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Readers Write: Leveraging Technology for Communicable Disease Care

November 19, 2014 Readers Write No Comments

Leveraging Technology for Communicable Disease Care
By Paul J. Caracciolo

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The Ebola crisis has been another wake-up call for healthcare providers to get prepared for national and global medical emergencies. Experts agree that it is only a matter of time before the world experiences another pandemic, such as the flu of 1918 that killed many of millions worldwide.

The recent outbreak of Ebola in West Africa and subsequent spread to the US has caused providers to re-examine how they handle sick (and potentially infected) patients, but we don’t have to use Ebola as the example. The seasonal flu still has a significant impact on health and many deaths occur each year. This past year has also seen the rise of enterovirus D68, sickening many hundreds of children across the country, resulting in several deaths.

The proper care of patients with communicable disease is a concern. We want to ensure that patients receive appropriate care, but at the same time, we need to take precautions around the containment and spread of disease. Recently, CNN News reported statistics that approximately 4.5 percent of reported Ebola cases in West Africa are infected caregivers. In the case of Ebola, disease management is further complicated considering the 21-day incubation period, with possible imposed isolation and continuous monitoring of potentially infected patients during this time.

Solutions can be implemented now that could make a huge difference in not only increasing the quality of patient care, but also protecting caregivers from prolonged or unnecessary exposure to sick patients.

Telehealth / telemedicine. It would be beneficial to have this capability in sick patient rooms to control access. This would allow remote consults with disease specialists, primary care providers, ancillaries, or whoever needs direct access to these patients and their caregivers. This solution could be expanded to include two-way audio and video with nursing staff and HD video conferencing between the patient and their families. Or in the case of isolation for potential infection, patients could communicate with their loved ones, employers, benefits providers, or anyone else on the outside.

Virtual patient observation. This solution includes video equipment, network integration with nurse call, and intelligent software that can be configured to be sensitive to patient movement. A monitoring console can be presented at a nurse station computer or accessed mobile from tablets. Several patients can be monitored from one station, or select rooms can be monitored. Coupled with two-way voice communication, this can be a powerful tool.

Alert and alarm management, workflow enhancement. This middleware that can capture relevant patient data from monitoring devices and lab results and then present this data to caregivers on mobile devices. Staying with the theme of patient and caregiver safety and more efficient workflows, this technology can streamline communications. Alarms from biomedical equipment in a patient’s room can be triaged by the configured system, thus preventing alarm fatigue for caregivers and focusing attention on critical alarms. Additionally, these applications can use push notification technology to send out critical lab test results, with related information, to the mobile devices of clinicians Secure text messaging, typically another feature, can streamline communications and record the information and send it to the EMR to complete the care record and maintain compliance.

Care team collaboration applications. Having the ability to share patient related data is key to keeping care teams on the same page. Access to the EMR may not be feasible for all caregivers involved. The ability to share documents, notes, lab results, and images (and imaging) among care team members wherever they may be is powerful. Even caregivers who are suspected of being infected (and in isolation) could still be part of a productive care team with these applications. Cloud applications could be used on demand and are easily scalable to fit emergency scenarios.

Hospitals can take action now to be better prepared to deal with outbreaks. Although many hospitals may not have formal isolation rooms, they may want to designate and prepare certain rooms that could be used in a more formal manner if needed in emergencies. For instance, specific nurse wards, floors, or group of rooms could be outfitted with these technologies. In time of emergency, the emergency protocol would kick in, with technology in place and workforce trained. These technologies can also be used on demand for triage or isolation tents, with portable versions of telemedicine and virtual patient observation solutions.

Paul J. Caracciolo is chief healthcare officer of Nexus – A Dimension Data Company of Valencia, CA.

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November 19, 2014 Readers Write No Comments

HIStalk Interviews Joe Torti, CEO, ESD

November 19, 2014 Interviews No Comments

Joe Torti is founder and CEO of ESD of Toledo, OH. 

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Tell me about yourself and the company.

I started in healthcare IT in 1983 when I got out of graduate school. I worked in healthcare IT for a few years and left the industry. In 1990, I was talking to some people that I worked with for a couple of years and they said, "There’s a need for this."

I felt entrepreneurial at that time and I went for it. I was an HBOC project manager on a few jobs working for myself. Then I slowly started hiring people as I talked to people I knew or met more people in the industry. I started building up the practice one consultant at a time.

 

The company just announced some layoffs and a restructuring, which is something most companies aren’t as forthright about. What challenges led to that decision and what have you learned from it?

We had increased our sales force to get more exposure to the market. As the forecast got closer and closer, we realized that the market for our products and the consulting industry in general was down. A good majority of the clients that we dealt with that were ripping and replacing systems had already done it.

A major portion of our business is still go-live and staff augmentation, which have slowed down significantly throughout the industry. One of our contracts, a very large one, just moved from April to the end of the year. We did not see that in our sales forecast and our salespeople were not seeing a lot of traction in the market for the next three to six months. That’s what drove our right-sizing, if you want to use an industry phrase. 

We have not closed. We’ve sized for the market we see over the next three to six months. We have kept key people in key positions to move forward in the market that we see.

 

How has the business changed in the past two years?

Two years ago, everybody was trying to get Meaningful Use dollars. They were putting in systems. The staff augmentation on these projects was huge. The activation part of the business was huge.

Since a lot of the organizations have made the decision, they’ve moved ahead a lot of what we thought was going to be first half 2015 work. They dropped ICD-10 work, spent the money on other projects, and now they’re back to spending it on ICD-10 because they’re trying to get that done.

The market will be very strong again over  the next two to three years. Even though a lot of hospitals have made the call on switching or upgrading, a lot of them are still making that decision.

 

Where do you see the opportunities going forward?

There will be activation work in the next  18 months, but optimization is the opportunity. Clients have said, “We put in a model system or a vanilla system and now we need to make it work for us better.”

We are uniquely qualified in that area because of our clinical focus. Many of our consultants are clinical, with very good knowledge of multiple installations of certain software . They can come back to a client and help them optimize it based on best practices from around the country.

 

How will you take the company forward?

Our COO, Kelly Myles, is an RN. We’ve always marched to her saying, "Whatever we do affects the patient eventually." That’s been our guiding force. 

We provide good consultants who are focused on doing the best job so that the patients have the best experience with whatever organization they’re in.

 

Do you have any final thoughts?

Our business has been successful because of the value of the consultants that we have built relationships with. That part of our business remains unchanged. We’ve spent many years developing those relationships and working with the same consultants over the years. We know their expertise very well.  They’ve worked for ESD on many projects. 

We have multiple clients that we’ve been working with since 2005 or even 2003. They still have confidence in us, every one of them.

Moving forward, we will provide the same level of quality to our clients. We will keep those relationships intact. Our changes will allow us to be there for the consultants and for our clients.

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November 19, 2014 Interviews No Comments

Morning Headlines 11/19/14

November 19, 2014 Headlines No Comments

John Glaser to join Cerner upon acquisition close

Cerner reports that Siemens CEO John Glaser will join Cerner as a senior vice president following the acquisition. Glaser will focus on driving technology and product strategies, interoperability, and government policy development.

Fitch Affirms Duke University Health System (NC) Revs at ‘AA'; Outlook Stable

Duke University Health System retains its AA bond rating despite a $65 million reserve adjustment tied to billing issues following its Epic go-live.

Armed Robbery Of Doctor Puts Brigham and Women’s Patient Info At Risk

Brigham and Women’s Hospital (MA) is notifying 1,000 patients of a potential PHI breach after an armed gunman steals a physicians computer and then ties him to a tree and demands his username and password.

HSE sets up internal audit into awarding of hospital contract

In Ireland, federal auditors are investigating a public hospital group that signed a sole-bidder contract for a clinical IT system after a local reporter discovered that the CEO of hospitals had previously consulted for the private firm that won the business.

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November 19, 2014 Headlines No Comments

News 11/19/14

November 18, 2014 News 4 Comments

Top News

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HIMSS, IHE, and the EHR/HIE Interoperability Workgroup (created and led by the New York eHealth Collaborative) announce their combined efforts to streamline connectivity between EHRs and HIEs. IWG, formed in 2011 to improve that connectivity, will use ICSA Labs to test and certify products beginning in early 2015. It will continue its focus on standards and certification of query-based exchange and the use of Direct. The organization includes several HIEs and a large number of EHR vendors, including Cerner, Epic, and McKesson. 


Webinars

November 19 (Wednesday) 1:00 ET. Improving Trial Accrual by Engaging the Digital Healthcare Consumer. Sponsored by DocuSign. Presenters: B. J. Rimel, MD, gynecologic oncologist, Cedars-Sinai Medial Center; Jennifer Royer, product marketing, DocuSign. The Women’s Cancer Program increased trial accrual five-fold by implementing an online registry that links participants to research studies, digitizing and simplifying a cumbersome, paper-based process. This webinar will describe the use of e-consents and social marketing to engage a broader population and advance research while saving time and reducing costs.

Vince Ciotti and Frank Poggio delivered an HIStalk webinar Tuesday that held my rapt attention all the way through: “Cerner Takeover of Siemens, Are You Ready?” These guys have 90 years of healthcare IT expertise between them, including living through more than a dozen acquisitions as insiders, and both of them are cynical, snarky, and highly knowledgeable. Both also contribute regularly to HIStalk. Thanks to them for doing a great job. We had something like 280 attendees online and I’m sure the YouTube video recording will get a bunch of views — the record is held by Dim-Sum’s DHMSM 101 DoD one, which has been viewed 1,300 times in addition to the views it got directly from HIStalk and during the live session.


Acquisitions, Funding, Business, and Stock

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Analytics technology vendor MedeAnalytics acquires OnFocus Healthcare, which sells performance management systems.  

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Online wellness coaching vendor Fruit Street Health offers free shares in the company to those who lost their investment in CEO Laurence Girard’s previous failed venture. I wouldn’t bet my money on those shares either since it charges $300 per month for four weekly video calls with a fitness coach and dietitian, at least not before reviewing this site whose entire mission is “to protect investors from Laurence Girard” that claims he has said repeatedly that Prevently was a Ponzi scheme and that he’s not disclosing several other failed ventures.

