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News 12/21/16

December 20, 2016 News 15 Comments

Top News

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HIMSS announces that President and CEO Steve Lieber will retire at the end of 2017. The organization has opened a search for his successor.

Lieber seems a bit young (63) to be retiring. The timing is interesting since EVPs John Hoyt and Norris Orms announced their retirement in February 2016, yet both are still working – Hoyt is consulting back with HIMSS Analytics and Orms is a VP of a recruiting firm.

About the only long-time senior executive left will be Carla Smith, who would seem to have a good shot at replacing Lieber unless the intention is to start over with a clean slate for whatever reason.


Reader Comments

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From Spilt Infinitive: “Re: like/dislike buttons for comments. Have you considered adding them? I like that online articles in the Economist, WSJ, NYT, etc. show me which comments are most liked by readers. It’s also satisfying when people ‘like’ my comments.” Good idea. I’ve added that capability to both articles and comments. You are now free to like and be liked as much as you like.


HIStalk Announcements and Requests

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An anonymous vendor executive has once again donated $10,000 for use as DonorsChoose matching funds, meaning that for every dollar donated by HIStalk readers, the executive will match it (along with likely other available  matching money from the corporate partners of DonorsChoose). I’m not soliciting donations since charitable contributions are a personal decision, but those who want to get extra bang for their educational donation buck can do this:

  1. Purchase a gift card in the amount you’d like to donate.
  2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
  3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
  4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers.

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Ms. M from Illinois expressed a lot of appreciation for our funding of her small DonorsChoose grant request (around $100) to provide nine sets of headphones for the reading center of her elementary school special education class. Students started using them the day they arrived, as she explains, “The morning of this grant getting funded, I had to throw away all of our classroom headphones because the ear pieces broke from wear and tear. All I can say, is that you made my students feel so special and they had the biggest smiles on their faces. I sincerely thank you for making such a significant sacrifice to our classroom.”

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HISsies nominations remain open. I’ve received only 12 responses that may or may not be representative of popular opinion (I can tell you for sure that some of them are way out there), so don’t blame me if major omissions creep onto the final ballot because you didn’t nominate obvious choices.

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Welcome to new HIStalk Gold Sponsor Dynamic Computing Services. The nationwide staffing and IT consulting firm — founded in 1990 by Gary Sherrell — has offices in Austin, TX and Maple Valley, WA. Healthcare makes up more than 50 percent of its business, where it has placed more than 3,100 resources and earned an 80 percent repeat business rate. DCS services include staff augmentation, legacy support, optimization, project management, analytics, and technical services. The company has completed 1,200 health IT projects – 200 of them involving Epic’s systems – and supports all major EHR vendors. Candidates can check out their open positions. Thanks to Dynamic Computing Services for supporting HIStalk.

A slight majority of poll respondents think I should list contract extensions and upgrades in my “Sales” section, but some commenters agree with me that we’re mostly interested when a hospital switches vendors. Others, however, point out that the hospital may have undertaken a full product search before re-upping with their same vendor (even though we have no way of knowing if that’s the case) and that might make it newsworthy. I think I’ll go this route – I won’t run contract extensions or seemingly minor expansions of the original agreement (like adding one more minor module when re-upping), but a product conversion like Meditech Magic to EHR or Soarian to Millennium is probably newsworthy.

To my fellow progressive music fans: Yes is finally chosen for induction in the Rock and Roll Hall of Fame after three tries. The Hall-accepted lineup contains the obvious choices from the dozens of musicians who have been part of Yes over its nearly 50 years – Anderson, Bruford, Howe, Rabin, Squire, Wakeman, White, and Kaye (I would have omitted Rabin and included Peter Banks). Yes shares a dubious distinction with its fellow 2017 inductee Journey: both bands tour today with a sound-alike replacement lead singer they found by watching YouTube videos of crappy tribute bands covering their hits, keeping the cash registers ringing from non-purist fans who just want to hear familiar heyday hits in a slightly elevated form of karaoke. It will be awkward if the bands play at their induction since they have three choices: (a) reconfigure in an uncomfortable, temporary reconciliation that omits current members who weren’t named; (b) play without key personnel from their glory years; or (c) fill the stage with a bevy of former and current members like Yes did on its cobbled-together and dishonestly named Union tour of 1991 that was more of a redundancy-filled, synergy-seeking corporate merger than an organic (no Wakeman pun intended) artistic effort.


Webinars

January 18 (Wednesday) 1:00 ET. “Modernizing Quality Improvement Through Clinical Process Measurement.” Sponsored by LogicStream Health. Presenters: Peter Chang, MD, CMIO, Tampa General Hospital; Brita Hansen, MD, CHIO, Hennepin County Medical Center. The presenters will describe how they implemented successful quality governance programs, engaged with their health system stakeholders, and delivered actionable information to clinical leadership and front-line clinicians. Q&A will follow.

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Charlotte Brien, MBA, solutions consultant, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.


Acquisitions, Funding, Business, and Stock

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TPG Capital will acquire healthcare software vendor Mediware from its private equity owner Thoma Bravo. TPG’s portfolio also includes Evolent Health, PatientSafe Solutions, and Quintiles.

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India-based cloud services provider 8K Miles will acquire healthcare consulting firm Cornerstone Advisors Group for $10.25 million in cash and stock. Cornerstone was founded in 2008 by Keith Ryan, who was previously CIO at Stamford Health System and Elmhurst Memorial Hospital. Reader Dave notes that the acquiring US entity had $5 million in profit on $27 million in revenue last year, with the overall entity reporting $40 million in revenue.

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Active aging app vendor GreatCall acquires remote monitoring technology company HealthSense.


People

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Gil Enos (EHealth Intelligence) joins WiserMazars LLP’s healthcare consulting group as principal.

Digital rehab technology vendor Reflexion Health hires Sudipto Sur, PhD (Signal Genetics) as CTO.


Announcements and Implementations

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BayCare (FL) implements an electronic screening system for newborns that allows sending EHR-stored patient information electronically to the state’s department of health.

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University of Miami Health System (FL) will take over 17 Walgreens retail clinics in South Florida and will use the drug chain as its exclusive retail pharmacy provider. Both organizations use Epic.

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Caradigm enhances its population health management solutions to support MACRA and bundled payments, adding Care Bundles, Content Builder, MACRA solutions, Advanced Computation Engine, and Utilization and Financial Analytics.

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A Healthgrades survey finds that most consumers would choose a doctor who has limited appointment openings but who offers online scheduling over a more available doctor who schedules appointments only by telephone. Two-thirds would be willing to trade a convenient location for being able to schedule online. The company’s new physician directory enhancements include online scheduling, smart reminders, and Google Maps integration. I only wish Healthgrades would eliminate the entirely incorrect inclusion of the non-specific, redundant social title “Dr.” in front of the name that already includes the correct designation of “MD.”

Iatric Systems is developing IV-EHR interoperability with Hospira’s smart infusion pumps using its Accelero Connect technology. 


Government and Politics

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ONC’s Director of Public Affairs and Communications Meghan Roh joins Epic as director of public affairs. I don’t know if this is a newly created position, but it’s interesting that Epic is hiring someone with quite a bit of political and government experience.

A Massachusetts law takes effect January 1, 2017 that requires doctors to give patients electronic access to their medical records and to use EHRs that are connected to the Massachusetts Health Information Highway.


Privacy and Security

From DataBreaches.net:

  • A Texas company that provides elective ultrasound baby pictures exposes its images, physician reports, and employee information to Web searches after misconfiguring a server to activate an unsecured RSYNC directory synchronization protocol.

TMZ reports that UCLA Medical Center (CA) may discipline several dozen employees who couldn’t resist snooping around in the medical records of Kanye West during his recent breakdown-triggered stay. It’s not the most reliable source, but the story is easily believable since not only is Kanye a big celebrity, he lost it publicly while performing


Innovation and Research

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Glytec earns its sixth patent for precision diabetes management technologies related to its SaaS-powered eGlycemic Management System that provides personalized insulin dosing, enterprise glucose surveillance, and analytics.


Other

An AHRQ-authored Health Affairs article raises concerns about the financial burden caused by high-deductible health insurance policies. I might take the contrarian approach in suggesting that high-deductible plans were created for exactly that reason – to encourage better self-care and rational health choices while exposing high prices in hopes healthcare competition will kick in (note: it hasn’t – the big just keep getting bigger). Our healthcare dollars provide way too much profit for the companies and people involved, but we also need to change the attitude that health and healthcare costs should be convenient.

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Jordan Shlain, MD is a good writer whose latest work, “Medicineball is the new Moneyball,” argues that doctors need to develop a data perspective for the good of patients. He says,

The crazy thing is that doctors, and I am one, have historically not participated in the data collection game. This was just a artifact of geeky computer science engineers building crappy code that doctors hated using (and still, mostly do.) Data will give us a new perspective — A data perspective. This new illuminating presence is an opportunity that presents itself once in a generation. We can now see things in a new light.

This puts doctors into the precarious position of being in the “if you’re not at the table, you may be on the menu” paradigm. Physician data is currently collected by EMR vendors, insurance companies, laboratory and radiology companies, pharmacies, revenue cycle management companies, and a host of other third parties — but not the doctor….or if they do, it’s the exception. I have a hard time believing that your friendly, local insurance company will happily supply doctors all they data they want. This data is expensive, comes at a premium, and is viewed through the lens of market share; not necessarily patient care. Doctors need to step up and start collecting their own data.

A New York Times article questions whether taxpayers get a good deal when NIH researchers help develop promising immunotherapy cancer drugs that are then licensed to drug companies that will make millions of dollars. Critics point out that taxpayers paying for the drugs twice — once to develop them, then again in buying them at high list prices since Medicare isn’t allowed to negotiate prices. NIH gets a tiny chunk of the proceeds as royalties, but has removed from its contracts a requirement that the drug companies sell the products at a “reasonable price.” The article notes that a  prostate cancer drug that sells for $129,000 per year in the US (two to four times what other countries pay) netted UCLA $500 million when it sold its royalties, but NIH says it’s not qualified to determine whether the price is reasonable and thus likely to make it unavailable to most people. 

An article notes indignantly but unsurprisingly that “pharmaceutical distributors have been quietly stocking pharmacy shelves with these pills in areas where addiction is the highest,” with a single West Virginia pharmacy in a town of 300 people receiving 9 million narcotics tablets to resell in two years. The article fails to mention that those doses were dispensed because they were prescribed by doctors and presumably requested by patients, both of whom escape the article’s misplaced wrath in shooting the literal messenger. The same investigative reporting methods could probably self-righteously proclaim that McDonald’s, during the same time period, sold a lot of hamburgers to massively overweight West Virginians. The key in both cases is to reduce demand, not complain that suppliers meet it.

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A JAMA-published observational study finds that Medicare patients managed by female intensivists experience lower mortality and readmission rates than those who are managed by their male counterparts. The authors cite previous studies in which female doctors were found to be more likely to practice evidence-based medicine, deliver more patient-centered care, and approach problem-solving more deliberately. The difference is not large enough to get excited about (despite the moronic USA Today headline above), but my takeaways are: (a) anyone who thinks female doctors are somehow less competent – if indeed any of those folks are still around — can see how wrong they are; and (b) it would also be interesting to similarly look at outcomes by country of medical training and the age and personality type of the doctor. I’ve worked with some flamingly incompetent physicians and many of them were questionably qualified foreign medical graduates, but that was a long time ago when standards were lower and this was in geographically undesirable areas where most of the dangerous docs were unmotivated locals or overseas opportunity-seekers. I would be happy now to have a doctor who graduated outside the US, especially since their educational system is a lot better than ours.


Sponsor Updates

Holiday Activities

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PerfectServe employees are supporting charitable programs that include donating duffel bags packed with personal items for adolescents completing treatment services; providing financial support to a co-worker who lost belongings in an apartment fire; collecting food and supplies for families affected by the Gatlinburg, TN fires; and collecting food for the Chicago food bank.

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Cumberland Consulting Group team members wrap presents for the Youth Villages Holiday Heroes Program in Nashville.

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The Ingenious Med sales team creates care packages for The Packaged Good.

  • The Chartis Group publishes a white paper titled “Post-Election Analysis: Strategic Imperatives for Providers in an Uncertain Landscape.”
  • Besler Consulting releases a new podcast, “The potential impact of the Tom Price nomination as HHS Secretary.”
  • MModal is awarded a three-year agreement as an awarded supplier to Vizient’s Novaplus, its exclusive provider of clinical documentation improvement.
  • Black Book’s latest user survey ranks Oracle Healthcare Cloud the number one ERP solution for value-based care processes.
  • InstaMed opens registration for its User Conference 2017 March 27-29 in Philadelphia.

Blog Posts


Contacts

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

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Morning Headlines 12/20/16

December 19, 2016 News No Comments

How Geisinger Health System Uses Big Data to Save Lives

Harvard Business Review profiles Geisingers use of analytics and natural language processing to drive earlier identification of sepsis, improve post-acute follow up care for patients who have non-critical conditions diagnosed during a hospitalization, and track surgical outcomes and costs.

The Children of Agent Orange

ProPublica and the Virginian-Pilot analyze decades-old data from the Department of Veterans Affairs and find that the odds of having a child born with birth defects is significantly higher among veterans exposed to Agent Orange during the Vietnam War.

Amidst Political Uncertainty, the shift to Value Continues: PwC Health Research Institute’s Top Health Industry Trends for 2017

PwC publishes its list of top issues healthcare issues for 2017, which includes shifting to value-based reimbursement models, engaging patients more effectively, modernizing payment processes, and adopting new technologies to drive each of these initiatives.

Rethinking the Role of Retail Clinics

December 19, 2016 News 3 Comments

HIStalk takes a deeper dive into a recent study that found retail clinics have a negligible impact on nearby ED admissions.
By
@JennHIStalk

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Retail clinics have gotten a bad rap lately, thanks to an Annals of Emergency Medicine-published study that found the clinics had a less-than-hoped-for impact on local ED visits. While that particular statistical nugget certainly made for good headlines, a deeper dive into the research finds that such clinics may well be on their way to not only alleviating low-acuity ED visits, but to finally becoming a trusted part of the care continuum.

Evolution of a Business Model

Since debuting in 2001, retail clinics seem to have grown exponentially, taking up valuable real estate in strip malls, pharmacies, shopping malls, and even the local commuter train station. Accenture predicts that their numbers will close in on 3,000 within the next several months – a 46 percent increase over 2014 figures. Patients – primarily those with private insurance – have become accustomed to their convenient hours, accessibility, and increasingly transparent pricing.

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Health systems have certainly jumped on the retail clinic bandwagon for a variety of reasons. “Hospitals and health systems are employing a variety of strategies to reduce the use of emergency department and hospital readmissions,” says Nancy Foster, AHA’s vice president of quality and patient safety policy. “One such strategy is partnering with existing retail clinics or creating their own. This helps patients by giving them an additional access point for critical follow-up care after a hospitalization. And by having a formal partnership, the hospital or health system can more easily share follow-up instructions with clinical staff at the retail clinics.”

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Mount Sinai Health System (NY) is one such health system that has recognized the need to offer additional access points as part of broader population health programs. The system, which has seven hospitals and over 140 physician practices, announced a partnership with urgent care company CityMD earlier this month, and seems intent on closing the loop between urgent care and primary and specialty care visits. The partners plan to jointly establish quality metrics for a shared network of preferred providers, ensuring that CityMD patients have immediate access to specialty care through Mount Sinai providers. They will also share EHRs for faster data access, though they haven’t gotten into specifics as to how their respective Epic and EClinicalWorks systems will talk to one another.

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Some clinics, like the new Westmount Place Walk-in Clinic in Ontario, are opening with the express intent of alleviating the local ED’s physician shortage. “We know we are in a crisis from an emergency room perspective if our hospital is fundraising for an emergency room resident,” explains local government official Catherine Fife. “Having urgent care centers like this, which are community based, is an important asset we need to have in more communities across the province.”

Rethinking the Results

Though the Westmount clinic’s provenance puts it outside the purview of the AEM study, it provides a concrete example of the potential role retail and urgent care clinics can play in a community’s care continuum, including significantly reducing ED visits.

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This potential did not show up in study results because, according to MinuteClinic President and CVS Health Executive Vice President and Associate Chief Medical Officer Andrew Sussman, MD, it looked at data from 2,053 EDs between 2007 and 2012 – a time when awareness and general usage of retail clinics was very early on.

