magic Leap – shows the possibilities in perhaps showing a patient’s medical record while talking to them, reviewing surgical information in the OR, or reviewing medical literature while rounding.

An analysis finds that Microsoft’s IE and Edge browsers have lost 331 million users so far this year, dropping the company’s browser market share from 44 percent to 23 percent even though those products are bundled with Windows. Google’s Chrome jumped from 35 percent to 55 percent market share. Firefox users (including me) held steady at around 11 percent, while Apple’s Safari represented around 5 percent.


Other

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Facebook panders to drug companies with big advertising budgets in creating a new automatic scrolling for long lists of side effects, allowing drug companies to turn off comments on pages that promote their products to relieve them of their FDA responsibility to report any unverified side effects that patients might enter, and creating condition-specific community pages that drug companies can sponsor to promote their product. Facebook put together a team just to work with drug companies, explaining, “This was borne out of tons of interest we were getting from pharmaceutical advertisers to figure out Facebook.”

A South Florida woman complains that Boca Regional Regional Hospital charged her $7,000 for delivering her baby even though she gave birth in the hospital parking lot before she could get inside. Laypeople will miss the RCM aspect of the story – she didn’t get the bill until seven months later.

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An attorney sues the Popeyes fried chicken restaurant for including only a spork in his drive-through order, claiming that be choked for lack of a plastic knife. In an update, the attorney drops his suit following “extreme comments directed to me and my family.”


Sponsor Updates

  • Intelligent Medical Objects will offer a free workshop titled “Terminology: The Secret to Leveraging your EHR for MIPS and MACRA” at AMIA 2016 on November 12, with non-AMIA attendees invited to participate as well.
  • Gartner lists Medecision as a representative vendor of PHM platforms for providers in its latest “Market Guide for Healthcare Provider Population Health Management Platforms.”
  • KLAS recognizes Uniphy Health for accomplishments in secure messaging in its report, “Secure Communication 2016: Vendors Transitioning to Secure Communication Platforms.”
  • The Tampa Bay Technology Forum recognizes CareSync as 2016 Technology Company of the Year.
  • Ingenious Med releases a major update to its IM1 patient encounter solution, adding real-time care team member interaction.
  • Iatric Systems, Imprivata, InterSystems, MedCPU, Nordic exhibits at the CHIME Fall CIO Forum through November 4 in Phoenix.
  • InstaMed, Intelligent Medical Objects will exhibit at the NextGen One UGM November 6-9 in Las Vegas.
  • Kyruus will exhibit at HCIC November 7-9 in Las Vegas.
  • MedData will exhibit at the HFMA Region 9 Annual Conference November 6-9 in New Orleans.
  • Meditech will exhibit at the American Association of Physician Leadership 2016 Fall Institute November 4-8 in Chandler, AZ.
  • NTT Data will host an Innovation Summit November 10 in Charlotte, NC.
  • Obix Perinatal Data System will exhibit at the South Carolina HIMSS Annual Fall Conference November 9-10 in Columbia.
  • KLAS recognizes PatientSafe Solutions as one of the strongest platform options for care team communication in its 2016 Secure Communication Report.
  • PatientKeeper and Summit Healthcare will exhibit at HealthAchieve November 7-9 in Toronto.
  • The Institute of Healthcare Consumerism features PokitDok on Healthcare Consumerism Radio.
  • The SSI Group and Streamline Health will exhibit at the HFMA Region 9 Annual Conference November 6-8 in New Orleans.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
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News 11/2/16

November 1, 2016 News 5 Comments

Top News

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CMS publishes changes to the EHR Incentive Program that will allow returning EPs, hospitals, and CAHs to use any continuous 90-day reporting period between January 1 and December 31 for both 2016 and 2017.

CMS will also eliminate the clinical decision support and CPOE objectives and measures for hospitals and CAHs attesting under the Medicare EHR incentive program.

CMS says it is finalizing the process for a one-time EHR hardship exception for the Medicare EHR Incentive Program for certain eligible professionals for EPs who participate in the EHR incentive program in 2017 who will transition to MIPS in 2017.


Reader Comments

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From Pilsner: “Re: Epic’s posted study showing the change in operating margins after switching from Cerner to Epic. The data are minimally cited and the methodology is not documented. It gives Moody’s as the source, but Moody’s rates only 441 hospitals and therefore the graph must not include all hospitals that implemented Cerner and Epic from 2004 through 2015.” I would be curious about how many hospitals this graphic represents. I’m also skeptical that a change in systems was the cause of the improvement as opposed to other, more impactful changes that coincided with that change (such as being acquired by a Epic-using health system that instituted its own superior revenue cycle practices). Also, the stated average margin improvement from 3.19 percent to 6.45 percent happened over years in which hospital margins improved in general and covered hospitals that could, by definition, afford Epic. There’s too little information to infer further, but Epic’s non-marketing team has done a nice job making a compelling point without providing the details in trying to discount the headlines describing hospitals whose Epic project expense got them in trouble.

From Master Blaster: “Re: [company name omitted]. Can you please remove the rumor you ran about us?” I sometimes get requests to take down a rumor, but I don’t do that, instead offering the company a chance to provide a response or to confirm/deny, which they generally decline to do. Invariably the rumor the company wants removed turns out to be accurate and they just wanted more time to spin it publicly. It’s the same when health system CIOs email me to rather sternly suggest that I contact them before mentioning items from public records indicating the cost and status of their big implementation projects – that information doesn’t seem to require IT clarification, but they’re always welcome to provide a comment. My conclusion after doing this for 13 years: everybody loves to read rumors except those that pertain to them, which instantly transform me from a must-read news-breaker to an irresponsible trouble-maker.


FHIR

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Grahame Grieve provides a response to a reader’s question and my comments regarding FHIR.

World peace — we’ll do that next year. This year we sat it out because we wanted to handicap ourselves. (more seriously, Mr. H already quoted me about this).

From the original question, "After years of implementing HL7 and being able to do just about anything with an HL7 message," well, there’s all sorts of things you can’t do with HL7 v2, and ways you can’t do it, but for all the things you can do with HL7 v2, FHIR is an incremental improvement, not world shaking. But even there — testing, conformance, infrastructure — there’s still a lot in the increment. 

"FHIR without discipline could turn out the same way if customers don’t demand better." Yes, but also vendors understand where the other approach ends up. We’ve lived it, and in today’s social media world, we can do better for much less. So it costs less to be disciplined, and as you said, there are other reasons to get it right this time.

"Providers understandably have no incentive to exchange data with their competitors." But banks exchange data with the customer, etc. Why? In fact, there are reasons to exchange some data, some times. It’s not a binary all-or-nothing, and some providers are keen to do it. Because of cost minimization, for example. And while data sharing might allow patients to shop between systems, it can also allow systems to shop to patients previously locked in. (more about this).

For these reasons, we — the FHIR team — believe that now is a great time to spend our effort creating a better way, and we live in hope that it will make a difference for patients across the world.


HIStalk Announcements and Requests

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Ms. M reports that she’s using the iPad we provided in fulfilling her DonorsChoose grant request to assign specific reading interventions to her Texas first graders. She is also having the students record themselves as they work through the writing process, followed by taking a picture of their work and recording themselves talking the problems out.


Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Cerner reports Q3 results: revenue up 5 percent, adjusted EPS $0.59 vs. $0.54, missing analyst expectations for both. Shares dropped 2 percent at Tuesday’s close and were down another 6 percent in early after-hours trading. The company announced plans to offer a voluntary separation plan for eligible employees.

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Telemedicine technology vendor Avizia closes its $17 million Series A funding round with a $6 million investment that includes the participation of New York-Presbyterian.

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Meditech posts Q3 results: revenue down 7 percent, EPS $0.68 vs. $0.37. Product revenue declined 26 percent while service revenue increased 2 percent, but a 47 percent drop in sales costs boosted net income to $25.5 million.

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Vital Images will acquire Karos Health, which offers “deconstructed PACS” diagnostic image viewing and sharing tools.

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Private equity firm Blackstone Group will acquire hospital physician staffing outsourcer Team Health for $6.1 billion. The company was previously owned by Blackstone, which paid $1 billion for it in 2005 and then took it public in 2009. Team Health turned down a $7.6 billion acquisition offer last year after running up a pile of debt to finance the acquisition of a competitor that didn’t really work out.

Sunquest owner Roper Technologies announces Q3 results: revenue up 7 percent, adjusted EPS $1.63 vs. $1.61, falling short on revenue expectations but beating on earnings. The company said in the earnings call that Sunquest’s revenue is two-thirds recurring and therefore new orders aren’t usually that important, but the Lab 8.0 release and a new blood bank solution will cause a record number of Q3 orders. 

A federal appeals court affirms dismissal of Fair Warning’s patent lawsuit against Iatric System regarding Iatric’s technology to detect fraud and misuse of PHI.


Sales

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Baylor Scott & White Health will use technology from Pager to provide nurse triage services to patients seeking services.


People

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Aetna promotes Patrice Wolfe to CEO of Medicity, where she will also be responsible for the company’s population health management technology products that include Healthagen Outcomes and HDMS.

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Long-term care technology vendor MatrixCare hires Gary Pederson (Richland Advisors) as SVP of life plan community solutions.

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Healthgrades promotes Andrea Pearson to EVP and chief marketing officer, Christian Dwyer to EVP of product management, and Chris Catallo (not pictured) to GM of hospital solutions.

Athenahealth hires Diane Holman (TE Connectivity) as chief people officer.


Announcements and Implementations

Health services price comparison vendor HealthSparq adds tools so that health insurers can offer their members financial rewards for choosing cost-conscious options, send them secure messages, and send them claims-based alerts to offer money-saving suggestions.

A Spok-sponsored, CHIME-administered survey of 100 CIOs finds that 81 percent name improving data security as their #1 priority over the next 18 months, while the top workflow they hope to improve with technology is care team coordination for treatment planning. Two-thirds are actively implementing secure messaging.

CareCloud will integrate population health management tools from Lightbeam Health Solutions into its EHR/PM.

Availity announces that its health information exchange technology will support the FHIR standard for eligibility, labs, diagnoses, medical attachments, and ADT and is developing a provider solution for member lookups.


Government and Politics

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Healthcare.gov was apparently again overloaded on the first day of open enrollment, but at least the site provided a polite waiting room message instead of just timing out. I put myself in yesterday to compare to today’s new prices for 2017 and the premium for my theoretical coverage would be jumping 68 percent from 2016. I can say with confidence after looking up premiums for different parts of the country that a lot of self-employed folks who earn too much for federal taxpayer subsidies are going to be paying $1,000 per month or more for Silver-level coverage with a $3,500 deductible and $7,150 out-of-pocket maximum. Another option, I suppose, would be to purchase individual coverage directly from the insurance companies that offer it, but I don’t know if that would be a better deal than the exchange. A Wall Street Journal article says Arizona is the best example of the ACA’s problems in that most counties are down to only one insurer, premiums for some plans will more than double, and higher costs and cutbacks in the federal risk corridor program have caused nearly all of the insurers to pull out.

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CMS awards its next round of Recovery Audit Contractor (RAC) contracts.


Privacy and Security

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In England, the three hospitals of the North Lincolnshire and Goole NHS Foundation Trust cancel appointments and elective procedures as they go back to paper following an attack by an unspecified computer virus. The hospital hopes to restore its systems Wednesday following Sunday’s attack. They deny that ransomware is involved.

From DataBreaches.net:

  • In England, a former hospital administrative employee is prosecuted for accessing the medical records of her former girlfriend and her partner.
  • Three former district managers of drug company Warner Chilcott are sentenced for healthcare fraud and HIPAA violations trying to boost sales of the company’s osteoporosis drugs by using patient information to fill out prior authorization forms. The company’s drugs, Atelvia and Actonel, require doctors to justify why less-expensive generic drugs can’t be used, so the drug reps completed and submitted the forms using boilerplate text that was often unrelated to the patient’s condition. The company’s former president was arrested and charged with paying kickbacks last year (including bribing high-prescribing doctors with “honoraria” for speaking at events with no educational component) but was acquitted. Warner Chilcott paid $125 million to settle its criminal and civil liability and was acquired for $5 billion by Actavis.

Other

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Among the proposed policies to be discussed at the AMA’s Interim Meeting in Orlando November 12-15 is integrating mobile health apps and devices into everyday practice. A draft resolution that calls out Epic and EClinicalWorks as “data blockers” would ask federal and state governments to prohibit withholding patient information from non-affiliated physicians and asks AMA to support legislation that would limit EHR vendor interfacing fees. Another proposed item seeks federal legislation that would eliminate medical practice costs involved with converting patient data from a replaced EHR to a new one.

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Weird News Andy notes that this story is a few months old, but still amazing. A 14-year-old girl returns to competitive ballet dancing after having her leg amputated above the knee due to osteosarcoma, when was then repaired by attaching her foot backward to her upper leg in an uncommonly performed procedure called rotationplasty to give her optimal mobility.

WNA may regret going for the feel-good story above since he likes OR-related oddities such as this. A patient undergoing cervical surgery is burned when the laser ignites her passed gas.


Sponsor Updates

  • HCI Group posts a podcast titled “Epic Upgrades: Key Strategies and Cost Considerations.”
  • Aprima will exhibit at the American College of Phlebology event November 3-5 in Anaheim, CA.
  • CenterX, CoverMyMeds, Cumberlad Consulting Group, Dimensional Insight, EClinicalWorks, and HealthCast will exhibit at the CHIME Fall Forum November 1-4 in Phoenix.
  • CompuGroup Medical will exhibit at the National Association of Community Health Centers FOM/IT Conference November 2-4 in Las Vegas.
  • Elsevier Clinical Solutions will present at the US News & World Report Healthcare of Tomorrow Conference November 2-4 in Washington, DC.
  • Evariant will exhibit at the Healthcare Internet Conference November 7-9 in Las Vegas.
  • KLAS names PerfectServe’s Synchrony as a top-performing care team communication platform.
  • Extension Healthcare will exhibit at the HealthAchieve Conference November 7-9 in Toronto.
  • Healthfinch will sponsor DevOp Days November 2 in Madison WI.
  • Healthwise will exhibit at Wellcentive’s annual UGM November 2-4 in Atlanta.

