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Curbside Consult with Dr. Jayne 12/5/16

December 5, 2016 News 2 Comments

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

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

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

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

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

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

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

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

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

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

Email Dr. Jayne.

Monday Morning Update 12/5/16

December 4, 2016 News No Comments

Top News

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


Last Week’s Most Interesting News

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

Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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


People

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


Decisions

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

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


Announcements and Implementations

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

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


Privacy and Security

From DataBreaches.net:

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

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

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


Innovation and Research

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


Sponsor Updates

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

Blog Posts


Contacts

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

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News 12/2/16

December 1, 2016 News 3 Comments

Top News

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

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

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

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


Reader Comments

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

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


DonorsChoose Updates

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

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

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

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

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

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


HIStalk Announcements and Requests

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

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

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

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


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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


Sales

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


People

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Greg White (Allscripts) joins PerfectServe as COO.


Announcements and Implementations

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

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

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

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

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

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


Government and Politics

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


Privacy and Security

From DataBreaches.net:

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

Innovation and Research

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


Other

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

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


Sponsor Updates

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

Blog Posts


Contacts

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

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Morning Headlines 12/1/16

November 30, 2016 News No Comments

21st Century Cures seeks multiple health IT policy improvements

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

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

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

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

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

Value-based Care Prompts Glass to Grow Up

November 30, 2016 News No Comments

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

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

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

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

From Pipe Dream to Readmissions Reducer

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

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

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

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

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

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

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

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

Following in the Smartphone’s Footsteps

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

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

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

Opening Up Use Cases

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

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

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

With Scale Comes Management Concerns

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

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

The Cybersecurity Question

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

The Future

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

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

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

News 11/30/16

November 29, 2016 News 3 Comments

Top News

12-16-2011 10-57-52 PM

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

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

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

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

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

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


Reader Comments

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

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


HIStalk Announcements and Requests

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

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

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

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

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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


Sales

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

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


People

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


Announcements and Implementations

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

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

Phynd releases version 2.0 of its Unified Provider Management system.

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

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

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

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

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


Government and Politics

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

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


Privacy and Security

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

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


Innovation and Research

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


Technology

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


Other

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

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

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

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


Sponsor Updates

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

Blog Posts


Contacts

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

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Monday Morning Update 11/28/16

November 27, 2016 News No Comments

Top News

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The European Union Agency for Network and Information Security makes security recommendations for “smart hospitals” that rely on interconnected IT assets, especially those that are based on the Internet of Things, recommending that they:

  • Establish effective enterprise governance for cybsersecurity, including performing a cost-benefit analysis for IoT components, developing a BYOD and mobile device policy, and identifying how each component connects to other components or to the Internet.
  • Implement state-of-the-art security such as smart firewalls, network monitoring, intrusion detection, encryption, and authentication and authorization.
  • Publish IT security requirements for IoT components.
  • Create a community for hospitals to share security information.
  • Have an independent firm to conduct penetration testing and auditing.
  • Support the adoption of information security standards by hospitals and have hospitals certified by independent experts as meeting those standards.

HIStalk Announcements and Requests

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LinkedIn dwarfs other social media sites for professional use by poll respondents, with Twitter coming in a far-distant second. New poll to your right or here: how interested are you in health IT news from outside the US?

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

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It must be end-of-year housecleaning – I know of at least three companies that have quietly replaced their CEOs in the past couple of weeks. Announcements will be forthcoming, I assume.

Listening: new from New Zealand-based No Wyld, which crafts darned good haunting, catchy hip-hop rock. I’m also desk-drumming to the new release from Finland’s legendary rockers Remu and the Hurriganes, which has played no-nonsense, American-sounding, pre-Beatles bluesy rock and roll since 1971.

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HIStalk reader Mike left health IT eight years ago, but still reads regularly to stay in touch. He sent a $500 donation to my DonorsChoose fund, which was magically magnified by matching money to fund these teacher grant requests:

  • An iPad videography kit for documenting the engineering design process in Mr. C’s middle school class in San Jose, CA.
  • Two tablets for Mrs. M’s second grade class in Newport News, VA.
  • A programmable robot for the library of Mrs. E’s elementary school in Greenwood, SC.
  • Science books and kits for Ms. M’s elementary school class in Kansas City, MO.
  • Replacement bulbs for the Smart Board projectors of Ms. L’s seventh grade class in Brooklyn, NY.
  • A listening center and dry erase boards for Ms. M’s elementary school class in Houston, TX.
  • A BreakoutEDU pre-calculus problem solving kit for Mrs. S’s high school class in Independence, MO.
  • A document camera for Mrs. W’s elementary school class in Phoenix, AZ.
  • Computer speakers and a tablet for Mrs. D’s elementary school class in McKees Rocks, PA.
  • Supplies to run a writing master class taught by an award-winning author at the library of Ms. H’s high school in Long Island City, NY.

Several of the teachers above emailed after receiving notice Sunday that I had placed the donation, with Ms. L describing how important something as simple as replacement projector bulbs can be:

Thank you so very much for your generous donation to my science classes. I would have been forced to change my entire curriculum if it was not for your help. Due to the struggling economy, it is difficult to supply the classroom with all of the necessary materials. The Smart Board projector is such a valuable education tool that you have returned life to once again. You truly did a wonderful thing. Your assistance means so much to me but even more to my students. Thank you from all of us.


Last Week’s Most Interesting News

  • UMass pays $650,000 to settle HIPAA charges over a 2013 malware infection in one of its component organizations that was not properly defined as part of UMass’s hybrid organization status.
  • HIMSS and CHIME form HIMSS-CHIME International to manage their programs outside of North America.
  • The Gates Foundation funds a project in which Factom will create a secure, transportable, patient-managed medical record powered by blockchain technology.
  • President Obama expresses concern about maintaining a cohesive society and democracy as technology empowers its developers but marginalizes the value of other types of work, citing radiologists potentially losing their jobs to artificial intelligence.
  • A study finds that conveniently located retail clinics don’t reduce unnecessary ED visits for minor “treat and release” conditions.

Webinars

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

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


Sales

ProMedica (OH) chooses Sectra’s cardiology imaging module.


People

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AMIA selects incoming Regenstrief Institute President Peter Embi, MD, MS as chair-elect.


Announcements and Implementations

Massachusetts Governor Charlie Baker forms the Massachusetts Digital Healthcare Council to advise him on accelerating digital health innovation in the state.

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Physical therapy telehealth platform vendor In Hand Health releases a new version of its patient engagement app that includes the ability for therapists to create video exercises on their smartphones, send them to individual patients, and track their exercise activity between visits. A 400-patient license for up to six physical therapists costs $800 per year.

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Israel-based imaging analytics vendor Zebra Medical Vision announces a service in which patients can upload their medical images to receive an automated analysis for conditions such as osteoporosis, compression fractures, and emphysema, although the company notes that “our analysis does not replace a physician or a proper medical examination” and the service is not available in the US.

GE Healthcare announces several products at RSNA that include patient-controlled mammography pressure, an imaging collaboration suite, and enhancements to Centricity Solutions for Enterprise Imaging.


Privacy and Security

From DataBreaches.net:

  • The Fancy Bears hacking group that previously published the medical information of US Olympic athletes publishes internal emails from doping organizations that it obtained by phishing, with some of those emails suggesting that certain athletes were blood doping or using cocaine to lose weight.
  • CHI Franciscan Health warns an unspecified number of patients that a laptop stolen from an employee contains their medical information. The employee’s stolen backpack also contained a day planner in which the employee had recorded his or her user ID and password.
  • A security magazine warns that hackers might not only steal data, but intentionally change information to either make the data owner look bad or to benefit from the effects the altered data will cause, such as in stock market manipulation. DataBreaches.net ponders whether the next generation of hackers might go beyond ransomware attacks and instead change some patient records and offer sell the provider a list of the “before” and “after” values so they can correct them.
  • Thieves place skimming devices on ATMS in four New York City hospitals, using tiny cameras to collect credit card information that they used to steal $46,000 from at least 75 people.
  • A Georgia surgical practice notifies patients that its server was breached repeatedly over a six-month period by a hacker using a compromised EHR vendor’s password.
  • In Canada, Nova Scotia’s Information and Privacy Commissioner recommends implementing electronic referrals after investigating several incidents in which mental health referrals were faxed by practices to a private business instead of a mental health clinic due to misdialing. The commissioner also recommended that physician practices identify one person to send faxes, pre-set the clinic’s number in their fax machines, set a reminder to check regularly that the clinic’s fax number hasn’t changed, and use cover sheets.

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A security expert’s test finds that his new Wi-Fi $55 security camera was infected with malware just 98 seconds after it was installed, attacked by a worm that used the hidden, hard-coded default login and password.

A man sues CNN for airing photos of him taken in a hospital as he recovered from a gunshot wound that he says was inflicted by his friend, former pro football player Aaron Hernandez.


Other

The Burlington, VT newspaper reviews the difficulty providers have had in attempting to launch services that compete with University of Vermont Medical Center, which uses its legal clout and political and business connections to protect its business interests. A group of eye doctors trying to open the state’s second ambulatory surgery center had their project killed by an antiquated certificate-of-need process and a developer’s lease that required them to ask another client of the developer — UVM Medical Center — for permission to build their surgery center,  which the hospital opposed. Another doctor who attempted to build a similar center was opposed by the Vermont Association of Hospitals and Health Systems, which complained that its members would be hurt financially and that a market-driven ASC would undermine payment reform. UVM Medical Center complained that the ASC wasn’t needed because hospitals already have adequate capacity, warned that the ASC would create its own demand, and questioned how the hospital would get the ASC’s medical records if its patients showed up in the hospital’s ED with complications after hours.

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A Wall Street Journal report notes that drug companies are increasing prices for specific drugs in lockstep with those of competing products, with examples being Viagra and Cialis (now at around $50 per tablet vs. $20 in 2013) and insulin that now retails for over $400 per month. The practice isn’t illegal as long as the drug companies haven’t agreed in advance to pursue such a strategy. 

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The cash crunch caused by India’s demonetization has driven a big uptick in telehealth visit volume as consumers seek services for which they can pay electronically.

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Actor Chuck Norris, who I note with surprise is now 76 years old, describes improvements being made in the VA, specifically noting some of its technology projects:

In a 2015 briefing by VA Chief Information Officer Stephen Warren, it was pointed out that more than half of the VA’s proposed 2016 technology budget was earmarked toward delivering better outcomes for vets; to build out a tech infrastructure that supports customized health care tools for veterans. These tools were to include mobile and telehealth technologies, advanced electronic health records, and a new scheduling system. Also included was the beginning of a pilot program for a major 10-year investment in updating the VA’s aging telephone system. Warren described the programs as an enhanced part of “mission delivery” and a move to “veteran-focused outcomes versus an organizational-focused” outcomes. Progress on these efforts need to be reviewed and the public must be kept apprised.

