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Morning Headlines 2/11/15

February 10, 2015 Headlines No Comments

Cerner Reports Fourth Quarter and Full Year 2014 Results

Cerner announces Q4 results: revenue up 16 percent to $1.16 billion, adjusted EPS $0.47 vs. $0.39.

Premier, Inc. Reports Fiscal 2015 Second-Quarter Results

Premier, Inc. announces Q2 results: revenue is up 19 percent to to $294 million, EPS $0.36 vs. $0.31.

Is Your Doctor’s Office the Most Dangerous Place for Data?

ABC News cover the rise of hackers migrating toward the healthcare space, an industry that finds itself 10-years behind financial services in terms of protecting consumer information.  

WakeMed posts $3M Q1 income, goes live with electronic records

WakeMed goes live with its $100 million Epic install.

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February 10, 2015 Headlines No Comments

News 2/11/15

February 10, 2015 News No Comments

Top News

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Premier, Inc. announces Q2 results: revenue up 19 percent, adjusted EPS $0.36 vs. $0.31, beating analyst expectations for both. President and CEO Susan DeVore says the company will make more technology acquisitions following its recent buys of TheraDoc, MEMdata, SYMMEDRx, and Aperek, noting an interest in supply chain analytics, alternate site, ambulatory data, and population health.

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DeVore adds that HHS’s fee-for-value push will increase the need for the company’s technology related to quality and clinical analytics, labor analytics, infection surveillance, and population health. Above is the one-year share price chart of PINC (blue, up 0.6 percent) vs. the Nasdaq (red, up 14 percent). The company’s market capitalization is $1.32 billion, with DeVore holding shares worth $7.3 million.


Reader Comments

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From Smartfood99: “Re: Ohio Valley in Wheeling, WV. Chose to upgrade to Meditech 6.1, beating out other finalist Ohio State University’s farm out of Epic.” Unverified.

From Webejammin: “Re: patent trolls. They’re using ONC’s list of certified EHRs to file suits using old patents that never should have been issued. This will dampen innovation and increase the cost of EMRs.” It’s not hard to get a list of EHR vendors from ONC’s list or elsewhere. Nor is it hard to find an old, intentionally vague patent and use the threat of an expensive legal defense to coerce EHR vendors into paying settlements or licensing arrangements whose cost is intentionally placed at the extortionate sweet spot between “annoying” and “profit-threatening.” Thank your lawyer-heavy Congress for its resistance to embracing the “loser pays” frivolous lawsuit policy that would increase unemployment among our vastly superior US force of ambulance chasers.

From Dingman: “Re: companies in financial trouble. You probably see some of that firsthand when they either are slow to pay their sponsorship or don’t renew because of financial issues.” I could indeed, although I usually lose sponsors instead because (a) they get acquired, or (b) a new marketing person who doesn’t even know what HIStalk is decides to wield their low-level decision-making power in deciding not to renew, which sometimes gets them in trouble down the road with their executives who wanted to support HIStalk in the first place. Sometimes I do hear directly from companies that their budget has been cut or executive upheaval is so extensive that they can’t even figure out who has purchasing authority, which might involve more transparency than customers get.


HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Galen Healthcare Solutions. The Grosse Pointe Farms, MI-based professional and technical services consulting firm also offers products for Allscripts TouchWorks  — remote patient monitoring, integrated health calculators, downtime chart review, note form reporting, and reporting. Technical services include EHR conversions, integration, technical consulting, and contract programming, with experience in Epic, eClinicalWorks, Allscripts, Meditech, Orion, Medfusion, and others. Galen helped Citizens Memorial Hospital (home of one of my favorite CIOs, Denni McColm) convert an acquired Allscripts-using practice to its Meditech system, bringing over 1.5 million documents and 3.5 million test results. Galen’s full (and huge) client list is available freely online along with client testimonials. Thanks to Galen for supporting HIStalk.

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Sign up now to attend HIStalkapalooza on April 13. The “I want to come” form is still open, but that won’t be true for much longer. Every year I get annoyed at people who email after signups close to insist that they weren’t aware that it had taken place and demand special treatment, which generates little sympathy from me because that tells me they don’t really read HIStalk. On the other hand, I’m amused by some of the creative uses of the comments field on the form from the responses so far:

  • On a Cerner life raft in an ocean of Epic. Would love to come and party with the smartest, coolest people on this blue planet.
  • Is there a more senior VC in HCIT? What do I gotta do?
  • I figured since even you were filling out the "I want to go" form, so should I! 😉
  • I went two years ago and loved it!!! I didn’t get an invite last year :( I hope I am still a cool kid!
  • [enter pithy/witty comment that guarantees entry here]
  • Often watched the big party bus roll out without me while I searched the conference town for tourist food. I had the HIMSS blues, man.
  • Can we get the band from last year? They were brilliant!

I took over running the event myself this year with the support of multiple sponsors so that I could invite more people, and so far it’s looking good for covering the cost of a big guest list. House of Blues is an amazing venue and I will indeed be bringing back last year’s musical entertainment, Party on the Moon, America’s #1 private party band. I’m hoping the winner of the “Healthcare IT Lifetime Achievement Award” will accept the award on stage. I’m also contemplating whether the individual named as “Industry Figure in Whose Face You’d Most Like to Throw a Pie” would be willing to receive delivery of said pie in public, possibly delivered by the second-place vote-getter (I might be able to mount a charitable fundraising campaign rivaling the Ice Bucket Challenge to shame both parties into participating).

One more HIMSS-related event item: we’ve emailed HIStalk sponsors about our networking reception on Sunday, April 12. Email Lorre if you’re a sponsor and you want to come because sometimes we don’t have good company contacts.

I could use some help from folks willing to critique the recorded rehearsals of our webinars, suggesting to the presenter what they might change for the live event. Provider CIOs, CMIOs, or other hospital IT types are ideal given the topics often covered. I’ll send a $50 Amazon gift card in return for the 45 minutes or so it takes to watch the video and fill out the eval sheet. Email me if you’re interested.


Webinars

February 13 (Friday) 2:00 ET. Inside Anthem: Dissecting the Breach. Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. The latest intelligence about the Anthem breach will be reviewed to provide a deep understanding of the methods used, what healthcare organizations can learn from it, and how to determine if a given organization has come under similar attacks. Attendees will be able to ask questions and put forth their own thoughts. 


Acquisitions, Funding, Business, and Stock

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Hitachi Data Systems will acquire Orlando-based business analytics tools vendor Pentaho, which has some healthcare-related customers and partners, for $500 to $600 million.

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Aventura raises $14 million in an oversubscribed Series C funding round and will use the proceeds to expand its awareness computing services and product development.

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Image-sharing cloud vendor LifeImage raises $2.6 million in funding, increasing its total to $68 million.

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Shares of Merge Healthcare jumped substantially in the past week in hitting a 52-week high Monday, doubling in price since October. Above is the one-year share price chart for MRGE (blue, up 101 percent) vs. the Nasdaq (red, up 14 percent).

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Cerner announces Q4 results: revenue up 16 percent, adjusted EPS $0.47 vs. $0.39, meeting earnings expectations and beating on revenue.


Sales

Frontier Behavioral Health (WA) chooses the CoCentrix Coordinated Care Platform as its EHR and care management tool.

Quintiles signs a five-year contract with the National Football League to track player injuries using the league’s EHR data.


People

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AMC Health names Jonathan Leviss, MD (WiserCare) as SVP/medical director.

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HIMSS names Michelle Troseth, MSN, RN, chief professional practice officer of Elsevier Clinical Solutions, as  the recipient of its Nursing Informatics Leadership Award.

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Joe Miccio (ESD) joins Impact Advisors as VP.

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Brigham and Women’s Hospital promotes David Bates, MD to SVP/chief innovation officer.

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Adam Wright, PhD, who leads a biomedical informatics team at Harvard Medical School, is promoted to associate professor of medicine.

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Kaiser Permanente names interim CIO Dick Daniels to the permanent position. He was previously SVP of enterprise shared services.

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Personalized medicine analytics vendor Kyron names Jacob Reider, MD (ONC) as chief strategy officer.

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Cumberland Consulting Group names board member Brian Cahill (LifeImage) as CEO. His predecessor, founder Jim Lewis, moves into the board chair role.

Surgical Information Systems names John Spiller (Origin Healthcare Solutions) as CFO.


Announcements and Implementations

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WakeMed (NC) goes live with Epic.

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Imprivata launches Confirm ID, which supports DEA-mandated policies for electronic prescribing of controlled substances.

The US Patent and Trademark Office awards DR Systems seven imaging-related technology patents.

Divurgent and Sensato will jointly offer healthcare cybersecurity and privacy services and will host Hacking Healthcare 2015 in March.

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Cone Health (NC) issues easy-to-read patient bills using Patientco’s PatientWallet.

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PatientSafe Solutions expands its clinical communications tool and renames it PatientTouch Clinical Communications.


Government and Politics

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A GAO report seems satisfied that CMS is ready for the ICD-10 implementation date of October 1, 2015, although it seems to have looked more at CMS’s responsiveness to suggestions than its actual technical readiness.

The New York Times calls out little-noticed White House budget language that urges Congress to eliminate the financial incentive for hospitals to buy physician practices so they can charge more for delivering the same services to patients.


Privacy and Security

The largest insurer of the Lloyd’s of London insurance marketplace says that breaches — such as the one just experienced by Anthem — involve financial risks that are too large for insurance companies to cover, suggesting that only governments have the resources to manage those liabilities. Insurance companies worry that multiple cybersecurity insurance customers could be hit by the same exploit simultaneously.

ABC News asks, “Is Your Doctor’s Office the Most Dangerous Place for Data?” citing the FBI’s warning that healthcare organizations are being targeted and quoting a security expert who says healthcare is 10 years behind the financial services sector in protecting consumer information such as Social Security numbers.

A Swedish biohacking group offers to replace the security key fobs used by a high-tech building’s employees with a palm-embedded RFID chip that allows them to wave their hand to unlock doors, activate the photocopier, and pay their cafeteria bill. The group says the chips could be used to make payments and replace fitness trackers.

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Reporters are trying to create a story around whether Anthem was irresponsible in not encrypting its customer records. I’m not an expert, but my minimal exposure to encryption involves three types: (a) encrypting a secure online session connection such as with SSL; (b) encrypting a storage device so that nobody can dig into its contents without logging on with the appropriate credentials; and (c) encrypting individual database elements so that they can’t be queried without logging on with the appropriate credentials. The only relevant form in Anthem’s case would seem to be (c) and that wouldn’t have helped since the attackers stole a database administrator’s credentials via a phishing attack. Encrypting data at rest is great for physical protection (a stolen disk drive or a physically breached data center) but otherwise the system doesn’t know that the correct login was used by an unauthorized person, short of using biometrics or privileges tied to IP address. I think the story is misleading, but I’ll defer to any experts who care to respond.

Anthem’s hackers knew that database credentials would give them access to everything, so perhaps the immediate health system to-dos would be (a) review users who possesses DBA credentials; (b) monitor the use of those credentials for irregularities, such as large queries that are run off hours or that involve outside that individual’s normal job scope; (c) monitor for large data transfers outside the firewall; (d) enlist DBAs to help watch for problems since they were the ones who detected the Anthem breach; and (e) put efforts into anti-phishing technology and user education rather than worrying about encrypting databases on the off chance that someone will physically steal a server. I really don’t understand in this day and age why we haven’t moved to biometric security instead of the easily pilfered “what you know” password – our data center doors are more technically secure than the systems they house.

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Several Atlanta-area businesses fall victim to ransomware, where malware encrypts the files on a user’s PC and demand anonymous payment to restore access. A Secret Service representative says that physician offices are targets since their often-unsecured wireless networks can be hacked from their parking lots, although I would have assumed the method of infection would be via other methods.


Technology

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Google will incorporate Mayo Clinic-curated information into its medically related search results, providing symptoms and treatments via its Knowledge Graph and Now personal assistant (which I’ve never heard of).

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Medical device manufacturer DexCom will release an app that will display readings from its implanted continuous glucose monitor on the Apple Watch when the latter goes on sale in April. Dexcom already offers such monitoring on its own hardware with Bluetooth-powered iPhone data sharing.

Merge Healthcare announces that users of its iConnect Network will be able to transmit and receive imaging orders and results to Emdeon Clinical Exchange users.


Other

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The local newspaper covers the migration to Epic by two Lehigh Valley, PA competitors, Lehigh Valley Health Network and St. Luke’s University Health Network. Epic replaces GE Healthcare at LVHN and McKesson and Allscripts at St. Luke’s.

Health system consolidation continues: Emory Healthcare and WellStar Health System are discussing merging into a single Atlanta-area system, while in New York, North Shore-LIJ is talking to Maimonides Medical Center about a “partnership” that sounds more like the former acquiring the latter.

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Why do reporters feel qualified to interpret scientific information and render related opinion without consulting experts? The Toronto Star runs a self-proclaimed investigative article on the dangers of HPV vaccine Gardasil, dramatizing the 60 potential cases of side effects out of 800,000 doses administered. Expert physicians called out the poor reporting, to which one of the paper’s otherwise uninvolved left-leaning, American-hating columnists (best known for calling Sarah Palin a “toned-down porn actress” and insisting that male conservatives make bad decisions because of impotence) responded with a bizarre rebuttal that invokes government secrecy, Twitter, the US Tea Party, and her own self-study of statistics. The physician author of a book the columnist cited immediately blasted out a series of tweets calling out the paper’s “appalling, ignorant, irresponsible journalism” in running a “scare story.” The exchanges were summarized and brilliantly titled as “When ‘Teaching Yourself Statistics’ is No Match for Being a Doctor.”


Sponsor Updates

  • Craneware enhances its Supplies Assistant solution to make it easier for hospitals to add new devices and supplies to their chargemaster.
  • Dental software vendor Curve Dental incorporates DrFirst’s e-prescribing technology into its product, which will allow users to comply with New York’s I-STOP mandatory e-prescribing regulation that takes effect March 27, 2015.
  • Meditech will add more products from Truven Health Analytics’ Micromedex Patient Connect Suite to its EHR platforms.
  • Clockwise.MD announces that nearly 1 million patients have been seen through its Web-based appointment reservation tool.
  • Clinical Architecture offers the third installment of its blog series on “The Road to Precision Medicine.”
  • Certify Data Systems validates the interoperability of its HealthLogix solution at the IHE North American Connectathon.
  • Anthelio renews its contract with Saint Mary’s Health System (CT).
  • Besler Consulting latest blog post covers “Optimizing Communications to Reduce Readmissions.”

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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February 10, 2015 News No Comments

Monday Morning Update 2/9/15

February 8, 2015 News 2 Comments

Top News

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Experts say hackers can sell the patient information exposed in Anthem’s 80 million member breach for up to $1,000 per record (or a staggering potential payout of $80 billion for the thieves) since it forms a “complete identity theft kit” that includes insurance and Social Security numbers (stored unencrypted, in Anthem’s case). A stolen credit card number is worth only $1 and insurance credentials alone fetch just $20. Anthem admits that hackers used the credentials of at least five of its IT employees for up to a month before the attack, which the company detected only when a database administrator noticed someone running queries under his user ID. Investigators are looking into evidence suggesting that China-sponsored hackers launched the attack to obtain information to be used in espionage-related phishing, which seems to be the standard, non-verifiable post-breach excuse.

Meanwhile, scammers pile on by sending bulk spam using Anthem’s logo (above) and cold-calling people claiming to offer credit monitoring trying to get recipients to divulge their own confidential information.