Blog Posts


Contacts

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

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Monday Morning Update 10/31/16

October 30, 2016 News 3 Comments

Top News

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McKesson’s poor earnings report, released after the stock market’s close Thursday, resulted in a Friday shareholder bloodbath as MCK shares shed 23 percent of their price and continued to slide in after-hours trading Friday.

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The company’s $290 million EIS write-down was barely mentioned in the analyst call since technology isn’t a key McKesson business; it’s dumping out of healthcare IT anyway; and its failures there are insignificant compared to its exposure to a changing pharma market, uncertainty about which hit the shares of all its drug distributor competitors as well.

Drug companies can credit the unapologetically capitalistic Martin Shkreli — whose drug pricing practices at Turing Pharmaceutical created a public backlash — for their potentially less-profitable future.

Pharma is scared to death of California’s Proposition 61, which if passed will require that state agencies pay no more than the VA’s heavily discounted price for a given drug. Drug companies have spent $100 million trying to defeat it.


Reader Comments

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From HL7 Interface Engineer: “Re: FHIR. Sorry to vent, but after years of implementing HL7 and being able to do just about anything with an HL7 message, FHIR can’t solve the underlying problem of trying to connect old EHR systems as each uses the fields differently. Real-life examples I’ve experienced: (a) connecting a system with a 23-character patient ID with one holding only 12; (b) systems that may or may not allow spaces between first and middle names; and (c) a system vendor that wants ADT^A16 (pending discharge) and ADT^25 (cancel pending discharge) transactions and our system can’t send either one. Hoping someone at HIStalk will understand and either validate my feelings or explain why I’m wrong.” I don’t think  you are wrong, although that’s not what the non-techies who naively believe that FHIR will create world peace want to hear. My thoughts:

  1. Providers understandably have no incentive to exchange data with their competitors, no different in healthcare than any other big-money industry. If customers don’t care, neither will their vendors. You can’t create interoperability demand by simply developing new standards or asking for it as a downstream customer (patient). Providers would lose more business in sharing data with their competitors than they would just declining to do so since it’s not usually a patient must-have.
  2. Dissimilarly designed systems make it hard to even batch-convert data, much less handle real-time, bi-directional data exchange where errors cause missing data elements that might impact patient care.
  3. HL7 as a standard was successful, but could have been even more so if vendors hadn’t kludged their systems (and thus HL7 messages with endless custom extensions) as a lazy, check-the-box way to approximate interoperability support without enthusiasm. FHIR without discipline could turn out the same way if customers don’t demand better.
  4. The value of interoperability isn’t to the EHR or ADT systems, but rather to those systems that want their information. That stifles innovation as the smaller, newer vendor can’t get a hospital foothold without integrating with core systems and their foot-dragging vendor. The bigger, more expensive, and older system is always the transaction boss because it’s the most entrenched at a given customer site.
  5. ADT transactions are standard, but even then exceptions exist, such as those you mentioned. ADT is easy compared to clinical domains. Healthcare is a lot more complex than financial transactions that were based on standard accounting practices.
  6. Exceptions always come up due to unsynchronized upgrades among systems or corner cases, meaning someone has to monitor the error logs. That’s easier for a hospital’s IT department than a small practice with no technical resources.
  7. Paradoxically, the inflated expectations for FHIR may make it successful since everybody from the federal government to insurers and researchers is pressuring its use, giving vendors less ability to ignore it. I don’t have the expertise to say whether it’s better or worse than HL7, but we’re a lot smarter about interoperability now than back in the late 1980s when HL7 combined with interface engines instead of point-to-point custom interfaces was considered the holy grail of system-to-system communication. Maybe we’ll learn from those mistakes and do better given a blank slate. The witless punsters that put FHIR in their headlines (for which it is inarguably sexier than calling it HL7 Version 4) highlight the value of FHIR as a public relations and political tool rather than a technical one.
  8. Interface engineers got us through the days when best-of-breed systems ruled the earth and hospitals had to patch them together within their four walls. The change to single-source systems has moved the battleground outside those walls, where instead of tying together departmental systems whose vendors are equally motivated to make it work, the challenge is making competing and vastly different EHRs talk to each other in an equally competitive and inherently distrustful provider environment, something even clever engineering can’t fix.

HIStalk Announcements and Requests

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Epic’s supposedly non-existing marketing program is the most effective of all inpatient EHR vendors, according to poll respondents.

New poll to your right or here, triggered by the reader’s comment above: what impact will FHIR have on interoperability? Those taking the non-committal choice of “some” might want to click the comments link after voting to explain so that we know that you have modest expectations rather than limited knowledge.

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Welcome to new HIStalk Platinum Sponsor Haystack Informatics. The Philadelphia-based company’s security technology, created at Children’s Hospital of Philadelphia, detects hospital employee EHR snooping. Healthcare security professionals warn that insider breaches are the greatest single privacy threat, beyond the more highly publicized hacker or ransomware incidents. Instead of fixed rules, the company’s dynamic and static anomaly detection engines learn normal user behavior and call out exceptions, providing investigation workflow those incidents as well as for lost laptops, theft, and improper disposals, creating the necessary documentation for the compliance department and OCR. I sponsored their recent webinar that addressed insider threats. I was slow to notice that the company’s name comes from “a needle in a haystack,” which I assume references those few nefarious insiders among the majority of employees and staff who do nothing wrong. Thanks to Haystack Informatics for supporting HIStalk.

I found a YouTube overview of Haystack Informatics featuring CHOP AVP/CMIO Bimal Desai, MD, MBI, who is also the company’s co-founder.

Listening: new from AFI (an initialism for A Fire Inside), a hard-rocking, punk-leaning four-piece from Ukiah, CA that hasn’t changed members since 1998. They’re hard to categorize, but easy to listen to. The new single is a lot more richly polished and smooth than some of their earlier stuff.

I was thinking that instead of everyone racing for the cure or wearing pink in October for breast cancer awareness in a self-congratulatory show of support, perhaps those dozen or two Americans who aren’t already aware of it could instead wear pink and we could just take them offline individually to explain and invest the extra time and energy into public health projects.


Last Week’s Most Interesting News

  • McKesson turns in bad quarterly numbers, lowers guidance, sees shares shed nearly 25 percent of their value, writes down $290 million on its Enterprise Information Systems (EIS, which includes Paragon) business, and lays off an unspecified number of EIS employees.
  • Vocera acquires Extension Healthcare.
  • Netsmart acquires HealthMEDX.
  • Apple’s 15-year streak of increasing sales is broken due to falling iPhone demand.
  • Athenahealth misses quarterly revenue expectations and admits that its promised 30 percent bookings growth is no longer like to be achieved due to a changing (i.e., non-Meaningful Use-driven) market.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Athenahealth lays off nearly 150 employees in consolidating its R&D function, with 102 employees dismissed in San Francisco and 40 in Atlanta as the company focuses R&D in Watertown, MA; Austin, TX; and India.

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Germany-based medical software vendor CompuGroup Medical formally notifies Agfa of its interest in acquiring the medical imaging company. CGM’s market cap is $2.1 billion, while Belgium-based Agfa’s is around $625 million.


Decisions

  • Drew Memorial Hospital (AR) went live with Paychex time and attendance in September 2016.
  • Memorial Hospital at Craig (CO) went live with Kronos time and attendance in October 2016.
  • Hardin Medical Center (TN) will go live with Kronos HR, time and attendance, and payroll on January 1, 2017.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.


Announcements and Implementations

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Audacious Inquiry releases CAliPHR (CQM Aligned Population Health Reporting), an open source CQM calculation tool to support provider participation in federal and state incentive programs and value-based payment systems, available on Github.

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A new Peer60 report looks at healthcare IT trends in the UK, identifying as the top concern the shortage of doctors and nurses, with 76 percent of respondents saying Brexit is hurting their staffing. Net promoter scores are terrible for both EPR and PAS, but limited replacement activity (as well as equally poor scores across vendors) suggests a reluctant acceptance of the status quo.


Government and Politics

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The Ohio State Medical Association complains that the state’s medical board overreacted in sending a sternly worded letter to the state’s doctors, one-third of whom were not using the Ohio doctor-shopping database as the board requires. The top 25 doctors who weren’t looking up patients before prescribing opioids averaged 30 such prescriptions per month, while one doctor prescribed narcotics for 705 patients in one month without using the database at all. The letter had the intended effect of spurring sign-ups, also resulting in subpoenas for seven non-participating dentists for unspecified issues.


Privacy and Security

From DataBreaches.net:

  • A man treated for life-threatening injuries in a hospital’s ED says he will sue the hospital after one of its employees took photos of him that were later sent to him by someone claiming to be a friend of a nurse there.
  • The information of 1.3 million Australian citizens is exposed when a security researcher finds that the Red Cross’s donor record SQL database is accessible to Internet searches.
  • A report finds that messages sent to unsecure alpha pagers (like those still used widely by hospitals) can be easily intercepted, noting particularly that the US is the only country where detailed alert messages are automatically sent by nuclear power plant monitoring systems. The report recommends encryption, data authentication, and limiting how email-to-pager messages are managed.

Technology

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Apple finally announces a refreshed MacBook Pro line four years after its last update, creating little excitement given that the big innovation (details of which had already leaked out) was an on-screen Touch Bar along with the usual “thinner, lighter” one-upmanship. The entry-level price would buy a handful of Windows laptops or a dozen Chromebooks. Apple might want to invest some of its giant cash reserves in trying to clone Steve Jobs, who would surely not have taken the stage to do his “one more thing” bit with Apple’s unexciting, grindingly incremental improvements. You know it’s bad when the biggest takeaway from the iPhone announcements was the elimination of the headphone jack and the biggest from the MacBook announcements was that the headphone jack remains.


Other

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Money-losing Nevada Regional Medical Center (MO) provides an interesting glimpse into the odd ways Medicare pays providers. The hospital buys one medical clinic and plans to purchase another because they are designated as rural health clinics, meaning Medicare pays 2.5 times the amount the hospital would make from an inpatient or regular clinic patient. The hospital’s three rural health clinics are its highest-margin business lines courtesy of Medicare’s financial incentives to keep people out of the ED.

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Everybody knows John Halamka as a pre-eminent health IT spokesperson with endless energy and enthusiasm, but I enjoy even more his writings as a gentleman farmer and animal sanctuary operator, evidence of which I submit from his latest Unity Farm Journal:

Before I left, I cut a road from the barnyard to the new aviary area and around the back of the alpaca paddock to the edge of the new sanctuary property we’re acquiring next door. In my absence the gravel for that road arrived, so we now have a new area to drive over with farm equipment. I’ve called it Sanctuary Road … This weekend I’ll be busy doing animal care — trimming alpaca toenails, running with the dogs, giving the pigs the belly rubs they’ve been missing. I’ll be crushing and fermenting 500 pounds of apples. I’ll be racking the cider I fermented before I left. The work on the farm is invigorating and I will not miss sitting in economy seats while the person in front of you leans back all the way.

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In Canada, Island Health’s Nanaimo Regional General Hospital offers its doctors extra pay for “the extra burden the new electronic health record has placed on many physicians during the roll-out phase of IHealth.” The hospital’s doctors previously reverted back to paper charts, citing patient safety and workload concerns with its newly implemented Cerner system.

Doctors in United Arab Emirates complain that their hospital employer is docking their pay for clocking in minutes late, even when they work past their quitting time. The HR people tell them it’s an automated system and there’s nothing they can do. The doctors also note that right before orientation day, the hospital decided not to hire residents and interns even though the government pays their salaries.

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The folks at Epic, many of whom aren’t many years removed from trick-or-treating under the watchful eyes of their parents, have trotted out their Halloween-themed web decorations.


Sponsor Updates

  • Experian Health will present “Denial: It’s Not Just a River in Egypt!” at AAHAM WA November 10 in Spokane.
  • PatientMatters will present at the Missouri Hospital Association Annual Convention November 2-4 in Osage Beach.
  • AdvancedMD will introduce an all-in-one cloud site (scheduling, billing, EHR) at MGMA, also adding fully integrated telehealth capabilities and an expanded AdvancedPatient.
  • The SSI Group will exhibit at GC3 HIMSS November 3-4 at the Beau Rivage Resort & Casino in Biloxi, MS.
  • SK&A publishes a new report on “Provider Move Rates.”
  • The American College of Pathology names Aprima a certified ACP PRO Venous Registry EHR vendor.
  • Valence Health will exhibit at the National Association of Medicaid Directors November 6-8 in Arlington, VA.
  • Voalte will host its second annual user conference November 9-11 in Sarasota, FL.
  • Built in Chicago names ZirMed to its list of 2016 Top 100 Digital Companies.

Blog Posts


Contacts

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

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News 10/28/16

October 27, 2016 News 3 Comments

Top News

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McKesson announces Q2 results: revenue up 2 percent, EPS $1.35 vs. $2.65, missing expectations for both. The company also lowered guidance.

McKesson will take a $290 million write-down of its Enterprise Information Solutions (Paragon) business due to “a decline in estimated cash flows” and says it is still seeking a buyer for it. As recently announced, it will retain only EIS and RelayHealth once it has divested its other health IT businesses into a new joint venture company to be formed with Change Healthcare, with closing expected in the first half of 2017 pending anti-trust review.

Technology Solutions revenue was down 6 percent with a loss of $174 million.

MCK shares dropped 13 percent in after-hours trading immediately following the announcement. They were already down 14 percent in the past year.


Reader Comments

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From Hush Hush Sweet Charlotte: “Re: McKesson. Apparently it’s really hard to send out a super confidential list of McKesson employees who are getting canned to the executive team without sending it to every employee in the business unit.”  A McKesson admin apparently mistakenly emails upcoming layoff details, including names and communication plans, to the whole business unit instead of just the executives. Anonymous commenters suggest that the Charlotte, NC-based Paragon group was hit hard Wednesday, especially in lab and ancillaries, but that’s not confirmed. An HIStalk reader says one-third of the EIS workforce was let go, some effective immediately and some “held hostage for severance benefits if they stay through March 2017.” McKesson was already trying to unload its EIS division — of which Paragon is key element along with other old systems like Star and HealthQuest – as part of its plan to get out of the health IT business by transferring the non-EIS assets to a new company formed with Change Healthcare. McKesson just announced a new version of Paragon this week, which probably gave the unfortunate salespeople a rare positive talking point right before the layoff rumors leaked out.