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Alabama internist Richard Snellgrove, MD is indicted for prescribing the opioids that killed 3 Doors Down lead guitarist Matthew Roberts in August 2016. Roberts was found dead in a Hampton Inn hallway with fentanyl patches applied to his body and filled Lortab and Xanax prescriptions in his backpack. The federal complaint cites a close friend who said Roberts was addicted to prescription painkillers and who told police, “If you want to arrest the drug dealer who killed [him], arrest his doctor.” The doctor, who had been described as a celebrity junkie who Roberts called “Snelly,” wrote a prescription for 240 methadone tablets for Roberts that cause other doctors to question his prescribing habits when they looked Roberts up in the state’s doctor-shopper database. The PDMP database also showed that the doctor wrote at least 31 controlled substance prescriptions for Roberts without a corresponding office visit, as evidenced by the lack of claims filed by the practice to his BCBS insurance.


Sponsor Updates

  • Qpid Health and Visage Imaging will exhibit at RSNA November 27-December 2 in Chicago.
  • Data Center Knowledge profiles TierPoint CEO Jerry Kent.
  • AdvancedMD donates 600 necessity bags to Ronald McDonald House Charities.
  • Agfa Healthcare and Elsevier Clinical Solutions will exhibit and present at RSNA November 27-December 2 in Chicago.
  • Besler Consulting releases a new podcast, “Three Ways to Succeed Under Emerging Payment Models.”
  • HIMSS features Caradigm’s Michelle Vislosky’s thoughts on population health management capabilities.
  • EClinicalWorks releases a recap video from its annual conference.

Blog Posts


Contacts

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

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News 11/23/16

November 22, 2016 News 3 Comments

Top News

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UMass will pay $650,000 to settle HHS OCR HIPAA charges over a 2013 Trojan malware infection of a single workstation at its Center for Language, Speech, and Hearing that exposed the information of the PHI of 1,670 people.

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OCR found that UMass had chosen a “hybrid” status — which requires it to designate in writing which of its components perform HIPAA-covered functions and which do not – but had failed to list the Center and some other components. UMass also failed to implement a firewall at the Center and had not performed a risk analysis at the time of the incident.


HIStalk Announcements and Requests

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ST Advisors donated $500 to my DonorsChoose fund as part of their annual charitable giving, which through the magic of matching money funded these classroom projects:

  • Strategic thinking, economics, and entrepreneurship games for Mrs. D’s middle school gifted class in Springdale, AR.
  • Robotics programming kits for Mrs. F’s STEM high school class in Lincoln, KS.
  • A microscope and other science materials for Mrs. M’s third grade class in Newport News, VA.
  • A document camera for Mrs. R’s second grade English as a second language class in Englewood, NJ.
  • Math manipulatives for Mrs. O’s second grade class in Kansas City, MO.
  • A programmable robotics kit for Mrs. R’s third grade class in Brooklyn, NY.
  • Headphones for Mrs. M’s school library in Bronx, NY.
  • A Chromebook for Mr. G’s high school class in Bluejacket, OK.
  • Math manipulatives for Ms. P’s middle school class in New Orleans, LA.

In addition, reader Bill sent a nice note and donation that funded a Kindle Fire and headphones for Ms. W’s kindergarten class in Los Angeles, CA.

I have another donation or two that I’ll apply later this week. Thanks to everyone who supports STEM learning in our schools. Watch this space for photos and teacher reports. I know the teachers are excited because I received emails from all of them within a few of hours of funding their projects, such as this one from Ms. W:

What an awesome way to start the day to know that an important project was funded by an awesome donor! Thank you from the bottom of my heart for your very generous donation! My students will be so excited to hear this news! They are so fired up about protecting the environment. This project will help further ignite that passion! Have an amazing and warm Thanksgiving.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Oracle acquires domain name services provider Dyn, which was the subject of an October 21 distributed denial-of-service attack that rendered major websites unavailable to much of North America and Europe, for a rumored $600 million. Ironically, Dyn serves as the authority on Internet downtime and data blocking by monitoring web traffic and offering companies a rerouting service to make sure their visitors get through.

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Symantec will acquire consumer identity protection LifeLock for $2.3 billion. LifeLock has paid more than $100 million in FTC fines for false advertising and reports found that its previous CEO, who was featured in endless ads listing his Social Security number with a challenge to hackers to try to steal his identity, was found to have had that identity stolen at least 13 times. At one point, the company’s main way of trying to prevent fraud was to place a red flag every 90 days on the credit files of its subscribers (who pay from $10 to $30 per month) as though someone might have compromised their accounts, with its reps calling Experian up to 15,000 times per day on their toll-free number and filing the same fraud alert that consumers could have requested on their own at no charge. Experian, which offers a competing service, sued and won.


Sales

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Main Line Health (PA) selects Bernoulli for medical device integration as it transitions to Epic.

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Spectrum Health (MI) chooses MModal for speech-driven clinical documentation.

In England, Royal Free London NHS Foundation Trust signs a five-year agreement for the Streams acute kidney injury event notification system from Google-owned DeepMind.


People

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Canada-based mental health software provider Ehave hires Prateek Dwivedi (University Health Network) as president and CEO.


Announcements and Implementations

HIMSS and CHIME form HMISS-CHIME International, which will work together on their existing programs outside of North America. That raised my curiosity about CHIME’s finances. Its recent financial report shows total revenue of $6.5 million, of which $1.7 million came from conferences and sponsorship, $480,000 from dues, and $4 million from grants from what is labeled “Collegehlth Mgmt Exec Foundation,” which I assume is where the vendor checks are collected. There’s also the for-profit CHIME Technologies, which sells speaker services and provides vendors with advisory groups. CEO Russell Branzell earned $437,000 and his two EVPs made $162,000 each.

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In Ireland, Cork University Maternity Hospital will go live on Cerner next week, with all 17 of the country’s hospitals expected to be live on Cerner by the end of 2017. Following that is the rollout of a single national EHR for oncology hospitals and another for acute care hospitals if funds are approved. Cerner is also providing national laboratory information system. Ireland prepared for single health record by implementing a universal patient identifier in August.

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A new Peer60 report finds that 81 percent of respondents create patient reports using radiology speech recognition vs. the 12 percent that still send off dictation for transcription, with that number jumping to 96 percent of high-volume sites. Nuance was used by 85 percent of respondents, with the small remainder being divided among MModal, Dolbey, and Agfa. Nearly 75 percent of sites that aren’t already using speech recognition plan to do so, with the only holdouts being smaller sites. Net Promoter Scores are fairly high, making the replacement market unattractive.

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The Mount Sinai Hospital (NY) goes live on a clinical research VNA from Vital Images that offers researchers a de-identified view of the fully detailed patient data used by clinicians on the same system.

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Hardeep Singh, MD, MPH and the Houston VA Patient Safety Center win the VA’s research impact award for their work on delayed diagnoses, delayed test follow-up, and EHR safety.


Government and Politics

HHS Secretary Sylvia Burwell warns that a “repeal and replace” approach to the Affordable Care Act that would require years to offer a replacement program is really a repeal since it will cause collapse of the exchanges as the remaining insurer participants would pull out in 2018 in the uncertainty about what’s next. It would also leave 20 million people without insurance. Burwell is concerned that signups during open enrollment through December 31 may suffer because people are confused that the program is going away on Inauguration Day. Meanwhile, President-Elect Trump’s YouTube video in which he describes his highest priorities did not include repealing Obamacare, which he previously promised would happen the day he took office.


Technology

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Drug maker Novartis says its Alcon eye care division will miss its goal of performing clinical trials on Google-designed smart contact lenses that can correct far-sightedness and measure blood glucose levels.


Other

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The Wall Street Journal profiles the “fentanyl billionaire” whose company, Insys Therapeutics, is charged with bribing doctors to overuse its drug. John Kapoor, PhD, who’s worth around $2 billion, made his first fortune by spending $50,000 to buy a drug company selling an old AIDS drug, after which he quadrupled its price and netted $100 million when he sold the company. He then started Insys, which hired salespeople he called PhDs (poor, hungry, and dumb) who were paid little in base salary but who received a cut of every prescription issued by their doctor-clients, encouraging the reps to push high doses and large quantities. Two Alabama doctors are charged with making $40 million in illicit gains by prescribing $4.9 million worth of the drug for their Medicare patients alone in 2013-2014, also earning $271,000 in “speaking fees” from the drug company and millions more by having the prescriptions filled at a pharmacy they owned. One of the company’s reps, who was hired as a kickback to the doctor who confessed “a certain affection” for her, made $700,000 in two years from just the prescriptions written by the two doctors.

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Stat ponders why President-Elect Trump recently met with drug billionaire Patrick Soon-Shiong, who is possibly under consideration to privatize Vice-President Biden’s cancer moonshot (which Soon-Shiong co-opted in forming his own Cancer MoonShot 2020 that mostly involves drug companies). Stat notes that not everyone is a Soon-Shiong fan, quoting a geneticist who summarizes, “A hype merchant propping up a lucrative empire with almost no real substance.” NantHealth shares have dropped 36 percent since their June 2016 IPO, while those of NantKwest are down around 75 percent since the company went public in July 2015.

In England, an NHS trust IT director pleads guilty to accepting a bribe to issue an ED software contract to the company of a local man who has also pled guilty.

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ED physician Keith Pochick, MD pens a great, poetic opinion piece titled “Handheld electronic devices are the thieves of our meaningful moments,” describing a conference’s challenge to disconnect attendees from their smartphones:

On the second day, he invited us to turn off our handheld devices and put them into a basket at the front of the room. Most of us were able to do it, although quite a few participants needed to peek at their lifelines during breaks to ensure that the world was still spinning. Each of our respective loved ones knew exactly where we were, and would have had no trouble contacting us, yet the thought of “de-vicing” initially brought an incredible amount of angst. As the final two days of the conference developed, it became more and more liberating for me to be free from the chains of my digital master. While the conference wound down, we were each asked to list a few specific changes we’d make to enrich our lives and break behavior patterns which we believed were holding us back. I obviously couldn’t help but consider how many meaningful moments my constant accessibility and connectedness were stealing from me. I had become a slave to email, text messaging, instant Internet and YouTube access, and Facebook.