The healthcare- and privacy-related background of Anthem CIO Thomas Miller: zero. He came from Coca Cola just eight months ago, hired because of his background with digital marketing and loyalty programs. 


HIStalk Announcements and Requests

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Nearly 80 percent of poll respondents think the federal government should issue a national patient identifier, about the same percentage that answered positively in my 2013 poll asking the same question. They added some thoughts: (a) an opt-in version would be more acceptable; (b) the VA could use the identifier to provide information needed to process Social Security disability claims; (c) the ID should be used only for healthcare, employers can’t ask for it, and the individual owns the information associated with the number; (d) use Social Security number as the patient identifier; (e) since nobody wants their Social Security number used for fear of hacking, instead create an ID consisting of date of birth, first three letters of the last name, and the last four digits of the SSN; and (f) a private company’s solution is available now and they’re looking for partners.

New poll to your right or here: will Athenahealth be able to create a competitive, large-hospital information system by rewriting BIDMC’s internally developed WebOMR? Vote and then click the poll’s “Comments” link to elucidate further.

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Welcome to new HIStalk Platinum Sponsor CoCentrix. The Sarasota, FL-based company’s Coordinated Care Platform, built on the Microsoft Dynamics CRM solution, optimizes the behavioral health continuum for the benefit of state and local government agencies, providers, and consumers. Components include a certified HHS EHR for state agencies and community providers (intake, assessments, treatment plans, orders, documentation, billing, dashboards, and data mining), enterprise-level case management, a managed care solution, and the rather cool Caretiles integrated mobile app marketplace for consumers. The 32-year-old company has 500 customers in 42 states. Thanks to CoCentrix for supporting HIStalk.

Here’s a patient-centered overview video of CoCentrix that I found on their site.

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Sign up now if you want to come to HIStalkapalooza on April 13. I’ll have to shut the page down once I get too many requests to accommodate. I can’t necessarily invite everyone who wants to come, but I can say for sure that you won’t be invited if you don’t sign up (which is true for me as well, so I’ll register today).


Last Week’s Most Interesting News

  • Roper Industries acquires two health IT companies, including the leading laboratory middleware vendor as a complement to its Sunquest business, for $450 million following its recent acquisition of Strata Decision Technology.
  • Insurance company Anthem announces that a cyberattack exposed the information of 80 million of its customers, but says no medical or credit card information was stolen.
  • Athenahealth acquires rights to Beth Israel Deaconess Medical Center’s self-developed WebOMR hospital information system, announcing plans to rewrite it to sell to large hospitals.
  • ONC requests $92 million for its FY2016, budget, with $5 million of the 50 percent increase set aside to create a Health IT Safety Center.
  • Cerner completes its $1.3 billion acquisition of Siemens Health Services.
  • ONC publishes the draft version of its 10-year interoperability roadmap that includes a goal of allowing most patients and providers to exchange and use a common set of electronic clinical information by the end of 2017.

Acquisitions, Funding, Business, and Stock

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From Friday’s Athenahealth earnings call:

  • Chairman and CEO Jonathan Bush says the company “fell short of the finish line” in 2014 due to “over dependence on one channel partner, over focus on ambulatory medicine, and limited experience with turnaround situations.” He says those were “admission tickets to new levels of adulthood” that will allow the company to get back to 30 percent growth.
  • Bush admitted that the company’s enterprise prospects have balked at solutions that don’t address inpatient.
  • He says that the acquired RazorInsights product, built for hospitals under 50 beds and priced at around $250,000 to $500,000 per hospital, is “the multi-tenant platform we need to manage most hospitals in the country,” while BIDMC’s WebOMR can handle the more complicated hospitals. Those will be merged together to form Athena Inpatient Clinicals.
  • Bush says the company failed in missing its Net Promoter goal of 52.5 in hitting only 42 for Q4.
  • The company hired 1,300 employees in 2014, raising its total to 3,700, and will add another 1,000 in 2015.
  • Athenahealth’s CFO says RazorInsights produces “a very small amount of revenue at a loss” and that WebOMR is not immediately commercializable, so she recommended that analysts view the acquisitions as ways to eventually enter the inpatient market rather than as revenue-contributing products.
  • The company “tried to stop the bleeding on the nervous prospects” who were passing on Athenahealth to choose Epic.

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ATHN shares closed Friday down 0.8 percent. Above is the one-year chart of ATHN (blue, down 17 percent) vs. the Nasdaq (red, up 15 percent).

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From the McKesson earnings call, which had few mentions of its Technology Solutions business:

  • Technology Solutions revenue was down 7 percent due to lower revenue from Horizon Clinicals and the exited UK workforce business, in line with projections.
  • John Hammergren says McKesson is “in middle of the game” in trying to move Horizon customers to Paragon.
  • He adds, “There’s a bunch of interesting places that we’re placing bets, including CommonWell Health, that we think will pay off” as the company sells data-related products.
  • Asked about the future Technology Solutions product line, Hammergren said, “I would say though that as you think out two or three years, the EMR space and the transition away from Horizon will be more complete or complete, and we’ll see more results, we think, in terms of this pay-for-performance priority. I mentioned that HHS and others believe that the market has to move more towards a value-based reimbursement methodology. That’s going to require additional investment.”

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Crain’s Chicago Business profiles 73-year-old, near-billionaire investor Dick Kiphart, who says of his investment 10 years ago in healthcare communications company Emmi Solutions, which he sold two years ago to Primus Capital, “It stumbled for a long time. I kept my money in, and it looks like it will be a two- or three-bagger.”


People

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Jennifer Haas (Microsoft) joins Aventura as VP of marketing.

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John Hallock (CareCloud) joins Imprivata as VP of corporate communications.

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Tony Scott (VMware) is named chief information officer of the United States, replacing Steve VanRoekel.


Announcements and Implementations

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Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, MD donate $75 million to San Francisco General Hospital (CA), where Chan did her pediatrics residency. The city will name the expanded facility Priscilla and Mark Zuckerberg San Francisco General Hospital and Trauma Center, which is pretty much the opposite of creatively and succinctly naming a social media website “Facebook.”


Government and Politics

The Defense Health Agency says its top 2015-2016 priorities will prepare it for its EHR implementation: continuing to work with the VA on interoperability, consolidating infrastructure, and standardizing configurations.  The agency’s director explains that, “This is an $11 billion procurement. When you think about that, this infrastructure piece is huge. So we have to think about what we’re going to do to make sure we get the best performance out of that EHR."


Technology

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A CNN report says the Apple Watch will fail (at least in compared to typically blockbuster Apple offerings) because: (a) for $350, all it does is allow users to perform existing iPhone functions from their wrists; (b) rumors are that the battery life will be awful at just 10 hours; (c) it’s rectangularly chunky compared to sleeker products already on the market; (d) it doesn’t do anything particularly compelling; and (e) it’s likely to be improved in a year, forcing users to buy it all over again.


Other

Grant-funded Vermont Information Technology Leaders pitches its new HIE to consumers by running regional Super Bowl ads on local TV stations at a cost of around $13,000 of its $195,000 marketing campaign.

University of California’s 10 campuses will require students to be vaccinated for measles starting in 2017, with students expected to enter their vaccination records into UC’s electronic system. Religious and medical exemptions will be honored, UC says.

Forbes notes the “emerging bull market” for “digital healthcare journalism,” with examples being Politico’s three-reporter subscription-only eHealth launch in 2014 and its plans to expand to an overall healthcare team of 16, the recent sale of Med City Media, and establishment of a five-reporter health and science department at BuzzFeed.

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Patients of Reid Hospital (IN) complain when the hospital tries collect debts from as far back as 2011. The hospital has apologized, saying that some patients didn’t receive the usual three monthly bills before their accounts were turned over to collection agencies by a former contract company.

The gutted healthcare system of cash-strapped Greece requires hospitalized inpatients to hire their own nurses for even basic inpatient care, but lack of money and insurance leads many of them to retain poorly trained and illegal phony nurses – often immigrants — provided by temp agencies that cruise the hospital halls handing out business cards. Hospitals say they are too understaffed to expel visitors who offer to rent TVs, bedding, and chairs to patients, adding that even the state doesn’t have the legal authority to issue fines to violators.

Weird News Andy never eliminates stories about fecal transplants, titling this one “Does this bacteria make me look fat?” Researchers suggest not using gut bacteria from overweight fecal donors to treat infections since a case study found that the recipient gained 34 pounds in the 16 months following the procedure.


Sponsor Updates

  • Medicity offers a recap of the HL7 conference that showcased FHIR as the “next big thing” in healthcare.
  • Sandlot Solutions writes about “Interoperability: Making the ONC’s Vision a Reality.”
  • Courtney Patterson asks, “Could Your Reporting Team Structure be Helping or Hurting Your Organization?” in the latest Sagacious Consultants blog.
  • RazorInsights will exhibit at the Rural Healthcare Leadership Conference February 8-11 in Phoenix.
  • Qpid Health’s Amy Krane summarizes the company’s recent webinar on how Partners Healthcare eliminated prior authorization.
  • Siavosh Bahrami rants about the importance of simplicity in a new pMD Charge Capture blog.
  • PatientKeeper offers a post on “The Interoperability Non-Controversy.”
  • Park Place International offers advice on “Getting Ready for the Meditech Patient and Consumer Health Portal.”
  • Patientco posts an article titled “The Importance of Payment Plans in Your Revenue Cycle Strategy.”
  • NVoq Director of Healthcare Industry Solutions Chad Hiner, RN explains why “EMR adoption will require more than financial carrots.”
  • In the latest Phynd blog, Thomas White asks, “How many employees does it take to enroll a new provider in a hospital’s EMR?”
  • Ryan Reed offers “5 Tips to Prepare for Cloud Migration” in the latest NTT Data blog.
  • Netsmart will exhibit at the Open Minds Best Management Practices Institute meeting February 12-13 in Clearwater Beach, FL.
  • MBA Health Group Consultant Nicholas Bocchino writes about the possible changes to Meaningful Use this year in its latest blog.
  • PeriGen launches its Five-Minute Challenge for labor and delivery managers.
  • Medfusion will introduce its Help Center in an event on February 12.
  • Nandini Rangaswamy asks “What works? EHR-based PHM or PHM-based EHRs?” in the latest ZeOmega blog.
  • WeiserMazars releases its Group Annual Report.
  • T-System shines a spotlight on staff member Javariah Khan in its latest Informer blog.
  • General Manager of Clinical Solutions Eric Brill writes about Voalte’s work with UCSF Medical Center Mission Bay in a new blog.
  • Stella Technology Founder and SVP of Business Development Salim Kizaraly discusses HIEs past and present in a Relentless Health Value podcast.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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February 8, 2015 News 2 Comments

News 2/4/15

February 3, 2015 News 5 Comments

Top News

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Cerner completes its $1.3 billion acquisition of Siemens Health Services as announced in August. Cerner reiterated in the announcement that it will continue to support Siemens core systems for an unspecified period, with Soarian maintenance guaranteed for 10 years. Former SHS CEO John Glaser has joined Cerner as SVP and a member of the company’s executive cabinet. Julie Wilson, Cerner’s chief people officer, says Monday was “the biggest single hiring day in Cerner history” as its employee count jumped from 16,000 to 22,000 with the acquisition. CERN shares rose 0.57 percent Monday on the news, giving them a slightly better performance (blue, up 20 percent) than the Nasdaq as a whole (red, up 17 percent) over the past year.


Reader Comments

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From Lemmy: “Re: Athenahealth’s purchase of BIDMC’s WebOMR. Not sure why Athenahealth would be interested – WebOMR is a complete piece of crap being held together with gum.” I mentioned the acquisition in last weekend’s post as a rumor provided by reader InTheKnow, although I left out specific details since ATHN is publicly traded. More discussion follows below – I got details from John Halamka that go well beyond the announcement and invalidate some incorrect assumptions I had.

From Mr. Smith: “Re: national patient identifier. HHS and ONC are prohibited by law from even discussing anything related to an NPI even though they are acutely aware of the challenges posed by not having one. The legislative branch should address the issue, but HHS and ONC are trying to create a workable solution.”


HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor West Corporation and its healthcare practice. The Omaha, NE-based company processes billions of voice-related transactions each year. Its West Engagement Center drives patient engagement, care coordination, and provider collaboration using a variety of technologies (voice, text, email, mobile, contact center). Available solution sets include telehealth, patient access, prevention and wellness, and chronic disease management. It is used by providers, payers, and employers that are transitioning to value-based care, managing populations,  creating chronic disease care coordination programs, or adding patient engagement capability to existing population health management technologies. Sign up for an online tour here. Thanks to West Corporation for supporting HIStalk.

Here’s a YouTube video that shows how patients report their daily blood pressures using the West Engagement Center.

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We’ve received just a handful of requests from real-life patients who want to take advantage of our HIMSS15 conference scholarship ($1,000 in travel cash plus registration). We’re accepting applications through February 9 and will choose the five based on their patient stories and their writing ability. See Regina’s description and send entries to Lorre.


Acquisitions, Funding, Business, and Stock

Athenahealth makes its second recent  push into the inpatient EHR market by acquiring the WebOMR system that was developed by Beth Israel Deaconess Medical Center (MA). Terms were not disclosed. The company will integrate WebOMR with its AthenaNet system. The internal announcement from BIDMC CEO Kevin Tabb says that BIDMC will do a “trial implementation” of “some of athena’s current products” in “select areas of our network.” BIDMC’s only obligation to Athenahealth is to help its engineers understand how WebOMR works “so they can try to expand its use beyond our walls” as “the days of self-built information systems will not last forever.” Athenahealth acquired small-hospital EHR vendor RazorInsights on January 14. Athena shares ended the day up just over 1 percent, the same daily gain as the Nasdaq composite.

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I spoke to BIDMC CIO John Halamka, MD for clarification about the agreement:

  • BIDMC originally developed WebOMR as an ambulatory application, but it has been extended to include all BIDMC-developed automation – a certified inpatient EHR, OR management, oncology, laboratory, radiology, electronic medication administration record, and bedside barcoding. The only external dependency is First Databank for drug information. The only excluded module is the ED information system (which had been previously commercialized as Forerun) and the agreement doesn’t cover billing (which is performed by a McKesson application). BIDMC has done work with Google Glass and Apple Health and those components are included as well.
  • Athenahealth is buying BIDMC’s intellectual property, but it will not use BIDMC’s programming code, which was developed by a 25-member team using Cache’ and Cache’ server pages. Athenahealth will instead rewrite the entire product (or at least the parts they want to commercialize) using their own workflow, user interface, and business logic to create a new platform.
  • BIDMC will not act as Athenahealth’s development partner. What Athenahealth bought for an unstated cash investment is the intellectual property, one BIDMC FTE for two years to help them understand the applications, and access to an alpha site in BID-Needham, which has a 29-bed medical-surgical ward running Meditech (which will not be replaced there).
  • BIDMC gets a 20-year license to use the code that Athenahealth develops, but they do not have to move to Athenahealth’s version and are not precluded from replacing WebOMR with a commercial product, which Halamka says may happen at some point.
  • Halamka estimates that it will take Athenahealth 18 months to rewrite the product.
  • Athenahealth and BIDMC signed two agreements. The first covers the intellectual property as described above. The second is an agreement in which three practices within 38-site BIDMC Healthcare will begin phased implementation of Athenahealth’s ambulatory product, but BIDC has no further obligation to continue or extend the trial beyond those three practices that are participating in the trial.
  • Halamka says in a blog post that BIDMC won’t necessarily choose Athenahealth products when they consider replacing WebOMR since “we are a meritocracy and the best services at the lowest cost will win.” He adds, “Just as Mayo chose Epic to reduce the number of different IT systems, BIDMC will pursue a parsimony solution – the fewest moving parts possible. That might be one vendor, but hopefully it will not be more than two … While we want to continue to innovate, we know that commercial vendors will be able to leverage their knowledge and capabilities to build future platforms at larger scale.”

