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Curbside Consult with Dr. Jayne 7/17/17

July 17, 2017 News No Comments

There’s a well-known quote attributed to Henry Ford: “Quality means doing it right when no one is looking.” Sometimes that’s a hard sell for organizations that haven’t done the cultural transformation work to make it a reality. Practice administrators sometimes make excuses for this with the old adage, “When the cat’s, away the mice will play” or try to convince me that their team just tends to slack off.

Usually this conversation segues right into the concept that what gets measured gets managed, and that there are ways to motivate people that don’t always involve having a manager looking over their shoulders. Quality is often driven by the goals we set for people – whether they are goals related to compliance with a specific processes or to a desired outcome.

I’m a big fan of setting both individual and organizational goals. I’ve worked with too many organizations that either set one or the other, or try to blend goals but give too much weight to one. When individuals are overly incentivized without the right systems in place, we sometimes see a breakdown in teamwork.

I’ve seen members of consulting teams who jeopardize their clients’ success by scheduling them far into the future when other team members have current capacity — to make sure they hit their billable metrics. Others may create their own collateral and tools and not share with peers because they feel it offers them a competitive edge. They don’t believe that the rising tide floats all boats, but rather seem to be focused on making sure their boat doesn’t take on any water and stays farther ahead than the competition.

When organizations swing too far to the group incentive side, I tend to see formerly hard-charging individuals begin to withdraw. They may feel that the group is pulling them down or that they aren’t empowered to lead the group to higher levels of achievement. If the group incentives aren’t aligned with what individuals can actually impact, we sometimes see outright apathy.

I saw this recently with a group of workers who previously had individual productivity goals that were directly tied to tangible bonuses and were then shifted to a bonus framework that was tied exclusively to the overall financial performance of the hospital. They had done a great job controlling their own costs and utilization metrics under the previous system, but were disheartened at knowing that poorly performing departments would likely cost them their bonuses in the coming year. Since there weren’t any cross-functional initiatives to take the successes from one team and implement them elsewhere and there weren’t any ways for the teams to work together, they saw it as a lose-lose situation and their own performance suffered.

These are always challenging issues to deal with in healthcare, where our ultimate customer is a patient with a health need. It sometimes feels crass to talk about processes and metrics when you’re working with a certain quantity of human suffering in the equation. Of course, there are extremes: organizations that seem to treat the patient like a widget that can be moved from point A to point B and always with the same characteristics. Such organizations are often accused of being heartless or profit-driven, regardless of their not-for-profit status. The other end of the spectrum often fails to understand the business ramifications of their processes and decision-making or refuses to factor in efficiencies due to the perceived uniqueness of each patient’s or worker’s situation.

As with many things, the answer is typically somewhere in the middle and this also applies to how we incentivize our teams. In addition to balancing individual goals, we also need to look at blending both short-term and long-term goals. When the finish line (or the prize) is too far in the future, it’s hard to stay motivated.

This is the particular challenge we are seeing in trying to motivate physicians and their teams to fully engage with quality initiatives. I think many of our friends in government assume that physicians are motivated by money, hence the way regulatory programs have been structured. Although a good number of physicians took advantage of the incentives or finally jumped in to avoid the penalties, others were more motivated by the idea of autonomy and continue to opt out. One could argue that the incentives (or penalties) weren’t large enough to meaningfully hit people in the pocketbook, but that only applies to some.

Autonomy can sometimes be a negative force when we’re looking at clinical transformation, as providers feel that “their way” is better than that of their peers and don’t want to come together to participate in common care paths or clinical protocols. I’ve seen this to the point of irrationality, where one physician was willing to leave the practice because her personal colorectal cancer screening protocol (which incidentally didn’t mesh with current available data) was not built into the EHR’s clinical decision support framework. Providers like this are the same ones who argue with me when I recommend posting signs for diabetic patients to remove their shoes (shown to increase the percentage of diabetic foot exams) because they have any number of reasons they disagree with it.

In order to be successful under new value-based care systems, we have to let go of some of that autonomy and figure out how to align our individual goals with those of both small (practice) and large (ACO) organizations. We also have to design systems to address short term “wins” such as a more efficient workday that will help get people to the right psychological space to play the longer game with quarterly holdbacks and annual payer incentives.

Finding the right way to motivate people is always a challenge. Physicians tend to be at least a little competitive, having been through the process of medical school admissions, residency matching, and finally entering their fields. Some will be motivated by seeing their performance against their immediate peers, such as partners or hospital data, more than they will be motivated by national benchmarks. Those individuals love real-time reporting or as close to real-time as their technology will allow. They may be more willing to participate in operational tweaks to streamline outcomes and have a vested interest in being part of the solution. Others who are less competitive or unsure of their own abilities tend to shy away from those frameworks, needing more individual coaching or peer-to-peer involvement to be successful.

This spectrum varies across specialties as well. Some have been used to publicizing complication rates for some time, where others find this brand new. One has to be careful with competition though, especially when you’re dealing with top-caliber people and processes. I am working with one organization where all of their providers are routinely in the top decile for various care metrics, if not in the top 3-5 percent. Pitting them against each other isn’t going to be productive from an efficiency (or psychological) perspective.

There’s no magic recipe or secret sauce on how to incentivize people. The best advice I can offer an organization is for them to spend time and energy consciously thinking through these concepts and working with their managers and employees to find a solution that will motivate them to excellence. Assuming it’s one size fits all is a mistake but one that I see all too frequently, as is assuming that people are just intrinsically motivated to do the right thing.

How does your organization motivate people? Email me.

Email Dr. Jayne.

Emids Acquires Encore Health Resources

July 17, 2017 News No Comments

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Global health IT services provider Emids has acquired Encore, A Quintiles Company, the company announced this morning. Terms were not disclosed.

Pharma development services vendor Quintiles acquired 300-employee Encore Health Resources in 2014 for an unspecified price. Quintiles merged with competitor IMS Health to form QuintilesIMS in a $9 billion deal in May 2016.

Encore will be operated as an Emids business unit under Tom Niehaus, president and CEO of Encore. Encore co-founder Dana Sellers will join the Emids board. Encore has 200 consultants.

Sellers and Ivo Nelson launched Encore Health Resources in early 2009 with headquarters in Houston, focusing on EHR-related services. The company gradually transitioned into analytics.

Nashville-based Emids also has offices in London and Bangalore.

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Emids Founder and CEO Saurabh Sinha said in a statement, “As healthcare becomes more integrated and the focus on consumerism grows, payers and providers are working more closely together. The ability to provide healthcare technology expertise and solutions that serve both payers and providers, as well as healthcare technology partners, will be critical to help our customers succeed in the future.”

Monday Morning Update 7/17/17

July 16, 2017 News 3 Comments

Top News

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Athenahealth CFO Karl Stubelis resigns “to pursue other opportunities” after just over a year on the job. Board member Jack Kane has been appointed to serve as interim.

Stubelis’s predecessor Kristi Matus resigned in May 2016 “to pursue other challenges” that her LinkedIn profile suggests she hasn’t found yet.

ATHN shares closed up 2 percent Friday on the news, but the year-long price chart is basically flat.


Reader Comments

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From IT Guy: “Re: expensive implementations like at Mayo Clinic. Same thing is going on at NYCHHC. With the total cost of some of these implementations, these hospital systems could literally BUY an HIT vendor.” We had that discussion many years ago at my hospital, where I somewhat jokingly suggested that we buy the company instead of its product since the investment wasn’t much different and we could at least control our own destiny. We also signed up with a desperate vendor that we privately worried we would drive out of business via the overly generous contract they signed in trying to meet that quarter’s revenue target. Don’t forget, however, that the software vendor’s licensing fees are a tiny chunk of the contract’s value, with most of the cost being labor (both internal and external), third-party licenses, and hardware. A $1 billion Epic implementation does not mean the health system writes Epic a $1 billion check. It’s also true that the client would have borne some of those expenses anyway – it’s not like they went from paper to Epic, they were already paying contract fees and labor for the legacy systems being replaced and the savings will offset some part of the new system’s cost. Finally, a lot of the figures you see are just a rumored number with no confirming detail.


HIStalk Announcements and Requests

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More than half of poll respondents spend one hour or less each week on Facebook, with many of those not using it at all. Thirty-eight percent are on the site for one to 10 hours, while around five percent of respondents spend more than 10 hours weekly on Facebook. I can’t personally imagine that the seven people who park for 20 or more hours each week won’t eventually regret spending a big chunk of their lives staring at an imaginary world instead of taking 10 steps outside to see the real one where actual people and experiences live, but that’s just me. Quite a few people live under the illusion that they aren’t under Facebook’s spell, a premise easily disproven by observers who can plainly see how often and how long they are entranced by it on their PCs and phones.

New poll to your right or here: of the endless number of awards available in healthcare — most of them created solely to advance the agenda of the awarder – which ones do you think are meaningful? (you can choose more than one). Click the Comments link on the poll after voting to explain.

I was reading yet another celebratory announcement about a donor who funded the purchase of some hospital’s new diagnostic imaging machine as a benefit to the community. I’m puzzled why it’s a community benefit since the hospital isn’t going to perform those procedures for free (begging the question, why not?) The hospital will undoubtedly profit from cranking out more billable procedures on the machine, paid for by the insurance companies of those same community residents and thus raising the costs for all. As I’ve said before, I’ve spent most of my career working for hospitals and never, ever would I donate money to one or mistake them for a charity rather than a business of questionable motivation and management.

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I’ve just about run out of DonorsChoose money even though I have matching funds left, but the project we funded for Ms. A in South Carolina  was a big hit as her students “clapped and cheered” when their new “teacher’s table” arrived, giving them a space to work on small group projects.


This Week in Health IT History

One year ago:

  • Hacker The Dark Overlord lists the digital assets of breached healthcare IT vendor PilotFish Technology on the Dark Web.
  • The VA hires KLAS for $160,000 to advise in on an EHR selection.
  • Philips acquires Wellcentive.

Five years ago:

  • Dissident Quality Systems shareholder and board member Ahmed Hussein launches his fourth attempt to take control of the company by nominating his own board.
  • The CDC reports that 55 percent of US doctors use some type of EHR, with an 85 percent satisfaction rate.
  • SAIC announces that it will acquire MaxIT Healthcare for $473 million.
  • Microsoft reports the first quarterly loss in its 26-year history as a publicly traded company, triggered by a $6.3 billion write-down of its purchase of ad platform AQuantive.

Ten years ago:

  • Cerner announces the retirement of 48-year-old COO Paul Black.
  • A Modern Healthcare editorial says “national interoperability can wait” and instead advocates the use of patient-carried smart cards that contain information downloaded from each provider’s EHR.
  • McKesson announces plans to acquire Awarix.

Weekly Anonymous Reader Question

Responses to last week’s question:

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  • Evernote has become my go-to app for everything from minutes, notes, and online article indexing to creativity with its drawing capabilities. All data elements are available on all devices, which alleviates access issues, especially for those of us with a hectic travel schedule.
  • I use the Hemingway Editor to trim emails and write-ups. Brevity is a virtue.
  • OneNote. I use it to organize meeting notes and key documents that are needed for reference. I take handwritten notes during conference calls and then take photos of the notes to post in OneNote for recall later.
  • CamScanner on my smart phone to create PDFs. Allows me to work on expenses during my travel — no scanner required.
  • FollowUpThen.com, a free service that automatically reminds you about emails you send to other people after whatever time you specify elapses. For example, if I email my co-worker asking for some information or action, I can add 2days@followupthen.com in the BCC field, and I’ll get a reminder in two days about it. If I put the email address in the CC field instead, we’ll both get reminders. It’s like a nearly-automatic task list for email follow-up.
  • Any time (iPhone or http://e.ggtimer.com/) where I can put 60-90 minutes on the clock, turn my phone over, minimize Outlook, and dig into something without interruptions. That and Evernote.
  • Evernote. Love being able to synch notes between my ipad, PC, and phone. Use it for everything from meeting notes to grocery lists.
  • OneNote. It’s an amazing tool for keeping me organized and I’m sure I don’t even use a fraction of its capabilities.
  • Google Inbox.
  • Outlook. As much as I have a love-hate relationship with it, it has a fair amount of flexibility to do the things your need if you spend the time to set it up fully.
  • Excel. I can dump and sort data there. If I’m trying to reason something out, I can structure my thoughts in a list or table and easily add rows/columns.
  • Tiny Scanner. Mobile scanning app, free, and it has saved my neck so many times.
  • Datawatch’s Monarch software. I was a programmer/analyst before I retired but when I worked there wasn’t a day that went by where I didn’t use Monarch for data/problem analysis. You could create ad hoc extracts or put code in scripts using Monarch to extract data from downloaded reports and delimited or fixed length files. Coupled with some other free or inexpensive software that ran in DOS (and its successor environments) like febootimail, WinSCP, etc., I could put together a script that grabbed a standard report from an HIT system, separated the wheat from the chaff, put it into a human- or machine-readable format and email/FTP the output, typically in less than a couple of hours. I’ve been out of the HIT biz for a few years now and I still use a personal copy of it from time to time.
  • SelfControl www.selfControlapp.com. Free open-source application for Mac OS. It lets you block your own access to distracting websites, your mail servers, or anything else on the Internet. Just set a period of time to for blocking, add sites to your block list, and start. Until the timer expires, you will be unable to access those sites–even if you restart your computer or delete the application. ColdTurkey https://getcoldturkey.com, Flexible and difficult to circumvent. Dashboard accommodates a weekly schedule, including a lock to prevent the impulse to make changes during the lock time. It accepts brea ktime between work periods. It will allow for setting up blocking everything except for a few sites, or the entire Internet, and offline games. Wonderful for assuring sleep time with Frozen Turkey, a feature which assures you’ll be locked out of your device for a specified period of time. It is also activated 10:30 p.m. to 6 a.m. on kids’ devices during the week.

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This week’s question: How well does your boss know you and your family socially? What off-work interaction do you have?


Last Week’s Most Interesting News

  • Mayo Clinic goes live on Epic at the first sites of its $1 billion implementation.
  • Cerner Chairman, CEO, and co-founder Neal Patterson dies of cancer at 67.
  • Jawbone’s financial pressures lead to its planned shutdown, with its founder moving on to data acquisition and analysis vendor Jawbone Health Hub.
  • Some Nuance cloud-based systems remain unavailable to users nearly three weeks after its June 27 cyberattack.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Collectly — which offers EHR-integrated personalized debt collection programs with a focus on physician practices — raises $1.9 million in seed funding. The company charges a flat rate of 10 percent of collected debts that are less than six months overdue.


Sales

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Baylor Scott & White Health (TX) chooses Kyruus for provider search and scheduling across its 48 hospitals and for its API-powered ability to match consumer-reported conditions and symptoms to potential providers on its website.


Decisions

  • Mary Starke Harper Geriatric Psychiatry Center (AL) went live on CoCentrix in 2017.
  • Cozad Community Hospital (NE) will replace NextGen Healthcare’s revenue cycle management software.
  • Several Select Specialty Hospital locations will implement Epic.
  • Treasure Valley Hospital (ID) will replace Healthland with Cerner in July 2017.
  • Saint Thomas Highlands Hospital (TX) will implement Cerner in October 2017, replacing Medhost.

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


People

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Howard Landa, MD (Alameda Health System) joins Sutter Health as VP of clinical informatics/EHR.

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Stony Brook Medicine hires Kathy Ross, MBA (Ascension Health Services) as CIO.


Announcements and Implementations

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A tiny Reaction survey of 113 ambulatory providers finds that a significant percentage of them trust EHR vendors less in general following news that EClinicalWorks paid $155 million to settle Department of Justice charges, with two-thirds of them also indicating that they probably won’t consider buying EClinicalWorks in the future.


Other

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The local paper covers the replacement by Kittitas Valley Healthcare (WA) of its NextGen, Empower Systems, McKesson Paragon, and McKesson Horizon Home Care with Cerner.

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Interesting: a failing, formerly county-run Alabama hospital prevails in a four-year-old legal battle over the 12 citizens of China it recruited to invest $500,000 each in return for a fast-tracked citizenship via a federal government program. US Citizenship and Immigration Services rejected the application in saying that the hospital didn’t meet the federal government’s definition of a “troubled business” that would allow wealthy foreigners to buy their US citizenship via investments.

Here is Part 2 of Vince’s HIS-tory of Cerner from a few years back. It’s fascinating to read about Cerner predecessor PGI’s fortuitous entry into health IT when lab systems were catching on and the big players were HBO, Spear, BSL, MedLab, SMS, and McAuto, all long gone since those heady days of 1980. I saw some familiar but also-dead companies on his 1988 list – TDS, Antrim, Citation, and Terrano, for example. I’m peeking ahead at Vince’s next episode and I’m fascinated about how the name Cerner was chosen and by whom.

Weird News Andy pitches a new TV series he’s calling “Ambulance Wars,” even providing a tagline of “Both companies are losing patients.” Houston-area Republic EMS sues rival City Ambulance and its president Mohammad Massoud, claiming that City Ambulance vandalized its ambulances a dozen times in retaliation for losing business and employees to Republic. Republic says City Ambulance hired people to shoot out its ambulance windows, cut the brake lines of one of its ambulances, and covertly installed GPS trackers on its ambulances to harvest client addresses for follow-up advertising.


Sponsor Updates

  • Optimum Healthcare IT posts a study of its work on Allegheny Health Network’s Epic Community Connect.

Blog Posts


Contacts

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

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News 7/14/17

July 13, 2017 News No Comments

Top News

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An HHS OIG report finds that one out of three of Medicare Part D’s 44 million prescription drug coverage beneficiaries filled at least one opioid prescription in 2016 at a taxpayer expense of over $4 billion.

Alabama and Mississippi led prescribing rates, as nearly half of their Part D patients received opioids.

HHS finds that 90,000 people are at risk of misuse or overdose due to high doses or apparent doctor-shopping. One patient filled 11 opioid prescriptions in a single month from eight prescribers and six pharmacies across five states.

The report says prescribers must use state PDMP doctor-shopping databases, recommends that HHS crack down on doctors who overprescribe opioids for possible patient resale or recreational use, and urges improved public health surveillance and advancement of pain management practices. 


Reader Comments

From Mel Practice: “Re: lab results. We had a patient harmed because the lab didn’t receive their orders from the EHR due to interface problems. For HIStalk readers, do your nurses track pending results and follow up with the lab or does the EHR auto-alert the provider if no results are reported? What happens when the lab receives a specimen without an order?”


Webinars

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


Acquisitions, Funding, Business, and Stock

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Five-employee, Seattle-based BloomAPI raises $2.4 million in venture funding to continue development of its EHR information exchange and record release and technology. Founder Michael Wasser also co-founded insurance signup site HealthSherpa as an alternative to Healthcare.gov.

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Venture capital firm Canal Partners sells its stake in rehab and therapy EHR vendor WebPT to Battery Ventures for 16 times its original investment.

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A Craneware trading update says the company expects to report double-digit revenue and earnings growth in its September report, also noting the first sale of its cloud-based Trisus Claims Informatics solution.

