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Reader Survey Results: Job Promotion Factors

May 27, 2017 News No Comments

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I asked what factors affected a job promotion.


Being humble, but speaking up in meetings (especially with solution ideas for important problems).


Many factors worked together to promote me through three levels in five years. An ability and willingness to drive change and tackle challenges in areas traditionally labeled as “impossible” because they required revamping entrenched negative habits. An unflinching determination to get tasks done on time (with no short cuts) and work out compromises even with the most difficult stakeholders. The ability to get to the root cause of an issue and focus on how to avoid future snafus with education and documentation without dwelling on placing blame. Consistently keeping EVERYONE very well aware of a projects progress and problems – so everyone felt in the know. Taking copious and diligent notes so as to instill trust and confidence when making statements at meetings, allowing decision makers to move forward more quickly. It also didn’t hurt getting another master’s degree specializing in a key niche area! Never let your skills become stale or your attitude become obstinate.


Proving myself works in getting more responsibilities. Moving to a new company was required to get a promotion.


Paying attention. I don’t believe in random luck, I believe that if you keep your mind open, you will be able to see the opportunities that are all around you. Luck is the ability to see the doors that are already open, waiting for you to step through. Also, be kind and generous.


I do not seek a promotion as something to have, a title to add to my business card or resume. I do not seek a promotion as a reward for time served or deeds already done. I seek a promotion for the opportunity to connect with new people to share ideas, the ability to move forward with new kinds of projects, the ability to tap into new resources. If you can articulate your desire for promotion in the context of moving forward instead of looking backward (a reward) or appearance (new business cards), then your organization will see you as a part of their future as well.


Always doing what I think is the right thing,and the best things for my customers. Always be honest and when I see a problem or an opportunity for improvement, regardless if I am responsible for it or not, I try to identify a solution.


Not looking for the promotion and focusing on making my boss(es) look good. Supporting their ideas and approaches.


I’ve had three offers to get a significant bump in salary and/or role. Every time was when I threatened to quit.


Receiving offers from other companies willing to pay me more.


Job changes, willingness to take on new projects, show value and communicate it.


Building relationships and consistently delivering results.


Who you know and certifications. Also geographical location seems to be a factor — if the person who is doing the hiring is from the same area of the country as you, then that helps with a connection.


Being better at the job than all the other people around me.


I’m a white male. I am also smart, talented, and hard working. But judging from my colleagues, being a white male is often all that is needed to climb the ladder. Competency does not seem to be a requirement.


A good boss. There are ideas, and there is doing. Do. Prompt responses to your boss and your boss’s boss.


#1: Asking for them. Having competing offers (that helped with salary level). Having (at the time) a relatively unique background with IT and medical experience. Having the right networks of people who give your request credibility


Company laid off one-third of people. We all applied elsewhere, they begged us to stay. To stay, I requested improved salary, vacation, and title. They obliged.


Leaving.


Most of my promotions have occurred when I’m working for someone who gets things done and cares about my career. Lesson: Think about who you are aligned with professionally.


Self-sufficiency and a willingness to figure things out on my own.


The ability to lead others, even if not in an appointed leadership role. Last promotion to Lead Analyst role earned by demonstrating ability to assist new and current co-worker analysts to achieve positive results. Sometimes though one is born with an innate nature to lead and enjoy doing so (without be overbearing – i.e., “bossy”). One can always possess a technical ability to perform job duties, but needs guidance and mentoring to achieve success.


My ability to smile while professionally dealing with the jackasses that infest our fine HIT industry.


Being a woman. Just kidding!


My top 3: specific measureable business results from work. The ability to communicate effectively with both non-IT and IT people. Reasoned risk-taking.


Integrity, dedication to performing at the best of my ability, and respect for everyone’s role and contribution to delivering quality services.


Being in the right place at the right time. Having a track record of delivering results. Being helpful and useful. Thinking critically and anticipating my next action. Dressing nice, being well groomed and presentable, speaking clearly and confidently, having a sense of humor, and being able to relate to everyone, not just my peers.

News 5/26/17

May 25, 2017 News No Comments

Top News

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The uncertain future of the Affordable Care Act is forcing some health IT startups – especially those that sell mostly to hospitals – to change their strategies, according to a Wall Street Journal report.

The political turmoil has also raised the funding bar as investors seek out companies with solid revenue and market validation, thereby putting their money into fewer but larger deals.

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These companies are reported to have made changes due to ACA uncertainty:

  • Smart pill bottle maker Pillsy is refocusing its sales efforts on consumers rather than providers.
  • Diabetes management technology vendor Omada Health is increasing its sales emphasis on clinical evidence and return on investment.
  • Pregnancy tracker app vendor Babyscripts is concentrating on large health systems instead of physician practices.
  • Take Command Health, which helps people who can’t get employer-provided health insurance find coverage, is revamping its platform to target small businesses that reimburse employee healthcare costs.
  • Amino, whose tools target specialty care, raised $25 million after changing its platform to analyzing the cost of preventive services that may no longer be free with ACA changes.

Reader Comments

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From Ex Epic: “Re: CommonWell. In the Madison consultant community, it’s pretty much understood that CommonWell is/was a Cerner marketing campaign to win the DoD. They tweeted these numbers at their collaboration forum last week, with quick math showing they have roughly one document retrieved per customer facility.”


HIStalk Announcements and Requests

This week on HIStalk Practice: Solutionreach’s Jim Higgins highlights the importance of patient relationship management in attracting and keeping millennial patients. Qliance Medical Management abruptly shuts down clinics amidst financial and legal difficulties. Lemonaid Health raises $11 million. Harbin Clinic adds PrecisionBI analytics to its Athenahealth tools. School nurses up in arms over incentivized telemedicine consent. Femwell Group Health will offer HealthGrid patient engagement tech. ClearHealth Quality Institute looks for telemedicine committee candidates.


Webinars

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

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

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

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


Acquisitions, Funding, Business, and Stock

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Clinical trials software vendor Medrio receives a $30 million equity investment from Questa Capital Management.

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Apple acquires Finland-based Beddit, which offers a sleep tracking app that uses mattress-attached flexible sensors.


People

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Jessica Campbell (Leidos Health) joins Nordic as VP of client partnerships.


Announcements and Implementations

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Elsevier will add its ClinicalKey clinical search engine to the World Health Organization’s Research4Life journal access program for developing countries. 

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The DiamondView HIE of South Country Health Alliance (MN) goes live with Medicity Notify, which provides electronic notification services for population health management that will be rolled out across its 11 counties.


Government and Politics

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ProPublica reports that some Republican lawmakers who are being called out on social media for their support of the American Health Care Act (and their sometimes incorrect statements about it as copied and pasted from White House talking points) are blocking their vocal constituents on social media after deleting their comments. An example is Congressman Peter King (R-NY), who not only appears to be censoring critical comments, but is also declining to conduct in-person town hall meetings because attendees scream at him.


Privacy and Security

In Australia, Queensland Health experiences a major EHR failure after applying WannaCry security patches from Microsoft, Cerner, and Citrix that slowed down systems and affected the ability of users to log on.  

A survey finds that only 9 percent of medical device manufacturers test the security of their products at least once a year, with nearly half saying they don’t perform security testing at all. One-third of both manufacturers and health systems say no single person is in charge of device security and half say they don’t follow the FDA’s guidance to reduce security-related risk.

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A security researcher finds that medical claims processed by insurer Molina Healthcare were freely accessible over the Internet simply by changing the number at the end of any claim’s URL to bring up a different claim, with no authentication required. The company fixed the problem after being notified and has shut down its portal pending a security review.


Other

NantHealth CEO Patrick Soon-Shiong announces plans to open a cancer center, saying that the city has a great basketball team and newspaper (he owns a chunk of both), but not a great cancer center.

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Slides from Cerner’s investor conference presentation show that Cerner and Epic (which Cerner references by name, which doesn’t happen often) each hold 24 percent of the acute EHR market. Cerner won decisions involving 109 hospitals in 2016 vs. Epic’s 91, although it was 69 vs. 66 when excluding existing customer add-ons. It also notes that 2,400 hospitals are using legacy systems that offer a replacement opportunity, with more than one-fourth of them running Meditech Magic or C/S.

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A group from Kaiser Permanente writes a Harvard Business Review article about KP’s efforts to get surgery patients out of the hospital quicker by using standardized processes and team coordination. The authors honor Jess Jacobs, who at the time of her death in 2014 at 29 had measured that in her 20 ED visits, 54 inpatient days, and 56 outpatient visits, only 0.08 percent of her time was spent actually treating her medical problems.

The State of New Jersey temporarily suspends the medical license of a psychiatrist who had prescribed thousands of doses of oxycodone for a single patient, with the attorney general announcing, “Our message to these doctors is clear: if you are not checking the Prescription Monitoring Program database as required by the new law, we will take swift and punitive action against you.”

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The Wall Street Journal profiles CVS Health EVP/CIO Stephen J. Gold, who says that 30 percent of the company’s pharmacy customers use its text messaging system for prescription refills. He mentions CVS’s Fast Mobile Prescription Pickup, which allows customers to pick up their refills at the counter or drive-through by scanning the barcode sent to their phones. The company is also using a proprietary health engagement engine to look for intervention opportunities, such as sending a message to patients who aren’t taking medications as prescribed or reminding diabetics to test their blood glucose. Another CVS digital tool allows patients to synchronize the refills of all of their prescriptions to save a trip and to improve adherence.

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The State of Minnesota, admitting that it can’t keep up with complaints about nursing homes that mistreat their residents, warns nursing homes that they cannot harass families who install “granny cams” in the rooms of residents to document the care their loved one receives. The ruling came after a woman who had placed a $199 video camera in her mother’s room complained that nursing home employees frequently covered it with a towel, unplugged it, pressured her mother to remove it by refusing to speak to her when entering her room, and eventually seized it.

The US finishes in its customary back-of-the-pack spot in a new global health measure that looks at: (a) how well countries prevent deaths by applying known medical interventions; and (b) how health measures improve with increasing national wealth. The author says it’s “an embarrassment” that the US spends $9,000 per citizen annually on healthcare while failing to improve its lagging world health position.


Sponsor Updates

  • The Chartis Group publishes a white paper titled “Performance Transformation: An Undeniable Requirement in Uncertain Times.”
  • GE Healthcare previews its upcoming film, “Heroines of Health.”
  • Meditech announces that it sold systems to five customers representing 16 hospitals in Q1.
  • EClinicalWorks will exhibit at the 2017 MPHCA Annual Conference May 30-June 2 in Biloxi, MS.
  • FormFast, HealthCast, Iatric Systems, Imprivata, and Intelligent Medical Objects will exhibit at the 2017 International MUSE Conference May 30-June 2 in Dallas.
  • As of May 18, people have counted on Healthwise information 2 billion times.
  • DrFirst is sponsoring next week’s MUSE conference, where its executives will present seven medication management sessions.
  • InterSystems will exhibit at the DoD/VA and Gov Health IT Summit May 31-June 1 in Alexandria, VA.

Blog Posts


Contacts

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

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News 5/24/17

May 23, 2017 News 8 Comments

Top News

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The Bipartisan Policy Center calls for creating a public-private effort to set health IT safety priorities and to disseminate best practices.

The report recommends:

  • General patient safety efforts should incorporate the safety of health IT throughout its life cycle.
  • Health IT safety should be addressed via a non-punitive learning system similar to medical error reporting.
  • Voluntary and mandatory reporting systems should collect de-identified data about health IT safety issues that can drive creation of evidence-based practices and tools.

The report does not specifically address ONC’s proposed EHR safety center.  


Reader Comments

From Vaporware?: “Re: Cerner. How long do they get a free pass on selling interoperability without delivering? Beth Israel Deaconess Care Organization lists just six EHRS of the 40 its providers use – Cerner not among the six – that are willing and able to contribute information to its population health analytics system. Do the live MHS Genesis pilot sites have connectivity to outside EHRs?” I’ll invite readers with the firsthand experience with either project that I don’t have to comment anonymously.

From Chaste Kiss: “Re: this HIMSS-owned publication’s story. I’m embarrassed that I actually clicked the tweet to read more.” No wonder – you were cheated when a publication runs a story titled “Is a takeover of Athenahealth inevitable?” that doesn’t actually answer the question it poses (nor could it). It simply rewords a lazy Bloomberg opinion column in which those original authors speculated  –without using any sources or providing evidence of analytical thought — that maybe Cerner, IBM, UnitedHealthGroup, Aetna, or Epic might be interested in buying Athenahealth (the fact that Epic was named means the authors are clueless). The embarrassingly lazy source article wasn’t improved one iota by having the HIT publication improperly legitimize it by rephrasing its undisciplined conclusions. In both cases, the writers seemed desperate to fill their allotted space with whatever fizzy “news” they could make up with a minimum of expended effort.

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From Greg: “Re: sepsis monitoring. The new Meditech 6.1 Surveillance product has a rules-based approach that looks at real-time EMR clinical data in the EMR. There the clinician can be notified and take appropriate action in an efficient and sometimes life-saving manner. These actions can include orders, medications, labs, documentation, problems, interventions, etc. I have personally not seen another EMR that is as far advanced with regards to surveillance.”

From SgtPerkins: “Re: John Brownstein’s tweet about Epic’s App Orchard developer terms. It is no longer available. $50 says he got a C&D from Epic to remove it. Even their awful legalese is intellectual property to them.” Unverified. My screenshot of his tweet from the Boston Children’s chief innovation officer is here. My experience is that such takedown requests often come from an individual’s employer rather than the subject of their comments, especially when the employer is a partner of the company mentioned (as I well know, having been threatened in my early, less-anonymous HIStalk days with being fired by my hospital employer for writing about one of our vendors even though it wasn’t inside information). Also, Epic’s App Orchard legal wording wasn’t really a secret anyway since it’s publicly available and, as other readers have noted, is similar to that of the Apple Store.


HIStalk Announcements and Requests

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Readers funded the DonorsChoose grant request of Mrs. D in Arkansas, who asked for writing journals and math activity kits and games for her elementary school class. She reports, “These materials have allowed students to learn using a hands on approach. We love all of our games and our writing journals! Students are so proud to have their own journal to write in each day. You have made all the difference! Thanks again.”


Webinars

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


Acquisitions, Funding, Business, and Stock

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Post-acute care software vendor Optima Healthcare Solutions acquires Hospicesoft, which offers hospice software.


Sales

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Five Ontario hospitals add PatientKeeper CPOE and medication reconciliation to their existing system and will expand their use of the company’s physician documentation solution, providing an overlay to Meditech Magic and other systems. 

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St. Joseph Health (CA) will expand its use of Clearsense analytics in implementing Inception for archiving, access, and visualization of its legacy Meditech data.

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Harbin Clinic (GA) chooses analytics from PrecisionBI, a division of Meridian Medical Management.


People

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A Philadelphia innovation organization recognizes Children’s Hospital of Philadelphia AVP/Chief Health Informatics Officer Bimal Desai, MD, MBI as its healthcare innovator of the year. He co-founded CHOP spinoff Haystack Informatics, which offers security technology that detects EHR snooping by learning normal staff behavior and calling out exceptions.

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NantHealth hires Ron Louks (BlackBerry) as COO.


Announcements and Implementations

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Rush Health (IL) launches Rush Health Connect, which aggregates information from its Epic and Allscripts EHRS using InterSystems HealthShare to give clinicians patient information and real-time alerts and notifications.

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Change Healthcare joins the Hyperledger open source blockchain project.

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The Fresno paper covers the use by Community Medical Centers of RightPatient iris recognition at patient registration, which the article explains isn’t an infrared scan, but rather just a photo of the patient’s eye. It also notes that palm vein ID systems are an alternative. RightPatient can also analyze a patient’s general headshot to identify them going forward.

DrFirst will integrate prescription pricing information from GoodRx into its e-prescribing platform.


Government and Politics

A VA OIG suicide prevention report finds that around 20 percent of inspected VA facilities don’t perform the mandated five outreach events per month, haven’t developed suicide prevention safety plans that are documented in the EHR, and don’t flag high-risk patients in the EHR. More alarmingly, OIG found that while 84 percent of non-clinical hospital hires completed their mandatory suicide prevention training within 90 days, nearly half of newly hired clinicians did not do so.

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The director of Denmark’s version of the FDA expresses concern that US tech companies like Google and Apple are rolling out medically-related fitness tools and devices that “have no requirements to demonstrate efficacy and safety, but we are forced into the direction of taking them seriously.” The finance minister warns that while patients are notified by email any time their Denmark-based interoperable electronic medical records are viewed, private services and apps offer no such protection, explaining, “We need to make our citizens aware that there is no free lunch with these big companies. People should make some more demands when they give their data away. These companies want to know what you want before you know it yourselves. We need to look into regulation. These private companies will have this patient data for eternity. Can we be sure they’ll always do good things with it?”

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A report by HHS’s Office of the Assistant Secretary for Planning and Evaluation blames the Affordable Care Act for the 105 percent jump in premiums from 2013 to 2017 in the 39 states participating in Healthcare.gov, as the average monthly premium increased from $224 to $476. The report, however, didn’t look at the increase in non-exchange sold individual plans and admits in its “Limitations” section that much of the premium increase is probably due to older, sicker people signing up in 2017 vs. 2013. The analysis also fails to note that pre-ACA policies (Healthcare.gov went live in 2013) were often full of coverage loopholes, exclusions, lack of coverage for pre-existing conditions, and lack of insurer experience with an uncertain risk pool.

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HIMSS complains about President Trump’s proposed federal budget that calls for major funding cuts for ONC, CDC, CMS, and NIH along with zero money for AHRQ, which would likely be rolled into NIH. The proposal also calls for cutting Medicaid by $800 billion over 10 years.


Other

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A Spok survey of 100 hospital CIOs finds that 40 percent of hospitals don’t discipline staff members who violate mobile policies, 30 percent say a significant portion of hospital data is shared insecurely, and more than half of doctors and nurses are unhappy with the communications methods available outside their EHR. Forty-one percent of hospitals don’t offer secure texting and those that do are equally split between providing it via the personal devices of employees vs. hospital-issued technology. Nearly one-third of clinical staff can’t receive clinical alerts or mobile messages from colleagues. CIOs say their hospitals are still using pagers because they are appropriate for some groups, are reliable, and are cheap and easily supported. More than half of the respondents say their biggest challenge in protecting hospital data is a lack of money and people.

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A ProPublica investigative piece observes that the still-increasing US maternal death rate is the highest in the developed world and 60 percent of those fatalities are preventable, profiling NICU nurse Lauren Bloomstein, who died of preeclampsia shortly after giving birth in which hospital medical errors apparently contributed. Factors include women giving birth later in life when their medical histories are complex, the nearly half of US pregnancies that are unplanned, the complications of C-sections, and the fragmented health/insurance system that makes it hard to get prenatal care (likely to get worse with any cutbacks to Medicaid, which pays for nearly half of US births). The article notes that perhaps the healthcare system is focused so much on saving the lives of babies – which it has done well – that it isn’t paying enough attention to the health of the mother. A standardized approach to quickly reacting to possible preeclampsia reduced UK maternal deaths to just two in three years, while up to 70 US mothers die of it annually even as US hospitals push back on implementing evidence-based processes.

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All you need to know about US health insurance is contained in this one story. An Army veteran whose wife requires pregnancy-related injections not covered by their medical insurance finds that they make $70 too much per month to quality for Medicaid, so they move from North Carolina to Alabama for a job that offers better insurance. He pays COBRA to cover the one-month lapse before their new insurance kicks in. The baby came in early, the NC insurance wouldn’t pay since Alabama is out of network, and the couple gets a bill for a two-week NICU stay for $178,000, of which neither insurance would pay a penny. They can’t get loans and he will lose his defense-related job if they file bankruptcy. They raised a few thousand dollars in a GoFundMe campaign and are hoping to work out a hospital payment plan for the balance that will probably last the rest of their lives.

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Instead of the help desk tech term PEBCAK (problem exists between chair and keyboard), this was PEBCASW (steering wheel). In China, a car show model who is demonstrating Nissans’s emergency braking system by standing in front of the moving car is run over (with only minor injuries despite being thrown 10 feet) after the demo driver – who was not familiar with the system – pushes its button twice, turning it on and then off again.  