“The results show statistically significant reductions in low-acuity ED use for commercially insured patients in communities where retail clinics were open,” he explains. “While the reduction may be small (1.2 percent), you should keep in mind that the old data evaluated in this study had only 1,200 clinics at its peak. MinuteClinic alone has 1,100 clinics today across 33 states. The effect of retail clinics today is far greater than the early phase of their development in this study.”

“The study also doesn’t take into account the presence of any urgent care clinic sites in a particular area,” he adds. “There are far more urgent care sites, around 9,000, than retail clinics in the US overall. Urgent care has been growing at about 8 percent annually, compounding their effect. Without knowing the precise location of the large number of urgent care sites, it is impossible to interpret the trends of low-acuity care seen in EDs.”

From Concept to Cost-Savings

Sussman goes on to point out that the study’s results should ultimately be viewed through the lens of today’s healthcare ecosystem rather than that of five years ago, when “coordinated care” was still in its infancy and “value-based care” was a concept confined to a cocktail napkin. “We have far more clinics, much higher levels of utilization, and higher awareness of retail clinic services,” he says. “Also, transparent retail clinic pricing is particularly attractive to today’s growing number of Americans with high-deductible health plans, not present prior to 2012, and as consumerism in healthcare grows. In addition to private insurance, today more retail clinics accept Medicaid than they did during the study period.”

Sussman brings up a good point: Retail clinics, which traditionally have opened in suburban communities with higher-income, privately-insured consumers, are seeing reimbursement opportunities increase thanks to Medicaid expansion. Couple that with the burgeoning interest of health systems – especially where shared referral networks and healthcare technology are concerned – and you have a recipe for retail clinic success when it comes to significantly impacting ED visits and even hospital readmissions.

Sussman sums up by saying, “in today’s retail clinic world, we would expect to see even more significant reductions in ED low-acuity visits due to retail clinic presence. Many millions of patients appreciate the access to care and cost savings that retail clinics provide.”

Monday Morning Update 12/19/16

December 18, 2016 News 7 Comments

Top News

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HHS tweaks the Health Insurance Marketplace rules for plan years starting January 1, 2018, assuming it’s still around then (670,000 people signed up on Healthcare.gov last Thursday alone in its busiest day ever). The new rules, most of them addressing risk pools, include:

  • An interim final rule on the payment of premiums by third parties.
  • A pilot program program to test whether it’s worth checking the eligibility of people who sign up during special enrollment periods.
  • Risk models that take partial year enrollment and prescription drug utilization into account.
  • Creating a high-risk enrollee pool.
  • Increasing the out-of-pocket maximum to $7,350.
  • Showing an indicator of each plan’s network breadth and flagging those plans offered by a provider delivery system.

Reader Comments

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From Truven Watcher: “Re: Truven Health Analytics. Rumor was that new owner IBM was deep-sixing its Unify and Unify ACO population health initiatives, which never got off the ground. The website now shows no references to population health or those products – you get a 404 error. How long before CareEvolution, the engine for several of Truven’s products, goes away too?” Searching Truven’s site for “Unify” brings up links to now-deleted press releases and product pages. IBM acquired the company for $2.6 billion in February 2016 and rolled it into Watson Health, joining its mishmash of puzzlingly unrelated and expensive acquisitions that include Phytel, Explorys, and Merge Healthcare.

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From Stock Doc: “Re: Athenahealth. It’s hard to believe that ATHN can sustain the price bump from this week. Upping earnings guidance after a year of misses reeks of desperation to placate the Street.”

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From HIT-A-Go-Go: “Re: HIStalkapalooza. Where is it written that it must be a free event? I’d still go if there was a modest charge.” I’ve thought about requiring those who RSVP to put some financial skin into the game in hopes of reducing the maddening no-show rate of 40-60 percent, but the big challenge is that a modest payment doesn’t have much impact on the overall cost of $150-$200 or more per attendee. The facility’s minimum buy-out and the band’s fixed cost means I can’t really flex it down (I created a horrifically complex Excel worksheet to try to find the sweet spot in telling me how many people I can invite vs. the bar, food, and endless service charges). The amount of financial risk and work makes me yearn for my original vision – a do-it-yourself kind of keg and barbeque party with a marginally skilled but really loud local band blasting away in a vacant parking lot where anyone with a HIMSS conference badge is welcome to attend. Every year I swear I won’t do it again because it’s too much to manage, but then I see how much fun people have and I soften up.


HIStalk Announcements and Requests

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Half of poll respondents expect their overall 2017 health spending to be modestly more than in 2016, while 29 percent say they’ll probably spend a lot more next year.

New poll to your right or here: Which inpatient EHR vendor seemed to gain the most ground in 2016? Your answer will be subjective, but that’s OK since perception is often reality in HIT-land.

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Mrs. M says her Virginia third graders are using the science equipment we provided in funding her DonorsChoose grant request to make real-world connections to what they’re studying. They are working with a gemstone dig kit, a microscope, a terrarium, and a chain reaction kit.

While reading “Between You & Me: Confessions of a Comma Queen” last week, I was grammatically inspired to think about which conversational traits I find most puzzling. Maybe it’s blurting out “Yeah, no” or “No, yeah” in an excited response to a question or statement that the original speaker has barely completed. It’s often young uptalkers who do it, I’ve noted, and who are also prone to beginning sentences with “so.” It’s not so much the usage, but that it’s peculiar to their demographic, maybe due to sloppy phone-texting habits carried over from virtual social situations into real-life ones. I have my own conversational crosses to bear since I drop G’s at the end of words like “talking” due to being raised in a hardscrabble holler so far back that we had to pipe in daylight.

Listening: Blood Ceremony, 1970s-style, prog-influenced “flute-tinged witch rock” from Canada (think Jethro Tull mated with Coven). Singer, flutist, and organist Alia O’Brien is unsurprisingly eloquent and thoughtful given that she’s in her fourth year of her PhD studies in ethnomusicology at the University of Toronto with emphasis on the music of North American Muslims.

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My broadband provider sent a tech out to investigate my connection speed problems, which he apparently resolved by replacing some of the wiring connectors out by the street. He also mentioned that my modem is dual band and thus puts out a faster 5 GHz Wi-Fi signal that my old laptop doesn’t recognize, so it defaults to the slower connection. He suggested I try a USB wireless adapter that supports higher speeds and the $25 Net-Dyn is doing the trick – obviously the broadband provider’s throttle won’t let me greatly exceed the speed I’m paying for, but it’s definitely faster than before.


HIMSS Conference

I’m struggling to believe that it’s just nine weeks until the HIMSS conference, meaning I should get some of my many to-dos out of the way now. I say it every year, but health IT newcomers don’t appreciate the seasonality of the industry in which 75 percent of the year’s work happens between January and April when companies spend a big chunk of their marketing budgets (because of the HIMSS conference), the first financial reports of the calendar year set the tone, and lots of job-hopping and acquisitions take place.

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I’ve opened the HISsies nominations. It’s like the presidential elections – skipping the primaries means you lose the right complain about who’s on the final ballot. I’ll email the final voting ballot HIStalk readers who subscribe to my email updates (to avoid ballot box stuffing) in the next couple of weeks.

February 13-17 will be New Sponsor Intro Week on HIStalk, which I just made up. I’ll interview the CEOs of new Platinum sponsors who sign up between now and then during that prime, pre-HIMSS week (a maximum of five). Assuming they say something interesting, perhaps folks will drop by their expensive booths to check things out. Contact Lorre.

It’s not quite time to open up HIStalkapalooza invitation requests (even though I’m getting inquiries regularly), but look for that in the next 2-3 weeks.


Last Week’s Most Interesting News

  • SocialWellth resurrects the mobile health app certification program of the former Happtique, which it acquired in late 2014.
  • Scanadu ends support for its Scout, which was once touted as the early phase of tricorder-like development.
  • Carequality and CommonWell Health Alliance announce plans to allow their users to exchange information.
  • The American Heart Association, AMA, DHX Group, and HIMSS launch the non-profit Xcertia, which will establish best practices for mobile health apps.
  • President Obama signs the 21st Century Cures Act into law.
  • The consumer app of Quest Diagnostics is breached, exposing the information of 34,000 users.
  • Cost estimates of California’s prison system implementation of Cerner are doubled to $400 million due to a poorly designed contract that omitted key items.
  • The Wireless-Life Sciences Alliance trade group and the HIMSS-owned Personal Connected Health Alliance merge.

Webinars

None scheduled soon. Contact Lorre for webinar service


Acquisitions, Funding, Business, and Stock

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West Corporation acquires 911 ETC — which allows companies to identify the location of 911 callers within their premises — for $10 million in cash.


Decisions

  • Erlanger Bledsoe Hospital (TN) will go live on Epic in 2017.
  • FirstHealth Richmond Memorial Hospital (NC) will switch from McKesson to Epic in 2017.
  • NYC Health and Hospitals/Jacobi (NY) will go live with Epic In 2017.

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


People

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Henry Heimlich, MD, inventor of the namesake choking intervention, died Saturday at 96. He performed his own technique for the first time earlier this year in saving a fellow senior living resident.


Privacy and Security

From DataBreaches.net:

  • LA County reports that more than 100 of its employees fell for a phishing attack in a single day this year, exposing the information of 756,000 people and resulting in felony charges against the Nigerian national behind the attack.
  • A Florida man is sentenced to four years in federal prison for attempting to sell the information of 1,000 patients stolen as printed records from medical device vendor Rotech Healthcare.
  • East Valley Community Health Center (VA) announces that it was attacked by ransomware in October, although it didn’t pay the ransom. The hackers used the Shade ransomware, whose control servers were seized by Dutch police in July 2016, allowing Intel Security and Kaspersky Lab to create free unlock tools as part of the “No More Ransom” project.

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The latest Protenus breach report shows that 57 health data breaches were reported in November, although the number of records affected was lower than in June and August since no massive breaches were reported. Just over half of the breaches involved insiders, nine were due to hacking, and three of the hacks involved ransomware.

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The Yahoo breach provides a reminder that everyone should use a password management program (it also reminds me how superior Yahoo Mail is to the incredibly clunky and frustrating Gmail, having used both for years). I use the free and life-changing LastPass. Benefits:

  • You only need to remember the master LastPass password.
  • Passwords are synched and shared not only among devices, but among other people you designate for accounts you share.
  • It will automatically log you into sites if you choose.
  • It will store multiple credentials for the same site, so that if you have both a business and personal Facebook or Twitter account, you choose which one to launch.
  • Changing a password is no big deal since it’s invisible afterward – LastPass logs you in normally using the new password behind the scenes.
  • Best of all, you can create complex passwords (or let LastPass create them for you) because you don’t have to remember them. Alt-G brings up a password generation menu, I just figured out. It even has a one-click change option where it logs into a site, changes the password to an automatically generated complex one, and then saves it.

Technology

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A startup in Kenya is developing Flare, an Uber-like app for summoning an ambulance, hoping to reduce the two-hour delay involved with getting help from private ambulance companies in Nairobi. Users will be able to call an ambulance, stay in contact with the driver, and send their location with directions.


Other

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A hospital in Canada blames a parking company’s software bug for charging a visitor’s credit card $320 for one hour of parking instead of the correct $6 shown by his receipt. The hospital is about as consumer friendly as most – it advised the man to fill out a form and wait 4-6 weeks, after which he “may” get a refund check.

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@EricTopol always finds interesting articles to tweet about, including this brilliantly written one in the New York Times Magazine (so good, in fact, that I subscribed to the digital version of the paper for the first time since good journalism and sharp writing is nearly impossible to find – the holiday special is just $98 per year). It describes how Google has rebuilt its popular Translate service to use artificial intelligence — allowing it to provide results much closer to those of human translators — and the rapidly evolving state of AI in general. The article notes that artificial intelligence is built without rules or assumptions and “learns” from what it observes, just like children who learn to speak without studying dictionaries first. It provides the work of radiologists as an example:

Medical diagnosis is one field most immediately, and perhaps unpredictably, threatened by machine learning. Radiologists are extensively trained and extremely well paid, and we think of their skill as one of professional insight — the highest register of thought. In the past year alone, researchers have shown not only that neural networks can find tumors in medical images much earlier than their human counterparts but also that machines can even make such diagnoses from the texts of pathology reports. What radiologists do turns out to be something much closer to predictive pattern-matching than logical analysis. They’re not telling you what caused the cancer; they’re just telling you it’s there.

John Halamka visits Israel with a Massachusetts trade delegation, leaving impressed with the confidence and self-sufficiency of children there (vs. the US, where he says “we’ve become helicopter parents and consider child self-sufficiency a risk”) and the large number of students who participate in military service before going to college. He will create a program for Israel-based companies to pilot their software in Boston.

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This is pretty cool: Visage Imaging sends up a drone inside the RSNA exhibit hall (before it opens) to provide an unusual perspective of their booth. I wonder if conferences will have to implement no-fly zones to prevent competitor espionage? It’s probably that or an overzealous vendor will shoot down another vendor’s drone and display it proudly in their booth. It would be cool to film HIStalkapalooza from a drone inside the House of Blues, but lawyers would have a field day if it came crashing down on the heads of unsuspecting attendees.

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Bizarre: a panicked passer-by calls 911 when she spots what appears to be a elderly woman frozen to death in a car in Hudson, NY (a not-unreasonable assumption since it was only 8 degrees there). Police rush to the scene and smash through the car window hoping to save the woman, who turned out to be the very lifelike CPR dummy of a medical training aids salesman who indignantly explained that he always straps it into the front seat beside him for transport (want to bet he travels solo on highways with an HOV lane?) I’m skeptical of his story because nobody’s CPR dummy is that realistic and dressing them up doesn’t make sense.

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‘Tis the season: Bethlehem, PA police arrest a local woman for stealing a baby Jesus from a nativity scene and dropping it off at the “safe space” of a hospital with a note signed by “concerned citizens” that said, “Child has a broken right foot which has been neglected. Parents Joseph and Mary Christ got a warning.” The woman says it was a joke, the long-tail humor of which she can contemplate during her court-mandated psychiatric evaluation.


Sponsor Updates

  • KLAS names Talksoft the highest-rated vendor for outreach services in its patient outreach report.
  • Computerworld recognizes TransUnion Chief Information and Technology Officer Mohit Kapoor as a 2017 Premier 100 Technology Leader.
  • Consulting Magazine recognizes Huron Consulting Group for its commitment to corporate social responsibility.
  • In England, Countess of Chester Hospital NHS Foundation Trust will pilot the Care Coordination Center Model using technology from TeleTracking to manage beds, patients, employees, and equipment.

Blog Posts


Contacts

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

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News 12/16/16

December 15, 2016 News 2 Comments

Top News

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SocialWellth — whose parent company DHX on Monday revived the Xcertia mobile health app guidelines program with HIMSS, the AMA, and the American Heart Assocation – brings back the Happtique app certification program.

Happtique closed its doors in late 2013 after researchers found obvious security holes in apps that had passed Happtique’s certification criteria that included security. SocialWellth acquired the dregs of the company in December 2014.

Apparently SocialWellth stripped app certification out of the new Xcertia and is separately offering “to showcase their proprietary apps, offer promotions, and provide discounts and services” at an unstated cost. 


Reader Comments

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From In Poor Taste: “Re: Epic VP Eric Helsher. He took to Twitter to throw shade at CommonWell once the CEQ/CW announcement was released. He then deleted the tweet. Wonder who got to him? It was mentioned in Politico’s daily email and that probably brought unintended attention. Don’t think for a minute that Epic doesn’t take an aggressive or competitive stance on the interop topic. Shame that at least he (if not all of Epic) are keeping score on such an important topic.” The deleted tweet apparently said, “Welcome @CommonWell to the interoperability party,” which seems innocent enough. His colleague, Epic VP Peter DeVault, left this comment on my Tuesday night post that explains the company’s position:

As for Epic’s ‘notorious’ non-participation in CommonWell, I’ve been saying for years that it’s likely there will always be multiple health information exchange networks such as Care Everywhere, CommonWell, various state-run HIEs, etc., and new ones not yet born. What Carequality neatly does is provide the governance and technical framework for any of those networks to communicate with each other. What that means is that not everyone needs to belong to everyone else’s networks in order to exchange information. That was never going to happen (just as it’s never happened, to my knowledge, in any other industry). What it means most importantly is that patients who receive care at facilities that belong to different networks that have implemented the Carequality framework are much more likely to have their complete record available at the point of care.

In addition to the networks themselves implementing the Carequality framework, individual organizations that are part of those networks have to agree to the Carequality rules of the road. Almost all Epic clients have already done so, as have clients of several other vendors. Assuming many CommonWell members’ customers also agree to those rules of the road, this will be seen as having been a great day for patients.