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Social services coordination platform vendor Healthify raises $6.5 million in a Series A funding round led by BCBS Venture Partners, increasing its total to $9.5 million.

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The fading-fast Theranos lists its Palo Alto, CA headquarters building for partial or complete sublease.

Minneapolis-based medical liability insurance vendor Constellation sells its health IT consulting and analytics business (MMIC Health IT) to Med Tech Solutions.


Sales

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New York-Presbyterian (NY) chooses Epic to replace several systems, most notably those of Allscripts. MDRX shares have declined in price by around 7 percent following analyst reports stating that NYP is the fifth-largest Allscripts Sunrise EHR customer, representing 6 percent of its installed base and contributing up to $30 million of the annual revenue of Allscripts.


People

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Merrie Wallace, RN, MSN (Premier) joins PerfectServe as chief revenue officer.

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SPH Analytics hires Suzanne Cogan, MBA (Orion Health) as chief commercial officer.

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AuntMinnie.com International Editor Eric Barnes died July 5.


Announcements and Implementations

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USC’s Keck Medicine (CA) goes live on QGenda for publishing ambulatory clinical and call schedules.

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Datica publishes its Digital Health Success Framework, which helps digital health developers “take products from napkin scribble to market without any snags.”

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Health Fidelity launches a patient data acquisition and aggregation platform for providers and health plans, with its first customer Mount Sinai Health Partners (NY) using it to automate retrieval of Epic patient records for review in bypassing the use of extract-transform-load tools.

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Healthcare Growth Partners publishes its mid-year health IT market review, which notes that while digital health investments have increased dramatically, mergers and activities haven’t quite kept up. The economic analysis is, as always, near-poetic in its brilliance:

Last year, HGP discussed the concept of Exploiters and Solvers in the healthcare industry. The US healthcare economy is indisputably inefficient. Inefficient markets create opportunities for exploitation or solution. Exploiters seek to exploit inefficiencies to maximize returns for a select few. Solvers seek to eliminate inefficiencies to maximize returns for many. In the context of healthcare, one can quickly see the potential for moral hazard. Martin Shkreli, for example, is an egregious exploiter.

However, exploiting versus solving in healthcare cannot be taken at face value because economic interests often do not align with patient interests. Martin Shkreli is chastised for his actions, but many stakeholders in the healthcare industry pursue some degree of self-interest at the expense of patients that ultimately utilize their product. Two non-profit health systems in the same region may compete at the expense of the patients they serve. Shkreli just crossed the subjective line of moral hazard.

The basic economic pricing model underscores the disconnect. Pricing is generally the equilibrium (or optimization point) between profit and quantity based on the consumer’s perceived value of the product. In practical terms, this means that a product is priced as high as a customer can bear before choosing a substitute product. The latter definition of pricing certainly sounds like a moral hazard in the context of healthcare, and it would be if the patient were the customer. However, the patient is not the customer because he or she is not part of the economic equation to establish price equilibrium

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Piedmont Atlanta Hospital (GA) rolls out Atlanta-based Gozio Health’s mobile way-finding app.

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Mayo Clinic’s first sites go live on its $1 billion Epic system.


Government and Politics

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HHS’s Medicaid Strike Force charges 412 defendants — including 115 licensed professionals – with fraudulently billing $1.3 billion in medically unnecessary services, many of those incidents involving patient recruiters who were paid kickbacks to provide patient information. Of those charged, the DOJ says 120 were prescribing and/or distributing opioids. 

Paralyzed Veterans of America urges the VA to focus on moving ahead with its Cerner contract negotiation and implementation, explaining that the organization believes that, “Cerner Corp. holds the key to saving the lives of disabled veterans in the future, and doesn’t want it waylaid by political posturing about the bigger healthcare debate.”


Privacy and Security

In England, the government pledges $27 million to help hospitals update their IT systems to protect them against ransomware. NHS Digital will also issue cybersecurity threat alerts, staff an incident hotline, and conduct onsite security assessments.


Other

Here’s Vince’s HIS-tory of Cerner, Part 1 from a few years back to pay tribute to Neal Patterson. I’m thinking about re-running the remaining five parts of the series since I enjoyed them the first time around.


Sponsor Updates

  • Optimum Healthcare IT is named a top-rated implementation services firm in a new KLAS report.
  • EClinicalWorks describes how its Healow Kids mobile app connects parents with their child’s pediatrician.

Blog Posts


Contacts

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

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News 7/12/17

July 11, 2017 News 2 Comments

Top News

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A memorial service for Cerner co-founder, CEO, and chairman Neal Patterson will be conducted at 11:00 a.m. Central time Thursday at United Methodist Church of the Resurrection in Leawood, KS. The service will also be live-streamed.

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Patterson’s extensive and well-written obituary was published in the Kansas City Star and on Cerner’s site.


Reader Comments

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From Park City: “Re: Rick Adam. Seems to have left Stanson Health and is now CEO of some Intermountain spinoff called Empiric.” Rick’s LinkedIn profile shows the new job, but it also continues to list his position as president/COO of Stanson and he remains on Stanson’s executive page. The website of Empiric Health says its program is based on Intermountain’s ProComp program. It appears to offer evidence-based, analytics-powered process improvement. Empiric was formed in February 2017 by Intermountain and venture capital firm Oxeon, with Loma Linda University Health as its first customer.

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From The Care Rationer: “Re: EviCore. Being bought by UnitedHealth Group.” Unverified, but not surprising if true. The South Carolina-based specialty benefits manager, which focuses on evidence-based cost reduction, was rumored earlier this year to be seeking a sale or IPO, valuing itself in the $4 billion range. The company was formed via the December 2014 merger of CareCore and MedSolutions.

From MerryMe: “Re: IQPC. They reach out to us (as a vendor) about attending their CIO Healthcare Exchange in October in Dallas, dropping a lot of big-hospital names. Is this a viable CIO/CMIO event that would be worth investing in as a sponsor?” I’ll invite readers to comment since I’ve never heard of the event. It’s one of those where the attendees (who I assume get free attendance in the “ladies drink free” model that I’ve experienced) are forced to schedule time with vendors who have paid for captive access to them. Of the 10 listed speakers, four are health system CIOs. The conference is run by IQPC, which claims to offer 2,000 events each year, of which a few are related to healthcare. Sponsors can buy whatever level of influence they can afford – a keynote panel moderator slot, a plenary session speaking session (“the grandest speaking platform at the event”), a half-group session that “is positioned to present the sponsor as a master in the topic,” or the usual giveaways such as meals, WiFi, or hotel key cards.


HIStalk Announcements and Requests

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I incorrectly reported a promotion at Agnesian HealthCare (WI) on Monday. Nancy Birschbach is still VP/CIO – the promotion involved the CFO position, not the CIO role.

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I’m getting increasingly frustrated by Spotify, of which I’m a premium subscriber. Every time I click the desktop icon, it launches a clunky web page that runs a software update. It used to just do the update automatically upon launching. That’s a minor problem compared to users and web publishers who host their images on the formerly free Photobucket, which in a desperate bid for revenue after adblockers killed its already shaky ad-supported model, decided without warning to start charging users who display their photos on other sites (which is nearly all of them) $400 per year. That action suddenly left broken images all over sites like Amazon, Ebay, Etsy, and blogs as users accuse the company of a ransomware-like tactic in replacing their long-functioning images with a threatening warning graphic and with no easy resolution other than to ante up. I’m curious about the legal standing of such changed terms of service, although I suspect we’ll find out soon enough via a likely class action lawsuit, which better happen quickly to beat the inevitable demise of Photobucket, which was already circling the bowl even before this monumentally stupid management decision.

Listening: The Alan Parsons Project, which I never liked much, but the local low-powered FM station got my attention by playing “Old and Wise,” which I tracked down with Shazam. I was sure it was the Zombies since the singer sounded like Colin Blunstone (who I saw live in a fantastic Zombies concert a few years ago), and sure enough, he did the singing for TAPP on that 1982 album. Maybe I just like Colin.


Webinars

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


Acquisitions, Funding, Business, and Stock

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In England, healthcare Internet of Things startup Drayson Technologies increases its total funding to $46 million and announces a deal to commercialize technology developed by Oxford University Hospitals NHS Foundation Trust. The company was started in 2015 by former science minister, entrepreneur, and race car driver Paul Drayson.

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Healthcare payment analytics vendor Cotiviti will acquire Louisville, KY-based provider performance analytics vendor RowdMap for $70 million.

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Healthcare sourcing and contract systems vendor TractManager acquires MedApproved, which offers a hospital new product approval workflow system. The CEO of TractManager – which offers products under the MediTract and MD Buyline names — is former Cerner, TriZetto, and Nuance executive Trace Devanny, who took the job in October 2016.

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Hospital pharmacy technology vendor Inmar acquires the MedEx pharmacy logistics product line from Aethon, best known for its TUG delivery robot.

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CellTrak Technologies, which offers a homecare care delivery portal, raises $11 million, increasing its total to $23 million.

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Published rumors of Amazon’s quiet rollout of a Geek Squad-like home installation and service knocked a billion dollars off the market cap of Best Buy this week. Meanwhile, a study finds that Amazon gets 37 percent of the money consumers spend online, with its Prime subscription and fast delivery setting a bar few other online retailers can meet. I can identify – I always worry that my trash day recycling activities will trigger a concerned neighbor’s “gunshots fired” police visit while I’m deconstructing mountains of Amazon shipping boxes and loudly popping endless strings of the accompanying packing air pillows.

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Lexmark’s Perceptive Software product line is folded into Hyland Software’s product portfolio following completion of a previously announced Thoma Bravo buyout of Lexmark’s enterprise software business.


Sales

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University of Virginia Medical Center (VA) extends its contract for LogicStream Health’s clinical process improvement solutions.

Three Florida ACOs — Central Florida AVO, Next ACO of Nature Coast, and Space Coast ACO – choose the population health management solution of EClinicalWorks.

The Nebraska Health Information Initiative and the state’s HHS choose DrFirst to capture prescribing information and deliver it to the state’s prescription drug monitoring program database, the first state to require (as of January 1, 2018) the tracking of all prescriptions dispensed (not just opioids) to give pharmacists and physicians a complete medication record for detecting drug-drug interactions and therapy duplication.

Houston Methodist Coordinated Care (TX) chooses PatientPing to give providers real-time notifications when their patients receive care elsewhere.


People

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Stanley Crane (Allscripts) joins prescription price comparison and patient adherence technology vendor InteliSys Health as CTO.

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Imprivata hires Mark Nesline (Lionbridge) as SVP of engineering.

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Jean-Claude Saghbini (Cardinal Health) joins Wolters Kluwer Health as VP/CTO.

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Communication, care coordination, and patient education technology vendor CipherHealth hires Lisa Romano, RN, MSN (CareExperience) as chief nursing officer and promotes Barbara Davis, MA to SVP of client success.

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Training and HR software vendor HealthStream hires Jeff Cunningham (Informatics Corporation of America) as SVP/CTP and promotes Jeff Doster to SVP/CIO and Scott Fenstermacher to VP/head of sales.

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Bonny Roberts (Aventura) joins Diameter Health as VP of customer experience.


Announcements and Implementations

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In Canada, Grand River Hospital goes live on Wellsoft’s emergency department information system.

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Cardiac Insight releases its Cardea Solo ECG monitoring system that is FDA-approved for monitoring atrial fibrillation following ablation procedures, noting that unlike competitors, it does not require use of a third-party monitoring service and instead sends data directly to the physician. 


Privacy and Security

Nuance updates suggest that the company has still not fully recovered from its malware attack of June 27. A 14-day outage seems problematic for a company  that offers critical cloud-based services globally.


Other

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NPR profiles the nurse recruitment strategy of Johns Hopkins All Children’s Hospital (FL), which buys lists of clinicians and then applies “geofencing” technology to pop up recruitment ads on their cellphones when those potential job candidates enter or leave designated physical zones. The hospital says not only is it receiving several resumes weekly vs. none before, it can even serve up ads as nurses head off to work at rival hospitals, adding, “We have invaded their space in which they live and work, so it’s a much better use of our dollars.”

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A review finds that while patient-created recordings of their encounters (often made covertly) offer clinical benefit to themselves and malpractice protection for their providers, state wiretapping laws are inconsistent as to which of the two parties must consent. The patient can record their encounter without provider consent in 39 of 50 states plus DC (the light-colored states above are the “single-party consent” states). The authors also note that patient-created recordings are not subject to HIPAA and that patients are free to share those recordings with anyone without permission. While patients are legally allowed to make such recordings in single-party consent states, the physician also has the right to terminate the visit if they don’t want to be recorded. The article did not address the recording of telemedicine visits in which the patient and provider might live in different states.

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This might be the jump-the-shark moment for startups. A China-based company whose app allows renting umbrellas from its code-locked public stands (it’s one of an alarming 15 such companies in China) has almost all of its 300,000 umbrellas stolen by renters who didn’t bother to return them (their deposit covered only one-third of the umbrella’s cost and locations to return them are scattered). Unlike two bicycle-sharing startups in China that recently folded when customers stole all of their rolling stock, the company says it will order another 30 million umbrellas and keep trying.


Sponsor Updates

  • Datica posts a podcast in which CEO Travis Good, MD interviews Sanjeev Arora, MD about improving rural access to care using telehealth.

Blog Posts


Contacts

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

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Neal Patterson Guestbook Comments

July 10, 2017 News No Comments

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I invited readers to share their thoughts and memories about Neal Patterson following his death Sunday. I’ll keep this page updated with new submissions from the guestbook form and from my LinkedIn post comments.


I remember doing rounds at Spectrum Health in Grand Rapids Michigan many years ago and Neal kept saying, “Two seconds is too slow!” Somehow I think he believed if he said it enough, it would come to pass. Alas, we in healthcare IT wish for that kind of performance. A true visionary, passionate and compassionate leader lost too young. (Kate Crous)


Neal Patterson had great vision and will be missed.


As an EHR veteran for 20 years, I’ve always felt that Cerner was a “good guy” in the emerging market. Am sad to see his passing and thoughts and prayers are with his family. (Matt Ethington)


My deepest condolences go out to Neal’s family, friends, and colleagues. For nearly four decades, Neal’s vision and spirit helped transform the healthcare landscape in a way that will have a lasting impact for generations to come. (Judy Faulkner)


Neal Patterson was controversial in and out of Cerner. He pushed a lot of buttons and sent many an executive on a high-speed-wobble. He was a hands-on executive with a vision that held true for decades.

I always looked up to Neal as someone who used his vision to craft an entire industry. For those of us old enough to remember, he was doing clinical computing when clinical computing wasn’t cool.  It wasn’t easy to sell clinical applications to CFOs who ruled IT back in the 80s and 90s, yet Cerner always prevailed. He created a clinical software and services company that did revenue cycle, unlike his peers who grew up during the gold rush of revenue cycle dominance a couple of decades ago. His vision that eventually the revenue cycle would become subservient to the core of patient care, where the patient is treated and where medical knowledge resides, proved true as the industry moved to his vision allowing Cerner to become a dominate healthcare companies in the world.

Healthcare can be flaky as a business. Companies come and go as our government shifts policies and changes funding. Few companies have the patience to survive the waves of change. Neal was a one-of-a-kind who saw a future in healthcare and was unwavering in staying the course, even when the course was hard to see through the fog of regulatory uncertainties we’ve experienced over his professional life.

While Neal was a tornado of a businessman, he not only leaves the legacy of Cerner, but also leaders who spawned out of Cerner to run many of the major corporations in our industry – maybe more than any other healthcare company. I’ve met many of those leaders and they all have the same get-it-done, make-no-excuses, grit that Neil fostered in them in building the culture of Cerner. I tip my hat to one of the original entrepreneurs in our industry. (Ivo Nelson)


I got involved with our Cerner EMR Committee at the start of my career, and worked on Cerner pretty happily for 15 years. I got to know Neal over that time and found him to be the CEO you would want in an HIT company – he was a visionary that made things happened. He listened to clients and cared immensely about making their product better and improving the healthcare system at the same time. I enjoyed his quirkiness and quick mind, which made me realize that it’s OK to be a rebel in healthcare. And in fact, this is the quote that I think embraces Neal the best: “Without Rebels, The Storyline Never Changes.” (DrLyle)


Sad news. Neal was indeed a great competitor and as EXVP of IDX I competed with him many times. The industry has lost a valuable asset in changing healthcare. (Bob Galin)


Absolutely loved that man. He was a warm, and dedicated soul. He “got it.” His visionary leadership style has been inspirational. He will be sorely missed. (Alistair Erskine)


I had the pleasure of working with and for Neal for 16 years (not directly). Neal was a visionary. He was brash and intense and at the same time one of the most down to earth and loving people I had the opportunity to know. Neal was passionate about leadership and about culture. He was passionate about innovation and interoperability. Because of his amazing leadership, Cerner will be a place where I am proud to be for another 16 years. We are changing healthcare for the better with our clients and that, in the end, will be Neal’s legacy.


I was a pioneer with the original HBO. I remember when Neal started Cerner. I had just started my own market research firm. He was a real inspiration and a patron to healthcare IT. He left behind wonderful successes in healthcare IT. Many people have had the luck of working with Neal and I bless God that he gave me the opportunity 20+ years ago to conduct his win loss and customer satisfaction studies. Neal had a passion to understand his marketplace and customers and really cared as he was actually involved. I learned a lot from him, like so many others have. Thank you — I will miss you.. (Cynthia Porter)


I bumped into Neal at the Cerner Health Conference one year and made him laugh with my impersonation of an Irish presenter at CHC. He seemed like a hard-driving yet friendly guy.


As a Cerner customer, I had the opportunity to meet Neal on several occasions. I can say without a doubt that he truly wanted to improve the care of patients. One can argue the pros and cons of how he went about that, but I don’t think anyone should doubt that his ultimate goal was to improve the patient’s experience and outcome.


