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Monday Morning Update 1/11/16

January 10, 2016 News 4 Comments

Top News

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The Office for Civil Rights declares that it won’t tolerate providers who refuse to give patients copies of their medical records, publishing clarifications of what providers must do, with these examples:

  • Covered entities must provide designated record sets to patients or their designee.
  • They can verify the requester’s identity however they like as long as the verification process doesn’t delay the delivery of the information.
  • They cannot require patients to physically visit their premises or mail a paper form to submit their request.
  • They must offer records delivery by email if requested.
  • They cannot withhold records copies just because the patient hasn’t paid for their services.
  • They must provide requested electronic copies of paper documentation if they have a scanner.
  • They cannot tell patients that, “We have a patient portal, so log in and print your own information.”
  • The patient has a right to obtain all information about them, not just EHR data. That includes images, billing and payment records, claims data, and any information the provider used to make decisions about their care.
  • They must provide electronic copies of information they store electronically if the patient requests electronic instead of paper. They cannot insist that the patient accept paper copies instead.
  • Fees charged must be “cost-based,” which includes the labor required to make paper or electronic copies, supplies, and postage. The fee cannot include the cost of retrieving and verifying the information. This is a big deal since providers impose absurd per-page charges – often through their third party release of information vendor – even when providing information in electronic form. OCR is clear that federal law overrides state law in this case, so extra fees are not allowed even if state law says they are.

The question is what OCR does now that it has clarified the rules. Patients most likely don’t know how to file complaints despite widespread lack of provider compliance with these guidelines.

From my own experience in having filed an OCR complaint six months ago about a hospital that refused to give me an electronic copy of my electronic records resulting in no response, I doubt they are geared up to take fast action even when patients are knowledgeable enough to contact them.


Reader Comments

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From Little Buddy: “Re: President Obama. This quote sounds like someone very much out of the loop who happens to have the solution to healthcare woes with Obamacare.” The President said, “I don’t have a Fitbit yet, but I work out hard. Word is these Apple Watches might be a good companion for my workouts. So I’m gonna see, I’m gonna test it out.” I actually think it’s kind of cool that he’s not afraid to drop some pop culture references and that he takes care of himself with technology help. Speaking of the Watch, I got stuck behind an older lady in the airport security line the other day who was confused about which items to place on the scanner belt, oversharing with the TSA agent, “I have an iWatch.” People apparently don’t even know the name of their expensive, short shelf life gadget, which is not called the iWatch because smart companies had already trademarked the name before Apple.

From Apollo Creed: “Re: health IT companies. Which ones do you like?” I don’t think my opinion is relevant, or if it is, it’s not available. It’s best that prospective investors and employees perform their own due diligence, especially since I’m not an investor or employee of any of them.

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From DC VA Insider: “Re: VA CTO Marina Martin. Will be leaving soon.” Unverified.

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From Rowdy Roddy: “Re: Leidos. I heard a Leidos ad on a Madison classic rock station. They are looking for Epic and Cerner help. Is the world that short of Cerner expertise that they have to find Epic folks, which themselves are in short supply?” I can’t imagine that many Epic youth spend their commute gramps-moshing to “Sweet Emotion” and “Sultans of Swing” in between Leidos commercials. There’s a business opportunity for you: launch an Internet radio station just for Epic or Cerner employees – including company gossip, the cafeteria menu, and customer news interspersed with Justin Bieber and Adele songs — and sell ads to consulting firms that want to poach them.

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From The PACS Designer: “Re: iPhone 7. With Apple reducing the price of iPhone 6 Plus S by 30 percent, soon there had to be a reason. Now,we know why. The iPhone 7 leaks have started and sales will drop as everyone waits for the new model.” The cell phone and services market are changing quickly as competition heats up (thanks, Google, for creating Android). The major carriers are getting better and cheaper as they worry about upstarts and companies selling unlocked phones that use their networks at a discounted rate. A new Consumer Reports survey found that the worst-rated carriers for value are Verizon, AT&T, and Sprint, as smaller providers like Consumer Cellular and Ting top the customer satisfaction scale.


Reader Gripes

  • “Epic’s #6 list of principles says they don’t do deals, yet it’s hard to imagine Mayo wasn’t swayed by Epic’s $46 million offer to buy its data center.”
  • “When I am alone with a patient, one on one, in an exam room and try to show caring and compassion, as I have always done over these many years as a clinician, it gets harder knowing that everyone and everything around this patient is treating them like the latest gold rush or oil boom. Their insurance company, hospitals and their administrators, pharmacies, medication manufacturers, many of my colleagues with their over-testing, etc. I do the best I can. I still think medicine is a noble profession and am proud that both my children wish to become doctors.”
  • “It bothers me that you’ve created yet another forum to complain, like the comments section wasn’t enough. No one comes to HIStalk to hear people crap on companies or news, much less co-workers. I would rather see a Great Box, stories of awesome stuff people are doing in this industry. We don’t hear enough about the outcomes of our work.”
  • “CommonWell members Cerner and McKesson, who claim to be in favor of interoperability, won’t allow us to interface to their systems even if we match the spec of one of their existing interfaces. Even though they interface to our competitors. Even though their own clients request it. Hypocrisy is alive and well.”
  • “People that are more interested in building their fiefdoms than great companies.”

You can sound off about your gripe or you can even say something positive if you’d rather.


HIStalk Announcements and Requests

Thanks to the CIOs who volunteered to raise DonorsChoose funds by making themselves available to donating vendors at a lunch on Wednesday, March 2 at the HIMSS conference. CIOs interested in raising money for education by spending a couple of hours socializing with vendors can contact me.

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About half of poll respondents will attend the HIMSS conference next month. A few more folks who attended in 2015 won’t attend vs. those who will attend, but I don’t think that necessarily portends lower overall attendance. New poll to your right or here: do company funding announcements make you curious to check them out?

Listening: Blackstar, the new album from David Bowie. The Thin White Duke is 69, but he eschews the profitable victory tour of mindlessly mumbling moldy hits in favor of creating complex, fresh music that throws down the gauntlet in setting the pace rather than wheezing to keep up with it. The album came about because Bowie saw a jazz band he liked and decided to perform some musical experimentation them. He just keeps doing his own thing, emerging from obscurity only when he has something new to say musically. The music is among his most experimental, the lyrics are hard to comprehend yet poetic and chilling (especially the title track), and it sounds like a real band with occasional boluses of electronica just to challenge the listener. It won’t change your mind if you don’t like Bowie, but it’s a gift if you do. UPDATE: a few hours after I posted this review, I was shocked to hear that David Bowie has died.

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Mrs. K’s middle school science class in Brooklyn is using the iPad Mini we provided in funding her DonorsChoose grant request for researching STEM projects. She reports, “On behalf of my students, I want to thank you for your generous donation of an iPad mini. This gift will provide our students with real world connections to current research that will support all our ongoing investigations in our classroom. Curiosity and access to technology is the key to our success as productive Americans. Thank you for your support!”

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My Christmas present to myself even though I don’t travel all that much is Global Entry, a known traveler program powered by fingerprint scan that lets you skip the line when entering the US by plane or car. It also includes TSA’s Pre-Check (shorter line, shoes and belt left on, laptop left in bag, metal detector instead of scanner), which is newly important since the days of free “upgrades” to Pre-Check often are about to end. Global Entry costs $100 for five years, only $15 more than Pre-Check alone. Every road warrior should (and probably does) have it. One might quibble that Department of Homeland Security is charging a premium to bypass its intentionally created inefficiency, but arguing that point with everybody else stuck in long lines doesn’t make sense unless you can’t spare $20 per year to save a lot of time and frustration.


HIStalkapalooza

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Sign up to request an invitation for HIStalkapalooza. I have only about 400 requests so far, but I just announced it Friday.


Last Week’s Most Interesting News

  • Henry Schein Practice Solutions pays $250,000 to settle FTC charges that it overstated the database encryption technology used in its Dentrix G5 dental practice management system.
  • Oncology software vendor Flatiron Health raises another $175 million, increasing its total to $313 million.
  • The Rochester, MN paper reports that Mayo Clinic will run Epic hosted from Epic’s Wisconsin data center, while the data center Mayo sold Epic for $46 million will be used only for failover. The organizations will also work together to create new products.
  • Health kiosk vendor HealthSpot shuts down.
  • NantHealth acquires NaviNet to create a payer-provider collaboration network. 
  • Navigant acquires 70-employee consulting firm McKinnis Consulting Services for $52 million.
  • “Brain training” app vendor Lumosity pays $2 million to settle FTC charges that it made unproven claims that its software can reduce age-related cognitive decline.
  • A local paper reports that Epic’s headcount has grown to 9,400, increased by 1,400 in the past year.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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UltraLinq Healthcare acquires Cardiostream as the companies combine their medical image management expertise.

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Several  Fitbit users sue the company, saying that its fitness trackers cannot accurately record heart rates during intense exercise even though the company markets them for that purpose. One of those users said her Fitbit showed a heart rate of 82 beats per minute when it was actually measured at 160, making the trackers “worthless.” In an interesting response, Fitbit stands by its technology but adds that its trackers “are not intended to be scientific or medical devices.”


Sales

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Mount Nittany Medical Center (PA) chooses paperless electronic forms on demand from Access.


Announcements and Implementations

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MedStar Health adds a “Ride with Uber” button to its home page that will hopes will make it easier for patients to keep their scheduled appointments on time. They should do something similar with discharged patients since, as bizarrely as it sounds, a top reason for extended length of stay is patients who can’t get a ride home and calling 911 for a free ambulance ride only works for those headed to – not from – the hospital.


Government and Politics

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Two Phoenix VA executives who were suspended over scheduling wait times surface in new VA jobs 19 months after they were suspended with full pay and given a notice of termination that never happened.

The IRS says that 1.4 million households may lose their Healthcare.gov insurance subsidies because they they took government tax credits in advance last year but didn’t account for them in their federal tax returns. That means that 30 percent of households that received insurance subsidies handled the tax implications incorrectly. The announcement was made late Friday, when the federal government often releases unflattering information about the administration’s pet projects.


Other

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@Cascadia caught this: Amazon is recruiting for a Leader, Global Healthcare for Amazon Business, the business-to-business supply marketplace it is building.