This has never been about us versus them, although that makes better copy for the press. It’s about deploying the right technology and agreeing on the right governance to make interoperability widespread, easy, and realistic – regardless of the endpoints, so that patients get the best care. 2016 has been a good year for that.

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From Jack Polarity: “Re: rags rewriting press releases. The plagiarism checker I tried showed the so-called news item to be mostly just repurposed vendor verbiage.” And you were surprised?


HIStalk Announcements and Requests

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Our long-time HIStalkapalooza red carpet sponsor Elsevier has declined to participate this year, so I’m looking for a replacement who will get a ton of invitations and exposure. I’ll even allow the red carpet sponsor CEO to greet attendees personally, hang around backstage or in my inner sanctum, and welcome guests from the stage – because otherwise I’m writing a scarily large (and probably NSF) personal check to cover a significant chunk of the event’s cost, which will then render this 10th annual HIStalkapalooza the last one since I’m not going into debt to throw a free party. Contact Lorre. Meanwhile, thanks to the several companies that are helping to underwrite the event — I’ll recognize them soon.

I need your advice: Should a health system’s vendor contract extension or product upgrade be listed in my "Sales" section? I set up a poll so you can tell me. I’m slightly leaning toward “no” since I think readers are mostly interested only in sales involving new products, but I’m torn because of new contracts like Soarian to Millennium or Meditech Magic to Web EHR, which require the customer to sign a new contract and implement a new system.

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Mrs. G from Minnesota says her first graders are already using the new science books we recently provided in funding her DonorsChoose grant request, where she allows them to choose a book to read for 20 minutes each day and then take home to read with their families.

This week on HIStalk Practice: The Los Angeles County Dept. of Health Services selects the Ez-Cap managed care tool from Allscripts. GAO reports on a plethora of data-sharing practice challenges. Physician Retraining and Re-entry Program finds slow going in impacting physician shortage. McKesson Specialty Health expands. Seven health IT CEOs make the "Best Value" list. First Choice Healthcare Solutions CEO Chris Romandetti recounts the importance of disaster recovery preparedness in the wake of Hurricane Matthew. Marathon Health goes with Quippe documentation tech. Humana consolidates its quality metrics by 80 percent. Kansas City Care Clinic VP of Behavioral Health and Community Programs Dennis Dunmyer details the IT challenges involved with integrating primary care, behavioral health, and oral care.

Everybody has poetic songs that make them a bit sniffly. One that’s been one of my favorites for a very long time: “The Drinking Song” by the long-defunct, fantastic Moxy Fruvous. The band wouldn’t say if it’s about the obvious (alcoholism), the subtle (the AIDS epidemic), or perhaps even death-caused loss in general. On the other hand, when I want to raise some goose bumps, it’s usually the live version of  Rush’s “Working Man,” which I was fortunate to have seen played live with stunning virtuosity on their Time Machine tour.


Webinars

None scheduled soon. Contact Lorre for webinar services.

Here’s the recording of this week’s webinar, “Three Practices to Avoid Drift Between Audits.”


Acquisitions, Funding, Business, and Stock

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Athenahealth raises 2017 earnings guidance, sending shares up 23 percent Thursday. They’re still down 26 percent in the past year.

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Publicly traded physician practice EHR/PM/RCM vendor Medical Transcription Billing will sell $10 million in Series A Preferred shares to help pay for its October 2016 MediGain acquisition and to acquire more companies. Shares of the money-losing MTBC face Nasdaq delisting since they trade for $0.82, having dropped 33 percent in the past year, and are down 84 percent since the company’s July 2014 IPO. The company’s market value is $8.5 million.

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CareSync will hire 350 people as it moves its headquarters to Tampa, FL. I interviewed CEO Travis Bond a few weeks ago.

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Scanadu, the one-time disruption poster child for its Tricorder-like diagnostic device, ends support for its Scout product, explaining that it was an investigational device and the FDA required the study to be closed (the accuracy of last statement is questionable). It’s not much of a loss except to those who paid $150 and more to participate in the $1.6 million online fundraising project of Scanadu (or “Scamadu,” as upset users are calling it). Scout never lived up to the Tricorder hype anyway, having been stripped down to record just a few rather boring vital signs like temperature and heart rate for all the dozens of millions of dollars it spent on research. The company is now pitching Scanadu Vitals, which measures blood pressure, temperature, heart rate, and pulse oximetry (which it manages to spell wrong on its site). It’s not as shady as Theranos or as predictably flawed as Google Glass, but it the similarities are increasing. The product also didn’t give users access to their own data.


Sales

Workplace health center operator Marathon Health chooses Medicomp’s Quippe and its MEDCIN Knowledge Engine to transform unstructured data into meaningful information and to streamline encounter documentation with templates and workflow tools.


People

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Rachel Neill (Nordic) joins Carex Consulting Group as president.


Privacy and Security

From DataBreaches.net:

  • A single-doctor medical practice in New Jersey notifies 4,277 patients that it was hit with a ransomware attack on October 6. 
  • Yahoo says 1 billion of its accounts have been breached in an incident going back to 2013, just three months after the company reported that the information of 500 million accounts was stolen in an unrelated breach. My bet is that this second huge breach will kill Verizon’s plan acquire Yahoo for $4.8 billion.

Kent Murphy, MD of Summit ENT Associates (TN) left a comment on a recent HIStalk post stating that his practice was hit by a ransomware attack on Wednesday. He paid the demanded $1,600 ransom but his EHR isn’t back up yet.

In India, hackers breach the systems of Apollo Hospitals, the country’s biggest private hospital chain, and gain access to the medical record from the recent 75-day stay of now-deceased Jayalalithaa Jayaram, chief minister of Tamil Nadu. The hackers also breached the accounts of several journalists and found emails suggesting that Jayalalithaa was given the wrong diabetes medication. Another article notes that  her stay will cost the government at least $2 million, as the entire floor of 30 rooms surrounding hers were vacated, 39 doctors were involved, and experts were brought in from the UK and Singapore.


Innovation and Research

Amazon announces completion of the first autonomous, GPS-directed drone delivery in its Prime Air service, which dropped the customer’s package in his yard 13 minutes after he placed his order.


Other

University of Louisville pays go-away money to two former executives who are targeted in a federal investigation. The university paid former VP of Health Affairs David Dunn, MD, PhD $1.15 million to leave the school, while former CIO Priscilla Hancock received $250,000 before she retired. Also under investigation is Russell Bessette, MD, former AVP of health affairs and health informatics. The FBI is reviewing the possible misuse of federal grant money. Dunn’s attorney says he was attempting to make U of L “a leader in healthcare informatics” as authorized by the university president. Dunn and Bessette previously ran the now-defunct Health DataStream, which sued SUNY Buffalo for stealing its health status-scoring algorithms.

MD Anderson Cancer System considers layoffs and research cutbacks as its losses hit $102 million during the first two months of its fiscal year. Officials name its Epic implementation as one of the four issues affecting its financials, but its president concludes, “The situation requires serious attention, but it is not out of control, our long term balance sheet is strong.”

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As just about anyone could have predicted, Pokemon GO turned out to be a quickly-abandoned fad offering minimal long-term health benefits, with BMJ-published research concluding that while users moderately increased their daily step count right after installing it, they had returned to their old levels of inactivity within six weeks (at least those who weren’t run over by cars or shot for trespassing in wandering around in a zombie-like trance at a rate only slightly higher than among regular phone users). 

A newspaper’s field test of presenting prescriptions for two dangerously interacting drugs at 255 Chicago pharmacies finds that half them dispensed the medications with no warnings or intervention. Independent pharmacies failed 72 percent of the time vs. 49 percent for drugstore chains. The newspaper concludes that pharmacists cut corners to keep up with crushing workload demands and computer system alert fatigue may contribute, while one pharmacist said the pharmacy tech receives the warning and may or may not alert the pharmacist. “The patient will get mad if you call the doctor and take time, “ said a pharmacist who caught the potential error. “Sometimes they think it is fast food.” The report notes that while most Kmart pharmacists dispensed the risky drug combination without question, they were good about pestering the patient into signing up for the company’s loyalty program.

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A fascinating New York Times article frames the US economy (and its world-leading inequality) around the much-ballyhooed 2013 revival of the Twinkie. Private equity firms bought the brands and bakeries of bankrupt and PE-owned Hostess for $186 million, then flipped the company four years later for $2.3 billion after closing plants, slashing the workforce from 8,000 to 1,200, eliminating union contracts and pension payments, and saddling the company with a $1.3 billion loan that was used to pay the PE owners and investors in advance. The article notes that the highest-earning CEOs in the country run private equity firms, with their one-year compensation listed above (note that the group is about as diverse as Hostess’s Wonder Bread). Those CEOs defend their activities by saying their firms provided much-needed capital and expertise to turn the companies around, which nearly always involves employee takeaways. You would think news like that would encourage people to start businesses rather than serve as wage slaves for others, but I’m not sure our educational and social system is geared to produce people willing and able to become something other than faceless widgets in the means of production.

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The Pope — visiting a Vatican children’s hospital whose former president is charged with using $440,000 of its money for apartment renovations — urges its employees to resist the urge “to transform a good thing like a children’s hospital into a business, where doctors become businessmen and nurses become businessmen.” He apparently hasn’t seen the salaries that US children’s hospitals pay their executives.

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The feel-good, viral story about a terminally ill five-year-old hospital patient who died in the arms of a man portraying Santa Claus turned out to be another example of sloppy journalism intended to draw eyeballs without editorial control. The Knoxville newspaper says it can’t stand behind its original story since it can’t verify anything written by its columnist, who took the fake Santa’s description of the event at face value even though he refused to provide identities, dates, or even the name of the hospital that was supposedly involved. The worst part is that the average Facebook user wants to be entertained, not informed, and probably will neither notice nor care that the story as written was crap. I bet both the editor and the columnist (not to mention the snotty big-name papers that ran the story without question) are secretly high-fiving each other for drawing clicks at the expense of accuracy and objectivity. Just because analytically challenged readers react emotionally to a story doesn’t mean it’s true.


Sponsor Updates

  • The Orange County Register includes MedData in its list of Top Workplaces for 2016.
  • Infor will offer its customers McKesson Strategic Supply Sourcing and McKesson EIS, in turn, will offer Infor CloudSuite Healthcare to its user base.
  • Two hundred Meditech customers receive an ‘A’ hospital safety rating from The Leapfrog Group.
  • GetWellNetwork will participate in the VA’s “Telehealth Education Delivered” mobile showcase that will visit 200 VA medical centers.
  • Buyers Laboratory awards Lexmark its BLI PaceSetter 2017 award for Healthcare: Group Practices.
  • PeriGen hosts a team-building bike challenge for Big Brothers Big Sisters.
  • Surescripts recaps its video chat on the “abysmal” prior authorization process.

Blog Posts


Contacts

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

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News 12/14/16

December 13, 2016 News 6 Comments

Top News

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CommonWell Health Alliance and Carequality will connect their respective systems, allowing their members to share information.

Most notable (but unstated) in the announcement is that Epic uses Carequality’s Interoperability Framework but is a notorious non-participant in CommonWell, with the agreement potentially allowing Epic to connect to other systems outside of its own proprietary connectivity suite. Likewise, Cerner is a CommonWell founding member but doesn’t participate in Carequality.

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I’m not sure if the announcement can be accurately characterized as health IT’s version of the transcontinental railroad’s golden spike, but it has potential to become a significant joining of the patient data tracks, assuming of course that competing health systems are actually willing rather than conveniently unable to exchange patient information.


Reader Comments

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From Much Too Much: “Re: HIMSS17 registration list. Vendors received it Friday. For the first time, this list does not include a postal address. Vendors wishing to send direct mail will have to have the campaign approved by HIMSS and then use HIMSS preferred mailing vendor. The cynic says this is just expanded vendor extortion, while the optimist says that maybe we’ll get less junk in the mail before the conference.” I surmise that the motivation was income rather than junk mail curtailment. However, from a purely economics standpoint, HIMSS should keep raising the exorbitant prices it charges vendors for the annual conference until they push back by not participating. The frenzy to rack up HIMSS points to allow spending even more money on prime exhibit hall square footage suggests that the supply-demand curves do not yet intersect.


HIStalk Announcements and Requests

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HIStalk reader Mike sent a DonorsChoose donation that, with some pretty amazing matching money, will give Ms. A’s fourth grade class in Stone Mountain, GA an iPad Air, Amazon Echo, and Amazon Fire and also economics books and games for Mrs. M’s gifted classes in Springdale, AR. Mrs. M responded, “It is so exciting to have others help in providing amazing resources to my students. Your generosity is appreciated more than you can imagine! I can not wait to receive these resources to share with my students! Your help allows my students to experience hands-on real world economics.”

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Mrs. G in Wisconsin says the best part of the day for her elementary school students is using the makerspace materials we provided in funding her DonorsChoose grant request, as their confidence is growing from making decisions together as teams. 

Listening: the latest album from Australia-based Wolfmother, which is down to just one of its three original members but still rocks it out well in the fashion of Black Sabbath or perhaps Led Zeppelin. If rock ever makes a comeback, these guys should be part of it.


Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Here’s the recording of the recent webinar titled “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” 


Acquisitions, Funding, Business, and Stock

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Analytics vendor Inovalon lowers full-year revenue and earnings guidance after a collaboration agreement with an unnamed partner fell through last week unrelated to the company’s offerings. Inovalon expects annual revenue of $426 million instead of $470 million and net income of $25 million vs. the previous guidance of $43 million. Shares were predictably hammered on the news, shedding 36 percent of their value by the market’s close on Tuesday. INOV shares are down 64 percent in the past year vs. the Nasdaq’s 12.5 percent increase.

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EHR vendor IMedicor warns that three of its financial statements from 2014 and 2015 should not be relied on because they misstated liabilities that were later discovered in a year-end audit. The amount involved was only $471,000, however, caused by double-recording the same set of warrants in two accounts. The greater question might be how a money-losing company with a market cap of barely $1 million can afford to remain publicly traded with a current share price of $0.0009, which suddenly makes that $471K seem more significant.

Canada-based VSS Medical Technologies acquires a majority interest in Legato Healthcare Marketing. VSS also owns Sigmund Software, MedicFusion, VersaForm, DeviceTrak, and Health:PCP.


Sales

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In Canada, Mackenzie Health chooses Orion Health’s Rhapsody integration engine.

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AtlantiCare Health System (NJ) selects Santa Rosa Consulting to strengthen its analytics program.

Frances Mahon Deaconess Hospital (MT) will upgrade to Meditech’s Web EHR.


People

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Tom Clark (Direct Recruiters) joins Direct Consulting Associates as VP of operations. He is a former US Army captain and Airborne Ranger.


Announcements and Implementations

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The American Heart Association, AMA, DHX Group, and HIMSS launch the non-profit Xcertia, which will establish best practices for mobile health apps. It’s the second time around for Xcertia, having been originally announced a year ago under the direction of Columbia University and vendor Social Wellth, which bought the assets of defunct health app certification vendor Happtique in December 2014 and created its own app guidelines. SocialWellth CEO David Vinson created the non-profit DHX along with the AHIP insurance company trade group with the intention of offering app certification, which apparently isn’t a priority for Xcertia 2.0.

Black Book’s 2016 RCM survey finds that hospital outsourcing of complex claims has jumped from 20 percent to 40 percent in the past three years, with hospitals that previously wrote off those claims because of the effort and expertise required to pursue them realizing they were leaving significant money on the table.

Another Black Book survey finds that competing priorities have killed off hospital ERP implementations, with just a 29 percent penetration and 2 percent growth in 2015. Shockingly, more than one-third of those hospitals that have bought ERP systems aren’t keeping up with available upgrades, rendering those systems basically obsolete. More than half of hospital C-suite executives admit that they didn’t really understand their supply chain (which represents nearly a third of hospital budgets) until the move to value-based care forced them to dive deeper.

Consulting firm RTI International and Validic partner to optimize the use of wearable consumer sensors in health research.

Centralized tele-ICU programs can increase case volume by 44 percent and contribution margins by 665 percent, according to a journal-accepted study by UMass Memorial Medical Center (MA), which uses Philips eICU. 

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Connected home software vendor Orbita releases a development tool for creating Amazon Echo-powered home health voice assistant apps.


Government and Politics

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President Obama signs the 21st Century Cures Act into law.

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CMS’s chief data officer Niall Brennan is among the federal political appointees leaving their jobs (voluntarily or otherwise) with the administration change. He will be replaced in interim by Office of Enterprise Data and Analytics Deputy Director Christine Cox.