Much has been and will be written about this remarkable man and industry icon. In the many interactions I had with Neal over the past 30 years, one thing was clear — this man was purpose-driven and committed to solving healthcare’s most vexing challenges and to those who worked with him. He built a great company and will be missed. My condolences to his family and friends. (Scott Kolesar)


I had the honor of working with Neal for 20+ years and his passion and leadership will be sorely missed. He never backed down from a challenge and inspired us all. Condolences to Neal’s family and the entire Cerner family. (Sam Pettijohn)


Sad day for our industry. I interviewed with Neal for my start at Cerner in 1990. Thanks for the opportunity Neal and may you Rest In Peace. Thoughts and prayers to Neal’s family. (Jay Deady)


A very sad day! (Bill Gouckenour)


Wow, so many people got their careers started in HIT under his tutelage. (Michael Silverstein)


With a heavy heart, I express infinite gratitude for being in the Cerner family. Neal’s vision and unparalleled tenacity had me at hello. Goodbye is hard. (Jean Scherschel)


I started working for Neal I the early years of Cerner. He was a leader and visionary beyond all. This is a loss of an amazing person. (Sarah Sample-Reif)


Sad to hear the battle was lost. I am proud I worked for Cerner and was led by a man I must say impacted more people to be better and accomplish more than any other man I’ve personally met. His imprint is upon so many other companies because of the leaders he and the Cerner team built. Condolences to his family and the entire extended Cerner family. (Mark Horner)


Possibly the most progressive and visionary health IT executive in the world. Will be seriously missed. RIP and my condolences to his family and all Cerner employees. (Rick Valencia)


His legacy will continue. My condolences. (Jarrett Runey)


Hit me hard when I read the news today. 67 years young and really transformed HCIT. Made a real difference. All the best to family friends and  colleagues. Too young to be gone. RIP. (Jim Maughan)


I love it when a good personality leads a high pressured and elevated role. I could sense his smiles throughout the photos. (Alex Guizzotti)


Proud to have been mentored by Neal for 26 years. Neal was always there for me and my family. Rest In Peace my friend, leader, mentor, and fraternity brother. (Ken Boyett)


I have had the opportunity to be both a client and an employee of Cerner. While I’ve never been fortunate enough to get to know Neal personally, his vision and leadership has significantly influenced my career the past 20 years. Cerner is the company that I measure all other vendors against. It was not surprising to hear that a succession plan was in place and a new CEO would be named shortly. I hope Cerner continues to challenge the status quo and move us to new heights. I am hopeful that Neal was able to instill his way of looking at the world in his top leadership. He will be missed. (Sheri Rawlings)


I would like to extend a posthumous thank you to Neal for creating an organization that introduced me, and countless others, to the complex and wonderful world of healthcare IT. The recruiting program at Cerner Corporation has brought scores of talent into our industry. As it was with many of my fellow recruits, I entered the health IT world wide-eyed and eager to learn with very little (that’s generous) knowledge of healthcare. The Cerner jumpstart program was a constant feeling of drinking from the fire hose. We worked long hours, had some great fun, and established lasting bonds and relationships. I remember those days fondly. Mr. Patterson was a healthcare visionary, entrepreneur, and fraternity brother that will forever leave a lasting mark on healthcare and myself. (Don C. Ellis)


Neal Patterson was brash, arrogant, and aggressive. Yet despite some of his less admirable personality traits, we have to admit that he did reshape the healthcare IT industry. Neal took a relatively small lab company and changed it into an innovative, expansive, and formidable enterprise. By changing Cerner, he inadvertently changed all of his competitors who designed, developed and sold hospital information systems – whether we knew it, or even liked it, we became better vendors because of Neal. I’ll never forget his full-page picture in the Wall Street Journal. And, yes, “tick, tock” — time runs out for us all. Rest in peace, Neal.


I worked at Cerner for a brief time and everyone always referred to him as Uncle Neal. When the news of his passing was made public, I received at least 10 text messages among my Cerner friends- all of us in shock. Did you know that Cerner requires all new staff to receive orientation in Kansas City no matter where their home base is? Kansas City is a different place because of Cerner and Uncle Neal. RIP


Neal gave me not only the opportunity of a lifetime, but a renewed passion for the health and care of people. Even though I only got to meet him twice during my 14 years at Cerner, he was a daily inspiration to me and helped me get some very tough days. RIP Neal. You’ve made me a better person. (Liz Chamberlain)


A great guy, and he treated everyone with dignity. I met him abut 10 years ago when I was providing services to him and his wife, Jeanne. They were both kind and unassuming. Neal was appreciative, and even took time to get to know me. As busy as he was, and with all he had going on in his life, it was amazing that he would take the time to be such a decent and pleasant guy to someone like me. I remember one evening my wife and I were walking on the Plaza, and encountered him as he came out of the Capitol Grille. I said hello to him, and he courteously acknowledged me. As we walked on he suddenly ran after me, he had obviously just remembered me (as I was not in uniform and in a completely different environment from where he would normally see me). He just could have not been nicer, and even remembered that I had told him that my wife regularly utilized Cerner programs in her management job at a local hospital. What a memory for as busy as he was. Again, a great guy. He will be missed. (Tom Scatizzi)


Deeply saddened by the loss of a health IT giant and bold visionary. Neal inspired and made it possible for thousands in my generation to start and pursue meaningful health care careers where we can make a difference. I have infinite gratitude to my Cerner family and remember my time there fondly. It’s an honor to have known Neal and to have had personal interactions that I will cherish dearly as treasured memories. For many like me, he remains a lasting example long after last encounters. (Santosh Mohan)


A leader in our industry. Respected by all. A legacy that will live on for decades. Thank you for what you brought to healthcare and technology. (Tom Aikens)


This is indeed sad news to read of Neal’s passing. Like many on this post and countless others, Neal instilled vision and passion in his work, those who worked for him, and transformed HIT like no other single person — he was a contrarian that often bucked conventional wisdom and pushed his organization and the industry to innovative heights. Building Cerner from a meeting on a park bench with friends Cliff and Paul and idea born on the back of a napkin, very few CEOs can lay claim to Cerner’s shareholder ROI over the years. (Greg Leder)


Neal was one of the smartest people I ever met and one of the greatest business minds of any founder/CEO of any industry, let alone healthcare. I met him when he was taking the young lab IT company to a new level with an inpatient system and Cerner was installing it in a brand new hospital in Edinburgh, Scotland. I was supplying the cardiology and patient monitoring stack with Marquette. We made an attempt to buy Cerner after that — you can imagine how long it took him to turn us down.

Later, after starting Picis, we met again and I told Neal that he wasn’t getting the market credit for the complete rewrite of his codebase which was well received by customers. He listened to people and he started to pitch that to the analysts and the stock appreciated quite a bit. Though we eventually became quasi-competitors, Neal would personally stop by the Picis booth every year at HIMSS — once with a young associate who he said to in front of me, “Watch this company.” I took that as a great measure of pride and respect.

Neal built a great team — the Cerner culture is one of a strong sales culture backed by execution and delivering. From his partner Cliff to Paul Black, Trace Devanney, Bill Miller, Mike Valentine, and Zane Burke today — all are leaders in Neal’s image. They know because while being a bear to work with/for, they all came away with great leadership skills. The people I’ve hired out of Cerner know how to get things done. Look at the tremendous same store sales record Cerner has had with its customers over the years as a testament.

Neal was one of those people in my life that greatly influenced me — one that I could sit around with for hours and just engage in the most vibrant conversations I’ve ever had about our industry, politics, Ayn Rand, human nature, you name it. We will miss you greatly, Neal! (Todd Cozzens)


When you look back over your career and think about leaders that made you better, anyone that has worked with Neal would have his name high on their list. The healthcare informatics industry is better because of Neal and the leaders he has supported, coached, mentored, and pushed over the years. Neal has seeded this industry with some of the best and brightest leaders in this industry, including Paul Black, Mike Valentine, Bill Miller, and Zane Burke. His legacy and his vision have been left in good hands! Rest in peace, Neal. We will continue to pursue your vision.


I had the good fortune of working for Cerner for 16 years, half of it in the early days. When Neal would begin to spin a tale of the intersection of health and IT, it was spellbinding, engaging, dramatic, motivating, and above all, about improving the quality, dignity, capability, and humanity of all involved in the endeavor. He has been an inspiration, a motivation, and mentor for many of us. But to me, he was the guy — the leader — the reason to work in this industry. He will be sorely missed. His ideas will live on in the next few generations wherever health is impacted by IT.


Every once in a while you meet people who are doing exactly what they love and are called to do. Neal was one of those people. This news is sad. He was inspirational, innovative, provocative, entrepreneurial, yet personal. The world is a much better place because of Neal Patterson and Cerner. (Doug Pousma)


Neal will be missed. (John Simmerling)


Although I didn’t know Neal Patterson at all, his name and company were well known to anyone in the industry. I was fortunate (or so I think!) to have joined the HIT industry around 17 years ago and still laugh at some of the crazy things vendors did back in the day to convince docs they needed to get on the bus. I really enjoyed reading the HIT eulogies from others in this industry who have also been a part of this movement, both leaders and others like me who were just blessed to be a part of the movement.  It was interesting to see who added their thoughts, as well as those who didn’t. That being said, Neal Patterson won’t be the first or last to leave the planet, but I want to thank him for all the things he did to keep this HIT stuff moving forward. Thoughts and prayers to NP and his family! RIP Neal Patterson.


Healthcare IT is such a difficult place to do business in, and on top of that, to have a vision and look into the future. Not many people have that. Always amazes me that it all started on a bench in a park. Visionary and a true leader. Neal, you will be missed.


Rest in peace, Neal. It was an honor to have had the pleasure to know him, to have been a proud member of the Cerner family, and watch him build a formidable legacy which will continue to unfold far into the future. My deepest condolences to the Patterson family. God Bless! (Guillermo Moreno)


One of the few leaders in our industry who did the “right” things for the “right” reasons. (Mark Edelstein)


I never worked for Cerner, but as a business partner of Cerner’s many years ago, I was in a handful of meetings with Neal, always a small group of four or six. Driven, passionate, and visionary is how I would describe him in those meetings. While I didn’t always agree with Neal’s position, there was no denying that he was a driving force and advanced our industry. His contributions to HIT have been invaluable and everlasting. RIP. (Jim Hall)


All of us who worked in the Cerner family learned from Neal Patterson’s passion, drive, and vision. All of us who knew him are better for the experience, and the world is poorer at his passing. RIP Neal, and respects and condolences to your family, and the great company that was your passion for so long. (James Hazy)


He made a difference in so many lives, including mine. The man had a well lived life, overcoming obstacles as they arose with his own style — brash or pushy to some, direct and incisive to those who got his vision. Show me another CEO who can stand up and answer and ask questions about the entire company for 3+ hours year after year, who saw the big picture and drove innovation years ahead consistently. We need him now more than ever, and he will be missed. If you don’t have a Neal Story or two (even if handed down), you didn’t work at Cerner. You can shove that Pie Award. (Joe Boyce, MD)


Exceptional visionary and indeed he created a visionary company. His legacy isn’t just Cerner, but also the leaders he created that went on to lead many other companies — creating a much wider AND generational impact. I had the privilege of working for him and earning my stripes. He had this innate ability to extract the best out of you! He will be missed! (Hemant Goel)


Neal was an extreme visionary leader and a demanding manager. I’m glad to have worked under his tutelage. (Rich Marra)


My deepest condolences to the family friends and colleagues of Neal. He was a true visionary that helped to transform the delivery of patients, families, and communities world wide. His spirit, passion, and vision has helped all of us drive for improvement.
This world is a better place thanks to his work and that is a beautiful thing. Thank you Neal for helping us take care of one patient and family at a time. Rest well, Starfish. (Cynthia Davis)


Though we met only a couple times — in the Cerner Vision Center when I was a much younger Cerner implementation project manager — your enormous Midwestern presence in those meetings made an endless impression on me. Your ability to see a day in the not-so-distant future when data-driven healthcare delivery would make a positive difference in peoples’ lives is here! As someone who shares in this same vision, I am forever grateful for your work and the opportunities your pursuits have afforded me and many, many others. Rest in peace, Neal Patterson. Your innovative spirit lives on, now more than ever. You will not be forgotten, sir. (Jamie Trigg)


I first met Neal in 1994. A kind but driven man with a vision. He altered the landscape of healthcare and thus the lives of many. Thanks, God Speed Neal. (Tom Liddell)


Neal’s years of dreaming, passion, and creative engineering have brought much to our healthcare system and others around the world. It was always an exciting environment in the vision center with Cliff and Neal driving, energizing and listening to all who would share their passion and convictions for dramatic change and a better system of healthcare. From labs, to hospitals, to health systems, to integrated delivery systems, CINs and ACOs and National Delivery models they and all the leaders who grew up in Cerner (the list is too long to list here) brought so much energy and commitment to making things better for patients, people/employees, and now consumers. My best wishes to all those in his family at home and all those Cerner family members who shared their lives with him. We are all better for his being here with us all these years. God Bless you all. (Jay McCutcheon)


A healthcare game changer and warrior is no longer with us. Neal Patterson has been an icon, a mentor in the industry, and will be remembered forever.

I have been in this challenging arena of healthcare IT for almost 2½ decades. Challenging only because of the constant changes that forced all of us to constantly adapt and re-invent ourselves. I have faced some challenges as an ally to Neal, and some on the other side as competitors. We won and lost some battles together and as competitors. The challenge is what made it fun and Neal’s brilliance made us think harder to stay in the game. The most important thing is that we were always driven by our shared mission and passion to do the right thing for our customers and the healthcare industry. The customers and the industry always won!

As we get older and wiser we all are confronted by our own mortality and realize that we are at that inflection point, where the only way to transform healthcare is by leveraging from the experience gained to this point and joining forces with other game changers to make a difference. Today we should carry Neal’s torch and together execute on our shared vision. We thank you my friend for making us better and joining your mission and vision. We will not disappoint you! (Alan Portela)


Neal’s Cerner was an adventure ride unlike anything Disney had ever imagined. Being on the front lines and having a court-side seat while executing his vision to transform an industry was daunting, crazy, fun, unpredictable, and, above all, incredibly rewarding. For the hundreds of alumni who have gone on to run businesses, the lessons we learned and experiences we gained from Neal Patterson eclipse the most prestigious MBA one could earn.

We vision using white boards, we are never comfortable with status quo, we give ‘pen-raised’ youngsters opportunities beyond their current experiences, and cringe at the words vendor, customer, or employee.

I smile when I think of Neal in Heaven. His new associates will be certain to have their vision statement ready to be recited at a moment’s notice, they’ll absolutely have a riveting question to ask during the Town Hall and, by all means, they’ll know to stay low when a debate gets especially lively.

I extend my deepest condolences to Neal’s family. (Gary Pederson)


Neal was truly an amazing person that never forgot his roots. From the moment I met him, he made me feel very welcome and supported. Like most farm boys, he did not expect people to address him as Mr. Patterson or anything formal. Instead, he would insist that you just call him Neal.

I had the privilege of working closely with Neal for many years and gained invaluable professional experience while also getting to know him personally. Make no doubt, whether in the professional environment or personal, Neal was competitive and encouraged and expected excellence. Those years were packed with many late nights, early mornings, … and fun. Neal would joke that when he was around, others had more fun, but it was a reality. I also got to see the personal side of Neal, which was a very compassionate and caring person, something the business world unfortunately often overlooks.

My hope is that we (not just Cerner, but this industry) continue to do what is right for the person, the patient … us. Let us all be compassionate, caring, empathetic, and make “one last round after sundown” in honor of Neal. Because after all, Neal (and many before him) proved that in the end, health care is personal.

Neal made each of us better. He may be gone from this place, but his legacy lives in each one of us. Let’s make him proud!


Morning Headlines 7/10/17

July 9, 2017 News No Comments

Cerner Announces Passing of Chairman and CEO Neal Patterson

Neal Patterson, co-founder, chairman, and CEO of Cerner, died Sunday of cancer complications. Fellow co-founder and Vice Chairman of the Board Cliff Illig has been named interim CEO.

Nuance Healthcare: Impacted Customer Update

Nuance issues an update on its hosted services outage reporting that Dragon Medical Practice Edition servers have been restored.

Jawbone to Be Liquidated as Rahman Moves to Health Startup

Consumer electronics manufacturer Jawbone plans to shut down following years of financial pressures. CEO and co-founder Hosain Rahman has opened a new business called Jawbone Health Hub that will make health-related devices.

UnitedHealth, Vista Said Near Deal to Split Advisory Board

UnitedHealth is working with Vista Equity Partners in a deal that would allow the two to acquire the Advisory Board Company and split it, with UnitedHealth taking the healthcare division and Vista Equity Partners taking the education business.

Monday Morning Update 7/10/17

July 9, 2017 News 1 Comment

Top News

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Neal Patterson, co-founder, chairman, and CEO of Cerner, died Sunday of cancer complications. He was 67.

Arthur Andersen consultants Patterson, Paul Gorup, and Cliff Illig founded the company in 1979.

Patterson’s “treatable and curable” cancer was announced in January 2016. His wife Jeanne is a metastatic breast cancer survivor.

Vice board chair Illig will serve as chairman and interim CEO. Cerner says its succession plan will allow it to name a new CEO shortly.

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A gaunt Patterson made an unscheduled appearance at the Cerner Health Conference in November 2016, when he vowed to return to work in January 2017. He told the crowd, “I made a plan, got a strategy for treatment, and then went to execute it. I realized God had a sense of humor: he put me in a place undergoing an EHR conversion.”

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UPDATE: a reader suggested that I set up a guestbook for folks to leave their thoughts and memories about Neal. You can send your thoughts here and I’ll run them later in the week.


Reader Comments

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From Cab Heater: “Re: Twitter live-tweeting from conferences. ADA doesn’t allow.” The American Diabetes Association warns attendees of its Scientific Sessions that photography is not allowed, to the point that staffers monitored use of the #2017ADA hashtag and warned people individually to remove their tweets that contained photos of on-screen slides.  ADA says it is concerned about its legal obligations to grant-funded presenters, although it did not cite those concerns specifically, while others assume the sponsor-enriched ADA panicked over an incident last year in which a conference attendee tweeted out study results an hour before they were officially released, sending a drug company’s share price down.


HIStalk Announcements and Requests

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Half of the relatively few Nuance users who responded to last week’s poll say they’ll send less business to the company following its malware-caused cloud services outage.

New poll to your right or here, following up on research showing that the more time people spend on Facebook, the worse they feel about themselves: how much time do you spend on Facebook each week? Click the poll’s Comments link after voting to explain.

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Readers funded the DonorsChoose teacher grant request of Ms. G in Virginia, who asked for hands-on math centers to replace her “tragically bare-bones and outdated” ones. She reports, “Having access to educational games like Shape Matching, Sorting, Patterning, Measuring, and Counting hands-on activities make learning both visual and social. We can introduce important science and social studies skills while practicing important life skills like turn-taking, waiting, losing, and much more. Thank you for providing such entertaining materials to my students!”

I’m in a bit of shock over Neal Patterson’s death, feeling similarly to when I heard that Steve Jobs had passed away. I never met Neal other than a brief encounter at some kind of Cerner CIO executive retreat that I once attended (and my impressions then were mixed, although he seemed to be enjoying himself and was pretty genuine), but I interviewed him a couple of times and found him to be thoughtful and patient even though he was clearly no-nonsense. Like most significant leaders who get big things done, the man who was raised on a pig farm had a reputation of being ruthless and egotistical, and certainly the company flourished in some part due to its “Vision Center” executive schmoozing strategy in which Patterson and other company bigwigs wooed customers into signing up without looking too closely beyond the big-picture promises and glossy PowerPoints that made them feel important, at least until the deal was done. Industry newcomers won’t recall the huge Wall Street hit Cerner took when Patterson decided to re-architect Cerner’s entire product line into Millennium in the 1990s, one of few times in corporate history where a ground-up software rewrite turned out to be the key positive event in a company’s future. Patterson took Cerner into the stratosphere, accomplishing the unusual in remaining in charge the whole time and reshaping the company’s strategy to grow consistently and to move into new markets tangential to healthcare IT. He was also loyal to Kansas City, passionately supporting local causes and creating a respected technology firm in an unlikely location. I certainly had a lot of fun with his famous “tick, tock” email that in retrospect was probably entirely appropriate given the circumstances even though it was uncomfortably (and in my mind, admirably) blunt for the CEO of a publicly traded company, but looking back on where he took Cerner and the industry, the “tick, tock” might now serve as a reminder to us all that our time here is limited. I’ve rarely said this about someone I didn’t know, but I will miss him.