CVS Health will open a 100-employee technology development center in Boston for “building customer-centric experiences in healthcare” and to connect with health-related startups. The company — which operates drugstores, pharmacy benefits management, specialty pharmacies, and MinuteClinic retail clinics — will also open three drugstores that will be used for live testing of new digital technologies. Its Digital Health group is headquartered in Woonsocket, RI, where it recently opened a Digital Experience Center.

Kaiser Permanente will open retail clinics inside four California Target stores. Insurance competitor Blue Shield of Competitor says it will contract to have its members covered in the KP locations, which will also accept Medicare and Medi-Cal in offering services for minor illness, checkups, and chronic disease monitoring.  

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UPMC sells its 51 percent interest in the procurement systems vendor it created — Prodigo Solutions — to a private equity firm, realizing a $9 million gain.

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Zipnosis, which offers consumers a $25 televisit using an automated interview and clinician review, receives an undisclosed seed round investment.

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North Bridge Growth Equity secures a majority stake in Atlanta-based Ingenious Med.


Sales

Chicago-area FQHC Mile Square Health Center chooses Forward Health Group’s PopulationManager and The Guideline Advantage.

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Memorial Healthcare (MI) and King’s Daughters Medical Centers (MS) engage Iatric Systems to perform EHR-neutral integration with Apple Health.

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Orlando Health (FL) chooses Ingenious Med’s charge capture system.

Ob Hospitalist Group (SC) chooses PatientKeeper Charge Capture for its physicians that provide services to 75 hospitals.

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Arnot Health (NY) selects eClinicalWorks for EHR and health exchange for its 160 providers.

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Virtual Radiologic chooses SyTrue’s natural language processing systems to extract information from its radiology reports, with plans to use the company’s Semantic Search to present teleradiologists with exams similar to the one being reviewed to drive clinical performance and efficiency.

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St. Elizabeth Healthcare (KY) selects Strata Decision’s StrataJazz for cost accounting, budgeting, capital planning, and financial planning.

Rio Grande Valley HIE and University of Texas Health Science Center choose Wellcentive’s population health management solutions to help manage the care of people with diabetes.


People

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CTG promotes Ted Reynolds to SVP with responsibility over CTG Health Solutions.

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George Evans (Singing River Health System) joins Sagacious Consultants as principal consultant.

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The HCI Group names John McDaniel (NetApp) as VP of innovation and technology solutions.

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AMC Health hires Bruce Matter (GE Healthcare) as SVP of sales and client development.

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Afik Gal, MD, MBA (PwC Consulting) joins QPID Health as VP of product innovation.

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Siemens Health Services CEO John Glaser will join Cerner after its acquisition of SHS is complete. He says, “I’ll join as a senior vice president, focused on driving technology and product strategies, interoperability, and government policy development.” Leaders of acquired companies don’t usually last long, so we’ll see. As Vince and Frank said in Tuesday’s webinar, Siemens customers should get any promises in writing from Cerner, not from Siemens.

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Cal INDEX HIE hires Greg LeClaire (Aetna) as CFO; John Lee (Oracle) as CTO;  and Doug Hart (ConvergeHealth) as VP of marketing and corporate communications. Also hired but with no photo available anywhere I could find on the web: Andrea Leeb, RN, Esq. (LA Care Health Plan) as chief privacy officer. I’m amazed at technology people who don’t keep their LinkedIn profile current or who don’t include a photo of reasonable quality. Mistake #1 (second only to not including a photo at all): shrinking down the head shot to horrible quality, missing the point that LinkedIn thumbnails it automatically while still displaying the full-sized original when clicked. Mistake #2: using an informal snapshot that adds distracting features such as the shoulders of other people from the cropped group photo or a Hawaiian lei. Of course this advice comes from someone whose own profile doesn’t have a photo, but I have an excuse: LinkedIn shut mine down until I removed the “Caddyshack” image of Carl Spackler.


Announcements and Implementations

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Faith Community Hospital (TX) successfully attests for Meaningful Use Stage 2 shortly after choosing and implementing the RazorInsights EHR and using its Meaningful Use Dashboard.

Memorial Healthcare System (FL) is sending referral information from its ED to Henderson Behavioral Health (FL) to integrate medical and behavioral services. The health system sends HL7 C-CDAs from Epic to Henderson’s Netsmart CareRecord EHR that include completed labs, demographics, medical summary, meds list, and vital signs.

The Greenville, SC paper profiles ChartSpan Medical Technologies, which has developed a new PHR app for iOS.


Government and Politics

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A Federal Trade Commission investigation into website privacy certification company TRUSTe results in a $200,000 settlement. TRUSTe didn’t perform some of the the annual website privacy audits it promised. It also failed to require certified sites to display an updated seal indicating TRUSTe’s conversion to a for-profit company in 2008. 

Michigan’s top-earning doctors in CMS’s Open Payments database of drug and device company payments explain their income as follow, a good example of just how complicated the issues are around medical payments:

  • A diagnostic radiologist who was paid $688,000 by a medical device manufacturer says he doesn’t use the needle biopsy and software he developed because he no longer does biopsies. He says he supports Open Payments to expose doctors who are paid to use products on their patients.
  • A GP who was listed as earning $571,000 from a drug company is actually the medical director of a clinic that was paid for conducting three studies. The doctor does research work only and is paid a salary by the clinic, while the drug company payments were made to the clinic itself and he received nothing.
  • A plastic surgeon who earned $341,000 in drug company money for training doctors to use an Allergan breast implant says he doesn’t promote the product and loses money when consulting for up to $5,000 per day since that’s a tenth of what he would make otherwise.
  • A University of Michigan Medical School orthopedic surgeon who was paid $201,000 in royalties for a knee replacement device says he follows his employer’s conflict of interest guidelines and doesn’t receive royalties when the device is used by anyone within UM.
  • An orthopedic surgeon who made $196,000 from device companies says he holds 55 patents and he tells patients if he’ll get paid for using a particular one.

Innovation and Research

A study finds that use of EMR-triggered, telephone-based prescription refill reminders for heart-related drugs was associated with very slightly improved medication compliance and outcomes.

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A small, short-term study finds that smartphone-based weight loss apps (specifically MyFitnessPal) don’t really help users lose weight.

A Penn Medicine study finds that ambulatory clinic doctors prescribed generic drugs as a higher percentage when the EHR was modified to require an extra click to show the brand name item.

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The Washington Post profiles the Swasthya Slate, an inexpensive device that connects to Android-powered phones and tablets to perform 33 diagnostic tests. The device has been tested in India, where it excelled at detecting preeclampsia, increasing the rate of needed testing, and reducing administrative time for healthcare workers from 54 percent of their day to 8 percent. They expect the cost of the device to be around $150 at full production and see potential for its use with telemedicine.  

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Walgreens will offer inexpensive, minimally painful blood tests from startup Theranos, with the service already launched in the Phoenix area.


Technology

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Statistical software vendor SAS co-founder and CEO Jim Goodnight, PhD, a North Carolina programmer turned multi-billionaire,  tells a banking technology magazine that the data warehouse is not obsolete:

Fraud, customer intelligence, compliance — if you have the right set of data all together, you can use that set of data, you don’t have to keep go looking for data every time you need something. That’s one thing Hadoop provides. It’s a great place to store data. Also, you’re buying these 1.2 terabyte disks at about $300 apiece, you can hang 20 of these on a server and it’s local, so you can read the data straight on the machine … We’re seeing a shift away from that kind of hardware [IBM mainframes] to commodity. People are dropping AIX boxes and going to Linux x86 boxes and Intel chips. The chipsets are incredible. Dell has a machine we really like, it’s called an R920 and it has four slots, you could put four chips each with 16 cores, you end up with a server with 64 processors, you can put three terabytes of memory in that machine, and it’s about $100,000.



Other

Brigham and Women’s Hospital (MA) announces that the information of 1,000 patients was exposed in September when a robber held up a doctor at gunpoint, tied him to a tree, and forced him to give up his cell phone and laptop passwords. 

The bonds of Duke University Health System (NC) remain at an ‘AA’ rating despite a $65 million reserve adjustment due to a collections slowdown caused by its Epic implementation and problems with new IT systems at both North Carolina Medicaid and Blue Cross Blue Shield of North Carolina.

In Ireland, the health service is reviewing why a five-hospital group invited only one vendor to respond to a clinical information system RFP. Auditors also want to know whether the former CEO of the hospital group disclosed that he previously worked as a consultant for the company, Northgate Public Services.

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The provider folks behind “Just Epic Salary” make their survey results available for free Excel download. Some of the highest average salaries were for permanent hire physicians ($348,000), permanent hire management ($243,000), and contracted application management ($187,000), although even with 753 responses some of the categories had a small sample size.


Sponsor Updates

  • CIO Review names secure communications vendor PerfectServe as one of the “20 Most Promising Healthcare Tech Solutions Providers in 2014.”
  • Versus Technology announces that Amerinet members will receive discounts on its RTLS products.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 18, 2014 News 4 Comments

Morning Headlines 11/18/14

November 17, 2014 Headlines No Comments

International Classification of Diseases, 10th Revision (ICD-10) Testing -Acknowledgement Testing with Providers

CMS kicks off its first ICD-10 testing week, during which providers will be able to submit ICD-10 claims, and CMS will respond with an acknowledgement or a rejection.  Additional testing weeks will be held in March and June 2015.

Some New Frustrations as Health Exchange Opens

As the 2014/2015 health insurance enrollment period opens, sporadic but largely non-disruptive technical problems continue to plague both state and federal exchange websites. However, 23,000 people submitted complete applications in the first eight hours after Healthcare.gov opened on Saturday morning.

Strategic partnership between IWG, HIMSS and IHE focuses on EHR-HIE connectivity

HIMSS, the EHR/HIE Interoperability Workgroup, and Integrating the Healthcare Enterprise have formed a strategic partnership that will work to expedite the creation of national data exchange standards, and will develop EHR and HIE certification programs to independently validate vendor interoperability.

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November 17, 2014 Headlines No Comments

Curbside Consult with Dr. Jayne 11/17/14

November 17, 2014 Dr. Jayne 3 Comments

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Color me less than thrilled that the Institute of Medicine is now asking for EHRs to capture additional social and behavioral data as part of Meaningful Use Stage 3. That’s assuming that Meaningful Use is still viable now that the money is nearly gone and more than half of ONC’s senior leadership has left in recent months. Practice administrators have been dazed and confused trying to figure out if they are better off trying to apply for hardship exceptions, take advantage of the flexibility rule, or throw in the towel altogether.