 

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Cerner rang Nasdaq’s opening bell Tuesday.

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Voalte lays off 25 percent of its staff, or around 40 employees, in a reorganization.

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Canada-based consulting and services vendor Accreon is acquired in a leveraged buyout funded by its management team, its founders, and Mansa Capital. As part of the deal, the company gives up its 49 percent ownership in Velante, which ran a controversial e-heath project in New Brunswick, and turns it over to the other partner, the New Brunswick Medical Society.


Sales

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Yale New Haven Health (CT) chooses Mobile Heartbeat’s clinical communications system.

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Boulder Community Health (CO) chooses Voalte’s smartphone caregiver communication for its newly expanded facility.

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Pocono Medical Center (PA) selects Authentidate’s telehealth solution.


People

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Murray Reicher, MD is named CEO of DR Systems, which he co-founded in 1992. He replaces co-founder Rick Porritt, who has retired.


Announcements and Implementations

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Vancouver, WA-based patient monitoring systems vendor OSTAR launches a cellular network-powered blood pressure monitoring system to reduce CHF readmissions.

Mediware announces CareTend, which combines its home care solutions into a single platform.


Government and Politics

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HHS Secretary Sylvia Burwell announces a $28 million ONC-funded HIE grant program, described as, “Grantees will address interoperability workflow challenges, technical issues, and improve the meaningful use of clinical data from external sources. Providers will be engaged from across the entire care continuum, including those who are not eligible for the Medicare and Medicaid EHR Incentive Programs such as long term care facilities, to be able to send, receive, find, and use health information both within and outside their care delivery systems.”

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ONC requests $92 million for its FY2016 budget, up from $60 million. ONC wants $5 million to establish a Health IT Safety Center that will go live in FY2016.

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This is a great quote from former National Coordinator David Blumenthal, MD, tweeted by ONC annual meeting attendee @PharmDJD: “It is cognitive dissonance to want cutthroat competitive markets but to expect healthcare players to share valuable data.” It would be great if hospitals, retail stores, quick lube stations, and hair salons shared customer information freely for the benefit of their shared customers, but only healthcare providers are being (unsuccessfully) shamed into doing so.

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Health IT equities researcher Jamie Stockton of Wells Fargo Securities provides a slice and dice of CMS’s Meaningful Use Stage 2 data. Hospital attesters included 97 percent of eligible Epic users, 63 percent of Allscripts, and 60 percent of CPSI, with everybody else falling under that number (Medhost and NextGen trailed the pack at under 40 percent). Physician Stage 2 rates were predictably abysmal, with Athenahealth out front at 58 percent and Epic at 26 percent, but vendors such as Allscripts, Greenway, Cerner, NextGen, and McKesson (the latter at 0 percent) having less than 5 percent of users attesting. Obviously it’s dangerous to read too much into the vendor vs. the customer, especially given the mass EP Stage 2 bailout.


Privacy and Security

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Paper records from several New York City hospitals are lost when a Brooklyn document warehouse is destroyed in a seven-alarm fire that scattered charred patient charts over several blocks. Cleanup crews attempted to retrieve partially burned papers that contained patient clinical and financial information. New York City Health and Hospitals Corporation is among the organizations that stored documents in the warehouse, but says that as early EHR adopter, it expects no operational impact.

The creator of PGP encryption software (now owned by Symantec) says the Sony Pictures breach highlights the need for companies to redirect efforts from security to privacy by encrypting emails and documents and retaining less information online. “If you look at all the things that have been developed – firewalls, intrusion detection systems, all these things put in place to protect computers? They haven’t really hit a home run: they keep getting breached. But if you look at the Snowden material, the one thing that does seem to do well is strong encryption. Of all the things you see getting broken into, it’s conspicuously absent from that list … In the 90s, if you were using strong encryption, you’d have to defend yourself and justify what you were doing: ‘What, are you a terrorist or a drug dealer?’ Now, if you aren’t using strong encryption, you have to justify it. You’re a doctor? What do you mean you’re not encrypting your patient records? Or you left your company laptop in a taxi with 2,000 customer names on it? You better hope that data is encrypted or you’re in trouble.”


Other

Researchers at Penn State College of Medicine suggest 10 situations where it would be acceptable for doctors to Google a patient, boiled down to (a) if they suspect the patient is lying to them about their history; (b) if the patient could be a doctor-shopping drug user; and (c) if the patient seems to have the capacity to harm themselves.

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I received the email above from a well-known B2B spammer who apparently got an email list of HIMSS15 exhibitors and is offering to sell a database of full attendee details. The fraud clues are numerous: (a) the email purporting to be from “Tracy Nixon” was clearly not written by a native English speaker; (b) the company’s website is just a placeholder full of “lorem ipsum” text; (c) the domain owner’s name is blocked in its registration records; and (d) clearly a 7,500-record HIMSS conference attendee database is at best incomplete given the 40,000 or so attendees. The same company has scammed companies in other industries by selling them junk lists at high prices and then refusing to give refunds.

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Weird News Andy titles this story “Heaven Scent” and adds that the device should be worth the cost of at least 1,000 Fitbits. A smartphone-powered cancer detection system called the SniffPhone detects the odor of lung cancer on the breath with 90 percent accuracy


Sponsor Updates

  • SyTrue CEO Kyle Silvestro posts “The Secret Life of your Healthcare Data.”
  • Verisk Health’s HEDIS measures are certified by NCQA for 2015.
  • Nordic publishes a blog post titled “Optimizing My Birkie and Your EHR.”
  • Four Medicity HIE customers are named in “Survivor: Edition HIE"–Can Statewide HIEs Achieve Sustainability?”
  • Dan Hamilton, COO of Nor-Lea Hospital District (NM), writes an article titled “Handling the Demands of a Population Boom: Using RTLS to Improve Patient Care and Workflows” about its use of Versus Advantages Clinic RTLS.
  • ADP AdvancedMD asks, “Has the ICD-10 Delay Hurt Provider Preparedness?” in its latest blog.
  • Bottomline Technologies will exhibit at the NAMIC Claims meeting February 10-12 in Phoenix, AZ.
  • Divurgent offers a new white paper entitled, “From the Trenches: Leadership Strategies from the US Navy SEALs Applied to Healthcare.”
  • Clinical Architecture’s Charlie Harp posts the second installment of the company’s blog series on “The Road to Precision Medicine.”
  • Caradigm will exhibit at the iHT2 Health IT Summit February 10-11 in Miami.
  • Matt Patterson, MD asks “What stage of Meaningful interoperability are you?” in the latest AirStrip blog.
  • CareTech Solutions will exhibit at the Health Forum Annual Rural Health Care Leadership Conference February 8-11 in Phoenix.
  • Amber Harner blogs about her trip to Costa Rica to help build houses with Habitat for Humanity, courtesy of the CoverMyMeds 2014 CoverMyQuest competition.
  • Michael Passanante writes about the physician’s role in lowering hospital readmission rates in the latest Besler Consulting blog.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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February 3, 2015 News 5 Comments

Morning Headlines 2/3/15

February 2, 2015 Headlines No Comments

Cerner Completes Acquisition of Siemens Health Services

Cerner announces the completion of its acquisition of Siemens Health Services. The new merged organization has a combined customer base of 21,000 facilities and an annual R&D budget of $650 million.

Community Health Systems Professional Services Corporation and Three Affiliated New Mexico Hospitals to Pay $75 Million to Settle False Claims Act Allegations

For-profit hospital chain Community Health Systems will pay $75 million to settle False Claims Act charges with the DOJ. Three New Mexico hospitals are accused of making illegal donations to county governments. The funds were used to pay the state’s share of Medicaid payments to the accused hospitals, in an effort to drive up local spending and take advantage of a federal program that reimbursed New Mexico $0.75 for ever dollar spent on rural Medicaid services.

ONC Annual Meeting, February 2 – 3

ONC’s Annual Meeting kicked off in Washington DC today. Tomorrow morning Karen DeSalvo, MD will join the former National Coordinators for an hour long round table on the state of the HIT nation.

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial

Researcher compare the total cost of care for 205 patients over the age of 60 and find that, over the course of a 12-month period, traditional care costs the same as care supplemented with remote patient monitoring services.

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February 2, 2015 Headlines No Comments

HIStalk Interviews Alan Weiss, MD, Director of Medical Informatics, Memorial Hermann Medical Group

February 2, 2015 Interviews 3 Comments

Alan Weiss, MD, MBA is director of medical informatics with Memorial Hermann Medical Group of Houston, TX.

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Tell me about yourself and the organization.

I’m a general internist by training. I have a computer science background and an MBA. I’ve been involved in the development of EMRs for about 15 years. I practiced at the Cleveland Clinic for about 10 years doing EMR implementation and practicing.

I’ve been at Memorial Hermann for about a year and a half. It’s a 10-hospital system, about to become a 12-hospital system, with an outpatient medical group directly affiliated with about 170 providers. We’re a GE shop on the ambulatory side and a Cerner shop on the inpatient side. We also have an affiliated group of physicians, about 600 to 700, on a whole different group of EMRs, with our biggest one probably being eClinicalWorks. We are the largest healthcare provider here in Houston.

 

What is the state of EHRs and in what areas should they be better?

EHRs need to improve. When people talk about the current state, I always think about what the basics are of EMR — what does it have to do? It has to be able to allow providers to look at data, to enter orders, and to write notes in a clean and efficient manner. A lot of the EMRs don’t allow for this. Each EMR has its benefits and its drawbacks, but if you can do those three simply and easily, that’s when providers can use the tool as best as possible.

 

What is the place for the doctor’s true narrative and rather than text generated from click boxes?

I think we’re going to see a throwback away from the computer-generated text and back into true narrative. It’s gone too far. It doesn’t have a whole lot of meaning and notes are way too long. It doesn’t convey the clinical impression, which is what we need to provide the best care we can.

 

It wasn’t doctors who originally wanted to click boxes to create text. Do they have enough voice to turn the EHR back into a record that’s for them and not for someone else?

There are providers out there who love the being able to do all the clicking of text and checking the boxes to get things done. But it’s more to get things done, not to create the narrative. The problem is that the narrative that’s created through clicking boxes becomes a hard to read mess.

I think we’re going to see everything change back into a much better narrative. A better way of actually describing what providers want from the EHR, which is an easy way to document, but also a way that gives their notes meaning to them.

 

What parts of the note could give clinicians an immediate sense for what’s going on with that patient?

There’s a whole movement of trying to get the notes to be meaningful again. One of the best ones is to change your SOAP note — Subjective, Objective, Assessment, Plan — into an APSO note, where your assessment and plan are at the top. If you want additional information, you can go through and see the rest of the information. 

Many organizations have changed from SOAP to APSO as a way of making sure that the assessment and plan, which is what you really want, is right in your face with the supporting documentation later on. I think we’re going to see more of that as time goes on.

 

What do you think about the OpenNotes initiative and the new plan to allow patients to contribute to the notes?

It’s probably going to be the way of the future. I think we’re going to see open notes. I don’t see anything wrong with having patients see the notes the providers have written. It’s actually very good, and especially for patients who are very concerned about their own health, seeing what the providers write will help them. I think it will also help some providers write better notes in the process of providing care. That’s going to be great.

It’s interesting that in the whole notion of having the patients come in and add to the notes themselves; we have started looking at ways of taking some of the surveys that patients are filling out and incorporating those into the notes. It can have some very positive effects, especially when it comes to patient engagement.

 

Will the least technically savvy patients do that?

The technical savviness of patients versus physicians is interesting. I tend to think that patients right now are more technically savvy than a lot of physicians. They want more apps, they want more access to their data, and they want to be able to access their physicians all the time in as many ways that they possibly can. 

The technical savvy aspect is extremely important. The patients,though, who are least technically savvy also have some of the greatest health problems. For that population, we still need a better strategy.

 

What are some system-agnostic EHR changes you might recommend to improve care?

I’ve worked ambulatory and I’ve worked inpatient. You have to really distinguish between the two.

On the inpatient side, certainly order sets and standards are a lot easier to implement than on the ambulatory side. The ambulatory side is more of people doing whatever they want to do. It’s much easier to create rewards to get people to do either the right thing or to stop ordering the wrong thing. That’s much easier on the inpatient side.

On the ambulatory side, sometimes the right thing to do is actually not to change your EMR, but to give reports. For instance, we’ve got a very simple report that shows providers their top 20 medications, the ranking, and the amount. When we show it to the providers, they start to see patterns. We have one provider who saw their pattern with  very high antibiotic prescribing, lots of Zithromax, lots of Z-Paks prescribed. In fact, she was providing about one or two Z-Paks a day on average to her patients. When she realized that that was the most common medication and not the most appropriate medication for what she was seeing, she changed her behavior. She has reduced her prescribing of Z-Paks by two-thirds.

That’s the kind of thing you may do outside of the EMR itself. If you can provide those simple reports showing behaviors, they can often have a bigger effect than making huge changes in the EMR itself.

 

As more physicians who practice in ambulatory setting are acquired or are working more collaboratively on the patient as a whole via new payment models, will they see EHRs as the bad guy that enforces rules that they didn’t follow when they were on their own?

I don’t think it’s going to be EHRs. I think it’s going to be the medical practice itself. When you’re in large groups, you’re being held accountable for all of the costs. At the same time, you’re going to have a natural progression where everybody is going to be seeing that they have to be responsible for every single order they put in.

 

What is the medical group doing with managing populations and not just encounters?

We’re doing a huge amount of population health. We’re doing a lot of analytics, looking at gaps in care where we can better provide care for diabetics who are falling outside the ranges of desired HbA1C and other testing. We’re trying to make sure all the screens are being done.

We have a great population health program that is doing some wonderful things. We are part of ACO, and as part of that ACO and the analytics that it provides, we’ve become one of the highest savings ACOs in the country.

 

How are people reaching out to the patients who might need an intervention or education? They aren’t necessarily used to getting a call from a medical practice.

A lot of patients want it. They want people to be involved in their care, but certainly there are ways of making sure that the patients have access to the things they’re missing.

For instance, we have a patient portal that provides a way for our patients to check the things that are due for them. At the same time, the diabetics who haven’t been in for a while or who need testing done tend to like it that we’re reaching out. It makes them feel like we care about them, and in fact, we do care about them. It gives them a way of closing the loop in some of the testing that they need. Most patients are reacting very positively to it.

 

What opportunities and challenges do you see with being paid for value instead of volume?

Part of the problem is that what patients often want are more tests and more medications. The conflict that I see is that the advertising that’s out there, what’s on the Internet, seems to get patients to want to have all those tests done. It’s more testosterone testing, thyroid testing, checking this and checking that.

If anything, if you look at all of those news articles about the tests you should have, a lot of it is creating almost like a culture of fear. You have to get certain tests done in order to make sure you are healthy. Those are the kind of things that are coming out of the general advertising. Yet at the same time, all of the data shows we should be doing less testing.

For instance, there’s no reason to check for kidney problems in an otherwise healthy person without high blood pressure. There’s no reason to check for urine or chest X-rays or EKGs unless you have a reason for doing it. But the common practice often is that those things are checked and the patients demand them and want them.