Nemours is considering IT as one of this areas in which it may reduce headcount.

Donna Walters, CIO of Sharon Regional Health System (PA), is hit by a car as she crosses the street in a crosswalk in front of the hospital. She is apparently OK, suffering a broken wrist. The driver, who was driving with a suspended license, was charged with a felony.

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In bizarre healthcare news:

  • Workers partially demolish a hospital in China that is still being used with patients inside, with locals suspecting that a company working on nearby roads ordered it removed (photo above left).
  • In Russia, hospital security cameras capture a doctor killing a patient in the ED admitting area with a blow to the head after accusing the patient of touching a nurse, the most recent of several incidents in which the doctor used physical force on patients (photo above right).
  • In New York, a patient commits suicide by jumping off a building and lands on Mount Sinai St. Luke’s Hospital’s oxygen tank, forcing its ED to be evacuated.
  • In South Sudan, 10 patients – including premature babies – have died because its main hospital has run out of money to fuel its electrical generators.
  • In Cincinnati, the parents of a recovering seven-month-old baby overdose on heroin in the hospital. The mother died in the baby’s hospital room, while the father was arrested after being found in a hospital bathroom with a heroin needle in his arm and a loaded pistol in his pocket.
  • A San Francisco group sues to halt construction of a new professional basketball arena near UCSF Benioff Children’s Hospital, saying, “Some people will die trying to get to the hospital if this stadium is built next to the emergency room.”

Sponsor Updates

  • Extension Healthcare lists its 2015 awards and achievements.
  • Caradigm publishes an infographic on electronic prescriptions for controlled substances.
  • Valence Health CEO Andy Eckert will present at the JP Morgan Healthcare Conference, taking place January 11-15 in San Francisco.
  • ZeOmega ranks number 54 on the 2015 SMU Cox Dallas 100.
  • Strata Decision Technology publishes “Margin + Mission: A Prescription for Curing Healthcare’s Cost Crisis.”
  • YourCareUniverse receives national recognition for innovative patient engagement tools.

Blog Posts


Contacts

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

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January 10, 2016 News 4 Comments

HIStalk 2016 Reader Survey Responses

January 9, 2016 News No Comments

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I run an HIStalk reader survey once each year, inviting anyone to provide feedback and ideas. This year’s survey generated 396 responses, with the highlights summarized below.

Years in the industry
More than 20: 46 percent
11-20: 26 percent
1-10: 28 percent


Employer type
Vendor: 43 percent
Hospital: 28 percent
Consulting firm: 17 percent:
Other: 12 percent


Primary job
IT staff/management: 26 percent
Vendor management: 17 percent
Vendor staff: 17 percent
Clinician in an IT role: 7 percent
CIO: 6 percent
CEO: 5 percent
CMIO: 2 percent
Other clinician: 2 percent
CFO: 1 percent
Other: 17 percent


Elements appreciated in order of most to least popular
News
Rumors
Headlines
Humor
Dr. Jayne
Interviews
Readers Write
CIO Unplugged


I have a higher interest in companies when I read about them in HIStalk
True: 84 percent
False: 16 percent


Reading HIStalk helped me perform my job better in the past year
True: 88 percent
False: 12 percent


Respondents provided these suggestions that I thought were most important, which I’ll list with my comments. The one I won’t mention is “don’t change anything,” which was thankfully by far the most common response.

Respondents also suggested a lot of new areas I should cover in the same way I write HIStalk, but I don’t have the time or interest to stray far from healthcare IT and thus will most likely not be able to pursue those areas (but it’s pretty cool that someone thinks I’m the guy to cover them anyway).

Thanks to everyone who took the time to provide their advice. It renews my energy every year right about this time. I also promised to randomly draw a respondent to receive a $50 Amazon gift card, but then I decided to make it two respondents instead – those folks have received their prize.


Include more rumors because they nearly always pan out.
I run all the rumors I hear or receive and always welcome submitting more. Some respondents scolded me for running unverified rumors.

Do more reviews of books that are supposed to make me better and to educate me about what’s right for patients, families, and providers.
I’m happy to do that given the limits of time and my willingness to purchase books just to review them. Most of those books I’ve reviewed came from reader suggestions.

Limit Readers Write to less vendor and consultant PR.
I’ve tightened up the requirements and rejected quite a few submitted articles, but the real issue is that only vendors and their public relations firms take the time to write something. Everybody likes to read, but nobody likes to write, as evidenced by the folks who want to read more reader submissions but don’t write anything themselves. However, some articles are good and I’m reluctant to shut down reader submissions just because some aren’t.

Do more interviews.
I only interview CEOs for the most part on the vendor side, but I’ll interview different kinds of provider folks – CIOs, CMIOs, nurses, informatics experts, etc. It’s a bit tricky because quite a few people can’t be interviewed without the approval of their employer.

Get more contributors, such as CNIOs and CIOs. Dr. Jayne is no longer a CMIO and most of what Ed Marx posts is off topic.
Most people don’t have the interest or time to contribute, but I’m willing if they are. Just about everybody who has ever vowed to overwhelm me with frequent posts drops out after the first 2-3 when they realize that it’s more work than fun for them. Dr. Jayne and Ed have many fans.

Provide less commentary.
More folks chose “provide more commentary” in explaining the background of stories, which I do if I feel like I have something relevant to add.

Do more investigative and original reporting, following up on rumors.
Good idea if I can figure out how to make it happen. I’ll take that as a to-do.

Cover more about AMIA, CHIME, ACHE, AMDIS, RSNA, and review articles from academic publications.
I don’t really have any connections with those groups and it would be tough (and expensive) to get away to attend all of their meetings. I’ve tried a few times to get a clinical informatics expert to scan the literature and summarize the important articles, but have had no luck so far. I need to find a way to get electronic journal library access from home and then I could review some of the articles myself if I don’t find someone.

Define the acronyms you use in stories.
I keep thinking about publishing an always-updated acronym list. Maybe I should do that. Of course it’s also easy to Google a term as long as it’s not used in multiple ways.

Run a column of anonymous gripes people want to say to their bosses, students, colleagues, etc.
Great idea, although my experience is that it would dry up quickly due to lack of submissions. Another respondent said I should set up an electronic complaint box and run the results – I like that idea and have put it in place.

Do videos or podcasts.
I’m not a fan of watching or listening to something I could read myself a lot more quickly. I’ll think about it, but that’s one of those things lame sites do (along with writing over-sizzly headlines and tweeting pointlessly) that I like to think most of my readers wouldn’t enjoy in proportion to the effort involved.

The DonorsChoose project is important work, but it looks like you are bragging about your donations. Are the donations tax deductible to the donor?
All of the DonorsChoose projects I write up are paid for by reader donations, to which I apply any and all matching funds I can find. I don’t publicize the DonorsChoose projects that I fund personally. The DonorsChoose donations are indeed tax deductible – the folks there came up with a “gift card” method in which they donate directly to DonorsChoose and I just pick the projects to fund with their money. I try to make it clear that the projects are funded through the generosity of HIStalk readers and I hope that we can all celebrate the results.

How about creating a discussion board?
I could do that, but I’ve tried a couple of times and participation was minimal. Quite a few attempts to create a health IT social network failed miserably because the folks involved took a “build it and they will come” position and, fact is, the industry is 99.9 percent readers and 0.1 percent writers.

Offer a job board.
I already have one. It doesn’t get much use.

Provide an annual summary by company of the news you ran about them.
I’ve thought about that, although I’m not sure who would need that information. It wouldn’t be hard since anything that appeared in HIStalk already passed the “is this really newsworthy?” filter.

Reveal your true identity when you retire or die.
I would hope that nobody really cares at this point since I’ve been doing it for 13 years and I’m not looking for recognition, but I keep thinking (somewhat morbidly) that I should write a “posthumous use only” post to say goodbye and perhaps squeeze in one more music recommendation instead of just leaving up whatever news post I wrote last. I fear being like an actor who dies with their IMDB list of appearances being capped by an awful movie role they shouldn’t have taken.

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January 9, 2016 News No Comments

Morning Headlines 1/8/16

January 7, 2016 News No Comments

Dental Practice Software Provider Settles FTC Charges It Misled Customers About Encryption of Patient Data

Henry Schein Practice Solutions pays $25,000 to settle FTC charges alleging that the encryption used in its Dentrix G5 dental practice management system was not true encryption. Schein also makes the dental solution included in Leidos’ winning DHMSM bid.

Flatiron Health Raises $175 Million Series C Round to Further Bolster its OncologyCloud Software Platform for Providers and Accelerate Personalized Medicine

Oncology software vendor Flatiron Health closes a $175 million Series C funding round led by Roche, bringing its total funding to $313 million since its 2012 launch.

Top 9 issues that will affect physicians in 2016

The American Medical Association lists Meaningful Use, health data security, and the large-scale adoption of telemedicine as some of the top issues that will affect physicians in 2016.

Mayo plans more collaboration with Epic Systems

Mayo Clinic reports that it will only lease a small portion of the data center it recently sold to Epic, but confirmed that Epic will host its EHR platform at a larger data center in Verona.

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January 7, 2016 News No Comments

News 1/8/16

January 7, 2016 News 2 Comments

Top News

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Henry Schein Practice Solutions will pay $250,000 to settle Federal Trade Commission charges that it overstated the data encryption level used in its Dentrix G5 dental practice management software. Schein also agreed to let its customers know that its product does not use Advanced Encryption Standard as NIST suggests in complying with HIPAA requirements. You may recall that the Leidos consortium that won the Department of Defense EHR bid includes Henry Schein’s Dentrix Enterprise,which I assume is a different product.

Schein has updated its website to indicate that it no longer calls its database security “encryption,” explaining, “Available only in Dentrix G5, we previously referred to this feature as encryption. Based on further review, we believe that referring to it as a data masking technique using cryptographic technology would be more appropriate.”


Reader Comments

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From Punditry: “Re: things you could add to HIStalk. How about a gripe box where people can anonymously vent about a company, news item, or person that annoys them?” That could be fun. I created an anonymous Gripe Box form. Let’s see if anyone has something entertaining to complain about. I like just about anything that personalizes a sometimes impersonal industry.