I recently met a practice administrator who swore up and down her providers were attesting for Stage 2, even though they hadn’t yet installed a patient portal and didn’t have a Direct interface. Then again, she also thought that Patient-Centered Medical Home was some kind of design/construction initiative rather than a practice transformation activity, so I shouldn’t have been surprised.

I understand that the Institute of Medicine sees EHRs as a great place to mine data for research, but patients are already weary of having their privacy invaded. Anyone remember the Florida legislation to control whether providers could ask about firearms in the home? My vendor actually had to code in a setting where a practice could hide the firearms questions to avoid running afoul of the law.

Although we’re pushing patients to be more engaged and it’s nice to work with them when they are, at least in my world the majority of patients don’t care about engagement. They just want to be treated and get back to work, their kids, or whatever else was going on in their lives before they got sick. They’re not interested in proactively managing their health when they’re living paycheck to paycheck and think that even questions about alcohol and tobacco use (which are clearly linked to major health outcomes with most people understanding their significance) are over the line.

When we had to start asking about race and ethnicity, we spent on average two to three minutes per patient explaining why we needed that information and helping patients figure out how to answer the question. Many patients thought they were interchangeable, so we were at the front desk educating them on the vagaries of demographic data rather than collecting their co-pay and speeding them back to see the doctor. At least those particular pieces of demographic information don’t change over the life of the patient, so you only have to ask them once.

Now the academic crowd is going to push us to ask about factors that could change at every visit, including depression, education, intimate partner violence, financial resource strain, physical activity, social connections/isolation, and stress. I can tell you without gathering data or an exhaustive chart review that most of my patients would require discussion of the last four.

As a good primary care physician, I should be asking about these things anyway, but I want to ask about them at an appropriate time during an appropriate visit, after I have built a relationship with the patient. I don’t want them turned into screeners that my staff has to administer to every single patient so we can avoid being penalized.

Will providers be judged on the percentage of patients who follow advice to manage these issues, like we’re currently judged on the number of patients we can convince to go for colonoscopies or mammograms? That’s not what I signed up for as a physician. I should do my best to encourage my patients, but didn’t I spend a lot of time in medical ethics learning about patient autonomy and how the paternalistic model of healthcare delivery has to go? We’re just asking for more cherry-picking by providers as they dismiss non-compliant patients from their panels to improve their numbers.

Most patients don’t understand that their data is already being used for research by health plans and other payers without their specific understanding or consent. Sure, it’s probably in the fine print somewhere and it’s either aggregated or de-identified, but if you asked them whether they understand where their data goes or what it’s used for, they would say no. When people think their information might be used in a way they don’t want it to be used (or to be out of their control), they’re going to lie.

Mr. H’s recent poll showed that nearly half of HIStalk readers have withheld medical information from a provider due to privacy concerns. I’m one of them, I admit. Parents are lying on the California home language survey  because they don’t want their children labeled as “English learners” for fear they will miss out on other educational opportunities. The old medical school adage of “take the amount of alcohol the patient says he uses and double it” reminds us this is not a new phenomenon.

How about let’s actually get people to use the EHRs they already have and use them well rather than pushing more minutiae on overburdened end users? A friend of mine has an EHR with a great onboard reporting tool, yet hasn’t leveraged it at all for actual clinical care. They’re so busy trying to get their patient portal enrollment numbers up and micromanaging the rest of their “all or none” Meaningful Use metrics that they’ve lost their ability to do cancer prevention outreach, immunization campaigns, or other interventions that have been actually proven to save money as well as improve people’s lives. And that, dear readers, is a shame.

What do you think should be in Meaningful Use Stage 3? Email me.

Email Dr. Jayne.

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November 17, 2014 Dr. Jayne 3 Comments

Morning Headlines 11/17/14

November 16, 2014 Headlines 1 Comment

eHealth Initiative 2020 Roadmap

The eHealth Initiative publishes a HIT roadmap that focuses on improving interoperability and data access, while maintaining a focus on business and clinical adoption motivators.

Health IT Enabled Quality Improvement: A Vision to Achieve Better Health and Health Care

ONC publishes its own 10-year plan for advancing health IT capabilities. The plan focuses on advancing clinical decision support and laying the groundwork for standards-based interoperability.

£200 million eHospital system at Addenbrooke’s Hospital in Cambridge under spotlight after incident in operating theatre

In England, executives at Addenbrooke’s Hospital are denying widespread problems with its recently finished $200 million Epic install, despite concerns voiced by its OR staff and technical issues with its blood transfusion analyzer interface.

Did Jonathan Gruber earn ‘almost $400,000′ from the Obama administration?

The Washington Post analyzes the financial compensation that MIT economist Jonathan Gruber, the “architect of Obamacare,” received for helping the administration draft the ACA. The media has been focusing on Gruber recently after a video of him surfaced in which he claims that the ACA was intentionally written to hide its true cost, in what was a successful effort to exploit “ the lack of economic understanding of the American voter.”

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November 16, 2014 Headlines 1 Comment

Monday Morning Update 11/17/14

November 15, 2014 News 2 Comments

Top News

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EHealth Initiative releases its “2020 Roadmap” as a preliminary private sector alternative to the federal government’s Meaningful Use agenda, obviously sensing as others have that ONC’s rapidly decreasing influence will leave a power void in the industry. Some of its points, all of which are aimed at the federal government:

  • Reward providers for outcomes (quite a few of the proposed activities involved incentive payments, with no suggestion that the federal handouts be curtailed).
  • Focus federal policy on interoperability.
  • Simplify quality measurement programs and standardize measures for quality, cost, patient satisfaction, and value.
  • Hold the October 2015 ICD-10 date firm.
  • Push Meaningful Use Stage 3 back.
  • Focus federal policy on the minimum necessary data requirements to manage the health of individuals and populations.
  • Encourage HISPs to publish their provider address directories.
  • Encourage the use of APIs to support core functions.
  • Put more emphasis on Direct-based capabilities, including awareness.
  • Encourage the use of REST and FHIR.
  • Shift EHR certification to measure what the market wants, including interoperability, safety, and security.
  • Consider post-acute and behavioral health providers in interoperability programs.
  • Help define the elements of a nationwide interoperability ecosystem, help overcome privacy and security barriers, and use government purchasing and regulatory clout to advance interoperability.
  • Align federal interoperability efforts across the DoD, VA, NIH, FDA, and CDC.
  • Improve patient and data matching capabilities.
  • Study the costs and benefits of letting patients control the use of their own information.
  • Create a data breach policy guidebook and a trust framework.


HIStalk Announcements and Requests

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Nearly half of the respondents to my poll have withheld information from a provider because of medical records privacy concerns. New poll to your right or here: why did you leave your last job? You can elaborate further after voting by clicking the poll’s comment link. I especially like stories involving management incompetence since I’ve seen plenty of that.


Last Week’s Most Interesting News

  • The Institute of Medicine recommends adding 17 new mandatory patient social history data collection items, such as financial resources and social connections, to EHRs via the Meaningful Use program to give researchers more insight into social determinants of health.
  • UCSF School of Medicine Professor Bob Wachter, MD adds his voice to those calling for ONC to either be refocused on interoperability or shut down.
  • The UK’s Department of Health issues a broad and bold patient-focused health IT plan covering the next several years.
  • Reuters reports that the Federal Trade Commission is reviewing how Apple’s HealthKit manages and shares user health information, adding that Apple is considering hiring a health privacy expert.

Webinars

November 18 (Tuesday) 1:00 ET. Cerner Takeover of Siemens, Are You Ready? Sponsored by HIStalk. Presenters: Frank L. Poggio, president and CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The Cerner acquisition of Siemens impacts 1,000 hospitals that could be forced into a “take it or leave it” situation based on lessons learned from similar takeovers. This webinar will review the possible fate of each Siemens HIS product, the impact of the acquisition on ongoing R&D, available market alternatives, and steps Siemens clients should take to prepare.

November 19 (Wednesday) 1:00 ET. Improving Trial Accrual by Engaging the Digital Healthcare Consumer. Sponsored by DocuSign. Presenters: B. J. Rimel, MD, gynecologic oncologist, Cedars-Sinai Medial Center; Jennifer Royer, product marketing, DocuSign. The Women’s Cancer Program increased trial accrual five-fold by implementing an online registry that links participants to research studies, digitizing and simplifying a cumbersome, paper-based process. This webinar will describe the use of e-consents and social marketing to engage a broader population and advance research while saving time and reducing costs.

Recent webinar videos on YouTube:

Keeping it Clean: How Data Profiling Leads to Trusted Data

3 Ways to Improve Care Transitions Using an HIE Encounter Notification Service


Acquisitions, Funding, Business, and Stock

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Siemens says it will keep its healthcare unit, ending speculation that it wanted to sell that business as it did its healthcare IT and hearing aid divisions.

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Cleveland Clinic creates a company and website to distribute its self-developed software and technology developed by the academic medical centers in its Healthcare Innovation Alliance.


Sales

Mercy chooses Emmi Solutions to provide patient information tools.


People

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UnitedHealth Group announces executive changes that include adding to the duties of its Optum division CEO Larry Renfro, who was named vice chairman of UnitedHealth Group in charge of strategic and key client relationships. His responsibilities include OptumInsight, which is the software and consulting part of the business.

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Ross Martin, MD, MHA tweeted out this picture from Sunday’s Fun Run at the AMIA annual meeting in Washington, DC.  In the photo are Ross (AMIA), Danny Sands,MD (BIDMC),  Tom Payne, MD (UW Medicine), and Bill Hersh, MD (OHSU).

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Also from the AMIA conference: John Glaser of Siemens receives the William W. Stead Award for Thought Leadership in Informatics.


Announcements and Implementations

ONC released its 10-year plan Thursday. While it captured at a high level some of the same ideas expressed in eHealth Initiative’s “Roadmap 2020” report, it was less prescriptive and more self-congratulatory. I didn’t find much interesting in it other than its intention to define common data elements and to create a feedback loop between EHR-collected information and published quality information. The UK’s Department of Health digital strategic plan was a lot more interesting and patient focused than either of these in my mind.

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Baystate Health (MA) opens the TechSpring healthcare IT incubator where it will work with vendors such as Premier and Cerner, funded by a $5.5 million grant from the Massachusetts Live Sciences Center.