Sponsor Updates

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  • Docent Health assembles bags and lunches for Boston-based charity Bridge Over Troubled Waters.
  • The American Association of Critical Care Nurses chooses Kathy Douglas, RN, MHA, chief clinical officer of Abililty Network’s ShiftHound, for its Pioneering Spirit award.
  • CSI Healthcare IT provides at-the-elbow support for MaineHealth’s Epic go-live.
  • Besler Consulting releases a new podcast, “Lessons learned from the introduction of a physician incentive compensation plan.”
  • CapsuleTech and Dimensional Insight will exhibit at the International MUSE Conference May 30-June 2 in Dallas.
  • Spok executives will speak at several industry events.
  • Direct Consulting Associates will exhibit at the SIIM Annual Meeting June 1-3 in Pittsburgh.
  • The American College of Radiology – a National Decision Support Co. partner – wins the ABIM Foundation Creating Value Challenge for its Radiology-Teaches initiative.

Blog Posts

Sponsors named to Modern Healthcare’s “Best Places to Work in Healthcare” 2017 list:

  • Cumberland Consulting Group
  • Divurgent
  • Encore, a Quintiles Company
  • Hayes Management Consulting
  • Healthfinch
  • Impact Advisors
  • Imprivata
  • Nordic
  • PMD
  • Santa Rosa Consulting
  • The Chartis Group

Contacts

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

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Monday Morning Update 5/22/17

May 21, 2017 News No Comments

Top News

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A Buffalo News report describes the ransomware infection of Erie County Medical Center (NY), from which the hospital has still not fully recovered six weeks later. The hospital declined to pay the $44,000 demanded because it had backups, users could look up patient information from the HealthLink HIE, and administrators worried that the hackers might not restore its files even if the hospital paid up.

The hospital thinks hackers used a brute force password attack to gain control of a hospital Web server a week before the attack, then manually logged on looking for files to encrypt. Clinical systems weren’t restored until a month later.

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A hospital-provided screenshot of the ransomware message suggests that the malware is Samas, in which hackers use a variety of tools (including login-stealing malware) to gain credentials and install programs that use Active Directory to propagate the malware to all attached devices.

MedStar Health fell victim to Samas in March 2016 days after both Microsoft and the FBI issued public warnings of its threat. The malware requires online access to just one vulnerable server, often one that’s running unpatched Red Hat JBOSS middleware.


Reader Comments

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From Identity Thief: “Re: CHIME’s patient ID challenge. Is anyone questioning its usefulness? The $1 million winner has to provide their solution to the market free of royalties, which means they can’t use any underlying technology that isn’t free. Also, the challenge is based on authentication rather than identity assurance. From NIST, ‘authentication’ implies confirmation of the patient’s presence using authentication factors, while ‘assurance’ means verifying that the person presenting those factors is in fact who they say they are. The solutions of the finalist appear to focus on using tokens (most likely biometric) to authenticate themselves. But before a token can be used, there is a need to identify the patient via inspection of their documents, verifying via a third party , or conducting KBA activities. The FY17 Omnibus legislation requires a strategy that is more than just the pervasive use of an authenticator. It requires a way to roll out a program nationally for all patients and to link a known patient to all of their records from any location in which they have received services. We should question whether a winning authentication solution truly solves the patient identity problem. In my opinion, it does not.” I agree that someone would need to physically verify a person’s identity in issuing their authentication token, but then there’s the question of how a different provider would connect to that information collected elsewhere (perhaps it would be self-contained, like a fingerprint profile stored on a smart card.) As you said, positive identification doesn’t necessarily imply data sharing, but that doesn’t seem to be part of the conversation despite the NIST definition. I would be happy with a solution that would (a) prevent identity fraud; and (b) give hospitals a single ID that would eliminate patient merges and that would link all of a patient’s information even just within that one organization’s systems.

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From Arm Twister: “Re: Athenahealth. They say they have 35 MU attestations using their complete inpatient solution, but CMS shows only 17 inpatient attestations. Also, is it really Athena that’s being used to attest? HIMSS Analytics shows that most of Athena’s 25 sites are still running RazorInsights for registration, scheduling, and patient billing, so wouldn’t they also be running at least parts of the Razor clinical package, too?”

From Bushie: “Re: Athenahealth. Is it undervalued as the activist investor says?” Value is whatever the buyer thinks it is, but certainly the company has struggled to meet longstanding high-flying expectations as investors begin to question its slowed growth, management changes, forays into marginally related business lines that are defended by deeply entrenched competitors (inpatient), slowing post-HITECH EHR sales, and erratic investor guidance and resulting performance. I would also question, as I have from the day the company announced its IPO, if there’s too much of a Jonathan Bush cult of personality among fanboy equities analysts and whether Athenahealth is really a tech high-flyer vs. a boring business process outsourcer that just sends scanned paper to teams in India for manual entry. The stock price jumped after last week’s announcement that Elliott Management had acquired a 9.2 percent stake (and Wall Street firms predictably applied their impressive 20-20 hindsight to immediately upgrade their share price targets), but that’s probably more of a kneejerk reaction to the assumption that change is inevitable. Carving up the business into parts that are more valuable than the whole doesn’t seem likely and I don’t see opportunities to gain unmet synergy. I suspect the biggest fear out there is that JB will be pushed out and Athenahealth will be left as just another mature, sometimes struggling, not all that interesting industry player whose arc flattened out short of expectations. Quite a few EHR companies looked smart when the government was paying for EHRs in its $40 billion cash for clunkers program, but nearly all of them are scrambling frantically to pivot into population health, analytics, or revenue cycle to prop up their businesses that weren’t prepared for the inevitable scale-back required once the HITECH fired had been extinguished and doctors realized that the EHRs they hated pre-HITECH weren’t any more likable just because someone else (you and I) paid for them. I’ll turn to readers – is ATHN undervalued, what changes should it make, and what companies might like to buy some or all of it?

From Carry On: “Re: HIMSS. What are they paying Steve Lieber these days?” The newest IRS Form 990 I can find is for the fiscal year ending 6/30/15, when he made $1.1 million, a number that’s sure to swell dramatically this year as his retirement benefits are paid out. HIMSS paid more than $400K that year to Carla Smith, Norris Orms, John Hoyt, Jeremy Bonfini, and Alisa Ray. I would enjoy dissecting the HIMSS 2015 990 form if anyone has it – it’s apparently not online anywhere like the older ones.

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From Lengua Taco: “Re: VIPs. I was surprised to read that hospitals treat VIPs differently.” You must never have worked in one. My first eye-opening experience was when, as a recent graduate turned hospital department head (unimpressively – it was a crappy, for-profit rural hospital) the awful second banana executive nearly lost his mind upon hearing that the mother of our big-money ophthalmologist was being admitted. He cleared all the rooms around hers, mobilized the dietary people to make special meals well beyond their culinary capabilities, and bossed around the nurses and techs to make sure they tiptoed about deferentially and didn’t screw up clinically (which as any hospital person knows actually makes mistakes more likely in replacing well-honed routines with new exceptions). In hospitals, everyone is treated the same in the ED, but once they are admitted and are found to have connections, money, or power, they are elevated from economy class to first (which, like the best table at McDonald’s, still isn’t that great). Wealthy, demanding local businesspeople and politicians don’t share semi-private rooms with the unwashed rest of us, nor do celebrities or Middle Eastern oil sheiks who might get their own entire floor. I doubt their clinical outcomes are any better, though, just their accommodations, a free pass to break hospital rules, and the endless middle management fawning over their magnificence.


HIStalk Announcements and Requests

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Nearly 40 percent of poll respondents say the most important factor in reducing US healthcare costs is to move to a single-payer system that eliminates middlemen, with the next top choices being to control prices and increase emphasis on prevention. Frank provided a thoughtful response in saying that consumerism has worked well with cosmetic surgical procedures, won’t work as well with routine outpatient care and non-emergent elective procedures, and won’t work at all with care in emergencies, with the aged, and involving terminal illness, at least without societal upheaval. He adds that, unfortunately, most of the cost is involved in those areas where consumerism isn’t effective. He also warns that medical technology is advancing in providing expensive treatments for more Baby Boomer conditions. Cosmos says the best use of federal money is for public goods that have not not been addressed by the free market, such as disease prevention, promoting access to care and insurance, and rewarding physicians who do the right thing. Cash payer says treatment costs should be standardized to allow consumers to shop effectively.

New poll to your right or here: does your business card or email signature list a certification or fellowship credential? That issue comes up sometimes in HIStalk, where people complain that I don’t list their FHIMSS, FACHE, CHCIO, etc. My policy is that I list only academic degrees above the US bachelor’s level, with one exception — the non-US MBBS, which technically is a bachelor’s degree but is equivalent to the US MD. I also don’t list licensure, but it gets fuzzy where someone’s practice requires only a bachelor’s degree, such as a nurse, where I wouldn’t ordinarily list either the BS or the RN but there’s otherwise no good way to indicate that the person is a nurse. Sometimes I omit even graduate “degrees” that LinkedIn shows came from unaccredited (and sometimes hilariously phony) schools or that were honorary rather than earned, thus upsetting the folks who are anxious to flaunt a pointless credential in hopes nobody will notice the source.

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Readers funded the DonorsChoose grant request of Mrs. A in California, who asked for a projector, document camera, USB camera, and laser printer for her middle school’s library, where she teaches math to 150 students. She reports, “The document camera and projector have improved the quality of my instruction. We will often show different strategies with different colors so that students understand that there is more than one way to solve a math problem. Lately, students have been going up and presenting their work under the doc cam, while other students ask them questions about their work. I also use the document camera and projector heavily for instruction. One particular student who has warmed to the doc cam and projector is Ramses. He loves presenting his work, and he was the first student to do so under the document camera in my 6th grade class. After he presented, students gave him ‘glows’ and ‘grows feedback about his presentation. Now other students present based on his model presentation and students are able to practice presenting their work proudly in front of their peers.”


This Week in Health IT History

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One year ago:

  • Kansas Heart Hospital (KS) pays a hacker after a ransomware attack, but still doesn’t regain access to its systems.
  • Fired Practice Fusion founder and CEO Ryan Howard launches iBeat, which will offer a heart monitor and emergency notification watch.
  • Apple CEO Tim Cook says the company is focused on health and its entry point will be Apple Watch, which will have new sensors added.
  • HP announces plans to spin off its enterprise services business in a merger with CSC.
  • Paul Tang, MD joins IBM Watson Health as VP/chief health transformation officer.

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Five years ago:

  • Cerner CEO Neal Patterson predicts that the company will hit $10 billion in annual revenue by 2020 and says he will probably retire before then.
  • Victoria, Australia ends its HealthSMART hospital software project that involves Cerner, CSC, and InterSystems after running over budget to $557 million.
  • HealthCor launches a proxy fight against Allscripts following the resignation of three Eclipsys-connected directors the previous month.
  • The VA announces plans to spend up to $5 billion to enhance VistA via the private sector and open source community.
  • US CTO Todd Park announces the Presidential Innovation Fellows Program.
  • The UK NHS announces plans to shut down its HealthSpace personal health record.

Weekly Anonymous Reader Question

I made last week’s question too specific, I think, given the small number of responses to the question of the most customer-unfriendly contract term or condition seen. I’ll just list those few responses here:

  • Charging maintenance fees for applications that just kicked off an implementation, as well as charging implementation and hosting fees! The ultimate double-dip rip-off.
  • Arrogant PeopleSoft VP refused to include any language protecting the customer should they be acquired, after all, “they are PeopleSoft”. Two years later, Oracle had them.
  • Non-compete clauses that inhibit people from their employment choices.
  • Having one vendor try to set the terms for who else I can engage with to optimize pieces of my organization. I have software I like to buy. And I have professionals I prefer to do business with for process improvements. When the software company tries to restrict my ability to engage with the professionals I trust, I view that as very unfriendly toward me.

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This week’s reader-requested question: what factors have helped you attain job promotions?


Last Week’s Most Interesting News

  • Activist investor Elliott Management takes a 9.2 percent stake in Athenahealth.
  • Two highly-touted, well-funded, for-profit primary care clinic chains fail.
  • GQ exposes the efforts of fired Trump campaign manage Corey Lewandowski to sell access to the President, with Flow Health hiring the company hoping to reverse the VA’s termination of its data analysis contract.
  • Global impact of the WannaCry ransomware is muted when a security researcher finds and activates its kill switch.

Webinars

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


Decisions

  • Johnson Memorial Hospital (IN) will switch from Meditech  to Cerner in August 2017.
  • Marshall Medical Center (CA) will replace McKesson with Epic in November 2017.
  • St Michaels Medical Center (NJ) went live with Epic this year.

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


People

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Melissa Bell (MedAssets) joins Inovalon as SVP of client success.

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Jim Feen is promoted to SVP/CIO at Southcoast Health (MA).


Announcements and Implementations

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Messaging and patient engagement technology vendor Talksoft integrates its appointment reminder app with Uber, allowing patients to click an app button to call a car to take them to their appointment.

Teladoc will expand telemedicine services in Texas following the end of its six-year legal battle with the state over the now-eliminated requirement that patient-physician relationships begin with a face-to-face visit.


Other

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Doctors at MUSC’s Medical University Hospital (SC) are reportedly “livid” that the hospital will start paying them based on the number of patients they see (RVUs) instead of based on the profits of their department. The CEO says that doctors who aren’t clinically productive “are going to have a tough time. Everyone has to be accountable to this clinical productivity.,” He adds that the current system is unfair to trauma surgeons who treat uninsured patients but benefits gastrointestinal surgeons who treat mostly Medicare patients. A patient safety advocate whose son died from a MUSC medical error says, “Paying doctors by RVUs is a terrible system and absolutely antithetical to patient safety, never mind workplace satisfaction. The doctors are right to be worried. I think this is a real comment on the priorities of the current MUSC leadership.”


Sponsor Updates

  • Encore publishes a white paper, “Enabling Value Based Care through IT.”
  • QuadraMed, a Harris Healthcare company, will exhibit at the Texas Regional HIMSS Conference May 25-26 in San Antonio.
  • Sphere3 CEO Kourtney Govro co-authors an article on business relationship management in health IT.
  • Sunquest Information Systems will exhibit at the API – Pathology Informatics Summit May 22-25 in Pittsburgh.
  • Frost & Sullivan features Agfa Healthcare in a new whitepaper, “Vision 2027: Enterprise Imaging.”
  • Visage Imaging will exhibit at ACR 2017 May 22-23 in Washington, DC.
  • Huron employees volunteer time on day of service to give back to 51 communities worldwide.

Blog Posts


Contacts

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

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News 5/19/17

May 18, 2017 News 12 Comments

Top News

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Activist hedge fund operator Elliott Management takes a 9.2 percent position in Athenahealth, sending ATHN shares soaring 22 percent Thursday.

The fund issued its standard language that refers to “operational and strategic opportunities” (often involving selling the company) and expresses its interest in engaging with Athenahealth’s board.

Elliott has pressured other healthcare-related companies to increase shareholder value, most recently The Advisory Board Company and Cognizant.


Reader Comments

From Justin Box: “Re: Mary Washington’s video ‘Right Hand Man.’ We’ve reposted it on YouTube.” Justin, who is SVP/CIO of Mary Washington Healthcare (VA), said the hospital initially pulled the unlisted video from YouTube after I mentioned it Tuesday since it was intended to be for an internal audience only, but has since decided to repost the original, unedited version, which is spectacular. The hospital’s marketing people did an amazing job putting it together and the hospital employees who appear in it were fantastic. This would win my HISsies Best Picture award if I had one. Here’s an even more impressive factoid from Justin – President and CEO Mike McDermott, MD, MBA came up with the Hamilton theme idea, wrote the lyrics, and took on the starring role. I’ve watched it at least 10 times so far today. In one of those IMDB-type “goofs,” listen for the Epic product name that is mispronounced.

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From Aftab: “Re: Aspen Valley Health (CO). A failed Epic implementation caused a loss of millions of dollars and the RIF of dozens of long-term employees. The 20-something IT director brought in an inexperienced team with no healthcare background and farmed out the technical IT jobs to an Indian outsourcing company. There was open revolt from the hospital staff, coupled with the CEO and CIO leaving.” Unverified. The 25-bed hospital signed up for Epic at a cost of $5.4 million in October 2015, affiliating with UCHealth. I reviewed the online video minutes of the hospital’s recent board meetings to look for updates — in the March 2017 session, the board talked about choosing a new EHR from among Cerner, EClinicalWorks, and current vendor Meditech, focusing on a system that is “affordable and accessible to any practice.” The board also wants its own MPI that isn’t shared with another hospital and its own EHR build. The board also noted that Cerner and EClinicalWorks are cloud-based, while Meditech would require 50 hospital servers, but they want to make sure cloud-based systems are ready for prime time. They’ve issued an RFI and hope to be live by 2020.

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From Publius: “Re: Health Gorilla. Have you heard of them? They’re seemingly a Web-based EMR that supports electronic lab ordering. Is it used by smaller private practices?” I’ve mentioned the company a few times, labeling them as a “medical record aggregator” and secure network that allows sharing records and placing electronic lab orders. Practice price ranges from free to $60 per month. The Silicon Valley-based company – formerly known as Informedika — has raised $4.4 million, none of it recently, and hasn’t issued a press release since October 2015.

From SugerHound: “Re: Apple Watch and glucose monitoring. The rumors are more substantial than are being reported. Chrissy Farr has a great report on CNBC that cites multiple sources.” The article says Apple’s team of biomedical engineers has been developing non-invasive blood glucose sensors for several years in a project originally envisioned by Steve Jobs. They are reportedly conducting feasibility trials and figuring out how to earn FDA approval, which probably won’t come easily or quickly.


HIStalk Announcements and Requests

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Readers funded the DonorsChoose grant request of Ms. S in California, who asked for non-fiction books for her third graders, with an emphasis on the environment. She reports, “My students and I have become passionate about plants! Not just any plants, but native plants in particular. The chaparral biome which surrounds our school and community is thriving with plant and animal life. Using the books that you so generously donated, my students learned about the environment, and they started a close study of their backyard ecosystem: the chaparral. Caring for the plants and becoming experts of many of the living things in our ecosystem, my students are now serving as stewards for the environment. Without your generous donation, our project would not have been able to take off.”

My “Listening” selection from three weeks ago was the new solo release of Soundgarden and Audioslave front man Chris Cornell. He died by suicide Wednesday night after a Detroit performance of the reunited Soundgarden. His last song on stage was a cover of Led Zeppelin’s “In My Time of Dying.”

This week on HIStalk Practice: One Medical opens first practice in Seattle. Vivid Vision raises $2.2 million for VR-enabled vision disorder treatment technology. US HealthWorks develops telemedicine app. MD EMR Systems, Bridge Patient Portal work on Centricity integration. CMS allocates $30 million for medical societies interested in helping to develop MACRA measures, adds four regions to CPC+ program. Premise Health will roll out Epic over the next two years.


Webinars

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


Acquisitions, Funding, Business, and Stock

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A Singapore-based private equity firm buys a majority position in supply chain technology vendor Global Healthcare Exchange from PE firm Thoma Bravo, which bought the business in February 2014 and will remain a minority owner.

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Seattle-based primary care clinic Qliance Medical Management, which had raised $33 million from investors that included Amazon’s Jeff Bezos, shuts down. The two principal officers bought the company in March 2016 from its investors.

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Clinical process improvement technology vendor LogicStream Health closes a $6 million Series B funding round.

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Credentialing and compliance software vendor Symplr acquires Vistar Technologies, which offers a provider data management system.

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Conversa, which offers doctor-patient conversation programs, raises $8 million in a Series A funding round led by the venture arm of Northwell Health (NY), which will also use the company’s systems.

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UnitedHealthcare subsidiary Harken Health, launched in 2015 to offer health insurance combined with low co-pay visits in its Atlanta and Chicago health clinics, will shut down after extensive losses.

Amazon is considering entering the pharmacy market, according to reports, which could involve either selling drugs online (which it already does in Japan) or extending its in-house pharmacy benefits management program.