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From Topanga: “Re: another HIPPA sighting. In a click-baity headline besides.” They fixed the HIPAA misspelling in the questionably health IT-related story afterward.


HIStalk Announcements and Requests

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Attention CIOs: Centura SVP/CIO Dana Moore raised a lot of money for DonorsChoose at the last HIMSS conference by offering to meet with any vendor in return for their donation. We’re thinking about expanding it in Las Vegas by having other CIOs participate, where vendors who have made a DonorsChoose donation will be given a couple of minutes to pitch to the assembled CIOs and then mix and mingle during the lunch that we’ll provide. If you are a CIO who can spare two hours during lunchtime on Wednesday, March 2 during the conference for a great charitable cause, let me know.

Thanks to everyone who completed my reader survey and provided good advice. I’ll recap the results in Monday’s post.

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Mrs. Torres sent photos of her Texas pre-kindergarten students using the two Kindle Fire Kids Edition tablets we provided by funding her DonorsChoose grant request.

This week on HIStalk Practice: Doctors Administrative Solutions rebrands after acquiring ConXit Technology Group. The Orthopedic Institute of Wisconsin selects RCM tech from McKesson BPS. CES gives the notorious HIMSS taxi queue a run for its money. Vecna Technologies puts a designer spin on patient vitals, while President Obama touts Healthcare.gov in Jerry Seinfeld’s car. Momentum Physical Therapy upgrades clinical and financial software. DuPage Medical Group secures a $250 million investment. Covenant Surgical Partners selects PM and RCM tools from gMed.

This week on HIStalk Connect: CES kicks off in Las Vegas, bringing a number of notable digital health announcements. Under Armour introduces its UA HealthBox, which includes a fitness tracker, wireless scale, and heart rate monitor. Fitbit, Fossil, and Healbe unveil new wearable devices of their own. Hometeam raises a $27 million Series B to expand its caregiver platform.


HIStalkapalooza

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The “I want to come” form for HIStalkapalooza is open. Submit your information if you want to attend – even if you’re a sponsor, long-time supporter, or VIP, I still can’t invite you if I don’t know you want to come. I’ll follow up with actual invitations in a couple of weeks.

We had a couple of companies interested in our top-tier “HIStalkapalooza Rock Star” event sponsorship that couldn’t make it happen. The event goes on regardless, but without a few niceties and additional attendees that having a primary sponsor would have provided. We have about a week remaining before we have to move forward, so contact Lorre if your company is interested and can commit quickly. It’s really expensive to put on an event at this scale.


Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Northwell Health (the former North Shore-LIJ) and consulting firm Newport Health form Health Connect Technologies, which will commercialize population health management products. The joint venture was announced in August 2015, at which time I expressed some puzzlement as to who Newport Health is given its apparently intentional obscurity: “I couldn’t find much of anything on Newport Health other than it’s apparently connected to Newport Private Group with a real office in Newport Beach, CA and mail drawer addresses in New York and Texas.” Bean Enumerator’s pithy comment at that time was, “Newport says it has experienced and innovative health IT talent, but the only person listed as working for the company has no relevant experience whatsoever. It’s a bad sign when an investment banker starts a health IT company. How did Allscripts lose this one given their supposedly tight partnership with NS-LIJ and their population health management aspirations?”

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Pamplona Capital Management invests an unspecified amount in Patientco and will embed the company’s patient payment products into those of its other holdings, MedAssets and Precyse.

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An India-based newspaper profiles CitiusTech, which has doubled its revenue to $100 million since 2014 and expects to grow at 35 percent annually as it expands beyond its primarily US customer base. Co-founder Rizwan Koita says entrepreneurs focus too much on raising venture capital, having bootstrapped the company until it reached $50 million in revenue and 1,000 employees in 2014. The company is investing its 2014 $100 million investment from General Atlantic in expanding its capabilities in analytics, big data, and mobility.

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Health kiosk vendor HealthSpot shuts down, turning off its kiosks in Ohio Rite Aid drug stores and Cleveland Clinic. The company had raised $23 million. 

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Oncology software vendor Flatiron Health raises $175 million in a Series C funding round, increasing its total to $313 million. The lead investor in the round is drug company Roche, which takes a board seat with the investment. GV (the former Google Ventures) led the Series B round in mid-2014.

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Here’s a great tip from @RasuShrestha: registration is free for accessing live and recorded webcasts from the J.P. Morgan Healthcare Conference next week. Perhaps that will soothe our egos at not being invited to attend in person.

Allscripts and Medfusion announce that they have settled their legal differences over Allscripts reselling Medfusion’s patient portal, but then favoring the product it acquired from Jardogs in 2013.


Sales

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Sutter Health (CA) chooses QPID Health’s query and clinical reasoning software to mine its Epic EHR for actionable information.

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Franciscan Alliance (IN) chooses Vocera for secure clinical communications.


People

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PeraHealth hires Sloan Clardy (Parallon) as SVP/chief growth officer.

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Rick Adam (Recondo Technology) joins Stanson Health as president/COO. Long-timers will remember him as founder of New Era of Networks and president of Ibax.


Announcements and Implementations

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In Canada, Grace Hospital is testing patient flow software from Kitchener-based Oculys Health Informatics.

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Validic launches VitalSnap, a mobile app that allows consumers who use in-home medical devices that have limited digital connectivity to capture the information via their smartphone’s camera, have it translated using optical character recognition, and send it to their provider.

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Sensato will launch its Cybersecurity Tactical Operations Center next month, which will offer services to small and large provider organizations via a membership model that can include real-time monitoring, planning, threat intelligence, emergency support, and testing (phishing, social engineering, and penetration). It will also offer biomedical device monitoring.

Prestige Emergency Room (TX) goes live with Wellsoft EHR, designed specifically for freestanding emergency centers.


Government and Politics

Massachusetts Governor Charlie Baker announces plans to create a digital health hub that will offer accelerator space and networking opportunities.


Privacy and Security

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Application security auditing vendor FairWarning announces that all NHS Scotland hospitals are using its privacy monitoring software.


Technology

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Surgeons at Nicklaus Children’s Hospital (FL) use the $20 Google Cardboard virtual reality smartphone accessory to plan a child’s heart surgery. You can actually get a better deal on Cardboard from eBay – just $2.99 with free shipping. Or you could spend $599 for the just-released, Facebook-owned Oculus Rift, which is finally almost ready to ship.


Other

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The American Medical Association lists the top issues that will affect physicians this year, among them the “burdensome” Meaningful Use program, insurance company mergers, narrowing provider networks with increased out-of-pocket costs, soaring prescription drug costs, health data security, and elimination of telemedicine barriers.

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The Rochester, MN paper says Mayo Clinic will lease back only part of the data center it sold to Epic for $46 million. The article suggests that Mayo will have Epic host its implementation from Verona, while Epic will use the Rochester data center to store backups and as a failover location for Mayo and other of its customers. That sounds like pretty big news that Epic is apparently doing full hosting for Mayo, a model Epic is just beginning to embrace. Mayo says it will also help Epic develop software and services that Epic will roll out to its customer base.

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I’ve seen quite a few recent examples where headline writers misstate the relationship between public health and geographic location, as in , “Where you live has an enormous impact on health, well-being.” If that were true, moving would fix the problem. It’s only true that where someone live reflects certain aggregate health determinants – a ZIP code doesn’t impose its will to make someone unhealthy.

ECRI Institute lists its top technology advances to watch for in 2016, with the health IT-related ones being medical device cybersecurity and wearables.

A New York Times survey of insured Americans under 65 finds that 20 percent of them had problems paying their medical bills last year as insurance companies raised deductibles and co-insurance. Of those who had problems with medical costs, 63 percent spent all of their savings, 42 percent took on a second job or worked more hours, 14 percent moved or took in roommates, and 11 percent resorted to charity.


Sponsor Updates

  • PatientPay reports that Women’s Health Care Group of PA has shortened payment time to less than nine days and reduced billing expenses by 30 percent after implementing the company’s paperless billing solution.
  • Healthgrades SVP Mayur Gupta explains how marketing technology could transform healthcare.
  • MedData will exhibit at the ACEP Reimbursement & Coding Conference January 11-13 in New Orleans.
  • The Jacksonville, FL TV station runs a video story about HCI’s global expansion featuring CEO Ricky Caplin.
  • Crossings Healthcare Solutions publishes its Q4 newsletter.
  • Huron Consulting Group announces several promotions to managing director in the healthcare practice.
  • Experian Health publishes a new white paper, “Collect Now or Pay Later.”
  • PerfectServe CEO Terry Edwards is featured in a Global Big Data Conference article on health IT trends in 2016.
  • A Recondo Technology survey finds that manual insurance claims follow-up costs providers around $4 per claim vs. the previously accepted $3 as those providers don’t use exception-based technology.
  • GNYHA adds Phynd’s Unified Provider Management software to its contract portfolio.
  • PMD enhances its secure text messaging software to allow users to invite others to join at no additional cost.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
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January 7, 2016 News 2 Comments

EPtalk by Dr. Jayne 1/7/16

January 7, 2016 Dr. Jayne 2 Comments

Lots of buzz this week about practices getting ready for Meaningful Use attestation. One of my independent colleagues reached out to me about an offer to provide batch attestation for all physicians in the practice for less than $1,000. Looking at the amount of time that practices can spend doing an attestation, it certainly sounds tempting. Given the risks of a badly-done attestation, I’d make sure that I read the fine print and included some kind of language on performance or lack thereof. If anyone has used one of these services, I’d be interested to hear about it.

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AMIA as requesting submissions for the iHealth Clinical Informatics Conference to be held in May. The submission deadline is January 22. I’ve been to Minneapolis and enjoyed it. I’ll likely attend if I don’t have a conflict with a client engagement. I’m still working to get all my Maintenance of Certification hours for Clinical Informatics. I know there are some available at HIMSS, but I’m not sure if the courses are going to work with my social schedule. I did finally complete the required “patient safety module” for the certification and am grateful for ABPM for giving a six-month grace period to those of us who were in the first certification class.