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Vanderbilt University will move Vanderbilt University Medical Center into a financially separate organization that can “act nimbly and more independently in a rapidly changing healthcare environment.”

Healthcare IT companies making the Boston Globe’s “Top Places to Work” list include Kronos, athenahealth, Philips,  NaviNet, Imprivata, and Park Place International.

Wolters Kluwer Health launches the Consumer Education Center, which allows providers to create their own consumer health information website using the company’s medication handouts, drug interaction checker, and drug identification tool.


Government and Politics

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A Securities and Exchange Commission investigation finds that CMS employees apparently tipped off investment firms that Medicare was about to increase provider payments 19 months ago, sending insurance company shares soaring two days before the decision was announced publicly. Investigators found that at least 456 CMS employees knew about the increase beforehand and believe that 44 investment funds made trades based on the information insiders provided. An internal CMS email says CMS struck a deal to raise Medicare Advantage payments in order to  get Marilyn Tavenner confirmed as CMS administrator.

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Meanwhile, a Washington Post investigation finds that HHS paid MIT economist Jonathan Gruber $400,000 to help design the Affordable Care Act even as the White House cited him as an unbiased expert who supported its plan. HHS paid him another $2 million to review Medicare’s prescription drug program. Gruber is best known for his comments from several recently discovered videos, including, “If you have a law that makes explicit that healthy people pay in and sick people get money, it wouldn’t have passed. Lack of transparency is a huge political advantage and basically call it the stupidity of the American voter or whatever … This bill was written in a tortured way to make sure the CBO did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies.” Gruber help design the Massachusetts reforms that inspired the ACA, of which yet another video captures him saying, “The dirty secret in Massachusetts is the feds pay for our bill … Ted Kennedy … and smart people in Massachusetts had basically figured out a way to sort of rip off the feds for about $400 million a year.” The New York Times says at least CBO was clear on providing guidance on how to write the ACA legislation “in order to not move trillions of dollars of healthcare expenditures onto the federal budget.”


Technology

Reuters reports that early Google Glass developers and users appear to be losing interest in the product, which is still in beta with no announced rollout date. Of 16 Glass app developers, nine abandoned their projects because of poor business or device limitations, while three that were working on consumer apps refocused on businesses. Several key Glass developers have left Google and a funding consortium of high-profile VCs appears to have shut down.


Other

A Wharton School African forum called “Can Technology Enable Healthcare for All?” finds that simple technologies could improve poor conditions, such as giving expectant mothers cell phones and tracking vaccines with barcodes. A speaker said that Kenya Airways quickly deployed technology and protocols to limit the spread of Ebola, with a result of “Ebola is actually more feared in New York than Nairobi.”

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The Columbus, MS paper describes the iPad-powered EHR created by local dentist Patrick Singley, DMD (on the left in the photo above) for his medical mission trips to underdeveloped countries. He has formed a non-profit organization and is offering the system to other groups.

In the UK, Cambridge-affiliated Addenbrooke’s Hospital says rumors of widespread problems with its $300 million Epic IT system are false, but admits a patient’s on-screen OR record was missing information and that surgeries have been postponed due to problems with blood transfusion analyzer interfaces.

“Remote Area Medical,” a film covering the non-profit volunteer medical relief corps of the same name, opens in New York on November 28 and nationwide December 5. It focuses on a single three-day clinic held at the Bristol Motor Speedway in Tennessee. Remote Area Medical was founded by former “The Wild Kingdom” host Stan Brock in 1985 to provide free medical clinics. Most of its work is in its home state of Tennessee, which is apparently the only state that allows volunteer doctors licensed in other states to practice.

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Boston Magazine runs a feature on the completely solar powered 1966 Volkswagen Bus of Daniel Theobald, co-founder and CTO of patient check-in system vendor Vecna Technologies. He chose that particular vehicle to convert because it’s a “big open box” for experimentation and it was large enough to hold his wife and their seven children. 

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Sing along with Weird News Andy: “I am stuck on the MRI ‘cause the MRI’s stuck on me.” Two hospital employees in India are injured when one of them brings a patient’s oxygen tank into an MRI room, pinning both employees to the giant magnet for four hours as staff tried to turn it off.  The hospital blames GE Healthcare for what it says was a malfunctioning switch.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 15, 2014 News 2 Comments

Morning Headlines 11/14/14

November 13, 2014 Headlines 2 Comments

Capturing Social and Behavioral Domains and Measures In Electronic Health Records

The Institute of Medicine calls on ONC to mandate the inclusion of far more comprehensive social and behavioral health assessments as part of the MU Stage 3 requirements.

Personalised Health and Care 2020: Using Data and Technology to Transform Outcomes for Patients and Citizens

In England, the Department of Health publishes a “framework for action” that outlines its  ambitious digital transformation plans spanning the next five years.

Saving Patient Ryan — Can Advanced Electronic Medical Records Make Patient Care Safer?

Researchers at Carnegie Mellon University compare pre and post-implementation data sets and measure a 27 percent reduction in patient safety events following the deployment of an advanced electronic medical record.

Former Shelby County Hospital CFO Guilty in EHR Incentive Case

The former CFO of Shelby Regional Medical Center (OK) pleads guilty in federal court to charges that he attested for Meaningful Use and collected $785,000 in incentive payments while the hospital was still almost entirely on paper. He faces up to five years in prison.

Meaningful Use. Born, 2009, Died, 2014?

UCSF School of Medicine Professor Bob Wachter, MD recall the history of the Meaningful Use program from inception to its current state, concluding that the ONC does not have the leadership to right the ship, and that the program should be scaled back and focused solely on interoperability, or altogether scrapped so that vendors can go back to developing features that customers are interested in.

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November 13, 2014 Headlines 2 Comments

News 11/14/14

November 13, 2014 News 7 Comments

Top News

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The Institute of Medicine urges ONC and CMS to add additional social and behavioral health measures to EHR certification and Meaningful use criteria to allow researchers and health systems to uncover determinants of health. The unshaded items on the list above, involving 17 patient questions, would be new for most providers.


Reader Comments

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From Flatus Maximus: “Re: ONC’s data matching project. I can’t believe that ONC thinks that these two (or anyone, for that matter) can solve this problem in two years given the huge legal an policy issues. I don’t think ONC understands that this is a socio-technical problem that requires more than a technology fix.” ONC and HIMSS bring in two people to solve the patient identity matching problem via HHS’s “Innovators in Residence” program that temporarily hires technologists to fix specific problems. Hired were Catherine Costa, RN (marketing director at PatientPoint) and Adam Culbertson (NIH biomedical informatics fellow). Political reality takes the obvious answer off the table: a unique consumer ID with biometric verification.


HIStalk Announcements and Requests

This week on HIStalk Practice: The Massachusetts eHealth Institute offers grants to spur EHR adoption among behavioral health and long-term care providers. New York inches closer to becoming the largest HIE in the nation. SCHIEx and GaHIN launch one of the first state-to-state HIE connections. Billings Clinic implements vein scanners. Envision Medical Group selects new Aprima RCM services. Florida Heart & Vascular’s IT Administrator details the tough time they’ve had with EHRs.

This week on HIStalk Connect: The Nokia Health Sensor XPRIZE competition concludes, with DMI Diagnostics taking the $525,000 grand prize. Samsung opens its SAMI health data SDK service to developers and showcases its new open design Simband prototype. Two Singularity University grads raise $12 million to launch a machine learning-backed population health platform. Ginger.io announces a handful of new research partnerships that will test its behavioral health app within a variety of remote patient monitoring initiatives.


Webinars

November 18 (Tuesday) 1:00 ET. Cerner Takeover of Siemens, Are You Ready? Sponsored by HIStalk. Presenters: Frank L. Poggio, president and CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The Cerner acquisition of Siemens impacts 1,000 hospitals that could be forced into a “take it or leave it” situation based on lessons learned from similar takeovers. This webinar will review the possible fate of each Siemens HIS product, the impact of the acquisition on ongoing R&D, available market alternatives, and steps Siemens clients should take to prepare.

November 19 (Wednesday) 1:00 ET. Improving Trial Accrual by Engaging the Digital Healthcare Consumer. Sponsored by DocuSign. Presenters: B. J. Rimel, MD, gynecologic oncologist, Cedars-Sinai Medial Center; Jennifer Royer, product marketing, DocuSign. The Women’s Cancer Program increased trial accrual five-fold by implementing an online registry that links participants to research studies, digitizing and simplifying a cumbersome, paper-based process. This webinar will describe the use of e-consents and social marketing to engage a broader population and advance research while saving time and reducing costs.


Acquisitions, Funding, Business, and Stock

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Australian telecommunications company Telstra’s health division acquires 2 percent of New Zealand-based Orion Health prior to Orion’s upcoming IPO that values the company at $725 million.

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MMRGlobal, which makes a lot of its money licensing (via nuisance vendor infringement lawsuits) its PHR and other medically related technology, took in nearly $2 million in the most recent quarter, up 1,584 percent over last year. I interviewed CEO Bob Lorsch last year and asked him some pointed questions about the company’s business model – you can decide what you think about it.

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Xerox invests in telemedicine kiosk vendor HealthSpot and will provide it with cloud hosting, system integration, and claims processing services.

The Portland, OR business paper highlights the $150 million venture fund of Providence Health & Services, which is looking for healthcare startups in telehealth, wearables, clinical applications, and e-commerce that seek up to $5 million. The fund is finishing due diligence on four unnamed companies. The fund’s partner explains, “The point isn’t just financial. Our chief investment officer could buy bonds. Our goal to make products and services that help our community, our patients, our members and providers.”

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IBM invests an unspecified amount from its Watson investment fund in genetic testing company Pathway Genomics, which will develop a Watson-powered mobile app that will answer a consumer’s health questions by analyzing information from their wearables, genetic markers, and electronic health records.


Sales

Baylor Scott & White Health selects McKesson’s Performance Analytics, Analytics Explorer, and Pay-for-Performance for financial analytics.

City of Health and Science University of Turin, Italy chooses InterSystems TrakCare.

Wellmark Blue Cross and Blue Shield (IA) will implement employer reporting from MedeAnalytics.

Presbyterian Medical Services (NM) selects the analytics platform of Lightbeam Health Solutions.