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Cleveland Clinic CEO Toby Cosgrove disputes the many studies showing that hospital consolidation raises prices via their increased market power, saying instead that hospital mergers will prevent struggling facilities from closing by improving their efficiency. He also says that insurance must remain available for the 20 million people who buy theirs via the exchanges to prevent hospitals from having “major economic problems.”

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New York-Presbyterian Hospital gave its former $3 million per year president another $6.4 million in severance when in September 2015 he abruptly resigned after having an extramarital affair.

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Upworthy profiles “hippie turned doctor” Larry Brilliant, MD, MPH, who was motivated as one of only 60 attendees at a 1962, six-hour Martin Luther King, Jr. speech to later help cure smallpox, create the Seva eye charity that has restored sight to 4 million people, win a TED prize, and fight global pandemics. Brilliant’s just-released book is titled “Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History.” From his 2013 commencement speech to the Harvard School of Public Health:

As for my generation of young radicals, we had prejudged a mostly conservative profession, assuming they couldn’t be good doctors for being out of touch with the great social upheaval of the time, for not understanding the needs of the marginalized, not seeing the patterns and linkages between disease and poverty, the relationship between social justice and life expectancy, and how the battle then as now was about dignity and human rights. And here is the point as you go forward. Somehow, these two sides of our national health debate—one outward looking at social justice and inclusion and one inward looking inward at high quality patient care that is exclusionary—met then and must meet now on sacred ground, sharing the profound obligation and great joy of improving the health of the people …

Imagine that arc of history that Martin Luther King inspired is right here with us. The arc of the universe needs your help to bend it towards justice. It will not happen on its own. The arc of history will not bend towards justice without you bending it. Public health needs you to insure health for all. Seize that history. Bend that arc. I want you to leap up, to jump up and grab that arc of history with both hands, and yank it down, twist it, and bend it. Bend it towards fairness, bend it towards better health for all, bend it towards justice. That’s your noble calling of public health.


Sponsor Updates

  • Huntzinger Management Group announces a strategic partnership with DCCS Consulting.
  • GetWellNetwork announces that more than 100 hospitals are using its Marbella data collection tool for rounding and collecting patient and staff feedback, with 20 new customers added since July 2016.
  • HCI Group posts a podcast titled “EMR Training: What Goes IN to Achieving High Levels of Adoption.”
  • Sutherland Healthcare Solutions announces its investments in healthcare analytics that include development of its SmartHealthSolutions portfolio, the acquisition by its parent company of big data analytics firm Nuevora, and a partnership with IIA.
  • Optimum Healthcare IT is named a top 10 RCM provider.
  • Baptist Health South Florida realizes $45 million in increased appropriate reimbursement following its implementation of Nuance Clinical Documentation Improvement.

Blog Posts


Contacts

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

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Morning Headlines 11/21/16

November 20, 2016 News 1 Comment

Factom, Inc. Receives Grant to Create Secure Medical Records Using its Blockchain Technology

The Bill and Melinda Gates Foundation issues blockchain vendor Factom a grant to build a tool to secure electronic medical records with blockchain technology.

NHS trusts overshoot maximum annual deficit in just six months

Six months into its fiscal year, the NHS has passed its permissible deficit for the year and is on pace to end the year $3 billion over budget.

What Does the Trump Presidency Imply for Healthcare and Healthcare IT?

John Halamka, MD discusses the impact President-elect Trump will likely have on health IT.

Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits

A study investigating the relationship between availability of local retail clinics and ED utilization finds no decrease in the use of emergency services for low-acuity conditions.

Monday Morning Update 11/21/16

November 20, 2016 News 2 Comments

Top News

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The Bill & Melinda Gates Foundation awards a grant of unspecified value to blockchain technology vendor Factom to create a secure, transportable medical record using blockchain.

According to the company’s CEO, “Our goal with this new partnership is to demonstrate how global identity and record-keeping as a public utility is possible. We hope to show how individuals can manage important, private records like medical records using very simple tools and a lot of backend cryptography. My belief is that the blockchain will be used more and more over time for these aims. If we all follow these core beliefs, we will get to a very, very good place in this world.”


Reader Comments

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From John: “Re: MGMA and HIMSS booth sizes. RSNA’s exhibit hall demonstrates where the real money is made.” RSNA’s exhibit hall floor plan shows that three companies bought space of 20,000+ square feet, or about a half acre: GE Healthcare, Philips, and Siemens Healthineers, with Toshiba and Hitachi not far behind. Providers who order excessive numbers of imaging studies to pay for the machines they bought are also underwriting that kind of excess, as are we taxpayers who are stuck with Medicare and Medicaid bills. In addition, every one of those big-booth vendors are foreign companies, taking the profits from our screwed-up healthcare system back to England, Netherlands, Germany, and Japan. The WHO health system performance ranking of their home countries is not only better than ours (coming in at #18, 17, 25, and 10, respectively, vs. our pitiful #37) but a lot less costly, a fact the starry-eyed RSNA attendees are not likely to appreciate since our ridiculous healthcare costs fund their nice incomes and conference attendance.


HIStalk Announcements and Requests

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About 60 percent of poll respondents expect their companies to fare as well or better under a Trump presidency than now. CIO Looking says the ACA cost him his job because his financially stable community hospital was forced to join a larger health system, so he or she at least expects to be employed under a Trump presidency. HITgeek says the real problem is Congress and Trump’s appointments and urges people to take advantage of the Notice of Proposed Rule-Making comment period by adding thoughtful, fact-based responses.

New poll to your right or here: which social media services do you use professionally? “Use” means whatever you want it to mean – maybe you post content on a particular site or maybe you just check it out for business purposes occasionally.

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We provided math manipulatives for Mrs. B’s first grade class in Texas by funding her DonorsChoose grant request. She reports, “With these games, we have been able to further our addition and subtraction skills. My students love playing these games and work very well together while playing them. Kids today need hands-on manipulatives that excite and motivate them to learn.”

Meanwhile, a generous vendor has provided significant matching funds to double the impact of donations (actually it’s more like quadruple in some cases since many DonorsChoose projects already include match offers). You can donate as follow:

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

Last Week’s Most Interesting News

  • Cerner CEO Neal Patterson makes a surprise appearance at the company’s user conference, saying that his experience as a cancer patient has inspired him to make EHRs faster and safer and to incorporate more patient involvement.
  • CMS releases an API that gives developers access to information from its Quality Payment Program.
  • A new ONC report makes recommendations on the safe use of EHR pick lists for selecting patients and medications.
  • The Social Security Administration connects its disability system with the VA’s medical records to speed up processing time for the applications of veterans.

Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Salus Telehealth chooses a new board of directors following its merger last month with VideoMedicine.


Decisions

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  • Central Washington Hospital (WA) will switch from Cerner to Epic in 2017.
  • St Joseph Memorial Hospital (IL) will switch from Meditech to Epic in mid-2017.
  • Houston Methodist St. Catherine Hospital (TX) will switch from Meditech to Epic in February 2017.

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


Announcements and Implementations

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A study finds that extended, continuous cardiac monitoring using the Zio system of IRhythm Technologies performs better than Holter monitoring in detecting arrhythmias. Patients wear the Zio Patch for 14 days, then mail it in for analysis. Shares in the company have jumped 23 percent since their October 20 IPO, valuing it at $644 million.

The University of Toronto profiles its researchers who tested their lab-on-a-chip measles and rubella screening technology at a refugee camp hospital in a remote part of Kenya. They created their system using 3D-printed components and open source hardware. The 15-member digital microfluidics team, which ranges from undergrads through post-docs, wants to create a rugged, solar-powered system that locals can transport on motorcycles and operate themselves.

The American Medical Association adopts principles regarding mHealth applications, acknowledging the need for clinical evidence to help weed out the unsafe ones. The principles are fairly predictable, including AMA’s insistence that apps maintain the physician-patient relationship and that doctors who provide services through the app be licensed in the state where the patient is located.


Government and Politics

John Halamka, MD weighs in on the impact of a Trump presidency on health IT. He predicts:

  • Lowered taxes, simplified regulations, and moving Medicaid closer to individual states could spur innovation.
  • Free market competition could increase.
  • Health insurance exchanges will probably be an early target, but other parts of the ACA will live on.
  • FDA scrutiny and enforcement may be dialed back.
  • Funding for NIH, the Cancer Moonshot, precision medicine, and CMS’s Center for Medicare and Medicaid Innovation may be cut back.
  • The transition to value-based purchasing and the rollout of the Quality Payment Program will continue.

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President Obama describes the country’s technology-assisted employment challenges in an excellent post-election New Yorker article and interview:

But at some point, when the problem is not just Uber but driverless Uber, when radiologists are losing their jobs to A.I., then we’re going to have to figure out how do we maintain a cohesive society and a cohesive democracy in which productivity and wealth generation are not automatically linked to how many hours you put in, where the links between production and distribution are broken, in some sense. Because I can sit in my office, do a bunch of stuff, send it out over the Internet, and suddenly I just made a couple of million bucks, and the person who’s looking after my kid while I’m doing that has no leverage to get paid more than ten bucks an hour.


Privacy and Security

From DataBreaches.net:

  • Live streaming video of patients having sleep studies performed by a California sleep clinic are found to be viewable online due to an improperly secured camera.
  • A financial counselor at Hennepin County Medical Center (MN) is sentenced to probation for keeping cash co-pays and charging the amount to a different patient’s credit card.

Innovation and Research

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Yale startup Spring, which offers a 10-minute machine learning-powered online questionnaire that suggests the best antidepressant for a given patient, wins the Harvard-Yale Pitchoff.


Other

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Perhaps this headline’s error was a Freudian slip suggesting either hospital body area specialization or mediocrity.

In England, NHS trusts are running over their maximum allowed annual deficit six months into the fiscal year and despite an $1.1 billion emergency government infusion. The CEO of NHS Confederation blames budget cuts, especially in the areas of social care, mental health, and public health. On the positive side, 142 trusts reported a YTD deficit through Q2 vs. 182 in the same period last year and total expense has been reduced by 2.9 percent.

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Drug maker Pfizer sues the Texas Health and Human Services Commission for providing Medicaid rebate data to to state lawmakers, saying the agency compromised the company’s trade secrets and will harm the state’s Medicaid program because Pfizer may stop offering the rebates if other large purchasers demand the same prices.

A study finds that nearby retail clinics don’t reduce the number of unnecessary ED visits for “treat and release” conditions such as flu, respiratory infections, and urinary tract infections. The authors note that their numbers may have been skewed by patients who wouldn’t have sought treatment at all until retail clinics came along, the number of patients seen in a retail clinic whose conditions required an ED visit anyway, and the fact that most of those clinics don’t accept Medicaid.