It’s the same kind of thing with antibiotics. When patients come in for a URI, they want and they expect antibiotics because that’s what they think the medical practice should be giving them. They’ve taken time off from work or school and they feel like they need something to justify them being there. I’ve had friends who have said to me that if they don’t give them something, the patient has threatened to go see other doctors.

Certainly there are patient satisfaction scores that are part of this whole issue, the need to satisfy the patient and give them what they want. We have to divorce that. We have to start thinking about what we should be doing. What is good evidence and what do the patients really need. That’s going to be the big conflict that we are going to have in the next five to 10 years to try and rein in some of the healthcare costs.

 

Do you have any final thoughts?

EHRs are just one great tool to help us. If anything, it makes it easier to provide care in the EHR. I’ve been on EHR since I finished my residency almost 15 years ago and I would never go back to a paper system. There’s just absolutely no way. For me, it’s the way things should get done.

What I look forward to being able to do is to optimize EHRs to create a healthcare system that helps you to provide the best care possible. If we do it the right way, we can rein in costs. We can provide better care. We can take care of those gaps. It will work its way through, but the EHR has to be the backbone. It has to be the new tool for us.

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February 2, 2015 Interviews 3 Comments

News 1/30/15

January 29, 2015 News 7 Comments

Top News

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CMS announces plans to shorten the 2015 EHR reporting period to 90 days and to change hospital reporting to be calendar year in a new rule it expects to be approved in spring 2015.


Reader Comments

From Information Dirt Road: “Re: Practice Fusion. Earlier this month they interfered with all lab results traffic during peak business hours and now are having another outage. All who work with PF are cursed by the absurd spectacle of PF being the clueless center of their own special universe.” They have a scheduled weekly maintenance window of Thursdays from 9 p.m. to 1 a.m. Pacific, which seems sensible to me. I followed the link to their EHR status page, which appears to be rarely updated.

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From HIS Junkie: “Re: HX360. I thought this was supposed to get people going on a new interoperability phase of HIT, but HIMSS has created a new meeting program for it right in the middle of its conference. It’s amazing how fast HIMSS jumped on this to make another buck.” I’m not a fan of co-located conferences, but you can watch a just-posted interview with HX360 CEO Roy Smythe, MD for more on what they’re doing. The HX360 exhibit hall is included with normal HIMSS15 registration, the full track is an extra $225, and the executive sessions are invitation-only.   

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From Deli Meat: “Re: electronic signature pads. Thanks for an amazing website. We are trying to reach Topaz Systems about problems with their signature pads that we use in registration with Epic. Emails are bouncing, phone calls aren’t returned, and their website seems to be down. Please assist with any insider information you may have.” The website is up for me and I got a live salesperson when I called their number, so I passed along your email address and said you needed help as a live customer.


HIStalk Announcements and Requests

I forgot to include a link to the the now-separate Dr. Jayne post in the email update, but it’s right here.

If your company sponsors HIStalk and didn’t receive our email in which we’re taking RSVPs for our HIMSS sponsor networking event and collecting information for our HIMSS guide, contact Lorre. Sometimes the information we have for contacts is incorrect or even missing entirely.

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We’re still accepting applications through February 9 from real patients who want to attend the HIMSS conference with a $1,000 scholarship and registration provided. These are for non-healthcare IT folks who have a compelling patient story to tell and who want to attend the HIMSS conference and write about their experiences on HIStalk afterward. Email Lorre with your story and why you want to attend – we’ll judge on both motivation and writing ability.

This week on HIStalk Practice: Telehealth takes over the headlines, with state licensing issues and vendor compliance making the news. GE Ventures looks to HIT to the potential tune of $40 million. Community Eye Center Optometry goes with VersaSuite. Doximity offers interactive physician salary data by state. Premedex launches new chronic care management solution for physician practices. Clinicient secures $7 million. Customer satisfaction with government services reaches a new low. Google Fiber heads southeast.

This week on HIStalk Connect: Google partners with Biogen Idec in a multi-year project focused on researching multiple sclerosis. The FDA approves the first smartphone-connected continuous glucose monitors, technology that diabetics have been demanding for years. Researchers from the University of Pennsylvania find that Twitter data analytics can be used to create highly accurate maps depicting the prevalence of heart failure at the county level. 

Welcome to new HIStalk Gold Sponsor CenterX. The Madison, WI company’s next-generation e-prescribing network improves medication adherence by closing the physician-pharmacist loop. It offers enterprise medication authorization, formulary management, pharmacy benefit eligibility, and medication profiles. Doctors are notified when the prescription is picked up and flat rate pricing eliminates the per-transaction penalty that discourages communication. Physicians benefit from electronic refill requests and automated prior authorization. Only about 40 percent of patients nationally pick up their prescriptions and use them correctly, but CenterX users have up to 90 percent adherence. The company just announced that it has fully integrated its Enterprise Medication Authorization solution with Epic. Thanks to CenterX for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

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Lexmark turns in anemic Q4 results, but its Perceptive Software business books a solid quarter.


Sales

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Penebscot Community Health Care (ME) chooses Forward Health Group’s PopulationManager and The Guideline Advantage.

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St. Joseph Health (CA) selects Clinical Architecture’s Symedical for terminology management, semantic normalization, and interoperability.


People

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St. Tammany Parish Hospital (LA) promotes Craig Doyle to VP/CIO.

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Impact Advisors promotes Jenny McCaskey to VP.

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Richard Holada (IBM) joins Truven Health Analytics as chief data and technology officer.


Announcements and Implementations

First Databank announces GA of FDB Cloud Connector, an Amazon Web Services-powered web API solution that reduces development time and IT overheard required to deliver FDB’s drug knowledge. Meditech was an early adopter, and interestingly, the company mentions that future pharmacogenomics decision support may be impractical to deliver by traditional means.

Medsphere announces OpenVista Population Health, a Windows-based enhancement developed by the Indian Health Service for its RPMS ambulatory EHR version of the VA’s VistA. The company signed a $15 million contract in 2011 to support and enhance RPMS.

Epic wins Best in KLAS 2014 for overall software suite, acute care EMR, HIE, patient accounting, patient portal, surgery management. Epic Beaker beats the best-of-breed LISs as the #1 lab system (although one might argue that Epic Care Everywhere as the #1 HIE is equally surprising). Epic also wins best physician practice vendor and several EHR/PM categories. Athenahealth wins for practice management in the two larger practice size categories (11 docs and up), while Impact Advisors takes the top spot in overall IT services and clinical implementation principal.


Government and Politics

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New ONC Meaningful Use Stage 2 numbers show that 88 percent of hospitals that are MUS2 eligible have attested so far with an April 2015 due date, with 25 percent of those using the Flexibility Rule. EP attestations are much less robust, with only 15 percent of MUS2 eligible providers attesting so far with a February 28 due date and nearly half of those using the Flexibility Rule.


Privacy and Security

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The psychologist who pioneered the study of facial expressions in the 1970s fears that companies will use his work to infringe on privacy. Software can measure consumer reaction to ads, but is being extended to detect shoplifters and to interrogate suspects, leading him to worry that facial expression algorithms will be used in public spaces without consent. On a positive note, the technology is being testing for measuring post-operative pain and to detect stress levels.


Technology

A New York Times editorial by a Mayo Clinic anesthesiologist warns that despite President Obama’s call for heavily funded research for precision medicine, it won’t make most people healthier. He says that genes can’t predict the most common and expensive chronic diseases, but we can already do that with simple tests, while the treatment is decidedly non-technical: eat better, exercise more, and don’t smoke. He concludes that “moonshot medical research initiatives” such as the “war on cancer” usually fail and that efforts would be better directed to studying human behavior.

Bloomberg Business says IBM has lobbied Congress for two years to pass the 21st Century Cures bill that would keep Watson-powered medical capabilities free of FDA oversight. The bill, which also includes the Software Act and addresses several health IT issues, was drafted by the House Energy & Commerce Committee, whose Democrat members just pulled their support of the bill.

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AliveCor’s smartphone-powered heart monitor earns FDA approval for new algorithms that assess an ECG as normal and that warn users that interference makes the ECG unreliable. The just-introduced third generation model costs $75, creates readings from a two-finger touch, and includes an algorithm to detect atrial fibrillation.


Other

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A group of health systems – including Advocate, Ascension, Atrius, Dartmouth-Hitchcock, Dignity, OSF, Partners, Providence, and SSM — and other healthcare players unite under the name Health Care Transformation Task Force in committing to put 75 percent of their business into value-based payments by 2020.

A NEJM study suggests that while the Affordable Care Act prohibits insurance companies from excluding coverage for pre-existing conditions, they may be using high drug co-pays to keep people with expensive diseases such as HIV from signing up in the first place.

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The bonds of Einstein Healthcare (PA) are downgraded due to financial losses that are partly attributed to a drop in employee productivity caused by its Cerner EHR.

Massachusetts General Hospital (MA) used telemedicine virtual visits during the recent snowstorm when clinics closed.

A physician’s editorial in NEJM called “Death Takes a Weekend” ponders the age-old question of why — in this age of high-acuity admissions and fast discharges — hospital services shut down on weekends. “It seemed callous on the hospital’s part — expecting very sick patients and very worried family members to understand that the doctors’ convenience had to come first. They need the weekend off, so you’ll have to wait till Monday. Even in good hospitals, weekends had a decidedly makeshift feel, with a constant refrain of ‘I’m just cross-covering, we’re short-staffed, the person you need will be here Monday.’”

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Weird News Andy researches scam online medical journals that charge authors to publish their work. A doctor tests their editorial review process by submitting an article composed of randomly generated phrases titled “Cuckoo for Cocoa Puffs?” with primary authors Pinkerton LeBrain and Orson Welles. Seventeen of 37 journals accepted it within the first two weeks and offered to publish it upon submission of a processing fee. One of the journals shares an address with a strip club. I checked out Global Science Research Journals, which publishes dozens of journals such as “Global Journal of Neurology and Neurosurgery” and “Global Journal of Pediatrics” and charges a $500 per article fee. The Nigeria-based publisher’s US office is in a Brooklyn apartment.

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Another WNA find he calls “My Doctor the Car”: Mississippi’s medical board investigates an 88-year-old doctor whose practice consists only of house calls, saying they don’t like the idea that he writes prescriptions from his 2007 Camry. In the TV station video, a guy walks right up to the car window to explain his medical issues. WNA proposes a solution: he should upgrade to an RV.


Sponsor Updates

  • Named as KLAS Category Leaders for 2014 are Sentry (340B management inpatient), SIS (anesthesia), Merge (cardiology hemodynamics), Zynx Health (CDS care plans), Wolters Kluwer (CDS order sets), Premier (CDS surveillance), Optum (computer-assisted coding), Strata Decision (decision support business), Emdeon (eligibility enrollment), NextGate (EMPI), Allscripts (global acute EMR, Northern America), Encore (go-live support), GetWellNetwork (interactive patient systems), Capsule (medical device integration), Nuance (medical records coding, quality management), Ingenious Med (mobile data systems), Nordic (other implementation), TeleTracking (patient flow), Iatric Systems (patient privacy monitoring), Craneware (revenue cycle charge capture), SSI Group (revenue cycle claims management), and GE Healthcare (staff/nurse scheduling, time and attendance).
  • Named Best in KLAS 2014 are Merge (cardiology), ZirMed (claims and clearinghouse), Impact Advisors (overall IT services, clinical implementation principal), Wellsoft (emergency department), Streamline Health (enterprise scheduling), McKesson (ERP), Allscripts (global acute EMR), CareTech Solutions (IT outsourcing extensive), Orchestrate Healthcare (technical services).
  • Logicworks publishes the eighth installment in its DevOps Automation series, entitled, “Improving the End User Experience with Amazon Web Services.”
  • Orion Health earns accreditation as a HISP.
  • William Seay of Lifepoint Informatics writes a new blog entitled, “Get Your Laboratory & Anatomic Pathology Results in Real-Time, When You Want, How You Want & Where You Want.”
  • LifeImage’s Mike Murphy blogs about saving time, increasing referrals, and improving orthopedic patient care via medical image sharing.
  • PDR will exhibit at the NACDS Regional Chain meeting in Naples, Florida on February 2-4.
  • Ivenix Medical Advisor and anesthesiologist Matt Weinger, MD shares his views on infusion pump technology at the Association for the Advancement of Medical Instrumentation’s blog.
  • Kathleen Aller writes about looking for meaning in mounds of data in the latest InterSystems blog.
  • HealthMEDX offers insight into its full EHR implementation at Lexington Health System (KY).
  • Jim Blanchet, associate management consultant at Greencastle, blogs about “The Valley of Despair” and asking yourself the right questions.
  • The HCI Group offers five tips on meeting the ICD-10 implementation deadline.
  • Pepper McCormick writes about the four healthcare trends that will shape 2015 in the latest Healthwise blog.
  • Greythorn will exhibit at this weekend’s Geek Wire Startup Day in Seattle.
  • Health IT Outcomes profiles e-MDs and its work to exchange provider data directly with the new Kansas infectious disease registry.
  • DocuSign announces that over 50 million people in 188 countries now use its technology.
  • The Healthfinch team offers a new blog on healthcare IT assumptions versus reality.
  • Cynthia Ethier of Hayes Management Consulting offers advice on how to create an ACA front desk.
  • HDS takes a look at the growing phenomenon of walk-in clinics at local malls in its latest blog.
  • Ingenious Med Mobile Product Manager Brannon Gillis posts a new blog entitled, “Useful and Usable: Basic Mobile Development Philosophy in Action.”
  • ICSA Labs participates in the IHE North America Connectathon today in Cleveland.
  • Extension Healthcare will exhibit at the Association of California Nurse Leaders Conference in Anaheim from February 1-4.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 29, 2015 News 7 Comments

Startup CEOs and Investors: Bruce Brandes

Startup CEOs and investors with strong writing and teaching skills are welcome to post their ongoing stories and lessons learned. Contact me if interested.

All I Needed to Know to Disrupt Healthcare I Learned from “Seinfeld”: Part I – Do The Opposite
By Bruce Brandes

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In my continued efforts to learn from progressive healthcare thought leaders, I recently read Eric Topol’s new book “The Patient Will See You Now.” I was heartened to see Dr. Topol’s opening chapter illustrate his first point with an intellectual / cultural equilibrium I can appreciate … through an amusing story from “Seinfeld” about Elaine’s medical record woes. That anecdote caused me to reflect on how my favorite iconic TV show about nothing is instructive for the entrepreneurs who strive to reinvent our healthcare delivery system.

Cautionary note:  my comments in this series will assume that HIStalk readers have at least a baseline knowledge in all things “Seinfeld.” I apologize in advance to the two or three folks out there who have not seen (or heaven forbid, did not like) “Seinfeld.”

Do The Opposite

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If you are relatively new to healthcare (and missed Vince Ciotti’s insightful HIStalk series on the history of healthcare IT), you may have asked yourself how Epic became so epic. Like George Costanza’s approach in landing a job with the New York Yankees, Epic did the opposite of what every other healthcare information systems vendor did.  

Most enterprise clinical systems originated as either hospital-centered extensions of patient billing systems, intended to capture just enough clinical information to get the bills out the door (SMS and HBOC) or as an expansion of a niche departmental system (Cerner and Meditech). Epic, on the other hand, began as an ambulatory system focused on winning the hearts and minds of the physicians. Those same physicians would later have significant influence over hospital decision-making. 

