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Weekender 1/12/18

January 12, 2018 Weekender 3 Comments


What the Heck Is This?

HIStalk Weekender is a way to close out the week in a Hawaiian Shirt Friday kind of casual way, free of the limitations of the regular M-W-F news format. It incorporates suggestions from my reader survey, such as:

  • Lighten the M-W-F news posts but still run interesting stuff in its own section for reading at less-busy times
  • Keep DonorsChoose updates but separate them from the news
  • Recap the week’s best reader comments that might have been missed or posted later
  • Provide links to the entire week’s posts for those who are catching up
  • Queue up items through the week to allow posting Weekender by Friday afternoon

Readers who are of the “just give me the news headlines customized to my personal interests and nothing else” genre can skip these posts and just read the daily headlines, but as I always caution, succeeding in a profession means keeping up with it instead cocooning off Facebook-style or glancing at headlines. I wouldn’t put something on HIStalk if I didn’t think it was important, debatable, or interesting to C-level executives, even if only as watercooler topics.

Weekly News Recap

  • Change Healthcare retools its claims management network to use blockchain, the industry’s first high-volume test at 50 million claims-related events each day.
  • Allscripts buys Practice Fusion for $100 million in cash.
  • ONC’s Genevieve Morris says regulations will be published this spring that will define and regulate information blocking.
  • ONC publishes a draft of its Trusted Exchange Framework.
  • Cerner hires former Philips North America CEO Brent Shafer as CEO and board chair.
  • Wolters Kluwer Health sells Provation MD for $180 million in cash.

Best Reader Comments

Cerner has a gap to close and it would help everyone if the VA pushed them to increase the clinical value of their interoperability to rival Epic’s. (Switch Clicker)

Allowing physicians to run the whole show sounds good, except it led to healthcare being a lagging adopter of technology, unsustainable cost growth, and a 17-year delay (on average) in clinical best practices receiving universal adoption. Healthcare was run like a medieval guild. That’s what physicians running everything led to and leads to. (Brian Too)

With regards to Cerner and the VA, I would agree with you. I, too, am surprised that they didn’t leverage the Leidos relationship and have them act as the primary, similar to what occurred with the DoD. To my knowledge, Cerner, on their largest government contracts, hasn’t been the direct supplier. They won the DoD with Leidos playing lead, and in the United Kingdom, they first were with Fujitsu as the primary before BT took over for Fujitsu. (Associate CIO)

It’s amazing how the ONC thinks that healthcare organizations are adopting FHIR. Not one single EMR, LIS, or RIS vendor in the US utilizes FHIR yet for interoperability. If they really want to invoke change, they need to figure out ways to either force adoption or incentivize it. (Annon)

Eva. Once again, a virtual assistant is given a woman’s name. (HIT Girl)

The amount of times I have sat in a room to have two physicians in the same organization get into a shouting match as to how something should work is uncountable. If you cannot figure out your ideal workflow, how is a vendor supposed to create software to support it? Vendors/developers still need to be in charge of creating software, there simply needs to be more input from qualified clinicians, and less regulation on the specifics regarding clicks and metrics from the government. As someone who has grown up with a laptop in hand, the state of Health IT is atrocious, and the fact that far greater strides have not been made is an absolute travesty. (Seargant Forbin)

Reducing the cost of health care with interoperability, even with the sharing of information, isn’t going to happen until physicians learn to trust the documentation and test results of other facilities. If a CT has been done at Facility A and the patient is then consulted on by Facility B, they are likely to repeat the CT since they trust their technicians. (Barbara)

I see that healthcare is similar, in more ways than clinicians know or admit, to software development in every other industrial sector. Real software solutions are built on a foundation of failure and inadequacy, slowly rising to competence. Fortunes are spent on this process. A few winners emerge over time. Sectors like Finance had the advantage of (far) fewer data elements and strong theory, widely taught (this includes GAAP and goes all the way back to Luca Pacioli). Biology is more complicated but healthcare will get there. The real question should be, why did physicians expect highly competent EMRs to exist when so few physicians bought them, used them, or participated in designing them? A market economy will build what the market supports. Low investment results in sub-par results. Except, sub-par EMRs also discourage physician adoption and chokes off investment. (Brian Too)

Watercooler Talk Tidbits


Ms. C says of the 200 sets of headphones readers provided to her Utah elementary school class in funding her DonorsChoose teacher grant request, “One project for STEAM that we are excited to use these headphones for is studying living and non-living things. We will watch live feeds and videos to see animals in their habitats, write observations, and report on our findings. Our headphones will help us hear these videos, so thank you for donating them!”