Christus Health signs a five-year extension with Strata Decision Technology.

NantHealth licenses Streamline Health’s Looking Glass analytics to track populations and compare clinical effectiveness.

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MaineGeneral Health (the combined words represent their conceptual mistake, not my typographic one) renews its Allscripts Sunrise and TouchWorks agreements and adds FollowMyHealth.


People

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Nordic Consulting CEO and co-founder Mark Bakken will leave the company to start a venture capital fund in which he and Nordic will invest.

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Ed Kopetsky, CIO of Lucile Packard Children’s Hospital Stanford (CA), receives the Distinguished Achievement Award of his alma mater, University of Wisconsin-Madison and its College of Engineering.

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Allina Health announces that CEO Ken Paulus will retire at the end of the year, with President and Chief Clinical Officer Penny Wheeler, MD replacing him. She’s done quite a bit of work with their Epic and data warehouse systems.


Announcements and Implementations

Named to Deloitte’s “2014 Technology Fast 500” are DrFirst, Etransmedia, Imprivata, InstaMed, Kareo, Liaison Technologies, Qlik, VMware, and ZeOmega.

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Silver Hill Hospital (CT) implements QPID Health’s Cohort App to product HBIPS behavioral health quality metrics and will work with the company to deliver a behavioral health portal.

Billings Clinic (MT) goes live on patient identification via palm vein scanning using technology from PatientSecure that is integrated with its Cerner system.  

The medical school of Mount Sinai (NY) enrolls its first patient in a televideo-powered prostate cancer clinical trial, working with real-time patient management solutions vendor AMC Health.  

The state HIEs of Georgia and South Carolina connect to each other with the help of technology partners Truven Health Analytics and CareEvolution.

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Healthgrades launches a new version of its doctor search site that uses claims data to show users the level of experience a doctor has with a given procedure or diagnosis.

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Intel-GE Care Innovations announces Health Harmony, a remote patient monitoring platform that aggregates information for clinician review and helps them collect the new $40 per month Medicare payment for chronic care management. The joint venture was started in January 2011. Only one executive remains of its original 10-member management team.

Novant Health (NC) joins the federal eHealth Exchange, adding that so far this year it has shared 148,000 patient records via Epic’s interoperability as well as a total shared record count of 38 million this year.


Government and Politics

UCSF School of Medicine Professor Bob Wachter, MD says the “accidental” Meaningful Use program has achieved its goals of putting stimulus dollars on the street and increasing EHR use, but says that Meaningful Use Stage 2 is an indication that ONC should be put out to pasture once it has handed out its remaining incentive money. He says it’s time to declare victory, move Meaningful Use toward encouraging API-driven interoperability, and let quality and clinical demands rather than government checklists drive the technology market.

CMS releases three free ICD-10 education resources that offer CME and nurse CE credits.

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In the UK, the Department of Health’s National Information Board creates a wide-ranging, technology-focused policy draft covering digital health over the next several years. Highlights:

  • EHRs are used by 96 percent of doctors, but only 4 percent of them allow patients to see their information. All will be required to offer patient access by April 2015.
  • Technology has had minimal impact on the patient experience.
  • Interoperability is a big problem, as hospital systems are “impenetrable” and little electronic information exists for nursing home and hospice patients.
  • Hospitals and practices don’t integrate their services with mental health and social care.
  • Digital services should be the default delivery channel, with services such as appointment booking and prescription refill requests combined into a single information platform (an extension of NHS Choices) that requires citizens to verify their identity through the Government Digital Services IDA program.
  • Health-related apps and devices should be nationally accredited and service marked to encourage their adoption
  • Specifications will be published by April 1, 2015 for accessing NHS’s core systems, such as Spine and e-referrals.
  • NHS England will pilot technology in which patients will hold their electronic records and a personal budget.
  • A national pilot will give consumers a PHR that they control that is also available in real time to clinicians, which will also include their end-of-life preferences.
  • NHS will seek universal adoption of its healthcare ID number, which was introduced in April 2014 as the primary identifier in clinical correspondence.
  • NHS will propose that clinical systems adopt clinical structure standards developed by the Academy of Royal Medical Colleges.
  • The entire health system will adopt SNOMED CT clinical terminology by April 2020, while additional work with semantic web technologies will be undertaken.
  • NHS England will develop a standard for adopting the GS1 identification standard of patients, products, and places as well as RFID tagging.
  • NHS will reduce the number of organizations that collect patient information for purposes other than clinical care, moving by 2020 to process that requires patients to consent to having their data shared.
  • The Department of Health has created the role of National Data Guardian for health, which will lead efforts inform patients where their data has been used and the benefits they received as a result. Named to the role is Dame Fiona Caldicott, chair of the Oxford University Hospitals NHS Trust and a psychiatrist whose government-created committee reviewed the protection and use of patient information in 1997.
  • Technology made available under the General Practice Systems of Choice will be more selectively targeted to encourage integrated services, SaaS-based systems for new providers of primary care services, and innovative systems for non-hospital services.
  • IT investment will shift to investments that support older citizens, those with chronic conditions, and those being cared for informally.
  • NHS England will decide with the GPSoC contract ends in April 2018 whether it should continue or whether PCP payments should be increased to let them buy whatever systems they want as long as they meet data standards.

Also in England, the $6 billion fund created to reduce ED visits and readmissions of elderly patients is declared a “shambles” by auditors who say it probably won’t save NHS even one-third of the original $1.5 billion estimate.

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A Reuters report says that the Federal Trade Commission has been meeting with Apple for several months to make sure the health information contained in HealthKit and Apple’s upcoming smart watch will be managed appropriately and not shared with third parties as was found to be the case with health and fitness apps from other companies. Sources say Apple is considering hiring a health privacy czar.


Innovation and Research

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A study of Pennsylvania’s mandatory hospital patient safety reporting database finds that “advanced EMRs lead to a 27 percent decline in patient safety events.” I was predisposed to not liking the article because its overly cute title asks a question rather than states a conclusion (“Saving Patient Ryan – Can Advanced Medical Records Make Patient Care Safer?”) and its regurgitative academic meandering goes on for 40 painful pages. However, I originally assumed the authors didn’t look at individual hospital performance pre- and post-EHR, but I asked an expert in statistics to wade through the endless graphs and methods to tell me and he says they did, which is admirable. That still leaves a few weak links – underreporting of errors, failing to distinguish between how individual EHRs were implemented, and non-EHR confounders that make proving causation difficult – but overall it seems to be pretty solid as long as you trust the HIMSS Analytics database, which was built for selling data to vendors for marketing rather than research.


Other

India-based hospital chain Narayana Health, best known for performing high-volume and low-cost heart surgeries, opens Health City Cayman Islands in a joint venture with Ascension Health. It expects the 108-bed hospital, its first outside of India, to expand to 2,000 beds as it capitalizes on a location near (but not in) the US for medical tourism. The hospital chain prices its services in flat rate bundles and sends the patient a single, all-inclusive bill. The Cayman Islands hospital has a sophisticated EHR, its clinicians use Google Glass and smart watches to review information and communicate with patients as they round, and (most interesting to me) every patient gets a mobile tablet that is updated with their most current information. The chain is also a big user of telemedicine, where India-based command center doctors monitor patients all over the world. Health Catalyst created the video above that includes a profile of Narayana Health’s founder, philanthropist and cardiac surgeon Devi Shetty, called “the Henry Ford of heart surgery” by the Wall Street Journal. He also designed a comprehensive health insurance plan for poor farmers in India that costs 20 cents per month.

An interesting survey finds that Americans are increasingly worried about their electronic privacy, yet continue using the services they distrust (social media, text messaging, email, and cell phones) because they don’t see an alternative. They’re also willing to give up privacy in return for getting something free, such as providing personal information to use a website.

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Texas Health Resources apologizes, creates a memorial fund, and pays an undisclosed settlement to the family of deceased patient Thomas Duncan for discharging him from its ED without making an Ebola diagnosis. Meanwhile, Duncan’s fiancée signs a book deal.

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The former CFO of Shelby Regional Medical Center (TX) pleads guilty to falsifying the hospital’s Meaningful Use attestation in November 2012, earning it a $785,655 CMS payment. He faces up to five years in federal prison. The CFO, who rose from the position of maintenance worker, claimed the hospital used EHRs when in fact it remained mostly paper-based and entered minimal EHR information after discharge. He attested using the Social Security number of another employee who refused to put his own name on the form. The for-profit hospital, since closed, was one of six owned by Tariq Mahmood, MD, who was involved in the scheme and was found guilty in July 2014 of healthcare fraud, identity theft, and conspiracy. He threatened to fire coders who declined to falsify diagnosis codes and hand-wrote his own additions to patient records to maximize billing. The six hospitals were paid $18 million in HITECH money despite ongoing allegations of fraud from former administrators going back to 2008. CMS didn’t even know Mahmood owned multiple hospitals.

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Spartanburg Regional Healthcare System (SC) celebrated Veterans Day by honoring 240 of its employees, volunteers, and contractors who are veterans. VP/CIO Harold Moore (second from left) was among the executives serving lunch. It looks like barbeque given the squirt bottles of what could be the mustard-based South Carolina style sauce that isn’t my favorite, but the picture wasn’t clear enough for definitive zooming.

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Niko Skievaski polls some of his fellow Epic alumni to determine why they left the company, with results that aren’t too surprising since they are similar in most places: lack of work-life balance, technicians with poor people skills who are promoted into management, and lack of company appreciation. Meanwhile, copies of Niko’s “MU2 Illustrated” art book have arrived from the publisher and are ready to ship. His projects are often fun, marginally commercial, and reflective of his youthful optimism, so Lorre contributed some art and I wrote the book’s foreword. We’ll probably have a virtual launch party or something just for fun and maybe invite him to sign books at our microscopic HIMSS booth.

Weird News Andy gestated this story that makes his heart go pitter-patter. Doctors at a Florida hospital perform CPR for three hours trying to resuscitate a woman who had an amniotic fluid embolism (which has a fatality rate of at least 25 percent, up to 90 percent in some studies) during an otherwise successful C-section. The team called the family into the room to say goodbye after 45 minutes of a flat-line ECG, but just as they were pronouncing her, she spontaneously revived. The baby is fine and the mom is not only alive, but miraculously free of brain damage.