From LeftCoaster: “Re: CPT codes. The AMA fought hard to to keep ICD-10 from being implemented. The original ICD-10 PCS code scheme developed for the US contained codes that would have theoretically replaced CPT codes (both inpatient and outpatient procedures). We’re left with a mishmash of coding schemes with CPT for outpatients and ICD-10 PCS for inpatients.” Unverified.

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From Persnicker: “Re: your (or is that ‘you’re’) favorite HIMSS publication. It’s not cool that it can’t spell ‘its.’” Americans just keep getting dumber in confusing the contraction “it’s” with the possessive “its.” I see that mistake every day, with a misuse rate of at least 50 percent. Looking at the half-full glass, I know I can immediately stop reading since I won’t trust whatever else the careless author is attempting to communicate.


HIStalk Announcements and Requests

I’ve used Bitdefender for PC security for years, and as I installed the latest upgrade to the 2017 version, I was thinking about how smooth the process is (even though years ago I initially resisted the idea of paying for ongoing AV protection as a subscription). Too bad healthcare software usually doesn’t work like this. It’s a smart, smooth, background installation; it installs in auto-pilot mode with no tinkering required; it hides its underpinnings from the user; it provides a Web-based dashboard for managing the devices covered under the subscription (up to five in the version I have); and it now includes ransomware protection. AV protection will never be fun, but Bitdefender is at least close to painless and it’s a pretty good deal at around $50 per year for up to five devices. I had high hopes for its $99 Bitdefender Box security appliance, but reviews are awful and the company doesn’t seem to talk it up much.

This week on HIStalk Practice: New AAFP President John Meigs, MD deems MACRA, opioid abuse prevention, and workforce development his top areas of focus in the coming year. Seward Community Health Center preps for Epic go live. Signia develops telemedicine app for hearing aid users. CMS keeps the MACRA flexibility options coming. Alliance Physical Therapy pilots Docity telemedicine software. The American Red Cross and Teladoc collaborate on telemed for natural disaster victims. Athenahealth shifts gears in light of disappointing sales figures. The HIStalk Must-See Exhibitors Guide for MGMA 2016 goes live.


Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the recording of “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries” from earlier this week.


Acquisitions, Funding, Business, and Stock

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Medical device vendor Zimmer Biomet – which is developing a remote rehabilitation platform — acquires RespondWell, which provides post-surgical patients with physical therapy programs.

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Quality Systems (NextGen, Mirth, and QSI Dental) releases Q2 results: revenue up 1 percent, adjusted EPS $0.23 vs. $0.21, beating analyst expectations for both. CEO Rusty Frantz declined to comment on rumors that the company is shopping its NextGen business. EHR vendor HealthFusion, which Quality Systems acquired a year ago for $190 million, had $5 million in bookings and $10 million in revenue.

Insurer Anthem will create 2,000 jobs at its new software development center in Atlanta.

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Government contractor Cognosante acquires BITS, which provides services to the VA and DoD. BITS is involved with the VA’s open source technical support contract.

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Spok reports Q3 results: revenue down 2 percent, EPS $0.20 vs. $0.20.

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Vocera acquires Extension Healthcare for $55 million in cash. I reported the retrospectively correct rumor of Nasty Parts on October 19.

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Netsmart acquires long-term and post-acute care EHR vendor HealthMEDX.


Sales

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The Ohio State University Wexner Medical Center chooses Kyruus ProviderMatch for patient-provider matching and appointment access.

Vanderbilt Bone and Joint will use MyHealthDirect for Epic-integrated patient self-scheduling.

Sacred Heart HealthCare (PA) chooses Dbtech for document management.


People

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Ascension promotes Gerry Lewis to SVP/CIO and CEO of Ascension Information Services.

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Contract management software vendor TractManager names Trace Devanny (Nuance Healthcare) as CEO.

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Mark Costanza (Lumeris) joins Nordic as chief client officer.


Announcements and Implementations

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An actuarial study finds that Forecast Health’s predictive models are more accurate than those of its competitors in identifying potentially high-cost patients for early intervention. The Durham, NC-based company developed its analytical model with UNC Health Care.

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Athenahealth lists Healthfinch’s Swoop prescription refill management app on its marketplace.

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Stanson Health’s new clinical decision support release includes evidence-based rules for atrial fibrillation, comprehensive joint replacement, Medicare Advantage star ratings, antimicrobial stewardship, and opioid management.

Influence Health announces a new cloud-based experience management solution for healthcare marketers.


Government and Politics

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The NIH’s translational sciences group awards nine universities a $6.3 million grant to integrate the PROMIS patient-reported outcomes assessment with EHRs (including Epic and Cerner) so that the questionnaire omits irrelevant questions.

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Less than half of the 22 million people that were expected to buy health insurance via the exchanges have actually done so, with the smaller number of enrollees – most of them self-selected because they’re sicker – driving insurers to drop their participation. The risk insurance program that protects insurers from signing up a disproportionate number of sicker policyholders will end this year since the original ACA legislation mistakenly assumed that the marketplace would have stable, high enrollment by now.


Innovation and Research

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The local paper profiles non-profit Fogarty Institute for Innovation, which works out of El Camino Hospital (CA). Diagnostic image manipulation system vendor EchoPixel, whose product was probably the coolest thing I saw at the last HIMSS conference, is among the companies involved. Founder Thomas Fogarty, MD is a cardiovascular surgeon who invented the balloon catheter, founded 45 medical device companies, and holds 165 surgical instrument patents. He also owns Thomas Fogarty Winery and Vineyards, which he started in 1981.


Technology

Google cuts staff and dials back the continued rollout of its Google Fiber broadband service that is available in eight cities. Fiber deployment requires digging up streets to lay cable, but Google has acquired Webpass, which uses fiber-connected antennas that would allow Google to expand faster at a lower cost. Webpass, offered only in six metro areas, offers 1 gigabyte residential service for $60 per month. The downside is that it focuses on apartment buildings and condos with at least 10 units since a central antenna must be installed.  Some Webpass reviewers also complain of the “Netflix effect” in which speeds slow to a crawl between 6:00 and 10:00 p.m.

Cleveland Clinic names FHIR as one of its top 10 medical innovations for 2017.


Other

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The Orlando paper covers Sanford Burnham Institute, a California-based research organization that was supposed to create the centerpiece of a Lake Nona life sciences complex called Medical City that failed despite having spent $350 million worth of public and private incentives. The VA and Nemours Children’s Hospital committed to building there and University of Central Florida put its medical school in Lake Nona despite its distance from the main campus and local hospitals. University of Florida just declined to take over the Lake Nona operation of the Institute, making it likely that it will shut down entirely.

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The Johns Hopkins Hospital (MD) launches a Capacity Command Center that was designed and built by GE Healthcare. It uses engineering and predictive analytics to manage patient movement and experience, fed by alerts from 14 IT systems. The hospital reports faster inboarding of transfers, faster bed assignment for ED patients, improved morning discharges, and reduced OR transfer delays.

In Nepal, government hospitals say they can’t expand outpatient hours from 10:00 a.m. to 5:00 p.m. because their doctors skip work during the day for jobs in private clinics. Paying them extra and forcing them to clock in and out didn’t help, so hospitals have decided to publicly post each doctor’s hours on his or her nameplate, hoping patients will complain if their doctor has ducked out to moonlight.

This case should keep jurors awake. A New Orleans plastic surgeon accused of raping his former wife and recording unconscious patients without their consent sues his former business partner for cashing $3.8 million in unauthorized checks. In an unrelated incident, the former partner is charged with crashing his Lamborghini into a wall at 118 miles per hour while intoxicated, killing his passenger. He accuses the surgeon of using him to pay $375,000 in severance for an employee with whom the surgeon was carrying on a sexual relationship.

Weird News Andy opines that a UK woman’s 132-pound “tumour” (as reported in an English newspaper) is actually a “fourmour” and maybe even a “fivemour.”


Sponsor Updates

  • EMDs will offer its customers claims financing from Provider Web Capital.
  • Optimum Healthcare IT publishes a white paper titled “Community Connect – Expanding Epic into the Community.”
  • CDW Healthcare recognizes Orion Health’s blog as a “Top 50 Health IT Blog.”
  • The Institute for Critical Infrastructure Technology welcomes Protenus co-founders Robert Lord and Nick Culbertson as the newest ICIT Fellows.
  • Dimension Insight achieves top ranks in BARC’s The BI Survey 16.
  • The ECG Management Consultants 2016 Pediatric Subspecialty Physician Compensation Survey shows continuing upward compensation trend.
  • EClinicalWorks kicks off 2016 national conference with over 4,000 attendees.
  • HCS will exhibit at the 2016 LeadingAge Annual Meeting and Exposition October 30-November 2 in Indianapolis.
  • HealthCast will exhibit at the 2016 CHIME Fall Forum November 1-4 in Phoenix.
  • Impact Advisors and InterSystems will exhibit at the CHIME16 Fall CIO Forum November 1-4 in Phoenix.
  • LiveProcess will exhibit at the New England Rural Health Roundtable November 2-4 in Southbridge, MA.
  • LogicStream Health will exhibit at the AMDIS Fall Symposium November 3-5 in Phoenix.
  • Meditech celebrates Canadian Patient Safety Week.
  • Netsmart will exhibit at the New Mexico Association for Home and Hospice Care Annual Conference November 3 in Albuquerque.
  • Obix Perinatal Data System will exhibit at the Riverside Methodist Hospital Perinatal Conference November 3 in Dublin, OH.OCLC

Blog Posts


Contacts

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

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Morning Headlines 10/27/16

October 26, 2016 News No Comments

Why the Key Indicators to Watch on Health-Care Marketplaces Come in 2017

Kaiser Family Foundation president and CEO Drew Altman addresses premium increases and a drop off in plan options on ACA marketplaces.

Copycat enrollment websites hamper ACA sign-up efforts

A proliferation of websites competing with Healthcare.gov are causing concern for regulators working to ensure that the ACA open enrollment period runs smoothly.

Northwestern leads consortium to integrate patient-reported outcomes into electronic health records

NIH awards Northwestern University a $6.3 million grant to begin integrating patient reported outcomes into EHR systems, with both Cerner and Epic signed on to support the effort.

News 10/26/16

October 25, 2016 News 4 Comments

Top News

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AARP sues the federal government over newly issued rules that allow companies to offer employees in their wellness programs big health insurance premium rebates, saying rebates of that magnitude become coercive rather than voluntary and that employees will be forced to give their employers medical and genetic information that could be used to discriminate against them.

The Equal Employment Opportunity Commission manages the rules for employer wellness programs. Previous rules did not define the term “voluntary” or specify the types of medical exams or questionnaires employers were allowed to require of their participating employees.

The new rules allow covered entities to receive the information of wellness program participants only in an aggregate form that does not disclose the identity of specific individuals. It also prohibits employers from requiring participants to agree to share their information with other organizations as a condition of their participation.

AARP questions whether programs are allowed to require participants and their spouses to complete a health risk assessment or undergo biometric testing that would expose their private information. AARP’s members are more likely to suffer from less-obvious medical conditions that could be disclosed by their participation.  


Reader Comments

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From Joy Division: “Re: NextGen Healthcare. An email was sent to all team members asking them to keep their heads down and work instead of speculating on the efforts with UBS Bank to find a buyer for the company. Most believe that Rusty Frantz was hired as CEO for just that reason.” An investor’s report from last week says NextGen parent Quality Systems has hired UBS to explore a sale and has conducted several presentations to interested parties.

From Magic Spell: “Re: patient engagement and technology. An OB/GYN practice in Arizona forces patients to arrive 1.5 hours early to fill in a lengthy DigiChart patient portal questionnaire to populate information that should already be there. Otherwise, they deny the services. The message that technology makes everyone’s life easier and helps engage patients could not be more displaced.”

From Cash Cow: “Re: CPT codes. The AMA has a lock on the coding system through a copyright and protects it as a cash cow. They insist on a seat license, which works for software but not applications that would meet an occasional or episodic need. You can’t provide a look-up service to find the numerical code or description without violating copyright or paying for an annual seat license for each unique user.” AMA charges $15.50 per user per year (named users, not concurrent). Several years ago, a court found that AMA misused its copyright in licensing CPT to CMS (it was HCFA back then) only if CMS agreed to not use competing coding systems, giving AMA a monopoly. A 2001 review by the Senate estimate that AMA earns at least $71 million per year in CPT sales and royalties, far more than it takes in from member dues.


HIStalk Announcements and Requests

I mentioned that last weekend’s health IT news was slow, so Brian Ahier provided some broader-picture material he’s reading:

  • DARPA investigates the use of blockchain to secure the country’s most sensitive information.
  • A research report forecasts a slight increase in wearable deals this year, but a big jump in VC funding mostly due to a single investor, mega-powered Magic Leap.
  • The White House publishes a report covering the future of artificial intelligence.

Acronyms often overlap across industries and here’s a good example: EHR is Heineken’s shortcut for its “Enjoy Heineken Responsibly” branding campaign.


Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Cancer care planning software vendor Carevive Systems raises $7.2 million in a Series B funding round.

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Apple’s 15-year streak of increasing annual sales is broken as falling iPhone sales reduce revenue by 9 percent.


Sales

St. Elizabeth Healthcare (OH) chooses Evariant’s marketing and physician engagement platforms.


People

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The Nemours Foundation names Marc Probst (Intermountain Healthcare) to its board.


Announcements and Implementations

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McKesson announces a new release of its Paragon EHR.

The Harvard public health school will offer a two-module, $7,210 program in “Leadership Strategies for Information Technology in Healthcare” in January and May whose faculty includes such notables as John Glaser, PhD; John Halamka, MD, MS; Joseph Kvedar, MD; Ken Mandl, MD, MPH; Blackford Middleton, MD, MPH; Dan Nigrin, MD, MS; Sue Schage, MBA; Dean Sittig, PhD; and Micky Tripathi, PhD. 