This Week in Health IT History

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One year ago:

  • Thoma Bravo announces plans to acquire Imprivata for $544 million.
  • England scraps plans to create and EHR-fed national database of patient information after a commissioned report criticizes its opt-out and consent policies.
  • NIH awards $55 million in grants to four universities and the VA to study the contributed information of “citizen scientists”, while Scripps and Eric Topol, MD get another $120 million to develop related apps, sensors, and recruitment processes.
  • CMS bans Theranos CEO Elizabeth Holmes from clinical laboratory involvement and stops all payments to the company.
  • HHS issues HIPAA guidance for ransomware attacks.
  • President Obama writes a JAMA paper describing the impact of the Affordable Care Act.
  • Evolent Health announces that it will acquire Valence Health for $145 million.

Five years ago:

  • University of Virginia settles its $47 million breach of contact lawsuit against GE Healthcare involving the acquired IDX, which UVA says botched its implementation.
  • E-MDs fires CEO Michael Stearns after what it said were employee accusations of inappropriate behavior, replacing him with board chair David Winn.
  • CSC begins laying off employees following the UK’s failed NPfIT project.

Ten years ago:

  • Dossia files a restraining order against Omnidmedx Institute after payment squabbles involving a personal health record development project.
  • Sage Software Healthcare President and CEO Andrew Corbin resigns.
  • ISoft shareholders vote to have IBA Healthcare buy the company.
  • A Kaiser Permanente study finds that outpatient visits and telephone calls are reduced when patients can email their doctor.

Weekly Anonymous Reader Question

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Responses to last week’s question:

  • My job is 100 percent remote management position with no restrictions or specific requirements, other than having suitable internet connection that I pay for. There is an expectation that I work at least 40 hours a week and be available during normal business hours and reachable by cell evenings and weekends.
  • The only requirement is to just get your work done. Physical requirements are a quiet, private place to work.
  • None. I travel for work 75 percent of the time and it all blurs. Except weekends. Those are sacred.
  • I’m enjoying the phrasing of this question, partly because at least one major employer in the health IT sector is notorious for not ever allowing its employees to work from home, and you know it, and we all know it. I am out of health IT now, and don’t miss my former employer’s lack of flexibility.
  • Be here now- work regular hours and be available for questions, problems, issues. I am an integration analyst.
  • Sales job. No questions asked if you hit quota. I love it!
  • None. Why? Because we are so lean right now due to cuts and attrition that I think (our leader at least) is just grateful that we have stuck it out, especially since our positions require 24/7 call availability and you ain’t lived life to the fullest until you are in a three-person on-call rotation! If you want to get the most out of your people, flexibility is an absolute must. (ha ha, see what I did there?)
  • Epic application analyst for a large system. We can work from home two days per week, so most people take Mondays and Fridays (with the exceptions of the lucky ones who live close by and the unlucky ones whose teams had to have SOMEONE in the office on those days). A lot of teams require a “work from home” form submitted at the beginning and end of the day, with your goals/work and then what you actually accomplished. For some people, these are their most productive days. For others, not so much.
  • I must be available between 0900-1500, but can set my work hours otherwise. I must be available via phone/email/IM.  If a need arises, I must be willing to come in to the office. I’m a former IS clinician, now working in a new capacity, “Operations Support.”
  • No restrictions. I’ve been a full-time work from home employee since 1999 for three different employers. My role is a software product manager, thus I interact heavily with my development team on a daily basis to build software and drive value for our customers. I travel as needed for customer visits or corporate meetings, but mostly am at my desk. I’ve been fortunate to be given the trust of my employers and accordingly have built a reputation for delivering results, thus I’ve never been micromanaged. Time management and an isolated office (or headphones plus white noise) are keys to success while working in a home-environment.
  • I’m a remote employee, meaning every day is a work from home day. No restrictions or requirements. I’m in my office every day around 8 and don’t end my day until after 6 or 7 pm with occasional work on the weekends.
  • I work in data analytics for a large health system and our work from home day is Friday. On Fridays, we must be as available for Webex meetings as we would be for in-person meetings on a regular day in the office. We also can’t refuse to meet with a customer in-person just because it’s a Friday.
  • I’m a consultant. Our requirements are based on what the customer needs. If the customer I’m contracted with wants me to work 9-5 every day, then that’s what I’ll do. But most don’t care that much so I’m generally available from 8-5 in case something comes up, and I attend any meetings they want me to join, but otherwise I can set my own schedule as long as I bill 40 hours. For weeks I’m onsite, it’s certainly more stringent, but I just follow whatever their staff do.
  • I work in professional services. I can work from home two days per week. I need to have a presence in the office three days per week in order to retain my assigned workspace. I am required to work in a space where I can have customer calls without crying babies or barking dogs.
  • No kids under 10 at home without a sitter. Office with lockable door. Access to printer/scanner.
  • Availability for meetings via WebEx or conference call and ability to focus on project and strategy needs.
  • Just need to meet the billable hours requirements.
  • I work in data analytics. I’m allowed to work from home as much as I like. My employer expects me to get my projects done on schedule, and be easily reachable during business hours.

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This week’s question: What software, app, or website is your secret weapon for increasing your professional or personal effectiveness? (excluding HIStalk from any possible consideration, please).


Last Week’s Most Interesting News

  • Patrick Soon-Shiong’s NantWorks buys controlling interest in the struggling , six-hospital Verity Health (CA) from its hedge fund owner.
  • The Department of Defense says Naval Hospital Oak Harbor (WA) will go live on MHS Genesis this month as the project’s second pilot site.
  • Heritage Valley Health System (PA) finishes bringing its systems online following a June 27 cyberattack.
  • VA officials warn that its $543 million RTLS project risks “catastrophic failure.”

Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Acquisitions, Funding, Business, and Stock

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Harris’s healthcare group acquires Warwick, RI-based population health management technology vendor Medfx, which it will operate as an independent business unit. 

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Bloomberg reports that UnitedHealth Group and Vista Equity Partners are close to striking a deal to acquire The Advisory Board Company, with UnitedHealth proposing to take over the company’s healthcare business that drives two-thirds of its sales. Vista would take on ABCO’s education product line. The potential sale of Advisory Board was driven by an activist investor’s acquisition of 8.3 percent of shares early this year.

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Fitness tracker and Bluetooth gadget manufacturer Jawbone, which once enjoyed a valuation of $3 billion, is shutting down. Jawbone’s founder is starting a new company called Jawbone Health Hub. Anonymous reports suggest the new company will focus on validating and reporting sensor-collected health information. Jawbone was rumored to be pivoting into a clinician-focused business in February 2017. Its failure was not a surprise given its series of strategic missteps it made as the public lost interest in me-too fitness trackers.


Decisions

  • UnityPoint Health-Pekin (IL) will replace McKesson Paragon with Epic in April 2018.
  • Genoa Community Hospital (NE) will switch from Healthland to Athenahealth In October 2017.
  • Spectrum Health Pennock Hospital (MI) will implement Epic In May 2018, replacing Meditech.
  • Herrin Hospital (IL) replaced Meditech with Epic in June 2017.

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


People

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Jeff Felton (McKesson) joins Providence Service Corporation subsidiary LogistiCare Solutions as CEO.


Government and Politics

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Kentucky Governor Matt Bevin’s proposed Medicaid changes would require able-bodied recipients to work 20 hours per week when they sign up. He previously proposed that the work schedules of recipients be ramped up slowly, but now says the state’s Medicaid computer system can’t track such a phased approach.

A campaign finance watchdog organization accuses HHS Secretary Tom Price of illegally using $40,000 from his congressional campaign fund to create self-promotional materials to urge the Senate to confirm his appointment.


Other

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Steve Orlow, MD, MMI, CMIO at Lutheran Hospital (IN), criticizes publicly traded parent company Community Health Systems in his resignation letter for under-investing in the facility and for retaliating against a group of 10 doctors that had tried to buy the hospital from CHS. Orlow says the financial weakness of 137-hospital CHS threatened to drag the hospital down and says CHS had approved only of the 26 IT-requested Cerner EHR modules until the 10 doctors went public with their gripes, after which CHS approved all 26. Shares of CYH have dropped 28 percent in the past year and 82 percent since their June 2015 high. The company’s market cap is just over $1 billion. 

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A woman (and nurse) who tweeted out a photo of the $231,000 hospital bill for her three-year-old son’s heart surgery – of which she credited the Affordable Care Act for leaving her with only  a $500 payment – receives Twitter death threats, arguments that her son’s life wasn’t worth it, and comments that her name Ali (short for Alison, “a white chick from New Jersey,” she explains)) means she must be a foreigner or a terrorist. On the upside, someone who read her tweet correctly diagnosed her son’s genetic condition. Some commenters noted the high prices charged by Boston Children’s Hospital, while others provided shrill political arguments or asserted that they weren’t going to pay for someone else’s medical bills.

Public updates from Nuance regarding its cloud systems outage have been infrequent as it updates customers via private conference call, but a July 6 notice says eScription LH is back online. 

I’m not sure why I find this interesting, but an article notes that England’s NHS would use about $260 worth of electricity to run a single MRI, but it’s using voltage converters to reduce costs.

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CNBC profiles John Brownstein, PhD, a Harvard Medical School professor and epidemiologist who advises technology companies that are interested in moving into health-related areas.

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Alabama’s state bar reprimands the attorney who in 2014 filed a highly publicized lawsuit claiming that a hospital amputated his client’s penis during a circumcision. The bar found that the lawyer hadn’t even looked at the medical records of his client before filing the lawsuit, and even after he reviewed the records that proved the allegations were improper, he filed another lawsuit.


Sponsor Updates

  • Learn on Demand Systems will exhibit at Microsoft Inspire July 9-13 in Washington, DC.
  • NVoq will exhibit at AHRA 2017 July 9-12 in Anaheim, CA.
  • Experian Health will exhibit at NAHAM Nebraska July 13-14 in Grand Islands.
  • QuadraMed, a division of Harris Healthcare, will exhibit at the FHIMA Annual Convention & Exhibit July 11-12 in Orlando.
  • ZappRx releases a new podcast, “Living with Systemic-Onset Juvenile Idiopathic RA.”
  • Aprima customer Mt. Olive Family Medicine Center wins the 2017 NCMGMA Practice of the Year Award.
  • Besler Consulting releases a new podcast, “How medical scribing is utilized at the point of care.”
  • CoverMyMeds will exhibit at McKesson IdeaShare 2017 July 12-16 in New Orleans.
  • EClinicalWorks will exhibit at the 2017 FSASC Annual Conference & Trade Show July 12-13 in Orlando.
  • FormFast publishes a new case study featuring Riverside Community Hospital.
  • InterSystems will exhibit at the Population Health Exchange July 10-12 in Colorado Springs, CO.

Blog Posts


Contacts

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

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Cerner CEO Neal Patterson Dies of Cancer Complications

July 9, 2017 News 1 Comment

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Neal Patterson, co-founder, CEO, and chairman of Cerner, died Sunday of complications following a reoccurrence of cancer. He was 67.

The company announced that co-founder and vice board chair Cliff Illig will serve as chairman and interim CEO.

Illig said in a statement, “This is a profound loss. Neal and I have been partners and collaborators for nearly 40 years, and friends for longer than that. Neal loved waking up every morning at the intersection of health care and IT. His entrepreneurial passion for using IT as a lever to eliminate error, variance, delay, waste, and friction changed our industry.”

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Cerner says its CEO selection process is nearly complete.

News 7/7/17

July 6, 2017 News 17 Comments

Top News

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Patrick Soon-Shiong’s NantWorks buys a controlling interest in hedge fund-owned Verity Health, which runs six California non-profit safety net hospitals previously operated by Daughters of Charity Health System under the Integrity Healthcare name.

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Soon-Shiong pledged in an announcement that the company will apply “the limitless powers of collaborative science and technology to transform healthcare practices and create a more efficient, more effective health system. Medical care is local and we strongly believe that community health systems should be supported with investment, technology, and science to build next generation clinically integrated networks to drive better outcomes at a lower cost.”


Reader Comments

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From Pithy Aside: “Re: Cerner wins/losses.Here’s the information from the 2016 and 2017 KLAS clinical market share report.” A reader previously subsetted the KLAS data in an attempt to focus on what he or she thought would be most interesting to Wall Street analysts, but the bottom line per KLAS (as commented here previously) is, “Acute wins for 2015-2016 for Cerner: 249 (this number includes 1 Soarian add on in 2015). Total Millennium losses for 2015 and 2016: 53. Cerner’s net growth is thus 196 acute hospitals for 2015 and 2016.” Certainly further segmentation by deal count vs. hospital count, organization type, bed size, accounting for multi-hospital deals like the DoD and Emerus, net-new customers vs. footprint expansions, migrations either way due to mergers, etc. could lead to further interpretation and speculation that may or may not add value. There’s also the unusual opportunity since CERN is publicly traded to simply look at the metrics Wall Street really cares about that go far beyond hospital count – revenue, bookings, and earnings, all of which reflect Cerner’s overall activities (not all of which involve hospitals) and the efficiency with which it operates its business. For that matter, share price since January 1, 2015 is the ultimate measure of company performance vs. Street expectations and the above real-time graph as I write this shows CERN (blue, up 1.1 percent) vs. the Nasdaq (green, up 29.3 percent). The reader also noted that some Soarian sites are trying to wangle out of their contracts to switch vendors claiming poor support, but I can’t say I side with them – they signed a contract for product that remains supported, and if company change of control was important to them, they should have put that – along with service level agreements if they left those out — into their contract’s terms and conditions. Weirton Hospital has sued Cerner claiming poor support, while Cerner sued PinnacleHealth for trying to walk away from its Soarian contract after signing with Epic.

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From Pinkeye: “Re: Epic. Hard to believe they didn’t bid on the Wisconsin DHS project if they have a viable behavioral health strategy. I’m also curious whether Allscripts/Netsmart bid.” Epic sent me a note after I mentioned that the company had chosen not to bid on the project, saying it wasn’t a big enough deal to interest Epic. I haven’t seen a list of the five bidders. Health IT websites created the self-serving notion that it’s cleverly-observed big news when a customer in Wisconsin or Missouri chooses Cerner or Epic, respectively, but that’s ridiculous.

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From Nuance Hospital Customer: “Re: Nuance outage. Escription staging environment testing is in process, with plans to bring  the first client on board. Rebuilt speech engines. They just announced that they are in process of updating employee laptop antivirus software and installing encryption (!). Over 200K physicians are on an interim solution, but still no commitment to make clients whole — only offering clients short-term use of Dragon Medical.  I can only speak for our organization, but we have had over 10 staff working around the clock since this outage to review options and stand up outside transcription service. This is very poor remediation.” Unverified, but seemingly solid since the reader emailed from their hospital account. Nuance has issued minimal public information, instead providing status updates via customer conference calls. Some systems remain offline 10 days after the initial malware incident.

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From NotPetya: “Re: Nuance outage. People are acting like they’re innocent victims of a cyberattack. Doesn’t this situation show what happens when you don’t upgrade your software? NotPetya exploits the same weakness as the May 4 outbreak and systems should have been patched.” I don’t think Nuance has confirmed that it was hit by NotPetya, but assuming that’s the case given the incident’s timing, it would seem that it had a PC running somewhere that didn’t have Microsoft’s Eternal Blue exploit patch from March 2017 (MS17-010) installed,  which also protects against the WannaCry strain. However, even someone as cynical as I would be hesitant to suggest that the company was negligent given the lack of facts, instead suggesting that every organization check every PC on the network to make sure they are running updated versions of Windows and antivirus.

From Crank Rod: “Re: HIT influencers. What do you think of this list that a Twitter monitoring service company assembled?” I question the premise of this list (and others like it) that assumes that hyperactive Twitter users must, by definition, be influential. I’ve never heard of most of the Twitter accounts listed, follow few if any of them, and note that their Twitter activity is often dominated by attention-seeking retweets and insight-lite comments that fail to rise above the level of social media circle-jerkery. I’ve also noticed that the real-world accomplishments of the anointed Twitterati are often much more modest than their outsized social media presence would suggest and that their self-assigned labels of “disruptor” and “innovator” sometimes ring hollow given their lack of personal success within the system they claim to be qualified to disrupt (it’s perhaps harsh to say that, “those who can’t, Tweet,” but sometimes that seems to be accurate). I’m happy for those named, especially for those whose self-validation demands it, but it’s just not something I care one iota about. I doubt many CEOs and other industry leaders are anxiously waiting for the winners to be named so they can call them up for advice.

From Money In the Banana Stand: “Re: #HIT100. Is it just me, or is this just another glad-handing campaign where the social media-verse celebrates the over-tweeters, many of whom have never even worked within a health system? While I find social media to be an effective medium to share, collaborate, inform, and educate, I am increasingly annoyed as I find folks have gotten away from why we are in this industry in the first place. In fact, I find several of these individuals exclusively making a living by talking about what the industry needs to do in social media and at conferences, but have no successful business or job within the industry. I am appreciative of those who HAVE worked in the industry who share their expertise and strategic thinking, but have had just about enough of the ‘marketers’ who are just recycling marketing and self-promotion. The tipping point for me was receiving countless messages from people ‘campaigning’ for my vote. Seriously?” I received this comment several hours after writing mine above, which was triggered by a similar but different “influencer” measure. Some of those folks don’t seem to have real jobs and are light on (a) healthcare-related education; (b) work experience; and (c) accomplishments. I apply the same standard to those who produce blogs, publication articles, or conference presentations – if you’ve never worked in a position of significant responsibility in healthcare IT, it’s hard to fathom why those who have should trust your assessment or value your opinions.

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From In the Beginning, There Were Delays: “Re: DoD’s MHS Genesis. The October 2016 military announcement said the pilot site go-lives would be delayed from December 2016 to June 2017. Should we assume they’re live but don’t want to brag about it with a press release?” Fairchild Air Force Base (WA) went live in February 2017. A tweet this week from the DOD says the the other pilot site, Naval Hospital Oak Harbor (WA), will go live “later this month.” 

From Informatics Professor: “Re: alerting privacy officers of users accessing unneeded patient information. The example of accessing records of a patient not seen in the past six months nor scheduled for an encounter implies that the only rationale for accessing a patient chart is direct treatment. There are other circumstances in which chart access is needed, such as data retrieval and quality audits.” The original poster suggested flagging such access for manual review, which would then uncover the extenuating user circumstances. The alerting could take user role into account, perhaps raising a more vigorous flag if the credentials used to look up inactive patients were those of a nurse aide rather than a quality analyst.