The VA creates a website for its Digital Health Platform, which describes its approach and includes use case videos. Previously issued documents indicate that the VA plans to acquire five system components:

  • An EHR
  • An operation management platform (resource allocation, financial, supply chain, and HR system) integrated with the EHR
  • A CRM system
  • An analytics system
  • An API framework

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The FTC settles consumer deception charges it had brought against Aura Labs, which sold $600,000 worth of its $4, smartphone camera-based Instant Blood Pressure app that it falsely claimed to be as accurate as a blood pressure cuff.


Privacy and Security

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Quest Diagnostics notifies 34,000 people that a hacker has breached its systems via a vulnerability in its MyQuest mobile app, exposing their demographic information and lab results. The app also allows users to record their provider contact information, prescription information, allergies, and health statistics.

Financial consulting firm PwC threatens legal action against a security advisory firm that had warned it of a vulnerability in a PwC-developed security tool, insisting that the company not go public with details. PwC says it has fixed the problem and says the security firm wasn’t licensed to work with its software. The security firm ignored the warning and published its security advisory anyway.

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Grammar matters: Russian hackers were able to penetrate the Democratic National Committee’s email system even though a Clinton campaign aide intercepted a phishing email sent to Campaign Chairman John Podesta. In his haste to alert Podesta, the aide mistyped “illegitimate email” as “legitimate email” in his urgent warning, after which Podesta obligingly clicked the phony password update link that compromised his account.


Innovation and Research

Inova Health System (VA) launches a venture capital arm and its Personalized Health Accelerator.


Technology

A surgeon in England uses Snapchat’s Spectacles – $130, camera-equipped sunglasses — to record 10-second video clips of a surgery he performed, allowing medical students follow his progress live and afterward.


Other

Cost estimates for the California prison system’s implementation of Cerner have doubled to $400 million in the past three years as the state realized it signed a contract that omitted the cost of maintenance, hardware replacement, mobile devices, additional required software, and dental recordkeeping capability. The federally appointed receiver in charge of the system mostly blames Cerner, which is being paid $177 million over 11 years, but also says his own office bears considerable responsibility for the overrun in missing several required items. He also says employees are struggling to learn the system, doctors don’t like doing their own data entry and are seeing one-third fewer patients due to the extra work required, and the pharmacy system was “damn near unusable” due to design and implementation problems. The state turned control of the prison healthcare system to the federal government in 2006 to settle lawsuits claiming that poor inmate care constituted cruel and unusual punishment. The receiver’s budget has since doubled to $1.9 billion per year.

The imaging system used by hospitals in South Australia goes down for six hours due to unspecified technical issues. 

A report from Imprivata and the Ponemon Institute finds that misidentification of hospital patients is a regular occurrence and the average hospital loses $17 million per year due to rejected claims due to missing or incorrect patient information, with respondents favoring the implementation of biometric ID at registration to improve both situations.

In England, an woman dies after a hospital admits her for a broken arm but then fails to send anyone to treat her for several days. The hospital had changed the way it lets doctors know they have new patients, moving from an old-school whiteboard to an email-based program. The patient shared a first name with another patient and the unit secretary mistakenly removed the woman’s name thinking it was a duplicate entry.

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AHRQ reports that hospital-acquired conditions are down 21 percent since 2010, with potential savings of 37,000 lives and $28 billion in costs. I guess the good news is that hospitals still harm and kill people every day with their screw-ups, but at least less often than they used to.

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A city in Japan offers free barcoded, personalized fingernail stickers for people with dementia who are prone to wandering, allowing police to scan the QR code to find their families. Stickers were already being attached to shoes or items of clothing, but those weren’t always being worn when needed.

A study finds that veterans with dementia who use the VA healthcare system and who also receive Medicare benefits have twice the odds of medication problems due to lack of connectivity between VA and non-VA doctors.

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The bond ratings agency of PeaceHealth (WA) notes that its $293 million Epic implementation costs have temporarily hurt its margins. The same agency reviews Seattle Cancer Care Alliance (WA), which it says is considering replacing its EHR  (it doesn’t say which one, but I think they’re running Cerner and they have listed Epic jobs).

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Here’s a frontlines report from the war on drugs. The owner of a chain of “clean and sober” residential drug recovery centers called “I.C. Clean People” in Washington State is arrested for drug trafficking, with a raid on his office turning up crystal meth, heroin, marijuana, oxycodone, methadone, and a loaded pistol.

Strange: a mother sues the hospital where she gave birth in a 2012 incident in which employees mistakenly gave her newborn baby to another mom to be breastfed. Abbott Northwestern Hospital (MN) says it has since switched to electronic bracelet baby-mother matching.


Sponsor Updates

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  • EClinicalWorks employees help out families through Project New Hope, Project Just Because, and the United Way.
  • Medecision launches population health management consulting services.
  • CloudMine and Validic will partner to advance integration of patient-generated health data into clinical workflows.
  • Healthgrades SVP Chris Baxley joins the Nashville Health Care Council Fellows.
  • Santa Rosa Consulting publishes a white paper titled “Critical Aspects of a Successful BI and Analytics Program.”
  • The Indo-UK Institute of Health names GE Healthcare a preferred technology partner in its IUIH Medicities program in India.
  • Agfa HealthCare will implement enterprise imaging for radiology in the first Acibadem International Medical Center in the Netherlands.
  • KLAS includes Bernoulli as a top vendor option for clinical alarm management and alarm reduction.
  • Besler Consulting releases a new podcast, Epic Conversion – Revenue Cycle Lessons Learned.
  • Elsevier Clinical Solutions offers predictions for the next 100 years of medicine.
  • Evariant releases a series of best practice guides on a variety of topics.
  • Built In Colorado features Healthgrades Director of Talent Acquisition Jenny Truax.

Blog Posts


Contacts

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

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Monday Morning Update 12/12/16

December 11, 2016 News 2 Comments

Top News

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The Wireless-Life Sciences Alliance trade group and the HIMSS-owned Personal Connected Health Alliance merge.

PCHA — formed in 2014 by Continua Health Alliance, mHealth Summit, and HIMSS – merged with the Partners Connected Health Symposium in October 2016. 

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PCHA’s Connected Health Conference, the former mHealth Summit, kicks off today (Monday), but its speaker star power seems to have dropped off considerably since I saw Bill Gates there in 2010. Here’s what I had to say about the mHealth Summit when I attended in 2013, which anyone attending this week’s show is welcome to compare and contrast:

I felt as though I had intruded on a geeky academic conference in 2010 … Presentations back then were often about public health projects in Africa, government informatics research, and government policy … I felt somewhere between virtuous and bored being there. HIMSS, as it usually does, put all of that unsexy and unprofitable subject matter almost out of sight. Now the conference is a freewheeling ode to capitalism showcasing companies willing and able to pay big bucks for space in the exhibit hall and in the endless number of HIMSS-owned publications. The exhibit hall is like a downsized version of that at the HIMSS conference and most of the educational sessions are either about companies or feature vendor people as presenters or moderators … HIMSS seems to be positioning the mHealth Summit as the minor league of its conference portfolio. Most of the small mHealth exhibitors will be toast in a couple of years, but those who survive will graduate to the big show, the HIMSS conference … The same issues dominated this year as in 2010. Nobody’s really sure what mHealth is, basically punting off by saying anything that runs on a smart phone must be, which means the subject matter is entirely unfocused and confusing. Startup companies keep trying to convince each other that they can hang on long enough to be bought out. Everybody fervently believes that mobile apps and brash startup spirit can transform the US healthcare system into one that’s cheaper, more health-focused, and more consumer driven. It’s always easy for me to be cynical and dismissive, but especially so at the mHealth Summit.


Reader Comments

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From FlyOnTheWall: “Re: SPH Analytics. President and CEO Al Vega is out and the VPs, SVPs, and enterprise teams are all gone.” Unverified, but Vega’s bio has been expunged from the executive page and four of the eight execs listed on the August 2016 cache of the page are equally invisible. Vega’s apparent replacement, J.T. Treadwell, is a money guy who sits on the board of half a dozen companies. I didn’t recall having heard of SPH Analytics, having mentioned them just twice in HIStalk, once for hiring someone and another for choosing an underlying technology.

From The PACS Designer: “Re: CDI with ICD-10. With the launch next month of ICD-10 Procedure Codes, the increased specificity of ICD-10-PCS Clinical Document Improvement will give procedures much improved descriptions of what treatments a patient has endured. For example, a patient having a two stent insertion procedure would have the following ICD-10 Procedure Coded recorded: 02710D6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Intraluminal Device, Open Approach. This more specific ICD-10 code replaces 5 ICD-9-CM codes which are 36.03,00.41,00.44,00.46, and 36.06. As one can see, ICD-10 is a big improvement over ICD-9.”

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From Smelly James: “Re: IBM. Putting itself at the feet of Donald Trump with several healthcare mentions. It wasn’t shy about suggesting future business interest with the VA. This letter will fit well in future RFP protests.” IBM CEO Ginni Rometty apparently congratulated Trump right after the election, suggesting six areas in which IBM could support his political agenda, including a cognitive computing system for the VA. She also dropped not-so-subtle hints that IBM would appreciate his proposed changes to a “punitive” tax system in which IBM’s $68 billion offshore cash stash would be taxed at a Trump-proposed 10 percent vs. the current rate of 35 percent in bringing it into the US, saving the company (and costing taxpayers) $13.6 billion.

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From Rural HIT: “Re: Smith County Memorial Hospital and Family Practice. Went live on Cerner, the first of 25 critical access hospitals in the Great Plains Health Alliance switching to Cerner CommunityWorks.” The internal announcement suggests that the hospital was using Siemens Soarian and was steered to Millennium by its new owner Cerner.


HIStalk Announcements and Requests

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Most poll respondents are interested in the most significant international health IT news stories. Mobile Man says it’s hard to make comparisons since other countries have different payment models, while Susan is interested because we in the US think we have the best healthcare in the world but really we excel only in spending the most. HIT Geek summarizes, “Innovation has no nationality.” New poll to your right or here: how do you expect your healthcare spending (including insurance premiums) to change in 2017 vs. 2016?

Thanks to Jenn for covering my little pre-Christmas break last week. I waded deep into some HIStalk website technology catch-up when I returned, with some tricky upgrades to newer versions of PHP and other stuff that will hopefully make the site more stable and secure.

I was chatting with someone about terrible singers who still have managed to create hugely successful singing careers – the names that came up included Neil Young, Bob Dylan, Willie Nelson, and Rod Stewart. That doesn’t even count those warblers who sound passably good only through audio techno-trickery. One who could carry a tune, though, was Emerson, Lake, and Palmer’s Greg Lake (also of King Crimson), who died last week at 69. We lost two-thirds of ELP in 2016 with the suicide of Keith Emerson, leaving just P and ensuring that their collective demise will be alphabetical.

Listening: a new cover of the telethon chestnut “You’ll Never Walk Alone” from Massachusetts celt-rockers the Dropkick Murphys.

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We provided 21 sets of headphones for Ms. S’s elementary school class in Tennessee in funding her DonorsChoose grant request. She teaches math and science to two classes totaling 44 students and says the classroom sounded like an arcade as students used the Chromebooks for assigned exercises, but now it’s quiet and they can concentrate.

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Donations from reader Laura and Direct Consulting Associates, plus matching money, fully funded these DonorsChoose teacher grant requests:

  • An amplifier and microphone for Ms. L’s high school class in Center Line, MI
  • Two Chromebooks for the seventh grade math class of Ms. F in Phoenix, AZ
  • Two tablets and headphones for the kindergarten class of Ms. W in Los Angeles, CA
  • A library of 26 science books for Mrs. G’s first grade class in Saint Paul, MN
  • A greenhouse set for Mrs. M’s high school class of severely mentally and physically handicapped students in Elyria, OH
  • Eight tablets for reading and math listening libraries for Ms. B’s kindergarten class in Kansas City, MO
  • A 9×12 reading circle carpet for Mrs. V’s first grade class in Seagoville, TX
  • A document camera for Ms. B’s second grade math class in Phoenix, AZ
  • 15 sets of headphones for Mr. S’s second grade class in Yonkers, NY

Ms. W sent a note saying, “Your kindness and generosity bring tears to my eyes! I love telling my students how amazing and kind people all over the world donated and funded our projects so we can have fun learning and be successful in the future. Then, I remind them when they have accomplished that to remember to pay it forward. For now they will learn how they can help protect our environment with the tablets!”


Last Week’s Most Interesting News

  • The Senate passes the 21st Century Cures act, which includes healthcare IT provisions related to interoperability, privacy, and security.
  • Entrepreneur Sreedhar Potarazu, MD, founder, chairman, and CEO of the now-defunct business intelligence vendor VitalSpring Technologies, pleads guilty to defrauding shareholders of the company by hiding its tax liabilities, overstating its financial condition to the tune of $30 million, and falsely telling investors that the company was on the threshold of being sold for a profit.
  • CompuGroup Medical ends discussions about a possible takeover of Agfa.
  • Epic’s quality assurance employees again sue the company claiming they were misclassified in being ineligible for overtime pay.
  • China-based Apex Technology completes its acquisition of Lexmark, renaming its enterprise software group (which includes the former Perceptive Software) as Kofax and announcing plans to sell it.

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Here’s the recording of last week’s webinar titled “Get Ready for Blockchain’s Disruption.”


Acquisitions, Funding, Business, and Stock

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Asset monitoring vendor Emanate Wireless raises $1.5 million in angel funding.

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Health coaching app vendor Vida Health raises $18 million in a Series B funding round, increasing its total to $24 million.


Sales

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Rusk County Memorial Hospital (WI) chooses Harris Healthcare Affinity ERP.

Los Angeles County Department of Health (CA) selects Allscripts EZCap for benefit management.


Decisions

  • Cogdell Memorial Hospital (TX) will go live on Cerner in 2017.

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


People

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Ed Park will join Athenahealth’s board following his previously announced resignation as EVP/COO that takes effect December 31.

Steve Holmquist, industry long-timer and SVP of new client development at Allscripts, died on November 29, 2016 in Phoenix, AZ. He was 55.


Announcements and Implementations

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New Zealand primary care provider Pegasus Health chooses Canada-based Intrahealth as its patient management system vendor of choice, ruling out Epic due to its cost.


Government and Politics

John Halamka summarizes the health IT impact of the 21st Century Cures act. He seems mostly positive, but is concerned about the effort required of EHR developers. His highlights:

  • ONC’s HIT Policy Committee and HIT Standards Committee will be merged into a single HIT Advisory Committee.
  • HHS is charged with developing voluntary certification of health IT for medical specialties and sites where the technology isn’t available or is not mature.
  • Vendors are prohibited from information blocking, are required to publish APIs, and must provide HHS with performance documentation. HHS is empowered to reward or punish performance as appropriate.
  • New interoperability, security, and certification testing criteria will be developed and ONC will get $15 million to support them.
  • HHS will develop or support a trusted exchange framework and ONC will publish an annual list of health information networks that are capable of using it.
  • Vendors must be able to exchange data with registries and will be treated as patient safety organizations for reporting and conducting care improvement activities.
  • The GAO will review ONC’s work on patient matching.
  • The GAO will conduct a study of the ability of patients to review their own PHI.

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NIH issues a challenge to develop a wearable sensor that can measure blood alcohol levels in real time, offering $200,000 for the first-place prototype and $100,000 for second place. The sensor would help researchers study alcohol use disorder and related conditions without relying on questionably reliable self-reported drinking data.


Privacy and Security

Fortified Health Security releases a review of 2016’s significant cybersecurity issues and its outlook for 2017.


Other

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EClinicalWorks issues a curious patient safety announcement about its EHR as part of its “ongoing effort to respond to and minimize such risks,” suggesting that users:

  • Pay attention to the company’s patient safety notices and apply available patches and upgrades
  • Update their Multum or Medispan drug databases
  • Designate a patient safety officer as ECW’s patient safety liaison
  • Confirm that orders are accurate and encourage patients and their families to do the same
  • DC and re-enter changed medication orders rather than modifying the existing order.
  • Limit the use of custom medications
  • Report any patient safety concerns or unexpected software behavior to ECW or by filing an ONC complaint.

ONC cited ECW’s announcement as the key item in its email newsletter, echoing the company’s recommendation to iECW’s customers that they apply available upgrades and report problems to the company and via ONC’s complaints website. I asked ONC If the announcement was triggered by a settlement with ECW over some unspecified issue and they said no, but the announcement suggests some kind of problem that raised ONC’s interest.