Sponsor Updates

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  • MediQuant’s employees launch a fundraiser to help build a school in Sierra Leone, with a goal of $5,000. A fundraiser will be held tonight (Friday) in Broadview Heights, OH and donations are being accepted. Company President Tony Paparella spent two years as a Peace Corps volunteer in Sierra Leone and will personally match the funds raised. Tony also plays harmonica in the company band The DeCommissioners and their “Legacy System Blues.”
  • First Databank informatics pharmacists Joan Kapusnik-Uner, PharmD and George Robinson, RPh will present sessions on pharmacy informatics and drug terminology standards at AMIA’s Annual Symposium November 15-19 in Washington, DC.
  • TeraMedica will debut Evercore 6.0, the latest version of its vendor-neutral archive, at RSNA.

EPtalk by Dr. Jayne

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I’ve subscribed to multiple CMS mailing lists in an attempt to stay current as an Eligible Provider. It’s to the point, however, that it’s a rare day when I don’t hear from CMS when I open my inbox. This morning’s offering gave me chuckle, however, as CMS is “pleased to announce that the 2012 Electronic Prescribing (eRX) Incentive Program Supplemental Incentive Payments are now available.”

Originally I thought it was a typo, but yes, now that it’s November 2014, you can get your money for 2012. I hope no one switched jobs because payments are going as a lump sum to the taxpayer ID associated with the claims. I’m not sure why it takes 20+ months to figure out the payments, so feel free to clue me in.

I spent a couple of days earlier in the week at Ebola response training. Our hospital asked for physician volunteers and I was assigned to be one of the clinical documentation liaisons. Essentially my job would be to scribe documentation as the care team treats patients. We’ve not been designated as a primary response site, but are training anyway, which is probably a good thing.

It’s a bit of a strange feeling though to have your EHR skills valued above your clinical skills. Experiencing what our scribes deal with on a daily basis was also an eye-opener. I’m putting some thoughts together on how to improve their documentation protocols and workflows.

There are still exhibitor openings available at the mHealth Summit’s Consumer Engagement and Wearables Pavilion. Even better, if you need a sassy spokesdoctor to show off your wearables, I might know where to find a couple. You could also pick our brains on what primary care physicians really think about wearables and how we do or do not want to handle the volumes of data that can be produced as patients quantify themselves.

I’m a big fan of my Garmin, but I’m pretty sure my doc just wants to know that I run at least five days a week as opposed to knowing what route I chose and what my lap split times were. My EHR vendor is starting to integrate personal tracker data and what we’re seeing come in is far more than we would ever want to see.

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It’s possible that being at some vendor events last week has given me trade show fever. Although I wasn’t initially looking forward to the upcoming HIMSS conference — the keynote lineup certainly didn’t help — I found myself today dusting off last year’s Social Schedule Pocket Guide so I can keep my eye out for noteworthy happenings and interesting events.

For anyone making his or her first trip to the big show, HIMSS is offering a series of “HIMSS15 Unveiled” webinars for attendees to learn about the event’s education, exhibition, and networking opportunities. Learning objectives for the webinars promise to “identify the latest initiatives designed to enhance the attendee experience.” I’m hoping those initiatives involve mid-afternoon martinis and massage therapists at the end of every exhibitor aisle.

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The holidays are approaching and I’m already dreading the dinner table conversations. In addition to the usual topics of Medicare and Social Security, we also have the recent elections as a potential discussion thread. To make things even better, the Supreme Court has agreed to hear King vs.Burwell, which addresses insurance premium subsidies under the Affordable Care Act. Thinking about those combinations almost makes me wistful for my favorite holiday table topic: health conditions of people that aren’t at the table.

Are you starting to plan for HIMSS? Have any suggestions for the holiday table? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 13, 2014 News 7 Comments

Morning Headlines 11/13/14

November 12, 2014 Headlines 1 Comment

New VA chief may fire 1,000 staffers over healthcare scandal

Veterans Affairs Secretary Robert McDonald unveils a restructuring plan within the VA that he says will be the largest in the organizations history. As part of the shuffle, McDonald confirmed that 35 staffers will lose their jobs immediately as a result of the recent scheduling scandal, and that nearly 1,000 others are being pursued for “violating our values.”

Health Information Technology: An Untapped Resource to Help Keep Patients Insured

Researchers with Oregon Health and Science University publish a study in the Annals of Family Medicine that concludes that EHRs and health information exchanges are untapped resources that could be used as tools to support clinic-based efforts to help eligible patients maintain insurance coverage.

AMA backs interstate compact to streamline medical licensure

The American Medical Association calls on more states to adopt the recently finalized interstate provider licensure compact drafted by the Federation of State Medical Boards. The compact was written to help reduce barriers to telehealth programs, but only 10 states have adopted it so far.

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November 12, 2014 Headlines 1 Comment

CIO Unplugged 11/12/14

November 12, 2014 Ed Marx 4 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

China

Thanks to a recommendation by friend and peer Pamela Arora, I was invited by the Chinese government to speak about health information technology. Having visited 29 years ago for my honeymoon, I was eager to return. This time, I would not be smuggling in bibles, but freely sharing lessons learned from my healthcare technology experiences.

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After a 14-hour plane ride, I landed in Beijing and was greeted by my gracious host, Michael Wang. Michael is an English-speaking administrator at the China-Japan Friendship Hospital, the primary hospital for the city and party officials. We shared much in common and bonded over many meals, discussing our values and ideologies. Heck, we even did Starbucks together! We would later catch up with Pamela, who was also invited as a speaker.

You may be wondering how I survived eight days without Facebook, Twitter, Google, and YouTube. The answer: barely.

I had shared in advance my Top 10 list of sites to visit and they gave me a personal tour guide. It was freaking unbelievable. Although not a fan of Asian cuisine, I promised I would eat and drink everything set before me. Gulp. I managed. Incidentally, sea cucumbers are not ocean vegetables!

We also bonded through the ritual of shared shots. In China, each toast is a three-shot minimum. I, well … lost count of the toasts. What happens in Beijing stays in Beijing.

As you would expect, we toured the magnificent Friendship Hospital. Our guide and senior host was hospital president XU Shuqang MD, PhD. Dr. Shuqang now serves as the Party’s undersecretary of health for emergency management. A very friendly man with a great sense of humor. We connected on several levels, as both China and USA share many of the same challenges in healthcare.

As a big believer in the power of technology to help transform healthcare, Shuqang was personally responsible for the content of this conference. Every hospital in China took part. The equivalent of the ONC sat in the first row. The 2014 Chinese EMR and Hospital Information Management Association Congress was underway. I still pinch myself. Was I really a featured speaker? Humbled.

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They employed simultaneous translation, which helped my speech go very smoothly. Until slide 12. Michael had entered the Chinese translation for all of my English bullet points, but for some reason, for every slide after the 11th, the English bullets disappeared.

It gave me pause, but I collected myself and then went on from memory. Thankfully, I recognized the pictures along the way that told a story related to the content. All was good. Who would know?

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What did they want to learn about? Meaningful Use, HIE, privacy and security, and HIMSS stages of EHR maturity. Because I couldn’t imagine not talking about it, I threw in a few nuggets on leadership as well. What good is all that other stuff if nobody can lead and execute?

They were ahead of us in some areas such as telehealth, but behind in other areas such as EHR adoption and HIE. We learned from one another and developed a lifelong friendship that transcends political ideology. We are in this to transform healthcare. Indeed, the world is flat.

As I headed home, I reflected. My new friends. The amazing sights and sounds. The beautiful people. I came away with renewed hope. Hope for the world.

What resonated with me most was one of the triple-shot toasts given by Dr. Shuqang. “Despite ideological differences,” he said, shot glassed raised, “our two super powers can collaborate and truly transform healthcare and make this world a better place for the citizens of every country.”

They will be in Texas visiting Pamela and Children’s Health. I aim to catch up on progress made since we first met. I also hope they’re ready for some Texas cuisine!

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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November 12, 2014 Ed Marx 4 Comments

Morning Headlines 11/12/14

November 11, 2014 Headlines 1 Comment

BULLETIN: HIPAA Privacy in Emergency Situations

HHS updates its HIPAA guidance in light of the ongoing Ebola outbreak to authorize disclosure of PHI to any member of the public in danger of contracting the disease.

New AMA Policy Continues Call for Penalties to Be Removed From the Meaningful Use Program

The American Medical Association is calling for MU-related penalties to be dropped and for the program be refocused on interoperability.

KLAS Offers Performance Insights on HIE and EMR Interoperability

KLAS publishes interoperability survey responses that suggests that Cerner offers more advanced interoperability features, but that Epic customers are reporting much higher overall interoperability success.

Walgreens’ Greg Wasson kicks off an extraordinary roster of HIMSS15 keynotes

HIMSS publishes its 2015 annual conference keynote speakers, with Walgreens CEO Greg Wasson kicking off the event and George W. Bush taking the Wednesday afternoon slot.

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November 11, 2014 Headlines 1 Comment

News 11/12/14

November 11, 2014 News 9 Comments

Top News

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HHS’s Office for Civil Rights issues a bulletin covering HIPAA privacy obligations in Ebola-type emergency situations. It bends the HIPAA rules a bit, clarifying that a provider can share patient information “with anyone” as needed to prevent an imminent public health threat, but points out that media disclosure is limited to acknowledgment (not announcement) that an Ebola patient is being treated and a statement of their condition, provided that the patient has not expressed a preference otherwise. That means hospitals can’t release an Ebola patient’s name unless a reporter asks about that patient specifically, in which case the hospital can acknowledge their presence and condition.


Reader Comments

From The PACS Designer: “Re: Dropbox. It can now operate inside Microsoft Office.” Office users can edit their documents directly from Dropbox and share them from inside Office apps, which are now free for iOS users and as such are residing at the top of the App Store popularity lists. Gartner predicted previously that standalone file storage and sync would be dead within a few years, emphasizing that users don’t want to screw around with a separate app like Dropbox as much as they just want to save and share within their software of choice. The competitive landscape gets murkier with Microsoft’s recently announced unlimited storage for Office 365 users, which you might expect would take Dropbox (and certainly the lagging #2 Box) out of the picture entirely. That doesn’t even factor in Google, which offers free basic storage and a full terabyte for $10 per month. The differentiators for healthcare should be: (a) the provider’s willingness to sign HIPAA business associate agreements; (b) enterprise-grade audit trails and permissions to give the IT department some degree of control; (c) controlled sharing within the enterprise only; and (d) APIs that allow vendor and self-developed apps to store information in a HIPAA-compliant manner in the cloud to eliminate the most common breach exposure of misplaced unencrypted devices. Vendors offering only consumer-grade storage will find it hard to survive commoditized competition, especially at the ridiculous valuation levels given to the top few.