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From ECW Watcher: “Re: the HIMSS-owned publication’s ‘breaking news.’ They’re a month late.” The publication ran a piece Thursday (along with breathless tweets and an email blast) indicating that CMS won’t make users of EClinicalWorks repay their incentive payments. The 12-paragraph story (nearly all background filler) contained three quoted sentences that it attributed to “a CMS spokesperson.” A competing publication ran the same information with the same quotes on June 9 (screenshot above), which also helpfully directed readers to a CMS FAQ (from months before that, but not naming ECW specifically) instead of omitting links for fear of looking less than omniscient.


HIStalk Announcements and Requests

It’s early July – do you know where your interns and first-year hospital residents are? (answer: driving your experienced doctors crazy with their inexpert questions, ordering tests and meds better suited for textbooks than a busy ED, consulting all but the most basic problems out, and requiring constant hand-holding to avoid harming patients).

This week on HIStalk Practice: Montana clinics come under fire for lack of interoperability. Hamakua-Kohala Health rolls out Medfusion patient portal. CMS develops new QPP resources for physicians in rural and/or underserved areas. This year’s digital health investments will likely make 2017 a record-breaking year. Physicians – no matter their type of employer – are still frustrated with EHRs. Carepostcard launches to help patients thank, find compassionate providers.


Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Acquisitions, Funding, Business, and Stock

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Home monitoring technology vendor VRI acquires competitor Healthcom.


Sales

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In Ireland, Saolta University Health Group chooses the Evolve clinical document management system of Northern Island-based Kainos. 

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Dialysis clinic operator Fresenius Medical Care North America licenses Forward Health Group’s population health management system.


Announcements and Implementations

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Patient engagement app vendor Fitango Health will use InterSystems HealthShare Connect to develop a post-discharge action plan platform.

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Minnesota-based Treatment.com announces its Merlin artificial intelligence platform for diagnosis and treatment.

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FirstHealth of the Carolinas (NC) goes live on Epic. CIO Dave Dillehunt is leftmost in the above photo.

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Baylor Scott & White Health – Grapevine (TX) goes live on Pulsara, a smartphone-based app that allows first responders who are transporting potential stroke patients to coordinate with the ED on the way to the hospital.

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Eisenhower Medical Center (CA) goes live on Epic, apparently replacing McKesson Horizon Clinicals it chose in 2007.


Government and Politics

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Politico suggests that the VA’s abrupt announcement that it will implement Cerner under a no-bid contract was influenced by the White House’s Office of American Innovation, run by presidential son-in-law Jared Kushner. VA Secretary David Shulkin met with Kushner’s team, but says the decision was made independently.


Privacy and Security

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In Australia, a professor says he’s not convinced the country’s health system is ready for digitization following news that the Medicare card details of all Australians are listed for sale on the Dark Web. He notes that the government’s systems use somewhat primitive security measures, as well as the fact that the information is also stored on provider systems with varying degrees of security. He’s especially worried since the government’s centralized medical record is operated under an opt-in model that will change to opt-out in 2018. The professor advocates the “100 points” identity model as used for firearm permit applicants, in which many forms of ID can be presented as long as their weighted security value adds up to at least 100.

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In England, the Information Commissioner’s Office chastises Royal Free NHS Foundation Trust for inappropriately providing patient information to Google-owned DeepMind Health without their consent, requiring the trust to align its procedures with law, complete a privacy assessment, and commission an audit of its DeepMind trial project.

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Speaking of DeepMind Health, the hired independent review of the company’s activities finds that “the digital revolution has largely bypassed the NHS” as doctors use Snapchat to insecurely share patient photos and NHS holds “the dubious title of being the world’s largest purchaser of fax machines.” It notes that the original, much-criticized agreement with Royal Free Hospital contained a “lack of clarity” that has since been corrected in a new agreement and recommends that DeepMind cooperate fully with the ICO’s recommendations. Panel members also voted to have DeepMind Health pay them an honorarium instead of donating their time for free.

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A Cisco investigation finds that the Ukraine-based tax software company whose updates were used to globally propagate the recent NotPetya malware attack had not updated its servers since 2013, resulting in at least three penetrations in the past three months. Police raided the office and seized its servers, with the unintended consequence that customers who are required to use its software are now sharing older versions of it via Google Drive and Dropbox links, exposing them to potentially booby-trapped copies.


Other

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A team from Marine Corps Base Quantico develops Infrascanner, a portable infrared device that allows detection of intracranial hematomas on the battlefield, replacing the old system of a paper-based evaluation form and potentially avoiding evacuation for unnecessary CT scans.

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Epic’s non-marketing department is getting bolder about calling out CommonWell, I noticed, with the company noting on its website that, “Care Everywhere exchanges every 12 minutes what CommonWell exchanges in a lifetime.”

A New York Times report about low-quality nursing homes concludes that stricter oversight (fines and seldom-enacted threats to halt CMS payments) don’t seem to deter them since they just keep operating with poor metrics. The lawyer of a resident who is suing one of them says fines are just a cost of doing business for their large-corporation owners, especially since federal budget cuts allow only 88 nursing homes to be labeled as “special focus” even though regulators recommend such scrutiny for 435 facilities. 

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I missed this originally, so maybe it’s appropriate given the pandering for social media influencer votes: a study finds that people who use Facebook more extensively feel worse about themselves. Previous studies found that excessive Facebook use detracts from face-to-face relationships, reduces meaningful engagement, and erodes self esteem, but the new study additionally found that real-world social networks were positively associated with well-being while Facebook use was associated with negative well-being, particularly in mental health. Interestingly, time on the site was more predictive of negative impact than the level of Facebook activity (liking, posting, and clicking). The authors conclude,

Exposure to the carefully curated images from others’ lives leads to negative self-comparison, and the sheer quantity of social media interaction may detract from more meaningful real-life experiences.  What seems quite clear, however, is that online social interactions are no substitute for the real thing.


Sponsor Updates

  • Aprima customer Mt. Olive Family Medicine Center wins the 2017 NCMGMA Practice of the Year Award.
  • Visage Imaging releases an update for its Ease mobile app that adds support for video and encounters-based workflow.
  • Besler Consulting releases a new podcast, “How medical scribing is utilized at the point of care.”
  • CoverMyMeds will exhibit at McKesson IdeaShare 2017 July 12-16 in New Orleans.
  • EClinicalWorks will exhibit at the 2017 FSASC Annual Conference & Trade Show July 12-13 in Orlando.
  • FormFast publishes a new case study featuring Riverside Community Hospital.
  • InterSystems will exhibit at the Population Health Exchange July 10-12 in Colorado Springs, CO.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, 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 7/3/17

July 2, 2017 News 3 Comments

Top News

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Nuance’s post-malware update says the company is bringing Emdat (aka eScription RH) clients and MTSO partners back online, but eScription Large Hospital remains down. 

Nuance advises transcription customers that use BeyondText or iChart Hosted Solutions to have their physicians re-dictate their documents going back to 48 hours before the incident that occurred this past Tuesday, June 27. 


Reader Comments

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From Judy Fake-ner: “Re: Hoag Health (CA). Will be leaving Allscripts Sunrise to join Providence-St. Joseph Health’s Epic system. Heritage Medical group is also transitioning from Epic to Allscripts.” JF sent over an internal Hoag memo from February 2017 that explained why it’s moving away from Allscripts.

From Amphibious Assault: “Re: [company name omitted]. I asked the CEO what publications his team reads. He said that everybody just reads HIStalk.” Thanks. We have that in common, then.

From Gitche Gumee: “Re: EHR access rules. Why can’t EHRs include an alert notifying the privacy offer if staff look at information without need, such as someone accessing records from a patient last treated six months ago with no treatments scheduled? There’s a legal case pending where we found 252 breaches in confidentiality on 12 patients over a 12-month period, where we can’t determine why someone would need to access their clinical information.” 

From EMRDoc: “Re: Nuance outage. It is interesting and somewhat ironic how providers who were not previously interested in templates, smarttext, autotext, etc. are suddenly hungry for education about those tools for creation of documentation. This outage may be the best thing yet for user adoption! We also appreciate Nuance’s action to make voice recognition licenses and microphones available to assist with the outage. Ironically, this outage may inadvertently result in a decrease of our overall transcription volume in favor of front end voice recognition.”

From EHR Datahacking MIPS Solutions: “Re: MIPS data submission. Is it ethical to skim EHR database schema? This is being offered as a service and professional societies are lapping it up since it is cost effective (offshored). The database design allows intelligent guessing of which data fields house the patient-specific data needed for MIPS/PQRS quality submission, which appears unethical. Only Epic is smart enough to have controls in place to ward off unauthorized use of its databases. The accuracy of the data extracted and submitted to CMS is a different can of worms.”


HIStalk Announcements and Requests

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One-fourth of poll respondents say they’ve lost an IT job due to a new system’s implementation. Just a Nurse Analyst says she walked away from her job (and her five Epic certifications) after seeing the “creepy” situation in which Epic was directing hospital staffing decisions and pushing the CIO with threats to go to the CEO. Furydelabongo experienced poorly executed layoffs at a previous health system employer that was desperate to find operating dollars to support “an Epic project run amok with consultants” once requesting more capital dollars became distasteful. Greek CIO says he/she was displaced when Eclipsys convinced hospital management to outsource all of IT to the company at a 300 percent increase in staffing cost.

New poll to your right or here: For Nuance users: how much business will you give the company following its cloud services outage?

My “summer doldrums” special deal on newly booked webinars and sponsorships is winding down after a few companies jumped on board. Contact Lorre.

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

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Listening: new from Iowa’s Stone Sour, moving away from their last couple of progressive-type albums to pure alternative metal that invites vigorous, four-limbed desk-drumming (as I can attest). Also: Diablo Blvd, catchy hard rock from Belgium with a singer who – no joke – is a stand-up comedian. 


This Week in Health IT History

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One year ago:

  • Allscripts sues former chief marketing and strategy officer Dan Michelson and his new employer, Strata Decision Technology, claiming that Michelson and the company used confidential information to displace Allscripts as the top-ranked product in KLAS’s “Decision Support – Business” category.
  • McKesson announces that it will spin off its Technology Solutions business into a new company that it will co-own with Change Healthcare.
  • Definitive Healthcare acquires Billian’s HealthData.
  • A study finds that PCs and servers that control hospital medical equipment are often running old versions of operating systems that make them vulnerable to malware attacks.

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Five years ago:

  • MModal announces that it will be acquired by a private equity firm for $1.1 billion in cash.
  • The Supreme Court upholds the legality of the Affordable Care Act, including its requirement that every American carry medical insurance or pay a fine.
  • In England, Cerner complains to Cambridge University Hospitals Foundation Trust that its EHR bidding process was a sham and that it had already settled on Epic before launching it.
  • The government of Australia admits that the signup function of its just-launched personally controlled record system had to be taken offline when it was found to not support hyphenated patient names, with Accenture getting the blame.

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Ten years ago:

  • Francisco Partners acquires Dairyland Healthcare Solutions.
  • Mediware President and CEO James Burgess announces his resignation.
  • PSS World acquires a 5 percent stake in Athenahealth for $22.5 million.
  • Apple provides developer information for the just-released iPhone.

Weekly Anonymous Reader Question

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Responses to last week’s question:

  • 50 hours, six days per month on the road.
  • I’m a woman who just hit child-rearing years, so now I’m down from 75 percent max to just above 0 percent. I like having a husband!
  • 45 hours, not counting time I spend reading industry, technology, or professional development articles and books. Travel approximately 5 percent or about 2.5 weeks a year
  • Work hours should be held around 50. As for travel maximum, it should be 1 1/2 weeks per month.
  • 45 hours and 10 percent travel.
  • 40-45 hours per week and 20 percent travel.
  • Work hours including time in the air? Does this include the number of days that require me to leave my family on a Sunday afternoon? Work hours range from 50-75 depending on where I am traveling. I typically travel 50-60 percent of the days during a month.
  • Three days, three nights. What’s that saying? “Fish and company start to stink after three days.”
  • 9-5, work from home option. 10 percent travel requirements.
  • After years of 80 hours per week and 75 percent travel, I’ve found balance and what’s important in my life. At this point, I wouldn’t do more than 50 hours per week and 25 percent travel.
  • 45 hours of work, per week. 10-15 percent travel (1x/month ish).
  • 40-45, one week up to a couple times a year.
  • In my line of work (consulting), job opening are pretty thin right now so my expectations have changed a bit. I would hope to limit travel to three days a week, and a corporate mindset that if travel isn’t necessary to move the project forward, we don’t travel. I’d hope to find a culture where weekend hours are not the norm.
  • About 45 hours per week. Special projects may require more occasionally, but if you need me more than that, then you have an issue with resource allocation. For a position which requires travel, every hour, from the arrival at the originating airport to the destination, should be counted as a work hour, especially since I am expected to be on calls or work while in transit. So, roughly the same hours, with some exceptions. And if traveling on a weekend or holiday—comp time.
  • Don’t recall going at it with that focus in mind. However, now that I’m away from the the travel jobs and requirements, I can share that, yes, it’s typically the case that you arrive at client’s site around 7:30-8:00 a.m., usually work through “breaks” and lunch so you can “answer client questions,” you leave around 5:30-6:00 p.m. (maybe later if you need to meet with the doctors after their workday is done). After grabbing some dinner back at the hotel, you go back to your room and start making edits to a template, writing up a report, answering emails, etc. and finally call it a day around midnight. And that is just the M-F schedule, not the catch-up on the weekend. If I added up all the hours, I’m guessing I earned $2.75/hour! I don’t honestly know how I would have limited the weekly work hours and travels requirements and still kept my job. Can’t say I miss it! Not that part anyway!
  • 50 percent.
  • 50 percent, less than 10 nights out per month.
  • 60 hours per week, no more than 75 percent travel.
  • Realistic expectation based on 25+ years in travel roles: M-F belongs to your work life. You’ll work as many hours as needed for whatever phase of the project, and travel however many hours are required to get to/from the client site(s) for the week of work. If you are lucky there will be slow-ish weeks where you can get out in the evening and sample the local culture. Be sure to protect your weekends/holidays else the lines will start to blur and you’ll find that your work IS your life.
  • 70 hours. What a blessing that would be after working conference meetings while carrying on numerous marketing functions, launching new campaigns, presenting annual budgets with their justification, training sales, producing new materials, securing new clients, and creating new products. During my 25+ years in the healthcare business, I’ve slept possibly three hours a night, missed my child growing up, and have lost more relationships than I can count – never mind the issues this took upon my health. I’m happy to travel at any level and take certain conference calls while on the road. However, when I am on the road and taking two conference calls in each ear while being asked to speak with a prospect or answer sales questions is unreasonable. I travel typically during the evening on my own time. However with time changes, conventions, conferences, prospect and customer meetings, as well as bosses’ schedules, the calls tend to eat up valuable face time with clients and prospects. Working from 5:00 a.m. to 2:00 a.m. simply to meet expectations is unreasonable, then add the travel to that schedule is not an acceptable demand. I don’t mind working a 70 hour week, but 126 hours a week is a two-person job. 70 hours per week, excluding evening travel, seems much more reasonable than 126.
  • A limit of 200 work hours per month and 15 days of travel, with the hours spent in transit counting against the work hours limit. If either limit is exceeded, travel in business or first class would be required. Expense limits on hotels, meals, and incidental expenses need to be realistic for the locations visited.
  • 50 hours, 50 percent.
  • Particularly in light of the efficiencies of teleconferencing , my limits would be no more than 50 hours weekly and 10 days of travel per month. Average should be 40 hours with seven or less days of travel.
  • 50 hours per week and travel only seven days out of the month.

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This week’s question: for those who are allowed to work from home for at least one day per week, what restrictions or requirements does your employer impose? It would probably be informative to describe (in high-level terms) what your job involves since it’s likely to be a lot different for a software developer than an implementation consultant.


Last Week’s Most Interesting News

  • An apparent ransomware attack takes some of Nuance’s cloud-based services offline.
  • CMS cancels its scheduled release of Medicare Advantage data to researchers at the last minute, citing data quality concerns.
  • The chairs of the Senate Veterans Affairs and Armed Services committees urge the VA to seek the DoD’s advice in its Cerner contract negotiation and implementation.
  • Google offers consumers the ability to request that their exposed medical information be filtered from its search results.
  • Anthem agrees to pay $115 million to settle a class action lawsuit involving its 2016 hacker breach of 78 million records.

Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Sales

Wisconsin’s Department of Health chooses Cerner for its seven care and treatment centers in a 10-year, $33 million contract. In-state competitor Epic did not submit a proposal for the project, which drew five bidders.


Decisions

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  • Cedar County Memorial Hospital (MO) will replace NextGen Healthcare with Meditech in 2018.
  • Rankin County Hospital District (TX) will go live on Cerner by November 2017.
  • Christus Mother Frances Hospital – Sulphur Springs (TX) will replace Meditech with Epic in October 2017.
  • Teton Valley Hospital (ID) will move from Healthland to Athenahealth in September 2017.
  • Liberty – Dayton Community Hospital (TX) will go live on Cerner in March 2018.

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


People

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Sandy Rosenbaum, SVP of contracts at Iatric Systems, died June 21, 2017. The Alzheimer’s Association fundraiser launched in her honor by her husband — Iatric founder and CEO Joel Berman — has raised $223,000 vs. his goal of $10,000.

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The family of former Sutter health CIO John Hummel launches a fundraiser looking for help covering his rehabilitation costs following a fall-related head injury that has depleted his insurance benefits and personal funds. His LinkedIn profile says he’s now director of IS at Taos Health System (NM).


Announcements and Implementations

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Learn on Demand Systems adds an API-accessible instant notification engine to its training management and lab-on-demand learning systems, allowing instructors to send tips to particular students or to send commands that the student can play back in their lab console.

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The patent office issues five new patent allowances to Glytec for its diabetes therapy management software, raising the company’s allowed/issued patent total for EGlycemic Management System to 11, with another 50 pending.

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T-System integrates EBroselow’s SafeDose and SafeDose Scan medication calculations functionality into its T-System EV EDIS.

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Sphere3 releases Aperum Enterprise, which allows health systems to analyze nurse call light data and patient feedback to set patient experience benchmarks.


Government and Politics

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Austin, TX-based VA officials warn that the department’s $543 million real-time location (RTLS) system is in danger of “catastrophic failure” as the overdue system has failed operational tests and may not work on the the VA’s WiFi network. The VA pitched the system as the solution for managing inventory and ensuring equipment sterilization, but a DC hospital site visit found that the lack of a functional system has caused supply crises that have required cancelling surgeries and using expired surgical equipment. A VA employee’s email referred to the former HP Enterprise Services (now DXC Technology) as “nitwits” and refused to give the company access to its backup systems, while the company blamed VA incompetence. The company’s RTLS subcontractor is Intelligent InSites. Employees at the same DC medical center are refusing to use Catamaran, a $275 million predictive analytics supply chain system whose contract has since been terminated.