Rather than deploying armies of salespeople, Epic let their customers sell for them. Rather than making shortsighted decisions to placate quarterly earnings reports, Epic remained privately held. Rather than growing by multiple acquisitions, Epic expanded organically and built their own software on a common database. Epic had successfully broken down the departmental silos of laboratory, radiology, and pharmacy as well as ambulatory and inpatient records so that the health system could be unified on a singular platform.

However, the radical changes underway in our healthcare system now create an interesting parallel from Epic’s history lesson. Hospitals that are lauded for successfully unifying on a single EMR are as limited today in an Accountable Care Organization or Clinically Integrated Network as the historical single hospital was limited by the siloed departmental systems. To achieve population health, information must be openly shared across disparate systems and organizations. The sky-high costs, antiquated technology, and limited interoperability inherent in these legacy healthcare IT investments may prove to be the Waterloo for hospitals struggling for economic viability and competitive relevance in need of flexibility and agility in a value-based care world.

Emerging, disruptive companies should learn from history – and do the opposite. What might “opposite" look like from the traditional vendors with whom healthcare organizations have become accustomed? Some ideas and examples:

  • Free vs. expensive (Zenefits, Practice Fusion)
  • Payments aligned with benefits vs. massive capital outlays with vague ROI promises (Athenahealth)
  • A better experience at a lower cost vs. causing customer dissatisfaction at higher additional costs (Theranos)
  • Simple vs. complex to buy, implement, and use (Apple)
  • Openly shared, interoperable data vs. closed, proprietary systems (anything built in the last few years)
  • Mobile-first (information to you) vs. desktop (you go to the information) (AirStrip, Voalte)
  • Cloud-based SaaS vs. installing and maintaining software (Salesforce)

But beware, big-bang industry disruptors. Over the last several decades, the healthcare IT road (except a certain one-mile stretch of Arthur Burkhardt Expressway) has been littered with major international corporations that saw gold, Jerry, GOLD, in healthcare and failed (American Express, McDonnell Douglas, Alltel, etc.). Healthcare is indeed a “bizarro” industry – almost the opposite of every industry you’ve ever encountered. 

That said, the underlying economic, technical, and clinical restrictions that have historically hindered change are lessening. New mainstream technologies that we all use in our everyday lives are resetting expectations of the tools we use in our healthcare workplace.  

Now is the time for innovative entrepreneurs to consider jumping into the healthcare pool – but make sure your target market’s water isn’t too cold in order to avoid “shrinkage” of your investment.

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"My life is the complete opposite of what I want it to be. I should’ve done the complete opposite of whatever I’ve done up till now.”

Is this quote from George Costanza or a healthcare system you may know?

Bruce Brandes is managing director at Martin Ventures, serves on the board of advisors at AirStrip and Valence Health, and is entrepreneur in residence at the University of Florida’s Warrington College of Business.

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January 28, 2015 Startup CEOs and Investors 2 Comments

News 1/28/15

January 27, 2015 News 8 Comments

Top News

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HHS Secretary Sylvia Burwell announces an ambitious plan to tie 30 percent of Medicare provider payments to alternative payment models by 2016 and 50 percent by 2018, and also to link 85 percent of Medicare fee-for-service payments to quality and value by 2016. The announcement was received positively, although with guarded enthusiasm due to the lack of details and the mixed results of early adopters.


Reader Comments

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From Nihilist: “Re: BJC. Rumor is that the Epic install will be run out of a yet-unnamed holding company as a partnership with Washington University School of Medicine, which employees the academic hospital faculty. That’s why no job postings have appeared.” Unverified.


Acquisitions, Funding, Business, and Stock

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Huron Consulting will acquire Pensacola, FL-based, healthcare leadership consulting firm Studer Group for $325 million. The 235-employee company was founded by former hospital CEO and author Quint Studer in 1999 and was reported to have had 2013 revenue of $67 million.

China-based Alibaba Group, one of the world’s most valuable technology companies, partners with a medical software company to develop cloud-based services for physician practice, payment systems, e-prescribing, and drug tracking.

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Roper Industries reports Q4 results: revenue up 7 percent, adjusted EPS $1.85 vs. $1.65, falling short on revenue expectations but beating on earnings. Chairman, President, and CEO Brian Jellison says the company will be making at least one more Q1 acquisition that relates to its Sunquest business. He adds that Roper paid $140 million for Strata Decision Technologies, which has $30 million in annual revenue, but Roper gets an immediate $40 million in tax benefit because the company was operating as a limited liability corporation.


Sales

Eastern Idaho IPA chooses Valence Health’s vElect contract administration system to allow physicians to compare fee schedules to Medicare benchmarks in selecting and declining payer contracts.

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Two hospitals in Dubai will use Oneview Healthcare’s interactive patient engagement and clinical workflow system.  

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University Medical Center Health System (TX) extends its agreement with Cerner.

MedConnect chooses clinical interface terminology from Intelligent Medical Objects for its EHR.


People

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Biotechnology company Biogen Idec hires Naomi Fried, PhD (Boston Children’s Hospital) as VP of medical information, innovation, and external partnerships. She was Kaiser Permanente’s VP of innovation and advanced technology from 2006 to 2009.


Announcements and Implementations

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Georgia’s GRAChie HIE – founded by Cerner, GRHealth, and Navicent Health — reports increased numbers of data sources and system usage.

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The DEA approves EHNAC as the sole certifier of applications for electronic prescribing of controlled substances.

The Anesthesia Quality Institute recognizes Shareable Ink’s newly released ShareQuality mobile quality capture product as Quality Clinical Data Registry ready, allowing practices to use CMS’s preferred reporting mechanism.

CoverMyMeds announces that its electronic prior authorization system has been integrated with Epic.

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Decisio Health earns FDA marketing approval for its EHR-powered bedside clinical decision support and triage dashboard that was beta-tested by Memorial Hermann Hospital (TX).  

The Apple Watch will begin shipping in April.


Government and Politics

An HHS OIG report says CMS should coordinate its multiple quality improvement programs to reduce duplication of effort and to make it easier to attribute results, adding that CMS awarded Quality Improvement Organizations a new $4 billion contract just after spending $500 million to roll out two other programs.  


Privacy and Security

St. Peter’s Health Partners (NY) warns that a manager’s stolen, unencrypted cell phone contained emails with patient scheduling information for its physician practices. I think I read that iOS 8 encrypts everything on the iPhone by defauult.


Innovation and Research

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Samsung engineers create a smartphone-powered early warning stroke detection headset that analyze brain waves, expressing hope that the sensors may also be useful for other brain-related conditions. The engineers add that while the prototype model is a headset, the rubber-like sensors could be attached to less-obtrusive eyeglass temples.


Technology

Logitech announces a $500 portable videoconferencing solution for medium-sized rooms, which might be interesting for remote teams and IT meetings. ConferenceCam Connect works on any device that has a USB port and includes both battery and AC power.


Other

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”

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Western Missouri Medical Center’s COO gives its Meditech-to-Cerner conversion a B+ grade, saying that continuity, integration, and data collection improved markedly, but getting data from Meditech was hard. They say they “never new when upgrades are coming” with Meditech.

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”


Sponsor Updates

  • Nordic suggests five areas that should be part of a 2015 health IT plan.
  • Beacon Partners explains Business Intelligence Competency Centers and how to implement them.
  • PatientSafe Solutions CNIO Cheryl Parker, PhD, RN publishes “Smartphone-Based Mobility for Nurses.”
  • Besler Consulting participates today in the HFMA Florida Chapter Mid-Winter Conference and the Tri-State Winter Institute in Mississippi from January 28-30.
  • Caresync CEO Travis Bond asks, “What’s it Really Going to Take to Have Personalized Medicine?” in the latest company blog.
  • Brian Mitchell of CommVault, asks if “2015 is the Year of Data Dystopia?”
  • Clockwise.MD is nominated as a finalist in the inaugural Georgia’s Top Startup Awards.
  • AirStrip’s Alan Portela writes about “The Healthcare Dinner Party” at the company’s Mobile Health Matters blog.
  • Craneware lists the “Top Five Reasons for Denials” in a new blog post.
  • Awarepoint posts a new article, “The ROI in RTLS for Hospital Asset Management.”
  • Divurgent writes about “The ABCs of Ambulatory EMR Training and Acceptance.”
  • Clinical Architecture’s Charlie Harp writes about “The Road to Precision Medicine” in a new company blog.
  • Jaffer Traish of Culbert Healthcare Solutions writes about data sharing.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 27, 2015 News 8 Comments

Monday Morning Update 1/26/15

January 25, 2015 News 3 Comments

Top News

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Private equity firm Veronis Suhler Stevenson completes the sale of Strata Decision Technology to Roper Industries. Strata’s StrataJazz financial planning and analytics software is used by 1,000 hospitals. Roper’s other healthcare IT-related acquisitions include Sunquest Information Systems, SHP, and CBORD.


Reader Comments

From Kim Jong-un: “Re: HIStalk. The CMIO of a large Midwest health system told me that the IT department has blocked web access to HIStalk. Now I am wondering if HIStalk was responsible for the Sony hacking.” I like when an organization blocks access to HIStalk since that means I’m providing accurate and potentially disruptive information. It’s always been vendors doing the blocking, though. Email me your employer’s name if they’ve blocked HIStalk so I can give them a mention.

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From Harold Reems: “Re: Bayhealth. Looks like they’re going Epic.” Apparently so – they’re running Epic job listings.


HIStalk Announcements and Requests

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Two-thirds of respondents say that technology hasn’t significantly empowered patients. AlmostAdjusted commented that we’re getting there, but “technology has brought complexity to the patients and our patients are spastically grasping at a number of hyped solutions that for now are causing more disillusionment than empowerment,” while Mak says providers need to trust patients and put all of their information on their portal. New poll to your right or here:  will you in the next 6-12 months buy an Apple Watch, a different smart watch, or neither?

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Speaking of empowering patients, I’m paying for five, $1,000 travel scholarships for real patients to attend the HIMSS conference, following through on an idea that patient advocate Regina Holliday and I had when I interviewed her last March. We’re accepting applications through February 9 and will choose the five based on their patient stories and their writing ability (since I want them to document their experience afterward). Those chosen  will wear a special tee shirt with a picture Regina painted just for that purpose (above is an example, but she’ll paint a new one specific for this project) as they attend sessions and visit the exhibit hall to represent the patient’s point of view. See Regina’s description and send entries to Lorre.

More on the patient travel scholarships: HIMSS declined to participate (like by comping their registration fees), so I could use some help. Exhibitor badges will work fine for the scholarship winners since they provide full conference access, but I only get five for my tiny HIStalk booth and I’ll use at least 2-3 of those. If anybody has extras, that would save me a bunch of money. UPDATE: Thanks to the several companies that offered to help out … CTG Health Solutions was quick to respond with an offer to provide badges to our patient representatives. Thanks to Amanda at CTG for supporting our project.

I learned a new, made-up word: “listicle,” a combination of the words “list” and “article” that refers to those lazy, click-baiting online pieces that start with a number, such as “10 EHR Vendors to Know” or “6 Cool Health Startups.” I like that it sounds like “Popsicle,’ a nutritionally devoid diversion that delivers little beyond the initial impulse to give it a quick lick (or “click” in this case).


Last Week’s Most Interesting News

  • A group of medical associations urges ONC to refocus EHR certification on usability, interoperability, and safety.
  • Industry groups ask that Meaningful Use and EHR certification require EHRs to accept the scanned barcodes of implanted medical devices.
  • ONC hires Michael McCoy, MD to the newly created position of chief health information officer, where he will oversee interoperability efforts.
  • Mayo Clinic selects Epic.
  • CMS Administrator Marilyn Tavenner resigns.
  • Harvard Medical School launches the Department of Biomedical Informatics, to be led by Isaac Kohane, MD, PhD.

Acquisitions, Funding, Business, and Stock

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Emdeon is considering an IPO, sources say. The earnings multiples of recent sector deals suggest a valuation of $5.4 to $6.6 billion, which would create huge profits for the two private equity firms that took Emdeon private in 2011 for $3 billion.

California Healthcare Foundation invests in Seamless Medical Systems to develop and pilot patient engagement software for safety net providers and patients.


People

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Nursing informatics pioneer Carol A. Romano, PhD, RN, who was chief nurse officer of the Public Health Service, is named dean of nursing school of Uniformed Services University of the Health Sciences.


Announcements and Implementations

Wolters Kluwer Health releases an eBook describing how health systems can create an antimicrobial stewardship program.


Government and Politics

ONC’s annual meeting will be held February 2-3 at the Washington Hilton. Karen DeSalvo will deliver opening remarks, describe the nationwide interoperability roadmap, lead a fireside chat with Tom Daschle and Bill Frist, and join a panel discussion with all four former National Coordinators (Brailer, Kolodner, Blumenthal, and Mostashari). The meeting will be streamed via webcast as well. It will be interesting now that HITECH is winding down if attendance at this meeting and Health Datapalooza will suffer.


Other

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OpenNotes co-founder Jan Walker, RN says the next project phase, OurNotes, will allow patients to add their own notes to their electronic chart. It will be piloted at Beth Israel Deaconess, Geisinger, Harborview and Group Health in Seattle, and Heartland Health. Above is a screen shot from Joe Boyce, MD, CIO/CMIO of Heartland Health, which is using Cerner to collect information from patients (visit goals, meds, problems, care preferences) ahead of their scheduled appointments. This is brilliant – there’s no reason to waste precious appointment time collecting routine information, plus patients get flustered and forget important facts when forced to recite them on demand.

A study of New York nursing homes finds that EHR adoption increased 7.7 percent from 2012 to 2013, but HIE participation remains minimal. Those using EHRs had no specific characteristics different from those that didn’t, but HIE participation was related to being associated with a hospital and not being run as a for-profit business.

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University of Virginia Health system announces that it is one of five academic medical centers that will use a $7 million CMS grant to pilot an eConsults/eReferrals model. PCPs can use Epic to send a quick question to a specialist who can then review the patient’s electronic chart to provide an answer. The goal is to free up specialists to see patients who really need a face-to-face appointment vs. PCPs looking for a curbside consult.

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Weird News Andy says this story is untitleable: an Australian woman chooses a “maternal-assisted C-section” for her 10th and 11th children, meaning she removed the babies herself during the otherwise normal procedure.


Sponsor Updates

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  • Surgical Information Systems team members make over 50 blankets for Project Linus at its SIS Cares event.
  • ZirMed announces results of the end-to-end ICD-10 testing of its customers.
  • Huron Consulting releases its Healthcare CEO Forum report.
  • Trey Lauderdale writes about the interconnected nature of physician messaging and alarm management in a new Voalte blog.
  • Versus Technology updates the agenda for its 2015 User Group Meeting, taking place May 11-13 in Chicago.
  • Verisk Health SVP of Population Health and Risk Adjustment Matt Siegel pens an article titled “Risk-Adjusted Base Payments can Support the Move to Value.”
  • HHS CTO Bryan Spivak visits Validic’s Durham, NC headquarters and poses for a photo.
  • Valence Health will participate in HFMA’s first Illinois Managed Care Meeting in Chicago on January 29.
  • Qpid Health releases the latest podcast in its “Intrepid Healthcare” series.
  • Thomas White at Phynd Technologies blogs about “Why a Single Provider Profile Matters.”
  • Patientco CEO Bird Blitch blogs about “Why 2015 is the Year Providers Will Embrace Cloud Technology.”
  • PatientSafe Solutions CNIO Cheryl Parker writes on the topic of supporting the cognitive workload of clinicians with mobile technology.
  • Nordic releases the fourth installment of its video series on Epic’s Cupid application.
  • Navicure’s Amanda Brown posts a new blog on “The New Normal for Revenue Cycle Management in 2015.”
  • NVoq’s Debbi Gillotti writes a new blog post on how to “Drive Even More Value from Your EMR with SayIt 9.3.N
  • TT Data’s Phil Thames provides his executive viewpoint on industry predictions for 2015.
  • In a new white paper, Perceptive Software Principal Solution Architect Larry Sitka writes about vendor neutral archiving as more than just a place to store images.
  • MBA HealthGroup publishes a new blog on “Security Risk Assessment – Balancing Data Protection & Efficient Workflows.”
  • Medicity offers a new blog on “The 10-Year Interoperability Roadmap: How do We Get There from Here?”
  • Sean Biehle writes about “Extending Patient Engagement Beyond the Point of Care” in a new MedData blog.
  • MedAptus takes an Austin Powers tone in its latest blog, entitled “$375 Billion Dollars … mwwahahahahahaha.”