Sponsor Updates

  • Xerox Healthcare features PokitDok in the first episode of its Health Future podcast.
  • Catalyze CEO Travis Good, MD interviews Georgia Tech health informatics professor Mark Braunstein, MD in a podcast titled “Healthcare in the Age of Interoperability.”
  • Voalte publishes a video of a mother describing her firsthand experience with the benefits of the company’s smartphones during her premature delivery.

Blog Posts


Contacts

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

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News 11/18/16

November 17, 2016 News 7 Comments

Top News

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Cerner CEO Neal Patterson makes a surprise appearance at the Cerner Health Conference in Kansas City on Wednesday, telling 15,000 attendees that he is getting stronger after being treated for soft tissue cancer and adding, “I realized God had a sense of humor. He put me in a place undergoing an EHR conversion.”

Patterson expressed his frustration as a patient: “I remember waiting four hours to get lab results. I asked a lady next to me in the waiting room how long she had been waiting, and her reply was seven hours. Seven hours! There’s no caring in that. It’s not like you have one doctor, one surgeon, a radiation oncologist, and a medical oncologist. It’s a team. It’s time for the patient to be part of the team.”

Patterson says he will resume his normal activities in January. He vowed to make Cerner’s EHR faster and safer and to include more patient participation, saying, “I know I was put in this position to make it better.”


Reader Comments

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From LeftCoaster: “Re: QuadraMed. Employees say owner Harris laid off another 15 people this week, apparently focusing the cutbacks on the Affinity product that has only a handful of developers left. Harris purchased NextGen’s hospital business last year and sales activity has been dismal.” Unverified.

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From MGMA Attendee: “Re: Athenahealth at MGMA. They had a huge amount of trade show real estate with a large number of corporate marketers marching the edges. At one point it was like 30 staff to zero attendees. I’m not sure if the intention was to intimidate the other EHR vendors, but their excess was ridiculous to the point my colleagues and I avoided it.” Unverified. MGMA’s 2016 exhibit hall floor plan shows Athenahealth with a 50×50 booth, more than quadruple the size of the next-largest exhibit. The MGMA 2017 floor plan indicates that the company will downsize to 50×40, still more than double the size of the next-largest spot. They have two booths at HIMSS, one at 4,200 square feet and the other 400, but that’s comparatively modest for HIMSS compared to Epic’s 7,700 square feet, Cerner’s 11,700, and HIStalk’s sprawling 100-square-foot shrine to corporate excess. To put it in perspective, Cerner’s HIMSS booth will cover more than one-fourth of an acre, and unlike their huge campuses, local and state governments aren’t subsidizing that super-expensive space.

From Acceler-8R: ”Re: our new accelerator. We would love to be featured on HIStalk.” Sorry, but I’m decelerating my accelerator coverage. Writing about accelerators and their barely-functional startups led by industry-inexperienced newbies is like holding a baby shower while the post-coital sheets are still wrinkled. I don’t like wasting the time of readers in breathily describing the now-endless number of accelerators and incubators that have exceeded the number of available good companies that have sound business models and proven leadership. I’ll wait to write about the Darwinian winners when they are closer to being ready for enterprise prime time.

From Twitterati: “Re: this rag’s list of HIT people with the most Twitter followers. HIStalk was omitted.” It’s the usual lame, easily compiled list presented in the infuriating slideshow form, requiring endless clicks by the three people in the US who actually care (other than those named). Some of the folks on the list don’t even work in health IT. By the magazine’s stated methodology, I would have come in at around #25 with 12,500 Twitter followers, although in their defense, they probably see me as a competing publication instead of just some guy noodling around on a spare bedroom keyboard.

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From David Hasselhoff: “Re: Epic. They’re looking to hire a German translator. Wonder if they have a German client in the works?”


HIStalk Announcements and Requests

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I’ve reached my annoyance tipping point with vendors who coyly call their sales to customers “partnerships,” which they clearly are not. From now on, if the words “partner” or “partnership” are included in a press release without saying specifically that the customer bought something from their vendor “partner,” I will exclude that announcement from my “Sales” section since I’m tired of trying to decipher vague press releases to figure out who sold what to whom. If you want to brag on a sale, then call it a sale. Above is my first example.

This week on HIStalk Practice: Greater Oregon Behavioral Health launches statewide telemedicine program. Arizona Connected Care rolls out new care management app. IHealth Innovations launches WRAP to help physicians transition to QPPs. Centerstone Tennessee selects predictive analytics tech from Faros Healthcare. ACO CVCHIP Board Chair Lerla Joseph, MD shares insight into the challenges practices face when it comes to reporting for value-based payment programs. Humana pays out $94 million to physicians for quality improvements. My Client Notes partners with E-Psychiatry to launch TelePastor. Westmed Medical Group Co-Medical Director Richard Morel, MD describes the group’s journey to launching a mobile patient portal.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Healthcare operations AI-driven dashboard vendor AnalyticsMD raises $13 million in a Series A funding round. The company’s website has a cool “Efficiency: how does your hospital rank” function that quickly displays in-depth publicly available information about any US hospital.

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The CEO of network security vendor PacketSled resigns by mutual agreement after a unleashing a flurry of obscene and threatening Facebook comments involving President-Elect Trump. The company reported him to the Secret Service after a post in which he said, “I’m going to kill the President-Elect,” followed by another saying, “Bring it, Secret Service.” He gave specific details about his plan to buy a sniper rifle and stalk the White House, but later claimed his comments were just a private joke.

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The Wall Street Journal reports that in 2014, 24-year-old Theranos employee Tyler Shultz tipped off authorities and the Wall Street Journal that the company’s technology was a sham. He’s the grandson of then-company director and former Secretary of State George Shultz. Theranos scolded him, at which time he resigned, but was accused by the company’s lawyer at a family event of disclosing trade secrets and violating his confidentiality clause. He says he was followed by Theranos-hired private investigators and was pressured to disclose the Journal’s sources for its series of critical articles. “Fraud is not a trade secret,” he says, even though his disclosure apparently created a family rift in which he speaks to his grandfather only through lawyers.

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ContextMedia acquires AccentHealth, uniting two companies whose life’s work (other than leaving out spaces between the halves of their conjoined names) is creating point-of-care demand for budget-busting drugs during the inevitable long wait to see the doctor by pushing sponsored content at waiting room patients. My PCP stuck a tablet-based “educational” application in the exam room that looks like it might have been from ContextMedia, and despite my hour-long, boring wait, I wasn’t tempted to unmute it because I resent being marketed to as a patient in healthcare setting (which is nearly universal these days).

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Tech-backed, consumer-friendly insurer Oscar continues to hemorrhage cash as it loses $45 million in Q3 in its New York, Texas, and California markets as high startup costs and medical losses mount even as the company exits some markets. Oscar, which is scrambling to distance itself from the dying ACA marketplace that could be killed off by President-Elect Trump, was ironically co-founded by  the brother of Trump’s son-in-law. The Kushner brothers were admitted to Harvard as the university weighed their cons (modest academic records) with their pros (their father, a convicted felon and disbarred lawyer worth $500 million, donated $2.5 million).

China’s Wuzhen Internet Hospital, launched less than a year ago, says it offers services from 260,000 doctors, 300 of them working exclusively for the company that was founded by Shanghai-based We Doctor and is valued at $3 billion. The hospital uses text, phone, and video messaging and will establish 32 branches across China by the end of 2016. It is building a cloud platform to store patient clinical and billing information, eliminating the common requirement in China that patients bring in their own paper records when receiving services. Patients pay $1.50 to $36 for a virtual visit.


Sales

New West Physicians (CO) chooses pMD for HIPAA-compliant messaging.

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Island Hospital (WA) will upgrade to Meditech’s Web EHR.

Thresholds, which offers support to people with mental illness in Illinois, chooses FormFast FastFlow for automating its event tracking.

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The CRISP HIE chooses Verato for patient matching.


People

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Clinical Computer Systems hires Ron Repking (Glen Ellyn Web) as president. Owner and former president Kim Sell remains with the company, which offers the Obix Perinatal Data System, as CEO.

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Rob Kill (Cogentyx Medical) joins Investment firm Frazier Healthcare Partners as an operating partner on the Growth Buyout team.


Announcements and Implementations

TransUnion Health integrates its Patient Financial Clearance solutions with Epic’s Prelude registration system for validation of patient demographic and financial data.

Vital Images will launch Vitrea Data Stream and an updated viewer at RSNA, providing a single account point for EHR enablement across multiple PACS.

Wolters Kluwer Health announces that its ProVation Order Sets now features bi-directional integration with Cerner and another unnamed EHR vendor that I would presume is Epic.


Government and Politics

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CMS releases an API that will allow developers build applications that retrieve information from CMS’s Quality Payment Program measures.

A review of the seven previously proposed Republican changes to the Affordable Care Act says they range from outright repeal with no replacement to tweaks that retain the marketplace. The author concludes that all of the plans will make it worse for older, sicker people in charging them more to reduce the premiums for younger, healthier people to entice them to sign up. All of the proposed plans would increase the number of uninsured Americans. One idea I like is “continuous coverage,” which provides financial motivation for people to renew their policies each year or to immediately buy their own coverage after losing employer-provided insurance. One of the biggest disappointments of Obamacare is (other than the huge misstep in not addressing provider costs) that healthy people can still get away without buying insurance due to the toothless “individual mandate,” skewing the risk pool and sticking providers with their unexpected medical bills. Maybe the feds should just randomly assign every American to an insurance company to thwart cheaters and spread insurer risk evenly.

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The federal government tells the state of Vermont to stop using Medicaid money to fund certain projects, among them the state’s health information technology fund that as a result will see its $2.9 million budget cut in half in 2018 and eliminated in 2019. One of its projects is the Vermont HIE.

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Obamacare been berry, berry good to hospitals, whose profit margins reached a 30-year high of an average 7.3 percent in 2014, making it obvious why the AHA was happy to support more widespread insurance coverage that its members could bill.


Privacy and Security

From DataBreaches.net:

  • A Florida man who created fictitious healthcare providers and billed $6 million in false insurance claims recruited patients willing to allow their information to be used in return for cash. He also used a patient eligibility service to enter consecutive member IDs until he hit valid ones, with the verification information then giving him the information he needed to generate fraudulent bills.
  • In England, security experts find that seven NHS trusts spent nothing on cybersecurity in 2015. Their tests using public searches discovered misconfigured email servers, expired security certificates, and exposed login credentials.
  • Emblem Health notifies its members that their Social Security numbers were accidentally printed in a mailing it sent.
  • A marketing company hired by BCBS of New Jersey sends a benefit letter to 170,000 policy that includes the information of other individuals.