I’ve received quite a few LinkedIn announcements lately that are congratulating people on new positions that they’ve actually held for some time. This usually makes me think that they’re buffing up their profile in preparation for job hunting, especially if they couple it with a “please endorse me” message. The one I received today was particularly amusing as it was from a former colleague who has habit of overstating his qualifications. I’m not likely to put my reputation on the line for that. In other cases, people might just have been delinquent in updating their profiles, but it’s more likely to be the former.

Speaking of job hunts, a reader responded to my recent comments on Glassdoor suggesting several more companies whose reviews are downright entertaining. I almost spit wine all over my new computer, so he’s lucky he’s not buying me new hardware. Feel free to send me your funniest examples and I’ll put together a top 10 list.

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Now that we’re in the new year, I’m starting to get excited about HIMSS and have secured my date for HIStalkapalooza. This year it’s someone clinical, so it will be interesting to hear feedback from that perspective. I’m starting to work on wardrobe and of course accessories. Last year I had a wardrobe malfunction involving my handbag becoming tangled up with my dress on the dance floor, so I’m not eager to repeat that episode. If you have any great wardrobe finds, let me know.

The new year is also a time of stress for many patients. I was at my own doctor appointment the other day and watched multiple patients being turned away because of issues related to a change with their insurance coverage. Some didn’t have referrals and others didn’t realize the physicians they were trying to see were out of network on their plans.

One of the patients had an interesting situation where she has a PCP on her HMO insurance but actually sees a “direct primary care” physician for her primary care needs. Although she had a consultation request from her actual PCP, she didn’t have one from the PCP on her card who she had never seen, so the practice wouldn’t see her unless she agreed to pay in full. Most of the patients were extremely frustrated, which is not surprising. The way we deliver care in the US is just crazy.

My visit was frustrating for other reasons. I was having stitches taken out from a skin biopsy and had received the results by phone the other day. The medical assistant offered me a copy of my results and I said yes, since I hadn’t received them through the practice’s patient portal and wasn’t sure they did pathology that way. She then said, “Oh, I need to go talk to the doctor and see if you need a re-excision” and walked out of the room leaving me with a giant “!?!” hanging in the air. Certainly people shouldn’t be calling with results if they don’t know the whole care plan or if it’s not documented anywhere.

She returned a few minutes later saying, “You’re good to go,” but didn’t have the result in hand. I was pushing being late for a client call and will just request my own copy of the results so I didn’t argue the point, but it was not the care I expected from a major university health system.

Once I made it home and finished my client call, I was glad to see this blurb from another reader with a fondness for unusual news. Possibly some competition for Weird News Andy? A suburban Chicago funeral home recently received approval for a liquor license. They’re hoping to partner with a nearby Italian restaurant to offer the refreshments and build the idea of funerals as a “life celebration.” I think EHR vendors could offer similar refreshments at their training centers – it certainly would make the experience more pleasant.

What do you think could be done to enhance EHR training? Email me.

Email Dr. Jayne.

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January 7, 2016 Dr. Jayne 2 Comments

Morning Headlines 1/7/16

January 7, 2016 Headlines No Comments

AT&T Just Announced a Major, New Health Care Venture

AT&T announces the opening of a health-focused innovation center called the AT&T Foundry for Connected Health. The new center will operate at the Textas Medical Center Innovation Institute in Houston.

HealthSpot shutters its telemedicine kiosk operations

Health IT startup HealthSpot, which sold telehealth kiosks outfitted with medical devices to health systems and retail locations, has shut down. The company had raised $28 million in VC funding since its 2010 launch, including $12 million in 2015.

Under Armour launches brand’s first suite of fitness-tracking products

Under Armour unveils UA HealthBox, a suite of devices that integrates with its digital health app including an activity tracker, a wireless scale, and a chest-strap heart rate monitor.

Death of man restrained at a D.C. hospital ruled a homicide

The death of a 74-year-old patient injured by security guards while trying to leave MedStar Washington Hospital Center without signing out has been ruled a homicide by the Washington DC medical examiner’s office.

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January 7, 2016 Headlines No Comments

CIO Unplugged 1/6/16

January 6, 2016 Ed Marx 14 Comments

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

Course Corrections

The faculty at our Combat Engineer Officer School encouraged us to have leadership fortitude—the courage to make those tough decisions where you admit a mistake, take corrective action, and move forward. Some leaders today are unable to swallow their pride and publically admit an error. Damn if they will acknowledge a failure and make the needed corrections.

Our instructors told us the story of an engineer lieutenant who found himself unable to extract two of his platoons combat vehicles from the mud. He kept adding more dirt to the water. More dirt on water makes more mud. In exasperation, he gave up and just ordered his men to hide his error by burying the vehicles with dirt.

In due time, he was held accountable for the whereabouts of the vehicles and the story went viral. He never made captain.

Halfway in my tenure at a former employer, I was confronted by one of my directors. We had a very successful implementation of an EHR across our continuum that positively impacted business and clinical outcomes. We were getting our feet wet with mobile technologies and innovation was a part of our fabric. From the outside, everything appeared perfect. It wasn’t.

Operationally, we were coming apart. Unplanned downtime skyrocketed. One day, we were picking up an award, and the next, we were on 2:00 a.m. Level One severity calls. Something was wrong. Very wrong.

I was driving down the Interstate headed to an IT quarterly leadership retreat when I answered a call from Michael. “Ed, I don’t see how we can all be meeting for a full day talking strategy when we have had several months of early morning disaster calls. I think it is time to focus on operations.”

Reality! Michael was totally right. Upon arrival, I grabbed my direct reports and we huddled. I shared Michael’s call and that we needed to redirect our attention toward operations. We would need to be creative how to best use our time together that day.

As our leaders settled in and I stood to welcome everyone, I was overcome with emotion and began to tear up and finally started to cry. “I am so embarrassed. I have never been embarrassed like this. We have so much potential. We are gifted and blessed with resources. Yet we are letting our customers down. I have failed you and our organization as a leader.”

There was stunned silence. Then, one by one, the directors chimed in. Though they had remained silent for many months, everyone confided that they had the same thoughts. We had lost our focus, our sharpness. We took our eye off operations, pursued distractions, and relied on past success. As a result, our performance sunk.

We were all ashamed. With the confessions and emotions out of the way, we brainstormed how to get ourselves out of this mess. It was beautiful. The team self-directed, formed into groups, and each tackled the tough issues in a thoughtful manner.

After a couple of hours, each group reported on the results of their efforts. Participants responded and honed the recommendations. In the end, a director from each group took accountability for the initiative.

For the next few months, we focused on these action points. Sure enough, a year later, we were performing at levels commensurate with our potential. We were no longer embarrassed and were once again providing value and helping our health system achieve superior clinical and financial outcomes. Strategy was a natural byproduct.

Course corrections are a sign of strength, not weakness. If we are intellectually honest with ourselves, we know that corrections are required if we hope to continuously improve. This applies equally to work, play, and relationships.

As the New Year begins, take time to reflect on the past and see where you need to make directional changes. In 2015 I made two major corrections, one with work and one with relationships. They were both gut-wrenching, but necessary. As I head into 2016, I find myself in a much better place. At peace. Content. Giddy as a schoolboy.

Never settle for the status quo and flat performance. Humble yourself. Seek input. Change is good. Life is too short for mediocrity.

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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January 6, 2016 Ed Marx 14 Comments

Readers Write: Industry Trends Impacting RCM in 2016

January 6, 2016 Readers Write 1 Comment

Industry Trends Impacting RCM in 2016
By Patrick Hall

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Higher out-of-pocket costs, new reimbursements models, and rising operating costs are just a few of the trends that will impact provider revenue cycles in 2016. These industry developments will force providers to evaluate existing RCM strategies and possibly implement new technologies and workflows to simultaneously maintain financial health and address evolving consumer and regulatory demands.

Consider some of the more significant trends and their potential impact:

Higher out-of-pocket costs for patients

As the cost of insurance continues to rise, patients are shouldering higher out-of-pocket costs for deductibles and co-insurance. As a result:

  • Consumers are paying more attention to the cost of care and requesting greater price transparency prior to receiving services.
  • Providers need efficient tools to estimate a patient’s out-pocket-costs. This includes accurate eligibility and co-pay details, up-to-date information on a patient’s deductible status, and specifics on what services are included in a patient’s coverage.
  • Consumers may need help managing the cost of their care. Providers may require automation tools to facilitate any special payment arrangements.
  • Existing workflows may need to be altered. For example, in the past a practice may not have verified insurance information until the patient arrived in the office. Administrators may now elect to verify insurance details in advance of scheduled appointments and advise patients when a large out-of-pocket cost is anticipated.
  • Providers face greater financial risk. When patients struggle to pay for services, providers risk losing revenue and must dedicate additional resources for collection efforts.

Overhead costs are rising, but not necessarily reimbursements

In order to preserve financial health, providers must:

  • Remain diligent in controlling costs and managing the revenue cycle.
  • Consider technologies that automate RCM processes and increase efficiencies.
  • Make sure staff is well trained in order to maximize the benefits of technologies.

Provider reimbursement models are shifting from traditional fee-for-service to models that include incentives for the efficient delivery of quality outcomes

RCM is no longer as simple as sending out a claim after a patient office visit. Instead, providers must:

  • Be proactive in managing the health of their patients.
  • Implement workflows and technologies to help track patient outcomes.
  • Improve care coordination to minimize test duplication, manage costs, and enhance outcomes.
  • Prioritize efforts to collect patient payments at the point of care or in advance of procedures.

Meaningful Use and the transition to ICD-10 are less of a priority

Meaningful Use and ICD-10 have been top priorities for providers for the past several years. Today, however, most organizations have implemented certified EMRs and achieved some degree of Meaningful Use success, as well as made the transition to ICD-10. Providers now have more time and resources to address revenue cycle needs, possible platform upgrades, and the addition of apps to increase operational efficiencies.

In recent years, RCM has taken a back seat to competing priorities, but the changing healthcare landscape is forcing providers to evaluate existing strategies and technologies. This could be the year that RCM emerges from the shadows and perhaps into the spotlight.

Patrick Hall is EVP of business development for e-MDs.

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January 6, 2016 Readers Write 1 Comment

Readers Write: Why Do Digital Health Startups Need So Much VC Investment?