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 25, 2015 News 3 Comments

News 1/23/15

January 22, 2015 News 3 Comments

Top News

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A group of medical associations that curiously includes CHIME but not HIMSS urges ONC to refocus EHR certification on usability, interoperability, and safety and to disconnect EHR certification from the Meaningful Use program. They add concerns that ONC isn’t paying enough attention to how ATCBs certify EHRs for privacy and security, such as not requiring complex passwords or insufficiently logging user privilege changes. Apparently the groups don’t think the free market is working since the implication is that the EHR vendors they keep buying from are ignoring their customers and won’t change without government intervention. Vendor priorities were so much more straightforward before Meaningful Use. 


Reader Comments

From JustAsking: “Re: Allina-Health Catalyst deal. Lots of headlines about a $100 million ‘valuation’ but no mention of additional equity, yet Allina now owns a piece of the company that investors sunk $40 million into last year. Was the customer unhappy? The Allina CEO took pains to say that it’s not an exclusive arrangement.” Unverified. I agree that the highly touted $100 million figure is meaningless since no details were provided about what that number represents, so I think the company overemphasized that just to add some sizzle (although the press seems to have accepted it without question). I don’t get the sense that Allina is unhappy with Health Catalyst at all – they seem to be thrilled with the information they’re getting. Most of Health Catalyst’s board members are from investment firms who would make sure to protect shareholder value, so I’m assuming the deal makes good business sense. The only downside for the company is that whatever impressive results Allina announces won’t be entirely credible given that they’re now a part owner.

From Hawaiian Charlie: “Re: Scripps. I heard Cerner dropped out before demos start next week.” Unverified. The semi-insider I know wasn’t aware of anything new.

From Just a CEO: “Re: our national user conference. I’m looking for a speaker and one name came to mind – Mr. HIStalk! We can give you a mask or burka.” I’ll pass, but I will instead ask readers: have you heard a really good keynote-type speaker lately, especially one with credibility in the ambulatory world? Let me know and I’ll pass it along.

From Pure Power: “Re: fitness trackers. Their allure is fading fast.” As it should. It’s fun for a couple of days to count steps, but the novelty fades fast as most people don’t really want to be reminded to do something they don’t enjoy (and whether fitness trackers change long-term exercise patterns is questionable). Wearables that can make a different in healthcare will need to: (a) measure something medically actionable; (b) contain enough smarts to figure out when data patterns – rather than a single reading – are meaningful, customized down to the individual patient; and (c) communicate those results quickly and perhaps silently to clinicians who are committed to act on them (probably without much hope of getting paid). Infrastructure will also need to be in place for clinicians to monitor what’s coming in, like those people who sit in burglar alarm monitoring centers who decide whether to dispatch police. Wearables won’t do much for healthy people, but with adequate sensors could help with chronic disease management, provided that those sensors aren’t unpleasant to wear. From a business perspective, steer clear of wearables that diagnose new conditions since nobody wants to pay for new medical problems – focus instead on reducing the costs of managing existing, expensive conditions. We diagnose people pretty well – it’s their care management that’s killing us (and them).


HIStalk Announcements and Requests

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Teach for America teacher Mrs. DiPaula sent over photos of her low-income Idaho first graders using the math games we HIStalk readers bought them a few months back via DonorsChoose.org. She adds, “Thank you from the bottom of our hearts!” I funded a bunch of grant requests using the proceeds from the top-of-page ads that I ran right before the HIMSS conference last year and I’ll do the same this year if companies buy those spots.

This week on HIStalk Practice: Auburn University Medical Clinic rolls out new electronic immunization record-keeping system. Wake Emergency Physicians launches RelyMD telemedicine business. Security divas scrutinize the current state of cyber threats. ARcare selects new pop health tech. Ringly raises a new round. Kaiser makes it official with the NBA.

This week on HIStalk Connect: the FDA issues clarifying guidance on general wellness apps. Stride Health raises $2.4 million to scale up its Healthcare.gov-like insurance shopping app. A team of Harvard and MIT scientists launch InnerAge, a mail-away blood test used to predict lifespan and provide personalized nutritional recommendations to extend life. 

Welcome to new HIStalk Platinum Sponsor Anthelio. The Dallas-based company has been a single-source provider of healthcare-only technology solutions for 15 years, offering a long list of services (outsourcing, application hosting and management, data protection, data warehouse and analytics, service desk, EHR implementation and optimization, HIM outsourcing, revenue cycle optimization, clinical documentation improvement, population health management, legacy system archiving, and ICD-10, among many others). Products include a population health management platform, patient portal, patient-facing mobile app, and a physician coding improvement collaboration tool. You probably know industry long-timers CEO Asif Ahmad (formerly of Duke and McKesson) and SVP Gary Trickett. Thanks to Anthelio for supporting HIStalk.

I always head over to YouTube to look for videos about new sponsors, so here’s an intro to Anthelio I found there.


Acquisitions, Funding, Business, and Stock

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Quality Systems (NextGen) reports Q3 results: revenue up 13 percent, adjusted EPS $0.16 vs. $0.11, beating estimates for both.

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Private investment firm Veronis Suhler Stevenson gets FTC approval to sell Strata Decision Technology to Roper Industries, which owns Sunquest. Stratus founders Catherine Kleinmuntz, PhD and Don Kleinmuntz, PhD moved on not long after selling the company to VSS in 2011. Roper also acquired post-acute care analytics vendor Strategic Healthcare Programs in August 2014 and already owned hospital dietary software vendor CBORD, so it’s liking the healthcare software business.

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Device and wearables Integration technology vendor Human API raises $6.6 million in venture funding.

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The Advisory Board Company announces a $200 million add-on public offering. Above is the one-year share price of ABCO (blue, down 29 percent) vs. the Nasdaq (red, up 15 percent). The company’s market cap is $1.6 billion.


Sales

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Sixteen-bed Jerold Phelps Community Hospital (CA) chooses Healthland Centriq for clinical and financial systems.

University of Texas MD Anderson Cancer Center selects Capsule Tech’s SmartLinx to integrate information from 2,000 medical devices with Epic.


Government and Politics

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Several industry groups request that Meaningful Use and EHR certification require that EHRs be capable of electronically tracking implanted medical devices. They want EHR users to be able to scan the device’s bar code (which contains an FDA-assigned unique identifier) to update the patient’s record for outcomes tracking, adverse event reporting, and recall management. They add that the information could also be used by the EHR to trigger patient-specific device warnings.

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ONC hires Michael McCoy, MD for the newly created position of chief health information officer. He’ll report to Karen DeSalvo and will lead ONC’s interoperability efforts. He ran a two-person consulting firm (Physician Technology Services) and has spent time as a CMIO and working for vendors such as DigiChart and Allscripts.


Privacy and Security

In England, NHS admits that it has ignored all of the thousands of requests it received from patients who don’t want their records shared, saying that those who opted out may not have understood that they wouldn’t have been notified of preventive services such as cancer screening.

SplashData studies 3.3 million leaked passwords from 2014, with the top 10 most used (and thus the worst ones to choose) being:

  1. 123456
  2. password
  3. 12345
  4. 12345678
  5. qwerty
  6. 124567890
  7. 1234
  8. baseball
  9. dragon
  10. football

Innovation and Research

The Center for Integrated Diagnostics at Massachusetts General Hospital (MA) is performing genomics research using InterSystems HealthShare, using the population information it collects for personalizing treatments.


Technology

Microsoft announces the HoloLens, an eye-worn appliance that blends holograms with vision. If nothing else, it should nudge Facebook to bear down harder on its Oculis Rift virtual reality headset. The company also announced that Windows 10 will be released later this year as a free upgrade for users of Windows 7 or 8 if they upgrade in the first year. I like Windows 8 just fine, but a free upgrade offer means plenty of users don’t.


Other

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It’s interesting to read Mayo Clinic’s history as it prepares to implement Epic and its “one patient, one record” philosophy. Henry Plummer, MD created the concept of a centralized medical record at Mayo in 1907, replacing ledger books kept by each of its clinics. Mayo built a pneumatic tube system to move records from location to another. It looks a lot like the ones still used by bank drive-through tellers. Most of the hospitals I’ve worked in considered the tube system or dumbwaiter to be their central nervous system – computers work fine for information, but not for objects. I once convinced one of my tiny co-workers to climb into the dumbwaiter so I could send her up to third floor, where she popped out and terrified a nurse who was waiting for something to be sent other than a mischievous, perky blonde.

New York gun rights activists file an injunction to strike down the state’s two-year-old SAFE Act, saying that it gives authorities access to protected health information that is used to confiscate the firearms of people who seek mental health treatment. The tough gun control law was passed a month after the Sandy Hook shootings of December 2012.

Early bird pricing for HIMSS15 ends January 26, so members will save $100 by registering now instead of later (or even more for the real procrastinators who’ll pay $1,145 if they wait until March 17). Attendees also get free online access to the session recordings, which is a nice benefit  — I used to always buy the CDs to review later.

I was reading an interesting legal case that involved an EHR. A patient being treated by a physician practice for insomnia found that his wife was having an affair and then killed her and then himself. The man’s estate sued the practice, claiming that the doctor failed to diagnose his depression and should have referred him to psychiatric help. The doctor testified that he asked the patient about suicide even though the pre-populated EHR checkbox didn’t say so. The plaintiff’s attorney used that discrepancy as an argument that the physician was practicing “point and click medicine” and wasn’t listening to the patient, arguing that the EHR interfered with the physician’s thought process. The jury found the practice liable for $8 million. The interesting aspect is that the jury’s deciding factor was conflicting, auto-generated EHR entries.

Hospitals in Vietnam report that thieves are posing as the family members of patients in order to steal jewelry or money (inpatients usually have cash because hospitals there require upfront payment for each service). In one case, a guy posing as a doctor convinced a woman in the OR waiting room to pay him for her husband’s perioperative blood transfusion, after which he he printed her a receipt from his iPad then took off with her money.

Weird News Andy says he could understand if it were pediatrics, but OB/GYN? Police responding to a hospital’s call about a “young black male who appeared to be a child was dressed as a doctor” find find a fully garbed 17-year-old in an exam room with a doctor and a patient. The teen, who had been hanging around the hospital for weeks, wasn’t charged since his mom says he’s under unspecified medical treatment and refuses to take his meds.


Sponsor Updates

  • The Sandlot Connect clinical interoperability platform from Sandlot Solutions earns ONC-ACB certification.
  • T-System announces the five winners of its client excellence awards and will make a charitable donation on behalf of each.
  • Pat Adamiak of Liaison Technologies writes a new blog on “Making Your Big Data Project Successful.”
  • Influence Health opens registration and speaker abstract applications for its Influence 2015 Client Congress, taking place in St. Louis May 3-6.
  • Impact Advisors post two new blogs: “When an IT Project Isn’t an IT Project” and “Meaningful Use 2014: Lessons Learned and Looking Ahead.”
  • Hayes Management Consulting Director of Informatics Pete Rivera offers insight into “What You Need to Know About Hiring Veterans.”
  • Healthwise wins gold and silver Web Health Awards for its health education videos.
  • HealthMEDX participates in the Georgia Health Care Association 2015 Winter Convention taking place today in Atlanta.
  • Amanda Randall blogs about the “5 Benefits of Working at Healthgrades.”
  • Healthfinch posts a new blog entitled, “A Nod to Nature: Building a Balanced Healthcare Ecosystem.”
  • E-MDs CEO David Winn pens a new article entitled, “Time to Let the Air Out of the Tires on ICD-10.”
  • Healthcare Data Solutions offers a new blog on content-marketing strategy.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 22, 2015 News 3 Comments

Morning Headlines 1/22/15

January 21, 2015 Headlines No Comments

Precision Medicine: Improving Health and Treating Disease

The White House releases details on the new precision medicine program President Obama announced during his State of the Union Address. The program will work to individualize treatment plans through advances in genetic research, medical imaging, and health information technology.

Survey finds physicians being forced to switch EHRs

The American Academy of Family Physicians releases survey results from physicians who have recently switched EHRs. The majority reported that the switch was an organizational choice and not their own. 61 percent of those that had a say in which EHR was selected reported being happy with the new system, versus a paltry 19 percent approval rating from new EHR users that were not involved in the selection process.

Doctors Choose the Best Health Apps of 2014

HealthTap, an online Q&A site where doctors respond to anonymous medical questions, publishes a list of the top 100 mHealth apps based on voting by its contributing doctors. The top three were all calorie counter apps, and there were no medication reminder or chronic disease management apps within the top 10.

Cerner Collaborates With VFW to Help Improve Lives of Service Members During and After Their Service

Cerner announces a virtual veterans job fair that it will co-host with the VFW on February 18, and a new conversion tool on its recruitment page that will convert a military job code to an ideal job at Cerner.

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January 21, 2015 Headlines No Comments

Health IT from the CIO’s Chair 1/21/15

January 21, 2015 Darren Dworkin 6 Comments

Fine print: the views and opinions expressed in this article are mine personally and are not necessarily representative of current or former employers.

Predictions

January brings the new year and the new year reliably brings two things: resolutions and predictions. I’ve already broken my New Year’s resolutions, so I’m going to try my hand at predictions.

For them to be any fun, I think they need to be as specific as possible and sufficiently bold so they don’t state the obvious. “I predict there will be a lot of change in the healthcare system in the year ahead” is not a prediction – it’s a campaign promise.

Here goes, in no particular order.