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McKesson is basically out of the health IT business (or will be soon), but if anyone still cares, the company announces Q4 results: revenue up 5 percent, EPS $16.76 vs. $1.88, although that includes a pre-tax net gain of $3.9 billion related to the creation of Change Healthcare. MCK shares rose 6 percent in early after-hours trading Thursday, having beaten earnings expectations but falling short on revenue.


Sales

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National non-profit behavioral health provider Compass Health Network chooses Netsmart’s EHR in a 10-year agreement.

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The VA awards Document Storage Systems (DSS) a $19.6 million contract to implement its ForSite2020 patient self-scheduling system that integrates with VistA. DSS acquired the product in December 2016 with its $2 million purchase of Streamline Health’s Looking Glass patient scheduling and surgery management software, which Streamline had previously bought in its February 2014 acquisition of Unibased Systems Architecture.

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Prime Healthcare will implement real-time sepsis surveillance systems from Hiteks Solutions, integrated with Meditech and Epic.


People

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Robert Califf, MD — who served less than a year as FDA commissioner before the administration change — returns to Duke Health as vice chancellor for health data science and will also split time in a leadership role at Alphabet’s Verily Life Sciences, where he will work with turning health-related data into practical applications. Verily, formerly known as Google Life Sciences, has worked on continuous glucose monitors, smart contact lens, retinal imaging, and surgical robotics.


Announcements and Implementations

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Visage Imaging releases its Visage 7 Open Archive solution of its enterprise imaging platform to customers in North America.

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Athenahealth announces a Meaningful Use Stage 3 guarantee for its hospital customers. The company also opens San Francisco-based MDP Labs, an innovation program that offers workspace, mentorship, and exposure to potential investors, partners, and customers.

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Healthgrades enhances its online scheduling system to allow health systems to display their nearby alternative providers when a given one is booked up.

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Siemens Healthineers will integrate test results from its HbA1C and urinalysis diagnostic equipment with practice-based EHRs via technology from Scotland-based Relaymed, owned by Goodmark Medical of Longwood, FL.

CHIME announces the finalists in its patient ID technology challenge that will move to the prototype testing round:

  • Michael Braithwaite (multiple biometrics)
  • Bon Sy (behavior information, biometrics)
  • HarmonIQ Health Systems (blockchain, FHIR, encryption)
  • RightPatient (photos, biometrics, other data)

Government and Politics

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The Justice Department files a civil fraud lawsuit against UnitedHealth Group, claiming that the insurer was overpaid at least $1 billion in Medicare Advantage payments after intentionally submitting inaccurate risk adjustment data. UHG says it tried to comply with CMS’s “unclear policies” and adds that the Justice Department either misunderstands or ignores how Medicare Advantage works.

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Insurance company executives and state insurance regulators say the ACA insurance marketplaces aren’t collapsing under their own weight, but rather because of the Trump administration’s erratic management, vocal lack of support, and ongoing threats to stop payments, according to an LA Times article. In a remarkably partisan response for a federal department employee, 28-year-old Alleigh Marre — quoted as an HHS spokesperson but self-identified on her LinkedIn profile as a “Republican Communicator,” —  said, “Obamacare has failed. For this reason, Republicans are reforming healthcare so it delivers access to quality, affordable coverage to the American people.” The article also notes that CMS Administrator Seema Verma told insurance company executives that the White House would continue allowing the payment of cost-sharing reductions (premium subsidies, required by law to be paid unless a court rules otherwise) if insurance companies would in turn support the Republican ACA repeal bill, a puzzling offer (even for a near-shakedown political demand) since repeal would do away with the subsidies.


Privacy and Security

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Bronx-Lebanon Hospital Center (NY) and its contractor iHealth send threatening cease-and-desist letters to the author of DataBreaches.net after she let the hospital know that their patient information was exposed due to an improperly configured server, for which the hospital originally thanked her. They claim that the discovery of their apparent screw-up constitutes “hacking,” which happens often when companies are embarrassed and attempt to shoot the messenger.

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Erie County Medical Center (NY) finally confirms that the April 9 cyberattack from which it is still recovering six weeks later was indeed ransomware, which had been widely speculated. The hospital declined to pay and was forced to move back to paper as its systems were slowly brought back online from backups. They don’t believe it was the WannaCry malware.


Technology

Google is applying machine learning to millions of de-identified patient records from major teaching hospitals to see if it can predict an individual’s medical events.

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Google’s major announcements from its developer conference:

  • Google Lens, an app that can identify objects from a smartphone’s camera.
  • New Daydream virtual reality headsets.
  • Photo facial recognition that will suggest sharing images with people pictured in them and AI-powered removal of unwanted objects in photos.
  • A visual positioning system that will identify a precise location based on nearby objects, such as finding items on a store shelf.
  • The addition of calling and proactive information presentation to Google Home and the porting of Assistant to the iPhone.

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In India, Aetna rolls out the first phase of its global launch of it subscription-based vHealth by Aetna, which offers unlimited PCP visits by video or telephone, diagnostic tests at home, home prescription delivery, and referrals. Patients can rate their doctor experience afterward.

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FiercePharma profiles Israel-based MedAware, which uses aggregated prescription data and a patient’s own medical records to predict what drugs are likely to be ordered, improving patient safety in providing what it calls a “spell checker” for prescriptions. The CEO has astutely noted that all of that information is also attractive to drug companies that are interested in targeting their physician prospects, giving it an unexpected yet lucrative market.


Other

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Boston Children’s Chief Innovation Officer John Brownstein weighs in on the language in Epic’s App Orchard agreement, which basically says that Epic can use any of the submitter’s information to develop a competing product and that Epic permanently owns any documentation that the applicant submits. In other words, it’s exactly opposite of the highly restrictive language contained in Epic’s customer contracts.

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In an interesting twist on medical tourism, a nearly completed medical center in Jamaica plans to lure not only medical tourists to fly there for procedures at discounts of up to 40 percent, but also to recruit American doctors to perform the work while taking a Caribbean vacation. Critics point out that it’s been tried before, failing because doctors are too busy to interrupt their vacations and are not likely covered by their malpractice insurance when doing work outside the country.

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Bizarre: Michigan suspends a DO’s license after a patient complained that her liposuction surgery was performed in an unfinished pole barn, during which the doctor poured her removed fat down a sink drain.


Sponsor Updates

  • Medicity and Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Texas Regional HIMSS Conference May 25 in San Antonio.
  • Wavelink is named as the first Spok distributor in Australia.
  • Medecision presents its annual innovation awards at its Liberation 2017 conference in Austin, TX.
  • Definitive Healthcare is recognized by Boston Business Journal for its growth and work environment.
  • FormFast and Imprivata will exhibit at the 2017 Spring Hospital & Healthcare IT Conference May 22-24 in Atlanta.
  • Healthwise will exhibit at the Cognizant Healthcare Conference May 21-24 in San Antonio.
  • InstaMed will exhibit at the 2017 HFMA Florida Chapter Annual Spring Conference May 21-23 in St. Petersburg, FL.
  • InterSystems releases a statement on the WannaCry cyberattack.
  • Intelligent Medical Objects will exhibit at the Advanced Healthcare Analytics Summit May 24-25 in Boston.
  • Liaison Technologies will exhibit at the Bio-IT World Conference & Expo May 23-25 in Boston.
  • NEA Powered by Vyne announces the recipients of its 2016 NEA Dental Awards.
  • Meditech customer Beaufort Memorial Hospital receives an ‘A’ for safety from The Leapfrog Group.
  • Health Professional Radio features Medicomp Systems CEO Dave Lareau.
  • National Decision Support Co. will exhibit at ACR 2017 May 21-25 in Washington, DC.
  • Consulting Magazine names NTT Data’s Mandy Selmer a Top 25 Consultant.
  • Experian Health will exhibit at the HFMA Florida Spring Conference May 21-24 in St. Petersburg, FL.
  • Forbes Councils interviews PokitDok Chief People Officer Maria Goldsholl.

Blog Posts


Contacts

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

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News 5/17/17

May 16, 2017 News 10 Comments

Top News

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GQ publishes an article critical of fired Donald Trump campaign manager Corey Lewandowski, who tried to parlay his connections to the President after his June 2016 dismissal into a lucrative lobbying business that includes a health IT connection.

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Among the clients Lewandoski recruited was Flow Health (the former GroupMD), which hired Lewandowski’s firm in December 2016 to pressure the VA to reconsider its termination of Flow Health’s contract for AI-powered patient care systems.

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GQ reports that Lewandowski’s partner (who managed Ben Carson’s presidential campaign) told Flow Health CEO Alex Meshkin that the lobbying firm could reverse the VA’s decision because he and Lewandowski were personally vetting Trump’s picks for VA secretary. He also promised that the firm would allow Flow Health’s CEO to submit a list of his preferred choices for role of VA CIO, overseer of the Flow Health decision.

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The article says that Flow Health proposed an apparently illegal payment schedule of a flat payment of $250,000 if the VA reversed its decision by February 17 and $100,000 if it took an extra week, later amended to reword the payments as severance fees. None of that mattered, as it turned out, because Trump chose as VA secretary David Shulkin, who had co-written the letter that dismissed Flow Health in the first place.

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GQ says Lewandowski then proposed that Flow Health do an end-run around the VA by either appealing to Trump directly or by using Lewandowski’s appearance on the Sean Hannity talk show to trash Shulkin in hopes of getting him fired.

Lewandowski quit the firm – for which he was serving as an unregistered lobbyist — two weeks ago after widespread questions about his efforts to sell access to the President, which he calls “fake news” and for which he blames his former partner. Flow Health’s VA contract remains terminated.

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Googling “Alex Meshkin” turns up a fascinating Bloomberg story from 2005 about the then-24-year-old’s questionable background as he formed a Nascar racing team that quickly failed.


Reader Comments

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From Athenahealth Spokesperson: “Re: Diego’s questions about Athenahealth’s inpatient customer MU attestations. All 35 hospitals referenced are using Athenahealth’s complete inpatient solution, including EHR, revenue cycle and financial management, care coordination, and patient engagement services. This past year, Athenahealth submitted Meaningful Use attestations on behalf of all of our hospital clients live on AthenaClinicals for Hospitals & Health Systems as of the end of 2016.”

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From Cerner Observer: “Re: Mon Health, Morgantown, WV. Hearing that its Cerner go-live has been pushed back to 2019 and they’re exploring other options.” Unverified. I couldn’t find a contact there to ask for verification. I was, however, a bit annoyed to observe that the locals are so challenged to pronounce the name of the county in which they live (Monongalia) that the health system that lives in the shadow of Epic-using WVU Medicine felt the need to officially dumb down its name to “Mon Health,” giving me visions of those rainbow-colored (and uncomfortably stereotypical) Rastafarian dreadlock hats you see for sale on vacation in the Caribbean that say “Hey, Mon, we be jammin!”

From Second Responder: “Re: anniversary date. Isn’t HIStalk’s anniversary coming up soon? I remember it’s late spring.” I started writing HIStalk in June 2003, although I don’t recall the exact date.

From Judith R. Lin-Miranda: “Re: video. It’s now a common practice for new Epic customers to introduce themselves. Mary Washington Health Care just set the standard by which all others will be judged.”The elaborate video is indeed well done, including taking some digs at Siemens/Cerner Soarian that was “cobbled together” as they were “working with a third of what Soarian promised.” The video even lobs some shots at Epic’s high cost. President and CEO Mike McDermott, MD, MBA did an amazing job in the lead role. It’s better than anything ZDoggMD has done. I would give it my “Best Picture” award if I had one.

From Gory Details: “Re: press release. Here’s ours, which you probably won’t mention since we aren’t an HIStalk sponsor.” Not true. I mention every press release that I think is newsworthy to my C-level audience, which typically includes all sales and go-lives that: (a) involve a vendor, client, and event that are all significant; (b) would interest readers who don’t follow the company; and (c) contain a link to a timely press release that is well enough written that I can quickly figure out what it’s trying to say. Otherwise, readers outside the company usually aren’t interested in fluff pieces about partnerships, self-proclaimed market momentum, and minor personnel and funding events and I’ll nearly always skip those. I’ve learned over the years that every company executive thinks all of their announcements are anxiously awaited, which is nearly always not the case. Do something newsworthy and you’ll see it on this page.


HIStalk Announcements and Requests

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HIStalk readers funded the DonorsChoose grant request of Ms. W, who asked for tablets and headphones for her California kindergarten class to extend their environmental studies. She reports, “The Fire tablets have been such a great learning resource for my students. They love using them to watch ‘Meet the Environmental Defenders.’ They love singing along to the song. You can hear them chanting quietly, ‘Reduce, reuse, recycle!’ They do this over and over again. Next thing you know, that tune is stuck in my head all day long!”

I’ve noticed a recent sneaky practice of call centers (both inbound and outbound) that place you on hold, but play pre-recorded keyboard clicking sounds so you think a human is on the line.

A reader offers a third punk band whose singer has a PhD (in addition to those I named, Bad Religion and The Offspring): The Descendents, which has been a major influence to untold bands that aren’t even punk for its 40 years of existence. Milo Aukerman left the band to complete his PhD in biology at UCSD and conducted post-doctoral research in biochemistry at UW-Madison. His nerdy caricature is the band’s mascot, rolled out in 1982 for the album “Milo Goes to College” that noted his temporary departure. Beyond all that academic talk, there’s a new hard-rocking album from Seether that’s worth a listen. 


Webinars

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

I asked John Gomez to put together a WannaCry malware webinar with only hours of lead time because his presentations are always outstanding and informative. This one he did Tuesday afternoon is no exception. I was attentive for the whole thing, which isn’t usual for me since I have a short attention span. Thanks to John for agreeing to help get information out quickly.


Acquisitions, Funding, Business, and Stock

Wisconsin startup IDAvatars, which develops healthcare avatars powered by IBM Watson, opens a funding round in hopes of raising $2 million.


Sales

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Premise Health will implement Epic in its 500 work site health and wellness centers. It apparently replaces Greenway Health.

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University of Miami Health System (FL) chooses Kyruus Provider Match and KyruusOne to connect patients with providers based on their clinical needs and preferences.

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The Commonwealth of Virginia and Bayview Physicians Group will integrate Appriss Health’s prescription drug monitoring program analytics software into provider EHR workflow.


People

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Mark Costanza (Nordic) joins Spok as SVP of professional services.


Announcements and Implementations

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Memorial Hermann Memorial City Medical Center (TX) goes live with a digital wayfinding app powered by Connexient’s MediNav. 

National Decision Support Company adds appropriate use criteria for pediatric imaging to its ACR Select product.

CPSI’s TruBridge subsidiary announces its business intelligence dashboard at the company’s user conference.


Government and Politics

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Social media outcry pressures Miss USA to walk back her comments from the Q&A portion of the competition in which she stated that healthcare is a privilege rather than a right, unconvincingly explaining that what she really meant is that she is “privileged” to have healthcare, but regardless, it’s a “right” for all.

Missouri’s lost its chance to stop being the only state that doesn’t have a doctor-shopper prescription database as legislation to authorize it failed Friday after the Senate added a mandatory prescriber participation clause, which was opposed by the state medical association.


Privacy and Security

HHS says in a ransomware update call that several medical devices have been infected with the WannaCry virus, but otherwise the US healthcare system seems mostly unaffected for now. Several hospitals around the world reported that they were attacked. Northwell Health (NY) initiated its incident command system Friday morning and patched 200 computers that were behind on Microsoft security updates.

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In England, a leaked February letter from National Data Guardian Dame Fiona Caldicott to Royal Free Hospital’s medical director says the hospital should not have turned over the detailed records of 1.6 million patients to Google DeepMind for testing of its Streams application, saying it was not appropriate to send Google the information without patient permission since it was not related to their care.

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Rutland Regional Medical Center (VT) becomes the latest in a long string of hospitals that have exposed patient information by sending a bulk email to patients using CC: instead of BCC:.

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Marcus Hutchins — the 22-year-old security researcher who interrupted his vacation to stop the global spread of the WannaCry virus by discovering and activating its kill switch before it hit US hospitals – is awarded a $10,000 hacker’s bounty that he will donate to charities. He works from a spare bedroom in his house in England for US-based Kryptos Logic.


Other

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Wired runs a lengthy piece describing the last creation of Steve Jobs, Apple’s $5 billion, 2.8 million square foot mother ship campus.

A graphic, moving blog post by ED physician Kristen Ott, MD explains that medical professionals use profane language outside of public spaces because they have to deal with the aftereffects of unspeakable atrocities that can’t really be described politely.

This should ring the cash registers of pharma lobbyists: three members of Congress introduce the Fair Drug Pricing Act, which would require drug companies to provide detailed cost and price records to HHS before increasing an expensive drug’s price more than 10 percent in one year or 25 percent over three years.

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Australia-based surgeon Eric Levi, MBBS muses on the suicide of a Brisbane gastroenterologist, which triggered him to think about what factors lead him to his own “dark seasons” as a doctor:

  • Loss of control with extensive hospital call time and new physician-directed policies written by people who don’t see patients.
  • The impersonality of computer-assigned work, pressure to beat the timer that says tonsillectomies should take no more than 14 minutes of surgeon time, overbooked clinics, and never-ending telephone calls, all of which leave no time to reflect about life with colleagues or to spend time with friends and family. Doctors who ask for emotional support can be placed on restriction or labeled as underperforming.
  • Relentless administrative pressure that takes away meaningful patient engagement as medical practice transforms from a “meaningful pursuit” to a “tiresome industry” that has been “codified, sterilized, protocolized, industrialized, and regimented.”

Sponsor Updates

  • Point-of-Care Partners publishes a white paper titled “EPrescribing Information to Improve Medication Adherence.”
  • Arcadia Healthcare Solutions will speak at the HFMA Region 1 annual conference May 23 in Uncasville, CT.
  • CapsuleTech will exhibit at the National Teaching Institute & Critical Care Exposition May 21-25 in Houston.
  • Besler Consulting will exhibit at the HFMA Region 1 annual conference May 23 in Uncasville, CT.
  • CoverMyMeds will exhibit at the QS/1 Customer Conference May 17-19 in Atlanta.
  • Besler Consulting releases a new podcast, “Evaluating post-discharge cost and quality.”
  • CTG announces expanded portfolio management and help desk services in its Application Advantage program.
  • Cumberland Consulting Group will sponsor the ASO Opportunities Value Visit May 17-19 in Chicago.
  • Impact Advisors VP Lydon Neumann is named one of Consulting Magazine’s Top 25 Consultants of 2017.
  • The local business paper profiles Diameter Health and its ties to Connecticut Innovations.

Blog Posts


Contacts

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

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WannaCry Ransomware Webinar Tuesday, May 16

May 15, 2017 News No Comments

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Sensato CEO and cybersecurity reseaercher John Gomez will present an HIStalk-sponsored free webinar on Tuesday, May 16 at 1:00 p.m. ET titled “WannaCry Threat Intelligence Briefing.”

John will provide an in-depth analysis of the current state of WannaCry as well as a technical review of how it operates and possible go-forward cybersecurity impacts. John will also present technical and regulatory counter-measures you should consider, specific to healthcare organizations.

Monday Morning Update 5/15/17

May 14, 2017 News 3 Comments

Top News

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An unprecedented ransomware attack affects 48 of England’s 248 trusts in waves of infections that spread globally on Friday. All but six trusts say they have returned to normal operations after they were forced to divert ambulances, cancel appointments, revert to paper, and order employees to unplug network cables from PCs and telephones.

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The WannaCry ransomware, which demands a $300 ransom per infected Windows machine, initially affected computers primarily in Russia, Ukraine, and Taiwan. It uses the EternalBlue exploit that was made publicly available by hackers in mid-April. At least one hospital in Canada said it was threatened by WannaCry, but its antivirus software blocked it. Two hospitals in Indonesia were also hit as well as one in Taiwan and another in Scotland.

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Microsoft issued a Windows patch to protect against the exploit in March, but many machines worldwide have not been updated. NHS is still  running many Windows XP PCs, for which Microsoft’s extended support and security updates ended in 2014. Microsoft has responded to the attacks by providing an unprecedented public security update for Windows XP, Windows 8, and Windows Server 2003 to address WannaCry. Both Kaspersky and Bitdefender antivirus programs already protected against it.