January 6, 2016 Readers Write No Comments

Why Do Digital Health Startups Need So Much VC Investment?
By Tom Furr

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It is projected that by the end of 2015, $4.3 billion in funds will have been raised to bolster digital health startups. The first half of 2015 saw $2.1 billion invested in this area.

To clarify, a digital health company is one that could not exist without broadly available digital technology (like the Internet) and serves the healthcare market exclusively — pure plays. A company that publishes software and happens to have a health application in its portfolio is not considered a digital health company. Providers and partners are also not in this area – they are service organizations.

It’s been reported that digital health represents eight percent of all venture funding. However, there are many companies that have been in business for nearly 10 years that have raised more than $50 million but are not experiencing anything approaching “Google-like growth.”

Even someone who reads business news occasionally understands that mega-startups like Uber are raising huge amounts of money to build a legal war chest to contend with suits and regulatory pressures around the world. There must be an obvious reason for the continued big raises for the Ubers out there as well as digital health companies.

So why are we seeing such a robust funding for digital health outfits? Is it that digital health companies require large capital requirements to contend with regulatory challenges akin to what Uber faces? Is it that digital health companies are started by people from healthcare who don’t really understand how to build scalable technology solutions that have great usability? Is healthcare continuing to be an industry that lags in the adoption of new technology? Are consumers, when they’re the ultimate end-user, unaware or unimpressed with the new offerings?

What’s going on? Companies may be bulking up with funds so they can last through a long, slow adoption cycle or the twisted path to regulatory acceptance. However, here’s my take on these important questions.

Is it that digital health companies require large capital requirements to contend with regulatory challenges in the healthcare?

I suggest that most established, large healthcare IT companies have been built on government subsidies and regulations that force providers to purchase their products. In some cases, this is the only way some companies will be successful, in stark contrast to software companies that build a product that adds value to the customer instead of it being a requirement.

The ability to transition from being forced to purchase to wanting to purchase (based on recognized value) has clearly built up lots of apathy in the industry against change or innovative products. That is why healthcare is the last major industry to send so many paper statements as compared to all other sectors, including banking and financial services.

Is it that digital health companies are started by people from healthcare who don’t really understand how to build scalable technology solutions that have great usability?

In my examination of currently available products, none strike me as being user-friendly or innovative. Even Athenahealth – arguably one of the top established healthcare IT innovators in digital health history — says it’s time for an upgrade to usability for all products, including their own.

I come from the payments space, which has similar characteristics to healthcare with regards to its established companies. However, it has seen massive amounts of innovation from companies like Square that is shaking up the status quo by building a solution that is easy to get up and running, even by my young son, validating the importance of usability.

3. Is healthcare continuing to be an industry that always lags in the adoption of new technology?

I think most will agree that healthcare is at the back of the line when it comes to applying innovative technology to operations versus clinical settings like the latest heart procedure. I challenge any of the established players to say they’ve kept back-end systems or user interfaces fresh. At least Athenahealth’s Jonathan Bush is willing to call a spade a spade, which I respect.

No established player wants to see their company become a Yahoo (they did not value contextual ads like those served by Google) or an IBM (which did not value a PC operating system as Microsoft did) when life gets comfortable and profits are healthy, so they crush innovation.

4. Are consumers, when they’re the ultimate end user, unaware or unimpressed with the new offerings?

If you look at any number of healthcare-related portals, it appears that usability was the last thing in mind when they were created. In fact, if it were not for Meaningful Use, would any of those vendors have even created portals? This gets back to my second point — that any new company is going to have to spend substantial amounts of money to educate patients on the value of their offering. In all likelihood, the same thing has to do be done with provider solutions.

So we’re clear, I am not advancing a radical change in the way the healthcare market behaves. It is an industry whose product is positive outcomes for people with, or prone to health issues. That must remain its focus. But it needs to realize that there are ways to do things better, faster, cheaper, and designed to be easy to use for providers and patients.

Let me restate my central question. Why is this happening? Let me ask you to join the conversation with your thoughts. Getting to the core reason will not only help healthcare investors, but more importantly, anyone providing or getting healthcare.

Tom Furr is founder and CEO of PatientPay of Durham, NC.

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January 6, 2016 Readers Write No Comments

Morning Headlines 1/6/16

January 6, 2016 Headlines No Comments

NantWorks and NantHealth Complete Acquisition of Navinet, America’s Leading Healthcare Collaboration Network

NantWorks and NantHealth acquires NaviNet, a payer-provider collaboration platform, for an undisclosed sum. The acquisition aligns with NantHealth’s vision of “delivering on whole health systems integration.”

Mayo sells data center for $46M to new IT partner

Mayo Clinic sells its data center to Epic for $46 million and will lease it back from Epic for the next four years, with an option to continue the arrangement indefinitely.

No time for stodgy: Crusading editor aims to shake things up in science

The British Medical Journal is being criticized for its perceived transition from a science magazine to one that takes controversial political stances. One Yale epidemiologist comments BMJ “should carefully think about what it wants: to remain a top scientific medical journal, or to transition into a public-opinion publication that seeks to attain the highest ratings possible based on one-sided positions that are not carefully researched.”

Many See IRS Penalties as More Affordable Than Insurance

The New York Times reports on the 10.5 million Americans who are eligible to buy coverage through an insurance exchange but are still uninsured, noting that for many the $1,800 IRS fee is still far cheaper than paying for an insurance policy.

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January 6, 2016 Headlines No Comments

News 1/6/16

January 5, 2016 News 3 Comments

Top News

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NantWorks and NantHealth acquire eligibility and benefits management software vendor NaviNet, explaining that, “we are now poised to be the nation’s leading healthcare collaboration network by transforming the payer-provider relationship to evolve from transactions to interactions and finally to collaboration,”adding that NaviNet Open will serve as a web portal for cancer patients and providers. NaviNet sold its PM/EHR customer base, which was using rebranded versions of CureMD products, to CureMD in 2013 in continuing its focus on payer-provider collaboration tools. NaviNet was in 2012 acquired by Silicon Valley investor John Doerr’s Essence Healthcare, which I believe still owns ClearPractice and Lumeris.


Reader Comments

From Walter: “Re: health systems moving to Epic or Cerner. If you want to predict those, start with a list of McKesson Horizon and then Paragon clients.” I haven’t seen the numbers of Horizon customers who have followed McKesson’s hopeful suggestion that they replace their now-retired system with Paragon, but I’m guessing they are negligible.

From The PACS Designer: “Re: WiFi HaLow. At the Consumer Electronics show this week, the WiFi Alliance announces a new service called WiFi HaLow. It will bring a longer-range, low-power WiFi application that could benefit the patient engagement initiatives in healthcare as well as applications in other healthcare areas.” HaLow also penetrates walls better, which coupled with longer ranges and less battery drain should make device connectivity (including wearables) more practical. Unlike Bluetooth, HaLow connects devices directly to the Internet, not just to a smartphone.


HIStalk Announcements and Requests

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Quite a few folks in health IT-land like this recent Dilbert, which might be the perfect preview (or replacement for) the HIMSS conference techno-blather.

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Ms. Brown from Michigan sent photos of students in her K-3 special education resource room using the math puzzles and learning centers we provided by funding her DonorsChoose grant request.

I was thinking about the HIMSS conference and that my least-favorite US city — Las Vegas — has the perhaps unique distinction in that its residents indignantly scorn tourists who pronounce its state name correctly as “nev-AH-dah” instead of the local version “nev-AD-ah,” which is probably an ongoing challenge given that 75 percent of the state’s residents were born elsewhere. I suppose it’s like cities whose names we Americanize (i.e., we say it wrong) as we scorn those who say the name correctly (Los Angeles, St. Louis, New Orleans, and probably a bunch more). My go-to example for the odd-but-universal pronunciation is the Empire State Building, which you and everyone else say as “empire STATE building” even though New York is the Empire State and therefore the name should be pronounced “EMPIRE state building.”

Listening: the new and first EP from Cado Young, a couple of young guys (one of whom I’ve met) who have created some polished, hard-edged alternative music that deals maturely with the human condition.


Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Mayo Clinic sells its data center to Epic for $46 million and will lease it back from its EHR vendor. That’s news everywhere except here since reader Sturges said exactly that in as a perfectly accurate Rumor Report from April 6, 2015.

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Navigant acquires 70-employee McKinnis Consulting Services for $52 million to expand its revenue cycle management consulting practice.

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Healthfinch raises $7.5 million in a Series A funding round, planning to use the money to complete development of its EHR “extender tool” that will expand its business beyond automated prescription refill management technology. The 30-employee Healthfinch was founded by biomedical engineer Jonathan Baran and Lyle Berkowitz, MD.

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Minneapolis-based virtual care technology vendor Zipnosis raises $17 million in Series A funding, with Ascension Ventures and Fairview Health Services participating. The company offers a white-label virtual care portal for provider groups in which patients answer online questions and are then triaged to an appropriate clinician.

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Pre-surgery patient portal software vendor One Medical Passport receives a $4 million Series A investment.

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Smart pill bottle manufacturer SMRxT, whose name veers off the “distinctive” roadway into the “utterly unpronounceable as written” swamp, moves its headquarters from New York to Orlando. The company pronounces its name “Smart” in ignoring its own un-clever “Rx” pun and incorrect capitalization that renders the entire nomenclature exercise baffling, making me question whether it employed too much or too little marketing expertise.

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Imaging technology vendor Sectra acquires Sweden-based RxEye, which offers a medical imaging collaboration platform.


People

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Healthwise promotes Adam Husney, MD to chief medical officer.

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Microsoft senior director of worldwide health Bill Crounse, MD retires from the company.


Privacy and Security

Hackers take down three electric power substations in the Ukraine by installing malware packaged as Microsoft Office document macros, with the resulting blackout sure to cause concern that similar actions could affect healthcare facilities if careless employees (was that redundant?) open documents from unknown sources.


Technology

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Twitter will expand the 140-character Tweet limit to as many as 10,000 characters as it had already done for private messages. The downside is that plenty of Tweeters were already stretching the limits of their appeal within their allotted count of 140, now giving them the opportunity to move from “dull” to “insufferable.” On the upside, people were already kludging around the limit by taking screenshots of text anyway. Maybe a compromise would have been to expand the character limit while imposing a tweets-per-day cap.