  1. Provider healthcare organizations will move into the cloud by adopting Office 365 and moving email off premise at record rates. Hospitals historically wanted grand atriums (often with pianos) and big, shiny data centers. No prediction on the pianos, but not only will the tipping point occur on cloud-based email in 2015, but this will be the start of the shift away from “everything needs to be managed by hospital tech staff” and will pave the way for ERP and EMR to be next (in that order).
  2. While I’m on the topic of Microsoft, I predict that when it comes to Windows, you will hear two things in 2015: (a) “What happened to Windows 9?” and (b) “I hate to say this aloud, but Windows 10 is kind of cool.” Microsoft has a lot of ground to make up to win the hearts and minds of their base, the enterprise user. But Windows 10 will bend the curve back in Microsoft’s favor.
  3. Security will be in the news and will shape everything, period, everything. The focus on cybersecurity — with the help of Apple, who is making fingerprints mainstream — means we will see biometric everywhere. Two-factor authentication will become the norm. Your finger will be your password by the end of 2015.
  4. Wearables. We are all growing tired of the huge number, but this spring will bring the iWatch. It will spur the market and create the needed tipping point that has been missing – software and apps to make wearables worth the effort. The iWatch will be huge, no, I mean really big! Apple will not be able to make them fast enough and waits will be measured in weeks. Innovation will abound and the Internet of Things will all start to make sense.
  5. Virtual reality will capture our imagination. Magic Leap will forever change things this year. The “cinematic reality” startup raised over $500 million from names we know. We will all soon understand why. Our imagination will be captured as we think about new ways we never imagined we could interact with a computer.
  6. Big data will stay flat. By the end of 2015, we will have nothing new to report. We will be using the same buzzwords and holding the same optimistic promises. 2015 just won’t be the year we figure it out. I do predict we will stop using the term “data lakes,” but I can’t tell you why.
  7. HIE obsessions will give way to FHIR talk. The HIE interoperability goal was moving the record from Point A to Point B. The yardstick has shifted and will be defined by how we can integrate workflows from site to site. FHIR will gain even more steam and be the talk everywhere.
  8. The VA decision will change everything. It won’t go to Allscripts, Cerner, or Epic (which will be unfortunate), and while the project will be huge and take many years to deliver, in 2015 it will act as an engine to drive standards and data structure conversations as a new open source style system will be born.
  9. 2015 will continue to set records in terms of health IT startup funding. Many major health systems will become more active by investing directly in companies in an attempt to capture the value they believe they help create. At least one health IT software company will IPO in 2015, setting a record. Cerner, McKesson, The Advisory Board, Allscripts, and Athenahealth will all continue to exercise one of the few advantages they have over Epic in the EMR space — they will continue to buy strategic assets to innovate at the fast pace required.
  10. Cerner will seek to divest the Device Works division so that it may become a company that can compete in the whole market, not just in Cerner accounts. The new entity will become a powerhouse and take market share from both Philips and GE.

Think my predictions are wrong or ridiculous? Don’t tell me why. Instead, leave me a comment and give me yours. Remember: be specific and be bold.

1-29-2014 12-54-46 PM

Darren Dworkin is chief information officer at Cedars-Sinai Health System in Los Angeles, CA. You can reach Darren on LinkedIn or follow him on Twitter.

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January 21, 2015 Darren Dworkin 6 Comments

Morning Headlines 1/21/15

January 20, 2015 Headlines No Comments

Mayo Clinic Selects Epic as Strategic Partner for Electronic Health Record and Revenue Cycle Management System

Mayo Clinic announces that it has chosen Epic to replace its incumbent Cerner and GE Centricity EHR and revenue cycle systems.

Federal Marketplace: Inadequacies in Contract Planning and Procurement

A report from the HHS Office of the Inspector General finds that CMS failed to oversee Healthcare.gov development work adequately, failed to review past performances of vendors selected for key Healthcare.gov contracts, and structured vendor contracts so that the risk of unanticipated cost increases were absorbed solely by the government, rather than shared among the selected contractors.

Geographic Clusters in Underimmunization and Vaccine Refusal

Kaiser Permanente uses its EHR data to pinpoint areas in California with low rates of childhood vaccination,  finding in one school that 50 percent of the children were unvaccinated due to “personal belief exemption.”

MMRGlobal Proceeds With $30 Million Patent Licensing Case and Files Three New Federal Appeals

MMRGlobal announces that it will appeal decisions made by the California district court to throw out its patent infringement lawsuit against Allscripts and WebMD.

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January 20, 2015 Headlines No Comments

News 1/21/15

January 20, 2015 News 6 Comments

Top News

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Mayo Clinic chooses Epic, as I mentioned a few days ago from a reader’s rumor report. Cerner gets a double whammy – not only do they lose the Mayo bid, some of their systems will be displaced as they (along with GE Healthcare) are the Mayo incumbent. Actually, there’s one more Cerner insult: former Mayo CEO Denis Cortese, MD sits on Cerner’s board.


Reader Comments

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From Banned in Boston: “Re: McKesson Horizon. The attached letter verifies its sunsetting on March 31, 2018. The event has passed with little fanfare since Horizon has become increasingly obsolete.” The letter, signed by McKesson EVP Pat Blake and President Jim Pesce, says the company will issue a Meaningful Use Stage 3 update and thanks Horizon users for their “partnership,” a trite, vendor-created synonym for “sending checks as a customer.”

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From Jose Francisco: “Re: Scripps Health. Will be moving to Epic. Impact Advisors led the system selection – Cerner never had a real shot. Decision will become public in 30-60 days.” Unverified. Scripps chose GE Healthcare’s Centricity Enterprise in 2007 and Allscripts Enterprise for its outpatient clinics in 2009. Assuming the rumor is true, EMR critic and Scripps cardiologist and author Eric Topol, MD will become an Epic user – it will be interesting to see what he says about it among all of his smartphone infatuation. Update: I reached a non-anonymous source who says that Scripps hasn’t yet made a decision as far as he or she knows.

From Lips Pursed: “Re: HISsies voting. It’s just a popularity contest and the ballot choices are stupid.” Of course it’s a popularity contest, just like the Presidential election – what did you think it was? Readers (few of whom are stupid) make the nominations and vote for their choices as they’ve done since 2008, with the most-nominated entries appearing on the ballot. Having people who didn’t nominate anyone complain now is like moaning about the Presidential candidate chosen by your more responsible peers in that primary election voting you skipped.


HIStalk Announcements and Requests

The results of my reader survey are always interesting and useful. Thanks to those who responded.

Some nice point-counterpoint commentary was generated by CommonWell’s answers to HIStalk reader questions and a reaction article by Brian Weiss of Carebox. The comments are getting interesting as Brian suggests that (a) HIStalk readers vote as consumers on the approaches of the respective organizations, and (b) that the organizations consider developing a prototype for exchanging information securely and under the control of patients, driven only by their email address. They are also discussing patient-controlled health record banks.

Welcome to new HIStalk Platinum Sponsor Oneview Healthcare. The Dublin, Ireland-based company (with US offices in San Francisco and Pittsburgh) offers a Microsoft-powered customizable interactive patient care system that’s accessible by smartphone, tablet, or in-room TV. Patients get education, entertainment, communications services, messaging, scheduling, way-finding, meal ordering, nurse rounding, and remote consultation, while clinicians use it to access electronic medical records and other point-of-care applications. Two big reference clients are the newly built Chris O’Brien Lifehouse in Sydney, Australia (they have a patient experience focus and every patient interacts with the Oneview system) and UCSF Mission Bay (a three-hospital campus opening in a couple of weeks). Maimonides Medical Center (NY) SVP/CIO Walter Fahey says, “The capability that the Oneview solution can deliver is second to none and it will transform the healthcare experience, not only for our patients, but for our healthcare teams and hospital managers.” Thanks to Oneview Healthcare for supporting HIStalk.

I found this overview video of Oneview Healthcare on Vimeo.

Listening: Gary Lewis and the Playboys. Like most of America, I can’t understand how the unattractive, minimally talented son of the annoying Jerry Lewis could have become a 1960s pop star, at least until his career was waylaid when he was drafted and shipped off to Vietnam in 1967. I’ve seen him live a couple of times –he’s good natured (he’s 68 now) and he had some massive songwriting and production firepower behind his records. I have a strong need to hear “This Diamond Ring,” “Palisades Park,” “Everybody Loves a Clown,” “Save Your Heart for Me,” and “Little Miss Go Go “ every few years. Trivia: there were no actual Playboys on the records – it was all Gary and some studio musicians, heavily overdubbed and recorded using the opportunity created by his mom’s money and his dad’s name.


Acquisitions, Funding, Business, and Stock

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Xconomy profiles nonprofit Wisconsin investor BrightStar, which funnels charitable donations of around $200,000 to complete funding rounds for early-stage companies that are creating state jobs. It quotes Forward Health Group CEO Michael Barbouche, who says working with BrightStar is painless and easy.

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Patent troll MMRGlobal challenges recent court rulings in which its infringement lawsuits against Allscripts, WebMD, and others were rejected. Above is an illustration from one of its 13 patent applications from its 300 open lawsuits. MMRGlobal’s penny stock shares (literally: its shares are listed at $0.01 on the pink sheets) have dropped 59 percent of their value in the past year. Founder Bob Lorsch and his spokesperson/president wife were featured in a 2012 TV show called “Interior Therapy with Jeff Lewis” in which they are portrayed as emotional hoarders of a crammed houseful of stuff. I interviewed him a couple of year ago and found him charming and his product interesting, although the endless lawsuits overshadow all of that. He made one of his fortunes selling 976 telephone services in the 1980s, including a Santa Claus hotline (he sued a phone sex company for using a number similar to his) and running a children’s 976 phone service as a fundraiser for museums in which he kept $1.75 from each $2 call.

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The Washington Post profiles hCentive, a software development company started by a guy who in 2009 downloaded a copy of the Obamacare bill the Senate was then debating and saw opportunity. The Affordable Care Act was signed into law nine months later and the three-person company now has 700 employees and $50 million in annual revenue after building four state exchanges and being signed by the federal government to build a small business site after it fired CGI for the failed Healthcare.gov rollout.


Sales

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Wheaton Franciscan Healthcare (WI) chooses Epic in a $54 million, five-year project.  

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Southeastern Health (NC) chooses eClinicalWorks Care Coordination Medical Record.

Aetna selects HealthEdge’s rules-powered health management system for payors.


People

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Randy Carpenter (Omnicare) joins Stoltenberg Consulting as SVP of strategic services.

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Xerox Government Healthcare names Scott Bennett (Siemens Healthcare) as SVP of sales.


Announcements and Implementations

PeriGen announces a doubling of its customer base in 2014, with 140,000 births to date supported by its PerCALM Tracings electronic fetal monitoring system.

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St. Maarten Medical Center says it will be the first hospital in the Caribbean to use a fully electronic system when it completes its implementation of CPSI, which replaces a Siemens MedSeries4 system that was “no longer reliable and nearing a system failure.”

GE Healthcare and NextGen earn EHNAC’s first practice management system accreditation.


Government and Politics

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Computer scientist Kathy Pham, a new employee of the United States Digital Service, attended Tuesday night’s State of the Union address as one of 22 guests invited by the White House. She has been a healthcare informatics researcher, a software engineer for Harris Healthcare Solutions, and a healthcare consultant with IBM. She also serves as a patient advocate for her mother, who has acute lymphoblastic leukemia.

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A report by HHS’s Office of Inspector General finds that CMS’s work on Healthcare.gov was sloppy, hurried, and poorly overseen, awarding no-bid contracts worth hundreds of millions of dollars without reviewing past company performance or having firm requirements defined. As has been widely reported, CMS hired 33 companies to work on the site, but didn’t name any one of them to be in charge, although they just assumed that CGI Federal was running the project. The agreements also didn’t cap payments and allowed overbilling with minimal documentation, so some companies were paid up to three times their bid amount. CMS originally estimated the value of six key contracts at $464 million, but has paid $824 million so far.


Privacy and Security 

A security company finds that Healthcare.gov connects in the background to dozens of private websites, including Facebook, Google, and Twitter, raising concerns about cybersecurity exposure and whether user information is really private.


Innovation and Research

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A new research article describes how Kaiser Permanente analyzed its EHR information to identify neighborhoods with a low rate of childhood vaccinations, allowing it to mount outreach efforts to five areas. One private school had a 50 percent rate of “personal belief exemption.”


Technology

in England, the medical director of NHS says wearables will play a vital part in future health in allowing people to be monitored at home for irregularities in heart rhythm, breathing, and edema. He adds that NHS will push a “huge rollout” of those technologies.

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Bizarre: Airbnb-inspired Airpnp lets app users in need of a bio break rent bathrooms in private homes. The founders were inspired by a New Orleans decision to ban street-located Porta-Potties during Mardi Gras. It’s hard to fathom that sellers would allow a stranger into their homes (and bathrooms) for a dollar or two. It sounds like a spoof to me, but then again it’s sometimes hard to tell if a startup is serious. Perhaps the same skepticism applied early on to Uber, however, which just announced that its San Francisco revenue alone is $500 million per year – nearly four times the entire taxi market there — and is growing 200 percent per year.  

Microsoft patents user-configurable technology that can automatically dim and silence a smartphone when the phone’s GPS detects that the user has entered a theater, when it senses darkness and quiet, or when so instructed by the Wi-Fi system being used.


Other

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An epidemiologist with New York City Department of Health and Mental Hygiene tells the Health IT Policy Committee that fast outbreak identification and control requires better integration between EHRs and its disease surveillance system. She envisions EHRs sending real-time data for surveillance and then receiving back prompts for additional information, such as patient demographics.

A North Carolina OB-GYN says doctors should use computers and not vice-versa, urging his peers to look at the patient instead of the screen. “The folks who sold us these systems talked about all the wonderful things EMR can do … One might assume the EMR would excise the tumor, lower the blood glucose and stop the hallucinations. The problem is that the EMR really should not ‘do’ anything. Patients tell us their concerns. Practitioners do their best to listen and perform the appropriate evaluation, with or without technology … everything we need to know about our patients is in their face, in their voice, and in their eyes.”

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Forbes India profiles India-based Narayana Health, whose first non-India hospital opened in the Cayman Islands a year ago in a partnership with Ascension Health. Founder and cardiac surgeon Devi Shetty got the idea for his medical tourism hospital from a friend who mused, “The most profitable hospital in the world is the one which is built on a ship and parked outside US waters because it gets to serve American patients and yet stays away from its jurisdiction.” The hospital has implanted an artificial heart for what Shetty says is less than half of the $1.2 million US hospital price. He’s working with two US-based health systems on new hospital software (I’d be curious to learn more about that) and is talking about starting a Caymans medical school.

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Weird News Andy likes the glucose-monitoring temporary tattoo on the left better than the diabetes-hating one on the right, although I’ll add that both might illustrate diabetic monitoring assuming there’s a Diastix right above the word “diabetes.”  


Sponsor Updates

  • Zynx Health VP Guillermo Ramas writes about attaining the impossible in the company’s latest blog.
  • Frank Myeroff of Direct Consulting Associates interviews Denver Health CIO Jeff Pelot.
  • Huron Consulting Group will exhibit at the AHLA 2015 Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions conference in Washington, DC from January 22-23.
  • Voalte Product Manager Anthony Mitchell blogs about the smart use of smartphones in the latest company post.
  • ExitEvent highlights Validic and its relationship with digital health startup Qardio.
  • T-System Clinical Systems Engineer Deon Melton, RN shares “Life Lessons Learned in the ER” in a new blog.
  • Caradigm Director of Product Marketing Scott McLeod pens a new blog, “All Signs Point to Population Health Management.”
  • AtHoc President and CEO Guy Miasnik writes about the role AtHoc technology played in protecting Gritman Medical Center from an active shooter.
  • The local business paper highlights the venture capital funding raised by CareSync in Q4 2014.
  • CareTech will attend the January 28 MCACHE event on “Building a Leadership Team for the Healthcare Organization of the Future.”
  • AirWatch’s Noah Wasmer offers five end-user computing technology predictions for 2015 in a new blog.
  • ADP AdvancedMD offers tips on leveraging practice data to view key performance indicators in a new blog.
  • Besler Consulting offers advice on how to increase Medicare EHR incentive payments.
  • Aventura will exhibit at the IMN Health Impact Conference of the Southeast in Tampa on January 23.
  • CitiusTech achieves the ISO 13485 quality management system standard for medical devices.
  • CoverMyMeds shares a moment with Account Coordinator Josh Campanella in the latest installment of its “Hey, You!” blog series.
  • ABCNews.com lists Clockwise.md amongst other companies making a name for themselves developing online booking software.
  • CommVault launches new endpoint data protection to secure, support, and back up mobile enterprises.
  • Craneware lists its goals for 2015 in a new blog post.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 20, 2015 News 6 Comments

Startup CEOs and Investors: Brian Weiss

Common CommonWell Thoughts (or, Who is Working on A National Social Being Identifier?)
By Brian Weiss

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Did you read the CommonWell piece on HIStalk?