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The Russia-based hacker group that claims responsibility for the attack says it used cyber tools that were stolen from the US National Security Agency.

A 22-year-old security researcher apparently stopped the worldwide spread of WannaCry when his tests revealed that the malware was accessing an unregistered Internet domain, which he then registered to perform further testing. In doing so, he found that the ransomware stopped activating itself around the globe. The researcher theorizes that the hackers used the domain as a “kill switch” to prevent experts from analyzing in a sandbox environment. However, he cautions that the hackers could simply change the domain name the program checks, making it imperative that Windows PCs be brought up to date on patches.

A PC can be infected via a hyperlink spread by a phishing email, a web link or advertisement, or a document link.

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John Gomez of Sensato offers these tips for health systems:

  • Apply the SMB patch (MS17-010) to all Microsoft systems.
  • Close ports 22, 23, 3389, TCP 139 and 145/UDP 137 and 138.
  • Test backups and store them offline.
  • Warn users not to open attachments.
  • Restrict access to file-sharing sites.
  • Review ransomware response protocols.

HIStalk Announcements and Requests

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Eighty percent of poll respondents are not happy that the House passed the American Health Care Act. Frustrated says people should actually read the bill instead of parroting the opinions of others, adding that no healthcare system can survive if only sick people sign up and both the ACA and AHCA address that. Just a Nurse Analyst wonders about the backroom deals that were struck to pass it and questions the zeal to undo anything President Obama did regardless of the impact on Americans. Cosmos says every step of the process lacked moral discipline and integrity – the headlong rush and repeated attempts to repeat the ACA, the backroom negotiations, voting without CBO analysis, and a two-vote majority that suggests compromises undeserving of the resulting White House victory party. Malvern says that our healthcare cost of $10,000 per person each year can’t be solved by attacking coverage and premiums alone. Disgusted says it’s the most cynical, heartless pieces of legislation ever, especially the Medicaid cuts and the requirement of continuous coverage to have pre-existing conditions accepted. Printgeek thinks it’s a shame that the two political parties can’t even initiate a dialogue about healthcare. Bill says at least AHCA eliminates the word “affordable” as Congress finances access by increasing the federal deficit. HITgeek says healthcare requires a community health insurance risk pool to spread the cost of involuntary events, adding, “I am sick and tired of compassionless insurance, abetted by politics, being the gatekeeper for US healthcare.”

New poll to your right or here: What’s the most important factor in reducing US healthcare costs? The presence of the word “most” means I’m not oblivious to the desirability of an easy-out “all of the above” response, although I provided an “other” box in case my mental checklist of options is incomplete.

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We funded the DonorsChoose grant request of Ms. L in Michigan, who asked for Chromebooks, headphones, and academic software subscriptions for her fourth grade class. She reports, “I am a fourth grade teacher on paper, but in reality, I teach students anywhere from a first grade to a fourth grade level. This poses a very real challenge that both my students and I deal with head-on. Technology is one way to successfully mitigate this particular hardship and thanks to you, our class was able to get the technology we need to be successful! Students have grown tremendously through these online platforms; we track and celebrate their progress weekly! It also makes students feel that they are valued. They have something BRAND NEW, that people whom they will never meet gave to them. That sense of value and feeling appreciated is HUGE and cannot be overstated. Thank you, thank you, thank you for making our class feel important!”


This Week in Health IT History

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One year ago:

  • Theranos says 2014-2015 lab test results from samples it ran using its proprietary Edison analyzer should not be trusted.
  • The VA releases a software development kit for its open source Enterprise Health Management Platform.
  • Competing Missouri HIEs argue over connectivity, member charges, and unnamed special interests.

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Five years ago:

  • Partners HealthCare announces plans to implement Epic at a cost of $600 million.
  • Greenway Medical Technologies is the largest percentage gainer on the New York Stock Exchange, with shares up 20 percent since the company’s February IPO.
  • NextGen parent Quality Systems acquires EDIS vendor The Poseidon Group.
  • 3M makes its Healthcare Data Dictionary available worldwide at no cost.
  • California’s HHS moves oversight of the Cal eConnect HIE to the Institute for Population Health Improvement.
  • Allscripts appoints Paul Black to its board.
  • A report finds that one-third of prescriptions are being sent electronically.
  • Fairview Health Services admits that it was getting extensive negative feedback from its employees about the strong-arm collection tactics of Accretive Health.

Weekly Anonymous Reader Question

I’m delighted that my anonymous reader question surveys are getting so many responses that they don’t fit nicely into the Monday Morning Update. I’ve posted the two most recent sets of results at these links:

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Quitting CHIME.

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Why I left my last job.

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This week’s survey: What is the most customer-unfriendly term or condition you’ve seen in a healthcare software contract that the customer approved? This would be a good opportunity to warn others about items they shouldn’t accept.

Meanwhile, if you have ideas for future surveys, let me know – it’s an easy way to learn what your peers are seeing or thinking.


Last Week’s Most Interesting News

  • ONC appoints Genevieve Morris, MA (Audacious Inquiry) to Principal Deputy National Coordinator for Health Information Technology.
  • Memorial Hermann Health System (TX) pays $2.4 million to settle HIPAA charges after naming an arrested patient in a press release.
  • Specialty EHR vendor Modernizing Medicine raises $231 million in funding.
  • A contractor’s error exposes patient records of Bronx-Lebanon Hospital Center (NY) to the Internet due to a misconfigured backup.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Google parent Alphabet invests $130 million in San Francisco insurance startup Clover Health, raising its total to $425 million and valuing the company at more than $1 billion. Clover manages claims for just 25,000 Medicare Advantage customers in New Jersey and competes against much larger insurers, but says its forte is mining patient data to identify potential problems that can be addressed via a Clover-managed home visit or other intervention.


Decisions

  • Memorial Hospital of Lafayette County (WI) will switch from Medhost to Epic in November 2017.
  • Kaweah Delta Health Care District (CA) will replace Cerner/Siemens Soarian with Cerner Millenium in November 2017.
  • Haxtun Hospital District (CO) switched from NextGen Healthcare to Athenahealth in April 2017.
  • Platte Valley Medical Center (CO) will go live with Infor human resources in May 2017.

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


People

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Allscripts promotes Dennis Olis to interim CFO following the resignation of Melinda Whittington, who is leaving the company for unstated reasons after just over a year on the job .


Government and Politics

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MedSolutions CareCore – now part of specialty benefits manager EviCore — will pay $54 million to settle an HHS fraud lawsuit in which the company authorized Medicare and Medicaid payments for procedures it had not validated as medically necessary. The company admits that its executives monitored a dashboard of medical review cases, and when the list got too long, ordered clinical reviewers to approve requests for prior authorization even though nothing had changed, which the Department of Justice says resulted in improper payment in up to 300,000 cases. EviCore was rumored earlier this month to be reviewing a sale of the company or an IPO, with its $300 million in 12-month EBITDA valuing it at up to $4 billion.

A former podiatrist pleads guilty to defrauding Medicare of $6 million by implementing an EHR in his 16-state long-term care practice to generate false patient documentation that would earn payments, such as falsely describing toenail conditions as “painful to such a degree as to affect ambulation and balance.”


Privacy and Security

The local paper reports that Erie County Medical Center (NY) is still trying to recover its systems more than a month after an apparent ransomware attack.


Other

The New York Times questions advertising drugs directly to consumers – legal in only two countries, the US and New Zealand — in noting TV commercials for a drug for an uncommon neurological condition for which it can stop uncontrolled crying or laughing. It notes that the commercial will likely pique the interest of overly emotional people well outside the drug’s target market who will pester their doctors to prescribe them the $700 per month drug.

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Interesting: Dexter Holland – singer/songwriter of punk rock band The Offspring for more than 30 years – earns his PhD in molecular biology from USC with his dissertation titled “Discovery of Mature MicroRNA Sequences within the Protein-Coding Regions of Global HIV-1 Genomes: Predictions of Novel Mechanisms for Viral Infection and Pathogenicity.” As a clearly Renaissance man, he also has his own brand of hot sauce, is the former owner of a record label, and is a certified flight instructor who made a solo trip around the world in 10 days. Dr. Holland isn’t the first punk rocker to earn a PhD – Bad Religion founder Greg Graffin earned a Cornell doctorate in zoology and has taught and written on academic topics.

In Canada, Island Health tells nine internists who are refusing to use its Cerner-powered EHR because of patient safety concerns that they will no longer provide other doctors to enter their paper orders electronically. The CEO of Island Health says it’s OK that ED and ICU doctors haven’t used the systems – citing similar concerns – because they never fully transitioned to the EHR, but it’s too late for the internists to go back to paper. One of the protesting doctors, who is also president of the hospital’s medical staff, says the decree puts him in a difficult position because “it has the effect of barring me from practicing … without actually suspending me.”

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Weird News Andy says that even though Sir Winston does not approve, he suggests ICD S01.22XS. In England, cocaine users are “getting Winstoned” when they use new, stiffer five-pound bank notes bearing the image of Winston Churchill to snort their drug of choice, leaving them with nose cuts.


Sponsor Updates

  • Gartner names Salesforce a leader for the ninth consecutive year in its Magic Quadrant for the CRM Customer Engagement Center.
  • The SSI Group will exhibit at the HFMA Spring Joint Conference May 17 in St. Louis.
  • TierPoint will host a grand opening for its Dallas-Allen data center on May 18 in Allen, TX.
  • The Chartis Group publishes a white paper titled “The Impact of the American Health Care Act on Children’s Hospitals: Preparing for the Road Ahead.”
  • TransUnion publishes a new white paper, “Uncompensated Care is on the Rise.”
  • Conduent reports first quarter 2017 financial results.
  • ZirMed publishes a new infographic, “ZirMed Denials by the Numbers.”

Blog Posts


Contacts

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

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Reader Survey Results: Quitting CHIME

May 13, 2017 News 1 Comment

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At a CIO’s request, I asked former and current CHIME members who have either quit or thought it to explain why.


I was once a CIO member years ago. Great networking and exchange of ideas. I became vendor, and after several years, pulled out. It became a pay-to-play with diminishing value. Let me tell you, even the sponsor companies don’t like it much.


It’s become a mini-me of HIMSS.


Vendors are running the show and there is no sense of working to better the industry.


CHIMe used to be an exclusive group of of IT executives and limited number of foundation members (vendors and consultants). Now it’s a mini-HIMSS dominated by vendors, with limited value for all participants. I’m not sure what CHIME’s mission is any more.


Way more time spent with the Foundation members than with fellow CIOs.


It has become so vendor-heavy and the membership drive now allows most anyone to join.


As a CHIME Foundation member for 12 years, I am disgusted with the direction both CHIME and HIMSS are going. It has become a”Russ Branzell “let’s look as much like HIMSS as we can” show. Quantity is more important than being a true CIO venue, having invited people as far down as the director level. I talk to a lot of CIOs who are no longer attending CHIME because of their new focus on money rather than collaboration. As a vendor, I no longer get the same value and am paying a lot more money for decreased value. I still feel I have to belong, just like HIMSS, because absence in noted more than presence.


Just like HIMSS, all about collecting vendor money and less about colleagues teaching and learning from each other. It is overwhelming being a CIO and have to deal with eight vendor staff to each one of us.


As long as CHIME works to keep the vendor contacts at the highest executive levels (Carl, Judy, etc.) it is fine. Complete openness and transparency is needed to give confidence that it exists to serve its members and not enrich its leaders though lucrative associations and spin-off ventures.


I’ve been involved in HIMSS and CHIME for many years, but have limited participation due to the vendor involvement. This has changed the focus for both organizations from members to vendors.


The move away from being a CIO-focused organization to having a variety of members, especially vendor firms.


It has taken on the same mentality as HIMSS — expand the focus to more vendors and non-CIO types. I attended HIMSS for the education sessions and the focus moved away from them. I attended CHIME for networking and CIO sessions to learn what others were doing. Sorry to say this has grown so much it does not work any more. It does not matter to me anyway because I have retired. There is a group of CIOs that formed HISEA. I could not join because a competitor CIO was already a member and that rules out many. But the concept was centered on presentations of great new ideas for other CIOs.


They are selling access to us. It felt a bit more subtle in the past, but is not that way and feels far more commercial.


I don’t like the Fall Forum. Too many vendors, the focus groups are a waste. It is clearly a business, not a professional society. Too bad.


Seeing declining value from participation year to year.


I was booted from CHIME after being a long-time member because I became employed by a healthcare vendor instead of a healthcare provider. I understand the rules, but there are plenty of old timers who are still members even after they went to work on the vendor side because their company has the massive funds to become a CHIME foundation member. So two reasons why I wouldn’t rejoin CHIME even it they would let me: 1) CHIME negates your years of healthcare provider experience once you go to work for a vendor, and 2) they purposefully exclude many vendors from the foundation by charging a huge amount of money for that privilege. I think that CHIME has done great work in the past, but I hate to see it become so commercialized and HIMSS-like.


The leadership seems more committed to growing members and expanding rather than serving the needs of the current membership.


Not providing value.


Insufficient value from membership.


I am considering it. The Fall Forum was the highlight of the year for networking with fellow CIOs and the Foundation firms. The last event I went to, the experience had dramatically changed. Now vendors have booths and instead of one or two people from a Foundation firm, there are MANY. Likewise on the CIO side. There are associate members that may number greater than the number of actual CIOs in attendance. This has moved from a very effective, intimate industry leader gathering to a mini-HIMSS. And who needs that? CHIME is clearly focused on growing revenue, just like HIMSS. I hope HIMSS selects a new leader that can actually save HIMSS from itself and that CHIME leadership watches closely and learns.

Reader Survey Results: Why I Left My Last Job

May 13, 2017 News 1 Comment

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I asked readers: what specific event crystallized your decision to leave your last job?


I was asked if I’d be willing to relocate after 3 years at one office. Said yes so my manager started the process. He never even told me what the HR package was, as it was so insulting. Knew then that it was time to leave the (slowly) sinking ship.


The PE firm that bought our company had little interest in the actual work we were doing. The CEO they put in place fell asleep in the first customer meeting I took him to and then after the meeting told me the customers in the meeting were idiots and he would rather get a needle stuck in his eye than attend another meeting like that.


Was notified by McKesson in fall 2016 my job would end March 31, 2017. Two months later was told I would need to train offshore resources how to utilize and quality test a large piece of clinical software. Given my training and years of front line experience in hospitals, my principles were on the line and no amount of severance was going to compensate me for principles. I turned in my two-week notice in early 2017 with several irons in the fire, but no offers. On my last day at McKesson, I got a call at noon offering me the job I was hoping for.


I took an early retirement package equaling a year’s pay, easing the way into lucrative consultancy for the next few years. However, the event that crystallized my decision was the concurrent layoff of valued colleagues who did not qualify for the package. It was the right choice.


To start a new company and see an idea turned into reality. Hopefully, hah.


Micromanaging leadership and leaders out for self-promotion over the company’s goals.


I was working 60-70 hours per week, seven days a week. My boss assigned me another project, and when I told him I couldn’t, he said something about digging deeper and that I could do just a little more. I already knew I was going to quit, but was trying to hold off one more month. That sealed me. They distributed my work among nine people.


I was a founding but minority partner in a consulting firm. After Having several disagreements with our managing partner about the future direction of the firm, I reached out to our board chair for advice. He made it clear that the managing partner was the majority owner and he would run the firm as he pleases. Great advice. I left and and subsequently founded a very successful and highly regarded consulting firm.


When the company that had acquired our niche software provider changed my network username from a name-based alpha to a nine-digit number.


Cruel management.


Realizing they owed me nothing, and I was simply in the way.


Missing a concert of one of my favorite performers to finish up something “critical” at work then driving home from the office so late that the sun was rising.


Promoted the worst director to be the new CIO.


Realization that in five years with an HIT consulting firm, we never once talked about “the patient.” Our mission statement was embarrassing to read.


Promoting and doctor to be the head of all IT clinical applications, over 100 people, when this doctor had NO experience being in charge of any size of team before, as he told all of us when he announced his promotion. No experience leading any organization whatsoever, no business or HR training, nothing. Talk about promoting someone to his level of incompetence. How often does leadership in healthcare think that just because someone is a doctor they can do anything?


A VP valuing contracts over business ethics and being completely detached from the realities of the marketplace, both in terms of realistic revenue targets and competitive compensation for our top talent, combined with a failing new product that was doomed from the start. The final acceptance of the fact that none of this was ever going to change was the “event.”


I left my last job because it was acquired by another company that was based in the South and I didn’t want to move from the SF Bay Area. Turns out to be the best decision.


A wholesale reduction of the middle management positions in the organization, making communication with manager more difficult (had too many direct reports to effectively manage); pushing many of our previous manager’s duties down on my team with no acknowledgement, support, or consideration of any type; and finally, removing almost any chance for future career advancement in this organization.


The CEO was corrupt (the controller quit rather than approve the yearly numbers), misused federal funds (set policy to have healthcare navigators sign up patients for ACA who were illegal using made up SSNs), racist (but because he was pro-Hispanic, it was not considered racism), did not support his leaders, required the implementation of the EHR when the environment was not stable and had not been thoroughly tested, and put blame on anyone who did not agree with him. The only reason I stayed as long as I did was due to the poor economy. It was a horrible situation to be in. The CIO was the only bright spot and he left soon after I did.


I am in sales and in a previous job sold well over $XXM and as deployment of the promised technology continued to fail, we were at a point with these clients of moving into Phase 2 of the project which would have netted the company another $XXM+ and the clients stopped everything. Lawsuits quickly began to fly. It was at this point I realized my leadership at this company was simply lying. They had done the Wolf of Wall Street. Created imaginary software that was incapable of supporting the demonstration they had put together with bubble bum and duct tape. I lost over half a million in commissions on Phase 2 because they had also conned me into believing they could make it work.

It is a train wreck in healthcare and amazingly complex. The demo experience worked flawlessly on their perfect data, but drop that bad boy vision into the reality of healthcare data and KABOOM. “Mr/s. Customer, you have to give us perfect data or this won’t work. Sorry, no refunds.” Plus, their contracts were unreal with one of the customers saying they were longer and more complex than the ones they worked through with their EMR vendor.

Unbelievable. Investors should have gone after that executive team with guns blazing in a lawsuit. They even made sales pump up pipeline numbers by telling us if anyone even picks up the phone, it is a 20 percent opportunity. Then post-acquisition, if you deleted those inflated opportunities, the same executive team (CEO) would literally email you within five minutes demanding an explanation.


When the going got tough, the C-suite exec refused to take responsibility for any of the struggles being dealt with by the staff that reported to him. In fact, he was quite adept at not listening and throwing people under the bus. Finally got to the point where I got on the bus and rode off to another job.


My company was purchased and I did not believe in the management or strategy of the acquiring company.


I found termination for cause suasive.


Toxic medical director, toxic culture , being treated like three year olds .


My director seemed to be semi-sabotaging our market install. At core team meetings, she would ask leaders whether they were on schedule, and upon hearing they weren’t, she would only say OK before moving to the next person. We were months and about a million over. She knew I thought we should ask people what the hold-up was, if they needed help, more training, etc. We had a planned core team meeting with the market CFO to give a status and tell him whether we felt on track and could make our live date. My manager came in to my office right before the meeting and told me to keep my mouth shut at the meeting. I sent my resume out the next week.


When my boss left, and HIS boss left within a day of each other. This was just after a new CEO took over.


My division was sold. The buyer offered a voluntary severance package within two weeks of the sale being final.


My company was acquired by a competitor. That’s probably the most obvious sign that’s it’s time to move on.


Our company was acquired. Marketing and accounting are the first to go.


Continually getting new “managers” who kept asking me how they should do their job.


When I realize the culture and the legacy leadership was never going to change.


My boss, the CIO of a large, multi-state IDN, falling asleep in my annual performance review.


New CEO hired through board member good-old-boy network was threatened by my skills and influence over the organization. Good thing my employment contract had a decent severance clause. CEO actually offered to extend the severance for signing a draconian non-compete agreement that went far beyond original employment contract. I turned him down. CEO was fired by the board a few months later after running the company into the ground with extravagant spending on a flawed strategy.