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This month’s Protenus Breach Barometer finds that 36 healthcare breaches were reported to HHS or the media in October, with 664,000 patient records exposed due to known hacking and ransomware incidents. Several organizations lost patient data permanently after ransomware incidents. Insiders were responsible for 37 percent of October’s breaches, of which five were accidental and eight were intentional.


Innovation and Research

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UCSF’s Center for Digital Health Innovation and GE Healthcare will work together to develop clinical diagnosis and management algorithms that will be applied to data from imaging systems and EHRs. It’s called a partnership, so your guess is as good as mine as to who’s making money from the deal.


Technology

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Twitter enhances its twit filter to allow muting conversations that contain a specified keyword or hashtag, giving users a welcome method to continue following mostly-useful tweeters while suppressing their passionate but off-topic posts about sports and politics or their endless updates from a seemingly dull conference. Click your profile icon and then Settings to clean up your stream. I vaguely remember a few months ago suggesting this feature, also wishing for Twitter and Facebook enhancements to allow users to categorize their updates (work, politics, mindless cute videos, precious child updates) so I can keep following the parts that interest me without having to suffer through the rest. That’s a cleaner option than hoping they create separate accounts for work vs. everything else, although I’m not opposed to that either.

Fast Company cites sources saying that Apple is researching the possibility of monitoring Parkinson’s disease patients with its iPhone and Watch. However, it would only work for the subset of Parkinson’s patients whose symptoms include tremors and slow movement.


Other

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The New York Times summarizes a NEJM article about patients who visit an in-network ED staffed by out-of-network doctors, which the study found happens in 22 percent of ED visits at an average patient cost of $900. The problem varies by area, with McAllen, TX EDs sending 89 percent of their patients surprise bills. The insurance trade group AHIP says it’s the job of hospitals to get their outsourced ED doctors to sign contracts with the same plans the hospital accepts. For once, I agree with the insurance companies.

In Canada, the corporate communications director of Stevenson Memorial Hospital is charged with several counts related to child pornography after police say he looked up the information of a minor female patient on the hospital’s computer system and tried to lure her into a sexual relationship.

The American College of Emergency Physicians parodies Cigna’s “TV Doctors of America” public service video from September 2016, with real-life ED doctors accusing the insurer of unfair coverage policies that exploit the federal EMTALA law that requires EDs to provide care regardless of the patient’s ability to pay. ACEP says Cigna should have spent the $9 million video cost on patients instead of on hiring actors who played TV doctors. Above are both videos for comparing and contrasting.

In India, patients complain that hospitals and pharmacies are refusing to accept 500 and 1,000 rupee bills that have been newly removed from circulation and replaced with a different bill design even though the government specifically allows them to accept the old currency. The government’s demonetization project makes the old, higher-value bills illegal in trying to stem corruption, black market exchange, and terrorism, meaning 500 rupee bills worth just $7.35 can no longer be used, although they can be exchanged until December 30 for the new notes and exceptions were granted for gas stations, hospitals, airlines, and crematoriums. One hospital says its business dropped 50 percent overnight, while another refused to release a patient’s body to the family until they could come up with cash in valid currency.

Several dozen laid-off IT employees of UCSF file discrimination complaints and threaten lawsuits after their jobs are outsourced to India-based companies. Experts note that the legal precedent isn’t favorable since other companies have successfully argued that they didn’t replace the employees individually — they restructured their departments and the outsourcing company hired the offshore workers.

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Odd: a study finds that 76 of the known 127 reported “deaths by selfie” from March 2014 to September 2016 happened in India, where people spent their last seconds posing in front of an oncoming train, on a boat that tipped over, on the side of treacherous cliffs and rivers, and on the steps of the Taj Mahal. The US had just eight known deaths by selfie (or “killfie,” as the study authors say).


Sponsor Updates

  • Iatric Systems proposes a YourTurn session on the help desk at HIMSS17.
  • Deloitte includes ID Experts in its 2016 Technology Fast 500.
  • LifeImage releases a new eBook, “CIO Perspectives on Enterprise Imaging.”
  • IDC recognizes Medecision as a major population health management player.
  • KLAS recognizes Direct Consulting Associates as a leading business intelligence provider in its Enterprise Healthcare BI 2016 Report.
  • EClinicalWorks will exhibit at MAHP 2016 Annual Conference November 18 in Boston.
  • The University of Wisconsin College of Engineering recognizes Healthfinch CEO and co-founder Jonathan Baran with the 2016 Early Career Achievement Award.

Blog Posts


Contacts

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

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News 11/16/16

November 15, 2016 News 11 Comments

Top News

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ONC issues a report on improving the usability of pick lists for choosing patients and medications in an ambulatory care setting that also includes an EHR self-assessment. It recommends that vendors and/or users:

  1. Include a patient photo in their record to make sure the right patient was chosen.
  2. Standardize drug names using the concept of an e-prescribing preferred drug description name.
  3. Use pick list best practices, including display standards and proper validation and decision support checks.
  4. Display a summary screen before accepting a pick list-chosen medication order.
  5. Provide simple retract-and-reorder functionality and monitor its use to identify design problems.
  6. Give patients their own medication lists as a second check.

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Perhaps ONC should have edited the report more carefully since “prednisone” is repeatedly listed as “rednisone” in the section advocating standardized drug names. The example drop-down also misspells the trade name “Lamictal” as “Lamicatal” and the generic name “lamivudine” as “lammudine.” Even “aspirin” is misspelled as “asprin” in the sample visit summary.


Reader Comments

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From FLPoggio: “Re: consultants. People who need them don’t know how to use them. People who know how to use them probably don’t need them.” That’s probably true – the organizations that hire consultants are often clueless, overworked doing the wrong things, and obsessed with protecting their fiefdoms. The last thing they want is change, which is why I would advocate that the person who hires the consultant be one notch higher than the people who will be most affected by their recommendations. IT strategy consulting should be engaged by whoever the CIO reports to, for example, and that’s the person who should make sure the recommendations happen.

From Killian Red: “Re: AMIA. I see a lot of suits in those tweeted photos!” I can never figure out why people wear suits to conferences, ensuring that they will be less comfortable, indistinguishable lemmings compared to that one enviably free-spirited guy who struts through the exhibit hall wearing shorts, tennis shoes, and a backpack, ignoring the raised sartorial bar and instead limboing happily under it in avoiding the corporate battle uniform. There’s not even anyone there to impress except peers from elsewhere. Some of the dimmest, most self-absorbed, and most dishonest hospital IT people I’ve known wore suits everywhere at work (even walking to the restroom or going out to lunch), which might validate the theory that anyone can get promoted by projecting a fabric-driven aura of marginal competence paired with excessive sycophantism and unchecked ambition. Like most of life, the best person doesn’t always win – often it’s the one who wants it more.


HIStalk Announcements and Requests

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The industry is about to lapse into its usual Thanksgiving-to-New-Year’s coma, so before that happens and then we all get overwhelmed after January 1, I’ll make a final pitch to companies interested in sponsoring HIStalkapalooza. We still have prime spots left that will ensure the endless gratitude of attendees who will enjoy a fun evening thanks to your largesse, sort of like sending underprivileged hospital IT people to summer camp. I even agreed to hang out privately for a few minutes with the CEO of one sponsoring company who wants that for some dubious reason, so clearly it’s time to deal so I don’t have nightmares about writing that big check personally. Contact Lorre.


Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Medical practice EHR/PM vendor CareCloud completes a $31.5 million Series C funding round, increasing its total to $103 million.

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Non-ICU monitoring system vendor Stasis Labs, which provides a simple bedside display of six core vital signs and a tablet-based app for clinicians with red or yellow indicators, raises $5 million in a seed funding round. Its hardware is manufactured in India, while its software was designed in conjunction with Cedars-Sinai Medical Center.


Sales

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UAB Medicine (AL) chooses KyruusOne and ProviderMatch for Access Centers to match patients with available providers to reduce long appointment wait times even while provider capacity is available.

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Bayada Home Health Care will identify seniors in need of intervention using technology from Chicago-based PreparedHealth, which offers the enTouch healthcare social network and DINA digital nursing assistant.

Florida Health Care Coalition will offer its members quality and utilization performance reports from Quantros.


Announcements and Implementations

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A new Peer60 report covering ideal imaging configuration finds that 72 percent of respondents have pursued an enterprise imaging approach in which the same company provides PACS, VNA, and viewer, mostly because they believe it offers better customer support. Sectra had the highest net promoter score among the enterprise imaging vendors. Just over one-fourth of enterprise imaging customers say they are considering switching vendors, with McKesson leading their mindshare. Among that minority of best-of-breed participants, nearly half would prefer an enterprise imaging approach instead, mostly to facilitate better integration, but nearly all of them say they get better functionality by choosing individual vendors and only 23 percent are actively pursuing replacing their systems with those from enterprise imaging vendors.

Cerner will integrate American Well’s telehealth solution with its HealtheLife patient portal. Amwell offers a $49 urgent care video visit with its own participating doctors, which appeals mostly to health plans and employers, but also offers health systems and practices the ability to launch their own telehealth practice.

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Lexmark Healthcare launches a legacy data archive solution, expands its PACSgear suite to allow EHRs to capture and present DICOM content directly from devices, and releases a new version of its enterprise viewer.

The American Heart Association launches a precision medicine platform using Amazon Web Services that will allow clinicians and researchers to analyze data sets contributed by drug companies, research institutes, and universities.

University of Utah partners with South Korea-based Chung-Ang University to create new digital health innovations, including telehealth, that will be applied at CAU Hospital.


Government and Politics

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A Health Affairs blog post says CMS’s hospital star rating system is “confusing at best and misleading at worst,” as some hospitals don’t have enough data for some quality categories and CMS reweights the remaining categories accordingly, often to their advantage.

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CMS updates its Medicare drug spending dashboard and adds Medicaid spending as well. Four Medicare-covered drugs jumped more than 200 percent in a single year, with the price of blood sugar drug Glumetza increasing from $8 to $39. Medicaid saw a 1,264 percent hike in the price of anxiety drug Ativan, while taxpayers paid $9 billion for the hepatitis C drug Harvoni. Nine of the 20 drugs that had the biggest Medicaid price jumps are generics. 

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The VA goes live with a new health enrollment web page without first clearing it with the agency’s lawyers, without training its enrollment specialists on its use, and with technical problems that locked or lost up to 65 percent of the applications filed. It is also not interoperable with the VA’s VistA. The VA turned the application back off and is routing applications manually. Whistleblowers claim the VA intentionally told veteran applicants that they were ineligible for VA care just to reduce the VA’s embarrassing backlog of pending applications.