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Partners HealthCare posts its largest operating loss ever at $108 million, most of that coming from its Medicaid insurance division. Partners says it isn’t being paid enough by commercial insurers and government programs to cover its labor and drug costs. Including investment performance that must have been awful, Partners lost $249 million in 2016.

India-based media claim that 280 people have died of grief and shock following the December 5 death of Tamil Nadu Chief Minister Jayalalithaa Jayaram, raising the question (at least for me) of how their cause of death was determined. The political party in power says it will compensate their families and will also pay $750 to a party official who set himself on fire and another who cut his finger off in mourning.  


Sponsor Updates

  • Spok publishes a case study of the implementation of its Care Connect Suite at St. Dominic – Jackson Memorial Hospital (MS).
  • TelmedIQ earns a 91.4 score in KLAS’s review of secure communications.
  • Dimensional Insight earns top scores in 14 KPI categories in BARC’s “The BI Survey 16.”
  • The Chartis Group publishes “Election 2016: Implications for Providers.”
  • PeriGen’s PeriCalm Checklist is nominated for an Edison Award.
  • TeleTracking releases a new podcast, “The Essentials: 2017 Regulatory and Compliance Requirements for Patient Flow.”
  • CIOReview names Validic a Most Promising Healthcare Solution Provider of 2016.
  • Glassdoor ranks CoverMyMeds and Health Catalyst in the top 50 places to work nationally.
  • Verscend Technologies celebrates the 20th anniversary of its DxCG risk adjustment and predictive modeling solution that serves as the foundation of CMS’s hierarchical condition categories.

Blog Posts


Contacts

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

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News 12/9/16

December 8, 2016 News No Comments

Top News

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The Senate passes the 21st Century Cures Act in a 94 to 5 vote, sending it to the President’s desk for signature. The President praised the $6.3 billion legislation Wednesday and confirmed that he would sign it. Sen. Lamar Alexander (R-TN), chairman of the Senate health committee and one of the most ardent proponents of the bill, was understandably excited given that it has been circulating for two years and is considered to be one of most heavily lobbied pieces of legislation in recent memory. It provides money for cancer research; funds mental health treatment and resources to combat the opioid abuse epidemic; helps the FDA speed up drug approvals; and bolsters healthcare technology goals related to interoperability, privacy, and security.


HIStalk Announcements and Requests

This week on HIStalk Practice: Arianna Huffington includes Doctor on Demand in new wellness venture. Banner Urgent Care goes with RCM services from Zotec Partners. Health apps found sorely lacking in privacy precautions and safety standards. Marathon Health upgrades its EHR for workplace health centers. Montana preps for statewide HIE. PPJ Healthcare Enterprises raises $5 million.


Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.


Acquisitions, Funding, Business, and Stock

Google Ventures founder Bill Maris raises a $230 million venture fund dubbed Section 32 (a likely homage to Star Trek’s Section 31 security operation) that will focus on healthcare investments. Maris, who left Google earlier this year, plans to run the fund solo from San Diego rather than Silicon Valley.

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Augmedix closes a $23 million round of funding led by new investors McKesson Ventures and OrbiMed. It has raised over $60 million since launching its Google Glass-powered remote scribing service in 2012. Jenn talked with CEO and co-founder Ian Shakil about the company’s plans to move beyond its core services in “Value-based Care Prompts Glass to Grow Up.”

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Brentwood, TN-based consulting and staffing firm Vaco merges the newly acquired Pivot Point Consulting and Greythorn – both based in Washington – to form Pivot Point Consulting, a Vaco company. The new subsidiary brings together 50 employees and combines Pivot Point’s EHR implementation and advisory services with Greythorn’s recruitment expertise.

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The patent case over CRISPR-cas9 technology, likely the most valuable patent in biotechnology, begins as the University of California argues to have MIT and Harvard’s patent invalidated and transferred to UC. The patent office awarded The Broad Institute of MIT and Harvard its first CRISPR patient in April 2014, during which time it was reviewing UC’s patient, filed in May 2012.

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After much speculation, Fitbit buys Pebble’s software assets for an undisclosed sum, though Bloomberg has valued the transaction at less than $40 million. Pebble, which launched via a crowdfunding campaign in 2012, will no longer produce or sell its smartwatches.

Looking to further bolster its diminishing wearables market share, Fitbit also will work with Medtronic to add glucose monitoring to its fitness trackers. Type 2 diabetes patients will be able to combine their Fitbit-generated data with Medtronic’s IPro2 Continuous Glucose Monitoring system, which can send pertinent data to a patient’s provider.


People

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Juliana Hart (Verscend Technologies) joins MedCPU as vice president of market development.

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Brooke Patterson (FEI Systems) joins health IT and management consulting firm ARDX as SVP of government services.

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Cricket Health appoints University of California-San Francisco nephrologists Carmen Peralta, MD chair of its medical advisory board, and Anna Malkina, MD medical director.


Announcements and Implementations

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Chicago-based Union Health Service implements RadNet’s RIS, speech recognition, and mammography tracking.

Nemours Children’s Hospital, Seven Rivers Regional Medical Center, and Westchester General Hospital sign up for the Florida HIE’s event notification service, which patient hospital encounter notifications to participating ACOs, physicians, and payers.


Technology

SecureDx.net develops Secure Data Exchange messaging technology featuring two-factor authentication.


Sales

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Looking to set up a private HIE, Chicago-based Rush Health chooses HealthShare interoperability technology from InterSystems.

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Schleicher County Medical Center and Nursing Home (TX) taps CPSI subsidiary American HealthTech to help it implement technology upgrades to its clinical and business management operations. The company will also provide Medicaid AR management services.

TaraVista Behavioral Health Center (MA) signs on for MedSphere’s OpenVista EHR. The inpatient facility will also utilize the company’s Phoenix Health Systems division for IT support.


Government and Politics

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The FBI indicts 21 employees from Forest Park Medical Center (TX), claiming that they paid $40 million in bribes and kickbacks in exchange for referrals to its purely out-of-network health system. Those indicted include owners Alan Beauchamp, Richard Toussaint Jr., Wade Barker, and Wilton Burt; and Jackson Jacob and Andrea Smith, both of whom set up separate shell companies to funnel bribe and kickback payments to surgeons in exchange for the referrals.

The DoD taps Medical Information Network – North Sound to develop and maintain an HIE-like portal that will be accessible in any clinic or hospital within the DoD system. Integration with the department’s new Cerner-built EHR, currently in pilot phase at several bases in Washington, is expected.

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The House passes the telemedicine-friendly Expanding Capacity for Health Outcomes (ECHO) Act, which now heads to the president’s desk after receiving unanimous Senate approval last week. Once signed into law, the act will set in motion an HHS study on the feasibility of training providers to expand technology-enabled healthcare delivery in underserved areas.


Research and Innovation

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NantHealth makes its Quantum Immuno-oncology Lifelong Trial (QUILT) Programs available via ClinicalTrials.gov. CEO Patrick Soon-Shiong, MD believes making the QUILT trials available through the NIH registry will improve patient access to active and future immunotherapy-based trials for a variety of cancers.


Other

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Quite a space oddity: David Bowie treats former astronaut Buzz Aldrin in a New Zealand hospital after Aldrin was rescued from the South Pole after falling ill. The 86 year-old was part of a tourist group that was visiting the Amundsen-Scott South Pole Station through December 12.


Sponsor Updates

  • Imprivata will exhibit at the CIO Forum December 8 in Yorba Linda, CA.
  • Ingenious Med receives the Emerging Company of the Year Phoenix Award from the Metro Atlanta Chamber.
  • Database Trends and Applications Magazine names InterSystems Cache a trend-setting product in data and information management for 2017.
  • Kyruus will present at the Carolina Healthcare Public Relations & Marketing Society meeting December 9 in Charleston, SC.
  • Liaison Healthcare expands its relationship with London-based reseller partner AK Loman.
  • LifeImage releases video insights from RSNA 2016.
  • Gartner includes LiveProcess as a representative vendor in its 2016 market guide for clinical communication and collaboration.
  • Meditech shares a brief case study featuring Anderson Regional Medical Center (MS).
  • Netsmart will exhibit at the Community Behavioral Healthcare Association of Illinois Conference December 12 in Schaumburg.
  • Computerworld names NTT Data VP of Digital Experience Lisa Woodley a 2017 Premier 100 Technology Leader.
  • Black Book ranks Nuance first in CDI for the third consecutive year, and first for end-to-end coding, CDO, transcription, and speech-recognition technology.
  • Health Catalyst receives the 2017 Glassdoor Employee Choice Award.
  • Rock Health names Health Catalyst CEO Dan Burton the winner of its annual Most Beloved CEO award for 2017.
  • Verscend Technologies publishes a new white paper, “The Evolution of DxCG, the Gold Standard in Risk Adjustment and Predictive Modeling.”

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 12/8/16

December 8, 2016 News No Comments

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The FDA is making available its data on adverse events stemming from foods, dietary supplements, and cosmetics. I found it interesting that the coded symptom data contains numerous British English spellings: hospitalisation; dyspnea; diarrhea; and pale faeces to name a few. Pretty unusual for a United States governmental agency. Repeat offenders included the full range of “5-Hour Energy” products; B-complex vitamins; cabbage; and a number of products with the name “cleanse” in their names, which is not surprising to this physician.

I attended a continuing education session this week. Although I learned a lot, it was the first time that I heard so many gambling metaphors in one place. I’m used to hearing sports phrases, but the gambling references were new to many of the attendees. I had the privilege of explaining what “table stakes” were to a newly-minted pediatrician, as well as the meaning of “double down.” I’m grateful to my former partner who once invited me to be part of a ladies’ poker night, which ended up being less about poker and more about wine and catching up. It’s always a good reminder for presenters to consider their audience before including figures of speech. There were also some Yiddish references and some regional slang, which, although entertaining, might have been confusing to some.

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The reader mailbag brought quite a bit of correspondence this week. I always enjoy hearing from readers, even if it’s just a “thanks for writing” type comment. Being anonymous and doing most of my work solo while watching “Call the Midwife” can feel pretty lonely, so thanks for the feedback.

From Texas Tornado: “I enjoyed your recent mention on MU reporting. Would text analytics be helpful in this MU attestation scenario? I understand the push to do more discrete documentation, but what if you could report on structured and unstructured data combined? Does it really matter if the data is discrete or not as long as you can report on it?” That type of approach would certainly be appreciated by many clinicians who have been clicking their little hearts out over the last half decade. With most of the EHR-based quality reporting platforms I’ve seen, however, most documentation has to be discrete and in a fairly narrow workflow to “count” for quality measures. Ultimately, as natural language processing evolves, I think we will see more information being transformed to discrete data points; but I’d love to see some other approaches.

From Roaring Waters: “Thanks for your discussion of the need for clinical participation in IT projects. As a vendor selling to the acute care environment, I am always shocked at how often patient care workflow solutions are handed to an IT or non-clinical person to evaluate and determine how it will impact clinical workflow. I know people have been talking about end-users making user workflow decisions for decades, but for some reason these basics of project management are lost. Providers themselves are just as guilty, as I see them constantly passing these decisions off to a non-doc or non-clinical user to make decisions about their workflow and ultimately the patient care they deliver. It’s mind-boggling!” The providers that pass the buck for decision-making are often the first to complain when workflows or solutions don’t meet their needs. Another variation on this that I’ve seen lately is to pass the decision to a clinical representative who doesn’t actually practice or who doesn’t have any real buy-in to the clinical situation at the institution. I’ve been working with a group for nearly a year that has a CMO who constantly criticizes the EHR and demands a move to Epic, yet hasn’t shown up at a single executive briefing or strategy session where the EHR has been discussed. His comments are strictly hit and run via email and one-off conversations with the Board of Directors, which hasn’t learned to say no to his shenanigans. His peers are working hard for solutions and all he does is tear down their work, which is unfortunate.

From Science Guy: “Thank you for your comments about clinical staff having to take ownership of the quality reporting. Having worked in healthcare in both the payer and clinical side … there is a paradigm shift taking place that many clinicians have not come to grips with. That is that the payers are driving more and more of the clinical decisions based on outcome data and not clinical judgment. It is becoming increasingly difficult to practice medicine in a vacuum without using clinical information to justify decision making. Having worked at a University Medical Center, I saw this very plainly as the more experienced physicians struggled with this very topic and resented the IT staff for ‘creating additional hoops for them to jump through.’ I heard the statement more than once that ‘my time is too valuable for this … and my time is better spent healing patients than working on the computer.’ On the other side of the coin, there is a whole new generation of physicians coming out of school that are much more computer literate. They embrace using information from the health record to support their decision making. They realize this information could assist them with their clinical decisions, and all of this data was really just another clinical diagnostic tool to improve care. I guess my point is that like any other change, this current shift will cause a lot of frustration for a lot of staff, but it is certainly not going away. Hopefully many of the more experienced staff will be motivated to change as they see their younger peers embracing this technology and ultimately the patients will benefit from these changes. But hopefully, in the meantime, your information will help with the whole ‘shooting the messenger (the IT staff) mentality.’”

As a young physician working in clinical informatics for the first time, it took me longer than it should have to learn to stop shooting the messenger. Looking back, I realize I was working with a very inexperienced IT staff that had no idea how to work with physicians and didn’t understand how much havoc a poorly-run EHR project could have on a practice. I assumed that since the hospital had contractually agreed to provide me a paperless practice with a functional HER, that they would also provide staff that had the skills to deliver it. Some of the individuals involved in that debacle are now some of my information technology BFFs and we continue to learn a great deal from each other. Whether it was encountering chicken wire in the wall that was interfering with wireless connectivity or having providers install their own black-ops routers under their desks, it was kind of fun working in the early days (read “Wild Wild West”) of health IT.

Have you ever used poultry netting as a drywall patch? Email me.

Email Dr. Jayne.

News 12/7/16

December 6, 2016 News 3 Comments

Top News

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Ireland goes live on a nationwide maternal and newborn clinical management system at Cork University Maternity Hospital, making newborns like Emily, above (dubbed the country’s “first digital baby”), initial recipients of a digital patient chart. The Cerner-developed MN-CMS will roll out across the country’s 19 maternity units over the next three years, with near-term go lives planned for University Hospital Kerry, Rotunda Hospital, and National Maternity Hospital in Dublin. The new technology is the first of its kind in the world, and marks the Irish healthcare system’s first interoperable EHR.


Webinars

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.


Acquisitions, Funding, Business, and Stock

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Potomac, MD-based ophthalmologist Sreedhar Potarazu pleads guilty to charges related to a $30 million investment fraud scheme tied to VitalSpring Technologies, his now-defunct healthcare business intelligence company. Potarazu admitted to defrauding over 150 shareholders by lying about the company’s finances, failing to pay payroll taxes, hiding tax liabilities, and even going so far as to concoct a charade around a fake prospective buyer. He faces 15 years in jail.

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Theranos will dissolve its Board of Counselors, including two former secretaries of state, the former director of the CDC, and a former secretary of defense. James Mattis, a retired Marine general who has gained notoriety as President-elect Donald Trump’s pick for secretary of defense, will remain on the company’s Board of Directors.

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Grail, a spinoff of DNA-sequencing company Illumina, looks to raise $1.7 billion to fund large-scale clinical trials in the UK to test early-stage cancer detection tools. The company was initially funded early this year via a $100 million Series A round led by Illumina.

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Boston-based PatientPing raises $31.6 million in a Series B financing round led by Leerink Transformation Partners and Andreessen Horowitz. The company plans to double its workforce and expand beyond the six states it currently serves. Vermont announced statewide adoption of the care alert technology in April. The company raised $9.6 million in venture funding last year.

Germany-based CompuGroup Medical walks away from Agfa acquisition talks for undisclosed reasons. It began discussions with the Belgian company in late October.


People

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Shafiq Rab (Hackensack University Health Network) will join Rush University Medical Center as CIO and SVP effective January 9.

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Joe Driscoll (PC Connection) joins Verscend as CFO.

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The American Society of Clinical Oncology hires George Komatsoulis (NIH) as its first chief of bio-informatics.


Announcements and Implementations

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ColumbiaDoctors (NY) will roll out mobile patient engagement technology from HealthGrid across its 95 locations.

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Dayton Children’s Hospital (OH) begins a two-phase implementation of GetWellNetwork’s bedside Interactive Patient Care software. Phase two will take place next Summer with the opening of a new hospital tower.

Athenahealth adds ADP’s workforce payroll and time and attendance software to its AthenaOne offering for hospitals and health systems.