DocGraph releases a six-year Medicare cancer dataset. 


Government and Politics

Politico Morning eHealth reviews Q3 lobbyist spending:

  • AHA $4.05 million
  • AMA $3.87 million (part of that was spent to oppose a bill that would expand the military’s use of telemedicine, which AMA says would create a national medical license)
  • Athenahealth $140,000
  • Cerner $40,000
  • CHIME $10,000
  • Epic $36,000
  • Health IT Now $40,000
  • McKesson $220,000

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FDA will offer a December 5 workshop to solicit recommendations on how to improve hospital-based medical device surveillance systems and the incorporation of unique device identifiers in EHRs.


Privacy and Security

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Cybersecurity analysts say that patient information stolen in healthcare breaches is so readily available on the Dark Web that prices have dropped, with a full patient ID package fetching only $20 to $50 instead of last year’s $75 to $100.

An incorrectly configured master server in Guilford County, NC exposes the county’s EMS systems to the Internet. The server was running the Rsync file synchronization utility.


Technology

Amazon’s Jeff Bezos says the company isn’t working on specific healthcare uses for its Alexa virtual assistant, but that people there are thinking about it. He says, “I think healthcare is going to be one of those industries that is elevated and made better by machine learning and artificial intelligence and I actually think Echo and Alexa do have a role to play in that,” but cautions that even Amazon isn’t big enough to solve healthcare problems without the help of hospitals, doctors, and nurses.


Other

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A study of 128,000 people with sleep apnea finds that they are more likely to continue their positive airway pressure therapy when they are remotely monitored via wireless sensors or track their progress using ResMed’s app.

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A review of Medtronic’s upcoming MiniMed artificial pancreas says the problem is far from solved since the device works only with one expensive type of insulin; the user still has to count calories, perform finger stick readings, and administer their own bolus doses; and patients have to worry about pump and sensor errors. A professor who helped develop the device says it’s not a cure for diabetes and admits that it is “still a pain in the butt.”

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An Open Notes article in The American Journal of Medicine offers caregivers tips for creating documentation that will benefit the patient as well.

In Australia, the family of a 72-year-old patient sues the hospital where he died of the effects of a burst bladder after nurses accidentally attached an oxygen line to his urinary catheter. The family also says that caregivers were unable to determine the man’s “do not resuscitate” status because the hospital’s EPAS system failed to retrieve it.


Sponsor Updates

  • Netsmart and community care leaders connect the mind, body, and communities at Connections2016.
  • Bernoulli will host a focus group at the CHIME16 Fall CIO Forum November 1-4 in Phoenix.
  • Besler Consulting releases a new podcast, “Trends in HIM.”
  • Meditech recaps its Physician and CIO Forum.
  • Strata Decision Technology recaps the highlights of its recent client summit.
  • IDC names Caradigm a leader in its MarketScape for Population Health Management.
  • TransUnion Healthcare publishes a white paper titled “Recommended Resources for Hospital CFOs: Top 10 CFO Concerns about Revenue Cycle Management (And How to Address Them).”
  • CTG publishes a white paper titled “How Today’s Healthcare Regulatory Alphabet Soup is Driving the Need for Optimization.”

Blog Posts


Contacts

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

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Counting the Costs of a Data Breach

October 24, 2016 News 1 Comment

Fallout from a data breach affects much more than a provider’s bottom line. HIStalk looks at the impact ransomware attacks have on provider credibility and patient loyalty, plus offers tips on shopping for identity theft protection services.
By @JennHIStalk

Data breaches continue to make headlines, and while health IT system infiltrations may not garner as much press as those allegedly perpetrated by Russian hackers, they have providers and patients on edge all the same.

Much has been made of the breaches themselves – how attackers got in, how much ransom was paid, resultant HIPAA violations, etc. – yet little focus has been placed on the post-breach cleanup, which has perhaps the greatest impact on patients and the reputation of healthcare organizations.

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In attempting to handle the aftermath, providers typically send out communications with language similar to that included in Rainbow Children’s Clinic’s (TX) recent letter to the 33,368 patients affected by an August ransomware attack on its servers:

Notification letters mailed today include information about the incident and steps potentially impacted individuals can take to monitor and protect their personal information. Rainbow Children’s Clinic has established a toll-free call center to answer patient questions about the incident and related concerns. The call center is available Monday through Friday from 8:00 am to 8:00 pm, Central Time and can be reached at 1-844-607-1700. In addition, out of an abundance of caution, Rainbow Children’s Clinic is offering potentially impacted individuals monitoring and identity theft resolution through Equifax at no cost. Additional information and recommendations for protecting personal information can be found on the Rainbow Children’s Clinic website at www.rainbowchildrens.com.

The establishment of call centers, websites, and free identity theft resolution for affected individuals may seem logical, but they all come at a cost that some providers just can’t afford. Athens Orthopedic Clinic (GA) has suffered a tremendous amount of community fallout in the wake of a June ransomware attack that affected 200,000 patients. Patients have taken to the local paper and social media to voice their frustrations with not being told immediately about the breach and to condemn the clinic for not offering to pay for credit monitoring.

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“Many patients are upset and frustrated with the situation,” AOC CEO Kayo Elliott said in a statement. “And of course, they wish we could pay for extended credit monitoring. So do we. We truly regret that we are unable to do so, as we are not able to spend the many millions of dollars it would cost us to pay for credit monitoring for nearly 200,000 patients and keep Athens Orthopedic as a viable business. I recognize and am truly sorry for the position this puts our patients in.”

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The mea culpa continued with an op-ed authored by AOC surgeon Chip Ogburn, MD who pleaded with the community for understanding and brought to light the impact AOC’s cleanup methods have had on its reputation. “We are upset with the potential mark this leaves on the credibility and integrity of our clinic,” he wrote in the Athens Banner-Herald. “For 50 years we have endeavored to provide Athens with the highest level of orthopedic care and are even more committed to that promise today.”

Despite AOC’s public-relations efforts, it’s been reported that two law firms are investigating the possibility of pursuing class-action lawsuits against the clinic. Such PR nightmares, while a potentially business-ending burden for AOC, highlight the importance other providers need to place on preparing for such attacks. And while security assessments should be done and protections put in place, clean-up costs like credit monitoring services must be taken into account, too. Preparing for, dealing with, and cleaning up data breaches seem to have become a cost of doing business.

Providers Get Proactive With Identity Theft Protection Services

As with any type of data breach, patients are typically directed to the credit-monitoring and reporting services of three institutions – TransUnion, Equifax, and Experian. While they aren’t the only companies that offer identity protection services, they are the most well known.

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“TransUnion and other credit bureaus are resources for monitoring and protecting credit,” explains Gerry McCarthy, president of TransUnion’s healthcare solutions. “Our monitoring services include fraud alerts for any credit changes, access to live professionals to discuss any credit issues, and optional identity restoration services. In the event of a breach, providers will work with TransUnion and the other credit bureaus to set up monitoring services for affected patients.”

“We are starting to see proactive contracting with our healthcare customers who already utilize our RCM services,” he adds. “They are preparing to act quickly in case of a breach. Our credit and credit-monitoring usage by healthcare organizations has increased dramatically over the past two years. We believe this will be a standard service offered in both healthcare and other industries that deal in both consumer healthcare and financial data.”

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Michael Bruemmer, vice president of consumer protection at Experian Consumer Services, backs up McCarthy’s provider utilization figures. “Last year, we serviced about 3,600 different data breaches and 40 percent of them involved healthcare, including pharma, payers, and business associates,” he says. “We’re seeing the biggest growth in smaller entities tied to a rise in ransomware. About 25 percent of our clients that we’ve been involved with in these circumstances have actually paid the ransom.”

With such an increase, Bruemmer is certain that proactive identity theft protection services will soon become a regular cost of doing business, and perhaps even a customer service / loyalty differentiator. He cites the Blue Cross Blue Shield Association as an example: “They announced last August that all of their plans – 34 separate BCBS entities around the country – will provide free identity theft protection for any of their current members if they want to sign up. This would be in advance of a breach. That was something that the association got behind, and I think that’s a great leading example of where identity theft protection is going to be used as a preventative measure for all patients, employees … even BAs and their staff. If a breach happens after that, they don’t have to scramble and go through the process because people already signed up for it.”

“I think it’s important for patients, especially if they’re switching providers or reviewing their physician’s annual privacy policy, to start asking questions like, ‘Where do you have my records? Where are they being stored? What security practices do you have in place? If something bad were to happen, would you respond?’ I think those are fair questions to ask with any type of provider, whether it’s your dentist, doctor, or pharmacist, let alone your insurance company.”

Shopping Around

Providing such services ahead of a breach sounds nice in theory, but how viable of a solution is it for the average provider, especially independent practices that operate with little cash on hand? Bruemmer explains that Experian’s pricing is based on a number of factors.

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“We have a rate card that we publish out to clients that request it,” he says. “It’s an a la carte menu with prices tiered from quantity one up to the millions of people that could be affected. There are various pricing tiers and it is by each service. You have a cost for notifications, a cost for call center, and then a cost for the product itself. It depends on the circumstances, because in most cases, you’re going to be pricing by the number of people that actually sign up for a product. Let’s say there are 10,000 people affected by a breach. We would charge a wholesale rate for identity theft protection for only those people who subscribe to that protection. We then bill that back to the client who paid for this on behalf of the patients at the end of the breach.”

Aside from price, Bruemmer suggests that providers look at a credit-monitoring company’s experience, performance record, and response time when shopping around for such services. “They should be asking, how many breaches have you serviced? Have you serviced more complex breaches? Will you service small breaches? And then they should look at the performance record by asking, how big a breach have you serviced? What’s your customer satisfaction rating? Do you have any complaints? Any Triple A ratings from the Better Business Bureau?”

“Those are the typical things to look for,” he explains. “The third most important differentiator is response time, because the clock is ticking after a breach is discovered. The response time to a breach – determining how many people were affected and what type of information was compromised – to become legally compliant is important. The fourth factor is actually price, or the price-value relationship.”

Don’t Forget to Use It

Bruemmer stresses that once a provider has invested in such services, it’s important that their affected patients actually use them. “My advice for patients is to, first of all, read the notification letter, email, or visit the website of your provider. Second, take advantage of the services made available to you free of charge. There’s no reason not to sign up for it. Some consumers worry about giving us their information, but we’ve already got things like their Social Security numbers. We don’t allow fraudsters to get in. Last but not least, be curious about things that might happen and ask questions. I’ve already mentioned the questions you’ll want to ask a new provider, but also watch out for any new accounts, any unsolicited emails or letters that you might not normally receive. Those might be early indicators that someone is trying to get more pieces of your identity or use your identity against you. The more curious you are, the easier it is to spot these things. It goes without saying that you should pay attention to the free credit monitoring report or Dark Web service alerts included as part of your provider’s identity theft protection package. We have some people that sign up for the service and they never look at their alerts, which is just unconscionable.”

Be Proactive to Keep the Doors Open

Providers eager to avoid AOC’s predicament should, as McCarthy stresses, “be proactive and ensure they have contingency plans to protect patient information in case of a data breach. This includes having a relationship with a credit monitoring service to protect that information, the long-term identity of patients, and their credit.” It seems that in this digital day and age, taking such proactive measures might also just save a provider’s reputation.

Monday Morning Update 10/24/16

October 23, 2016 News 2 Comments

Top News

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Friday’s major Internet outage appears to have been the result of a cyberattack launched by a botnet that targets Internet-connect devices. A scan last week found 11.3 million IP addresses of infected devices, many of them DVRs and IP cameras manufactured by China-based XiongMai Technologies.

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The distributed denial-of-service attack was launched against Internet routing company Dyn, which is one of several that host the Domain Name System that translates text Web addresses to IP addresses.

Some speculate that Friday’s outage may have been a test to see if US election technology could be disrupted on November 8.

I saw no mention of hospitals that were affected, although it’s likely some were.


HIStalk Announcements and Requests

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Few poll respondents say their organizations are doing anything to prepare for Medicare’s 2019 switch of patient ID numbers. Glen says the change seems like “bureaucratic masturbation” since it won’t improve his care or reduce costs, but the point is that Medicare cards will no longer enable identity theft by exposing Social Security numbers.

New poll to your right or here: which inpatient EHR vendor’s marketing program is most effective?


Last Week’s Most Interesting News

  • Athenahealth’s Q3 results beat earnings expectations, but fall short on revenue.
  • HIMSS announces IBM CEO Ginni Rometty as the HIMSS17 opening keynote.
  • St. Joseph health (CA) pays $2.14 million to settle HIPAA violations in which a misconfigured server containing Meaningful Use data exposed patient information to Internet searches.
  • Shares of IRhythm Technologies, which offers continuous skin patch monitoring of cardiac arrhythmias, jump 53 percent on the company’s IPO day.
  • Industry groups respond mostly positively to the newly issued MACRA final rule.
  • FDA approves an ultrasound sensor for Android smart phones developed by Philips.

Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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From the Athenahealth earnings call following a revenue miss that sent shares down nearly 6 percent on Friday:

  • The company added a record 5,092 providers in Q3.
  • The company’s expected 30 percent bookings growth for the year is behind “as the lack of sense of urgency in the market has elongated the sales cycle” and Epocrates revenue was lower.
  • Jonathan Bush says the MIPS program changes provider focus to “the operational cost of managing quality” and closes out the focus of the past six years, requiring a change in product approach.
  • Bush says the company is building a new EDI platform that will be more reliable, more stable, and less expensive for adding new network connections.
  • Bush said when asked about revenue growth and hiring, “You could look at the provider adds … as the great men of Monty Python like to say, I’m not dead, actually feeling much better.”
  • University of Toledo is still the company’s only larger-hospital inpatient EHR customer.
  • Bush says there’s not value-based care being delivered despite a lot of talk. “Obamacare was extremely incremental this idea of an ACO that takes the first two percent itself and gives you half of the incremental savings 18 months after you generate them when it is done calculating them. Even if the calculation is wrong, you still have to accept it. If you generate savings for three years, they reset your base at the new lower number. It is a crap game to play, so not many people really play it. There are a few companies that are standalone, independent to the hospital systems, that have more to gain. The economic rents doesn’t come out of their own. The other problem is most of the ACOs that are affiliated with us know that the savings would come out of the hospital.”
  • Bush summarized, “The big news, of course, is that I have been promising to tell you if I ever thought that there was no chance of making 30 percent bookings growth, I never had to because there is always a chance. There is no chance. The reasons behind it are fundamental shift in the market, a shift that inspires us and that gives us more confidence in our ability to differentiate ourselves from traditional software, install it and run the traditional way.”