Mr H. did us all a great service in providing a platform for directing HIStalk reader questions to the CommonWell alliance from Cerner and company. Yes, I know that only 60 percent of the panel responding to the questions actually works at Cerner, but my articles are too long already without listing the full membership of CommonWell. I hope you’ll forgive me if Brightree isn’t the first vendor that jumps to mind when I think about CommonWell.

Given the fact that CommonWell is not consistently spelled “Commonwell,” we need to be especially appreciative that Mr. H gave them publishing space. I’m only allowed to write this article because I named my company “Carebox” even though I’m still waiting for the first person not related to me to spell it that way rather than “CareBox.”

Now, if you’re reading this article (clearly you are) and you still didn’t read that one (and you’re not related to me), you need to do a better job prioritizing what parts of HIStalk you read. We’ll all wait for you here while you go read that piece.

 

The Alliance

CommonWell is an “alliance.” I’m pretty sure that was selected over “empire” in the tight balloting in the CommonWell name-calling subcommittee because of the whole “Star Wars” context. For those who slept through the relevant decades, the “Alliance” is what you call the good guys, and if you’re reading this article and never saw “Star Wars” (even if you’re related to me), you really need to work on overall life balance.

By the way, I’m not 100 percent sure they have a formal name-calling subcommittee at CommonWell and, yes, I’m aware that the term “name-calling” has other connotations that have little do with HIT (OK, maybe a little).

From the questions that appeared in that article and the comments building up afterwards, it appears that there’s a bit of debate among some readers of HIStalk as to whether this alliance really gets to wear the orange jumpsuits and fly the Y-wing fighters. I’m not interested in getting into that debate. However, given my recent self-appointment as the voice (representing nobody) of innovative (self-labeled) startup companies that are seeking to leverage consumer healthcare data in various applications and services, duty calls! Give me just a minute here to adjust my cape. OK, ready …

 

Is a Patient in HIT a Subordinate Clause of Their Provider?

The quote I want to focus on from the CommonWell article is this one:

A single connection to the CommonWell network will enable providers and the patients they serve to access to [sic] their health information at all those various systems and organizations and won’t require peer-to-peer contracting for each provider you need to reach.

I was busy doing my math homework when we were in English grammar class so I don’t know if “and the patients they serve” is actually a subordinate clause or not. I’ve got a sinking feeling, though, that the high-sounding “serving the patient” expression doesn’t change the fact that whoever wrote that sentence views patient access to their own data as “subordinate” to the healthcare IT vendors and their healthcare provider customers. And nobody can mistakenly think that the “you” in “each provider you need to reach” from the quote above, refers to the patient/consumer.

 

The Missing Patient Service

I went to the CommonWell services page and I couldn’t find the service whereby a patient can request a copy of their healthcare records from everyone on the CommonWell network.

Interestingly, the word “patient” appears seven times on that page. There is talk of how to “link patients across organizations” and “patient identification” and even “patient-authorized.” But as far as I understood, that all seemed to be in the context of how providers exchange information with each other behind the patient’s back.

In both the body of the article and the comments section, there was quite a bit of back-and-forth about payment models and how the revenue pie should be shared among CommonWell members (vendors), the doctors who contribute the data, and McKesson (the company that got picked to provide the service).

There were also some interesting analogies made to financial transactions. Indeed, I believe there is a whole world of “behind the consumers’ backs transactions” that take place across financial institutions and in other EDI contexts. But at the end of the day, as a consumer, I can get a (free) copy of all of my transactions from all of my financial providers. And I can use a service like mint.com to act on my behalf and make it easier and more valuable for me to do that.

I’m not saying that’s the ideal model, is consumer-centric enough, or (conversely) is directly/fully appropriate for healthcare. But it’s interesting to think about how it works relative to how things are intended to work – and not only in CommonWell – when it comes to healthcare networks.

Curiously, I don’t recall that there was a need for Congressional involvement in order to establish a National Banking Identity for everyone. If I want to establish a mechanism to transfer money from my checking account to my mutual fund account, I set that up and provide the authorizations. As far as I know, the mutual fund company and the bank aren’t part of an “alliance” that provides “identification and linking services” to make sure they correctly match my bank account with my mutual fund account so that they can move information about me between them once they get me to sign a consent form I don’t fully understand while I’m at the bank teller.

 

What’s Your National Photographer ID?

Given how tough it is to do patient matching (I have a little MPI experience and it really is pretty tough), I’m amazed that Instagram has manage to get as far as they have without a National Photographer ID. How come LinkedIn doesn’t need my National Employee ID and Facebook doesn’t need my National Social Being ID (or my National Annoying Communicator ID for WhatsApp?)

It seems that by some miracle, armed with nothing more than an e-mail address, I can securely and reliably authorize any sharing network I want about my most sensitive information. Oh, wait, there is one catch — I have to be a little involved in process.

If my mom and my wife want to share information about me without me being involved (scary thought) then I suppose they would indeed need some kind of ID and matching process to ensure they aren’t sharing information about someone else when they use their “record locator service” to access each other’s database of information about me. But if I have my information stored with each of them in my e-mail-keyed (and easily validated) account that I maintain with each of them (hey, it’s an analogy, relax) and I authorize the sharing, it doesn’t need an act of Congress to get the information flowing.

 

This is Not Just a CommonWell Issue

Now if it sounds like I was being disingenuous above about not taking sides on CommonWell while adjusting their Darth Vader helmets, that’s a mistake. As far as I can see, CommonWell is mostly providing a more practical and commercially effective model for what the US government said it wanted to do all along in terms of national health networks – with the usual vendor politics and dynamics in play, as is to be expected.

Whether it’s FHIR as per my previous article, CommonWell in this one, Epic openness debates, or evaluation of data interoperability strategic roadmaps, I think one of the litmus-test questions has to be something like this:

How does your (standard, service, alliance, network, system, strategy, roadmap) empower a consumer to exercise their HIPAA-mandated right to get an electronic copy of their healthcare data and share it with (family, caregivers, providers, research groups, pharmacist, clinic, employer, people who will pay them for it, whoever) whenever they want?

CommonWell may have a better answer to this question than most, but it isn’t shining through yet clearly enough for me in their article on HIStalk or on their web site.

Is that a question from the noble, bright, and good part of the Force? Not necessarily. It’s as self-serving as anything in the CommonWell materials or anything else. I have a smaller company than Cerner to try and make successful, so if anything (deliberately using that word a third time in this paragraph – and breaking the flow of the paragraph – again – so I can generate some loyalty from the commenter who critiqued my problematic writing style in my last article), I can afford to be even less altruistic.

In the interest of transparency, I’m working on a draft resolution for my upcoming board meeting to have our name-calling committee allow me to swap out “CEO/Founder” for “Emperor.” I’ll let you know how it goes.

Brian Weiss is founder of Carebox.

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January 19, 2015 Startup CEOs and Investors 4 Comments

HIStalk Interviews Ted Reynolds, SVP, CTG Health Solutions

January 19, 2015 Interviews 3 Comments

Ted Reynolds is senior vice-president of CTG and is responsible for CTG Health Solutions

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Tell me about yourself and the company. 

I’ve been in healthcare since the 1970s. My first go-round was in June 1979. I started off working for a hospital, the last of which was Stanford, and worked for a couple of vendors. Then I went to the dark side and went to consulting.

CTG is a long-established firm, having been around 48 years. I lead the healthcare division, which includes payers and providers. We’re one of what KLAS used to call Tier 1 firms. We provide a full breadth of services — advisory, planning, implementations, technical services, and application management. People know us a lot for legacy support since we do as much of that as anybody in the country.

 

CIOs are getting pulled in a lot of directions. What are they focusing on most?

Oh, boy, they’re getting pulled in all directions. A lot of them have been chasing Meaningful Use dollars trying to get EMRs implemented. But in the future, it’s going to be very confusing as people start to transition from volume- to value-based payments, whether you call it an ACO or population health or whatever. Those are going to be very complex. It’s going to change the paradigm to where you’re going to be reimbursed for not doing work. It’s going to be very interesting to see how they evolve. I think it’s going to be difficult for them.

 

What projects are requiring people to call you for help?

Because we work on the payer side, we help a lot of organizations as they move into the ACO world. We’ve been helping a lot of them set up patient-centered medical homes. We’ve been doing planning for that — getting tied into the physicians, helping them do evaluations of systems they should look at. We’ve worked for some of the payers in looking at what they need to do to help them manage the populations.

This is kind of like HMOs II. In the early 1990s, it didn’t work very well. A lot of them, candidly, really didn’t have the data. Most of them were trying to manage their populations using claims data. That’s like trying to drive a car looking in your rear-view mirror because the data is two months old. Now with EMRs, I think they will have more success.

But there were still some early successes back then. Kaiser and some of the large group models actually succeeded and survived, but a lot of them did fail because they couldn’t manage the risk. I’m hoping that we can see something that will drive the cost down. That’s going to be a lot of the challenges we’re seeing with the groups. 

A lot of the hospitals and large physician groups are looking are mergers and acquisitions. Who do you play with, how big do you need to be to absorb a risk. Because if you start going in some sort of capitated risk arrangement, you’ve got to have a pretty large financial base to survive.

 

Interoperability isn’t just a technology problem because hospitals don’t have much incentive to share risk with competitors. What are they telling you about their desire to exchange information with other health systems?

You hit the nail right on the head. A lot of them are competitors and they do not want to share their information. I don’t want to make it easier for you to steal my patients from me.

But I think you’re starting to see more and more of that break down as we go forward. If they go with some sort of at risk where they share any risk for a population, they’re going to have to share their information. I think that’s going to break down the barriers. That’s what we’re seeing. It is a technology issue, but also there’s a lot of issues I think socially we’ve got to understand and get over.

For example, in the United States, nobody wants you to know anything about them until they’re unconscious on the ER table. Then they want you to know all the information. Maybe it’s too late then. Whereas you’re seeing in Europe things like national patient identifiers. We’re not willing to step up and do that yet from a political perspective. It’s quite interesting.

I spent a third of last year over in Europe. They have big advantages. Most of them have a single-payer system, socialized medicine. I’m not sure that’s the way we need to go over here. I’m not sure that would be the solution.

But what they’ve done is that everybody has a national health identifier. They have issues with some certain percentage of the population like we do with immigrants, but they’ve addressed that. If you look in some of the northern parts like Denmark, some of them have a national patient identifier. They have national patient portals so they can look at the information. They have a national registry that has all the drugs, all the hospital visits, all the physician visits. They can inquire into those. The technology is not very conducive to use because it’s not one integrated system, but at least they do have access to it.

Some of them legislated that all the primary care had to implement an EMR about six years ago now. Because of that, they have a lot of information. Most of the care both here and there is provided in an ambulatory setting. That’s where you’re missing a lot of the information. Same thing here in the states. Hospital EMR implementation is further along than the physician offices, but it’s getting there very quickly.

 

Are providers here supporting the idea of empowering patients or are they resisting it?

They are moving to where more and more of them are encouraging it. But if you look at healthcare, it compares to the banking industry. In some ways, we’re back years and years ago when the banking industry started rolling out ATMs.The local banks could not afford to roll out an ATM network, so you started with the regionals buying out the local banks and then the nationals started buying out the regionals. This is very analogous. You wouldn’t go to a bank today where you didn’t have electronic banking or an ATM.

In the future, I think you’re going to see the same thing with what patients are going to expect. You’re going to expect to see your lab results within a day or two by the time you get home. You can schedule your appointments online. You can pay your bills. You can do your medication refills. Why wouldn’t you?

I’ve seen our employees and my previous employees switch which providers and hospitals they’re going to based on who had the patient portals. You’ll see that that’s going to put a lot of pressure. Regardless of what happens with the political situation, patients as consumers are going to expect that, especially the newer population. You have it with banking, which is a lot less complex. Why wouldn’t you have it with your healthcare? We’re starting to see that pressure. Some of the providers aren’t pushing as fast, but in some of the large metropolitan areas, this is already happening, where they have large EMRs already installed.

 

After the Sony Pictures breach, are you getting a lot of security-related inquiries from hospitals trying to figure out how to make themselves more secure?

Yes, we are. Not as much as I would expect, though.

 

How do you think cybersecurity fits into all the other things that are on the CIO’s plate today?

It’s a huge risk. The question is, is how much effort and cost do you put into it to prevent it? You see some organizations where it’s getting to become a larger part of their budget to actually try to put all the prevention in. 

A lot of it is just the basics. A lot of it is changing human behavior. Some of the breaches that you see is where people download the information on laptop and it gets stolen. You’ve seen it time and time again and that seems to be a lot. It’s just a matter of continuing education. I think it’s not only a technology issue, but it’s also an educational issue throughout the entire organization.

 

Health systems aren’t only helping each other with consulting, but also hosting systems such as in the Epic Community Connect model. Is that a threat to your business?

We just finished one of the largest region connects that Epic has done last year. They used us to help them install it because it was an hour and a half. They brought up six hospitals very quickly. I think it was 10 months and ten days from the date they signed the contract.

But it was an hour and a half away from their facilities. It’s hard to ask somebody who’s got a family to drive an hour and a half each way. They didn’t sign up for a travel job. They didn’t sign up for consulting. They want to be home with small kids, participating in their family’s activities at night and things like that.

We helped them what that deployment. Very successful. I think you’ll see more and more of that. However, some of them are starting to get teams who will travel and they’re starting to change expectations of some of their employees, too.

 

You worked for Epic during some of its biggest ramp-up years. What did you learn there?

That was a lot of fun. What I learned and what I always appreciated is that Epic always seemed to have the client’s interests first and foremost. I got to appreciate the integration that they’ve done between the hospital and the physicians. They’ve done quite well as they deploy that model across the country. 

I had tried to lead a development effort for that back in the 1980s for a company that McKesson now owns. They saw the integration dream. You’re seeing a rise of a lot of the integrated vendors. Cerner’s doing well, Epic’s doing well, and then probably Meditech. A lot of the other ones are struggling as they’re trying to integrate the packages. You’re seeing that in the market today.

 

What do the best health system CIOs do that the others don’t?

The ones that are the most successful see IT as an enabler and can help the organization drive value from the system. You try to drive it to where it has a true return on investment. It may be clinical quality, it may be patient safety. But also, you have some quality indicators and you involve the operational organization in trying to drive benefits from the system.

I’ve always been a believer that you don’t put in technology just for technology’s sake. You put it in to try to help improve your business operations. Clinically, financially, attract patients to your facility, one of those. The ones that have engaged the operational organization do the best and they take it out of the framework of being a pure technologist.

 

Do you have any final thoughts?

HIStalk is one publication I read religiously. It’s timely, it’s accurate, and I really enjoy it. It’s to the point. I love Dr. Jayne — she’s got a very pragmatic approach to things.

I think healthcare is going to change a lot. We’re finally getting automation to the degree to where we really can make a difference. With the advent of genomics, we’re going to see a pretty dramatic change in the next five years over personalized medicine to where you can really, truly provide the best, cost-effective care. A lot of the things we treat today don’t provide the highest quality for the least cost. I think we’ll get there, hopefully very quickly, because now we got the information that we didn’t have before.

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January 19, 2015 Interviews 3 Comments

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