Rochester RHIO adopts the Connect Image Exchange Transfer-to-PACS workflow from EHealth Technologies.


Sales

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Lurie Children’s Hospital of Chicago chooses MerlinOne’s digital asset management system.

The Oklahoma Dept. of Human Services opts for case management technology from Mediware to help it better care for aging and/or disabled residents.

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Rusk County Memorial Healthcare (WI) selects Harris Healthcare’s Affinity ERP solution for automation and integration of accounting and financial tasks.

Pharmacy procurement and utilization management company Sentry Data Systems signs on with NTT Data Services for data security and hosting.


Technology

Baxter launches the Sigma Spectrum Safety Management system, including infusion data analysis and reporting and technical support.

Premier develops performance benchmarking technology that sheds light on potential reimbursements and prioritizes areas of improvement.

Meditech releases a fall risk-management tool kit.


Government and Politics

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HHS releases the latest round of healthcare spending figures, which show a 5.8-percent growth in 2015 – the fastest rate since 2008. That puts the average annual healthcare spend for one person at close to $10,000. The increase coincided with 9.7 million people gaining insurance coverage under the ACA, and 10.3 million more enrolling in Medicaid.


Research and Innovation

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Tenable publishes a cross-industry analysis of cybersecurity preparedness, noting that readiness scores dropped an average of six percent from last year. It gave the healthcare industry a “D” in overall preparedness, a grade lower than its score of the previous year.


Sponsor Updates

  • Agfa Healthcare will present several sessions at the European Summit on Digital Innovation for Active & Healthy Ageing this week in Brussels.
  • Audacious Inquiry wins The Baltimore Sun’s 2016 Top Workplaces Award.
  • Arcadia Healthcare Solutions will exhibit at the CCO Oregon Cost of Care Conference December 13 in Salem.
  • Besler Consulting releases a new podcast, “Key takeaways from the 2017 OPPS Final Rule.”
  • B2B Marketing features Bottomline Technologies CMO Christine Nurnberger.
  • E-MDs offers early bird pricing for its user conference and symposium June 18-20 in Grapevine, TX.
  • EClinicalWorks will exhibit at the 2016 Connected Health Continuum December 11-14 in National Harbor, MD.
  • HCI Group releases a new podcast, “EHR Training: Developing Your Curriculum, Using Your LMS, and Organizing Your CTs ft. Stephen Tokarz.”
  • An Aprima survey of 312 physicians and practice staff finds that 52 percent believe a Trump presidency will improve healthcare, while 48 percent seem confident in a positive financial impact.
  • Meditech customer Farrer Park Hospital (Singapore) receives numerous health IT accolades.
  • PokitDok publishes, “5 Healthcare IT Trends to Watch in 2017.”
  • EClinicalWorks issues reminders about patient safety and the use of its EHR software.

Blog Posts


Contacts

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

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Morning Headlines 12/6/16

December 6, 2016 News No Comments

US Health Spending in 2015 Averaged Nearly $10,000 Per Person

Healthcare spending climbed 5.8 percent in 2015, the fastest rate since 2008, according to a recently published HHS report.

Theranos Dissolves High-Profile Board of Counselors

Theranos announces that its Board of Counselors, including two former secretaries of state, the former director of the CDC, and a former secretary of defense, will retire in 2017.

Global Cybersecurity Assurance Report Card

Tenable publishes a cross-industry analysis of cybersecurity preparedness, noting that readiness scores dropped an average of six percent from last year, and giving the healthcare industry a “D” in overall preparedness.

Illumina spinout Grail is seeking to raise $1.7 billion for large-scale clinical trial: sources

Grail, a spinoff of DNA-sequencing company Illumina, is in the process of raising $1.7 billion to fund large-scale clinical trials in the UK to test early-stage cancer detection tools.

Curbside Consult with Dr. Jayne 12/5/16

December 5, 2016 News 2 Comments

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Many organizations are starting to get ready for their Meaningful Use attestations early next year. Those that prepared well in advance and monitored their performance as the year rolled along are simply dotting the proverbial “i” and crossing the “t” before the year closes out. Others are in panic mode, realizing that they waited too long to get serious about it, or failed to follow up. I was contacted recently by a couple of clients that fell into the latter category, and was sorry to have to tell them that there isn’t a lot that I can do to help them.

One group started the year strong, using their EHR’s quality measures dashboard to make sure providers were posting solid metrics for their identified measures. They provided retraining for the end users as needed, making sure documentation was done using as much discrete data as possible. They were headed strong into May, and then had some changes in their office dynamics that resulted in the loss of some key staffers. The new office manager was tasked with picking up the Meaningful Use readiness work, and there is some debate about whether she simply didn’t do it or whether she told one of the partners that she was too overwhelmed to take it on.

Practice leadership realized about a month ago that they hadn’t been seeing any reports, and hired a new resource to start managing things. It took her several weeks to get up to speed, and even then it seems that it was too little, too late. Many of the providers have slipped back into documenting their visits using free text and dictation, and based on how the system reports, they aren’t getting credit for their documentation. The managing partner reached out to me asking for my firm to completely take things over for the rest of the year. I was willing to give it a go, until he demanded that I assure him that his providers would meet certain numbers on the metrics. Without a magic wand or a time machine, it would be pretty impossible to correct that much missed documentation, so I elected to take a pass.

Another client had a supposedly savvy IT person who was modifying patient visit data on the backside of the system. He would take the providers’ visits, and if there was free text documentation that kept the visit from qualifying for certain metrics, he would perform database inserts to trigger the discrete data points. That might be a valid approach as long as there is solid documentation on what is being done and clear boundaries around it, but they failed to document the plan or the authorization. Now the physicians are in a battle about having people modify their charge without approval of the individual visits, and it’s probably going to tear the practice apart. They wanted me to come in and audit the database and see how widespread the modifications are, but given the state of the practice, there isn’t enough money on the table for me to get into the middle of something like that.

These examples illustrate, in part, a major issue that we’re still seeing in healthcare IT. Far too many providers and organizations still think that these types of projects are technology projects. I hear a lot of nebulous references to “the IT department” owning such initiatives when really they are clinical/operational initiatives with IT support. There’s also a lot of blame on the EHR vendors. Although I’ve definitely seen my share of flawed workflows, strange workarounds, and oddly calculating measures, clients have to realize that unless they’re willing to switch systems, they have to work with what they have in front of them. Of course, they should also open tickets or support cases or use whatever complaint mechanism their vendor provides, but at some level the customer is responsible for selecting or staying with a particular vendor.

When physicians push back against my assertion that they need to own these projects along with their practice operational leaders, I ask them if they would assume that the company that manufactured the fax machine or the person who dialed it is responsible for the information written in the letter they’re sending to their consulting or referring physician. (Don’t get me started on the fax machine analogy. It’s sad that I have to use it, but so many offices are still faxing letters back and forth that it’s an effective way to make the point.)

It’s now December, and there are somewhere around 17 or 20 work days left in the year for most practices, depending on how you handle your holidays. If you’ve been asleep at the quality measures wheel for most of the year, there is virtually no way to make it up before the attestation window closes, unless you’re willing to engage in database shenanigans or know someone who will on your behalf. You’re not going to be able to retrain providers to fix their workflows for this year, but you can start educating them on what they need to do differently for 2017. And hopefully those organizations who are in a bind at the moment have realized what they too need to do differently for next year, if they want to be successful.

Whether you look at it as succeeding in a world of changing payment structures or avoiding penalties or complying with the requirements of your employer, staying ahead of quality reporting requires a lot of work. Providers have to be constantly monitored for compliance with recommended workflows. End users have to be educated on ways to support the providers so they don’t become data entry clerks. Practice managers and administrators need to be running reports regularly and taking action to mitigate issues as soon as they identify them.

Leadership should be careful on how often they run reports though and what results they expect – I had one client who was running them twice a week, and complaining that they weren’t improving. We had to have a lengthy conversation about interventions and how long they take to bear fruit, since it’s nearly impossible to change provider or end user behavior overnight. That’s also assuming that you actually reached the providers with the intervention, and that half of them weren’t in the operating room or missing it because they were rounding or not reading their email. Even with significant incentives or penalties, it’s still going to take several weeks (if not months) for new workflows to become part of daily routines.

Managing quality metrics is definitely more of a marathon than a sprint. How is your group doing with MU attestation preparation? Email me.

Email Dr. Jayne.

Monday Morning Update 12/5/16

December 4, 2016 News No Comments

Top News

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Allscripts acquires Australia-based Core Medical Solutions for an undisclosed sum. The company’s BOSSnet clinical information system seems to be its best known product, with numerous implementations across the Western part of the country. CMS will operate as an Allscripts subsidiary out of its South Australian headquarters in Adelaide. Allscripts has had a strong foothold in South Australia since 2010, when the government enlisted the company to develop and roll out an Enterprise Patient Administration System across its 80 hospitals to the initial tune of $225 million – a figure that has since escalated to $317 million over 10 years.


Last Week’s Most Interesting News

  • The House passes the 21st Century Cures act in a rare, bipartisan 392-26 vote and sends it off for the Senate to review.
  • A CDC report finds that the number of people struggling to pay their medical bills has fallen sharply in the last five years. Researchers cite reduced unemployment and the implementation of ACA as the primary reasons.
  • The Senate unanimously passes a bill requiring HHS and GAO to analyze the University of New Mexico’s Project ECHO pilot program and report on opportunities to expand the program nationally.
  • President-elect Donald Trump selects Rep. Tom Price, MD to replace Sylvia Burwell as the next HHS secretary, and health policy consulting firm CEO Seema Verma to succeed Andy Slavitt as the next CMS administrator.
  • Rupert Murdoch will likely lose $200 million in Theranos investments after his own newspaper, the Wall Street Journal, exposed the company for misleading investors.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.


Acquisitions, Funding, Business, and Stock

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Apex Technology and related investors wrap up their acquisition of Lexmark, originally announced in April. Lexmark’s Enterprise Software Group will separate from the investor-led company and rebrand to Kofax. Former Vice President and CFO David Reeder will take over as president and CEO, and appears intent on selling off the software business as quickly as possible to focus on its imaging assets. The sale includes the assets of Perceptive Software, which Lexmark acquired in 2010.

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Dallas-based civil and criminal justice technology company Securus Technologies acquires Quebec-based PHD Medical’s telemedicine assets. Securus has been intent on broadening its healthcare offerings for correctional facilities, having acquired EHR vendor Cara Clinicals last year, and healthcare management systems business Archonix in 2013.

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Cerner finds itself in the real estate market thanks to legal battles with Ahmed Saeed Mahmoud Al Badia, a property developer with ties to the United Arab Emirates Ministry of Health, which hired Cerner in 2008 via a subcontractor agreement with Al Badia’s company, ICapital, to develop a national EHR system. Cerner contends it hasn’t been paid the full amount due, despite finishing the project. It is suing Al Badia and trying to seize a $30 million mixed-use development and other assets to recoup $63 million it claims to have lost on the project.

Epic faces another class-action lawsuit pertaining to its overtime pay policies. This particular suit contends that quality assurance workers were illegally denied overtime pay despite the fact that they mainly tested Epic’s software products by simulating user experiences and documenting problems – work that required little training or education in computer programming or engineering. (Higher-level employees like analysts, programmers, and software engineers are typically exempt from overtime pay rules.) The company faces two other overtime-related lawsuits filed early last year on behalf of technical writers who believe Epic illegally classified them as exempt from overtime wages and then paid them a fixed salary irrespective of the number of hours worked.


People

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James Aita (Idea Couture) joins Medicomp Systems as director of strategy and business development, North America.


Decisions

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  • Sleepy Eye Municipal Hospital (MN) will switch clinical and physician documentation software from Healthland to Meditech on December 1.
  • UConn John Dempsey Hospital (CT) will go live on Epic in June 2018.

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


Announcements and Implementations

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The New Hampshire Health Information Organization can now share data with NH providers who care for veterans inside and outside of the VA.

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Gillette Children’s Specialty Healthcare expands its telemedicine program to facilities in Central Minnesota. The state passed legislation last year requiring payers to cover virtual consults to the same degree they would in-person appointments.


Privacy and Security

From DataBreaches.net:

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  • Tampa General Hospital (FL) settles a class-action lawsuit related to a non-hospital employee’s unauthorized access of patient information and the hospital’s failure to adequately protect that information. The hospital maintains it is not responsible for the misdeeds of former employees related to the access.
  • Glendale Adventist Medical Center (CA) fires a nurse after the employee accessed the records of 528 patients without permission.

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NIST’s National Cybersecurity Center of Excellence seeks help with designing simple and secure mobile login methods for first responders. Organizations interested in supporting the single sign-on effort can submit a letter of interest to NIST, which hopes to begin developing use cases in January.

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University of Iowa Hospitals and Clinics recovers from a six-hour Epic downtime caused by an electrical problem in one of its main server rooms. The health system shifted to standard downtime procedures and transferred critical services from its data center to a redundant data center off site.


Innovation and Research

A HealthLoop health literacy study of 2,226 diagnostic imaging patients finds that those offered educational materials via digital means were more likely to correctly identify what ionizing radiation was than those that received paper materials. The digital engagement group was also “significantly” more at ease with undergoing examinations using such radiation compared to their paper-based counterparts.


Sponsor Updates

  • Experian Health will present at the VA AAHAM meeting December 9 in Williamsburg, VA.
  • PokitDok will present at Health 2.0 Asia-Japan December 6-7 in Tokyo.
  • Surescripts and ZeOmega will exhibit at the AHIP Consumer Experience & Digital Health Forum December 6-9 in Chicago.
  • TierPoint will host the Nebraska Security Summit December 8 in Omaha.
  • Zynx Health will exhibit at the National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
  • Sutherland Healthcare Solutions publishes “Meaningful Use Stage 3 and its Impact on the Healthcare Industry.”

Blog Posts


Contacts

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

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News 12/2/16

December 1, 2016 News 3 Comments

Top News

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The House passes the 21st Century Cures act in a rare, bipartisan 392-26 vote and sends it off for the Senate to review next week.

Provisions include a less-thorough FDA drug approval process, $5 billion in NIH research funding, $1 billion to address the opioid epidemic, and mandatory EHR interoperability requirements that prohibit information blocking with potential fines of $1 million. The bill would also combine ONC’s HIT Policy and HIT Standards committees

A controversial measure that would have reduced requirements for drug companies to continue publicly reporting their payments to providers was removed.

The bill would be funded by taking money away from preventive health projects.


Reader Comments

From Luna Immortal: “Re: [vendor 1 name omitted]. I’m hearing that they have an upcoming merger and wonder if it might be [vendor 2 name omitted] since there’s a lot of people who worked at both companies and Vendor 2’s home health software vendor stake would help Vendor 1, whose product isn’t robust.” Unverified. Sorry about all the Vendor 1/Vendor 2 stuff, but I don’t usually list the names of publicly traded companies when I run rumors even when it’s not hard to figure out who’s who.

From Byte Bard: “Re: upcoming webinar. Your speaker’s bio says his prior company went public. That’s not accurate – it was an SEC Regulation D investment.” I see a good bit of accomplishment inflation in this industry, like the executive’s LinkedIn profile I was reviewing this morning that, in the absence of actual graduate education, listed one of those super high-priced, days-long visit to the campus of a big-name school that offers programs for those who are flush with cash but who don’t find it convenient to earn an actual graduate degree like many of their underlings managed to do. I’ll trust your resume forensics in this case. I recall that I got all kinds of nasty and threatening emails years ago when I wrote about unaccredited schools and linked to the bios of healthcare people who were throwing around their fake MBAs and PhDs. If the credential can’t withstand any sort of inspection, then it has no place on a resume or LinkedIn.


DonorsChoose Updates

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Donations from (a) the anonymous vendor executive who asked me to do a reader cybersecurity survey; (b) long-time reader Marty; and (c) our own @JennHIStalk funded these DonorsChoose classroom projects:

  • A library of books and a storage cart for Mrs. L’s first grade class in Cedar Hill, TX.
  • 30 calculators for Mrs. S’s sixth grade math class in Union, SC.
  • Math games for Mrs. S’s first grade class in Independence, MO.
  • Learning center headphones for Ms. M’s elementary school class in Chicago, IL.
  • Programmable robots for the library’s makerspace of Mrs. E’s elementary school in Greenwood, SC.
  • Science teaching items for the sixth grade class of Mrs. S in Union, SC.
  • Hands-on learning stations for the learning disabled students of Mrs. P’s kindergarten class in Oklahoma City, OK

Mrs. S from SC, who says she was “thrown in” to teaching science after school had already started and therefore had no materials to work with, checked in:

You do not know how much this means to me and to my students. This has been a difficult year trying to teach my students with limited supplies. I can’t wait to tell my students tomorrow morning. I’m sure they will be just as excited as I am. Thank you for your generosity.