I decided to leave my job when I was told the CFO wouldn’t support me to be named the director of the business unit I was already leading. She would have to sign off on the position even though it didn’t report up through her. We had brought in $5m of unbudgeted money into the organization. It was a political mess and I am so glad that I left for a similar director position.

News 5/12/17

May 11, 2017 News 3 Comments

Top News

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HHS appoints Genevieve Morris, MA as ONC’s principal deputy national coordinator. She was previously senior director of HIT policy with Audacious Inquiry.

Unlike her predecessor Vindell Washington, MD, Morris has no clinical education or experience (her master’s is in political science), having spent her nine-year career working on HIEs and Meaningful Use.


Reader Comments

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From Significant Other: “Re: Partners HealthCare. I worked at Partners for many years and attended a February conference  featuring CEO David Torchiana, MD (who had an insightful presentation, btw.) I asked the last question, which was ‘Can you talk a bit about Partners 2.0?’ His answer was quite candid — since its formation 23 years ago, little has been done to consolidate within the now $10+ billion organization. He expects to see a $500 million reduction over the next few years as the network reinvents itself. The Brigham and Women’s Hospital early retirement offering has nothing to do with Epic and that cost.” 

From Hospital Personality: “Re: Epic. Announced that they are developing a fetal monitoring solution so that customers don’t need to turn to a third party such as Perigen, GE, or Obix.” Unverified.

From Diego: “Re: hospital MU3 attestation for Athenahealth users. For the Athenahealth spokesperson, how many of the company’s stated 35 live hospitals are using the complete inpatient solution, including clinicals? How many have actually attested with the inpatient product? How many users have fully implemented the inpatient product, including clinicals, within a 12-month timeline with the past two years?” 


Epic’s App Orchard

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I received more reader comments about working with Epic’s App Orchard.

#1

The experience with App Orchard thus far has been very disappointing. After paying the hefty fee for the Silver tier, we expected to receive all of the perks of the tier as discussed in the App Orchard documentation. Unfortunately, upon receiving access to the App Orchard program, it became readily apparent that much of what was promised was either not available or, in some cases, not yet built. Additionally, we were informed by App Orchard personnel that our "Sandbox" access would only be for a testing Sandbox and not an environment that we could use to demonstrate our solution to clients. The original documentation was highly misleading on this point.

The documentation also suggested that any press releases were to be submitted to the App Orchard team for review. After we went through a lot of effort constructing a press release with our PR firm and submitting it to App Orchard personnel for review, we were told that Epic would be providing developers with a standard press package.

All of this inconsistency is making us very uneasy. While we appreciate that we are one of the first few companies to join the App Orchard, and that we will be helping define the process for other companies in the future, we expected the process to be far more robust and established.

On the plus side, the App Orchard personnel have been very responsive and have provided as much help as they could given the under-developed state of the Orchard at the moment.

#2

We applied to the Epic App Orchard right when it was opened to vendors. Our initial interaction with Epic required us needing some detailed information on the different levels that App Orchard offered. I was pleasantly surprised to see how quickly they replied and how helpful they were as we worked through this decision.

Our application was processed timely and we got the access that we needed to start working on the technical integration. We are currently working on the technical integration and will soon be planning the marketing efforts. So far, so good.

#3

The team has been very responsive and the APIs are robust. We wish there were a bit more clarity on the pricing model for the live application (transactions vs. revenue share structures are a bit hard to follow). We also wish we had a clear sense of the timing / duration of the approval process for an application, as well as acceptance / rejection criteria.


HIStalk Announcements and Requests

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Mrs. G’s DonorsChoose grant request was for STEM and engineering kits for her elementary school’s Robotic Rumblings program, noting that the city-wide STEM science fair includes few minorities and females. She reports, “The materials obtained through DonorsChoose are having quite an impact on my students. They are giving my students the opportunity to grow in the area of robotics. Their creative juices are definitely starting to soar. They are thinking and developing deeper thought processes on how to manipulate the materials. They are also learning how to better work together cooperatively. The students like working in small group settings. They appear to be quite focused when using the materials and do not want to leave when the session ends. We thank you from the bottom of our hearts. There are definitely some rumblings going on around here!!!!!!”


Webinars

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


Acquisitions, Funding, Business, and Stock

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NantHealth reports Q1 results: revenue up 16 percent, adjusted EPS –$0.24 vs. –$0.18, missing expectations for both. NH shares continued their slide on the news, now down 83 percent since last year’s IPO.

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Specialty EHR vendor Modernizing Medicine raises $231 million in a private equity investment, increasing its total to $322 million. 


People

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New York-Presbyterian promotes Peter M. Fleischut, MD to SVP/chief transformation officer. 

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Ivenix promotes Jesse Ambrosina to COO,  George Gray to CTO/VP of R&D, Janice Clements-Skelton to VP of HR, Carolyn Malleck to VP of finance, and Ben Powers to VP of infusion systems.


Announcements and Implementations

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PokitDok will build its healthcare transaction recording platform on the Linux Foundation’s open source Hyperledger Sawtooth blockchain project along with Intel Software Guard Extensions. 

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Vermont Information Technology Leaders and Medicity connect the Vermont HIE to the Veterans Health Information Exchange, allowing clinicians in the VA and the HIE members to view each other’s records for a veteran patient. 

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MModal announces enhancements to its computer-assisted physician documentation technology.

WellSpan Health brings its initial sites live on Epic.


Government and Politics

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Officers in West Virginia’s state capitol arrest a veteran journalist who was attempting to ask HHS Secretary Tom Price if domestic violence would be considered a pre-existing condition under the House’s American Health Care Act. Dan Heyman was taken away in handcuffs and charged with “willful disruption of state government processes,” with the Secret Service agents who were protecting Price and White House Special Counsel Kellyanne Conway claiming they had warned Heyman that he was interfering with their work by shouting questions that Price was ignoring.

HIMSS reports that while Congress’s spending bill still won’t allow HHS to spend money to develop a national patient identifier, it encourages HHS and ONC to provide technical assistance to non-governmental organizations trying to address the patient identification issue.

President Trump threatens to withhold $7 billion per year in ACA cost-sharing reduction payments to insurance companies, which would likely drive more insurers out of the exchange market or raise premiums. The President said in an interview, “There is no Obamacare. It’s dead. Plus we’re subsidizing it and we don’t have to subsidize it. You know if I ever stop wanting to pay the subsidies, which I will, anytime I want.”


Privacy and Security

Memorial Hermann Health System (TX) pays $2.4 million to settle HIPAA charges following a 2015 incident in which it issued a press release that named an illegal immigrant who was arrested after using a phony Social Security card at one of its clinics. The hospital said it called police because of concerns about fraud, not immigration status. The woman’s husband was also in the country illegally, but had insurance through his employer.  

Hackers breach two old data servers of a Memphis, TN family medicine practice using valid login credentials and demand a $10,000 ransom after encrypting its files, which the practice declined to pay since they switched EHRs 18 months ago and only those older records were involved.


Innovation and Research

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Cerner says it’s interested in just-announced Microsoft technology that can identify, name, and index objects depicted in photos or video, saying it could be useful for alerting hospital nurses of patient actions that require their attention. 


Other

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Healthcare Growth Partners analyzes the valuation differences for enterprise vs. healthcare software as a service companies, concluding,

If the set of health IT companies were able to grow more quickly, it is likely that their valuations would become more in line with general enterprise SaaS companies. The reason for health IT’s slow growth rate is no doubt a complex combination of factors including longer sales cycles, heavy regulation, and slow adoption rates. Potentially it may be due to the relative immaturity of the healthcare software market and a different mix of publicly traded comps in health IT as compared to the larger and more mature enterprise SaaS market.

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Sonar studies at University of Mississippi Medical Center (MS) reveal that up to 7,000 human bodies are buried on the hospital’s grounds, believed to be those of patients who died in the state’s mental hospital from 1855 to 1935 when it was located on what is now hospital property. Construction work turned up 2,000 bodies three years ago. The medical center, faced with a $21 million estimate to relocate the remains, is proposing to exhume a few of them for research and then just build a memorial.

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A scientific editor trolls one of the many predatory medical journals with lofty-sounding titles that will run articles from publication-desperate researchers in return for cash. He submits an article built entirely around “Seinfeld” episodes as researched at the prestigious Arthur Vandelay Urological Research Institute, listing himself as the primary investigator under the name Dr. Martin van Nostrand. The Urology & Nephrology Open Access Journal accepted the article about a made-up condition nearly verbatim, billing him for its $799 fee (a mistake on their part since he declined to pay).  

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Eric Topol interviews the fascinating Pardis Sabeti, MD, PhD: member of a family who emigrated from Iran just before its 1978 revolution, Rhodes scholar, physician, scientist (computational biology and medical genetics), host of an education TV series about statistics, and singer/songwriter for Thousand Days, a decent alt-rock band.


Sponsor Updates

  • Advisory Board Chief Medical Officer Dennis Weaver, MD, MBA presented “Pragmatic Approaches to Succeed at Value-Based Payment and Care” at the World Health Care Congress Hospital and Health System Summit in Washington, DC last week.
  • EClinicalWorks will exhibit at the Ohio Association of Health Plans Annual Convention May 16-17 in Columbus.
  • GE Healthcare will supply over 200 Egyptian hospitals with 700 units of its advanced healthcare technologies.
  • Healthwise will exhibit at the Cerner Collaboration Forum May 16-18 in Kansas City, MO.
  • Huntzinger Management Group’s William Reed is named a Life Fellow Member of HIMSS.
  • Consulting Magazine names Impact Advisors VP Lydon Neumann one of the Top 25 Consultants of 2017.
  • Imprivata will exhibit at VA Healthcare 2017 2017 May 15-18 in Arlington, VA.
  • Entrepreneur Magazine features LogicWorks CEO Kenneth Ziegler.
  • Healthgrades recognizes Meditech hospitals for patient safety.
  • National Decision Support Company will exhibit at WEDI 2017 May 15-18 in Los Angeles.
  • Navicure and PatientKeeper will exhibit at Centricity Live 2017 May 17-20 in Boston.
  • Shane McCarran joins Orchestrate Healthcare as senior recruiter.
  • Experian Health will exhibit at HFMA WV May 17-19 in Roanoke.
  • InterSystems will exhibit at the NEHIMSS Annual Spring Conference May 11 in Foxboro, MA.
  • The US Patent Office awards Intelligent Medical Objects a patent for its medical terminology solution.

Blog Posts


Contacts

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

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News 5/10/17

May 9, 2017 News 6 Comments

Top News

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A DataBreaches.net investigation finds that up to several million records of Bronx-Lebanon Hospital Center (NY) were exposed after its revenue cycle contractor, iHealth Innovations, apparently misconfigured an rsync backup


Reader Comments

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From Dr. Evil: “Re: EviCore. The specialty benefits manager is considering a sale or IPO, valuing itself at $4 billion. It pays to build a business around denying care.” The company describes its services as “comprehensive care management solutions,” although the emphasis seems to be on reducing cost via evidence-based solutions. It’s a good approach, although it fails to address out-of-control provider, drug, and device costs and instead focuses on restricting what is ordered. It’s an often-missed point that all of the political wrangling over health insurance would be much less necessary if costs were made reasonable, an even more daunting and therefore unlikely legislative accomplishment since the folks making fortunes on the backs of sick people also employ lobbyists.


Epic’s App Orchard

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I received these unverified reader comments when I asked for first-person experience with Epic’s App Orchard.

  • I have worked extensively with Epic Corp over the past two years with their iterations of the App Orchard. The rules of the road require that an app developer permit Epic to take whatever IP they choose, if Epic believes it makes sense to include in future releases of Epic software. Epic will reject apps that directly compete with Epic functionality, as determined by Epic’s current and future roadmap. Further, the 30 percent fee they charge is too broad in scope for the app revenue (if there is any). Most importantly, originally, only Epic clients could submit apps to the Orchard, effectively locking out the global collective genius of non-Epic entrepreneurs (I am not sure if such a restriction remains). Based on the approach to their App Orchard, Epic seems to be trying to respond to the market demand for "open" as heavily advertised by Cerner as their competitive differentiator. However, Epic also seems to want to control the Epic app environment and has absolutely no motivation to loosen their model to the wild, as Judy mentioned several times that such a move would be the end of Epic.
  • We have started working with Epic to build out an API integration under the App Orchard. For us, the biggest concern are the revenue sharing terms. For a software vendor that is operating under tight margins in a competitive market, having to factor in up to a 25 percent gross revenue share is an impossible burden. From our perspective, the App Orchard is a blatant money grab from companies trying to innovate on the edges of the Epic ecosystem.

HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Softek Solutions. The Prairie Village, KS-based company’s OnTrack software and consulting services optimize revenue integrity and system performance for Cerner Millennium hospitals (and those preparing to move to Millennium). Its Charge Integrity Control provides visibility into revenue management by correlating patient orders and charges throughout the transaction process –one customer found a lab charge error that lost them $3 million in appropriate billing over four months before they found it instantly with Charge Integrity Control. Revenue Conversion Services allows correction of application, workflow, and configuration problems that otherwise would cause millions of dollars in lost revenue right after a Cerner go-live — a single hospital called Softek three months after go-live and avoided $20 million in annualized lost charges due to orders that weren’t charging, a location-specific workflow problem with ordering, and ED batch charges that weren’t actually charging. The company also provides Millennium system performance optimization software and services as well as conversion and purge maintenance assistance using proprietary diagnostics. Thanks to Softek Solutions for supporting HIStalk. 

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I finally pulled the trigger on replacing of my years-old, $300 laptop that I use for everything. I chose an Acer Aspire E15, which has pretty decent specs for $621: an AMD FX 9800p CPU with 2 MB L2 cache, 16 GB of DDR 4 SDRAM, a 128 GB solid state drive running Windows 10, a 1-terabyte hard drive for data, a 15.6-inch display powered by a Radeon R8 dual graphics video card with 2 GB of dedicated VRAM, and thankfully nearly zero pre-installed bloatware. I’ve had no problems so far getting it loaded up.

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HIStalk readers funded the DonorsChoose grant request of Mrs. S in California, who asked for a 3Doodler child-safe 3-D printing system (it was actually inexpensive at just $113 for everything, plus our donation was matched). She reports, “I would like to thank you from 22 very excited third grade students that have really been enjoying and benefiting from your generous donation! We have been using our 3Doodler pen each Friday afternoon during our STEAM centers time and I have truly observed some fantastic skill building. Some of the benefits that are very noticeable to me are an increased attention to detail, improved direction following within a detailed task, increased patience for a task, increased observation of the steps necessary for a positive outcome, and an increased motivation to try something new! You have made a difference!”


Webinars

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


Acquisitions, Funding, Business, and Stock

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Video visit provider Teladoc reports Q1 results: revenue up 60 percent, EPS –$0.30 vs. –$0.40, beating analyst expectations for both.


People

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Reed Liggin (Athenahealth) joins electronic prescribing system vendor EazyScripts as CEO. He was president and CEO of the small-hospital information system vendor RazorInsights that was acquired by Athenahealth in January 2015.

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Telehealth solution provider Avizia hires Joe Quinn (ComScore) as CFO.

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Health Symmetric hires Bob Teague, MD (Quorum Health Resources) as chief medical officer. The company’s website uses a lot of vague gibberish in not saying exactly what it is they’re selling other than a “healthcare platform” that uses APIs.


Announcements and Implementations

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Intelligent Medical Objects is awarded a patent for its concept-based terminology management system that allows rapid distribution of terminology changes to the company’s EHR vendor partners. Clinician-entered terms are matched with appropriate billing and reference codes that capture clinical intent.

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Hybrid IT vendor TierPoint will expand its Hawthorne, NY data center campus for the third time, adding 38,000 square feet of raised floor to the existing facility that includes 52,000 square feet of raised floor plus a 70,000 square foot recovery and business continuity center.

PeriGen releases PeriWatch, a perinatal analytics system that integrates WatchChild fetal monitoring with PeriCALM decision support and adds a maternal dashboard.

­­­­­­­­­­­­­­­Penn Medicine Center for Health Care Innovation (PA wins ECRI Institute’s health device award for its app development platform that extracts clinical information from the EHR and other sources. 


Government and Politics

In England, the Cambridge University Hospitals trust will decide this summer whether to outsource commodity IT services that include enterprise infrastructure, service desk, and end-user computing in a tender expected to total $180 million over seven years. The trust says its increasing Epic use has created a need to expand its services. 

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The White House appoints Gopal Khanna (Illinois Department of Innovation and Technology) as director of AHRQ.


Innovation and Research

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University of Illinois at Urbana-Champaign is working on a virtual physician agent that can describe lab test results to patients via a patient portal, targeting older adults with conversational speaking, context-appropriate facial features, and other body cues that can help with retention.


Other

St. Mary’s Hospital (NJ) celebrates Nursing Week by laying off seven nurses and 13 med techs.


Sponsor Updates

  • The local paper profiles Ability Network CEO Mark Pulido.
  • Black Book identifies 10 top MACRA trends challenging providers with value-based care and quality metrics.
  • Agfa Healthcare launches a new version of its Integrated Care Suite.
  • Besler Consulting releases a new podcast, “Healthcare in the first 100 days of the Trump presidency.”
  • Washingtonian names The Advisory Board Company CEO Robert Musslewhite as one of its biennial Tech Titans.
  • Casenet announces its Connect 2017 speaker lineup, led by client executives from Cigna and Healthfirst.
  • CoverMyMeds will exhibit at the American Academy of Ambulatory Care Nursing Annual Conference May 10-13 in New Orleans.
  • Boston Software posts a white paper titled “Eliminate the Pain of EMR Upgrade Testing” that describes use of its Cognauto system to validate and set appropriate expectations for each department regarding
    the added benefits of the EMR upgrade.
  • The Hartford Business Journal interviews Diameter Health CEO Eric Rosow.
  • Health Professional Radio interviews Docent Health co-founder Paul Roscoe.

Blog Posts


Contacts

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

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High Hopes for HHS Cybersecurity Center

May 8, 2017 News 1 Comment

Stakeholders react to news that HHS will launch a healthcare cybersecurity center this summer.
By @JennHIStalk

While administrations may change and legislation come and go, the need for cybersecurity across healthcare’s many verticals seems to be a constant that will remain with the industry for the foreseeable future. News that HHS will create a Healthcare Cybersecurity Communications and Integration Center this summer highlights the federal government’s commitment to helping providers, payers, vendors, and (hopefully) patients prevent data breaches that could impact patient safety.

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Modeled after the Department of Homeland Security’s National Cybersecurity and Communications Integration Center, the new HHS center helps to fulfill the Cybersecurity Information Sharing Act of 2015, part of a broad initiative under the Obama administration to bolster the government’s offensive and defensive cybersecurity capabilities.

“HCCIC establishes the mechanism to provide proactive and anticipatory analysis of cyber threats to both HHS and the healthcare and public health sector,” says an HHS spokesperson. (The department declined a formal interview.) “The HCCIC will act as a clearinghouse to drive healthcare-relevant cyber indicators, briefings, and actionable intelligence to and from a wide variety of stakeholders – both public and private. HHS aims to begin initial operations this summer.”

The timing is apropos given the impending release of a report authored by the Health Care Industry Cybersecurity Task Force, a CISA-mandated group put together last spring tasked with:

  • Analyzing how other industries have addressed cybersecurity threats.
  • Reviewing the security challenges associated with networked medical devices and software connected to EHRs.
  • Developing and circulating cybersecurity best practices.
  • Establishing a plan the government can use to freely share real-time intel regarding healthcare cybersecurity threats.

While HHS would not confirm the HCCIC will help to implement the task force’s recommendations, one can only assume that the two resources will converge to some degree. Industry stakeholders are of course eager to collaborate and benefit from the new center’s deliverables, which are yet to be fully determined.

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“We are anxious to begin to see actionable data coming out of the HCCIC, including threat and vulnerability,” says Marc Probst, CIO of Intermountain Healthcare (UT), which formed a cybersecurity center last year with the University of Utah and several other partners. “The HHS goals around information sharing and analysis align perfectly with our organization and several that we are working with,” he adds. “We are anxious to contribute and develop automated feeds for the HCCIC.”