From Lysandra: “Re: our new company infographic. I thought you might want to run it on HIStalk.” I hate infographics, which dumb down already easily understood factoids into simplistic picture for those folks whose lips tire from reading more than three words. I don’t trust anyone, particularly an anonymous infographics creator, to tell me how I should think by packaging up often questionable information into a pretty graphic, urging me to not worry about the trees they have dismissed in providing their own description of the forest.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Stella Technology. The San Jose, CA-based company offers consulting and technology services and has strong domain expertise in HIE — its tagline is “exchange, coordinate, and collaborate.” They can help with Meaningful Use, ACOs, registries, patient engagement, remote monitoring, systems integration, messaging, provider and patient identity management, consent management, public health reporting, and Direct Secure Messaging. They are experts on interoperability standards for messaging, documents, and semantic interoperability. They can assist HIEs with architecture, emerging technologies, analytics, governance, business and marketing plans, privacy, and stakeholder engagement. The company offers turnkey products as well: Caredination (a communications and handoff tool that connects the care team with patients as they move among care settings) and Clinical Staging Database (an extensible relational store with a canonical clinical data model). Integration Toolkit will be introduced in 2015. You might know some of the executive team since the CEO, CTO, implementation SVP, and founder were all involved in leading Axolotl (now Optum) through its 2010 acquisition. Thanks to Stella Technology for supporting HIStalk.

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Thanks to Elsevier, which will be co-sponsoring HIStalkapalooza at HIMSS15. I’ll have more sponsors to announce later, but in the meantime, I still have openings for companies that want to co-sponsor or to book a private box for entertaining guests (which includes much-coveted tickets to the event itself). The amount of support will drive the number of people I can invite since events are a lot more expensive per attendee than you might think when you’re offering an open bar, dinner, and a topnotch band (I still have fantasies about a cheap outdoor barbeque and keg party instead). Email me if your company is interested in participating in HIStalkapalooza.

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HIStalk readers funded the purchase of English/Spanish picture dictionaries to help students in Ms. Weigand’s Louisiana middle school class who are newly arrived in the US (with a matching grant from the Bill & Melinda Gates Foundation via DonorsChoose.org). Ms. Weigand, a Teach for America teacher, sent the photo above of students using the dictionaries.


Webinars

November 12 (Wednesday) 1:00 ET. Three Ways to Improve Care Transitions Using an HIE Encounter Notification Service. Sponsored by Audacious Inquiry. Presenters: Steven Kravet, MD, MBA, FACP, president, Johns Hopkins Community Physicians; Jennifer Bailey, senior director of quality and transformation, Johns Hopkins Community Physicians; Robert Horst, principal, Audacious Inquiry. Johns Hopkins Community Physicians reduced readmissions and improved quality by implementing a real-time, ADT-based encounter notification service (ENS) to keep the member’s healthcare team informed during transitions in care. Johns Hopkins presenters will describe the clinical, operational, and financial value of the ENS for care coordination along with its technology underpinnings.

November 18 (Tuesday) 1:00 ET. Cerner Takeover of Siemens, Are You Ready? Sponsored by HIStalk. Presenters: Frank L. Poggio, president and CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The Cerner acquisition of Siemens impacts 1,000 hospitals that could be forced into a “take it or leave it” situation based on lessons learned from similar takeovers. This webinar will review the possible fate of each Siemens HIS product, the impact of the acquisition on ongoing R&D, available market alternatives, and steps Siemens clients should take to prepare.

November 19 (Wednesday) 1:00 ET. Improving Trial Accrual by Engaging the Digital Healthcare Consumer. Sponsored by DocuSign. Presenters: B. J. Rimel, MD, gynecologic oncologist, Cedars-Sinai Medial Center; Jennifer Royer, product marketing, DocuSign. The Women’s Cancer Program increased trial accrual five-fold by implementing an online registry that links participants to research studies, digitizing and simplifying a cumbersome, paper-based process. This webinar will describe the use of e-consents and social marketing to engage a broader population and advance research while saving time and reducing costs.


Acquisitions, Funding, Business, and Stock

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Telehealth provider MDLIVE acquires Breakthrough Behavioral, which offers online behavioral health counseling. Former Apple CEO John Sculley is mentioned as being investor of the $49 per visit MDLIVE, but then again he’s best known for firing Steve Jobs from Apple and we know how that turned out.

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Specialty EHR vendor Modernizing Medicine secures $15 million of a planned $20 million funding round.

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Healthcare.com, which benefits from the mistyped web addresses of people looking instead for Healthcare.gov, raises $7.5 million in Series A financing for its health insurance policy search engine.

Premier announces quarterly results: revenue up 15 percent, adjusted EPS $0.33 vs. $0.31, beating Wall Street expectations for both. From the earnings call:

  • The company’s revenue growth was fueled by its SaaS-based informatics products, particularly its population health management offerings that include contributions from recent acquisitions Aperek and TheraDoc.
  • Premier has 3,400 hospital customers representing 68 percent of community hospitals.
  • The company is developing the first surgical home collaborative with the American Society of Anesthesiologists in 43 hospitals.
  • President and CEO Susan DeVore says the company’s Aperek acquisition is critical in supporting the supply chain management need of members, while TheraDoc’s offerings will be integrated with PremierConnect to drive further clinical surveillance solutions.
  • The company is using technology from its Meddius acquisition to integrate ambulatory information across diverse EHRs in a given health system.
  • Premier continues to review potential acquisitions in the areas of supply chain, pharmacy, alternate site, physician preference, care management, risk stratification, ambulatory data, and population health management.
  • DeVore said of the demand by customers to unleash EHR value, “We do hear from our members that they are frustrated with the difficulty in connecting disparate vendors, disparate transactional systems, and EMRs and they’ve spent a lot of money installing EMRs. They are looking for more efficient ways to get data… it is driving not only our SaaS based-subscriptions, but our PremierConnect Enterprise as Mike discussed and the advisory services that wrap around it because remember it’s not just the technology, but it’s how do you take those insights and how do you actually reduce cost or improve quality. We are hearing actually a lot more from our members now too, something Mike mentioned, which was this need for data scientists, and data managers, and data governance and all the complexities that go with data, which we can provide as a service.”

Sales

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Sundance Behavioral Healthcare System (TX) chooses HCS Interactant Revenue Cycle, Financial, Mobile, and Insight.

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Mercy Health (OH) expands its Explorys relationship by adding Risk Models and Value-Based Care Program Framework.

Catholic Health Initiatives (CO) chooses Allscripts Hosting Solution for its TouchWorks EHR. CHI signed a $200 million hosting and IT management contract with India-based Wipro just over a year ago, so that status of that deal isn’t clear.

Humana chooses Valence Health’s tools for population health management.

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The VA selects Jive Software’s collaboration tools to share medical best practices.   


People

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Neiman Marcus hires Sarah Hendrickson (Children’s Medical Center of Dallas) as its first VP/chief information security officer.

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Joe Norris moves from interim to permanent CIO of New Hanover Regional Medical Center (NC).

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Awarepoint promotes Tim Roche from CFO to CEO.

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Carl Smith (Best Doctors) joins CompuGroup Medical US as GM of the laboratory division.

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The FCC names informatician Chris Gibbons, MD, MPH of Johns Hopkins Bloomberg School of Public Health as distinguished scholar in residence, where he will contribute health IT, analytics, and population health expertise.

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Accretive Health names Dave Mason (RelayHealth) as chief strategy officer.


Announcements and Implementations

Mitchell County Hospital District (TX) connects to the Texas Tobacco Quitline using Holon’s CollaborNet HIE platform.

Allscripts adds secure patient payments capability from TrustCommerce to its FollowMyHealth patient engagement platform.

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Xconomy profiles Madison-based startup HealthMyne, which appears from its poorly descriptive website to be doing something with merging diagnostic images and text to make them searchable.

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Appointment reminder technology vendor Talksoft introduces the ability for hospitals and practices to develop brand-specific iPhone and Android apps that use its technology.

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Kronos will integrate technology from TeleTracking to offer an integrated staff management solution that uses TeleTracking’s Capacity Management Suite for real-time patient volume data. 

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Non-profit health decision information vendor Healthwise announces that its materials have been used 1.5 billion times as of Tuesday morning.


Government and Politics

The American Medical Association just won’t give up its griping about Meaningful Use. It now demands that penalties be eliminated and that the Meaningful Use program be refocused on interoperability. In other words, nobody complained when taxpayers threw $25 billion at providers (including AMA’s members), but now that they have to start earning it, it’s unfair. AMA also voiced its support for FSMB’s previously published telemedicine policy — more details in my interview with Alexis Gilroy, JD, who served as a subject matter expert to FSMB.

Two HIV-related government sites finally start using SSL encryption for web- and smartphone-based user sessions. A security expert drily notes the irony that HHS enforces HIPAA, yet wasn’t protecting confidential patient information.

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A movement claiming to be grassroots (without providing details) urges that Congress support the nomination of Vivek Murthy, MD as surgeon general. He was nominated a year ago but wasn’t confirmed because of his stated beliefs that guns are a health hazard.


Other

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Farzad Mostashari, MD tweeted out the comment he left on the New York Times article that described how hospitals make it hard (and expensive) for patients to get copies of their own records. His comment wasn’t approved, so his screen shot is the only record.

A federal investigation finds that clinical staff attending to Joan Rivers failed to notice her deteriorating condition and didn’t start CPR until several minutes afterward. The report says her anesthesiologist initially documented that she was given 300 mg of propofol, but changed the record afterward to note a 120 mg dose instead, saying that the initial dose documentation was a mistake caused by double-clicking the default value. I’ve seen doctors falsify documentation (both paper and electronic) after making a mistake, so it will be interesting to see if the wrong dose was actually given and not just charted.