Decisions

  • Jennie Sealy Hospital (TX) switched from GE PACS to Philips in August 2016.
  • Little River Memorial (AR) will change payroll and time attendance from Healthland to ADP in January 2017.
  • Rockcastle Regional Hospital (KY) went live with Kronos HR, time and attendance, and payroll in September 2016.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.


Announcements and Implementations

Brigham and Women’s Innovation Hub and Evidation Health will work together to measure the impact of digital health solutions on outcomes.


Privacy and Security

From DataBreaches.net:

  • Baystate Health (MA) says five of its employees clicked on a phishing email link disguised as an internal memo, giving hackers access to their accounts that contained emails with the information of 13,000 patients.
  • Seattle Indian Health Board notifies 800 patients that a breach of an employee’s email account exposed their information to an unknown hacker. The organization says it will “implement more structured password management and control measures” and is working on a project to “move all staff to a more secure email system.”

Other

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Mayo Clinic and Arizona State University will build a new medical school adjacent to Mayo Clinic Hospital in Scottsdale, AZ that will also offer a certificate and master’s degree in the science of healthcare delivery. The organizations also plan to open a medical technology innovation accelerator. Groundbreaking is scheduled for 2017.

In Ireland, a hospital blames a system upgrade for sending doctors lab results that had been performed up to 20 years ago.


Sponsor Updates

  • Agfa HealthCare’s enterprise imaging will participate in RSNA’s Image Sharing Validation Program.
  • Experian Health will exhibit at the HFMA First IL Fall Summit October 24-25 in Oakbrook Terrace.
  • HIMSS names Patientco CEO Bird Blitch chair of its Revenue Cycle Improvement Task Force.
  • PatientMatters will exhibit at the Arizona Hospital and Healthcare Association Annual Meeting October 26-28 in Marana.
  • TierPoint joins the Amazon Web Services Partner Network.
  • Verscend will exhibit at AHIP Medicare and Medicaid October 23-27 in Washington, DC.
  • Visage Imaging will exhibit at the SIIM Wisconsin Regional Meeting October 24 in Madison.
  • ZeOmega will exhibit at the AHIP National Conference on Medicare, Medicaid & Duals October 23-27 in Washington, DC.
  • ZirMed will exhibit at the National Association for Home Care & Hospice Annual Meeting October 23-25 in Orlando.

Blog Posts


Contacts

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

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News 10/21/16

October 20, 2016 News 2 Comments

Top News

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Athenahealth announces Q3 results: revenue up 17 percent, adjusted EPS $0.35 vs. $0.15, beating earnings expectations but falling short on revenue.

ATHN shares dropped slightly on the news. They’re down 7 percent in the past year.


Reader Comments

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From CMIO: “Re: Text2Codes. It’s a pretty cool web app that extracts / annotates ICD-10 and CPT codes from copied and pasted free text.” The Web-based tool offers a free trial.

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From Excretory Gland: “Re: NIST/HHS conference on security. If the feds can’t get this one correct, what hope do we have?” A Twitter search of the misspelled hashtag turns up thankfully few recent instances of its recommended use.

From Media Maven: “Re: press party at HIMSS. I see HIStalk on the list as attending an event in which companies pay to speed-date members of the press.” I’ve never heard of the event. I’m not a fan of paying a third party to earn face time with so-called journalists who are mostly interested in scarfing down free drinks in return for a vague obligation to promote those companies that would otherwise not earn their attention. The promoter, oddly enough, is “a lifestage media and marketing company focused on parents and families.” Sounds like a waste of vendor money to me, a questionable display of journalist ethics, and something I will avoid entirely.


HIStalk Announcements and Requests

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Here’s a DonorsChoose donation opportunity for CIOs and other hospital senior IT professionals. An anonymous HIStalk supporter will donate $10 for each response (up to 200) to a short survey covering hospital cybersecurity. Respondents will also receive a copy of the results. Senior hospital IT executives with cybersecurity responsibilities can complete the survey  in 5-7 minutes. Thanks for supporting DonorsChoose.

This week on HIStalk Practice: South Florida Behavioral Health Network selects ODH’s Mentrics behavioral population health management technology. GE announces the winning communities of its HealthyCities Leadership Academy Open Innovation Challenge. Acuity Eye Specialists goes live with CareCloud. ICD-10 still gives some practices (and payers) problems. Westmed Medical Group selects Bridge Patient Portal capabilities. Pyramid Healthcare taps Qualifacts for behavioral health tech. Florida stakeholders reignite telemedicine talks. CDPHP and CapitalCare Medical Group launch Acuitas Health. Culbert Healthcare Solutions President Brad Boyd focuses on restructuring physician compensation in a value-based world.


Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Allscripts acquires CarePort, which connects acute care providers to post-acute care providers. Terms were not disclosed. The company had raised $3.13 million in four funding rounds.

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IRhythm Technologies, which offers continuous skin patch monitoring and data analysis of cardiac arrhythmias, prices its IPO shares at $17.00, valuing the company at $300 million. First-day trading on Thursday saw shares jump 53 percent.  

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Decision analytics vendor TrendShift acquires population health management vendor Health Data Intelligence, which the Columbus, OH business paper described in a July 2016 profile as a four-employee company that had raised just $125,000.

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Inhaler technology vendor Propeller Health raises $21.5 million in a Series C funding round, increasing its total to $50 million. 

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The Partners Connected Health Symposium and HIMSS-owned Personal Connected Health Alliance will combine their conferences into a single Connected Health Conference next year, with Joe Kvedar, MD serving as program chair. HIMSS, its mHealth Summit, and Continua Health Alliance were rolled into PCHA in April 2014. HIMSS hired Patty Mechael, PhD as EVP of PHCA in June 2016.


Sales

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Midland Health (TX) chooses Cerner’s clinical, financial, and population health management systems. They will apparently replace Medsphere’s OpenVista.

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In England, King Edward VII’s Hospital chooses the modular enterprise imaging solution of Vital Images. 


People

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Brattleboro Memorial Hospital (VT) promotes Steve Cummings, BSN, MBA to VP of information and support services and Jon Farina to chief compliance and security officer. Both were involved in the hospital’s Cerner implementation.

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Enterprise mobility solutions vendor Kony hires Cem Tanyel, MBA, MSc (TriZetto) as EVP/GM of global services.


Announcements and Implementations

Allscripts adds licensed health information from Healthwise to its EHR products via Infobutton integration.

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HIMSS again awards the prized first-day conference keynote slot to a vendor executive, this time IBM CEO Ginni Rometty. I expect the Watson hype to be thick since the company has bet the Big Blue farm on selling it into healthcare. HIMSS hasn’t announced its Thursday political keynote speaker, but Mr. Wonderful and Robert from “Shark Tank” will close the show Thursday long after most attendees have departed, which is a shame since they’ll be the most interesting.

Accenture Federal Health Services contracts with Sutter Health and Validic to guide an ONC-funded pilot project to study how patient-generated health data can be delivered to care teams and researchers to improve outcomes.

ENHAC will replace its privacy and security accreditation criteria with HITRUST CSF provisions and controls, allowing EHNAC to offer both its own accreditation as well as that of HITRUST CSF. 

Kareo adds prescription drug cost comparison information and coupons to its Kareo Clinical EHR using information from GoodRx.


Privacy and Security

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September’s breach report from Protenus finds that while an average of 25 breaches per month occurred in the first half of 2016, the number has jumped to 39 per month for July, August, and September. Forty-one percent of September’s breaches were insider incidents, of which over half were intentional. Thirty-two percent of the September breaches were due to hacking, with five victims specifically stating they were hit with ransomware.

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From DataBreaches.net:

  • The email accounts of Hillary Clinton’s campaign chairman John Podesta and former Secretary of State Colin Powell were breached by hackers believed to be working for the Russian government when both men clicked on a phishing email (disguised as a Google password theft warning) that contained a Bitly-shortened link pointing to a URL that embedded their encrypted Gmail account information. Their exposed emails ended up on WikiLeaks.
  • A medical practice in Canada is hit with ransomware, with no report of whether the ransom was paid.
  • A laptop stolen from a benefits management company exposes the insurance information of 7,242 people, although the files contained only basic demographic information.

Innovation and Research

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ONC awards Keith Marsolo, PhD of Cincinnati Children’s a one-year, $378,000 interoperability grant to develop standards and methods to populate clinical research systems with EHR information. Marsolo’s team hopes to create one-click access from the EHR to externally hosted electronic case report forms systems, pre-populating standard data elements.


Technology

Rush University Medical Center says use of RTLS at its Rush River North physician practice has reduced patient wait times in a pilot project of 350 patients. Patients are tracked throughout their visit via RTLS badges, with alerts sent to providers if they’ve waited longer than 10 minutes. The system also tracks equipment and notifies staff when rooms need cleaned.

Non-profit Trek Medics International offers Beacon, an SMS-based emergency medical dispatch system for countries that don’t have 911-type service. It allows requests for emergency assistance to be directly routed to any nearby trained responder. The company says most countries have the key components needed — young adults with phones and cars – and communities can create their own grassroots service. They’re working in Dominican Republic and Tanzania.


Other

An MIT study finds that people newly covered by Medicaid not only don’t cut back on their ED usage, but actually increase it significantly for at least the first two years, disputing the belief that insured patients would see primary care doctors instead of using the ED for routine care. The study found that the newly insured had a 13.2 percent higher likelihood of making visits to both an ED and primary care doctor, suggesting that the two types of visit are “more complementary, not more substitutable.”

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In India, the owner of a 1,000-bed hospital in which 22 patients died in a fire is arrested along with four hospital officials. The politically connected owner started a university with schools of medicine, dentistry, nursing, and biotechnology. The hospital did not have a mandatory fire certificate.

The Charlotte newspaper profiles the ED usage reduction efforts of Community Care of North Carolina, which mined the Medicaid ED bills of Charlotte-area hospitals to identify the 100 most frequent ED users (at #1 was a homeless alcoholic who made 223 ED visits in 15 months). Most of the frequency flyers had behavioral health issues and some were visiting multiple EDs, with one patient being seen in three EDs in a single day. The team that started monitoring high-risk patients to help them find primary care doctors and obtain social services won the Hearst Health Prize for significantly reducing unnecessary ED and inpatient visits. The program faces shutdown, however, after North Carolina’s Medicaid reform left it without a contract.

A new Ohio law requires providers to provide a written estimate of charges, expected insurance payments, and the patient responsible portion of the bill 48 hours before providing non-emergency services. It also requires insurers to respond promptly to the inquiries of providers who need to know what insurance will pay so they can tell their patient.

A reporter’s review of “our addiction to medical hype” finds that “we reporters feed on press releases from journals and it’s difficult to resist the siren call of flashy findings” even though only 3,000 of the 50,000 medical journal articles published each year are of adequate quality for patient care use. The article quotes sources indicating that $200 billion in worldwide research spending is wasted on poorly designed or redundant studies.

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Weird News Andy says a patient featured in a journal case study didn’t have a ghost of a chance. A man who eats a hamburger doused with ghost pepper puree and then tries to quench the fire by quickly drinking six glasses of water ends up with a torn esophagus from the ensuing vomiting. WNA provides helpful advice: “If it looks like one of Satan’s organs has prolapsed, you might want to reconsider eating it.”


Sponsor Updates

  • HCI Group will sponsor a session at the Health Informatics New Zealand conference November 1-3 in Auckland.
  • Ingenious Med will exhibit at Anesthesiology 2016 October 22-26 in Chicago.
  • InterSystems will exhibit at the Partners Connected Health conference October 20-21 in Boston.
  • Intelligent Medical Objects will exhibit at the EClinicalWorks National User Conference October 20-24 in Orlando.
  • Frost & Sullivan recognizes Influence Health with its 2016 award for enabling technology leadership.
  • Learn on Demand Systems donates servers and other hardware for computer science student use at Hillsborough Community College.
  • AHIMA will use Meditech’s EHR in its Virtual Lab to train and test future medical professionals.
  • Medicomp Systems releases a video describing the ways in which its technology can help providers transition to MACRA.
  • Netsmart will exhibit at the National Association of Home Care’s annual meeting October 23 in Orlando.
  • Obix Perinatal Data System will exhibit at AWHONN New Hampshire October 24 in Dover.

Blog Posts


Contacts

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

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News 10/19/16

October 18, 2016 News 11 Comments

Top News

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St. Joseph Health (CA) will pay $2.14 million to settle OCR charges that it exposed the information of 32,000 patients for a full year in 2012-2013 when it brought a server online using default security settings that allowed its contents to be viewed via Internet searches. The exposed files had ironically been created to document the health system’s Meaningful Use participation, so some of the MU money it presumably earned from HHS because of those files will go right back to HHS as punishment for exposing them.

OCR found that the contractors that SJH hired to assess its PHI security did their work “in a patchwork fashion” that failed to meet the requirement of performing an enterprise-wide risk analysis.

The health system paid $7.5 million earlier this year to settle a class action lawsuit filed by patients whose information was exposed.

SJH had previously reported the theft of unencrypted PHI-containing devices in 2010, 2012, 2013, and 2014 as well as a 2014 incident in which an employee failed to delete a PHI-containing Excel worksheet tab before sending it to an investment firm.