Other

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Critics question whether BMJ (the cute name that replaced British Medical Journal) has turned itself into a populist magazine rather than a scientific journal with its sometimes poorly researched editorial campaigns. The editor in chief acknowledges that it’s a fine line, explaining, “Some people would say we have gone too far down the magazine route. But we have no doubt that we’ve increased our influence and increased our readership among clinicians.”

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“Brain training” games vendor Lumosity will pay $2 million to settle FTC charges that it made unfounded claims that its software can help reduce age-related cognitive decline.

The bad news is that a year’s worth of a new drug for pulmonary artery hypertension will cost a patient’s insurance $170,000, based on the price set by its manufacturer that expects to sell more than $1 billion worth per year. The good news is that it’s still cheaper than existing drugs for the same condition. The more-bad-news is that insurance companies will surely pass the cost along to the rest of us because that’s how insurance works, meaning everybody is happy except the majority of Americans who don’t have the condition who are paying big premiums without getting much in return.

The New York Times observes that millions of Americans are declining to buy medical insurance since it’s more expensive than the penalties involved in not buying it, capturing some interesting logic from the folks they interviewed:

  • One woman says it’s better to die if something catastrophic happens, defying the government to collect the $1,500 fine she will owe in electing not to buy insurance.
  • A man who doesn’t like poor out-of-network coverage comments, “I’m just going on the hope that nothing bad is going to show up until I get a full-time position somewhere or there’s better choices.”
  • An artist who dropped his $455 per month plan that covered “zero medical expenses” says, “You’re asking a bunch of people to basically just give money into the system when they have an option not to,”
  • A woman who says she just keeps antibiotics in her home rather than buying insurance says, ““I do not believe it serves the public good to entrench private insurance programs that put actual care out of reach for those they purport to serve,” adding that she hopes any disaster happens while driving since her auto insurance covers personal injury.

Sponsor Updates

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  • AdvancedMD staff donates 4,402 pairs of socks to The Road Home, a social services agency that helps the homeless in Salt Lake City.
  • VentureBeat profiles AirStrip’s work with the University of Michigan and IBM to predict when a patient will become ill.
  • Aprima Medical Software donates a record eight tons of food to needy families in the Dallas area as part of its annual food drive.
  • CareSync CEO Travis Bond will speak in March at the South by Southwest Interactive Festival in Houston.
  • The Times of India features CitiusTech HR VP Sowmya Santhosh and her thoughts on accommodating different personalities in the workplace.
  • Divurgent releases a white paper, “Population Data: Healthcare’s Critical Success Factor for Health Management.”
  • E-MDs selects Dell Children’s Medical Center for its 2015 holiday giving program.
  • The local business paper profiles new GE Healthcare CEO Lee Cooper.
  • Greencastle Associates Consulting recounts the part it played in Einstein Medical Center’s EHR rollout.
  • The Huntzinger Management Group ranks number 10 in Consulting Magazine’s list of fastest growing firms of 2015.

Blog Posts


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

 

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January 5, 2016 News 3 Comments

Morning Headlines 1/5/15

January 4, 2016 Headlines No Comments

Health Insurance Portability and Accountability Act Privacy Rule and the National Instant Criminal Background Check System

HHS issues a final rule modifying HIPAA to allow psychiatrists to report potentially violent patients that should be prevented from purchasing a gun to the National Instant Criminal Background Check system.

Meaningful Use: When the Exemption Becomes the Norm

Athenahealth SVP and General Counsel Dan Haley discusses the impact that blanket MU hardship exemptions will have on the program at large, saying “when every program participant is potentially exempt from the application of what was heretofore deemed a key component of said program, there really isn’t a program any more.”

Artificial pancreas system aimed at type 1 diabetes mellitus

Researchers at Harvard Medical School will begin the largest-ever long-term clinical trial of an “artificial pancreas” comprised of an implantable continuous glucose monitor and  an insulin pump that will work together to auto-regulate insulin levels for Type 1 diabetics.

25 W.Va. hospitals see $265 million drop in uncompensated care

In West Virginia, uncompensated care has dropped $265 million in the last year, a shift attributed to an overall drop in the uninsured rate brought on by the ACA.

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January 4, 2016 Headlines No Comments

Curbside Consult with Dr. Jayne 1/4/16

January 4, 2016 Dr. Jayne No Comments

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This year started with a bang as I received my first request to bid on a new consulting engagement over the weekend. I need to do quite a bit of discovery before I decide whether or not I’m going to take it, but I admit I’m seriously intrigued.

It’s from a group of physicians that consults at various extended care facilities and nursing homes where documentation is still done on paper. They’re looking at ways to better manage the use of potentially harmful medications in the elderly. Their needs initially sounded like more of a traditional “assistance with system selection” effort, which I’ve done quite a bit of. That’s how they heard about me. But the more we talked, I understood that they’ve already narrowed it down to three vendors and are looking for some very pointed critiques of the approaches.

In hearing overviews of the proposals, they range from moderately serious to what sounds downright comical. They seem like they would be a good bunch of people to work with, although I’m halfway tempted to tell them they need to choose Door #4 and go back to the drawing board. I can tell from several states away that the one proposal was cooked up by some sales team who really doesn’t understand the business or the needs of the providers and I’m tempted to take the job just to skewer them. I’m not sure I’m going to be able to dedicate enough time to this job as it would likely need, so I may have to take a pass depending on their timing and some other factors.

I worked New Year’s Eve in the trenches, which is always a good time. My experience over the years is that staff members working the holidays tend to be motivated to help move things along as quickly as possible, since you never know when your next rush of patients is going to arrive and you don’t want to be caught behind if you can help it. My shift ended before midnight, though, so I didn’t get to see a lot of the more story-worthy patient visits.

I can say honestly, though, that influenza season is here in full force. If you haven’t received a vaccination yet, there’s still time and I would encourage everyone to do so. If this weekend is any indication, there’s a high potential for this season being quite challenging.

I spent the rest of the weekend getting caught up on email and around the house. My goal this year is to not have an inbox that is perpetually full.

I took particular delight in clicking “delete” on a couple of emails from CMS. One was regarding batch upload for 2015 EHR incentive program attestations. Although I’m still peripherally involved in assisting my clients through this process, I am glad to not be personally accountable for managing the process for my own physician group. The attestation period for Medicare programs starts today and runs through February 29 for those of you playing the home game.

I also enjoyed deleting a CMS “year in review” email celebrating a look back at ICD-10. There were several emails from CMS and ONC covering their joint effort to address quality measure reporting under the various inpatient and ambulatory reporting systems as well as the EHR incentive program. They’re trying (again) to streamline the reporting process and reduce the burden to users, organizations, and vendors, but I’ve not been impressed by their previous work in this regard.

I also found an email from CMS about the new Medicare Drug Spending Dashboard and spent a few minutes checking it out. Drugs were selected for inclusion on the main dashboard due to high total program spending, high annual spending per user, or a large increase in average cost per user. Some of the drugs having the highest jumps were generics – why is digoxin up 298 percent? It’s been generic as long as I’ve been practicing. It’s still relatively cheap in the grand scheme of things, but I was surprised by the numbers.

Not surprising was the inclusion of several medications that are extremely expensive and often-prescribed despite being only marginally more effective or tolerated than the traditional / generic / cheap competitors. There were more than 20 drugs on the list which have more than $1 billion in total spending (2014 data) with some in the $3B range. The original email about the dashboard mentioned that HHS convened a group of consumers, providers, employers, vendors, payers, government agencies, and others to discuss how to balance “the dual imperatives of encouraging drug development and innovation while ensuring access and affordability.” I’d personally like to see Medicare beneficiaries take this list to their doctors and if they are on some of these high-dollar drugs, discuss whether there are alternatives and how much benefit they’re really getting from the Cadillac vs. the Buick vs. the Chevy and how that meets their life goals.

I shudder when I see patients in their 80s and 90s who are on medications that are adding little to their health besides higher costs and an increasing risk of complications due to polypharmacy. I remember when a patient in her early 90s came to “interview” me as she was shopping for a new doctor. She and her daughter (who was 70) came to talk about my philosophy of geriatric care. She was reasonably healthy and shared a home with her daughter and had only been hospitalized once in the previous five years. I honestly told her that I didn’t have a lot of patients in her age bracket, but if she were to join my practice, my main goal would be to prevent as much as possible and to give her medications only if absolutely required. I must have made an impression because she transferred her records the following week.

Some of the reporting around the CMS drug dashboard data shows the shift in disease burden as different populations join the Medicare rolls. Hepatitis C treatment has a significant cost impact along with cancer, diabetes, and pulmonary disease. It also mentions that this is only part of the relevant data – it doesn’t include spending data for commercial payers, Medicaid, the VA, or the military and doesn’t show whether there are rebates or other cost-shifting arrangements.

I expect Medicare to be insolvent by the time I’m 65 and out-of-pocket costs to be absolutely insane, so I’m doing what I can to keep chronic disease off my doorstep. Although I’m not the most disciplined when it comes to food choices (the pastry therapy doesn’t really help either), I’ve got a pretty solid relationship with my treadmill since I upgraded it early last year. Committing to be on it as many days as possible is as close to a resolution as I’m getting.

What’s your New Year’s resolution? Email me.

Email Dr. Jayne.

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January 4, 2016 Dr. Jayne No Comments

Startup CEOs and Investors: Marty Felsenthal

The JPMorgan Healthcare Conference and the State of Healthcare Innovation
By Marty Felsenthal

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I had a lot of fun last year at this time writing about the JPMorgan Healthcare Conference. With thanks to Mr. HIStalk, I thought I’d take an opportunity to provide an update on the conference (it’s happening next week in San Francisco) and also on the state of innovation in healthcare services and healthcare software, as the two subjects are very related.  

This will be my 19th consecutive year at the conference, a streak that a handful of the very coolest people might find more impressive than the Golden State Warriors’ winning streak at the beginning of the NBA season. I have been investing in venture-backed healthcare software and services companies for all of those 19 years. I’m recently and temporarily retired, but I’ve been fortunate to have generated strong returns during my career, to have worked with some great entrepreneurs, and to have worked with wonderful partners.  