While emphasizing that long-overdue federal cybersecurity risk assessment and risk management efforts will provide good implementation guidance, Probst and his colleagues are reluctant to see cybersecurity become a compliance effort or a certification program. “Many of those currently participating are vendors or people with a product to sell,” Probst explains. “We hope the committees and chairs will seek more payer and provider participants.”

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While selling a product to providers in need would surely be seen as a positive outcome for any vendor involved, Divurgent CISO Stephen Watkins sees the benefit of an HHS-sponsored cybersecurity center as one of cohesive collaboration. “For advisory and consulting services organizations like ours,” he says, “these centers allow us to share and contribute our strategic, operational, and tactical insight from the field as well as act as both sounding boards and feedback loops for best-practice implementation guidance from the HCCIC, especially for small providers that may not have in-house IT security staff.”

Real-time cybersecurity guidance to the healthcare community will surely be welcome in light of today’s constant stream of data breach announcements, which have become so banal as to no longer incite the media hysteria it first engendered a year or two ago. While it may be too much to hope the center and its collaborators can help providers, payers, and vendors stay ahead of constantly evolving cyber threats, stakeholders no doubt hope HCCIC resources will become some of the strongest defenses in their cybersecurity arsenal.

Monday Morning Update 5/8/17

May 7, 2017 News 10 Comments

Top News

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Billionaire investor Warren Buffett says in the annual Berkshire Hathaway shareholders’ meeting that the American Health Care Act would be “a huge tax cut for guys like me,” adding that, “Medical costs are the tapeworm of American economic competitiveness.”

Buffett also complained that private equity firms load their acquired companies with debt, announced that the company has sold one-third of the IBM shares it holds, and joked in answering a question about how much his successor will be paid (Buffett is 86) that, “If the board hires a compensation consultant, I’m coming back.”


Reader Comments

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From Chiming In on CHIME: “Re: CHIME. You asked why people are quitting HIMSS. I’d like to see the same anonymous question about why people are quitting CHIME. I’m considering it since it has changed from a CIO networking organization to a vendor-driven one, where companies pay for CIO time.” I created a rather awkwardly worded survey here and will report the results next week. 

From 300-Buck Gyp: “Re: radiology report. A friend’s pelvic CT scan had this radiologist comment in the report: ‘CT pelvis. Reproductive organs – the uterus and ovaries are normal. I guess the fee includes copy/paste issues since the patient is a male.” Perhaps “normal” could be loosely construed as meaning that the lady parts are “absent” in male patients, thus streamlining the radiologist’s report template even more.

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From Privy Pathway: “Re: Brigham and Women’s. Any thoughts on the offering voluntary buyouts as a cost-cutting measure? It used to be that Epic only got the C-suite fired, but Brigham, MD Anderson, and Southcoast are proving a trend. I’ve also heard that a notable health system is cutting annual compensation increases for the rank and file given capital and operating constraints associated with their Epic go-live.” My cheap-seats view would be this. Epic is fanatical about forcing customers to budget the entire project’s expense. My survey of C-level execs of health systems that use Epic (which got pretty big participation) found that 75 percent of projects came in at or under budget, with just 15 percent saying they spent a lot more than they expected. Therefore, I’ll postulate that it’s probably simplistic to assume that Epic is guilty just because it was present at the crime scene:

  • Health systems that choose Epic should not be surprised by its upfront and ongoing costs. That would seem to be the case with most of its customers since few have had disastrous, permanent financial challenges purely because of Epic, especially those that have been live for a few years.
  • Leaders of financially challenged hospitals typically find a scapegoat, whether it’s unions, government payments, IT, or regulatory compliance costs. They haven’t blamed Epic all that often, but even when they did, the reality might not be quite so simple, especially if the executives are looking to justify unpopular decisions.
  • The type of health systems that choose Epic (large, aggressive, market-leading health systems) are those most likely to have had their bottom line hit by government, payment, and marketing challenges as the emphasis shifts away from heads in the bed and the extraordinarily high cost of hospital-provided care, especially in those with massive market clout that drives negotiation with insurers.
  • Timing is everything. Epic gained a lot of customers in the past 3-4 years and financial conditions have changed considerably since then, so those significant upfront costs may be hitting at an inopportune time for some health systems.
  • Having poor financial performance after Epic doesn’t necessarily mean Epic was the problem. Some hospitals screwed up their implementations with bad decisions, while others were poorly managed both before and after Epic. Sometimes you read about a high-profit health system choking on Epic and think to yourself, based on what I know about them, I’m not too surprised they managed to mess it up. Software ROI is usually more related to the client than the vendor.
  • Some of the hospitals are cutting back because of future expectations, not necessarily due to concerns about their current bottom lines.
  • It’s going to get a lot worse of the ACA is repealed and many millions of hospital patients go back to being charitable write-offs, shrinking health system profits.

HIStalk Announcements and Requests

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Nearly 80 percent of poll respondents haven’t bypassed insurance to pay cash for a better ongoing PCP. Stephen pays an $149 annual fee to belong to One Medical even though the actual visits are still covered by insurance. Nonsequitur took the concierge route for his father since few decent doctors in his area accept Medicare, adding that the new practice provides nearly 24/7 secure communications via Twistle. Amy says she hasn’t done it for a PCP, but does so for other services because some providers offer a cash price that’s cheaper than paying her high-dollar insurance deductible. Rose goes out of network to keep a particular PCP even as insurance contracts change frequently, although she’s cautious to get orders for expensive lab and rad tests ordered by an in-network provider since some plans won’t pay for them otherwise.

New poll to your right or here: what was your reaction to the House’s passage of the American Health Care Act last week? Feel free to elaborate further by clicking the poll’s “Comments” link after voting.

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HIStalk readers provided an Amazon Fire TV and accessories for Ms. D’s California elementary school class in funding her DonorsChoose grant request. She reports, “Technology is always changing, so my teaching strategies need to accommodate the needs of my students. Most of them are visual learners, so I play YouTube clips and videos all the time when I am teaching science. In addition, the Amazon Fire TV has allowed my students to visually see the concept as they are watching science videos on TV. Now, my students are extremely excited about science! On behalf of my students, thank you for supporting them as they continue to reach for their goals!”


This Week in Health IT History

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One year ago:

  • Theranos announces a reorganization that includes the retirement of President and COO Sunny Balwani.
  • HHS spells out details of its proposed MACRA program.
  • NextGen ceases development of its NextGen Now cloud-based PM/EHR as it moves focus to its acquired HealthFusion product.
  • The FDA rejects the application of the “digital pill” that uses technology from Proteus Digital Health.
  • Apple releases the CareKit developer’s framework.
  • Internal documents from University of Texas indicate that MD Anderson Cancer Center blames its Epic implementation for a nearly 60 percent year-over-year income decrease, although noting that it had already assumed some negative impact.
  • Siemens changes the name of Siemens Healthcare to Siemens Healthineers.

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Five years ago:

  • Partners HealthCare chooses Epic to replace Siemens Soarian.
  • ONC launches its Health IT Dashboard.
  • The Nashville Medical Trade Center names six companies that will join HIMSS as tenants.
  • Medseek announces plans to conduct a management buyout of the company.

Weekly Anonymous Reader Question

I asked readers to describe the best career advice they have received:

  • You can do better without working more hours.
  • From Ben Franklin: ask people for help in order to make them like you.
  • From my first professional manager who that had been employed for our then-current employer for the previous 30 years, "Don’t make the same mistake as me and think that you need to stay with the same company your whole career."  Knowing what I know now, and having held various positions with several different employers over the course of 25 years, I would have loved the opportunity to have been given the option to stay put.
  • Perception is reality. It doesn’t matter what you think — if people perceive X, then X is true.
  • Always put yourself in the other person’s shoes — most people have good intentions, so if they don’t behave in a good way, understand why from their point of view.
  • When I was thinking of starting my own independent, HIT consultancy in 1985 — terrified every step of the way, but more terrified not to do it — my mentor at the HIT company where I was employed advised me that, so far, my track record for getting through rough days is 100 percent and that’s pretty good.
  • Be nice to the administrative assistants.
  • When you walk somewhere, go fast so you look like you’re actually on your way to do something.
  • Realize when it’s time to recalibrate. Your vision of your life when you were 18 is probably different than it has turned out to be when you reach 40, so focus on the accomplishments rather than regrets.
  • Being told that I was not a good writer, and as such would never be published in one of the B2B magazines owned by the publishing company I worked for. While not your typical piece of advice, I took it as a challenge to prove the naysayers wrong. I believe my ensuing track record of published pieces for a variety of media outlets speaks for itself.
  • My daughter just became an RN and has started working at our local hospital. In her first week or so, she was introduced in passing to an OB/GYN who happens to be my wife’s and also happened to be the doctor who delivered my daughter. She says "Hello, Dr. A," to which he replies "Get out of healthcare, kid."
  • People will always remember how you’ve made them feel. Don’t be a jerk.
  • Don’t listen to your parents. They really think they know you, but they can’t because you only become you by following your nose and that takes time, experimentation, trial and error, and the occasionally do-over. In fact, don’t listen to anyone. Do something that is new every day, and when it stops being new at least a little every week, then move on.
  • Listen. You may be the smartest person in the room. Listen anyway. You’ll learn something.
  • If it’s not going to matter in five years, it doesn’t matter now. Pull back and reconsider your response to the situation.
  • You need to read HIStalk.
  • When the horse has died, dismount. (Ross Perot)
  • Your boss cares about results, not the path you took to get there.
  • If you are young and take a travel job for the higher pay, have an exit plan. Otherwise, you’ll find yourself still on a plane traveling every week when you are 65 years old, having missed so many family and friends moments because you were always on the road.
  • You can love your job, but it will never love you back. No job — no matter how rewarding either financially or emotionally — is worth destroying your peace or sanity for.
  • Do not let one person ruin your job. (Advice I should have taken.) I left a job after 6.5 years because I could not stand my boss. Other people just ignored or tolerated him. Many of them are still there today, 15 years later. He has since retired.
  • Back in the early 1980s:  learn to type. Sounds dated now, but as my mother said, you can always fall back on being a secretary if needed. Thankfully I took four years of typing in high school, and went onto college to get my bachelors. I type for a living now in IT.
  • Earlier in my career, I was really ambitious and wanted a promotion after my direct manager left. I wasn’t ready to be the department manager but i met with the VP making the decision anyway. He learned more about my background and experience and said to me, "You have to ask for the job you want, otherwise no one will know you want it." It was a revelation to me. A plain spoken truth and something so simple would be the best career advice I ever received.
  • My first CIO taught me not to ever say “no” to my business partners. Say “how long” what they want will take to acquire and/or develop, and “how much” it might cost. This is our obligation as IT professionals serving an organization.
  • Taking the path of integrity and good character will not always result in promotion within an organization. You must be willing to stick to your professional values and be ready to move on to new adventures if your superiors do not like your answers.
  • You hold yourself back more than anyone or anything. You are good at what you do. Have faith in yourself, be heard, make a difference.
  • Spend more personal time with your team. Show your human side. Both will build more trust, which will make the team closer and stronger.
  • Never talk to a reporter. Your response should always be "no comment."
  • Don’t do anything rash.
  • When you have an issue with the way the organization is being run, address it by tying it to core values or customers, not by calling out the way a specific person does things.
  • You should spend 10 percent of your time looking for your next gig.
  • Do what you say you’re going to do, when you say you’re going to do it. Return the call or email promptly even if you don’t have the answer. In other words, be there. If colleagues and customers know they can count on you, you’ll be given more opportunities (and responsibilities) to grow your career and, at the same time, build a network that will be increasingly valuable.
  • Arrive at a meeting at least five minutes early, and if you are leading, a meeting ensure that it ends on time or earlier.
  • I was having trouble getting what I needed professionally from a boss. The advice I received from a mentor was, "She will never be the kind of boss you need. So how do you make the most of what she has to offer and get your other needs met elsewhere?"
  • Live on what you currently make so your employer will never "own" you. I stayed in positions because I wanted to be there, not to get a paycheck.
  • Worry about the sale. The margin will take care of itself.
  • Advice to a just promoted CIO: "Remember that you are a VP of the organization, not just of IT."
  • Don’t apologize if you have not done anything wrong. Said to me by the late great Steve Macaleer, of the Macaleer/SMS family, who died way too young at 49.
  • Every five years or so, change jobs. You have probably developed bad habits that are best discarded. You can do this within your current employer or by getting a new employer.
  • Ninety-five percent of the time you are right, but 95 percent of the time your delivery sucks. You need to work on your delivery AND timing.

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This week’s question: what specific event crystallized your decision to leave your last job? (or another previous job if you’ve got a good story from there).

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Welcome to new HIStalk Platinum Sponsor CSI Healthcare IT. The Jacksonville, FL-based company, which has offered services nationally for 20 years, provides training and implementation solutions for EHR and coding as well as IT staff augmentation, legacy system support, and infrastructure staffing. Case studies: Houston Methodist (CPOE activation), Norton Healthcare (a 300-contractor Epic go-live), Sutter Health (Epic training), and Grady (big-bang Epic go-lives). The company’s consultants voted it to Inavero’s Best of Staffing Talent List, which recognizes fewer than 1 percent of staffing agencies in North America. The company provides customized consulting and staffing solutions that provide unmatched results at a fraction of the cost. Thanks to CSI Healthcare IT for supporting HIStalk.

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

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Last Week’s Most Interesting News

  • The House passes the American Health Care Act that would repeal most of the Affordable Care Act, sending the bill to the Senate.
  • Thoma Bravo buys Lexmark’s Perceptive Software business and moves it under its Hyland Software portfolio company.
  • Computer systems at University Hospitals (OH) go down for several days due to unspecified causes.
  • ONC launches a patient matching algorithm challenge.
  • Meditech announces Q1 earnings per share of $0.39 vs. $0.51 in the same quarter last year.
  • Internal medicine physicians at Canada’s Nanaimo General Hospital are disciplined for going back to paper orders in declaring patient safety concerns with Island Health’s Cerner system.

Webinars

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


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call, following the quarterly report in which the company beat expectations on earnings and met on revenue:

  • A strong segment was Payer and Life Science.
  • The company expects its acceptance into the UK’s NHS London Procurement Partnership to help it maintain UK momentum.
  • The Netsmart acquisition contributed around $50 million of the quarter’s bookings.
  • Paul Black says the company is watching the market evaluation being performed by the VA and Coast Guard, noting that the Allscripts loss in the DoD bid wasn’t due to technology, applications, workflow, security, or company background – it didn’t make it to the final round because of price.
  • The company is not seeing the decline in claims volume as reported by Athenahealth, although it notes that Athenahealth has greater exposure than Allscripts because of its business model.
  • Allscripts will focus on increasing the client base’s adoption of Sunrise Financial Manager rather than trying to roll out outsourced inpatient revenue cycle management services.

Decisions

  • Central Montana Medical Center (MT) will switch from Evident to Infor supply chain management in 2017.
  • Children’s Hospital Of New Orleans will go live with Epic in 2018.
  • New Orleans East Hospital (LA) will switch from Cerner/Siemens Soarian to Epic in 2018.
  • Thomas Memorial Hospital (OH) replaced Siemens with Meditech on March 1, 2017.

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


People

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New York-Presbyterian Hospital (NY) promotes Rosemary Ventura, MA, RN, DNP to the newly created position of CNIO.


Announcements and Implementations

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Reaction Data publishes its “Big Mega HIT Purchasing Report,” which finds that the top spending item of health systems and standalone hospitals in the next 12 months will be inpatient and ambulatory EHRs (Epic was #1 in mindshare for both, followed Cerner and Meditech that were nearly equal in score). Hospital-owned physician groups will focus on information security, while independent practices place telehealth as #1 with equal interest in four vendors.

Definitive Healthcare adds quarterly inpatient and outpatient Medicare claims data for hospitals, clinics, and long-term care providers to its provider data, intelligence, and analytics product line.


Government and Politics

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VA Secretary David Shulkin reiterates that he will announce the VA’s plans for VistA in July, choosing to either replace it with a commercial system or turn VistA over to a private company to convert it into a single, cloud-based, externally managed instance. When asked about the historic lack of technology cooperation between the VA and the Department of Defense, Shulkin promised better, saying, “We’ve always found ways not to do that.”


Privacy and Security

Hacker The Dark Overlord posts records of 180,000 patients online from medical practice hacks last year, most likely because those facilities declined to pay the extortion demanded.


Other

A Utah-based orthopedic surgeon is ordered to turn over 10 website domains to Intermountain Health Care, which complained that the doctor had no legitimate reason to have purchased domains related to Intermountain’s Cedar City Hospital and was instead was trying to use them to convince an insurance company to add him as an in-network provider.

 

Here’s the finale of Vince and Elise’s series on physician practice vendors, this time looking at the “other” ones.


Sponsor Updates

Blog Posts


Contacts

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

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News 5/5/17

May 4, 2017 News 1 Comment

Top News

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The House votes 217 to 213 to repeal the Affordable Care Act, sending the American Health Care Act to the Senate. President Trump said afterward in a White House victory celebration, “We’re going to get this passed through the Senate. I feel so confident,” adding a promise that premiums and deductibles will go down.

No Democrats voted “yes,” while 20 Republications voted “no.” Two more “no” votes would have killed the bill. The House allocated 40 minutes for discussion before the vote.

The voting was held just before the House leaves for an 11-day recess. Congressional Budget Office scoring of cost and the change in the number of uninsured has not been completed.

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Just about every medical and consumer group urged rejecting the American Health Care Act, which would:

  • End Medicaid as an open-ended entitlement.
  • Give the wealthiest Americans a $300 billion tax break over 10 years.
  • Allow insurers to charge older citizens five times the premium rate of younger ones (increasing it from three times).
  • Allow states to eliminate the requirement that insurance companies issue policies without considering pre-existing conditions.
  • Eliminate the requirement that individuals buy insurance.
  • Remove the penalties for large employers who don’t want to provide insurance to their employees.
  • A change added to the bill in a last-minute amendment would allow states to remove the out-of-pocket maximums now required of employer-provided insurance.

The expected millions of people who would lose insurance under the proposal would leave hospitals at risk for providing their emergency care without payment since the Affordable Care Act reduced hospital Medicare payments on the assumption that more of their patients would be insured.

The Senate’s debate on the bill will begin in June.


Reader Comments

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From LongInTheTooth: “Re: Australia’s Telstra Health. You mentioned them as being shortlisted for an EMR tender in Northern Territory. After making over a dozen health IT acquisitions in the last few years, they have decided to trim down and focus solely on the Australian market. New Managing Director Mary Foley is trying to turn around a larger-than-required health vertical without a coherent strategy and has just announced a massive reorg which includes layoffs. Last week they sold their Arcus EMR business in Asia to private buyers. Their CTO Roy Shubhabrata (ex-Epic, GE Healthcare, Microsoft) couldn’t save the sinking ship. Another acquisition, Dr. Foster in the UK, is up for sale as well.” Telstra Health is a business unit of Telstra, the biggest telecommunications and media company in Australia.

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From Polite Patrician: “Re: Epic’s App Orchard. The site seems to be free of legal disclaimers. I’m wondering how the submission and approval process works.” I’ve heard concerns that Epic asks a lot of questions about submitted apps and could theoretically use that information to guide its own product development. Epic could also reject apps in claiming without proof that they encroach upon planned future Epic functionality. It seems farfetched to me that Epic would use App Orchard submissions to glean product enhancement ideas or that it would deny applications without a good reason, but at least some small companies seem to worry about that possibility. I’m interested in hearing (anonymously) from anyone who has experience in working with Epic on App Orchard since we’re otherwise just sitting around wringing our hands without facts.

From Old Relay Dev: “Re: McKesson. Sweeping layoffs in NewCo/Change starting last night.” Unverified. An anonymous post on TheLayoff.com quotes a claimed internal email indicating that 394 employees were let go along and 89 open positions were closed, predicting that another RIF will follow in June.