Privacy and Security

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Princeton Community Hospital (WV) remains down as its IT department continues to “build an entirely new computer network and install new hard drives on all devices throughout the system” following last Tuesday’s ransomware attack. The hospital lost access to all systems, email, and the Internet but has since installed 53 new computers to provide access to Meditech.

A Connecticut hospital warns local residents that scammers are spoofing its caller ID to demand that they send payment for medical services.


Other

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A West Virginia community college hosts a week-long Drone Camp for high school students, with funding for the 12 drones provided by Cabell Huntington Hospital (WV) via VP/CIO Dennis Lee, pictured above with the participants. 

The Boston Globe says consumers are losing patience with waiting room delays caused by intentional provider overbooking to maximize profit. The article observes that many hospitals don’t even monitor delays, possibly because despite alleged consumerism, their waiting rooms remain full. Possible solutions include hiring a patient flow coordinator to monitor delays, giving patients pagers so they aren’t tied to their chair waiting for their name to be called, posting notices on the board when doctors are running late, and tracking patient flow by RTLS.

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An Oregon trauma surgeon designs and creates a $50 3D-printed hand and forearm for a six-year-old.


Sponsor Updates

  • ZirMed receives HFMA Peer Review Designation for its charge integrity and claims management solutions and also announces that its charge integrity solution has identified $7.5 million in recoverable net revenue for Novant Health.

Blog Posts


Contacts

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

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News 6/30/17

June 29, 2017 News 5 Comments

Top News

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Nuance’s most recent update from Wednesday afternoon says it is still recovering servers following Tuesday’s malware attack. The company has not provided an estimated time to resolution.

Affected cloud services include transcription, radiology critical test results, Assure, Dragon Medical Advisor, Cerner DQR, Computer-Assisted Coding, Computer-Assisted CDI, CLU software development kit, and all Quality Solutions products.

Nuance recommends that cloud transcription users move to Dragon Medical or use an alternative dictation service, which suggests lack of confidence that the systems will be restored soon. A few customers say they’ve been told not to expect restoration of services until next week or even longer, but I can’t verify that.

Patient care is surely being affected as hospitals and practices try to implement minimally-tested downtime procedures or switch to backup transcription providers with the inevitable delays in patient information flow.

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It will be interesting to see, once the smoke clears, how Nuance handles the HIPAA implications of the malware attack given its massive healthcare presence. HHS has advised that a ransomware attack is by definition a breach since an unauthorized party has acquired PHI, but adds that if the business associate (in this case since Nuance isn’t a covered entity) can argue that it is unlikely that the information was compromised, then breach notification is not required. The Petya malware – which arguably isn’t ransomware — does not send data anywhere but instead permanently encrypts it (in essence, destroying it), so assuming Nuance can restore the PHI from backups, it may be able to successfully argue that the information was never exposed or threatened.

NUAN share price has declined just 5 percent since its systems went down Tuesday.

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Nuance seems to be understandably struggling with its public communication, same as any of us who would rather be fixing the problem than explaining it individually to every user affected by it. Some customers say the company is doing a great job of keeping them in the loop, which probably means that it’s doing the best it can given potentially outdated or incorrect contact information. The company:

  • Launched a communications page that was quickly taken down.
  • Announced in a press release that updates would be provided on a different page and via a Twitter account, neither of which contain any updates.
  • Hastily put up still another page (I’m inferring “hastily” given spelling and punctuation errors) and went silent on Twitter except for a single link to the newly created page.
  • Is taking heat from its transcriptionists who are questioning in the absence of definitive updates from Nuance whether they’ll be paid for being unable to work during the several days’ of downtime. However, a Nuance email to employees says they will be paid their normal rate for their scheduled hours and will be offered incentive pay to help clear the post-resolution reports backlog.

Reader Comments

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From Gordon Gecko: “Re: my KLAS-corrected comments about Cerner. My math is right. I included ‘new’ customers, which are of more interest to the Street, and excluded add-on sales to existing customers. I also said ‘if you take away DoD and the 30 micro-hospitals,’ 85 total. I included all Cerner losses. Maybe the most relevant takeaway is that there have been more Millennium defections in the last two years than Soarian defections. Looks like for every Weirton and Pinnacle that sues Cerner to escape Soarian, there are dozens who don’t dare.”

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From Yuge Surprise: “Re: DoD. The swam is not draining, but swirling.” Frank Kendall — the Pentagon’s recently retired undersecretary of acquisition, technology, and logistics — joins the board of Leidos. Kendall presided over the DoD’s selection of Leidos for its $4.3 billion EHR project.


HIStalk Announcements and Requests

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HIStalk had 12,114 page views Wednesday, which I assume can be attributed to ransomware interest and the fact that – because of reader tips — I reported Nuance’s incident many hours before anyone else. It was the fourth-busiest day since I started the site in 2003.

This week on HIStalk Practice: HHS announces $195 million in HIT-related community health center funding. BCBS of Nebraska takes over Think Whole Person Healthcare. Rhode Island providers protest PDMP legislation.Independent Health forms Evolve Practice Partners. Physicians show a decided lack of interest in MACRA prep. PatientPoint raises $140 million.


Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Acquisitions, Funding, Business, and Stock

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Cincinnati-based physician office marketing technology vendor PatientPoint raises $140 million in financing from private investment firms.

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Anti-trust concerns cause Walgreens and Rite Aid to cancel their planned $9.4 billion merger and instead strike a deal in which Walgreens will buy half of Rite Aid’s drugstores for $5.18 billion in cash. In other news, Walgreens apparently puts its much-regretted experience with Theranos behind it in announcing that LabCorp will offer specimen collection services in some of its stores.

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Diabetes management app and data analytics vendor Glooko raises $35 million in a Series C round, increasing its total to $71 million.


Sales

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Henry County Health Center (IA) chooses FormFast’s FastPrint and FormFast Capture.


People

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MedeAnalytics hires Paul Kaiser (TriZetto Provider Solutions) as CEO.

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Anna Clark (Truven Health Analytics/IBM Watson Health) joins Medecision as SVP/chief revenue officer.

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Greg Chittim (Arcadia Healthcare Solutions) joins Health Advances as VP/healthcare IT practice leader. 


Announcements and Implementations

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Ability Network adds physician scheduling to its ShiftHound workforce management product.

Novant Health (NC) and Carolinas HealthCare System (NC) begin exchanging patient information via an HIE.


Government and Politics

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An HHS/ONC bulletin warns of the most recent ransomware threat and provides recommended actions for affected sites.

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CMS halts its planned release of Medicare Advantage of claims data at the last minute, cancelling a conference presentation at which it was to have been unveiled. CMS blames unresolved issues with the quality of the information, which immediately raises questions: (a) if CMS is using the information to pay providers, why isn’t it good enough for research purposes?, and (b) given lack of commitment to an updated release date, will the data ever see the light of day? 

The Senate considers legislation that would ban the Department of Defense from doing business with antivirus software firm Kaspersky Lab, citing intelligence agency concerns about the company’s close ties to the Kremlin. 

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This headline and the threat it references say a lot.


Privacy and Security

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Heritage Valley Health System (PA) has brought its hospitals back online following its ransomware attack Tuesday, although its community locations remain closed. Princeton Community Hospital (WV) says it will “rebuild its computer network from scratch” following its Tuesday infection and it remains on diversion. 

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An interesting analysis of the Petya malware concludes that it’s not technically ransomware since it has no ability to actually recover the drives it encrypts even if the victim pays. The author says Petya is instead a nation-state authored “wiper” that is intended to destroy systems, disguised as ransomware to influence media reports. The intended target may have been institutions in the Ukraine, with the malware’s global spread possibly being unintended. That would make Russia the obvious suspect.

In a bizarre incident highlighted by DataBreaches.net, a federal judge chastises California’s attorney general for harassing movie site IMDb.com, the subject of a California law that requires the site to remove the factual age of celebrities who want that information hidden. The Screen Actors Guild backed the law – now blocked by injunction — by saying it would reduce Hollywood age discrimination.


Other

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A BCBS analysis of insurance claims finds that opioid addiction diagnoses have increased 500 percent in the past seven years. Twenty-one percent of patients whose claims were reviewed filled at least one opioid prescription in 2015, while the study also found that short-term, high-dose therapy increases the chance of addiction by 40 times compared to lower doses. 

In Kenya, three men are charged with stealing the body of a four-year-old from a hospital morgue, apparently with the intention of burying it. The hospital wouldn’t release the body because his family hadn’t paid his bill.

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I love dogs, but this is as ridiculous as people scamming airlines into providing free main-cabin rides for their “emotional support animals.” A woman brags on Twitter that she snuck her grandmother’s dog into the hospital to see her, swaddling it to look like a baby. A fellow smuggler voiced support in providing a photo of the dog he brought in (or rode in) as a visitor. Apparently many folks believe that rules apply to them only when convenient.


Sponsor Updates

  • IDC Health Insights recognizes NTT Data as a Top 25 Enterprise.
  • Reaction Data publishes an industry brief on the Lexmark/Hyland acquisition.
  • Optimum Healthcare IT posts a video of the recent presentation of Dan Critchley, CEO of managed services, at UK eHealth Week.
  • ECG Management Consultants releases a new white paper, “ASCs at a Tipping Point: The New Reality of Surgical Services for Health Systems.”
  • Glytec publishes a new case study, “With Glytec, Hospital Moves to Basal-Bolus Insulin, Saves $9.7 Million.”
  • Imprivata will exhibit at the Patient Safety Congress July 4-5 in Manchester, England.
  • Twenty-seven Influence Health customers upgrade to its new Web CMS.

Blog Posts


Contacts

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

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News 6/28/17

June 27, 2017 News 14 Comments

Top News

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A cyberattack of an unspecified nature against Nuance takes all of its cloud services – including dictation and transcription – offline. UPDATE: Nuance has since listed those applications that were not affected and the company is providing service updates.

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One HIStalk reader reports that the culprit was ransomware. The company’s announcement says the attack originated in Europe.

I reached out to Nuance but my email couldn’t get through because of a Nuance mailserver error that was likely caused by powered-down servers.

Other newly reported ransomware attacks include drug maker Merck and Heritage Valley Health System (PA), which had to take all computers offline. A reader forwarded an email stating that a West Virginia hospital is also under attack.

Early reports suggest that Ukraine-based hackers used a tool developed by the National Security Agency to create the malware, which is also how the WannaCry ransomware was developed. A Ukrainian financial software firm that was infected then apparently inadvertently spread the malware widely via its software update.

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Security firms believe the malware is a variant of Petya, which encrypts entire hard drives rather than just the files they contain. Like WannaCry before it, the malware can’t penetrate properly updated Windows computers. Microsoft released a patch MS17-010 in March that closed the exploit used by both WannaCry and Petya.

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Preliminary hacker reports suggest that the a “kill switch” has been found that involves creating a file called C:\Windows\perfc. It has also been observed that the hacker message is displayed immediately as the hard drive encryption starts and CHKDSK is invoked, meaning the infected computer can be powered down immediately and left down and intact until the malware can be removed after booting from a Windows OS copy on disk or USB.


Reader Comments

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From Meghan Roh: “Re: Epic App Orchard reader comment correction. We offer 50 percent off the first year’s fee, and if any member is dissatisfied in the first six months, we’ll refund the program fee. We have not reduced program benefits. For developers who don’t know what we offer, we provide a list of more than 300 APIs during the enrollment process to help them make their decision.” Meghan is director of public affairs for Epic.

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From Established Relationship: “Re: health systems implementing Epic. Epic does not require hospitals to follow its hiring practices (tests, interviews, etc.) They recommend testing applicants, but it’s up to hospitals to say yes or no. If a hospital opts to set aside their usual hiring practice and follow one recommended by a software vendor, they have to accept responsibility for losing experienced resources and implementing a system with a high percentage of inexperienced resources.” I think most health systems follow Epic’s model of maddeningly SAT-like tests and competitive interviews for newly their newly created positions that follow Epic’s recommended job descriptions and titles. I’m mixed on the practice, as follows:

  • It seems to work in ensuring successful project outcomes, even though it was developed by Epic for hiring new college graduates into their first jobs.
  • It’s not really too much different from other IT migrations in which those who maintained the legacy system are seen as one-trick ponies who are put out to pasture once their single skill is no longer needed, marginalizing the value of their non-system skills, experience, and relationships.
  • It would be tough as a health system project executive to announce that you’ve decided to ignore Epic’s advice, whether it involves hiring, project reporting, or anything else. You don’t want to be the person identified as having gone rogue when the project stumbles.
  • The biggest unsettling fact is that Epic’s model places minimal (actually negative) value on experience with other IT systems, yet its rigid certification and project management requirements nearly always deliver the expected results. That’s threatening to those who equate broad, long experience with better project outcomes.

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From Smuggler: “Re: health insurance. Why should the government be allowed to require consumers to buy insurance, or anything else for that matter?” I agree, as long as those invincibles who decide to roll the actuarial dice sign a legally binding waiver acknowledging that they won’t get a penny in benefits from Medicare, Medicaid, or hospitals when something unexpected happens. It’s like homeowner’s insurance, flood insurance, or car insurance – if you opt out of the system, you’re on your own. Whatever’s left of the ACA made insurance available and relatively affordable, so it’s hard to drum up a lot of sympathy for those who could have afforded coverage but chose not pay the taxpayer-subsidized price. All of this would be moot if US healthcare costs weren’t so ridiculously high compared to the rest of the world, the elephant in the room that politicians seem unwilling to address, leaving the only balloon-squeezing choices of covering fewer or healthier people, restricting access to care via ever-narrowing networks or uncovered services, or raising premiums and deductibles.

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From KLAS: “Re: reader’s comment about market share. The correct information from the 2016 and 2017 KLAS market share reports is as follows.”

  • Acute wins for 2015-2016 for Cerner — 249 (includes one Soarian add-on in 2015).
  • Total Millennium losses for 2015 and 2016 – 53.
  • Cerner’s net growth — 196 acute hospitals for 2015 and 2016.

HIStalk Announcements and Requests

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We provided an iPad Mini for Ms. N’s elementary school class in New York, which is using the tablet for self-assessing their art projects. She reports, “Students are able to take photos of their work give it a title and describe their art, including what materials they used and how they feel their worked turned out. The Mini allows students a sense of independence. Students are better able to share their work with family by using an art app that gives family an opportunity to comment on the artwork.”

Every year I offer a “Summer Doldrums” deal on newly signed sponsorships and webinars, because otherwise it’s pretty quiet and I get nervous that my industry irrelevancy has escalated. Contact Lorre.

Listening: new from San Antonio-based Nothing More, which plays a slick blend of prog rock, Muse-like soaring orchestration, and hook-laden alternative rock.


Webinars

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Sales

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Women’s Care Florida chooses the Healow patient engagement mobile app from EClinicalWorks to help women manage their pregnancies, integrated with the OB/GYN group’s ECW EHR.


People

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Kyruus hires Soojin Chung (Caradigm) as general counsel and chief administrative officer.

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Jennifer Rouse (IBM) joins ClearData as VP of marketing.


Announcements and Implementations

A new TransUnion Healthcare survey finds that two-thirds of patients with hospital bills of under $500 don’t pay off the full balance, a big jump from 2014 as deductibles increased. The company projects that 95 percent of patients won’t pay their bills in full by 2020, noting also that the percentage of patients who pay nothing at all toward their balances is increasing.

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An HFMA/Navigant survey of 125 health system CFOs and revenue cycle management executives finds that 74 percent are increasing their revenue cycle technology budgets, but are struggling to keep up with EHR upgrades and optimization. Consumer-facing tools such online payment portals and cost-estimation tools are common, but few health systems run propensity-to-pay models for individual patients.

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Long-term care software vendor Cantata Health chooses Ability Network as its preferred revenue cycle management software vendor.

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Baxter International integrates its DoseEdge Pharmacy Workflow Manager with Epic’s Willow pharmacy system to meet CMS requirements for documenting IV preparation accuracy. 

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Craneware announces GA of Trisus Claims Informatics, which automates claims review for completeness, accuracy, and conformance to normal charging behavior.

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St. Joseph Hospital (NH) goes live on the EarlySense continuous monitoring inpatient system that uses an under-mattress sensor to monitor heart rate, respiratory rate, and motion.

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In Canada, Waypoint Centre for Mental Health Care goes live on Meditech 6.1.

The State of Connecticut and the Connecticut State Medical Society will launch competing HIEs the next few months, with both organizations hoping users will be willing to pay for their services.

An Advisory Board analysis finds that the average 350-bed hospital fails to capture $22 million in revenue.


Government and Politics

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The chairs of the Senate Veterans Affairs and Armed Services committees urge the VA to ask the DoD about lessons learned in its EHR procurement and implementation, expressing concern about potential VA cost overruns, implementation delays, lack of standardized processes, and excessive customization. 

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A GAO report says the VA’s clinical productivity metrics provide incomplete and possibly misleading information, noting that those metrics fail to capture information from contract physicians and advanced practice providers; don’t adequately incorporate clinical workload intensity; and are hampered by providers who don’t log their time and activities consistently. The lack of good data prevents the VA from identifying and promoting best practices, GAO concludes.


Other

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A hospital scrub nurse in Australia develops Scrubit, which improves OR setup by automating preference cards, setups, and lists of required equipment.

British military doctors blame the Ministry of Defence’s IT system for their mis-prescribing of antimalarial drugs for soldiers being shipped out to Afghanistan. They say the system is slow and can’t always bring up patient histories, meaning soldiers may be inappropriately prescribed mefloquine, which can cause depression and suicidal thoughts. The decade-old DMICP system is a customized version of EMIS PCS, provided by Canada-based vendor CGI, which has been the key player in quite a few IT screw-ups including Healthcare.gov.

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MIT Technology Review says IBM is overhyping Watson, but the product still has the best chance among AI competitors of delivering healthcare value assuming that IBM can gain access to the data the system requires. The article says IBM has a leg up on startups because conservative large health systems trust it more than any other company. It notes that both IBM and MD Anderson raised expectations unreasonably before the organizations recently shuttered their joint $39 million project (budgeted for only $2.4 million). A snip:

To train Watson to go through giant pools of data and pull out the few pieces of information important to a single patient, someone has to do it by hand first, for thousands and thousands of cases. To recognize genes linked to disease, Watson needs thousands of records of patients who have specific diseases and whose DNA has been analyzed. But those gene-and-patient-record combinations can be hard to come by. In many cases, the data simply doesn’t exist in the right format—or in any form at all. Or the data may be scattered throughout dozens of different systems, and difficult to work with … To really help doctors get better outcomes for patients, however, Watson will need to find correlations between what it reads in health records and what Tang calls “all the social determinants of health.” Those factors include whether patients are drug-free, avoiding the wrong foods, breathing clean air, and on and on. But Tang concedes that today almost no hospitals or medical practices get that data reliably for a significant percentage of patients. Part of the problem is that hospitals have been slow to take up modern, data-driven practices. “Health care has been an embarrassingly late adopter of technology,” says Manish Kohli, a physician and health-care informatics expert with the Cleveland Clinic.