That said, and as I mentioned last year, until the HITECH and the Affordable Care Acts were passed, I was as relevant as Rand Paul in a Republican debate or a movie theatre showing “Star Wars” I, II, and III. Until 2010, there was certainly innovation in the provision and administration of healthcare, but it was just more limited and — relative to its potential importance to our country — not enough people cared. That all changed with the passage of those two pieces of legislation.  

Once it became obvious that legislative and judicial efforts to change or repeal the Affordable Care Act would not be successful, almost overnight I underwent a combined transformation like Shia LaBeouf (Megan Fox) in “Transformers I,” Anthony Michael Hall (Kelly LeBrock) in “Weird Science,” and Will Ferrell (his first wife Leslie Bibb) in “Talladega Nights.” Life is pretty good these days for people like Steph Curry and me.

With Reform here to stay, the JPMorgan Healthcare conference became the Comic-Con of the healthcare services and software world. The conference this year will be every bit as crowded and frenetic as in recent years past. However, there are, in my opinion, two very big differences from last year.  

When we’re out with friends, my loving wife of 17 years often refers to me as her "old" husband and then goes on to describe what her "new" husband is going to be like. I still haven’t figured out if she intends to leave me, kill me, or just wait for nature to take its course, but she has made it very clear he won’t snore, he won’t nap on weekends, and he’ll be better at taking advice.  

The first big difference at the conference this year is the number of "old" companies that aren’t presenting — or at least won’t be presenting in 2017 if their mergers are completed. During 2015, we have seen a tremendous amount of consolidation activity in healthcare companies attempting to reduce SG&A as a percentage of revenue through the benefits of scale; attempting to gain negotiating leverage with payers or providers (as the case may be) through horizontal consolidation; attempting to gain the benefits of vertical integration by owning more of the value chain; and attempting to diversify away from their core business into areas of the healthcare value chain that potentially have more opportunity and/or may be less regulated.

OmniCare, Rite-Aid, IPC The Hospitalist Company, United Surgical Partners, Vanguard Health, Cigna, Humana, HealthNet, Catamaran, Merge, and Gentiva are just a partial list of public companies that have announced acquisitions this past year and won’t be presenting this year (or next, depending on their merger timing). There are countless other private companies that have been acquired by United, Optum, CVS, Blue consortiums, AmSurg, Emdeon, The Advisory Board, IBM, and others.  

I don’t know this for certain, but as a lifelong fan (for the past 3-4 years) and someone who one day aspires to own 0.0000001 percent of the Warriors, I’d wager my next NBA championship ring that there was more merger activity by dollar volume in healthcare services and healthcare software this year than we’ve ever experienced. This trend will absolutely continue in 2016.

The second big difference at the conference this year is the number of newly public and potentially very disruptive health care software and services companies presenting at the conference this year, all of which speak to the changing healthcare landscape.  

  • Evolent Health (NYSE: EVH) is presenting. The company provides technology and services to help health systems manage full or partial risk, obviously a huge opportunity in the transition to value-based care.
  • Press Ganey (NYSE: PGND) is newly public and deploys its technology and services to help providers measure and manage patient satisfaction, which is increasingly being tied to reimbursement and will only get more and more important as insurance networks get more narrow. 
  • Inovalon (NASDAQ: INOV) is presenting and is a very interesting company that helps health plans and provider organizations collect the necessary data to get paid appropriately, and more importantly, analyze that data to measure quality and identify opportunities to improve quality. 
  • Teladoc (NYSE: TDOC) is also presenting (disclosure:  I’m on the board of Teladoc). Teladoc is deploying its telemedicine platform across many specialties and in the payer and provider communities to address issues related to access, convenience, and cost. 
  • HealthEquity (NASDAQ: HQY) completed their IPO in the second half of 2014, but they also represent another newly public and innovative company helping consumers navigate the transition to high deductible health plans with better tools and engagement. 
  • FitBit (NYSE: FIT) isn’t presenting, but they have participated in healthcare conferences in the recent past and went public last year. I’m always a little torn about whether this is really a healthcare company, but suffice it to say the potential for inexpensive remote monitoring in healthcare using a tool like FitBit is pretty immense. 

These six companies had IPOs in the past 18 months and collectively represent more than $10 billion of market value.

In my 19 years of going to the conference, I’d wager my likely nomination as the next head of HHS that this is the first-year ever that the JPMorgan Healthcare conference had six newly public and truly disruptive healthcare services and healthcare software companies presenting. That’s a very big deal for healthcare — it will lead to more great entrepreneurship and it speaks to the great market needs and opportunity being created by healthcare reform.

This brings me to the current state of innovation in healthcare software and healthcare services, with a little bit of advice for entrepreneurs and larger companies alike trying to capitalize on that innovation.  

I’ve never been more optimistic or excited. Pessimists will point to the unsustainability of the exchanges (unaffordable for most in their current form without subsidies and attracting too few healthy people). They’ll say hospitals can’t manage physicians or assume risk. They’ll say that the sector is over-funded with venture and growth capital, there are too many companies being formed to do exactly the same thing, there are too many inexperienced entrepreneurs, and there are too many inexperienced investors. They’ll also point to the venture markets more broadly and the vulnerability of all the unicorns.

All fair points, but I have unbridled optimism for healthcare right now. I don’t think there has ever – ever — been a better opportunity to create more successful healthcare software and services companies, to make them bigger, and to do it faster (I sound like Oscar Goldman in “The Six Million Dollar Man”). I think the healthcare sector is undergoing the same kind of transformation that the financial services sector started in the 1970s and that continues to this day. The changes at the JPMorgan Healthcare conference I described above are a great reflection of the beginnings of that transformation and opportunity.

Healthcare is the single largest sector of the economy at almost $3 trillion. While there are certain things our healthcare system does extremely well and better than anyone else in the world, there are other aspects that are very broken. It obviously costs too much, we use way too much paper and don’t take advantage of software and automation to the extent other industries do, we still use way too much MUMPS and client-server technology, we don’t routinely use clinicians at the top of their license, our reimbursement system has historically incented volume instead of value, we aren’t as thoughtful about care at the end-of-life care as we should be, care is too fragmented and poorly coordinated, hospital systems don’t treat their best customers like a valuable asset that could walk across the street to a different system, insurers have customers paying them more than $10,000 per year year after year and do nothing to establish a personal relationship…

It’s an obvious list that could go on and on, and therein lies the opportunity. It’s so obvious. As a country with a political and economic system that responds better to change than any other place in the world, entrepreneurs have always risen to the task when markets were broken and/or a catalyst was provided. The Affordable Care Act (for all its imperfections) provided that spark. In my opinion, we’re in the top of the first inning of a game that’s going to last two to three decades. 

My advice to entrepreneurs is simple. Start your company. Try to think of a unique business or clinical problem that isn’t currently being addressed. Surround yourself with experienced people who have built businesses before. Recognize that you have an opportunity cost so establish a set of metric-based milestones that represent the least you’d hope to achieve over the next six, 12, and 18 months. Stick them on your bathroom mirror, stare at them every morning, and hold yourself accountable / be honest with yourself. If you aren’t hitting them, change paths or go do something else.  

Also, pick your financial partners carefully. Money is flowing loosely and freely in this environment. Personally, I think a lot of these capital sources are, in fact, a commodity (and some worse), but there are some truly value-added sources out there and I’d take their money at a discount to work with the right partner.

I’m biased towards experience so that you can diligence what you’re getting from your capital partner. I’d ask for every example they can provide of commercial contracts they introduced to (or helped facilitate for) the companies they invested in. I’d ask the same of every management team member they introduced. I’d make reference calls on them the same way they make reference calls on you and ask to talk not only to CEOs they did well with, but CEOs they fired or CEOs with whom they lost money.

Ask how they think about capital intensity and burn. Personally, I think one of the single most important areas where an investor can add or detract from value is helping to determine whether it’s time to throw fuel on the fire or to continue to let things simmer based on the market size, the competitive environment, the exit environment, and the company’s proven or unproven ability to execute. 

I started my investing career at the tail end of the dot-com bubble in the late 1990s. I was fortunate to have generated returns well above the benchmarks during that environment, too. For the reasons mentioned above, I do think this time is different, but there are some valuable lessons for entrepreneurs.

First, you can raise too much money. If you raise $50 million to execute against an opportunity where your exit is only going to be $75-$100 million, you won’t do too well and your investors won’t be too happy (and ours is a small community, so you want happy investors to back you or speak well of you for whatever you do next).

Second, just because you raised all that money, please don’t feel obligated to spend it. To my point above, I think it’s very important to manage your burn and be extraordinarily disciplined about when you put fuel on the fire.  

Third, every young company hits a bump (or five) in the road. The line to success is never straight. Treat everyone as respectfully and thoughtfully as possible because even though you’ve got everything figured out today, that might change tomorrow and you will still want doors to open freely and eagerly for you.  

Similar to the late 1990s, we’re seeing a tremendous amount of interest from a wide variety of large companies who want to partner with young, innovative companies. This is happening in the broader economy and in healthcare specifically.  

Until recently, I was a managing partner at a wonderful venture firm that included as its limited partners some of the largest for-profit and not-for-profit insurers, health systems, pharmacy chains, and healthcare foundations in the country. We also had the opportunity to interact with drug distributors, diagnostic companies, multi-sector technology firms, PBMs, and others who were equally interested in a window into healthcare innovation. There are some common characteristics of larger organizations that partnered with young and innovative companies the best.

First, they recognize that innovation is only a means to an end. There were too many large companies in the late 1990s (Time Warner AOL being the best example) and too many companies in this cycle pursuing innovation and change just because their competitors did it or just because something seemed cool and hip. The laws of nature still apply and you need a clear business objective, a product that makes sense, and a business model that makes sense.  

When partnering with young companies, don’t worry about over-paying or every little contract detail. You presumably have a strong balance sheet. To a degree, small differences in price or terms at this stage don’t make a difference in the long run.  