HIStalk Announcements and Requests

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HIStalk readers funded the DonorsChoose project of Mrs. F in Virginia, who asked for headphones for her kindergarten class. She reports, “During our group rotations, when students are not working with one of the teachers, then they are on the computer using a program that they sign into so that reading, word recognition, and spelling are at the student’s level. The headphones allow only the student who is on the computer to hear the program without distracting the groups the teachers are working with. The students on the computer are also not distracted by what the teacher is teaching. These headphones allow my classroom to run smoothly. The donors who help make my room complete are angels.”

This week on HIStalk Practice: Compulink develops all-in-one HIS solution for ASCs. MDLive CEO hints at the important role telepsychiatry will play in its future business model. NCQA develops Oncology Medical Home recognition program. Charlotte Eye Ear Nose & Throat rolls out Epic. Practice Velocity announces ownership changes. Change Healthcare helps Saltzer Medical Group transition to independence. Kerri Wing, RN of IHealth Innovations outlines the IPPS proposed rule’s peace offering to physicians.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Private equity firm Thoma Bravo will buy Lexmark’s enterprise software business — which includes Kofax, ReadSoft, and Perceptive Software – and will then sell the Perceptive business (image capture, vendor-neutral archive, and a universal viewer) to its portfolio company Hyland Software. The Kofax and ReadSoft businesses will be rolled into a new Thoma Bravo company under the Kofax name. Lexmark acquired Perceptive Software for $280 million in 2010, bought competitor Kofax in 2015, and then sold itself to a China-based investor consortium for $3.6 billion in 2016.

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Allscripts announces Q1 results: revenue up 20 percent, adjusted EPS $0.13 vs. $0.13 as GAAP earnings swung to a loss, meeting earnings and revenue expectations. Shares were unchanged early in after-hours trading and are down 9 percent in the past year.

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Germany-based CompuGroup Medical reports Q1 results: revenue up 5 percent, EPS $0.27 vs. $0.22. Share price has risen 20 percent in the past three months.

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Analytics vendor Inovalon reports Q1 results: revenue up 5 percent, adjusted EPS $0.07 vs. $0.05. Share price is down 22 percent in the past year, valuing the company at $1.8 billion.

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EHR prescription drug coupon vendor OptimizeRX reports Q1 results: revenue up 22 percent, EPS -$0.03 vs. –$0.01. OTC-listed shares are down 29 percent in the past year, valuing the company at $22 million.

Analytics vendor Koan Health buys ZirMed’s value-based care analytics business.

China-based insurer Ping An launches a $1 billion investment fund that will focus on overseas financial and healthcare technology. The company’s health Internet subsidiary, which offers free online doctor consultations, raised $500 million in a Series A round last year,valuing it at $3 billion.


People

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Patient engagement technology vendor Conversa Health hires Chris Edwards (Validic) as chief marketing and experience officer and Becky James (WebMD Health Services) as VP of operations.

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Phil Spinelli (Visiant Health) joins Ingenious Med as SVP/chief revenue officer.

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Kyruus hires Scott Andrews (Athenahealth) as SVP of delivery.

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AdvancedMD hires Greg Ayers (inContact) as CFO.


Announcements and Implementations

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Video visit vendor Doctor On Demand integrates its system with those of lab companies Quest and LabCorp, allowing its doctors to order lab tests and for its patients to choose a lab based on insurance coverage, availability, and location. The company — co-founded by TV psychologist Dr. Phil and his TV producer son – has raised $87 million in three funding rounds, although the largest and most recent was nearly two years ago. Among its investors are Athenahealth’s Jonathan Bush and Virgin’s Sir Richard Branson. It offers medical sessions for $49 along with ongoing psychology and psychiatry counseling.

In Australia, Pulse+IT reports that a Victoria-wide implementation of Epic did not receive funding in the state’s new budget.

Surescripts extends its real-time medication history service to long-term and post-acute care facilities.


Government and Politics

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The CEO of insurer Molina Healthcare – the son of the company’s founder who, along with his CFO brother, was fired Tuesday despite improved quarterly results – says his criticism of the Republican repeal-and-replace movement may have cost him his job. He says, “People are afraid of the administration. Why take an aggressive stance if you think you have nothing to gain, or if you think you have something to lose?” He adds, “The most troubling development has been the attempt to get votes from the Freedom Caucus by allowing states to get rid of the ban on pre-existing conditions … The Trump administration is destabilizing [the marketplaces]. Health plans need to plan ahead. He can pull the rug out from the health plans at any minute.” Molina shares rose 25 percent on the news as investors speculated that the company is now an acquisition target, having jumped 41 percent in the past year and 152 percent in five years.


Privacy and Security

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DataBreaches.net reports that an anonymous hacker is running a “summer sale” on his or her inventory of 500,000 recently stolen patient records from pediatric practices, offered at $3 per child. The site verified the validity of a sample of the records even though no cumulative breaches of that magnitude have been reported. The hacker, “Skyscraper,” says he or she simply searches for “patients,” adding that, “For some stupid reason, entire databases show up” and clarifying that the searches don’t involve the known weaknesses of IoT-connected devices or FTP servers. Asked what practices should do to protect themselves, the hacker says they need to pay for their software: “You wouldn’t believe how many of those offices run on cracked / downloaded software and outdated 2015 versions.” 

University of California regents sue several doctors and pharmacies, claiming that they defrauded the student health insurance of $12 million over six months by running Facebook ads offering students $550 to participate in phony clinical trials for a pain cream and recruited other students as sales reps for a drug “startup” at a campus job fair. The 500 respondents to both solicitations were required to provide their student health plan numbers, which the lawsuit claims were used to bill prescriptions for custom compounded, Ben Gay-like creams that cost the student health insurance up to $5,300 per tube. The prescribers did not examine the students, who were unaware that they were being billed for the creams. One podiatrist wrote 600 prescriptions for the creams in a single day, costing the system $1.7 million.


Other

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Ever-increasing patient cost-sharing has hurt the collection rates of medical practices, according to a Health Affairs article co-authored by Athenahealth’s Jonathan Bush that studied the company’s practice data. Patients paid around 90 percent of balances that were less than $200, but once they owed more than that amount, the figure dropped to 67 percent. The article also notes that collection rates are lower for specialists (because they charge more) and that practices must wait weeks to receive an EOB from the insurance carrier to find out what the patient owes, greatly reducing the chances of getting paid once the patient has left the office.

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An article in The Economist says that data rather than oil is the world’s most valuable resource, suggesting an antitrust evaluation of the companies that are profiting massively from it (Google, Amazon, Apple, Facebook, and Microsoft). It notes that access to consumer data gives those big companies an early warning (“a God’s eye view”) of potentially competitive upstarts that they can either copy or buy, highlighting Facebook’s $22 billion acquisition of 60-employee, zero-revenue WhatsApp in 2014. The article suggests that antitrust regulators look not only at company size when evaluating the consumer impact on a proposed merger, but also the extent of the data assets of the companies. It also proposes that companies be forced to let consumers know what information about them they hold and how much money they make from it; that governments open up their own data vaults; and that countries require at least some industries (as is being done with banks in Europe) to share their customer data with third parties.

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A Wall Street Journal article examines whether public outcry over a company’s $89,000 drug (previously sold for $1,200) forced that company to sell the drug to yet another company and effectively put itself out of business. Marathon Pharmaceuticals bought a old UK muscular dystrophy drug, paid $370,000 to buy study data from universities, researchers, and the Muscular Dystrophy Association that it used to earn FDA approval, then set an $89,000 per year US price. The CEO’s previous company bought another rare disease drug and upped the price from $289 per vial to $1,950, a formula it repeated in buying “under priced” drugs from big companies and increasing US prices by an average of 500 percent. He made $60 million when he sold the company for $900 million. He expected to sell the current company, Marathon Pharmaceuticals, for several billion dollars before the pricing backlash, but even though he fell short, the company received $140 million in cash and stock, 20 percent of future sales revenue, and a potential $50 million payout, all  thanks to 20,000 young boys afflicted with Duchenne muscular dystrophy.

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A survey of 800+ health IT workers (two-thirds of them consultants, most of them working on Epic) finds that 86 percent of them feel optimistic about their career opportunities and nearly half say they make $100,000 or more per year. The most important factors in deciding whether to accept a contract are pay, company reputation, and the expense reimbursement model, with the least-important factor being the ability to work from home. Interestingly, two-thirds of consultants would consider a full-time role, which represents a huge jump over surveys from previous years, although salary expectations seem to be a barrier given the tiny number of respondents who say they’re willing to take a pay cut.

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Wilkes Regional Medical Center (NC) will convert from McKesson Paragon to Epic as its lease is turned over to Wake Forest Baptist Medical Center on July 2, when it will be renamed to a name that will surely almost never be used in its entirety, Wake Forest Baptist Health – Wilkes Medical Center.

An interesting study finds that parents who Google the symptoms of their child are much more likely to question their pediatrician and seek a second opinion because they don’t understand the differential diagnosis process the doctor used. The author suggests that physicians explain how they arrived at their diagnosis during the office visit to avoid treatment delays caused by patient second guessing.

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Vending machines are offering $4 HIV test kits as part of a government pilot project in China, where people often don’t undergo testing because homosexuality — and with it, HIV and AIDS — are taboo subjects and hospitals reportedly regularly turn away HIV/AIDS patients even though the law forbids such discrimination.

Weird News Andy says 50-times-faster brain surgery is fine as long as it isn’t done half-fast. University of Utah develops a robotic, CT-mapped surgical drill that may reduce surgery time from two hours to 2.5 minutes, although it hasn’t actually been tested on humans.


Sponsor Updates

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  • Impact Advisors delivers 200 backpacks filled with craft supplies and games to patients of Florida Hospital for Children.
  • EClinicalWorks will exhibit at the 2017 ASCA Annual Meeting May 3-6 in Oxon Hill, MD.
  • Nuance recaps recent hospital sales of its computer-assisted physician document system and publishes a new report titled “CAPD 2017: Improve physician documentation at the point of care.”
  • Evariant will host its third annual Converge User Conference May 7 in Austin.
  • ECG Management Consultants will present at the 2017 ASCA Annual Meeting May 4 in Oxon Hill, MD.
  • An Emory University research study finds cost savings for CABG surgery, supported by Glytec’s Glucommander for personalized insulin dosing.
  • The HCI Group publishes “Selecting the Right Interface Engine – Top 5 Considerations.”
  • Healthcare Growth Partners supports the sale of Clockwise.MD to DocuTap.
  • Imprivata will exhibit at the Canada Collaboration Forum May 8-10 in Whistler, British Columbia.
  • Influence Health releases a new whitepaper, “Healthcare Consumer Experience in 2017.”
  • InterSystems will exhibit at the Blue Cross Blue Shield National Summit May 9-12 in Orlando.
  • Kyruus publishes “Health System Call Center Experience Report: Are Top Health Systems & Hospitals Answering the Call to Provide a Better Patient Experience?”
  • Liaison Technologies begins accepting applications for its new Data-Inspired Future Scholarship.
  • NVoq will exhibit at the MGMA NE conference May 10-12 in North Falmouth, MA.
  • Experian Health will present at HFMA Eastern Michigan May 12 in Livonia.
  • Wellsoft will exhibit at the Rural Health Conference May 9-12 in San Diego.

Blog Posts


Contacts

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

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News 5/3/17

May 2, 2017 News 9 Comments

Top News

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Computer systems at University Hospitals (OH) remain down following unspecified connectivity issues that started Monday.

Hospital executives say the lack of computer access is not affecting patient care.


Reader Comments

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From Nantwatcher: “Re: NantHealth. President Robert Watson has been separated, effective immediately. Co-Presidents Mark Dudman and Gary Palmer, MD are also gone.” The company hasn’t responded to my inquiry. However, those three folks have been expunged from the company’s leadership page. The year-ago cache of that page shows that of the eight executives listed then, only three remain – the CFO, chief people officer, and general counsel. The LinkedIn pages of Watson and Dudman remain unchanged, but that of Gary Palmer – NantHealth’s chief medical officer and president of its GPS Cancer division – says he left in January and is now chief medical officer of genomic sequencing and analytics vendor Tempus. The slide in NH share price continues – it’s down 40 percent in the past month and 85 percent in the 11 months since the company’s IPO.

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From Conjoined Triplet: “Re: Huron Consulting. Completed its fifth round of layoffs in two years Friday, this one targeting revenue cycle and technology consulting teams. They paid $30 million to acquire Vonlay three years ago and there’s hardly anyone left on the Epic team.” Unverified. The company hasn’t responded to my inquiry. Huron’s earnings and revenue beat expectations in Monday’s quarterly report, but CEO James Roth said in the earnings call that healthcare revenue (52 percent of the company’s total) was down 14 percent, mostly due to “softness in our revenue cycle offering within the performance improvement solution” as projects shifted to smaller engagements. He says that Huron “will continue to make adjustments in our cost structure to manage our profitability in this segment.” Shares rose Monday following the earnings announcement before the market’s opening, but are still down 19 percent in the past year.

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From Seal Flipper: “Re: speaking invitation. Check out this health IT magazine’s ‘invitation’ to pay to speak at its conference.” I can’t say I’m shocked that revenue-desperate health IT sites are brazenly selling pay-for-play article space on their sites and speaking slots at their conferences, no doubt encouraged by the similarly commercial behavior of HIMSS. I can only assume that providers will eventually wise up that they’re being fed vendor commercials and will push back, especially if the underlying content isn’t very good.

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From Kermit: “Re: algorithms. This comic makes me think of all the non-HIT firms that have jumped into HIT thinking they can ‘solve’ healthcare with their years of business experience.” There’s an uneasy tradeoff (in healthcare, politics, the arts, and other endeavors) in bringing in a fresh set of outsider eyes that can provide either: (a) brilliant insight and fresh inspiration; or (b) embarrassingly inept floundering while confidently trying to use a hammer to pound in a screw.

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From Jump Back: “Re: HIMSS. Their buy one-get one offer seems to be a sign of trouble in paradise.” I think it’s probably a sign that HIMSS members fuel its revenue not by paying dues, but rather by making themselves available as a target for big-vendor marketing. That was made clear when HIMSS announced its Organizational Affiliate program years ago in which everybody in a participating company can join at no incremental cost. The “Ladies Drink Free” model makes HIMSS a fortune as an intermediator and explains why they cater to vendor members and exhibitors rather than employees of non-profit health systems. I’m not sure there’s much value in joining HIMSS (and thus directly supporting some of its questionable behaviors) other than to earn a discount on the annual conference registration.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Mrs. B in Washington, who asked for building blocks for her kindergarten class. She reports, “The kids were over the moon about them, and though we don’t know who you are, they all think you are the best ever. While they are just thinking about playing, these skills (persistence, trying even when something goes wrong, working in a team, asking for help) learned in play now can help support them in the future in math classes, science classes, reading, and in their relationships. Now that is a lot from just a few more sets of toys! This is something I couldn’t have provided my kids without your support and I hope you understand how overwhelmingly grateful I felt when I got the email that said this project was funded (it actually came Christmas morning). Thank you so much, again.”

I tested my new cheap phone’s speed over AT&T’s cellular network and was shocked to see 60 Mbps down and 15 Mbps up. I got the same result testing in different locations on different days, all while connected via VyprVPN. Perhaps I missed some mobile speed developments while using my ancient iPhone 5 that I bought when LTE had just been rolled out.

Replacing my old phone was my #1 priority, while replacing my equally old laptop was #2. I ordered one from Amazon at a great price, but it was delivered yesterday with a giant gash in the package and a cracked display (thanks, US Post Office). I had the issue resolved in a couple of minutes – click Return on the online order on Amazon.com, provide a reason, choose refund or replacement, and print a UPS-paid return label (or schedule a free pickup). Today I got an apologetic email from Amazon’s Akshay, who fast-tracked my replacement to two-day shipping, passed my problem on to “the higher authorities at Amazon,” and wished me “a beautiful day.” You want to know why Amazon is killing retailers, look no further.

I’m enjoying the responses to my “best career advice” survey, so much so that I’m encouraged to remind you to respond if you are so inclined. 


Webinars

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

Here’s the recording from last week’s HIStalk-sponsored webinar, “3 Secrets to Leadership Success for Women in Healthcare IT,” presented by Nancy Ham (WebPT) and Liz Johnson (Tenet Healthcare).


Acquisitions, Funding, Business, and Stock

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India-based outsourcing firm Infosys will hire 10,000 Americans over the next two years and will open four technology and innovation hubs, the first in Indiana. Perhaps the company hopes everyone will forget that it paid $34 million a few years back to settle charges of widespread US immigration fraud. Several offshore companies, worried about President Trump’s “Hire American” policies, have announced similar hiring programs, although experts question whether the highly publicized plans will ever materialize.

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The board chair of EpiPen maker Mylan was paid $164 million last year, will receive $1.8 million per year now that he’s no longer an employee, and was given another $37 million worth of stock. Even though he’ll remain as board chair, he received a $22 million termination benefit, including $4.6 million to use the company’s jets for three years. I tried listening to music by his son Tino Coury, who is signed to the record label owned by good old Dad, and it’s really no better or worse than most of the other imitative, sterile, computer-enhanced dance music out there. Dad was caught in 2012 using Mylan’s jets to haul Tino around to concerts, but that shouldn’t be an ongoing problem since Tino’s musical career seems to have died young.

Baptist Memorial Health Care (TN) and Mississippi Baptist Health Systems (MS) complete their merger to form a 21-hospital, 16,000-employee health system. The president and CEO of Mississippi Baptist says, “With the cost of technology, it makes sense to spread that over 22 hospitals.” Baptist’s Epic system is being installed at Mississippi Baptist.

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The Chicago business paper profiles 13-employee care coordination software vendor PreparedHealth, which just raised $4 million in its first significant funding round. The co-founders came from Medicity.


Sales

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Athenahealth chooses electronic prescribing legal updates from Point-of-Care Partners to ensure its compliance with state laws.

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HealthlinkNY selects Diameter Health for normalizing, de-duplicating, and enriching clinical data to enable interoperability and allow the HIE to advise members on the quality and completeness of their clinical documents.


People

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The board of UMass Memorial Health Care (MA) elects health IT entrepreneur Rick Siegrist, MS, MBA as chairman. He founded decision support vendor HealthShare Technology (sold to WebMD in 2005 for $31 million) and PatientFlow Technology (sold for an unstated price to Press Ganey in 2009, who made him CEO).

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Medicare and Medicaid fraud detection software vendor MedicFP names board chair and private equity firm owner Ruben Jose King-Shaw, Jr. to the additional role of CEO. He was formerly secretary of Florida’s AHCA and deputy administrator and COO of CMS. The company offers biometric identity validation.

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LifeBridge Health (MD) promotes Jonathan Ringo, MD to president and COO of Sinai Hospital of Baltimore. He joined health system in 2014 as its first CMIO. 


Government and Politics

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ONC announces a $75,000 patient matching algorithm challenge, apparently giving up on the idea of a national patient identifier that would make such fuzzy logic necessary.


Innovation and Research

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Johns Hopkins University’s venture arm opens FastForward 1812 — the latest of its several business incubator locations — which will support companies hoping to create products based on Hopkins patents and licenses. Baltimore-based EHR security vendor Protenus was launched in the original FastForward.

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MIT researchers develop WiGait, a wall-mounted sensor that can measure the stride length of multiple people over time to potentially detect injuries and gait-affecting conditions such as Parkinson’s disease


Other

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Friends and family members of patients in 150 NHS hospitals are forced to pay per-minute charges to call their rooms, which includes having the meter running while listening to a 70-second-long “please be patient” message. The government outsourced phone services to in-room entertainment vendor Hospedia, which says it uses a third party’s service that allows it to give each patient’s room its own telephone number instead of being routed through the nursing station.

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In England, five hospitals of Barts Health NHS Trust are cancelling surgeries and chemo treatments after the failure of its radiology, PACS, dictation, and chemotherapy systems. A hospital manager’s email said cancer teams had to rebuild patient records from scratch. Systems were restored Tuesday after being down for 11 days. Barts declined to describe the cause of the problem, but previously had major downtime in January caused by a Trojan malware attack

In Australia, Northern Territory budgets $60 million for the first year of its $195 million clinical systems replacement project, for which it will name a prime contractor this month from the short list of Telstra Health, Epic, Allscripts, and InterSystems.