Here’s a welcome video from new Cerner Chairman and CEO Brent Shafer.


Allscripts provided this slide in its presentation at the J.P. Morgan Healthcare conference, describing its role as an “industry consolidator.”


France-based technology company Blade launches a cloud-based, subscription-priced replacement for the PC, with an initial target audience of gamers. PCs, Macs, or mobile devices plug into the Shadow box and app, turning them into a high-powered PC (eight-threaded dedicated Xeon server, 12 GB RAM, 256 GB storage, high-end NVidia graphics card) for an annual fee of $420 in offering “the last PC you’ll buy,” at least as long as your always-on Internet connection delivers at least 15 Mbps.

An excerpt from Genome Mag’s look into the commercial and research implications of DNA theft and health data ownership:

Stanford University Law School professor Hank Greely agrees that human biology does not fit neatly into the property box. “Do you own your kidney?”’ he asks. “Well, kind of. No one can take it from you without your consent, but neither can you sell it.” And, he says, the same awkward fit holds true for data. “I’d like to think that I own my electronic health record, but do I really? I can’t keep the hospital from using it, or sharing it with an insurer, or giving it in de-identified form to a researcher, or giving it to the FBI if the FBI asks.”


Two old-money Kansas City, MO families donate $75 million each to Children’s Mercy Kansas City to form the Children’s Research Institute and to build it a nine-story, 375,000 square foot building that will house 3,000 mostly new employees.


The 15,000 square foot Chicago mansion previously rented by Outcome Health CEO Rishi Shah for $50,000 per month is listed for sale at $9.99 million, down from the previous $15 million. The house became famous when the 31-year-old paper multi-billionaire Shah fled the property OJ-style in a black Escalade to avoid being served a summons related to allegations that the waiting room advertising company misled investors.

A surgeon in England is sentenced to community service for using an argon beam coagulator to burn his initials into the livers of two patients during transplant surgery in 2013. He said it was an attempt to relieve OR tension, but the judge scolded him in letting his “professional arrogance” stray into criminal behavior even though patients weren’t endangered.


Dr. Oz rushes to the aid of a fellow airline passenger and breathlessly recounts his heroic intervention to reporters – he asked the guy to lie down and raise his legs. At least he didn’t shove a weight loss pill down his throat or apply his entertainment-level medical guidance that experts say deviates from accepted medical knowledge at least 50 percent of the time.

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Reader Comments

  • DrM: Found the person who knows nothing about user change management. (Did I do it right, is this how we play the game?) S...
  • Seargant Forbin: @ What's with the Fairview guy? I don't think this Apple comparison is helping your case any. I bet if you spoke with de...
  • Bobby: Great point Bob. Cerner and Epic are both organic companies that value a “one big honking system” approach to thin...
  • AynRandWasDumb: "The most recent Epic trick I heard is that, now that Epic is requiring every customer to move to quarterly updates inst...
  • Bob: Even though Apple could take IP directly from the Apple ecosystem developers, their usual model is to just buy the compa...
  • You might say I'm a dreamer...: Will this Cerner dust up with the DoD now give us a real granular discussion on a national level as to what Interoperabi...
  • Eddie T. Head: To claim that Apple is a hardware company and not a software company is quite odd. Without their software, Apple's hardw...
  • DrM: Epic's model does assert the ability to use any IP in App Orchard without compensation or limitation, it's why the few v...
  • Matt: VA CIO: Expect another 10 years of VistA in facilities during new EHR rollout This is clear indication of how the VA ...
  • Satan warming up the fiddle?: Coming in to an election season where healthcare will most certainly be part of the debate are we starting to see the fi...

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