What makes a difference is whether you picked the right company. I was fortunate to have led a financing round at Teladoc early on and at the lowest valuation. However, the truth of the matter is that each investor in the subsequent three private rounds have generated outstanding returns to date as well. I led a later and more expensive round at Change Healthcare before Emdeon acquired it. In both cases, it almost didn’t matter what round you participated, just that you partnered with them.  

To that point, when partnering with innovative companies, the most important thing you can do is pick the right partner, and good people obviously make good partners. Avoid entrepreneur hubris when coupled with inexperience. Treat good people well. Give them responsibility. Be flexible and responsive with them. Commit to make the partnership work. Provide transparent and timely feedback on how the partnership is working and ask for the same. If you buy or partner with a company with good people, figure out ways to make sure the good people stay and to make sure they expose the rest of the organization to what they’re working on.  

There are some great examples of large companies that do innovation well. Aetna partnered successfully with lots of our portfolio companies. United / Optum have been wonderful at almost all of the points above.  A number of Blue Cross Blue Shield plans have really stepped up their games in the past decade with direct investments, collaborative investments, and partnerships and acquisitions of technology companies.   Walgreens and CVS have done it well with their retail clinics  UPMC and The Advisory Board have done it with Evolent. Intermountain Healthcare, Geisinger ….it’s a very large and growing list and much larger than just these companies.  

Some of their common themes are that innovation has senior level sponsorship and multiple sponsors. Many of these organizations have a senior-level executive (or someone reporting to a senior-level executive) whose responsibility is to act as facilitator between the executive sponsors of innovation and the folks in the lower parts of the organization who actually get things done. These organizations also make sure to incent their teams — not just on the next big acquisition or meeting projections, but on some of these softer points around innovation. Some of them provide capital for off-cycle and off-budget rapid pilots.  

Much more so than HIMSS, the JPMorgan Healthcare Conference is a microcosm of our healthcare ecosystem because it covers every major and minor sector of the market, not just technology. The name of the game at the conference for the past six years (and in healthcare more broadly) is change, and every student of markets knows that big change always creates big opportunity. Healthcare is the single largest sector of the US economy and it is undergoing an unprecedented amount of change. 

It’s going to be a great year for the entrepreneurs, investors, and large companies that can capitalize on it. Most important, I’m very optimistic that patients are also going to end up better off for all this change — with better and more consistent quality, with lower-cost alternatives, and with a much improved consumer experience.

Marty Felsenthal has been working with and investing in innovative healthcare software and services companies since 1992 and has led financings and/or provided growth capital to companies such as Teladoc (TDOC), Change Healthcare (acquired by Emdeon), Aperio (acquired by Danaher), PayerPath (acquired by Allscripts), Titan Health (acquired by United Surgical Partners), and USRenal Care (acquired by Leonard Green).

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January 4, 2016 Startup CEOs and Investors 1 Comment

Morning Headlines 1/4/16

January 4, 2016 Headlines No Comments

Epic Systems growth expected to continue

A local paper reports that Epic’s employee base has grown to 9,400, increasing by 1,400 in the past year.

Patients given just hours warning to attend hospital after problems plague new IT system

In England, an estimated 20,000 patients at Hull and East Yorkshire Hospitals NHS Trust have erroneous data in their medical records and appointment waitlists jumped from 40,000 to 60,000 patients as a result of a troubled CSC Lorenzo EHR migration.

How Denmark Dumped Medical Malpractice and Improved Patient Safety

ProPublica analyzes the results of Denmark’s decision to eliminate malpractice suits, replacing them with a government-run claims program that pays patients when they are harmed, but also collects the details of their case and uses it to improve the overall care delivery system.

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January 4, 2016 Headlines No Comments

Monday Morning Update 1/4/16

January 3, 2016 News No Comments

Top News

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The Madison paper reports that Epic’s headcount has increased to 9,400, up 1,400 in the past year. Campus 4 and Campus 5 are under construction and will add 3,500 offices and the company is sharing the cost of expanding Nine Mound Road to four lanes to handle Epic employee traffic. The company also announces that it has 360 healthcare organization customers in 10 countries and booked $1.8 billion in 2014 revenue.


Reader Comments

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From Crank Caller: “Re: McKesson. I agree with your prediction that it will divest its health IT business. I’ve heard from two reliable sources within McKesson that Paragon is for sale, not that anyone would want to buy it.” Unverified, but the company seems to be constantly apologizing for its health IT business, it hasn’t produced great numbers, the Better Health 2020 initiative doesn’t seem to get much airplay after an initial big splash, and the company has shut down product lines like Horizon. With the retirement of Jim Pesce, anything could happen.

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From Simmering Stock: “Re: 2015 share price performance. Some vendors are traded on non-US exchanges.” I intentionally limited my list to companies whose shares trade on US exchanges, but some that don’t are:

Pro Medicus (parent company of Visage Imaging), Australian Securities Exchange: up 191 percent
Craneware, London Stock Exchange: up 68 percent
Orion Health, New Zealand Stock Exchange: down 45 percent

From HIPAA Shake: “Re: your medical records request. Did you ever hear back from the Office for Civil Rights?” I filed a complaint in July with both OCR and the hospital that refused to provide me with an electronic copy of my medical records (the hospital claimed it is required to do so only for providers and patients can only get printed copies). I haven’t heard back from either organization. Good thing I haven’t been comatose for the six months with my doctor anxiously waiting to see what happened during my one-day stay in early 2014.

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From EHR Product Manager: “Re: LA Times op-ed piece on physician working conditions. I left a faith-based academic medical center to work on the vendor side, which definitely has a better work environment. The AMC emphasized work-life balance but I couldn’t get them to let me work remotely even one day a week, which is a given in the vendor world. Is healthcare seeing a brain drain due to perceived lack of perks?” The Stanford medical student’s article says it’s easy to understand why the school’s graduates often forego residency to jump straight into industry in contrasting their environments: the working conditions for low-pay medical residents involve fluorescent lights, endless pages, and cell-like on call rooms, while business school students ride fancy buses to tech companies that provide free gourmet meals, gyms, massages, and on-site services such as bike repair and yoga classes. I would hope that those who choose to pursue professions such as medicine or the ministry don’t expect the eye-popping perks awarded to a tiny percentage of the young workforce who are chosen to work at Google or Facebook (or Epic, for that matter) — I’d rather see the folks who are torn between patient care and Silicon Valley just hire on with Google instead of naively wasting a medical school spot. Excluding poor working conditions for residents, hospital jobs are a mixed bag, especially for non-executives who aren’t eligible for bonuses, fancy offices, and expense accounts. Sometimes the time-off policy is pretty generous and layoffs are less frequent, but otherwise the rewards of hospital work mostly involve the satisfaction of helping people rather than helping yourself. It’s also not a given that people have a choice between the two worlds – hospitals hire lots of people who overestimate their own capabilities in failing to realize that nobody else would want them. My only conclusion is that medical schools should paint a realistic picture of what it’s like being a doctor before offering admission to a student who might have unreasonable expectations, but that’s not their business model — university tuition coffers are filled by students who are destined for a rude awakening when they realize that their expensive degree has little market value or has prepared them for a job nobody would really want.


HIStalk Announcements and Requests

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Cerner and Epic share the lead as the companies for which poll respondents lost the most respect for in 2015. New poll to your right or here: what are your HIMSS conference plans?

I hope everyone enjoyed their most-of-December industry slowdown. The industry rocket is about to blast off now that New Year’s is behind us and HIMSS is just eight weeks away. News was understandably slow last week, so today’s post won’t consume too much of your first-day-back output.


Last Week’s Most Interesting News

  • ProPublica launches a searchable database of health data breaches and privacy complaints.
  • A new law takes effect that allows CMS to fine insurance companies for publishing incorrect provider databases.
  • AMA President Steven Stack, MD names EHRs as the top cause of physician frustration.
  • A New York non-profit rolls out an app that alerts volunteer first responders of nearby medical emergency 911 calls.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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South Carolina-based Singular Sleep offers $249 home-based sleep apnea studies and $69 online consultations for patients in 13 states.

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The Chicago business paper profiles Prepared Health, which offers a care team communications platform. The company was started by folks formerly with Medicity.


People

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Bruce Matter (AMC Health) joins Banyan Medical Systems as EVP of sales.


Other

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In England, problems with the implementation of CSC/iSoft Lorenzo at Hull and East Yorkshire Hospitals NHS Trust cause extended patient waitlists and short appointment time notices.

ProPublica covers Denmark’s 1992 elimination of medical malpractice lawsuits, replaced by a national compensation program in which patients file claims that are reviewed by independent experts who set compensation in return for gaining access to the details for ongoing improvement. The two most-used criteria there are: (a) was care of substantially lower quality than a specialist would have provided; or (b) did the patient experience a rare medical event, such as an unusual drug reaction. The average paid claim is $30,000, but citizens there file seven times the number of claims as in the US and four times more patients per capita receive awards. Doctors there are also legally required to tell patients when they’ve been harmed during medical care. The president of a US association of malpractice lawyers hates the idea, of course, fretting that “those with economically viable cases would take pennies on the dollar when their case is worth substantially more.” He left unstated the obvious two last words of the sentence that motivates him: “to me.”


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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January 3, 2016 News No Comments

Morning Headlines 12/31/15

December 30, 2015 Headlines 1 Comment

Nearly 1 in 3 patients say email communication with providers improved their health

Researchers from Kaiser Permanente have published results from a 1,000-patient survey,  finding that one-third of patients who sent messages to their providers said it improved their health, led to less office phone calls, and reduced office visits.

Valeant Says CEO J. Michael Pearson Is on Medical Leave

Valeant CEO J. Michael Pearson is being treated for pneumonia and will be on medical leave for an indefinite period. In his absence, the company will be run by a three-man office of the chief executive.

North Shore-LIJ ends first nine months with higher margin

North Shore-LIJ Health System (NY) ends its third-quarter with $6.4 billion in revenue, up from last year’s $5.4 billion, but ended the quarter flat due to poor investment performance.

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December 30, 2015 Headlines 1 Comment

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Reader Comments

  • The wisdom of inexperience: Niko, you're "blaming the customer for being dumb". Seriously? Why don't you go to med school or run a hospital or c...
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