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A study published in Health Affairs finds that high-priced medical practices – which charge an average of 36 percent more than low-priced ones – offer better care coordination and management, but don’t perform any better in overall care ratings.

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Weird News Andy concludes that in not focusing on the job at hand, “Now he’s broker.” Miami-based OB-GYN Ata Atogho, MD is hit with a $34 million malpractice lawsuit judgment for a series of mistakes he made in the delivery of a baby who was born with brain damage, one of which was to disappear from the mom’s room for eight minutes to consult with his stockbroker.


Sponsor Updates

  • LogicStream Health will host a happy hour Tuesday at The Great Dane Pub in Madison, WI during Epic XGM 2017.
  • Spok releases part two of its mobility in healthcare survey report.
  • Optimum Healthcare IT renames its go-live support application GoLiveSupport.com as Skillmarket.
  • CenTrak launches a charitable program to provide enterprise location services to cancer centers, with Vidant Medical Center (NC) the first participant.
  • Mediware will integrate CoverMyMeds electronic prior authorization into its CareTend specialty pharmacy software.
  • The Milwaukee Journal Sentinel names Nordic to its Top Workplaces for 2017.
  • Aprima Medical Software receives the 2017 United States Frost & Sullivan Award for Product Leadership.
  • Arcadia Healthcare Solutions publishes a Quick Guide on “Identifying Childhood Immunizations.”
  • AssessURhealth wins the GE Health Cloud Innovation Challenge.
  • Datica CEO Travis Good, MD will speak at the HITRUST Annual Conference May 8-11 in Dallas.
  • Besler Consulting releases a new podcast, “Coding clinic updates for first quarter 2017.”
  • CCSI employee Keith Yourg earns PMP certification.
  • Bottomline Technologies reports Q3 results.
  • Casenet announces the speaker lineup for its Connect event May 8-10.
  • CoverMyMeds will exhibit at the Oncology Nursing Society Annual Congress May 4-7 in Denver.
  • Direct Consulting Associates will exhibit at eMUG: Michigan User Group May 9 in Ypsilanti.
  • Diameter Health contributes to record growth at the University of Connecticut’s Technology Incubation Program.
  • The Virginia Chamber of Commerce includes Divurgent in its annual list of fastest-growing companies.

Blog Posts


Contacts

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

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Monday Morning Update 5/1/17

April 30, 2017 News 1 Comment

Top News

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From the Athenahealth investor call, which follows disappointing revenue and earnings quarterly results that sent shares down 19 percent Friday:

  • CFO Karl Stubelis blamed the miss on lower-than-expected claims. lower collection volumes, and slow onboarding of new customers.
  • The company lowered revenue, earnings, and bookings guidance for the fiscal year and expects a lower operating margin for 2017.
  • Jonathan Bush says office visits and payment per visit are both down for the first time, bucking the trend caused by hospitals buying practices and increasing their prices. He attributes the drop to consumer uncertainty around the Affordable Care Act and higher deductibles that consumers are unwilling or unable to pay.
  • Bush said, “When we get into a meeting with a prospect and that prospect decides to do something, 80 percent of the time they go with Athenahealth. That doesn’t suck. That does not suggest retrenching, going to cash flow, ceasing the entry of the hospital market. It suggests breathing into the beating until things get better, which we believe they will.”
  • Bush says the company had planned for doubled customer attrition for the year after its rollout of the Streamlined clinical product, but Net Promoter Scores have since rebounded.
  • The company was not considered in some deals due to its lack of a viable inpatient product, but Bush expects that to change as it expands its inpatient EHR, which he describes as, “For a one-year-old product, kicking ass” that more than pays for itself with elimination of capital expenditures and an improvement in collections.
  • Future drivers of what Bush says will be a restored higher growth rate are improved scalability of the inpatient product implementation, a cost guarantee for doctors, and automating practice tasks beyond previous government-mandated functionality.
  • Bush disagreed with an analyst’s slightly combative observation that the company’s guidance is aspirational and often at odds with actual results, thereby reducing investor confidence, saying, “While our goals remain ambitious, our guidance is something that we think is a balanced handicapping of what we think will actually happen on the field. My goals, my team, the guys who are out there in the field still think they can get this number, but they’re not prepared to reassure you in that regard … One thing we all took for granted is that Athena would know its revenue a year out … The one place that we all need to get our confidence back is understanding the activity in the practice. And believe me, we’re studying it.”
  • Bush concluded the call with, “Metamorphosis hurts. We’re feeling the crunch of several coming-of-age moments all at once here at Athenahealth. Attrition hangover from last year’s Streamlined rollout and the customer service issues, adjustments to Trumphealth from Obamahealth, a totally new guard at our senior management team, a tale of employee disruption from the change to it. Adjusting guidance hurts us, but it’s mostly the shame of coming to grips with that hurt. Our strategy is right, our traction against our challenges is better than ever, and optimism at the senior-most levels of this company is at an all-time 20-year high. Hence we enter execution mode.”

Reader Comments

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From Carrot Bottom: “Re: MUMPS. Curious, you mentioned a blog post about developers complaining about MUMPS. It wasn’t very long after your post that you changed the link from Hacker News to some academic professor’s personal wiki on MUMPS. Now when I go to the original Hacker News link, it also has been taken down. Were you pressured to remove this information by an unknown legal team from Wisconsin?” I didn’t change the link in my original post from Hacker News and that link still works. However, in trying to figure out what you are referring to, I noticed that Lt. Dan (who writes the daily headlines) inadvertently used a different link in his headline. I actually didn’t get any private feedback on that post.

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From Harry Angstrom: “Re: Jonathan Bush’s Instagram. This was quickly removed a few minutes later.” Unverified. The screenshot shows JB’s comment to Friday’s huge ATHN share price drop as, “K Thanks Bye.” Regardless, his other photos provide a glimpse into what life is like being raised rich and living hyperactively smart and quirky (like being one of a tiny number of trust fund kids to commendably serve in the Army).

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From Causative Agent: “Re: charity for sale. Given your stance on charities, I thought you would find this highly offensive and in-your-face advertisement interesting.” An unnamed Dallas charity offers itself for sale for $2.4 million, urging prospects to “do the math” since they can “legally keep $200,000 as a salaried director.” Beyond enriching the new owner, the charity sends handicapped children to Orlando theme parks “and helps other charities as well,” with the owner helpfully suggesting expansion via new fundraising offices, telethons, squeezing business for donations, and running galas. I couldn’t figure out which charity it is, but I’d be curious about its reviews on Charity Navigator, Guidestar, and CharityWatch. Most surprising to me is that somebody can just “sell” a charity to whomever ponies up the cash, although I supposed the owner can simply install the buyer as board director and then resign even though the assets can’t be transferred short of a merger with another non-profit. For that reason, paying $2.4 million to buy a $200K job seems like bad financial planning, and hopefully the new owner will reap what they sow. 

From Soiled Skivvies: “Re: suck-up writers. This writer lost objectivity and it’s obvious they were star-struck.” Much of the health IT content out there is written by newbies, underachievers, and raging introverts who are way too easily influenced by the phony, smarmy charm of some Type A industry bigwigs who turn it on knowing they’ll get uncritically positive PR as a result. It’s kind of like being that cubicle-bound programmer who mistakes minor casual exposure to the boss as newfound social acceptance. The inhabitants of mahogany row did not ascend to the throne being unaware of the org chart caste system and they are not like you. Which is probably OK since someone has to have the swagger, however misplaced, to get everybody else to follow orders.


HIStalk Announcements and Requests

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Poll respondents predict that the VA’s biggest problem if it decides to implement Cerner or Epic will be budget overruns, with lack of internal resources being another potential problem. Red Tape goes with “none of the above” in predicting that governance and bureaucratic decision-making will create an impossible struggle to stay on track. Daddio62 warns Cerner clients that if the company wins the deal, it will pull their experienced consultants off to the VA and replace them with greenhorns. Art Vandelay (welcome back, Art) says VistA was built around requirements that have no equal in the rest of the healthcare world and says user acceptance of a COTS will be a problem, possibly requiring a wrapper solution around the core product to support the VA’s unique needs. Cerner User also warns of the limited availability of skilled Cerner consultants and the pressure on the VA to increase productivity that will conflict with clunky software workarounds that reduce productivity.

New poll to your right or here, based on a reader’s comment: Have you ever bypassed your insurance and paid cash to choose a better ongoing PCP? It’s often depressing to have to settle when choosing a new PCP from your insurance company’s provider list (which is usually not only outdated, but fails to note that most of the docs listed aren’t taking new patients for their particular low-paying plan). You are often out of luck if you want a doctor who’s been out of school long enough to not be dangerous yet who isn’t past normal retirement age; one who attended a decent US medical school and residency; or a PCP whose Healthgrades reviews are better than appalling. In other words, you might not want to join a club that would accept you as an insurance-wielding member, while plopping down cash opens up endless (but expensive) possibilities. I suspect most of us just grit our teeth and choose the best-sounding of the substandard choices who will accept our insurance.

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We funded the DonorsChoose grant request of Mrs. R in California, who asked for egg shakers and a rhythm set so her elementary school students can have fun with music as a break between tough subjects. She reports, “We have Fun Friday every week and I have been able to give a small music and rhythm class using the instruments and shakers. It is a hit! The students love it! Sometimes we make our own music and sometimes we follow along to child-friendly versions of today’s radio hits. Other teachers have noticed the fun and have borrowed the instruments and shakers to enjoy with their students. It has been a true blessing to have the instruments and shakers as a stress reliever for both the students and myself!”


This Week in Health IT History

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One year ago:

  • Nokia announces plans to acquire consumer health device vendor Withings to create Nokia Digital Health.
  • CMS releases the warning letter it sent to Theranos in which it stated that, “The laboratory’s allegation of compliance is not credible.”
  • Verks Analytics agrees to sell its Verisk Health business to Veritas Capital for $820 million.
  • Caradigm quietly announces that Microsoft has sold its 50 percent stake in the company to JV partner GE Healthcare.
  • A science publication questions the privacy and exclusivity terms contained in the agreement between NHS and Google’s DeepMind.
  • Quintiles merges with IMS Health.
  • Joint Commission gives its OK (later reversed) to send orders via text messaging.

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Five years ago:

  • Allscripts shares lose more than one-third of their value following announcements of poor quarterly results, the departure of its CFO, the firing of board chair Phil Pead, the resignation of three board members who supported firing Glen Tullman, Tullman’s erratic defense of his performance in the investor call, and the company’s loss to Epic in two UK decisions.
  • Merge Healthcare shares shed 36 percent on poor quarterly results, with the company announcing that it will divide itself into two operating divisions, the traditional Merge imaging business led by Jeff Surges and a consumer kiosk and clinical trials division under Justin Dearborn.
  • Chicago Mayor Rahm Emmanuel pressures the state’s attorney general to back off its investigation of Accretive Health’s strong-arm patient collection tactics.
  • New health system CIO hires include Jocelyn DeWitt (University of Wisconsin Health) and Pamela Banchy (Summa Western Reserve Hospital).

Weekly Anonymous Reader Question

I asked readers to who have either considering quitting HIMSS or who have actually done so what motivated them:

  • Almost useless organization. What Epic has done to hospital IT cost should never have happened. HIMSS needs to be more than a vendor show.
  • Simply cost vs. benefit. HIMSS motives are suspect anyway.
  • Annual conference was my main involvement. It’s gotten too big to be useful. One cannot do anything of substance on the exhibit floor. Classes have been good, but it’s just too much. I’d rather be involved in a more focused group, like ATA (telemedicine) or something like that. Cramming it all into one show dilutes things.
  • I have been an individual member for over 20 years. No longer! Not continuing membership or attendance at national events. HIMSS is just about money, vendors, and more money. But the main reason is association with Federal government and DOD has taken over focus. Government nerds are not technological leaders. They have nothing to offer healthcare technology … boring bunk. Finally just bored with the agenda.
  • Increasing irrelevance ever since HIMSS changed from a member-driven org to a "mission"-driven one. Individual members have little impact or recognition, even those who donate numerous hours on committees. Smaller specialty associations provide more return on the membership fee. Also hard to justify the annual conference cost when the only value is networking.
  • Retirement.
  • I considered quitting until I changed my expectations from education and knowledge acquisition to it being a huge shopping mall. It fits that bill, not the other. It’s a reasonable way to keep in touch with product domains.
  • It has become such a racket. It has become nothing more than a vendor forum, which is very disappointing.
  • I left HIMSS about 15 years ago because: (a) the organization became exceedingly political with no requests for input from members, and (b) the focus shifted from users to vendors and thus had little value to me.
  • I did not renew in 2017 because of the increasing power of the vendor. The last straw was that the head of my state chapter was a vendor who behaved very badly in my organization (e.g. contacted board members when he didn’t get what he wanted from me). I prefer CHIME over HIMSS because I don’t feel like I’m a sales target every time I am on a phone call or in a meeting.
  • Haven’t quit yet, but working at an HMO presently, I don’t see a lot of value in HIMSS other than interacting with members from the provider side. While that is of great value to me, over half of the new people I meet are consultants or contractors.
  • The cost outweighs the benefit.
  • HIMSS educational and networking offerings had value for me early in my career. Now, I have experience in the field and am not a decision-maker in IT investments. HIMSS repeats the same "Informatics 101" and "Learn about TIGER!" webinars every quarter and they seem to be efforts to market products rather than educate members. I don’t know if this is a change from past years, if I was less aware of the context in early days, or if I’ve just grown old and jaded. Now I only renew membership in years in which my employer sends me to the annual conference, since registration + membership is more affordable than registration as a non-member. Otherwise, I see no return on the investment. I’d rather pay membership dues to AMIA.
  • Former HIMSS member here. I quit because as an IS analyst supporting the revenue cycle side of operations, the HIMSS focus is clinical. I wasn’t seeing the value.
  • Too much focus on vendor revenue.
  • Worthlessness of HIMSS CPHIMS certification. They sell it relentlessly but don’t even support it with networking at the annual conference or advertising to employers.

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This week’s question: What’s the best career advice you’ve received that goes beyond the usual platitudes? In other words, not just “work hard, learn, market yourself” and other obvious recommendations.


Last Week’s Most Interesting News

  • Greenway Health is hit with a ransomware attack that affects customers of its hosted Intergy systems.
  • Cerner announces good quarterly results., while Athenahealth shares drop sharply on missed earnings and revenue expectations.
  • Leapfrog Group’s hospital patient safety participants report nearly universally available bar code medication administration scanning systems, but with inconsistent usage.
  • The Coast Guard issues an RFI for an EHR following its failed attempt to implement Epic.
  • Ambulatory EKG monitoring services vendor CardioNet pays $2.5 million to settle HIPAA charges following the 2012 theft of an employee’s laptop.
  • The Trump administration dismisses US Surgeon General Vivek Murthy, replacing him in interim with Deputy Surgeon General Rear Admiral Sylvia Trent-Adams, who is a nurse.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Meditech announces Q1 results: revenue flat, EPS $0.39 vs. $0.51. Product and service revenue were both basically unchanged over Q1 2016.

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From the earnings call of Cerner, whose Q1 results beat expectations for both revenue and earnings and sent shares up 8 percent Friday:

  • Domestic revenue increased 13 percent, while non-US revenue was basically flat excluding currency fluctuations.
  • The company noted several wins over Epic, which it says is in a defensive stance following more coverage of its client cost overruns.
  • Cerner says its advantages over Epic are predictable total cost of ownership, more modern architecture, better ability to demonstrate value, and strong population health management capabilities.
  • The company says its Department of Defense work “is making Cerner better” in ways that will benefit all of its customers, adding that the remaining three DoD pilots are on track .
  • President Zane Burke says IT is the best way to drive down cost, which hasn’t been addressed by either party’s healthcare platforms that focus instead on access and insurance reform.
  • The company sold no new ITWorks IT management contracts in the quarter, but expects record sales of that product in 2017 as larger health systems conclude that some aspects of IT aren’t their core business.
  • Burke declined to specifically say if Cerner is taking ambulatory business from Athenahealth, saying only that, “We’re taking share from all competitors.”
  • Burke also declined to provide an update to previous comments that Cerner is seeking a CRM partner.

Sales

In the UK, Burton Hospitals NHS Foundation Trust expands its agreement with Summit Healthcare following its Meditech 6.1 go-live to include continued management of interface strategy, education, modifications testing, and developing additional interfaces as needed.


Decisions

  • OhioHealth Mansfield Health (OH) switched from Infor to Oracle PeopleSoft supply chain management in December 2016.
  • Franklin Memorial Hospital (ME) will replace Meditech with Epic in 2018.

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


People

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Nordic promotes Vivek Swaminathan to president of its managed services division; Katherine Sager to EVP of consulting services; and Matt Schaefer to EVP of strategic services. 


Other

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In Canada, 15 internists at Nanaimo Regional General Hospital go back to paper medication ordering in defiance of Island Health’s mandated use of its Cerner system dubbed IHealth. Doctors have long complained that the system causes medication errors. One of the internists was given a one-day suspension and another faces disciplinary action. The hospital says it can’t support paper orders and therefore has assigned other doctors to enter their paper orders into the EHR. Island Health previously tried bribing doctors to use IHealth, while the hospital’s ICU and ED doctors had gone back to paper in May 2016 — nine weeks after rollout — because of patient safety concerns. Island Health shut the CPOE system down in February 2017 following a 75 percent no-confidence vote by the medical staff, but restarted it a month later in saying it is too connected to other systems remain offline.

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University of Utah Health Care CEO Vivian Lee, MD, MBA resigns after she fired its cancer center director by email and following her acceptance of questionably motivated donations from NantHealth’s Patrick Soon-Shiong. Billionaire donor and cancer survivor Jon Huntsman’s threat to withhold his planned $250 million donation to the cancer center named after him forced the university to reinstate the fired director and to rearrange the org chart so that she reports directly to the university’s president. Huntsman called Lee a “one-person wrecking crew” and “the least ethical, least disciplined woman in the world.” Meanwhile, Utah House Speaker Greg Hughes has asked state auditors to review Soon-Shiong’s $12 million donation – which a STAT report suggested came with strings attached in requiring the university to buy products from his various companies – to determine whether a formal state audit is warranted.

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NBC News covers the often expensive consumer confusion between doc-in-the-box urgent care centers and freestanding emergency rooms, highlighting the case of a mother who pulled in what looked like a retail clinic in getting antibiotics for her daughter’s chest infection that ended up costing her $1,700 (later reduced to $1,000). She was flabbergasted when her insurer told her that PrimeCare Emergency Center is actually an ED, replying, “It was next to a nail place!” The report says 35 states allow freestanding ERs, most of them as off-campus hospital locations, but some are operated by for-profit companies. A class action lawsuit claims that now-bankrupt Adeptus Health, which runs 99 freestanding ERs, intentionally tricks patients into thinking they’ve entered a cost-effective urgent care center. A couple who took their child to an Adeptus ER racked up a $7,700 bill for an X-ray and pain reliever for what turned out to be constipation. 

Here’s Vince and Elise with their HIS-tory of the top 10 physician practice EHR vendors. 


Sponsor Updates

    • QuadraMed, a division of Harris Healthcare, will exhibit at the CHIMA Annual Meeting May 4-5 in Westminster, CO.
    • The SSI Group will exhibit at LA HFMA Annual Institute April 29 in Lafayette, LA.
    • SK&A publishes the “2017 Guide to Effective Email Marketing.”
    • GE Healthcare partners with Partnerships for Affordable Health Access and Longevity to address the healthcare needs of underserved communities in India.
    • Sunquest Information Systems releases a video celebrating Medical Laboratory Professionals Week.
    • Surescripts will exhibit at the annual Health Plan and Payer Summit April 30-May 4 in Washington, DC.
    • Wellsoft will exhibit at Emergency Medicine Update May 3-5 in Toronto.
    • ZeOmega will host its annual client conference May 2-4 in Plano, TX.
    • ZirMed will exhibit at ASCA 2017 May 3-6 in Washington, DC.

    Blog Posts


    Contacts

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

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    Reader Comments

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