Anthem Blue Cross customers in California receive wellness emails that contain their private information in the subject line, with an example of: “Don’t miss out — call your doctor today; PlanState: CA; Segment: Individual; Age: Female Older; Language: EN; CervCancer3yr: N; CervCancer5yr: Y; Mammogram: N; Colonoscopy: N.” 

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The summary graphic from KLAS’s just-released EHR interoperability review shows Epic and athenahealth leading the pack in contributing to the success of their customers. Meanwhile, KLAS corrects Politico’s overhyped headline that proclaimed “KLAS to Epic: Stop Putting Words In Our Mouth.” KLAS simply said that Epic’s claim as being #1 for interoperability isn’t technically correct since KLAS issues separate reports for interoperability and HIE, but it clarifies that “KLAS never had any such discussion with Epic to stop putting words in KLAS’s mouth.” So if you’re keeping score at home: KLAS corrected Epic, Politico dumbed it down incorrectly, then KLAS corrected Politico.

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A law firm’s telemedicine survey (and obligatory cute results infographic) is getting exposure from sites that aren’t paying attention to how the survey was performed. The conclusions seem insightful on first glance: 90 percent of organizations are implementing telemedicine and 36 percent expect 10-30 percent usage among patients within three years. Those glossy conclusions inspired ecstatic headlines from some sites anxious to summarize uncritically, but what they missed is that only 57 people responded (of an unstated number of surveys sent, making calculation of the response rate impossible) and job titles and organization types were all over the place. Example: only 52 percent of respondents were from hospitals, which means that big, seeming bold and authoritative insights were drawn from only 27 hospital respondents. The survey also asked questions that no single respondent was likely to have answered correctly given that they covered technology, reimbursement, and strategic planning. It’s embarrassing that people cover lame surveys as news, much less without critiquing their methodology.

HIMSS makes iffy choices in its “extraordinary roster” of HIMSS15 keynotes. Greg Wasson, president and CEO of Walgreens, gets the Monday morning slot, which in my mind should be reserved for someone with selfless healthcare-related accomplishments that might inspire non-profit provider attendees instead of a $14 million per year big-company CEO. At least Wasson is a pharmacist by training and has only ever worked for Walgreens, starting there as a pharmacist intern, and the company’s use of IT in its retail setting is nothing short of brilliant. Tuesday’s keynote is the CEO of Humana, which hasn’t always been a beacon of patient-focused healthcare practices, while President George W. Bush gets pushed back to an awful Wednesday 4:30 p.m. slot. HIMSS seems to be moving toward having for-profit CEOs as keynotes, having done the same with the mHealth Summit in the past two years — Aetna CEO Mark Bertolini got the prime spot in 2012 even as his underlings in Aetna’s healthcare IT vendor companies were setting up their booths in the exhibit hall and the same thing happened in 2013 with Qualcomm’s CEO as the opening keynoter.

Canada is observing the first Digital Health Week this week, although the only events scheduled appear to be some tweet chats and webinars.

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Brigham and Women’s Hospital hires an SVP/chief business development officer to launch a consulting service, saying it needs “new sources of revenue in order to sustain our precious mission.”

Wellcentive establishes a $1,000 scholarship for a military veteran attending medical school.

A 30-year-old Madison, WI woman tries to avoid bankruptcy caused by her cardiac arrest at 29, when an ambulance mistakenly transported her to out-of-network St. Mary’s Hospital. She’s stuck with a $50,000 bill instead of the $1,500 one she would have owed as a patient of in-network Meriter Hospital three blocks away. Blue Cross Blue Shield paid $156,000 of her $254,000 tab for a 16-day stay and the hospital reduced her balance owed to $10,000, but she still has to pay the other bills that included out-of-network physicians, the ambulance ride, and therapists. She can’t afford to get married until she sees what numbers her various providers make up.

Weird News Andy sends his greetings as follows: “Their has bin found a vieres that makes u less smart. LOL.” Scientists determine that a virus found in lake algae shortens human attention span, although even they aren’t quite sure why that’s important.


Sponsor Updates

  • CIO Review names DataMotion to its “20 Most Promising Healthcare Consulting Providers” list for its Direct Secure Messaging solution.
  • Gartner recognizes VisionWare in its “Magic Quadrant for Master Data Management of Customer Data Solutions” for the sixth consecutive year.
  • Visage Imaging will demonstrate its Visage 7 Enterprise Imaging Platform along with its integration capabilities at RSNA.
  • PDR Network will exhibit at and sponsor iPatientCare National User Conference (NUCON 2014) November 14-16, exhibiting its PDR Brief and PDR Search patient drug education solutions.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 11, 2014 News 9 Comments

Morning Headlines 11/11/14

November 10, 2014 Headlines 1 Comment

CHIME, HIMSS Letter To HHS

In a just released letter sent to HHS on November 3, CHIME and HIMSS call on Secretary Sylvia Burwell to replace national coordinator Karen DeSalvo, MD quickly if her new appointment as Acting Assistant Secretary of Health is going to be permanent, citing the need for leadership that can focus on the ONC in a full time capacity.

Identification of undiagnosed diabetes and quality of diabetes care in the United States

Researchers with Oxford University were able to identify over 60,000 undiagnosed diabetic patients by developing a search algorithm to pour through a data set of 11 million electronic medical records.

AHA unveils toolkit to help hospitals hire veterans

The American Hospital Association partners with the White House Joining Forces initiative and unveils a new toolset designed to connect hospitals with medically trained soldiers now actively looking for civilian employment.

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November 10, 2014 Headlines 1 Comment

Curbside Consult with Dr. Jayne 11/10/14

November 10, 2014 Dr. Jayne 1 Comment

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Assuming that it doesn’t get delayed yet again, ICD-10 is a little less than 11 months away. For those of us who had been preparing for the most recent and now-postponed transition date, it’s time to dust off our implementation and training plans if we haven’t done so already.

My organization had already done a fair amount of informational outreach to physicians and other providers, so most people know what it is and that eventually they will have to use it. Their actually readiness to do so, however, is variable.

I have to admit that I’m not well versed on our plans for the transition in the hospitals. As our employed physician base has grown, I’ve had to focus more and more of my time on the ambulatory projects. Although I’m still privileged for inpatient medicine, I rarely see patients in that environment.

Even so, the communication from our hospital to rank-and-file admitters has been spotty at best. I think I’ve seen maybe a handful of emails since the last delay. Hopefully they will get on their game soon at least as far as communicating with community providers is concerned.

On the ambulatory front, however, we’re really gearing up. We’ve been on the ICD-10 ready version of our EHR and practice management software for a year. It was helpful that they bundled the ICD-10 functionality in with the 2014 Meaningful Use Stage 2 content so we didn’t have to take multiple upgrades.

Now that they’ve had a little bit of a hiatus with regulatory requirements, our vendor has again turned to coding actual functionality and usability updates, which puts me in the lane again for an upgrade prior to ICD-10.

Timing the need to educate everyone around an upgrade is tricky with ICD-10. We do plan to bring all the ambulatory end users in for some type of formal training for both processes and don’t want them too close together (training fatigue) or too far away from the go-live dates. We also have to remain sensitive to the realities of pulling people out of office.

Although I wrote a few weeks ago that we’re doing computer-based modules for new practice go-lives and for addition of incremental staff, we’re still planning to do classroom training for these two projects. We’ll likely supplement them with on-demand resources as well, but right now I’m planning for traditional training.

We did purchase some external vendor content for ICD-10 for certain high-dollar and complex subspecialties, but I’m responsible for organizing the plan for medicine-based subspecialties and primary care. We had external trainers in last year to train our core team (physician leaders, compliance officers, auditors, training staff, etc.) but I’m sure most of us have forgotten the nuances. We’re going to have them back after the first of the year to deliver a refresher.

In addition to the classroom training planned for closer to October 1, we’re scheduling monthly lunch and learn sessions to re-familiarize people with the concepts of ICD-10 and prepare them for more intense documentation. During the decade we’ve been on EHR, many of our providers have developed an affinity for voice recognition-based narrative documentation. Since they’re not using the discrete elements of the EHR as much as they used to, their ability to leverage discrete data to suggest appropriate ICD codes will be limited.

We anticipate that those who are afraid of learning a new coding system may want to rely more heavily on the EHR’s computer-assisted coding features, which will require retraining on the template-based workflows for those providers. Being able to identify those individuals early will be good, especially since we didn’t exactly budget for basic EHR retraining as part of our ICD-10 transition. I’m hoping we can leverage super users in the practices and our regional physician champions to assist, but I want to make sure all the bases are covered.

Although some of our providers complain about the restrictions of being employed, ICD-10 is a prime example of why physicians are willing to give up a degree of autonomy in exchange for corporate management structures. I’m working with two other people to put together our strategy and it will be rolled out to all of our practices. If those sites were independent, they’d be on their own to find a consultant, develop a program, or potentially try to just wing it.

Of course, those organizations that aren’t even on their ICD-10 ready software yet have additional work cut out for them. I don’t envy the upcoming months for them. With the estimated cost of the transition ranging from $50K for small practices to millions of dollars for the rest of us, there’s a lot at stake.

Are you ready for ICD-10? What’s your strategy? Email me.

Email Dr. Jayne.

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November 10, 2014 Dr. Jayne 1 Comment

Morning Headlines 11/10/14

November 9, 2014 Headlines No Comments

Allscripts Healthcare Solutions’ CEO Paul Black on Q3 2014 Results – Earnings Call Transcript

Allscripts holds its Q3 earnings call after shedding 15 percent of its share price Thursday on disappointing earnings. CEO Paul Black and CFO Richard Poulton both acknowledged the poor performance, citing lower full system sales and hardware sales, and noted that Q3 is traditionally the slowest quarter for the HCIT industry.

Proposed EHR/Meaningful Use Regulations

The Massachusetts medical board presents its recommendations on how to implement a state law requiring physicians to demonstrate EHR proficiency as a condition of licensure prior to the law’s January 2015 effective date.

Nurse Value-Added and Patient Outcomes in Acute Care

Researchers with the University of Michigan compare data from the hospital’s EHR system and its HR system to evaluate individual nurses and the effect they had on patient outcomes. The study attributed 7.9 percent of variance in patient clinical condition to nursing skill.

Most people don’t know they have the right to view medical records online

In England, only three percent of practices have a patient portal in place despite an April 2015 federal mandate that requires all citizens be given online access to their medical records.

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November 9, 2014 Headlines No Comments

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