Reader Comments

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From Greek Goddess: “Re: Epic. The same publication that ran the R&D nonsense with Judy’s ‘trust me’ as verification seems to publish whatever Judy says. The latest contains the usual sound bites about industry misinformation about Epic and the tired narrative that it doesn’t have a marketing department.” They were obviously typing with velvet gloves. This 1998 article quotes Judy as saying that she was increasing Epic’s sales and marketing budget by 70 percent because “we want to be very big,” also mentioning the hiring of an advertising department and marketing director. In 2015 I reported a reader’s observation that at least eight former Epic employees identify themselves on LinkedIn as having done Epic marketing and one of them says she reported directly to Judy (“leading in-house marketing team,” she says). Epic hired a high-powered lobbying firm awhile back as well. I think the people who write for the HIMSS-produced publication (which lives in a picture-perfect fairytale HIT land in which seldom is heard a discouraging word about HIMSS-paying vendors) are so pleased with themselves at earning Judy’s rare attention that they simply uncritically regurgitate whatever she tells them, which makes that publication an Epic favorite for planting “news” that is really just Epic disputing any negative industry impressions about the company. Make no mistake: Epic is not naive about marketing and sales even though they might do it differently – all those gazillion-dollar contracts didn’t just happen because a health system CEO cold-called 608.271.9000 and asked to speak to any available 23-year-old programmer.

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From The Truth Hearst: “Re: Zynx Health. Laid off 50 percent of the company last week, including all of finance and marketing, perhaps to either fold the company or roll it into one of the other Hearst entities.” The company provided this response to my inquiry:

Zynx has taken the necessary steps to better position itself in a changing healthcare market. We are aligning our solutions, clinical expertise, and content capabilities to meet the needs of the shifting marketplace and new requirements with emerging value-based payment models. With the changes in the marketplace, the difficult decision to eliminate positions was necessary. However, new opportunities have opened as we deploy an interdisciplinary team of professionals to provide more comprehensive support for our products and services to each client. We believe Zynx will be better equipped to innovate as the healthcare market requires and that these changes will not only make Zynx stronger in this new marketplace, but also, and more importantly, provide better service and support to our valued clients. We are definitely not folding and look forward to another 20 years of market leading innovation and solutions.

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From Nasty Parts: “Re: Extension Healthcare. An executive tells me the company has been sold with an announcement forthcoming.” Unverified. Nasty Parts has a pretty good rumor-sniffing track record.

From Big ‘Un: “Re: HIStalk links. I notice some refer to a click counter rather than a direct link. What does that do?” It’s interesting to me how many times readers click on links to new sponsor web pages or webinar sign-up pages, which tells me what kind of information readers want (and how well or how poorly I present it). That’s all I use it for. A recent webinar announcement got more than 1,300 clicks to the sign-up page, for instance, and the ratio of how many of those actually registered to attend tells me whether the abstract and learning objectives were on point. Mentioning a new sponsor usually gets 200-400 readers to click over to the company’s webpage to learn more, which tells me the kinds of technologies that pique the curiosity of readers. Beyond my self-improvement efforts, the invisible click counter, which is run from a free PHP script I found on the Internet, does absolutely nothing.

From Jock O’ Lantern: “Re: fitness trackers. Do you think their lack of success in improving health will hurt sales?” No, since companies will continue to market them smartly (which is to say slightly deceptively). Fitness trackers and apps make few people healthier, but they play to the vanity of buyers who fancy themselves as possessing the willpower to change their lives and their mental outlook once they just buy more jock gear so they can look like the sweaty-yet-sexy models in the fitness tracker ads. Accurate ads would show several of the devices stashed in the underwear drawer along with unworn yet stylish exercise clothes while the owner — who moans about having too little time for exercise — spends the entire evening eating Cheetos, watching TV, and interacting with pretend Facebook friends. We’re going to muster one mushy militia if it ever comes to that.


HIStalk Announcements and Requests

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I’ve corrected my Monday mistake in listing Southwest General Hospital (OH) as moving from McKesson to Cerner next year. They’re already a Cerner shop – it’s Southwest General Hospital (TX) that’s changing systems. Sometimes Google magnifies rather than resolves my confusion over multiple hospitals that share a name.

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Welcome to new HIStalk Platinum Sponsor Protenus. The Baltimore company’s privacy monitoring system detects inappropriate EHR user behavior (with 97 percent accuracy and thus few false alarms) to proactively identify potential HIPAA violations in helping hospitals avoid huge OCR settlements and jury awards. Examples: EHR users who inappropriately access a VIP’s records; employees who snoop through the files of friends or estranged family members; employees who use patient information to file fraudulent tax returns; hackers who obtain user credentials by phishing and then move freely through patient records; contractors who use their access for unauthorized purposes; and laptop thieves who gain EHR access. Protenus learns how each user normally works instead of trying to apply simple rules to detect their unusual behavior, then provides alerting and collaboration tools that enable quick resolution instead of waiting the average 200 days it otherwise takes providers to detect and fix inappropriate access. IT folks benefit from the elimination of expensive managed services, lightweight data integration of any number of systems, and the option to run it in-house or hosted. The company was founded by Robert Lord, a former Hopkins medical student, medical researcher, and hedge fund analyst; and Nick Culbertson, MD, who earned two bronze stars during his eight-year service as a Green Beret sergeant with the 20th Special Forces Group (Airborne) and helps run an East Baltimore veteran support group. Read the Johns Hopkins case study or Robert’s Readers Write article. Thanks to Protenus for supporting HIStalk.

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Here’s a look at the privacy monitoring and incident tracking system of Protenus.

Listening: new from Avenged Sevenfold, polished, literate heavy metal in their first album since 2013. They sound great for a band that’s gone through more drummers than Spinal Tap. Pretty cool lyrics.


Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

Adobe sues MedAssets (via its new owner nThrive) for copyright infringement, claiming that MedAssets distributed Adobe’s ColdFusion web development tool in its CodeCorrect product despite having a license for internal use only.

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Home-centered clinical trials management vendor Science 37 raises $31 million in a Series B funding round, increasing its total to $38 million. The founders are dermatologist Belinda Tan, MD, PhD and Noah Craft, MD, PhD, who was chief medical officer of VisualDX.

UnitedHealth Group, which is pulling out many insurance exchanges because too many expensively sick people signed up, books Q3 revenue of $46.3 billion and a profit of $3.6 billion, with the CEO (whose shares are worth $356 million) saying the company will in 2017 “deliver more value to the health system overall.” 

Three post-acute care software vendors – Casamba, HealthWyse, and TherapySource – announce their merger under the Casamba nameplate.

The SEC declines to prosecute Harris Corp. after its auditors reported to the SEC that they found evidence that the fired CEO of its Carefx China subsidiary had in 2011-2012 bribed Chinese government officials with as much as $1 million to earn nearly $10 million in business. Harris acquired Carefx for $155 million in cash in 2011. The SEC fined the executive $46,000 and Harris sold its healthcare business to NantHealth in mid-2015. The executive, Ping Zhang, PhD, is now SVP of product innovation and CTO of MedeAnalytics.


Sales

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The Dubai Health Authority signs a collaboration agreement with GE Healthcare for hospital predictive analysis, efficiency, and training.


People

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Nancy Ham (Healthagen Population Health Solutions, an Aetna Company and Medicity) joins physical therapy EHR  vendor WebPT as CEO.

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Congratulations to interoperability expert Keith “Motorcycle Guy” Boone of GE Healthcare for completing his master’s in biomedical informatics from OHSU.


Announcements and Implementations

Nuance announces GA of a new version of its Dragon Medical Advisor real-time computer-assisted physician documentation system.

HCS integrates document exchange interoperability technology from Kno2 into its Interactant system to support care transition and care coordination with referring hospital partners.

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Long-term care EHR vendor PointClickCare releases an integrated smartphone app for skin and wound assessment and documentation.

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AHIMA will offer a health informatics certification credential in early 2017 to candidates with (a) a bachelor’s degree and two years of informatics experience; (b) a master’s degree with one year of experience; or (c) a master’s in health informatics. Like certification programs offered by HIMSS and other industry groups, the credential’s value is clear to the organization being paid to issue it (and the alphabet soup of other certificates AHIMA sells) but much less obvious to those who might receive it. Someone who has earned a master’s in health informatics doesn’t need to pass an AHIMA test to prove their knowledge for an employer who is probably more interested in experience and capabilities anyway. If I were interviewing a candidate for a non-technical position, I would place zero value on trade group certification. Actually, I would probably place negative value on them since I would question the motivation of a possibly insecure and under-qualified candidate who is proud of a credential that was earned by completing a single multiple choice test that has a high pass rate. CHIME’s certified healthcare CIO is the silliest one I can imagine – what health system CEO would value that credential when hiring a CIO? (perhaps only a certified healthcare CEO if there is such a thing, which I sincerely hope there isn’t). Organizations make a lot of money preying on the personal insecurities and educational shortcomings of ambitious people with generous disposable income or employer educational expense reimbursement programs.

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Healthgrades releases its annual hospital evaluation report. The company also announces Risk IQ, a questionnaire-based tool that allows consumers to evaluate their personal risk for six common surgical procedures.

MModal launches a risk adjustment solution suite that helps optimize chart documentation to improve HCC charge capture.

LifeImage releases version 5.0 of its image-sharing platform, which adds real-time collaboration, FHIR support, and more extensive integration of information from PACS, VNA, and clinical systems.

Agfa HealthCare announces a new version of its Enterprise Imaging platform that includes new migration tools, image management and workflow rules, live streaming and virtual conferences, and multi-specialty imaging.


Government and Politics

An investigation by the Minneapolis paper finds that FDA has allowed drug device manufacturers to hide reports of patient harm, either by rolling individual reports up into a generic summary or accepting years-overdue reports. A former FDA official who created a search engine called Device Events to track medical device performance says doctors might behave differently if they knew how many incidents were reported.

Wisconsin state inspectors cite a veterans home for dozens of medical errors, some of them related to incorrect transcription and employees confused by new software. An LPN who administered 100 units of insulin instead of the ordered 12 units said she attended training but then went on vacation, with her supervisor advising upon her return that she should just “wing it.” Nurses interviewed by the inspectors said the rollout was poorly handled.


Privacy and Security

St. Jude Medical forms a cybersecurity advisory board following published claims that its medical devices are vulnerable to hacking.

From DataBreaches.net:

  • Rainbow Children’s Clinic (TX) reports to HHS that it was attacked by ransomware on August 3, exposing the information of 33,000 patients to an unknown hacker and resulting in the permanent loss of some patient records.
  • Medi-Cal plan provider CalOptima reports its second breach in two months after discovering that a “departing” employee downloaded patient information to an unencrypted USB drive that was later returned.

Technology

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Philips earns FDA approval for an ultrasound sensor for Android-powered mobile devices, enhancing its Lumify ultrasound diagnostic solution to allow clinicians to perform heart, lung, and OB/GYN ultrasound without an ultrasound cart. It costs $200 per month.


Other

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Weird News Andy wonders whether this story really happened. An Oregon hospital quarantines its ED after treating a woman with hallucinations, after which the two deputies who brought her in as well as her caregiver and a hospital employee also began hallucinating for reasons unknown. They’re thinking her medication patch might have been spewing active ingredients all over the place.


Sponsor Updates

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  • Attendees of Experian Health’s annual Financial Performance Summit put together 1,000 hygiene kits and collected 200 pairs of socks for Nashville charity.
  • GE Healthcare will work with India-based Tata Trusts to train 10,000 students for healthcare technology careers.
  • Aprima earns high ratings for its RCM services in a KLAS specialty report highlighting ambulatory billing services.
  • Bernoulli CEO Janet Dillione is included in the 17 female health IT company CEOs to know.
  • Besler Consulting releases a new podcast, “Strategies for navigating bundled payments.”
  • Carevive Systems will host a half-day symposium on non-small cell lung cancer October 26 in Philadelphia.
  • CoverMyMeds will sponsor the CBI Electronic Benefit Verification & Prior Authorization Summit October 25-26 in San Francisco.
  • Consulting Magazine includes Cumberland Consulting Group and Divurgent on its list of fastest-growing firms.
  • EClinicalWorks will exhibit at AAP 2016 October 22-25 in San Francisco.
  • Iasis Healthcare streamlines documentation processes with FormFast technology during its EHR transition.
  • FormFast will exhibit at CHIMA October 24-25 in Edmonton, Alberta.
  • Healthwise will exhibit at the EClinicalWorks National Conference October 21-24 in Orlando, FL.

Blog Posts


Contacts

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

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Morning Headlines 10/18/16

October 17, 2016 News No Comments

Biden outlines five-year plan for ‘cancer moonshot’

Vice President Biden delivered his final status report on the administration’s cancer moonshot, laying out a five-year plan and reiterating the need for continued funding from Congress and private organizations.

A laboratory in your pocket

In The Lancet, Eric Topol, MD discusses the value that digitally connected point-of-care diagnostic tests would have locally and in resource-poor remote regions of the world.

Obese soldiers get £100 Fitbits in battle of bulge: Servicemen failing Army fitness tests are handed high-tech calorie-counting bracelets to help them lose weight 

In England, overweight soldiers facing discharge for failing the Army fitness test are being issued Fitbits to help them get back in shape.

Medical College spins out startup

A local paper covers RPRD Diagnostics, a spinoff from the Medical College of Wisconsin developing DNA tests to match patients with the pharmaceuticals that will work best for them.

Monday Morning Update 10/17/16

October 16, 2016 News 1 Comment

Top News

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HHS publishes the final MACRA rule (2,204 pages, although much of it is draft comments with responses) with a 24-page executive summary (provided the executive in question understands a lot of jargon in sentences such as, “We are finalizing the method to calculate and disburse the lump-sum APM Incentive Payments to QPs, and we are finalizing a specific approach for calculating the APM Incentive Payment when a QP also receives non-fee-for-service payments or has received payment adjustments through the Medicare EHR Incentive Program, PQRS, VM, or MIPS during the prior period used for determining the APM Incentive Payment”) and a website explaining it.