Privacy and Security

From DataBreaches.net:

  • A woman sues Charleston Area Medical Center for providing the medical information of her child to a pregnant acquaintance who the hospital misidentified as her.
  • In Canada, Manitoba Health launches an investigation after discovering that a former employee looked up the names, birth dates, and address of patients so she could send them birthday cards.
  • A Texas medical practice notifies several hundred patients that their records that were being stored for shedding were accidentally placed in the trash by its cleaning service.

Innovation and Research

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The CDC awards a $930,000 grant to University of Missouri-Kansas City, Truman Medical Centers, and Children’s Mercy to compare the de-identified information of 47 million patients stored in Cerner HealthFacts with TMC’s own information to identify laboratory-related quality gaps.


Other

Major League Baseball will standardize the player medical information that teams exchange during trade talks following the 30-game suspension of  San Diego Padres General Manager A. J. Preller, who traded players with known medical issues that he hid from the receiving team by maintaining two sets of their electronic medical records.

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Pediatrician Mona Hanna-Attisha, MD, MPH — who discovered Flint, Michigan’s lead poisoning crisis by mining patient data in Hurley Medical Center’s Epic system — will speak at TEDMED, November 30-December 2, 2016 in Palm Springs, CA. Several other healthcare-focused presenters are on the agenda.

Both sides in a New York Times pro-con discussion of mergers agree that hospital consolidation creates consumer-harming monopolies, citing successful FTC challenges presenting evidence that merged hospital competitors raise prices and lower quality.

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Lake Health (OH) blames its $30 million loss on an IT conversion that cost more than expected. I assume it was Cerner Millennium since the health system announced that decision in May 2016, replacing the former Siemens Soarian.

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The American Heart Association gives its people’s choice technology award to Twiage, which offers hospitals real-time triage and care coordination with incoming ambulances.


Sponsor Updates

  • AirWatch VP Blake Brannon looks back at the company’s top innovations of 2016.
  • Aprima will exhibit at the American College of Rheumatology conference November
  • Catalyze President and Co-founder Mohan Balachandran speaks on the IBM Cloud Innovation Tour November 15 in San Francisco.
  • Pater Back, CIO of Meditech customer Humber River Hospital in Toronto, Ontario, is named ITAC’s Canadian CIO of the Year in the public sector category for his work in creating North America’s first fully digital hospital.
  • Besler Consulting releases a new podcast, “What will happen to the S-10?”
  • Aprima offers a cloud-based faxing solution for its EHR.
  • CoverMyMeds will exhibit at Ohio State University’s Wexner Medical Center’s annual Advanced Practice Conference November 18 in Columbus.
  • Crossings Healthcare Solutions exhibits at the Cerner Healthcare Conference through November 17 in Kansas City, MO.
  • Consulting Magazine includes Cumberland Consulting Group on its 2016 list of fastest growing firms.
  • Sutherland Healthcare Solutions publishes a white papers, “Turning Data Into Information and  Moving Beyond Data for Data’s Sake,” and a case study titled “Helping Touchette Regional Hospital Enhance the Patient Experience and Increase Reimbursement.”

Blog Posts


Contacts

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

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Morning Headlines 11/15/16

November 14, 2016 News No Comments

Keynote Speaker: John Boehner

HIMSS announces former Speaker of the House John Boehner will keynote HIMSS17.

Cerner and American Well to Embed Telehealth Capabilities into Cerner EHR

Cerner will integrate telehealth services from American Well into its software, allowing providers working within the Millennium EHR to connect with patients over Cerner’s patient portal.

Obama administration disperses last of grants to fund health information exchanges

ONC issues a total of $2.4 million in grants to four state HIEs: Delaware Health Information network, Oregon Health Authority, Rhode Island Quality Institute, and the Utah Health Information Network.

MLB to standardize medical information in wake of A.J. Preller suspension

In the wake of Padres GM A.J. Preller being suspended for hiding medical information during trade talks, the MLB has agreed to a new standardized approach to medical data sharing.

Morning Headlines 11/14/16

November 13, 2016 News No Comments

Social Security and Veterans Affairs Partnership Means Faster Disability Decisions for Veterans

The Social Security Administration integrates its disability claims processing system with the VA, speeding up the claims approval process by granting SSA immediate access to medical documents.

Donald Trump, in Exclusive Interview, Tells WSJ He Is Willing to Keep Parts of Obama Health Law

During a Wall Street Journal interview, Donald Trump says that he will preserve some components of the ACA, such as the pre-existing condition exemption and the ability to keep children on a parents insurance plan until the age of 26.

Cerner uses employees’ DNA in pilot research; aims to use genetic info to improve health

Cerner is analyzing full DNA sequences donated  by 82 employees to help the company study how genetics impacts obesity, metabolic syndrome, osteoporosis, and depression.

Monday Morning Update 11/14/16

November 13, 2016 News 5 Comments

Top News

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The Social Security Administration connects to the VA’s IT systems via the eHealthExchange, allowing it to retrieve the VA’s medical records of veterans applying for Social Security disability. It went live nationally on Friday, Veterans Day.


Reader Comments

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From Nasty Parts: “Re: NextGen. Rumor here at UGM is that IKS Health is a potential suitor. Former NextGen and Quality Systems President Pat Cline sits on their advisory board and is CEO of Lightbeam Health Solutions. Maybe they are bringing the band back together – IKS, NextGen, and Lightbeam.” Unverified. UPDATE: Pat Cline’s passed along this comment: ““I am proud to be a member of the IKS Advisory Board but I am fully committed to and focused on Lightbeam Health Solutions and the continued growth of our company and the population health solutions we deliver to healthcare providers. While I believe that QSI/NextGen is a fine company, I am not involved in any acquisition discussions nor am I trying to open any such discussion. I’m squarely focused on the growth and success of Lightbeam so that we continue to deliver the value that our customers, investors, partners and employees expect.”


HIStalk Announcements and Requests

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Most poll respondents think the medical practice of their most recent doctor is pretty well run. I asked for details and received these:

  • Health IT Chic Extraordinaire says her Epic-using doctor at Palo Alto Medical Foundation and the Cerner-using hospital he sent her (it’s one of five hospitals in which he practices) had mismatched records due to lack of interoperability. She had to fill out the same medical history and medication questions at both, but the hospital’s discharge instructions missed a drug he prescribed immediately before on Epic. She also notes that on the day of surgery, all the information of her tests and other information had been repackaged into a three-ring binder, leading her to ponder if we’ve really come as far as we think.
  • Betsy says her OB-GYN was clearly not interested in using practice’s EHR, and during her first visit, his tablet batteries ran out and he called in a MA to take sparse notes. She also observes that she always waited at least an hour (even if she was the second appointment of the day), the practice forgot prescriptions, and their phone tree was dysfunctional. They also collect all payments upfront but failed to return any excess after insurance paid.
  • Susan is a big fan of her PCP’s office, which communicates well internally and externally and offers prompt appointments and walk-in sick hours.
  • PatientX entered questions before the visit on the practice’s portal that the doctor brought up on his own, making the visit feel more like an ongoing health conversation rather than just a metrics-driven checklist.
  • PharmarH had a tracheostomy and even though it’s documented, they always ask him or her to call them.
  • Jill loves that the pediatric office where she takes her kids has transformed into a patient-centered medical home that offers same-day appointments and makes it a point to obtain the hospital’s infant records before the first visit.
  • My recent experience with the front-office staff of my single-doc PCP (my first visit with her) was unimpressive with their indifference paired with inefficiency, both plainly obvious, and I questioned the choice of playing country music in the waiting room. I was herded off to the exam room a few minutes behind schedule and was told I was the next patient, but I still waited 75 minutes. I was about ready to walk out when the doctor wheeled in a mobile cart running Practice Fusion, apologized for the wait, cheerily introduced herself by first name with a big smile, and asked for and told stories (“I love stories,” she said) in wanting to hear my medical history as a narrative to which she listened intently without focusing on the laptop and she related the experience of other patients. It was a “getting to know you” session that was probably 10 percent relevant to my immediate medical needs (getting routine annual lab tests), but I left a big fan without feeling like a patient widget in her medical factory. It was almost like corralling a doctor at a party who actually wanted to chat about my medical needs. I suspect her documentation of my encounter (which lasted nearly an hour) was skimpy, but I have no doubt she will remember all the important parts regardless.

New poll to your right or here: do you expect the business if your employer under a Trump presidency to be better or worse? Click Comments after voting to explain.

The Greatest Generation of World War II is mostly gone now, but taking its place at the head of the next-to-die line is the ever-dwindling roster of the Greatest Entertainment Generation of the 1960s, as evidenced by last week’s death of poet-musician Leonard Cohen and “Man from UNCLE” Robert Vaughn, PhD. The cool thing about 1960s TV stars is that they hustled on whatever shows hired them for next to nothing, so you can spot them as small players on shows ranging from “The Twilight Zone” to “Wagon Train.” Unlike the rest of us, their digitally preserved work lives on forever and earns news fans daily, allowing people to feel irrationally but happily connected to an impossibly youthful Napoleon Solo forever fighting THRUSH and charming mini-skirted mods with suave indifference.


Last Week’s Most Interesting News

  • Siemens announces plans to take its Healthineers medical business public.
  • Experts and amateurs alike try to forecast the healthcare impact of the presidential election win of Donald Trump.
  • McKesson confirms the layoff of 60 employees of its Charlotte, NC-based Enterprise Information Solutions business that includes Paragon, for which it previously took a $290 million write-down and expressed hopes of selling the business.
  • Walgreens files a $140 million breach of contract lawsuit against lab company Theranos.
  • ECRI Institute get a $3 million, three-year to study optimization of EHRs and avoidance of patient harm.

Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the video of one of our webinars from last week, “CMIO Perspective on Successful 25-Hospital Rollout of Electronic Physician Documentation.”


Acquisitions, Funding, Business, and Stock

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Patient education vendor PatientPoint acquires MedCenterDisplay, which offers digital signage, apps, and marketing solutions.


Decisions

  • Ellenville Regional Hospital (NY) will switch supply chain software from Medhost to Jump Technologies in February 2017.
  • Cameron Memorial Community Hospital (IN) went live on Infor supply chain management in October 2016.

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


People

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Virtual doctor visit provider MDLIVE hires Scott Decker (HealthSparq) as CEO, replacing demoted founder Randy Parker.