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Industry long-timer Tom sent a very generous personal donation with a note saying that it’s sad that charity has to provide classrooms with essential learning tools, but he’s still happy to donate for “our future adult citizens.” The matching money really added up in funding these teacher grant requests with Tom’s donation:

  • A listening center for Mrs. H’s first grade class in Battle Creek, MI.
  • Additional books for the library of Mrs. L’s first grade class (the first donation to her class was above).
  • A mobile organizer and spelling games for Mrs. S’s elementary school class in Gaffney, SC.
  • Three sets of building blocks for Mrs. K’s elementary school class in Rome, NY.
  • An iPad Mini for read-along lessons for Ms. N’s elementary school class in Brooklyn, NY.
  • A social emotional library of 33 books for the International Baccalaureate class of Mrs. M in Nashville, TN.
  • Non-fiction books and subscriptions for Ms. S’s elementary school class in Chula Vista, CA.
  • Robotics and engineering kits for Mrs. G’s elementary school class in Springfield, NY.
  • STEM learning project kits for Ms. L’s elementary school class in Independence, MO.
  • Music and band supplies for Mrs. R’s elementary school class in Wasco, CA.


HIStalk Announcements and Requests

My fatigue is growing with lazy health IT reporters who craft “news” stories consisting mostly of loosely woven together tweets or quotes extracted from them. They should be practicing journalism that they promote via Twitter, not using Twitter as a news source. Every time I think that journalists (if you care to call them that) can’t possibly get lazier or less informed, they prove me wrong. The “eyeballs at any cost” movement among sites that don’t charge a subscription fee (and thus trade in titillation rather than education) has made us collectively dumber than we already were and that’s saying a lot. 

I’m also tired of people repeating the well-intentioned but dead wrong trite assertion that “Your ZIP code determines your health more than anything.” If that were true, people would be miraculously cured just by moving. Health status is certainly related to socioeconomic factors that are prevalent in a given ZIP code, but you and I won’t fall apart medically just because we move to East St. Louis. It’s a cute phrase that ironically confuses cause with effect and applies broad group characteristics to every individual in the group. Healthcare people should know better.

This week on HIStalk Practice: AbleTo adds care coordination capabilities to behavioral telehealth service. PCPs found extremely lacking in willingness to fess up to medical errors. Topline MD practices roll out telemedicine capabilities. Orb Health raises $3.2M for CCM-focused care coordination tech. Culbert Healthcare Solutions CMO Nancy Gagliano, MD shares four reasons why telemedicine hasn’t taken off more quickly. Excellus BCBS preps for MDLive roll out. CompuGroup Medical adds rehabilitation module. WebPT CEO Nancy Ham shares her thoughts on the importance of workplace culture in attracting top talent.

Listening: new from Seattle-based lo-fi rockers Dude York, which to my untrained ear can sound like the Pixies one minute and the Thermals the next. Their drummer nails it. I’m also kind of enjoying their former neighbors from their Walla Walla days, the riot grrrlish Chastity Belt, who bristle at being called a “girl band” in saying that all the members “just happen to be female” and that nobody would call Led Zeppelin a “boy band.” We get great recorded performances of both courtesy of the U-Dub affiliated KEXP in Seattle, which offers live streaming of its radio programming (I’m listening to it now). 


Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.


Acquisitions, Funding, Business, and Stock

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Document Storage Systems will acquire Streamline Health’s patient engagement suite that includes patient scheduling and surgery management. Those are the former systems developed by Unibased Systems Architecture, which Streamline acquired in 2014 and then renamed from ForSite2020 to Looking Glass Patient Engagement. I ran a reader rumor from Twice Bitten on October 5, 2016 saying that Streamline had laid off half of the team involved. DSS offers products and services to government and commercial clients based on the VA’s VistA, so I’m not sure what they’re planning to do with the former USA products.

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Omnicell will acquire Raleigh, NC-based Ateb, which offers pharmacy-enabled care and population health management solutions, for $41 million in cash. CEO Frank Sheppard left his IBM developer job in 1992 to form the company.

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Lifestyle telehealth software vendor Fruit Street raises $3 million from physician investors in a Series A funding round.

I messed up my New Zealand dollars currency conversion conversion in summarizing Orion Health’s just-announced results. Here’s the corrected version:

Orion Health announces first-half 2017 interim results: revenue up 9 percent, operating loss $12 million vs. $19 million in the first half of 2016. Shares dropped 18 percent to a record low on the news and are down 64 percent since the company’s 2014 IPO. While revenue is up, losses are down, and the company projects profitability in 2018, Orion’s cash position has dropped to $17 million after a net cash outflow of $23 million in the first six months of the fiscal year. The company has also expressed some concern that its predominantly US customer base might defer decisions following the presidential election, but it believes healthcare IT initiatives have bipartisan support.


Sales

Allied Physicians Group (NY) chooses Dimensional Insight’s Diver Platform for analytics.


People

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Greg White (Allscripts) joins PerfectServe as COO.


Announcements and Implementations

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Spok announces the T52 two-way pager that allows encrypting messages.

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Health Catalyst launches Healthcare.ai, an online repository of open source machine learning algorithms.

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National Decision Support Company expands its CareSelect clinical guidelines to include the Choosing Wisely campaign,medications, labs, and blood management.

NTT Data Services (the former Dell Services) announces analytics partnerships with Imbio (lung analytics) and AnatomyWorks (brain mapping analytics).

DrFirst will integrate pharmacogenetics-based point-of-care electronic prescribing from Translational Software into its Rcopia medication management system.

Northwell Health and Siemens Healthineers form research partnership to address imaging effectiveness and outcomes.


Government and Politics

A CDC study finds that the number of people whose families are struggling to pay their medical bills has dropped 22 percent in the past five years due to an improving economy and the large number of people who gained insurance through the Affordable Care Act.


Privacy and Security

From DataBreaches.net:

  • In Australia, SA Health fires two more employees for inappropriately accessing medical records, raising its total to seven after a February crackdown.
  • A research team hacks 10 types of implantable medical devices, claiming that a hacker could kill pacemaker and defibrillator patients within 15 feet.
  • In Canada, Carleton University temporarily bans Windows-using students from its network after ransomware takes down its internal systems.

Innovation and Research

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A group of cadets in an Israel Defense Force officer training course creates a digital bracelet and associated sensors that can be attached to wounded soldiers to record information about their treatment. The bracelet is powered by near-field communication technology that connects to the smartphones of medics. Medical teams are testing it for potential general army rollout.


Other

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California is testing an electronic registry for POLST (Physician Orders for Life-Sustaining Treatment) forms that would allow first responders and clinicians to look up their wishes for emergency treatments. POLST forms, intended for use by people near the end of their lives, contain actual provider orders and thus are more stringent than advance directives. Advocates fear that the barrier to widespread electronic registry use will be that hospitals won’t share their data. 

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This is sobering: gunshot detection system vendor Shooter Detection Systems gets its first (unnamed) health system customer.


Sponsor Updates

  • Agfa Healthcare, GE Healthcare, and Lexmark Healthcare complete the RSNA Image Share Validation program.
  • Xerox develops a printer for ambulatory providers capable of sharing patient information via the cloud.
  • EClinicalWorks will exhibit at the Orthopaedic Summit December 7-10 in Las Vegas.
  • Deloitte includes Evariant in its list of fastest growing technology companies in North America.
  • Iatric Systems will exhibit at the Privacy & Security Forum 2016 December 5-7 in Boston.
  • Imprivata will exhibit at IHI’s National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
  • Deloitte includes Ingenious Med on its list of fastest growing technology companies.
  • InterSystems will exhibit at the NYeC Digital Health Conference December 6-7 in New York City.
  • CompuGroup Medical adds a rehab module to its WebEHR.
  • EHR integrations drive nationwide adoption of CareSelect Imaging.
  • Navicure will exhibit at the HIMSS Revenue Cycle Solutions Summit December 6-7 in Boston.

Blog Posts


Contacts

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

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Morning Headlines 12/1/16

November 30, 2016 News No Comments

21st Century Cures seeks multiple health IT policy improvements

The 21st Century Cures Act passed a House vote and will now move to the Senate for consideration. The bill includes provisions calling for the reduction of documentation requirements associated with EHRs, a change that would allow scribes to document in lieu of providers, and a simplification of meaningful use requirements.

U.S. Senate passes law to bring Project ECHO model to rural health care

The Senate unanimously passes a bill requiring HHS and GAO to analyze the University of New Mexico’s Project ECHO pilot program and report on opportunities to expand the program nationally. Project ECHO uses telehealth to expand access to specialists to patients in rural areas.

OptumRx and CVS Pharmacy Partner to Expand Consumer Choice, Reduce Costs and Improve Health Outcomes

CVS Pharmacy partners with OptumRx, a free-standing UnitedHealth Group pharmacy care services business. The partnership will bring OptumRx’s patient engagement solutions to CVS patients and will create a single platform where the two businesses will co-develop new solutions.

Value-based Care Prompts Glass to Grow Up

November 30, 2016 News No Comments

HIStalk looks at the ways in which smart glasses – once thought to be an over-hyped novelty – are turning into a not-to-be ignored market force aimed at helping healthcare transition to value-based care.
By
@JennHIStalk

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The name “Google Glass” once evoked guffaws aimed at the early consumer adopters (Glass Explorers) who were seen sporting them in everyday settings. “OK Glass” – the command used to jumpstart the wearable’s software – was not, contrary to initial manufacturer expectations, uttered at a rate that demanded further mass consumerization.

Healthcare, however, did express interest, and at least a few headset-wearing folks walked the halls of the HIMSS conference in 2013 and 2014 The Glass hype in healthcare was understandably strong, given the industry’s propensity to create high-tech cures for low-tech problems.

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Though privacy and security concerns caused Google to take a step back from the consumer market for Glass, its prospects in the world of business quietly flourished (despite the fact that HIStalk readers voted Glass “the most overrated technology” in the 2014 and 2015 HISsies). Even Apple has taken notice, with rumors resurfacing of its intent to develop an iPhone-compatible pair of smart glasses. Healthcare providers and vendors have also shown increasing interest in the devices, which in turn has helped a number of startups flourish in the face of almost gleeful naysaying.

From Pipe Dream to Readmissions Reducer

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San Francisco-based Augmedix has made a name for itself in the smart glasses space, becoming one of the first companies in healthcare to recognize the value this type of technology can bring to physician workflows. Founded in late 2012 by Ian Shakil and Pelu Tran, the company — which offers remote scribing capabilities via smart glasses — has grown from two to over 700 employees.

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“In the beginning, people viewed us as a novel hype play,” Shakil admits. “Now that the hype has bled away, people are starting to view us a real, substantive, hard-nosed solver of big problems in healthcare. The problem we’re going after is the sad fact that doctors spend two to three hours a day charting, typing, and clicking. They hate it and the patients hate it. We’ve thrived in the world of volume and paper; doctors are busy and burdened, and so saving them a third of their day with our remote scribing capabilities is very valuable. Those same factors are still true in the emerging world of value-based care. Doctors are scarce, they’re expensive, and their overhead is expensive. Reclaiming those lost hours enables them to focus their energies on spending more time with patients or population health endeavors. Either way, the value translates in both worlds and it’s really starting to be tallied and received by the market, which is feeling a lot of growth.”

Augmedix’s J-shaped growth curve over the last four years is indeed indicative of healthcare market interest, which has helped spawn a number of other competitors. Mountain View, CA-based Drchrono jumped onto the Glass bandwagon in 2014, developing the first EHR-compatible “wearable health record” in partnership with Google and Box.

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Founded in 2004, Advanced Medical Applications got into the smart glasses game in 2014 with the first live broadcast of a surgery using Google Glass between two continents. The company, which specializes in mobile technology development for a number of verticals, has managed to find its niche in smart glasses-enabled telemedicine and emergency services.

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Austin-based Pristine plays in a similar space. The three year-old startup has focused on creating a telemedicine solution that enables doctors to provide their expertise visually from anywhere at any time.

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“The ‘See What I See, Hear What I Hear’ collaboration solution was initially adopted by teaching hospitals, ambulance organizations, healthcare systems that provide care for remote patients, assisted living facilities, and anywhere access to expertise was limited,” explains Pristine CEO Peter Evans. “In the past year, we’ve seen two changes that are accelerating that adoption. First, there has been a shift in approach from Explorers and those kicking the tires on the concept, often funded by grant money, to organizations that have specific pain points and realize that the traditional approaches to providing care are not scalable.”

“Second, we are seeing a rise in adoption by manufacturers of healthcare products,” Evans adds. “Companies that make complex healthcare technologies, produce pharmaceuticals, and provide other third-party solutions are enhancing their support models to healthcare providers through adoption of augmented reality and smart glass solutions. As an example, we are seeing the implementation of the rep-less model, where sales reps who normally provide in-person, in-theater support for a surgeon or doctor can now provide the same or significantly better support and expertise without having to physically be there. This improves efficiencies and reduces operational costs for both the hospital and vendor, while enabling reps to scale and support multiple clients.”

That accelerated adoption has helped Pristine’s provider customers begin to realize significant operational efficiencies. “Studies by our customers are showing that the ability to get the right skilled knowledge in the right place at the right time in an efficient manner is improving patient care and outcomes. Some of our customers using our solution for telemedicine applications have reduced readmissions by over 17 percent and reduced recovery time by almost 30 percent. We believe that we can be one piece of a complex puzzle that enables providers to be rewarded based on quality on value, not just quantity.”

Following in the Smartphone’s Footsteps

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Evans believes that the maturity of the market for smart glasses will grow in lockstep with related hardware. “The hardware is trying to catch up to the applications that users envision,” he says. “While many may be familiar with Google Glass, there is very good technology that has been introduced by companies like ODG, Vuzix, Epson, and Intel with its acquisition of the Recon Jet product.

“The state of smart glass hardware reminds me of the evolution of the smartphone,” Evans continues. “Early versions of the iPhone 2, for example, had hardware shortcomings. It didn’t have a camera, long battery life, GPS, or 3G. However, it had value with initial applications – sending texts, surfing the Web, and core apps that had immediate value. Over time, the hardware became more robust. Richer applications were developed and the incremental value grew. We are witnessing the same maturity of smart glasses and augmented reality solutions for business. The hardware has some limitations, but they are being addressed rapidly.”

Shakil also believes there are lessons to be learned from the world of smartphones. “It’s a vibrant space out there, with more smart glass offerings coming by the day,” he says. “Think back to when the first PalmPilots came out, and then compare that with the iPhone 7 – it’s like night and day. I think we’re going to see a similar progression in smart glass technology. They’re going to become more like normal-looking glasses – lighter, with a better battery life, more comfortable, and more resilient.”

Opening Up Use Cases

Today’s hardware limitations don’t seem to be holding providers back when it comes to reaping the benefits of smart glass technology. Shakil says that Augmedix customers anecdotally report more satisfied and engaged patients. “We’re beginning to see that showing up in the data,” he adds, “but it’s still early days. With our solution, the doctor feels more enabled to go deeper and get more investigative. The whole process becomes more hands-on for provider and patient.”

Customers participating in the OpenNotes initiative are also realizing new use cases for smart glass capabilities. “Sutter is one of our most progressive health system partners,” Shakil explains, “and while they’re very engaged with OpenNotes, they’ve struggled to deploy it operationally because it takes a lot of time and effort to write a beautiful note in rich, comprehensible English, get it into Epic, and then make it available to the patient by the time they get home. The Sutter team has found that, by using Augmedix, the note is almost always done in plain English by the time the visit is over, and is immediately available to the patient. They love being able to offer that. It engages the patient in their own care, helps them identify things they may have initially missed, and improves compliance in all the usual things. We’re really excited about the ways in which we can enable OpenNotes and all the downstream benefits that entails.”

Shakil is quick to add that some of the company’s more progressive end users – particularly those on the forefront of technology-enabled patient engagement efforts – have already expressed interest in taking smart glass capabilities even further. “Some of our health systems have an interest in going one step beyond OpenNotes to open up the visit from Glass itself for later retrieval on the patient portal,” he says. “We’re not doing that anywhere yet. We want to make sure that we have all the secure storage capabilities, opt-ins, and opt-outs from the patient side. Personally, as a patient, I think it would be amazing to go home and relive the appointment with my family – how to use the asthma inhaler, when to come in for refills, instructions on follow-up care. I think it will improve care and engagement in a big way.”