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CMS Acting Administrator Andy Slavitt summarizes the rule:

Other than a 0.5 percent fee schedule update in 2017 and 2018, there are very few changes when the program first begins in 2017. If you already participate in an Advanced APM, your participation stays the same. If you aren’t in an Advanced APM, but are interested, more options are becoming available. If you participate in the standard Medicare quality reporting and Electronic Health Records (EHR) incentive programs, you will find MIPS simpler. And, if you see Medicare patients, but have never participated in a Medicare quality program, there are paths to choose from to get started. The first couple of years are aimed at getting physicians gradually more experienced with the program and vendors more capable of supporting physicians. We have finalized this policy with a comment period so that we can continue to improve the program based on your feedback.

Like every other notable EHR-related legislation, the final rule came out on a Friday. Industry groups seemed mostly happy with it.


Reader Comments

From The Hurricane: “Re: [vendor name omitted]. Laying off half its employees and being folded into of the parent corporation’s entities.” Unverified. I’ll keep my eye out.


HIStalk Announcements and Requests

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Nearly 60 percent of poll respondents spend little to no time in their workday talking about patients and their needs. New poll to your right or here: How much work is your organization doing to prepare for Medicare’s 2019 issuance of new ID numbers to replace SSN?


Last Week’s Most Interesting News

  • The Department of Defense moves back its first Project Genesis Cerner go-live from December 2016 to February 2017 and says it will involve only one Washington hospital rather than the originally planned two, although the project’s 2022 completion date remains unchanged.
  • A hedge fund operator and $100 million Theranos investor sues the company for securities fraud.
  • A court orders Parkview Hospital (IN) to release its chargemaster prices and insurance company discounts after an uninsured patient says his bill, which the hospital sent off to collections, is unreasonable because insurers don’t pay the full price he’s being sued over.

Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Decisions

  • Southwest General Hospital (TX) will switch from McKesson to Cerner in July 2017.
  • Central Peninsula General Hospital (AK) went live with an Infor Lawson human resources system in October 2016 and will follow with time and attendance and payroll go-lives in November.
  • Fisherman’s Hospital (FL) will go live with a Paycom Human Resources System in October 2016.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare provider


Government and Politics

A military-focused reporter’s article on the delay in the initial rollout of MHS Project Genesis at Fairchild Air Force Base (WA) says the DoD’s new Cerner system will be interfaced to legacy systems that include AHLTA, the ancillary department systems of CHCS, and CliniComp’s Essentris. It doesn’t indicate how or when those systems will be phased out by Cerner.

Intuit and CMS release Benefit Assist, open source software that determines eligibility for income-based government benefits.


Privacy and Security

From DataBreaches.net:

  • The Russians that hacked into the Democratic National Convention servers used a phony Gmail security update message that lured users to reset their passwords, then sent them to a phony log-on page that stole their credentials.
  • The Vermont Health Connect insurance marketplace exposes the information of 700 users due to a payment contractor’s mistake.
  • Vermont’s attorney general reaches a settlement with software vendor Entrinsik to provide more explicit instructions for its business intelligence tool, which when users run reports from their browsers, sometimes creates temporary files that are not automatically erased and fails to warn users of their existence.

Innovation and Research

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CB Insights publishes a list of digital hospital technology vendors.

A UK psychiatric hospital pilots Oxehealth, which analyzes streaming video to monitor vital signs with no attached sensors and alerts staff if a patient appears to be at risk.


Other

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Surgeons at St. Vincent Hospital (MA) remove the healthy rather than the cancerous kidney of a patient after a mix-up with another patient’s CT results. Investigators also found several problems with patient ID bracelets, with a patient’s son receiving his father’s bracelet and another observed being taken to X-ray without any bracelet at all. They also noted that one patient had been registered with another patient’s name and was assigned two medical record numbers.

Texas authorities free the convicted murderer of a four-year-old boy because the county can’t afford to pay his medical bills. The inmate spent 967 days in incarceration in running up $19,000 in medical expenses, nearly 20 percent of the prison’s total annual medical budget. A local resident weighs in with the opinion that he should be just allowed to die untreated in jail as a cost for committing a crime.


Sponsor Updates

  • T-System, Vital Images, and VitalWare will exhibit at AHIMA through October 19 in Baltimore
  • .TierPoint presents “Hackers, Superstorms, and Other Disruptions” October 19 in New York City.
  • Valence Health, Verscend, and ZeOmega will exhibit at AHIP’s National Conference on Medicare, Medicaid & Duals October 23-27 in Washington, DC.
  • Visage Imaging will exhibit at Health Connect Partners October 19-21 in Chicago.
  • Wellsoft will exhibit at the ACEP Scientific Assembly through October 19 in Las Vegas.
  • ZirMed earns Frost & Sullivan’s 2016 Technology Innovation Award for revenue cycle management.
  • Zynx Health will exhibit at the 2016 Meditech Physician and CIO Forum October 20-21 in Foxborough, MA.

Blog Posts


Contacts

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

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News 10/14/16

October 13, 2016 News 8 Comments

Top News

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The Department of Defense announces that the first go-live of its MHS Genesis implementation of Cerner is scheduled for February 2017 at Fairchild Air Force Base (WA), moved back from the originally planned December 2016 date that involved two test sites. Three other Washington military hospitals will follow no earlier than June 2017.

The DoD says it pushed the schedule back to give it more time to develop interfaces to legacy systems and for system testing, as well as to allow implementing speech recognition and transfusion management. The project’s budget and planned completion date of 2022 have not changed.


Reader Comments

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From Redacted: “Re: Epic certification. Users are now required to complete proctored exams every five years for each application they’re certified in. As a consultant, it’s not the worst thing in the world for them to remove other certified people from the pond, but I have 10 certs and their time estimate is 6-8 hours for each (doubled between the assessment and booster training). Seems like a huge pain.” Unverified, although the forwarded document above appears genuine.

From Boy Blunder: “Re: Epic‘s 2016 release. My TS contact says there was a two-month period in early 2016 where the entire development division pivoted to fixing issues with the 2015 release, delaying 2016 projects. She tells me we should not upgrade to 2016 for a while because the key features won’t be added until months after the initial release, delaying the discovery and fixing of the kinks we usually find.” Unverified.

From Booster: “Re: Epic’s Boost program. It’s an attempt by Epic to provide consulting services to customers deploying new functionality or optimizing their systems. The concept has been around for years, but was only recently formalized. Boosters tend to be less available and are rarely around for more than a short engagement, with most of them on their way out of the company and working somewhere other than Madison (less than one year). It’s good in theory, but cannot get off the ground because Epic employees have such short half-lives and aren’t compensated competitively to retain them.” Unverified.

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From Little David: “Re: Hillary Clinton’s HIMSS14 speech. Did we get $225K of value?” It appears that the Secretary’s rack rate was $225K per speech, so HIMSS paid the same as everybody else. On the question of value, I’ll side with readers who observe that while we claim we want to hear selfless keynotes from patients, the size of the HIMSS crowd is always directly proportional to the fame of the presenter and Hillary (and Bill the year before) packed the house. I didn’t attend her presentation since I was tired of being at the conference before her Wednesday keynote slot, but I summarized it back then as:

I didn’t hear much about Hillary’s Wednesday keynote other than (a) it was extremely short; (b) like any skilled politician, she didn’t really say anything other than predictably lauding the work of the crowd that brought her there and kissing up to HIMSS. I would have been mad about waiting an hour or two to squeeze into the huge room for her talk given its lack of substance. Hillary’s rumored minimum speaking fee is $200K plus expenses, so she took home a big paycheck in addition to potentially impressing would-be Presidential voters who were apparently happy just to bask in her celebrity.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Healthlink Advisors. The St. Petersburg, FL-based consulting firm was founded by industry long-timer and former SVP/CIO Lindsey Jarrell, who hand-picks the people he (and the company’s client base) wants to work with based on their experience, passion, integrity, accountability, and commitment to social responsibility. Areas of practice include IT operations performance acceleration (leadership coaching, interim management, contract negotiation, application and technology rationalization, roadmaps); engagement (IT governance, system selection, program management, product and sales strategy development); and transformation (future state definition, consumer and digital engagement). I’m fascinated that one of the company’s core values that employees make healthy choices, which it supports by offering healthy foods at meetings, holding meetings while walking, requiring mandatory vacation time away from work, and insisting that no emails being sent after 10 p.m. or while the employee is on vacation. I also liked this insightful nugget in its “have fun” core value – “people leave managers, they don’t leave companies.” Thanks to Healthlink Advisors for supporting HIStalk.

This week on HIStalk Practice: Chinese Community Health Care Association moves forward with enterprise master patient index tech. Telemedicine companies offer free consults to victims of Hurricane Matthew. NextGen’s Cherie Holmes-Henry and Charles Kaplan offer advice on “Readying the Revenue Cycle for MACRA.” GMed develops patient check-in software for gastroenterologists. AmeriGroup partners with LiveHealth Online for telemedicine services in New Jersey. Health Fidelity co-founder Anand Shroff helps physicians understand the implications of risk adjustment. Zoom+ launches chat-based telemedicine app. Encompass Medical Partners gets into the IT maintenance and security game.

This week on HIStalk Connect: Pager raises $5.2 million. Proposal deadlines loom for the Stanford Medicine X | Withings Precision Research Challenge. Eccrine Systems closes $5.5 million in Series A financing. Bill Evans joins Rock Health. Charlie Rose focuses on artificial intelligence.


Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Axial Healthcare, which mines a database of 100 million patient cases to give insurers insight into risky pain care practices, raises $16.5 million in a Series B funding round, increasing its total to $26 million.

Nordic completes a minority recapitalization and announces plans to offer equity participation to all employees starting in 2017.


Sales

Providence Health & Services chooses LogicStream Health’s Clinical Process Measurement.

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Meditech customer Hays Medical Center (KS) will implement the company’s Web EHR.

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Cerner customer Olathe Health System (KS) will add Millennium Revenue Cycle and the RxStation automated drug dispensing system.

Insurer Highmark will implement Welltok’s CafeWell Rewards program for its Medicare Advantage policyholders.


People

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Family medicine practitioner Doug Spotts, MD takes a full-time role as chief health information officer at Evangelical Community Hospital (PA).

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Ascension SVP Mike Schatzlein, MD will resign effective December 31, 2016 to focus on his role as chair for the Nashville-based Center for Medical Interoperability. The non-profit was formed in 2015 with a $10 million grant from the Gary and Mary West Foundation, with membership focused on hospitals.

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Population health management technology vendor Altruista Health hires Munish Khaneja, MD, MPH (EmblemHealth) as chief medical officer.

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Zillion hires Cheryl Morrison Deutsch (Kronos) as chief experience officer.


Announcements and Implementations

T-System announces EVolvED, a low-cost, quickly implemented ED documentation system that combines T-Sheets paper documentation with a best-of-breed technology solution.

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Adventist Health System goes live on Imprivata’s PatientSecure palm vein biometric identification system.

InstaMed achieves PCI SSC Point-to-Point Encryption Standard version 2.0 validation for protecting credit card payment data, the first company in healthcare to earn that recognition.

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Portland, OR-based clinic model insurer Zoom+ launches a free medical chat service for its members that provides advice, diagnosis, treatment, prescriptions, and visit scheduling, with the chat transcript being added automatically to the EHR. I’m not sure if the apparently missing “with” in the “chat our doctors for free” page above is a mistake or intentional hipster wit.

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National Decision Support Company will debut its CareSelect Imaging decision support solution at RSNA, offering expanded Appropriate Use Criteria.


Government and Politics

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ONC and HHS OCR update their HIPAA Security Risk Assessment tool.

CMS will review MACRA-required documentation and hold regional meetings with practices in trying to reduce the clinician administrative burdens involved.


Privacy and Security

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Canada-based online medical advice startup Ask The Doctor becomes the first healthcare company to accept Bitcoin, providing users with extra privacy over charging services on their credit card. I can’t find any mention of how much the company charges to answer questions.


Innovation and Research

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Women who avoid having sex on the days a physicist’s temperature tracking app says they are fertile avoid pregnancy 99.5 percent of the time, offering the same reliability rate as oral contraceptives and condoms and much better than the 75 percent success rate of the rhythm method alone. The company is in Sweden, which is probably a good thing since its claims might otherwise interest the FDA and the lawyers of unexpectedly pregnant women.


Other

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A study of mobile health apps finds a crowded market in which downloads are limited and  declining, users aren’t willing to pay, newcomers have saturated the market, and 78 percent of publishers make less than $100,000 per year from their entire healthcare app business. Most app-related revenue comes from sales of sensors or other required hardware. Features seen as easiest to implement that have the highest user impact are personalized messages, dashboards, and the delivery of educational content. Publishers see their best hope of success as addressing users with chronic illnesses, but insurance companies haven’t shown much interest in getting them involved. Still, it’s a growing market even if it’s more competitive and selective.

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In England, St. George’s University Hospitals NHS Foundation Trust freezes all software rollouts following a June 6 infrastructure failure in which its Cerner-provided downtime system didn’t work. The trust is out of storage capacity, can’t perform backups, runs Windows XP on 2,000 PCs, and has network stability problems.

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An American Hospital Association report finds that hospitals spent nearly 40 percent more on drugs for each inpatient inpatient in 2015 than they did in 2013 due to higher drug prices rather than increased volume, saying that the price jumps “appear to be random, inconsistent, and unpredictable.” Prices increased from 52 percent to 3,263 percent for the 10 drugs on which hospitals spent the most money, with even the journeyman drug acetaminophen recording a 135 percent price increase from 2013 to 2015. It’s interesting to me that a couple of decades ago, the field of pharmacoeconomics was created to make sure drugs delivered outcomes commensurate with their cost, which turned on a light bulb over the heads of drug companies that realized they could price based on those same outcomes rather than simply defend a markup based on their research and manufacturing costs. These top 10 drugs are all old, work inarguably well for mostly specific uses, and have little competition. The pharmacoeconomics model then supports high prices and thus high drug company profits.

The local paper covers the November 1 Epic go-live at Vernon Memorial Healthcare (WI), which is working with Gundersen Health System (just writing that even with a different spelling makes me think of the police chief in “Fargo” or The Swede in “Hell on Wheels,” yah).