Researchers find that less than 1 percent of pathology specimens provide incorrect results due to mishandling (either switching samples between patients or “floater” cross-contamination), but DNA fingerprinting can eliminate those problems, albeit at a cost of $300 per test. Private insurance generally pays the cost to avoid higher bills for unnecessary or delayed treatment, but Medicare doesn’t. One urology practice starting using the error prevention system after being threatened by a lawsuit after it removed a man’s cancer-free prostate based on another patient’s specimen.

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A study finds that a combination of wireless smart pill bottles, lottery-based incentives, and social support did not improve medication adherence or readmissions for post-MI patients. 

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A drug company whose opiate addiction treatment drug was getting little market traction hires lobbyists and makes political contributions to influence drug court judges, who then order offenders to be treated with the product that is injected monthly. The resulting sales have increased the company’s market cap to $9 billion. On the positive side, the drug seems to work well in blocking the pleasurable effect of opiates, it’s not addicting, and it’s long lasting. The negatives are lack of proof of long-term efficacy and its $1,000 per month cost.


Sponsor Updates

  • The local paper recognizes AssessURhealth Director of Operations and veteran Kyle Mynatt for his community contributions.
  • Besler Consulting releases a new podcast previewing HFMA ANI 2017.
  • Glassdoor.com recognizes CoverMyMeds CEO Matt Scantland as a highest-rated CEO.
  • The General Services Administration (GSA) awards Audacious Inquiry (Ai) the 8(a) STARS II Governmentwide Acquisition Contract (GWAC).

Blog Posts


Contacts

Mr. H, Lorre, Jenn, 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 6/26/17

June 25, 2017 News 19 Comments

Top News

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Google adds medical records to the handful of categories that users can ask the company to remove from searches. Someone whose medical records have been exposed inadvertently or otherwise can ask Google to hide their information from its search results.

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Medical records thus join the Google categories of federal ID numbers, bank account numbers, credit card numbers, scans of signatures, copyrighted materials, and revenge porn that are already covered by Google’s removal policies.

The material is still visible on whatever site posted it, but is less likely to be discovered when it’s filtered from Google searches.


Reader Comments

From Vendor Locking, Data Blocking: “Re: Cerner and the DoD/VA. You covered this a year ago and it’s even more outrageous in light of the VA’s decision. Cerner forced the DoD to host MHS Genesis because, by Cerner’s rules, only Cerner can, even though the DoD finds that it’s technically doable by others. Cerner ‘is not willing to negotiate at this time for the procurement of the data rights that would enable the government to utilize the Cerner solution in a competitive environment.’ Why? Because it ‘could adversely impact Cerner’s … competitive market advantage.’  Is this is the good faith Shulkin should expect heading into negotiations without a competitive bid?” I don’t know much about government procurement (and don’t want to), but publicly naming Cerner and presumably Leidos as the VA’s no-bid vendor for a contract whose value could exceed $10 billion seems absurd regardless of the Congressional pressure the VA is facing. The DoD messed up in failing to force Cerner (pre-contract, of course) to open up the DoD’s hosting options even though Cerner came up with a hollow-ringing excuse about population health management requirements, forcing us taxpayers to ante up a few more dozen million dollars that unfortunately constitute little more than a rounding error in the massive project.

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From Supine Position: “Re: losing an IT job when systems are replaced. It’s SOP for health systems implementing Epic.” Indeed it is. Epic forces its own employment model onto its customers, requiring experienced hospital IT employees to interview competitively for newly created Epic positions and to take Epic’s bizarre but apparently effective logical reasoning and IQ-type tests that are scored secretly by Epic, resulting in only a gladiator-like thumbs up or down passed along from Epic to the hospital’s project executives who defer to Epic’s wisdom for fear of rocking the boat of their employer’s gazillion-dollar project. It’s almost like Epic is invalidating the hospital’s own methods of choosing and keeping employees. The rank and file who get passed over for the Epic team are thanklessly turfed off keep the legacy system lights on, huddling depressed like death row inmates as they watch former teammates head off to new physical locations, Epic training, and a secure employment future. I’m surprised that hospitals are readily willing to part ways with employees who have decades of experience, but on the other hand, the Epic model of creating new jobs and then eliminating the old ones is a convenient way to clean house without feeling guilty. Make no mistake – when your health system employer chooses Epic but not you, your IT life, your social standing among peers, and perhaps your city of residence will change.

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From Interested: “Re: Quantros. The CEO is leaving, according to this announcement that identifies her new position.” A May 26 trading update from Informa PLC says that Quantros CEO Annie Callanan will join the business intelligence and publishing company this summer. She joined Quantros in July 2014.


HIStalk Announcements and Requests

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The majority of HIStalk readers don’t believe Apple will live up to the hype in making the iPhone a significant interoperability component. John Smith says Apple doesn’t understand interoperability but instead is mostly interested in selling hardware to customers of its walled garden. Nick predicts Apple will be Fitness Trackers Round Two in giving already healthy people yet another gadget to play with. JC says the company’s deep pockets and strong consumer focus could allow it to make a difference, while Mobile Man says people need ways to store and share the medical information of themselves and family members that could be accessed by providers and anything Apple can do to support that would be great.

New poll to your right or here: Have you ever lost a job due to a health IT implementation?

Jenn did a great job covering for me while I was on vacation for several days. I like that she makes me at least temporarily redundant so I can get away without worrying about HIStalk, although I’m always anxious to get back in the saddle.

My candidate to become the next MySpace – LinkedIn, which under Microsoft’s ownership has become maddeningly slow, is being bloated with questionably useful and unintuitive features, and is becoming a nagware showcase of trying to get users to buy premium services. I actually dread looking someone up on LinkedIn now, nearly as much as I hate getting unsolicited pitches from it (like never-ending recruiter spam and generic partner pitches from India-based companies).


Webinars

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


This Week in Health IT History

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One year ago:

  • Massachusetts General Hospital (MA) notifies 4,300 patients that their information was exposed in a February 2016 breach of dental practice systems vendor Patterson Dental Supply.
  • McKesson announces that it will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare (the former Emdeon).
  • The VA signs up for IBM Watson to bring precision medicine to cancer treatment.
  • Teladoc announces its planned acquisition of consumer engagement platform vendor HealthiestYou for $155 million.

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Five years ago:

  • ONC’s Director of Meaningful Use, Joshua Seidman, PhD resigns to take a job as managing director of quality and performance improvement with Evolent.
  • The Supreme Court rules to uphold the ACA, including the individual mandate.
  • A GAO report finds that the VA and DoD have made progress in their pilot project to integrate care at the James A. Lovell Federal Health Care Center (IL), but delays in implementing the IT component have created additional costs.
  • Practice Fusion gets $34 million in Series C funding from by Artis Venture.
  • Five senators introduce a bill that would create a national standard for notifying affected individuals about information security breaches.

Ten years ago:

  • Michael W. Carelton joins HHS as CIO.
  • The Healthcare Solutions business of JPMorgan Chase and RelayHealth offer an integrated set of claim and payment processing solutions.
  • Mediware delists itself from the NYSE Arca stock exchange.
  • Two DoD medical agencies attempt to stifle use of the Joint Patient Tracking Application so they can spend millions to build their own.
  • Cerner gets 510(k) clearance for its new transfusion and specimen collection system that will be marketed under the Cerner Bridge Medical name.

Weekly Anonymous Reader Question

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Last week’s survey: what is the best practice you’ve seen for a company to encourage gender equity?

  • Pay equality.
  • Promote the qualified women into management, upper management, and into the C-suite.
  • I have not seen this implemented anywhere, but names should be removed from resumes. Resumes should stand alone on the quality of the content, not the name of the applicant. This would also level the playing field for people who get bypassed (and there are a LOT who do) for their “ethnic” sounding name.
  • Can we please stop referring to our MAs, RNs, and receptionists as “girls,” as in “I’ll have one of my girls get that for you” or “My girls didn’t come in today, so we unable to see patients.”
  • Actually promote women to senior line roles. Most senior teams are a horde of white guys and a few token women in legal, HR, and marketing.
  • Data, data, data. Benchmark all positions against market rates and target hiring/paying everyone at the 50th percentile. Stop asking new hires what they make (now the law in Massachusetts); decide what the position is worth and pay that to all applicants.
  • Having a respected female leader.
  • Hire more men? Not always true at upper management, but at middle and down, my teams have been dominated by women for as far back as I can remember. Nurses (female-predominant career) switching to IT plays a huge role in this.
  • None that I’ve seen, but the term gender equity is a good example of an oxymoron.
  • Truly following an employee engagement strategy like those from Gallup, Press Ganey, etc.
  • It’s not really a best practice per se, but I started my career at Epic, and as a female, I did not see any limits to my career based on gender. The CEO and many senior leaders are female. I think having that as a first example helped shape what I will accept and what I have sought out culturally at future employers.
  • Several years ago while I was on active duty, the Air Force opened fields that were previously closed to women. Of all the careers positions that I have held since then, I have come to appreciate that no organization does a better job at “assimilation” than the military.
  • Promoting a feminist to CEO.

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This week’s survey: If you were offered a new job, what would be your limit on expected weekly work hours and travel requirements? I’ve never had a travel-intensive job so I don’t really know how that works, other than I’ve heard people gripe about spending their evening hotel hours catching up on work after a full day in front of clients and prospects. Maybe my next survey should address travel tips from road warriors who have learned to live out of a suitcase with little time back at the office.


Last Week’s Most Interesting News

  • Senate Republicans publish the Better Care Reconciliation Act of 2017, the GOP’s renewed effort to repeal and replace ACA.
  • Theranos reaches a tentative settlement with Walgreens that would result in the retail pharmacy getting only $30 million and losing more than $100 million of its original investment.
  • Teladoc acquires Best Doctors, a telehealth vendor focused on offering remote second opinions to support complex medical cases.
  • CMS publishes the 2018 Quality Payment Program proposed rule.
  • FDA Commissioner Scott Gottlieb, MD outlines his digital health plans for the agency, which include the development and launch of a third-party certification program for low-risk digital health products.

Announcements and Implementations

The ACOs and IPA of Orange Care Group will implement Epic’s Healthy Planet population health management system and will also offer its EHR via Memorial Healthcare System (FL) and Epic Connect.


Government and Politics

Some of the scariest words I’ve heard out of Washington, DC involve the idea that people shouldn’t be forced to buy health insurance they “don’t want or need.” Who might that be, other than psychics who can predict with certainty that they won’t have an auto accident, experience a stroke or heart attack, get hit by an exploding genetic time bomb, or find that they have cancer? Choosing not to buy insurance is a gamble in which those who bet wrong on the likelihood of circumstances beyond their control stick hospitals with their bills (and thus everybody else who was responsible enough to insure themselves), receive inadequate care, or lead their families into medical bankruptcy. There’s a reason that even good drivers are forced to buy auto insurance even though they might rather spend the money elsewhere. Healthcare is so expensive that even the relatively rich couldn’t afford the uninsured cost of a major, short-term illness or any long-term one. Personal responsibility in healthcare comes from both lifestyle decisions as well as backstopping the inevitable eventual costs with insurance.

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Meanwhile, here’s the most insightful comment I’ve seen on the US healthcare system given that everybody focuses on the cost of insurance that inevitably reflects the cost of healthcare services.


Sales

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Australia’s Northern Territory selects InterSystems for its $196 million clinical systems replacement project. Telstra Health, Epic, and Allscripts failed to make the cut from the shortlist, while Cerner, Meditech, and Orion Health didn’t advance to the final four.


Decisions

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  • Ocean Beach Hospital (WA) will replace Healthland (CPSI) with Epic in October 2017.
  • University of California Irvine Medical Center (CA) will go live on Epic in November 2017.
  • Winneshiek Medical Center (IA) will replace Meditech with Epic in September 2017.
  • Mayo Clinic Hospital – Rochester (MN) will go live on Epic in 2018.

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


Privacy and Security

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Anthem will pay $115 million to settle a class action lawsuit over the 2015 cyberattack that exposed the information of 78 million people.


Other

A hospital in India denies well-placed rumors that its patient oxygen supply went offline for 15 minutes and thus killed 11 patients, even though reporters seeking information found that the records of the victims had vanished along with the oxygen supply logbook. Administrators of the 1,400-bed hospital say there’s no need for alarm since 10-20 patients die there each day. The same hospital killed two children last year after giving them nitrogen instead of oxygen.

A professor in South Korea says hospitals interested in artificial intelligence should focus their efforts on EHRs instead of IBM Watson. He adds, “I have to question whether we can use Watsons with absolute trust. It seems that hospitals have introduced the technology mainly for publicity reasons. They are promoting Watson to win the competition, especially now that its cost is falling.”

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A depressing New York Times article covers the opioid addiction problems of Delray Beach, FL, whose paramedics responded to 748 overdose calls in 2016, 65 of them involving fatalities. Most of the victims were from elsewhere since the town has several addiction treatment centers that draw in addicts from all over the country who stick around afterward, who are then pursued by minimally supervised, often fraudulent, and insurance-paid treatment centers, labs, and group homes that profit from their relapses. Delray’s mayor notes that you can’t cut hair in Florida without a license, but you can run a substance abuse center. Also noted is that the Affordable Care Act gave young addicts insurance that made them a target for unscrupulous operators found in abundance in South Florida, to the point that they try to steal business from each other by offering addicts manicures, gym memberships, and sometimes even drugs, also rooting for their relapses that restart the insurance benefits clock. Residents complain that the rapidly proliferating sober homes create endless noise, property crime, and homelessness once a resident’s insurance runs out.

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Georgia Tech researchers are developing a touchscreen that will allow dogs to call 911 if their owners experience distress or ask them to summon help. Those in technology-powered homes who plan in advance might name their dogs Alexa or Siri to double their chances of obtaining assistance.

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Weird News Andy notes the potential rollout of “self-driving doctors,” in which a Seattle design firm proposes a rather ridiculous system of in-home monitoring and a self-driving health pods that people step into to have their health-related measurements taken at their own location. The pods would also offer telemedicine sessions and dispense medications via artificial intelligence, whatever what means. The company says it’s just a concept, but adds that “there’s a very big need for much better care experiences.” I wish the many people who propose Jetsons-like ideas for improving health would take the time to understand it first, particularly from a public health perspective, but unfortunately all the techno-gimmickry focuses on that small population of self-paying people who can theoretically fuel a company’s bottom line.


Sponsor Updates

  • QuadraMed, a Harris Healthcare company, Sagacious Consultants, The SSI Group, T-System, ZirMed will exhibit at the HFMA ANI Conference June 25-28 in Orlando.
  • Surescripts will exhibit at the AHIMA Long-Term Post-Acute Care & HIT Summit June 25-28 in Baltimore.
  • Verscend Technologies releases a new podcast, “why value-based care requires ‘strength from all sides.’”
  • ZappRx names Julia Austin (Digital Ocean) to its board.

Blog Posts


Contacts

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

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News 6/23/17

June 22, 2017 News 1 Comment

Top News

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Senate Republicans release a draft of the Better Care Reconciliation Act of 2017. Main points of discussion thus far seem to be the bill’s curtailment of Medicaid expansion, elimination of most of the taxes created to pay for coverage expansion, elimination of subsidies for out-of-pocket costs beginning in 2020, restrictions on tax subsidies, and giving payers the right to charge older consumers more than younger ones. It does away with individual and employer mandates, and keeps policies related to pre-existing conditions and dependent coverage. A vote on the final bill is expected next week.


HIStalk Announcements and Requests

This week on HIStalk Practice: Industry insiders react to the 2018 Quality Payment Program Proposed Rule. The Dark Overlord strikes again. Persivia adds quality measurement reporting and submission capabilities to its PHM tech. Drchrono COO Daniel Kivatinos describes the ways in which blockchain just might survive healthcare. Eagle Physicians implements Carequality framework via ECW EHR. Tandigm Health selects Tabula Rasa’s medication risk mitigation technology. Formativ Health moves forward with $1.6 million expansion. Aledade announces Medicare Advantage ACO plans in Arizona.


Webinars

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


People

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Navicure hires Robert Hendricks (McKesson) as chief product officer and Andrea Maizes (Tradestation Group) as chief human resources offer.

Stanford Medicine (CA) hires physician burnout expert Tait Shanafelt, MD (Mayo Clinic) as its first chief physician wellness officer. Shanafelt will direct the WellMD Center and serve as the School of Medicine’s associate dean.


Acquisitions, Funding, Business, and Stock

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Theranos reaches a tentative settlement with Walgreens that would result in the retail pharmacy getting only $30 million and losing more than $100 million of its original investment. Theranos recently told investors that it only has $54 million left, while its monthly expenditures are said to be around $10 million.

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Bucking the current market-exit trend, Oscar Health will expand its ACA health plan offerings in Ohio, Texas, New Jersey, Tennessee, California, and New York. “For all of the political noise, there are simply too many lives at stake for representatives in Washington, DC not to do what’s right for the people,” says CEO Mario Schlosser, who co-founded the company in 2013 with Josh Kushner, the brother of President Trump’s son-in-law Jared.

Chronic disease management startup Omada Health lays off 20 employees just over a week after announcing a $50 million investment round led by Cigna.

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Forward Health Group is awarded a patent for its “system and method for the visualization of medical data,” which the population health analytics vendor will use to enhance its PopulationManager and PopulationCompass products.


Announcements and Implementations

Epic will offer end users the ability to license Mediware’s blood bank management system in combination with its Beaker LIS.

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University of Pennsylvania Health System goes live on NLP technology from Linguamatics.


Technology

GetWellNetwork will add medical animations from Nucleus Medical Media to its Interactive Patient Care software starting next month.

Iatric Systems will help US and Canadian providers integrate Think Research’s cloud-based medication reconciliation tool with their respective EHRs.

The SSI Group releases Analytics 2.0 to give providers deeper RCM insight.

ICare will add evidence-based content from Zynx Health via FHIR to its EHR for acute and post-acute markets.


Sales

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WellStar Health System (GA) will roll out PatientPing’s real-time care notification technology at 25 locations.

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Ohio Valley Surgical Hospital (OH) will implement Meditech’s Web Acute EHR next year.

The City of Corpus Christi Fire Department in Texas selects RCM software and ambulance supplemental payment program consulting services from Intermedix.

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In England, Taunton and Somerset NHS Foundation Trust will implement DeepMind Health’s Streams patient safety alerts app over the next five years. DeepMind Health is a London-based Google company that encountered media scrutiny in the UK last year after patients cried foul at having their data involved in a Streams pilot without their consent.

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Carolinas HealthCare System (NC) will deploy Cerner’s HealtheIntent population health management technology across the organization, including its Carolinas Physician Alliance. The health system – a Cerner Millenium shop – will also extend its remote hosting agreement with the company.