Government and Politics

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President-Elect Trump moderates his previously scathing opinions of the Affordable Care Act, which he had promised to scuttle on his first day in office, and says he wants to keep the elimination of pre-existing conditions and the ability for parents to leave their children on their policies for extra years. He (hopefully) appears to be moderating his over-the-top and ultimately successful election hyperbole with more thoughtful actions. A Washington Post opinion piece describes the problems involved with replacing Obamacare:

To guarantee that people with pre-existing conditions can get affordable health insurance, you need to have rules requiring guaranteed issue and community rating. To keep insurance companies in business because of guaranteed issue and community rating, you need to have an individual mandate. And because poor people can’t afford health insurance, you need subsidies. Combine all three, and what you have, in a nutshell, is … Obamacare … Of course, if you want to scrap guaranteed issue, scrap community rating, scrap the individual mandate, and scrap the subsidies, as Republicans, propose, then you end up where the country was in 2008—with a market system that inevitably gives way to an insurance spiral in which steadily rising premiums cause a steadily rising percentage of Americans without health insurance … you can’t have all the good parts of a socialized system (universal coverage at affordable prices) without freedom-reducing mandates and regulations and large doses of subsidies from some people to other people. Anyone who says otherwise – anyone promising better quality health care at lower cost with fewer regulations and lower taxes—is peddling hokum.

President-Elect Trump announces that his HHS transition advisor will be Andrew Bremberg, JD, who served as HHS special assistant and chief of staff from 2001 to 2007.

A Washington Post opinion piece explains why the author will never join AARP – the organization is a powerful Washington lobbyist that claims to protect Medicare and Social Security while it actually “prevents any serious discussion of meaningfully reforming these programs, which are in great danger of becoming insolvent.”


Privacy and Security

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From DataBreaches.net:

  • An IT recruitment site announces that an unnamed person accessed one of its development servers that it later determined had not been properly secured by its contractor Capgemini, exposing the information of its job seekers to the Internet. The UK file alone contained the information of 780,000 people, with the possible total exposure being in the millions or tens of millions.
  • An encrypted laptop containing the information of over 1,200 members of the Indiana Health Coverage program is stolen from the car of an HP Enterprise Services employee, but HPE disabled it remotely.
  • Vanderbilt University’s counseling center exposes the contact information of 468 of its clients to each other when an employee emails a survey using :CC rather than :BCC.
  • Kaiser Permanente notifies 8,000 members that a website upgrade’s new caching mechanism could have exposed their information to other people visiting the website at the same time.
  • A Texas dermatology practice is hit with ransomware that the practice says it was able to remove.

Other

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The local paper features a fun look back at Atomedic Hospital, the 1950s “futuristic hospital for the atomic age” for which prototypes were installed at demonstration sites, most notably the 1964 World’s Fair. The windowless, round, nuclear powered, and modularly constructed 28-bed hospital had an outer corridor for visitors, an inner circle for patient rooms, and a central core for services such as the OR, with patient rooms having doors at either end to allow moving them to the ICU within the central core. The low-cost, pre-packaged hospital was designed to make healthcare affordable. Patients would be served warmed frozen dinners with disposable dinnerware and disposable linen eliminated the need for a laundry. I Googled and found the Atomedic Foundation, which seeks to preserve the idea of quickly constructed, low-cost hospital buildings as envisioned by the original concept. Kaiser Permanente ran a history of the Atomedic Hospital idea last year even though it passed on the idea in 1961, mostly likely because of its high expense at $19,000 per bed and, perhaps most importantly, the fact that the federal government’s Hill-Burton program wouldn’t pay for it as they did for most of the hospital buildings that were erected in the 1960s.

Cerner participates in a study of 82 employee volunteers who turned over their DNA sequencing to the company, signaling Cerner’s continued interest in broadening its reach to healthcare service delivery.

In England, a doctor is jailed for possession of child pornography, which he attempted to hide by occasionally throwing his computers into a river.

Netsmart honors its veteran employees on Veterans Day with a nicely done video.


Contacts

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

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News 11/11/16

November 10, 2016 News No Comments

Top News

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Siemens will IPO its $15 billion Siemens Healthineers medical business, offering an unspecified stake while remaining a long-term majority shareholder.

Siemens CEO Joe Kaesar says Healthineers has gone from “good to great” by allowing it to focus and the IPO will “make it a fascinating business.” He says the company will invest in molecular diagnostics and consulting services.

Siemens Healthineers is the German conglomerate’s most profitable business unit. It offers medical imaging, laboratory diagnostics, point-of-care testing, therapy systems, imaging and laboratory diagnostics software, and services.


Reader Comments

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From Dell EMC Spokesperson: “Re: Fairview Health Services. The City Pages article was inaccurate and misleading across a wide range of facts, including the comments relating to the Dell EMC products. The Dell EMC products never went down or failed at any point. XtremIO was not the root cause of any incidents referenced in the article. Dell EMC values its strong partnership with Fairview and to serving as a top trustworthy and dependable partner from a technology, support, and strategic IT relationship perspective."

From Lever Puller: “Re: your article on election analytics. I loved it – you nailed down many reasons polls should be taken with a grain of salt. The media should take blame, too, for spending so much energy vilifying the eventual winner so that anyone who wanted to vote for him wouldn’t admit that to pollsters, throwing off their results.” Media people do indeed have their own agendas despite their claims of impartiality and they didn’t try very hard to hide it this time (that’s a big no-no when trying to gauge rather than influence opinion). My takeaways: (a) don’t believe any survey, clinical study, or product ranking until you’ve reviewed its methodology and the motivations of the authors; (b) choose carefully the people you allow to feed you predigested conclusions, especially if you plan to take important action from what they tell you; and (c) follow the money because the biases held by most companies and people are directly linked to their wallets. I’ll also add that actions are more important than words, so when a patient says they are medication-compliant or a company boasts that they have only ecstatic customers, ask to see their data proving it. What I was really saying in that article is that no amount of analytical firepower, even when correctly applied, can reliably predict the behavior of humans, especially when it pertains to their health. Meanwhile, if you really believe what people say instead of what they actually do, you should buy shares in UHAL and make a fortune from all the hand-wringers who swear they’re moving to Canada.

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Meanwhile, polling expert Nate Silver says in an analytics debrief, “We got a lot of crap for pointing out that the polls showed a fairly close election and that a fairly ordinary polling error could shift the Electoral College to Trump. People just didn’t want to hear it,” adding that the actual polls weren’t too far off in predicting the popular vote that Clinton won so far (Arizona, Michigan, and New Hampshire apparently ran out of fingers and toes and are still counting). The Huffington Post, which gave Clinton a 98 percent chance of beating Trump, has apologized to Silver for criticizing his projections as the news site earned its permanent place in the digital Dewey vs. Truman spotlight.

From Survey Says: “Re: your article on election analytics. As always, quite good and spot on. You would think a bad miss like Election Night would drive both some introspection and hesitancy to pontificate. I suppose nature abhors a vacuum and people have space on their sites that needs fresh content.” I’m already tired of self-proclaimed health experts confidently telling us what to expect from a Trump presidency, even trying to fine-tune their fuzzy crystal balls down to the level of health IT while barely holding back their post-election bitterness and fear. Some of them appear to simply be parroting each other judging from the identical ideas and similar wording.


HIStalk Announcements and Requests

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Today (Friday) is Veterans Day, which we set aside to honor everyone who has served in the US armed forces. If you spent time in uniform on US soil or elsewhere, in a combat role or not, thank you. Every service member experiences sacrifice, time away from family, the possibility of personal harm, and some degree of opportunity cost.

I was thinking about people who are said to have “died suddenly” versus the possibly more accurate “died unexpectedly,” although I’m not sure either phrase is any better than just “died.” Nobody knows when they’re going to die other than executed prisoners and suicide victims, so it’s otherwise always sudden and never expected.

This week on HIStalk Practice: Coordinated Care Oklahoma Chief Administrative Officer Brian Yeaman, MD gets excited about analytics and image sharing. Texas Association of Business CEO stumps for telemedicine. SRSsoft adds InteliChart tech to its practice software for specialists. ONC’s annual report to Congress shows patient engagement office progress. Practice Fusion receives funding from Orix Growth Capital. Glendale MRI Administrative Director Pamela Fletcher speaks to the value of pricing transparency when it comes to keeping up with the competition. BCBS of Kansas offers value-based contracts to Aledade Kansas. Jonathan Bush weighs in on next administration’s impact on healthcare. Northwest Physicians Network CEO Rick MacCornack highlights the value found in working with small technology startups.


Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the recording of this week’s webinar titled “How to Create Healthcare Apps That Get Used and Maybe Even Loved.”


Acquisitions, Funding, Business, and Stock

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Agfa’s board will enter non-exclusive discussions with CompuGroup Medical about being acquired. CGM’s CFO said Wednesday, “It’s either up or out (for the hospital information system business). If you wanted to step up and become a high-profitability, high-growth player, the position that our friends in Agfa have would be the number one choice.” Meanwhile, I’m pondering why Agfa’s logo lists the company’s name twice.

Sunquest acquires Sandy, UT-based UniConnect, which offers software for molecular laboratories.


Sales

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Carrus Hospital (TX) selects Nuance Power PDF to create, convert, and assemble PDF files.

Banner Health Network (AZ) chooses Evolent Health’s care performance management platform.


People

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Mike Tarwacki (Forte Research Systems) joins Ability Network as SVP of sales.


Announcements and Implementations

A Red Hat survey finds that 82 percent of large healthcare organizations have fully implemented a mobile strategy, a much higher rate than non-healthcare business, and 80 percent of them say their ROI is positive. However, budgets aren’t keeping up with their development and maintenance plans. The biggest reported technical challenges are back-end integration and securing data access.


Government and Politics

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A Health Affairs article says a Donald Trump presidency with Republican control over both houses can’t immediately kill the Affordable Care Act despite the President-Elect’s statement that he will ask Congress for its repeal the day he takes office. The article notes that such a proposal would likely be stopped by a Senate filibuster and adds that the ACA is so deeply ingrained into Medicare and other programs that it can’t simply be rolled back. However, funding for specific parts of “Obamacare” could be cut off, preserving features like coverage of pre-existing conditions, elimination of lifetime dollar caps, and age underwriting restrictions intact but leaving insurers to deal with their financial implications. The newly elected president will also need to quickly replace HHS’s many political appointees with people who might choose not to enforce regulatory requirements and could make it easier for states to pull out completely. The administration could also elect to drop its defense of ACA-related lawsuits, which could, as an example, immediately halt cost-sharing reduction payments to insurance companies in making marketplace participation undesirable to eliminate participation. Experts seem to agree that there’s little doubt that the Obamacare portion of the ACA will go away, with no firm proposals on the table to replace the health insurance carried by 20 million people.