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I ran across an article that mentioned Twine Health, which I’ve written about a couple of times. The company’s team-based coaching and primary care app offers shared action planning among patients, coaches, and clinicians; secure messaging; real-time population monitoring; and analytics. Practices can use its system for $1 per patient per month for up to 1,000 patients. The company has raised $6.75 million in a single December 2015 funding round. The founders are serial entrepreneur and former MIT professor Frank Moss, PhD  and John Moore, MD, PhD.

A UCSF hospital medicine professor makes his case for “clinician data scientists” to analyze complex and sometimes inconsistently entered EHR patient information. He suggests training in clinical systems, data extraction, report writing, and statistical methods.

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Cerner can honestly say that the company sits at the intersection of “Health Care” and “Information Technology” as it names the streets of its new campus. Other avenues are named after medical scientists and computing pioneers.

Eighty volunteers from HCA’s IT division participated in a 36-hour “Hack the Community” hackathon in Nashville this week, supporting local non-profits with limited technology resources.


Sponsor Updates

  • Florida State University recognizes Vyne CEO Lindy Benton with its 2016 Distinguished Alumni Award.
  • Forward Health Group COO Subbu Ravi will serve on panel discussing Wisconsin state health IT initiatives at a Wisconsin Technology Council innovation lunch in Madison on October 18.
  • Iatric Systems will exhibit at the Hospital & Healthcare IT Fall Reverse Expo October 19-21 in Chicago.
  • Momentum Partners includes ID Experts in its list of top 10 private cybersecurity companies to watch in Q3 2016.
  • Impact Advisors will exhibit at the Scottsdale Institute CIO Summit October 13-14 in Scottsdale, AZ.
  • Optimum Healthcare IT posts a white paper titled “The Problem (and Solution) With Data Governance.”
  • InterSystems, Intelligent Medical Objects, NVoq, PatientKeeper, Streamline Health will exhibit at AHIMA October 15-19 in Baltimore.
  • Kyruus will exhibit at the HMA Fall Forums October 19-22 in Laguna Beach, CA.
  • MedData will exhibit at the ACEP Scientific Assembly 2016 October 16-19 in Las Vegas.
  • Meditech Senior Manager Corinne Proctor Boudreau will speak at the Western Pennsylvania Healthcare Summit October 14 in Pittsburgh.
  • Nordic will sponsor Piedmont Healthcare’s Southeast User Group Meeting October 18 in Atlanta.
  • NTT Data announces its return to Chip Ganassi Racing Teams.
  • Obix Perinatal Data System will exhibit at the ACOG Annual District II Meeting October 21 in New York City.
  • Recondo Technology will present at the Michigan HFMA Fall Conference October 17 in Plymouth.
  • Experian Health will present at NEHAM October 17-18 in Providence, RI.
  • Red Hat accepts speaking proposals for Red Hat Summit 2017 through December 2.
  • The SSI Group will exhibit at the AHCA/NCAL Annual Convention & Expo October 16-19 in Nashville.
  • Sunquest Information Systems will exhibit at ASHG 2016 October 18-22 in Vancouver.
  • Sutherland Healthcare Solutions VP and Global Health of RCMS Healthcare Tina Eller will speak at the Region 2 HFMA Fall Institute Conference October 20 in Verona, NY.

Blog Posts


Contacts

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

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Morning Headlines 10/12/16

October 11, 2016 News 2 Comments

Unintended Consequences of CPOE

An emergency physician describes an event in which an intern using a CPOE system they were unfamiliar with ordered a CT scan of the abdomen and pelvis with contrast, and then separately ordered oral contrast, the combination of which resulted in contrast nephropathy.

Epic Fact Check

Epic responds to a recent Jonathan Bush interview during which he suggests that achieving interoperability with Epic sites was difficult until recently.

Google DeepMind has doubled the size of its healthcare team

Google’s UK-based AI team DeepMind has doubled its healthcare division from 20 to 40, including some of the biggest names in the AI industry.

Siemens Healthineers and IBM Watson Health Forge Global Alliance for Population Health Management

Siemens Healthineers announces an agreement to start reselling IBM Watson as part of a new population health management solution.

News 10/12/16

October 11, 2016 News 2 Comments

Top News

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Hedge fund operator Partner Fund Management sues Theranos for securities fraud, saying Theranos and CEO Elizabeth Holmes told “a series of lies” about its lab testing capabilities and prospects in soliciting a $100 million investment.

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Above is Holmes holding the company’s remaining credibility.


Reader Comments

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From Ken Bone: “Re: Athenahealth. JB got Trumped.” Epic posts a fact check for a recent interview with Athenahealth’s Jonathan Bush. Thankfully, JB’s brother Billy was not available to facilitate an uncomfortable Judy-JB hug.

From Looming Presence: “Re: HIStalkapalooza. Here’s video of Jonathan Bush doing his Donald Trump imitation at HIStalkapalooza earlier this year.” I had forgotten about that. JB, the most politically connected person in health IT, has said that he can’t support his Republican party’s nominee in calling him “a clinical narcissist” and “a wack job,” but says he’ll vote Libertarian instead of Democratic, explaining, “Why going for the nut on the right or the nut on the left when you can have the Johnson?” Bush downplayed his own political aspirations a few weeks ago by saying, “We need another Bush like I need a hole in my head,” although technically speaking, all of us need a hole in our head, just not another one that isn’t a mouth, nose, eyes, or ears (or in cases of emergency, a surgical trepanation). 

From PitViper: “Re: blockchain conference in Nashville last week. Humana’s CIO gave the keynote and his team participated in many of the breakout sessions. Nothing is production-ready and vendors themselves admit the technology is immature, but the ideas are interesting and if there’s truly a common trusted data layer in our future, it will address a lot of the issues we face.”


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Agfa HealthCare. The company, which provides eHealth and digital imaging solutions to half the world’s hospitals, offers Care You Can See, an enterprise-wide approach to medical imaging that provides a single patient record within a single EHR view. Its product line includes enterprise imaging (VNA, universal viewer, ECM, image exchange, patient portal, scheduling, business intelligence and clinical apps); integrated care (data aggregation for multiple sites, patient engagement); and digital radiography. The company focuses its radiology commitment to maximize the value of medical images within an interoperable ecosystem to support collaboration and the availability of image to all caregivers under value-based care. Its Engage suite provides a first step toward an integrated care model, offering patient-centric views and actions, native mobile functionality, support for clinical networks, and integration with third-party systems. The company is the #1-recommended image sharing vendor in a recent Peer60 report. Thanks to Agfa HealthCare for supporting HIStalk.

Here’s an Agfa HealthCare intro video I found on YouTube.


Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates "stickiness," and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Siemens Healthineers will resell  IBM Watson Health’s population health management solutions. The companies will also work together to create new solutions in a five-year strategic alliance.

3M Health Information Systems and Verily Life Sciences will work together to analyze population-level datasets into usable quality measures for complications, readmissions and mortality, and cost.

Pharmacy software vendors Rx30 and Computer-Rx announce their merger.


People

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AMN Healthcare-owned contingent workforce management systems vendor ShiftWise names Steven Rodriguez (Asure Software) as president.

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Outpatient rehabilitation therapy technology vendor Clinicient hires T. Kent Rowe (ZirMed) as CEO.

CTG promotes Rick Sullivan to VP of strategic staffing services.


Announcements and Implementations

HIMSS Europe is conducting a “Women in Health IT” survey whose results it will use to tailor future female-focused offerings. 


Privacy and Security

In India, Chennai city police have filed 43 cases against people they say have spread rumors about the health of the chief minister of Tamil Nadu, who has been hospitalized since September 22. The latest two arrests are of a website manager who published audio claiming to be from an Apollo Hospitals employee and an IT engineer who they said posted false information on Facebook. They’re charged under a law prohibiting statements intended to cause public panic.

The incarcerated human rights activist who coordinated an Anonymous-led denial-of-service attack against Boston Children’s Hospital in April 2014 to protest the involuntary commitment of a teenager stages a hunger strike to protest behavior modification programs for non-adults.


Technology

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China-based search engine Baidu launches Melody, a smartphone chatbot app that asks consumers AI-generated questions in performing basic triage before sending the information to a doctor to take over. The company says it’s talking to US healthcare companies as a potential market.

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London-based, Google-owned DeepMind has doubled its team to 40 employees since its February 2016 launch, hiring experts in artificial intelligence and from the NHS to help develop its products.


Other

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The Wall Street Journal says apps that help migraine sufferers predict their attacks or identify their triggering factors hold promise, but they struggle to distinguish triggers (causation) from warning signs (correlation).

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CMS Acting Administrator Andy Slavitt is one of my favorite tweeters, with refreshing recent examples above.

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Family physician, CMIO, and AAFP board member Carl Olden, MD says that EHRs provide important benefits despite the extra work they require of doctors. He suggests that documentation responsibilities be spread to non-physician care team members and that payment reform “get us off the E/M treadmill.”

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An emergency medicine professor blames CPOE for an error in which an intern ordered “CT Abdomen and Pelvis with contrast” and somehow thought she would need to order oral contrast separately, which she did in sending the patient into contrast nephropathy when both agents were administered. I disagree with blaming CPOE for these reasons:

  • The intern ordered an item without understanding it.
  • The same error would likely have occurred with paper-based ordering, especially if the hospital was equally sloppy in how it phrased the orderable’s description on paper.
  • All the other doctors appeared to have understood and used this orderable without problems. 
  • Receiving a non-paper, non-verbal order does not eliminate the responsibility of the employees acting on it to review it for mistakes, electronic or otherwise.
  • It’s hard to understand how an undertrained intern’s one-off mistake – without the author’s seeing even basic evidence, such as how the hospital built the pick list in question — provides sufficient rationale to throw CPOE under the bus.
  • I agree with only one point of the article – system administrators should monitor cancelled or replaced orders to help them understand where there system setup might be confusing users.

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Kaiser Permanente CEO Bernard Tyson says in a conference presentation that 52 percent of KP’s 2015 physician-member interactions were conducted via technology rather than face-to-face visits. The article’s author calls those encounters “virtual visits,” but I would bet that the huge number is mostly portal text messages, refill requests, and lab test communication. KP has turned in those big numbers going back to at least 2014, so this is really not news.

Canada-based drugmaker Valeant, known for acquiring old drugs and then jacking up their price, does it again with a drug for lead poisoning it bought in 2013, raising its price from $950 to $27,000. The company’s excuses (short shelf life, low sales volume) don’t hold much water since they haven’t changed since the previous owner was presumably making a nice profit at $950.

An expert criticizes vendor-operated company wellness programs, saying that data from the program that was recently chosen as the industry’s best suggests that employees were actually harmed rather than helped. He also cites the 2015 winner McKesson, who claimed savings despite no change in employee biometric risk factors.

In India, illegible doctor handwriting forces medical examiners to switch to computer-completed autopsy forms that police and juries can more easily read.

The Atlantic profiles Tristan Harris, a former Google employee who created an advocacy group called Time Well Spent that is trying to convince app developers to take a Hippocratic Oath that they won’t turn their users into slot machine-like tech addicts by exploiting their psychological vulnerabilities. He says app developers are like junk food vendors in introducing the digital version of sugar, salt, and fat into their apps to profitably satisfy user craving in earning “likes” and impressive LinkedIn connections via pointless yet hypnotic auto-play videos and clickbait stories. He’s thinking about developing an app to measure app usage vs. user-reported benefit in calling out apps that create addiction without satisfaction. Harris responds to the magazine’s reporter who expresses anxiety at trying not to check his cell phone during their interview:

Our generation relies on our phones for our moment-to-moment choices about who we’re hanging out with, what we should be thinking about, who we owe a response to, and what’s important in our lives. If that’s the thing that you’ll outsource your thoughts to, forget the brain implant. That is the brain implant. You refer to it all the time.


Sponsor Updates

  • AHIMA will add Meditech’s EHR to its Virtual Lab for HIM student training.
  • Haystack Informatics publishes a white paper on insider data breaches.
  • Aprima will exhibit at the Texas Association of Community Health Centers meeting October 17-18 in Dallas.
  • Arcadia Healthcare Solutions CMO Rich Park, MD will present at the inaugural meeting of the American Association of Strategic Regional Organizations October 17 in Philadelphia.
  • Bernoulli will exhibit at AARC16 October 15-18 in San Antonio.
  • Besler Consulting, Clinical Architecture, Direct Consulting Associates, and FormFast will exhibit at AHIMA October 15-19 in Baltimore.
  • The Chartis Group adds three principals: Mary Jo Morrison, Mark Pasquale, and Robert Schwartz, MD, MPH. 
  • Besler Consulting releases a new podcast, “Five keys to mitigating risks associated with hospital-physician contracting.”
  • Dimensional Insight and Hayes Management Consultants will exhibit at the Centricity Healthcare User Group October 13-15 in Austin.
  • MedScape includes E-MDs as a leading vendor for usability and customer satisfaction in its latest EHR report.
  • Elsevier Clinical Solutions features predictions from Geeta Nayyar, MD in its celebration of 100 years of medical clinics.
  • EClinicalWorks will exhibit at the AOAO Annual Meeting October 13-15 in Washington, DC.
  • HCS will exhibit at the NASL annual meeting October 16-18 in Nashville.Healthgrades will exhibit at the Built in Colorado Fall Startup Showcase October 13 in Denver.

Blog Posts


Contacts

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

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Morning Headlines 10/10/16

October 9, 2016 News No Comments

Court won’t take Parkview rate suit

Parkview Hospital (IN) has been ordered to release its chargemaster prices and insurance discounts after an uninsured patient that was charged $625,000 for his care sues the hospital, arguing that the bill is inflated and unreasonable since insured patients receive the same care at a significant discount.

Physicians’ Take on EHRs

A Peer60 survey of physician EHR satisfaction finds that usability and missing functionality still top the lists of physician frustrations.

Millions of Australians caught in health records breach

In Australia, Health Minister Sussan Ley apologizes at the annual conference of the Royal Australian College of General Physicians after the health department inadvertently published confidential data from three million patients.

How body-worn cameras improve EMS documentation

A pilot study finds that EMS documentation improves significantly if body-worn cameras are used so that EMS staff can review events after care is delivered.

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