Privacy and Security

From DataBreaches.net:

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  • The Halifax Supreme Court in Canada rules that Roseway Hospital must pay $1 million to members of a class-action lawsuit filed over a 2012 privacy breach. It seems to be the first successful suit of its kind in Canada.
  • Michigan-based Purity Cylinder/Airway Oxygen notifies 500,000 customers of a ransomware attack that did not ultimately compromise PHI.
  • Four-physician Cleveland Medical Associates experiences an unsuccessful ransomware attack that prompts it to switch medical records systems.

Innovation and Research

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An Accenture report projects a annual growth rate of 40 percent through 2021 for AI focused startups working in healthcare, with robot-assisted surgery, virtual nursing assistants, and administrative workflow assistance topping the list of top AI applications in healthcare.

A CHIME survey on medication reconciliation practices conducted on behalf of DrFirst shows that 75 percent of hospital executives are most concerned about inaccurate or incomplete medication data, followed by inconsistencies across departments and shifts, and discharged patients being given incorrect medication lists.


Government and Politics

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AHRQ reports that between 2005 and 2014 opioid-related ER visits doubled and opioid-related inpatient visits increased by 64 percent.

In India, the state of Andhra Pradesh’s Department of Health, Medical, and Family Welfare signs a three-year agreement with Cerner for HIE services, data analysis, and policy expertise. The organizations will set up a Knowledge Command Centre from which to direct operations. Chief Minister N. Naidu has expressed a desire to eventually give every citizen access to their health data electronically.


Other

A man who jumped from an ambulance in a drunken state sues the City of Staten Island, its fire department, and the EMS workers who attempted to care for him. He claims they should have prevented him from taking the leap, and ultimately caused the injuries he sustained as a result. The patient’s lawyer contends that, though the facts of the case are unusual, he was in such an inebriated state that he was in no condition to make decisions about his own safety.


Sponsor Updates

  • LogicWorks announces managed services support for Microsoft Azure.
  • Experian Health, MedData, and Navicure will exhibit at the HFMA ANI conference June 25-28 in Orlando.
  • Netsmart will exhibit at the Long Term Post Acute Care and HIT Summit June 26 in Baltimore.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN 2017 National Convention June 25-27 in New Orleans.
  • Reaction Data publishes “Hottest Trends in Revenue Cycle Management.”
  • Walter Groszewski joins The Direct Companies (Direct Consulting Associates and Direct Recruiters) as director of client partnerships, HIT & Life Sciences.
  • DrFirst exhibits at the Annual Physician-Computer Connection Symposium through June 23 in Ojai, CA.

Blog Posts


Contacts

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

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News 6/21/17

June 20, 2017 News No Comments

Top News

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Teladoc will acquire Best Doctors, a global company that provides virtual medical consult services to employers and payers, for $375 million in cash and $65 million in common stock.


Reader Comments

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From Ex-Epic: “Re: Epic billing services. Not sure if this has already been announced publicly. It looks like Epic is starting a Billing Services team: ‘Epic is seeking bright, motivated individuals to join our new Billing Services team as we enter the world of medical billing. Our goal is to simplify the payment process by helping Epic organizations with the complexities of submitting claims and posting payments. Attention to detail is vital as you’ll be posting payments and denials; reconciling payment files, claims, and statements; resolving posting errors; and calling payors to follow up on outstanding or unpaid claims.’”

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From Ex-McK: “Re: McKesson’s ranking. The Fortune 500 issue was not too kind to the Pharma division of McK and it’s difficult to fathom how John Hammergren can bring in an average of $60M+ per year over the last 10 years. As one of those who was ‘released’ from my employment I find it galling, but that’s probably just me.” Fortune’s annual list puts McKesson at number five, just ahead of UnitedHealth and CVS Health. I didn’t care to dig any deeper into the list given its obnoxious interface and floating auto-play ads that took too long to recognize my many attempts to stop them.


Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Acquisitions, Funding, Business, and Stock

LTC EHR vendor MatrixCare acquires competitor SigmaCare for an undisclosed amount.

The SSI Group expands its reseller agreement with Cerner, offering its RCM services to Cerner Millenium end users.


People

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Robin Hackney (Greenway Health) joins Ingenious Med as CMO.

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After just one year on the job, Memorial Hermann Health System (TX) CEO Benjamin Chu, MD resigns without providing a reason beyond his desire to pursue his “passion in health and public policy.” Charles Stokes, EVP and COO, has been named interim CEO.

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Ability Network hires Jamison Rice (BCBSMN) as EVP and CFO.


Announcements and Implementations

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Woman’s Hospital (LA) deploys electronic patient signature and eForms technology from Access.

HIE operator Vermont Information Technology Leaders implements Wolters Kluwer’s Health Language Enterprise Terminology Management solution.

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University of Toledo Medical Center’s multispecialty physician group (OH) rolls out PatientKeeper’s Charge Capture technology to streamline billing at UTMC and affiliated SNFs.


Technology

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Health Catalyst develops new technology to help providers better understand costs of care as they relate to patient outcomes.

Apple is reportedly working with digital health startup Health Gorilla in its efforts to turn the iPhone into a personal health data storage device. CNBC reports they are working to add integration points that will allow iOS to import results from hospitals and lab-testing companies like Quest Diagnostic and LabCorp.

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Payment technology vendor Patientco announces enhanced integration with Epic.

Modernizing Medicine adds electronic prior authorization capabilities from CoverMyMeds to its EMA specialty-focused EHR.

SCI Solutions adds new scheduling and worklist management features for multi-location providers to its Schedule Maximizer software.

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Recondo Technology adds payment collection capabilities from HealthPay24 to its RCM offering.


Sales

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Auburn Community Hospital (NY) selects analytics and 340B drug discount program solutions from Sentry Data Systems.

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Hartford HealthCare (CT) will implement Stanson Health’s analytics and clinical decision support software.


Privacy and Security

Citing last year’s ransomware attack on MedStar (MD), the Wall Street Journal reports that some hospital executives avoid reporting ransomware breaches because HHS rules say hospitals only need to report attacks that result in exposure of medical or financial information, while ransomware attacks encrypt the information, but don’t necessarily expose it.

From DataBreaches.net:

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  • Torrance Memorial Medical Center (CA) notifies patients of an April email breach that may have exposed personal information. Hospital officials have hired a third-party forensics firm to assess the scope and impact of the phishing attack.
  • Daniel Devereux, a homeless computer hacker in the UK known as His Royal Gingerness, is jailed for his 2015 attacks on the Norfolk and Norwich University Hospital and Norwich International Airport.
  • Thanks to a proactive encryption strategy, Waverly Health Center (IA) experiences little to no disturbance from a June ransomware attack.

Government and Politics

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Michigan Lt. State Governor Brian Calley gathers with Henry Ford Health System and Appriss Health representatives to announce $2.1 million in funding to connect the Michigan Automated Prescription System with provider EHRs across the state. Calley hopes the integration, which will be aided by Appriss technology, will increase physician use of the PDMP from 28 to 80 percent.

The Office of the Chief Actuary of CMS forecasts a 13 million reduction in insured patients by 2026 if AHCA is passed, 10 million less than the CBO’s prediction. Reuters reports Senate Republicans will unveil their version of the bill on Thursday.

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CMS releases the 2018 Quality Payment Program Proposed Rule. Health IT-related highlights of the 26-page summary include continuing to allow providers to use 2014 certified EHRs, and offering bonus points for using 2015 technology exclusively.


Innovation and Research

A West survey on patient experience finds that shorter wait times, upfront pricing, more communication options, and not feeling rushed during appointments are key to their satisfaction with providers. Nearly 80 percent claim they won’t hesitate to fire doctors that don’t meet their expectations.


Other

Australia makes genome sequencing available to patients for $6,000 through Genome One and the Garvan Institute in Sydney. Should demand increase, the Australian Genomic Healthcare Alliance may look for a way to fund testing through the country’s Medicare program.

Babies in China, on the other hand, can have their genome sequenced for the bargain price of $1,500. Earlier this month, Boston-based DNA sequencing company Veritas Genetics – a spinoff of Harvard’s Personal Genome Project – launched full genome sequencing via MyBabyGenome. Its sequencing report addresses 950 inherited diseases, 200 genes connected to drug reactions, and 100 physical traits the child is likely to have.


Sponsor Updates

  • Besler Consulting releases a new podcast, “Working with the first CJR reconciliation report.”
  • CoverMyMeds will sponsor Startup Weekend Columbus – Maker Edition June 23-25 in Ohio.
  • The Cleveland Plain Dealer and WorkplaceDynamics include Direct Consulting Associates in its list of Top Workplaces for 2017.
  • Diameter Health supports the Juvenile Diabetes Research Foundation Promise Ball Gala.
  • ECG Management Consultants will exhibit at the National Bundled Payment Summit June 26-28 in Arlington, VA.
  • EClinicalWorks, Hayes Management Consultants, Imprivata, and Kyruus will exhibit at the HFMA ANI conference June 25-28 in Orlando.
  • The Healthgrades award-winning internship program cultivates new talent to achieve excellence.
  • InterSystems will exhibit at the International Healthcare Summit June 26-27 in Kelowna, BC.
  • Solutionreach publishes a new white paper, “The Patient-Provider Relationship Study: The Ripple Effect Starts with Boomers.”
  • Mez Pharma Group selects the Liaison Technologies Alloy Platform for Healthcare.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, 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 6/19/17

June 18, 2017 News 1 Comment

Top News

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FDA Commissioner Scott Gottlieb, MD outlines his digital health plans for the agency, which include the development and launch of a third-party certification program for low-risk digital health products that it deems “software as a medical device.” He adds that using “a unique pre-certification program for SaMD could reduce the time and cost of market entry for digital health technologies.”


Reader Comments

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From Peg Leg Pete: “Re: Problems at Baptist Health. As a group concerned with how EHR implementations are affecting hospitals and their financial situations, we are currently seeing some problems in Florida. Baptist Health in Pensacola is having delays and cost overruns on their Allscripts implementation. The hospital may face layoffs. As it’s a private hospital, this news isn’t reported publicly.” The 492-bed Baptist Health selected Allscripts in 2015, deciding to implement Sunrise plus a number of other financial and population health management technologies. The provider’s bond ratings agency noted in April of last year that it had taken on a $22 million loan from Allscripts to fund the roll out.

From Potato, Tomato: “Re: VA Cerner vs. DoD Cerner. There seems to be some debate at the VA and in Congress as to whether Cerner will use an ‘identical’ system to the DoD or a ‘similar’ but separate system. (I’ll bet 10 out of 10 HIStalk readers know the answer.) No doubt Cerner’s PowerPoint experts are frantically focus-grouping which line style looks the most ‘seamless’ when you draw it between a VA box and a DoD box.”

From Gordon Gecko: “Re: Cerner financials. I read somewhere (was it HIStalk?) that Cerner’s stock price didn’t pop on the VA announcement because it was already expected/baked in. More likely, the street is aware that … if you take out the DoD and one deal that bundled 30 micro-hospitals … Cerner has actually lost more hospitals as customers (96) than it has added new (92) in the last two years. Not confidence-inspiring, especially when coupled with a late and scope-reduced DoD pilot.”

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From Eagle Eye: “Re: Middle Eastern HIT. Ministry of Health Saudi Arabia is about to sign a $1.5 billion dollar deal with GE. GE will be developing an HIS that consists of its specialty modules (maternity, cardiology, etc.), and combine it with two very basic health information systems – one locally-developed billing solution and a Turkish HIS. The MOH is in for a major mess as the solution has not been even built. It is not clear whether GE is planning to re-enter the HIS market after exiting it a long time ago, or if it’s a one-off thing taken on for the money.”


HIStalk Announcements and Requests

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The “Noes” have it when it comes to considering research studies before purchasing health IT or signing up to participate in private or public clinical programs. Pragmatist puts the role of such studies during decision-making in perspective: “Research results are very important from many standpoints, but generally provide minimal insight into commercial systems that are not readily subjected to research comparisons due to intellectual property considerations.”

New poll to your right or here: Given the latest round of industry speculation around Apple’s healthcare efforts, do you think it is truly capable of moving the patient-centered interoperability needle? I know it’s a loaded question, and so I’m hoping you’ll expound on your “yes” or “no” by leaving a comment.

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Welcome to new HIStalk Platinum Sponsor PatientPing. The Boston-based, Silicon Valley-backed company is building a network of providers who are notified via real time "pings" when their patients receive care elsewhere, allowing them to share care instructions for better care coordination. The network includes physicians, nurses, case managers, and care coordinators in hospitals, EDs, ACOs, physician practices, SNFs, home health agencies, and payers, all of whom rely on PatientPing’s network to support their delivery of high-quality, cost-effective care with improved patient outcomes and experience. I interviewed CEO Jay Desai earlier this year and he did a great job explaining the company’s lightweight technology, the resulting workflow, and its business model. Thanks to PatientPing for supporting HIStalk.


This Week in Health IT History

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One year ago:

  • Reuters reports that McKesson is discussing a merger of its Technology Solutions IT business with Change Healthcare (the former Emdeon).
  • An independent investigation recognizes Healthcare.gov as the second-most secure consumer website, while Twitter took top honors.
  • Doctors at the University of Pennsylvania are seeking approval to use CRISPR gene editing technology on humans for the first time.
  • Federal agents have arrested 300 suspects in the largest ever crackdown on Medicare fraud, with suspected losses totaling $900 million.
  • VA Undersecretary of Health David Shulkin, MD says during testimony before the Senate Committee on Veterans Affairs that its EHR modernization plans are “not dependent on any particular EHR.”

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Five years ago:

  • CMS reports that more than 110,000 EPs and over 2,400 hospitals have been paid a combined $5.7 billion in EHR incentives from Medicare and Medicaid.
  • The VA establishes a goal of conducting more than 200,000 clinic-based telemental health consultations in fiscal year 2012.
  • An FDA report finds that software problems cause 24 percent of medical device recalls.
  • The US Supreme Court refuses to consider an appeal by former McKesson Chairman Charles McCall to overturn his 10-year prison sentence for scheming to inflate company revenue.

Ten years ago:

  • Richard Granger, head of NHS Connecting for Health in the United Kingdom, has announced that he will leave the program at the end of the year.
  • Pro basketballer Dikembe Mutombo buys a smartcard-driven EHR for a hospital in the Congo.
  • Athenahealth announces IPO plans.

Weekly Anonymous Reader Question

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Last week’s survey: What characteristics made the worst doctor you’ve ever had so bad?

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This week’s survey: What is the best practice you’ve seen for a company to encourage gender equity?


Last Week’s Most Interesting News

  • Rumors circulate that Apple wants to store health information on the IPhone, and work with EHR developers to allow users to export information to providers as needed.
  • The House Appropriations Committee approves a $65 million down payment toward the VA’s Cerner procurement, with the stipulation that it will integrate with both DoD and private EHR systems.
  • Omada Health raises $50 million in a round led by Cigna, which will offer the company’s digital chronic disease management technology to its members.
  • Kieran Murphy is named president and CEO of GE Healthcare, succeeding John Flannery who has been promoted to CEO and chairman elect of GE.
  • An OIG report concludes that CMS inappropriately paid eligible providers $729.4 million in EHR incentive payments.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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


Acquisitions, Funding, Business, and Stock

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ChartSpan Medical Technologies raises $16 million in a venture round led by Cypress Growth Capital, bringing its total funding to $22.15 million since launching five years ago. The Greenville, SC-based chronic care management-focused technology vendor plans to create 300 jobs over the next 18 months and expand beyond its Appalachian borders.

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Inspira Health Network (NJ) announces plans to open the Inspira Innovation Center to develop and commercialize patient-focused health IT.


Government and Politics

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TIAG will customize its Warrior Performance Platform to meet the needs of US Navy sailors. Originally developed for training programs for Special Operations forces, the WP2 will evolve into the Human Performance Self-Service Kiosk, enabling sailors to log fitness, training, and nutritional goals, plus sync them with data from select wearables. No word on whether the data will eventually link with the DoD’s MHS Genesis EHR from Cerner.


Decisions

  • Wadley Regional Medical Center At Hope (AR) will go live with Cerner in December.
  • Sartori Memorial Hospital (IA) will switch from McKesson to a Cerner inpatient EHR in October. (Its clinic will remain with an Epic ambulatory EHR.)
  • Hereford Regional Medical Center (TX) will switch from Healthland (a CPSI company) to Cerner next month.
  • Select Specialty Hospital – Danville and Gainesville (PA) plans to switch to Epic.
  • Regency Hospital Of Central Georgia will go live with Epic in 2019.

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


Privacy and Security

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In New York, prescription eligibility check vendor CoPilot Provider Support Services agrees to pay $130,000 to settle a case with the state attorney general after waiting more than a year before notifying affected patients that a hacker had accessed its system and stolen 220,000 patient records.

A Global Cyber Alliance survey finds that US hospitals have, for the most part, not yet invested in cybersecurity tools at an enterprise level – a statistic that bodes well for hackers looking to take advantage of organizations that have made themselves sitting ducks either through lackadaisical attitudes on the part of upper management or lack of funds. Just six of the 50 largest public hospitals have adopted an email authentication, policy, and reporting protocol known as DMARC. Presumably bigger budgets have enabled 22 of 48 for-profit hospitals to implement DMARC; only one of those has implemented it to the level that it prevents suspicious emails from hitting inboxes.


Innovation and Research

Researchers from the University of Miami Miller School of Medicine and the California Pacific Medical Center will use a $300,000 grant from the Muscular Dystrophy Association to develop and integrate an ALS Toolkit with Epic. The kit will consist of a set of smart forms within the EHR that will help MDA ALS Care Center providers collect and access standardized health data for clinical and research purposes.


Sponsor Updates

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  • Summit Healthcare helps raise money for The Gatehouse, this year’s MUSE conference’s selected charity.
  • QuadraMed, a division of Harris Healthcare, will exhibit at the Wisconsin Rural Health Conference June 21-23 in Wisconsin Dells.
  • Salesforce will accept applications for its incubator program through July 15.
  • The SSI Group renews its HFMA Peer Review designation for the sixth consecutive year.
  • SK&A publishes a “US Elder Care Market Summary.”
  • Versus Technology offers its RTLS for wayfinding initiatives using Bluetooth Low Energy networks.
  • Zirmed will exhibit at the CAPG Annual Conference June 22-28 in San Diego.
  • LogicStream Health will exhibit at the 2017 AMDIS Physician Connection Computer Symposium June 20-22 in Ojai, CA.

Blog Posts


Contacts

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

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Reader Comments

  • meltoots: Let me get this straight, to improve efficiency and reduce burden on VENDORS they can self declare their cert EHR works....
  • Still doesn't make sense: Why would the tax payers have to charter a private jet for Secretary Price to go visit athenahealth? It smells bad in...
  • Sam: It's really not that funny (or hypocritical as I suspect you're trying to imply). First, if it were a similar story, was...
  • Tomhh: I think what is odious, is when the Obamas went on a a date night to NYC on Airforce One or when the Obamas would take...
  • Tom: RE: Equifax and waiving rights. A week ago, Equifax updated their incident website (https://www.equifaxsecurity2017.com...

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