Meanwhile, ACA sign-ups hit record levels the day after the election as people fretted less about skyrocketing premiums and more that the pre-existing condition policies could come back and leave them uninsurable.

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Anad Sharma, the founder of iPhone health tracking app vendor Gyroscope, is among a group of California technology company executives who say they’ll financially back the so-called #Calexit fringe movement in which California would secede from the US in protest of Donald Trump’s election.

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Former bad boy pharma exec Martin Shkreli follows through on his promise to publicly play his $2 million, one-copy-only Wu-Tang Clan album if Donald Trump were to win the election, calling Trump’s victory “fantastic.”

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The VA will launch online appointment scheduling in January 2017, using a system developed internally by the VA along with Accenture Federal Services.


Privacy and Security

From DataBreaches.net:

  • Broward Health (FL) is notified by law enforcement authorities that its patient facesheets were found at the home of an unidentified individual.
  • The Eastern Colorado VA system says the names and diagnoses of 2,100 veterans were exposed when one of its employees emailed unencrypted documents to her personal email account.
  • In Canada, the privacy commissioner of Newfoundland and Labrador orders Eastern Health to implement mandatory user log-outs and to consider proximity-based security after someone accesses patient information using the still-active Meditech session of a doctor who had left the area for rounds.

Other

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The Madison paper covers a new bus service that targets Epic commuters with hardwood floors, free coffee, Wi-Fi, and a widescreen TV.

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The USDA celebrates Allene Rosalind Jeanes, PhD (1906-1995), an agricultural chemist who was asked by a soft drink company to figure out why a batch of its root beer had thickened, leading her to develop a manufacturing process for the life-saving plasma substitute dextran. She and her team also discovered xanthan gum, used to thicken ice cream, medicines, and other products.

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Weird News Andy is ‘appy this didn’t ‘appen in England since “first, do no ‘arm” wouldn’t be convenient. A plastic surgeon in China grows an artificial ear on a man’s arm that will eventually replace the one he lost in an accident.


Sponsor Updates

  • Valence Health will exhibit at the AMGA Institute for Quality Leadership November 15-17 in San Francisco.
  • Verscend will exhibit at the NHCAA Annual Training Conference November 16-19 in Atlanta.
  • Optimum Healthcare IT is mentioned positively in the KLAS Healthcare Consulting 2016 report.
  • Group health extends its ZeOmega contract and will upgrade to the latest version of its Jiva population health platform.
  • ZirMed will exhibit at Wave 2016 November 17-18 in Austin.
  • Hilo Medical Center (HI) moves procedure consents to Web-based forms and electronic signatures from Access.
  • Zynx Health will exhibit at Cerner Health Conference 2016 November 12-16 in Kansas City, MO.
  • Sunquest will exhibit at the Association for Molecular Pathology Annual Meeting November 10-12 in Charlotte, NC.
  • Consulting Magazines names Impact Advisors VP Jenny McCaskey one of the “Women Leaders in Consulting” of 2016.
  • NCQA recertifies 17 Medecision disease management programs.
  • Imprivata, National Decision Support Company, and MedCPU will exhibit at Cerner Health Conference 2016 November 14-17 in Kansas City, MO.
  • LogicStream Health will host a networking event for Cerner Health Conference attendees November 15 at the Drum Room.
  • InterSystems will exhibit at AMP’s annual meeting November 10-12 in Charlotte, NC.
  • Intelligent Medical Objects, Meditech, and Streamline Health will exhibit at the AMIA 2016 Annual Symposium November 12-16 in Chicago.
  • Kyruus will host its annual ATLAS Conference November 14-15 in Boston.
  • The Kansas City Business Journal profiles Netsmart.
  • Obix Perinatal Data System will exhibit at the HIMSS Midwest Fall Technology Conference November 13-15 in Bloomington, MN.
  • Experian Health will exhibit at HFMA North Dakota November 12-13 in West Fargo.
  • The SSI Group will exhibit at the 2016 HFMA Mid-Atlantic Region Meeting November 13-16 in Asheville, NC.
  • SK&A publishes a new report, “Top 50 Free-Standing Surgery Centers.”

Blog Posts


Contacts

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

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News 11/9/16

November 8, 2016 News 2 Comments

Top News

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The Charlotte, NC paper confirms the reader rumors I ran on October 28 that McKesson has laid off 60 employees in its Enterprise Information Solutions (Paragon) business.


Reader Comments

From Look Now: “Re: Shriners Hospitals for Children. Signed a contract with Cerner to implement their EDW solution HealtheIntent across their 21 hospitals live on Millenium. Project started this week.” Unverified.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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NantHealth reports Q3 results: revenue up 76 percent, EPS –$0.30 vs. –$0.24, beating earnings expectations but falling short on revenue.

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Siemens Healthineers acquires Conworx Technology, a Berlin-based developer of point-of-care testing device interfaces.

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Clinical communication platform vendor Doc Halo opens its new corporate headquarters in Cincinnati, OH, committing to adding 65 positions in the next few months.

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Silicon Prairie News profiles Kearney, NE-based provider management software vendor Phynd, which chose that location because its software developer Expanxion is located there.

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Walgreens files a $140 million lawsuit against Theranos, claiming that the lab company violated confidentiality agreements about their partnership to offer lab testing in Walgreens drugstores in Arizona. Theranos responded by saying that Walgreens mishandled the partnership and says it will “hold Walgreens responsible to the damage it has caused to Theranos and its investors.”


Sales

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Grand River Hospital (Ontario) selects Wellsoft’s EDIS.


People

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Ann Mendlowitz (Leidos Health Consulting) joins Orchestrate Healthcare as VP of EMR consulting services.

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Telehealth technology vendor Zipnosis hires Scott Brown (Ulfbehrt Software Systems) as CTO.


Announcements and Implementations

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ECRI lists its “Top 10 Health Technology Hazards for 2017:

  1. IV pump errors (hardware failure, staff overriding safety features, and nurse programming mistakes).
  2. Improper cleaning of reusable instruments.
  3. Missed ventilator alarms due to alarm fatigue or notification failures.
  4. Undetected opioid-induced respiratory depression.
  5. Infection risks from cardiothoracic surgery heater-cooler systems.
  6. Software management gaps.
  7. Radiation exposure to clinicians working in operating suites that have built-in imaging systems.
  8. Automated medication dispensing cabinet setup and use errors.
  9. Surgical stapler misuse and malfunction.
  10. Device failures caused by cleaning products and practices.

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Burke Mamlin, MD and Paul Biondich, MD of Regenstrief Institute will receive AMIA’s Donald A.B. Lindberg Award for Innovation in Informatics this week for their work in developing and using open source software in developing countries.

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New York – Presbyterian adds video visit services to its app, offering virtual visits and the ability to ask an ED physician about minor illnesses that may or may not require an in-person ED visit.


Government and Politics

ONC publishes its annual report to Congress.

A JAMA opinion piece by two top FDA officials and CMS Acting Administrator Andy Slavitt says FDA and CMS are coordinating FDA’s approval of drugs with CMS’s decision to pay for them. They urge that clinical trials include diverse populations; that healthcare delivery data from EHRs, claims, and registries be used to reduce the cost of generating evidence and to study more representative populations, and that public-private collaboration groups such as PCORI lead efforts to integrate broader evidence generation into practice.

In New Zealand, the Ministry of Health hires an Accenture-led consortium to help it create a business case for a national EHR.


Privacy and Security

Madison County, IN officials will pay the ransom demanded by an unknown hacker when their systems are taken offline by ransomware. The county’s insurance company recommended payment and will cover part of the cost. Some county offices went back to paper, while others closed due to lack of computer access.


Other

A New York Times article questions whether the US really has a doctor shortage despite low numbers of practicing physicians and medical school slots. Instead, it says, we have a distribution problem in which doctors prefer to live in big cities (often where they trained and are paid more by Medicare for practicing there) and we have too many specialists as high medical school debt steers new graduates into more lucrative areas of practice. The article offers solutions: (a) train more doctors or allow more to immigrate; (b) decrease the number of specialty residency positions and pay primary care doctors more; (c) improve the efficiency of the healthcare system, changing regulations and licensing to use more mid-level practitioners. 

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Ram Raju, MD, CEO of the financially hemorrhaging New York Health and Hospitals, will resign.

The annual physician compensation survey of ECG Management Consultants finds that the income of PCPs and specialists increased by 1.5 percent and 3.6 percent, respectively, in the past year. Most respondents say their compensation models will incorporate value-based metrics such as quality, patient satisfaction, panel size, and adherence to evidence-based medicine.

In Australia, the first three sites to go live on the Allscripts-powered EPAS system go down for nine hours when a software module “consumed the bulk of all the computer resources.”


Sponsor Updates

  • Aprima will exhibit at the Practice Management Institute November 9-11 in Las Vegas.
  • Catalyze CEO Travis Good will present at Voalte’s VUE16 user conference November 9-11 in Sarasota, FL.
  • Medicomp Systems recaps its annual training event that was held October 3-7 in Bangkok, Thailand.
  • Besler Consulting releases a new podcast, “The relationship between EMR and physician documentation.”
  • CoverMyMeds COO Michelle Brown will speak at the BioOhio Women in Bioscience Conference November 9 in Columbus.
  • Visage Imaging will demonstrate its Visage 7 Enterprise Imaging Platform at RSNA later this month.
  • Wolters Kluwer redesigns its UpToDate online clinical decision support website to give clinicians who can’t use the company’s app a robust, Web-based alternative.
  • Impact Advisors VP Jenny McCaskey is named is named to “Women Leaders in Consulting.”
  • Crossings Healthcare Solutions will exhibit at Cerner Health Conference 2016 November 14-17 in Kansas City, MO.
  • Cumberland Consulting Group’s Lori Nobles will present at the NCHIMA Mid-Year Workshop November 11 in Concord, NC.
  • The success of National Decision Support Company CareSelect Imaging users will be highlighted at Cerner Health Conference 2016 November 14-16 in Kansas City, MO.
  • Direct Consulting Associates and HealthCast Solutions will exhibit at the HIMSS Midwest Fall Conference November 13-15 in Bloomington, MN.
  • Dimensional Insight and Extension Healthcare will exhibit at the HIMSS South Florida InteGrate Conference November 14-15 in Davie, FL.
  • EClinicalWorks will exhibit at the Kentucky Primary Care Association 2016 Conference November 9-11 in Lexington.
  • Impact Advisors publishes a white paper titled “The MACRA Final Rule: Key Takeaways on MIPS and Advanced APMs.”
  • Healthwise’s Leslie Hall will present at Partnering for Cures November 13-16 in New York City.

Blog Posts


Contacts

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

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