With Scale Comes Management Concerns

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The need for complementary solutions is also a strong indicator that smart glass technology is here to stay. VMware AirWatch has added smart glasses management to its line of enterprise mobility management technologies and services, a move the company attributes to increasingly larger pilot programs and the resultant need for assistance with device management.

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“We are seeing research being carried out in healthcare to identify use cases from training to documentation to data visualization during surgery,” says VMware Vice-President of Product Marketing Blake Brannon. “Pioneering customers are starting to pilot smart glasses and report gains in productivity and reduction in costs. We have started to see pilots move from less than five devices to a few hundred, or in some cases, a few thousand. When the scope of pilots increases to that extent, that’s typically when IT gets involved and needs a game plan to secure, configure, and deploy them at scale.”

The Cybersecurity Question

Though patients seem to have become more comfortable with smart glasses from a privacy point of view, enterprise adoption comes with its own set of adoption challenges. “Privacy and data protection will definitely come up as potential issues,” says Brannon, “resulting from any local storage of information and transmission of data. I’m not sure cybersecurity concerns will be addressed. They’re more likely to be amplified. We saw issues with Google Glass – not knowing if you were being filmed or having pictures taken of you. There will also be the same concerns as with other mobile devices. What if it gets stolen? Does it have patient information on it? Images? Can they be remotely wiped? Is the software or firmware up to date? Questions like these from our customers prompted us to develop an answer.”

The Future

Though smart glasses seem here to stay, albeit in a very niche capacity, Brannon believes the market still has to do its fair share of growing up. “The market is fragmented right now,” he notes. “There are many manufacturers with different devices that run different versions of Android. Some devices are also running proprietary operating systems. In the short term, we could see certain manufacturers create specific enterprise policies to differentiate their hardware, but, long term, we expect to see more consistency as the core hardware vendors emerge and build to a specific standard.”

Evans takes a more long-term view with the expectation that smart glass technology will become part of a person’s daily routine for work and play. “Some pundits are predicting that in 10 years we will see the demise of the smartphone, as it will be replaced by smart glasses. Anything that can be done on a smartphone or tablet can be done on the same Android operating system on smart glass.”

“Once the hardware becomes lighter,” he emphasizes, “then people will engage others by looking up rather than down at a small screen. Voice-recognition technology, which we’re already seeing with Siri and Alexa, will become a key enabler. We can all speak commands faster than we can type them, after all. Individuals will prompt their smart glasses with voice commands and other external beacons like barcodes and object recognition and will be immediately able to call up any information needed, to be displayed while we continue to interact with the world around us. The days of smartphone-induced disengagement will become a thing of the past.”

News 11/30/16

November 29, 2016 News 3 Comments

Top News

12-16-2011 10-57-52 PM

President-elect Trump nominates former orthopedic surgeon and Affordable Care Act critic Rep. Tom Price (R-GA) as secretary of the 78,000-employee HHS. He would replace Sylvia Burwell.

Price’s Empowering Patients First Act calls for age-adjusted tax credits for those buying health coverage on their own; a one-time credit for starting a health savings account; state-administered high-risk pools for people with pre-existing conditions; tort reform; and allowing insurers to sell policies across state lines. It would also allow individuals to opt out of government plans such as Medicare, Medicaid, and the VA programs and take the tax credit instead to buy their own insurance and would allow small businesses to create their own national insurance buying groups. It would also prohibit HHS from using comparative effectiveness or patient-centered outcomes research to deny federal insurance coverage of specific treatments. However, Price says he’s open to compromise and the only line he draws in the sand is the one opposing the ACA.

Here’s what I quoted Price as saying about the HITECH act back in 2011:

Instead, what does the federal government do and think it’s getting high tech? It is defining every little thing, every box that the physician or nurse has to check every time you see a patient, in order to get an extra 1.5 percent of reimbursement from the government. Or, not getting dinged for an extra 1.5 or 2 percent. These are the Meaningful Use things.  Washington always has these great lines, right, these wonderful Meaningful Use standards. They’re neither meaningful nor useful and they’re so ridiculous that they actually incentivize pathologists to have to ask on every single patient that they care for how old they are, how many allergies they have, what medications they’re on, when was the last time they saw their primary care physician, on and on and on, including of a slide of a patient … the pathologist never actually sees that patient … or a corpse for an autopsy. This is no lie. The federal government wants the pathologist to determine whether or not a corpse has any allergies. How you feeling today, right? This is nonsense.

So what do you do with technology to make it so it actually works for healthcare? I think the proper role of government in the area of technology in healthcare is to say, OK, this is the platform we will use. This is the highway upon which we will ride. Everybody needs to have a system that allows it to speak to another system within these parameters. And not dictate what the docs are doing on a day-to-day basis for a given patient, because it doesn’t make any sense. It’s a waste of time. They can never, ever put in place the right standards for a bureaucrat to determine whether or not the doctor’s doing the right thing.

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President-elect Trump also nominates Seema Verma, MPH to serve as CMS administrator, replacing Andy Slavitt. The health policy consulting firm owner is mostly known for her work on Medicaid expansion and her Indiana ties to VP-elect Mike Pence.


Reader Comments

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From Dillon Darkbird: “Re: Epic. NYCHHC does business with Epic, which doesn’t even pay its own state taxes.” DD provided a screen shot of New York’s tax warrant system showing that Epic owes the state $626,000, but I repeated the search and turned up nothing, which I assume means that Epic has since paid its tab.

From EHR Nomad: “Re: EHR migration. I’m looking for information moving from one system to another. Conversion is probably not a good option, as indicated by a number of sources that led me to that thought. What other options are there?” This is a hospital-based reader, so I’m thinking this refers to inpatient systems. You’ll probably want at minimum an application retirement system that will allow you to look up previously generated information as needed. It’s probably also both unnecessary and unwise to start with a blank EHR slate, converting at least the basic patient, provider, and clinical information to avoid frustrating users of the new system. However, it’s a good time to start over (at least technically) on order sets and system defaults. Readers with expertise in this area are welcome to respond. EHR Nomad didn’t specify the EHRs involved, but let’s assume they’re moving to Meditech 6.1. UPDATE: EHR Nomad clarifies that the conversion involves a practice the hospital is buying that runs MEDENT and they want to convert them to Allscripts. He’s wondering whether to just take possession of the practice’s server and keep it running or whether there’s a way to extract the information and store it in a logical way in case it’s needed. I think he’s given up on the idea of importing the information into Allscripts.


HIStalk Announcements and Requests

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Nordic donated $500 to my DonorsChoose fund, which with the addition of matching money fully funded these teacher grant requests:

  • Three sets of non-fiction books for the first grade classroom of Mrs. G in Saint Paul, MN.
  • Makerspace supplies for the school library of Mrs. G in Middleton, WI.
  • Three Chromebooks for Mrs. J’s first grade class in Lugoff, SC.
  • STEM modeling materials for Mrs. M’s elementary school class in De Soto, KS.
  • Headphones for students with profound disabilities in Mr. P’s middle school class in Oklahoma City, OK.
  • STEM materials for Mrs. W’s first grade class in Easley, SC.

Mrs. J was quick to respond, referring to her class — as teachers often do — as “us,” which gets me every time:

I am absolutely blown away by the generosity of others at this time of year and all year round with DonorsChoose. My students are going to be so surprised when these Chromebooks arrive! My students love technology and your donations and kindness will really make a difference in their learning. Thank you so much for your gift. Words can’t begin to tell you how much your gift means to us.

I don’t intentionally solicit funds for DonorsChoose because I don’t like being strong-armed for donations myself, but readers often send money voluntarily and I’ll always put it to good classroom use. I’ll have another round of funded projects to describe next time thanks to some new donations that came in on Giving Tuesday.


Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.


Acquisitions, Funding, Business, and Stock

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Canada-based Constellation Software’s subsidiary Harris continues its acquisition spree by buying iMDsoft. Its previous acquisitions include Picis, QuadraMed, MediSolution, DigiChart, and NextGen’s hospital systems business. 

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In Australia, the builder of the unfinished Royal Adelaide Hospital is preparing to sue the state government, claiming it has delayed the hospital’s scheduled April 2016 opening to cover up problems with its overdue and over-budget Allscripts-powered EPAS system. The health minister says an independent auditor previously dismissed those same claims.

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Austin, TX-based doctor-patient texting app vendor Medici raises $24 million. It pitches itself to doctors with, “Get paid to text with your patients on your schedule.” The 13-employee company tries to create buzz by calling itself the “Uber of healthcare” and “WhatsApp with your doctor.” Hopefully the example screenshot above isn’t representative of the degree of clinical thoroughness involved with those convenient, billable text exchanges.

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Orion Health announces first-half 2017 interim results: revenue up 9 percent, operating loss $12 million vs. $19 million in the first half of 2016. Shares dropped 18 percent to a record low on the news and are down 64 percent since the company’s 2014 IPO. While revenue is up, losses are down, and the company projects profitability in 2018, Orion’s cash position has dropped to $17 million after a net cash outflow of $23 million in the first six months of the fiscal year. The company has also expressed some concern that its predominantly US customer base might defer decisions following the presidential election, but it believes healthcare IT initiatives have bipartisan support.

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Wall Street Journal owner Rupert Murdoch is likely to lose most of his $200 million investment in Theranos, whose downfall was ironically triggered by investigative articles published by his own paper. Many big, later-stage Theranos investors were individuals and families with little connection to the usual VC vetting process who watched the company’s $9 billion valuation drop to nearly zero. Meanwhile, two more investors file lawsuits against the company claiming they were misled, one of them seeking class action status.


Sales

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NorthShore University Health System (IL) and Valley Children’s Healthcare (CA) choose Phynd’s provider management system.

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New York-Presbyterian Hospital (NY) chooses Mobile Heartbeat’s clinical communications system.


People

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Teleradiology services vendor Virtual Radiologic promotes Shannon Werb to president/COO, replacing departing CEO Jim Burke.


Announcements and Implementations

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Community Health Network (IN) expands its use of Kyruus ProviderMatch to its new consumer website.

Boston Children’s Hospital (MA) and GE Healthcare will work together to develop brain scan interpretation software that will be available via GE’s Health Cloud.

Phynd releases version 2.0 of its Unified Provider Management system.

Philips, following GE Healthcare’s lead, will develop medical software for its imaging systems, with its CEO telling investors, “The world does not need much more capacity in scanners, but is especially in need of better interpretation of data” for improving diagnosis.

The VA will partner with artificial intelligence vendor Flow Health to analyze the VA’s 20-year database to identify disease markers, suggest treatments, and discover the influence of genetics on risk, diagnosis, and treatment.

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Nationwide Children’s Hospital (OH) and SeizureTracker.com release a seizure diary app for the Apple Watch that allows people to record their seizure data and video, share it with their doctors, and contribute it to a research database.

Marketing and customer service software vendor Pegasystems offers FHIR-powered APIs to connect with its healthcare applications.

Clinical Architecture adds Advanced Clinical Awareness Suite to its new Symedical terminology management platform release, which normalizes patient data from multiple EHRs or virtual medical record formats and applies inference rules to suggest diagnoses, recommend orders, or provide advice or alerts.


Government and Politics

A pending Medicare rule change would require hospitals to discuss nursing home quality data with inpatients who are about to be discharged to one of those facilities. Current Medicare patient choice requirements prohibit hospitals from doing anything more than just handing over a list of nearby facilities that have space available. Hospitals like the idea because they can be penalized for readmissions caused by poor nursing home care.

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Kaiser Health News reports that a record 1,455 lobbyists representing 400 companies are trying to convince members of Congress to either pass or reject the 21st Century Cures Act in voting this week, which would increase NIH funding, devote funds to address the opioid crisis, and change the FDA’s drug and device approval standards. Even the US Oil and Gas Association is involved since the Cures Act would be paid for by selling oil from the government’s Strategic Petroleum Reserve. The drug company trade association PhRMA has spent $25 million to support the bill, which would get their expensive drugs to market faster and would also reduce their requirement to publicly report payments made to doctors via the OpenPayments database. The Cures Act still falls far short of the ACA’s record-setting lobbyist activity, when 1,200 companies mobilized their ear-whispering firepower seeking favorable treatment .


Privacy and Security

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HHS OCR warns providers that phishing emails are being sent to HIPAA covered entities that include the HHS letterhead and the signature of OCR Director Jocelyn Samuels. The email includes a link that appears to direct readers to a document involving their inclusion in HIPAA audit, but it actually sends them to a cybersecurity firm’s website. HHS OCR says it takes “unauthorized use of this material by this firm very seriously.” I’m not sure in the absence of details whether HHS’s use of the term “phishing” in describing a disguised link is correct since it’s not clear whether the user is asked for confidential information, but obviously they aren’t happy about it.

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Trend Micro reports that 35 healthcare organizations, 17 of them in the US, have been scammed in the past two weeks by cybercriminals who spoofed the CEO’s email account and ordered employees who manage wire transfers to send money to their bank accounts.


Innovation and Research

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In Australia, Metro North Hospital and Health Service and Queensland University of Technology are building a dedicated 3D tissue-printing facility for the hospital’s OR, predicting that biofabrication can create personalized implants, help with robotic-assisted surgery, and improve surgical training.


Technology

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The Gates Foundation funds the work of low-cost, rapid-result portable molecular diagnostics vendor QuantuMDx, which is fine-tuning its field tuberculosis testing system.


Other

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NPR’s “All Things Considered” finds that biomedical research information is proliferating due to EHR rollouts and well-funded projects like the Cancer Moonshot, but nobody’s actually looking at all that big data. Reasons: the information is not all that robust and reliable due to variations in EHR database usage and much of the good stuff is recorded as free text. FDA Commissioner Rob Califf says the only way to validate the datasets is to get people to participate in studies that try them out, with increased study participation being the #1 FDA big data issue.

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Stat profiles Myriad Genetics, which made $2 billion in the 17 years of patent exclusivity it enjoyed for its BRCA breast cancer genetic testing. With competitors offering similar tests for a few hundred dollars instead of the $4,000 that Myriad charges following their successful patent litigation, Myriad has instructed its salespeople to disparage those competitors that it labels as a “public health crisis.” An interesting review by members of the Free the Data consortium compared the results with those of its competitors and found little difference, although patient recommendations from all of them change over time as they gain more real-world data. The group was formed because Myriad refused to share its database with physicians and researchers, so Free the Data gathers the reports downstream directly from participating providers.

Patients at C.S. Mott Children’s Hospital (MI) will receive a custom cardboard virtual reality viewer that can run apps from their own smartphones, including a University of Michigan game day app, courtesy of a $50,000 grant from the Jim Harbaugh Foundation.

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A radiologist’s JAMA opinion piece written with Eric Topol, MD suggests that radiologists should emulate pathologists in embracing technologies that can replace much of their work, often more accurately and always more efficiently, and retool their practices as “information specialists” whose job would change from extracting information to managing the information created by those technologies. The authors even suggests that perhaps the pathology and radiology specialties should be merged.


Sponsor Updates

  • Catalyze releases a new podcast, “Why Healthcare Should Expand its View of FHIR.”
  • Black Book announces the top ranked, end-to-end crisis management PR agencies.
  • Forward Health Group is sponsoring the December 7-9 annual conference of the California Association of Public Hospitals and Health Systems in Pasadena.
  • Besler Consulting releases a new podcast, “What healthcare policy might look like under the Trump administration.”
  • Black Book lists the top 20 issues faced by healthcare PR and crisis management firms.
  • CapsuleTech will exhibit at the National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
  • CoverMyMeds sponsors the Healthcare Association of New York State’s Back to Basics Bootcamp November 29-30 in Tarrytown, NY.
  • Cumberland Consulting Group will sponsor the Health Plan Alliance’s Informatics and Analytics Value Visit December 6-8 in San Antonio.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
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Reader Comments

  • HIT Girl: Amazingly, he's the CEO of a patient-payment company. You'd think he'd have bothered to pop the hood on the whole billi...
  • Johnny B: ACP paper - I don't know that providers will ever be able to come to a consensus on how they want to document. Some want...
  • FLPoggio: What this piece totally ignores is that you and the provider (roofer) dealt directly with each other. Now what if you ha...
  • AC: That's not an apt comparison. Imagine instead if while the roofer was doing his thing, another random roofer dropped by ...
  • HIT Girl: I've worked in EHR design & support for the last 14 years or so, and when I was hospitalized in I think 2007 I got m...

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