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High Hopes for HHS Cybersecurity Center

May 8, 2017 News No Comments

Stakeholders react to news that HHS will launch a healthcare cybersecurity center this summer.
By @JennHIStalk

While administrations may change and legislation come and go, the need for cybersecurity across healthcare’s many verticals seems to be a constant that will remain with the industry for the foreseeable future. News that HHS will create a Healthcare Cybersecurity Communications and Integration Center this summer highlights the federal government’s commitment to helping providers, payers, vendors, and (hopefully) patients prevent data breaches that could impact patient safety.

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Modeled after the Department of Homeland Security’s National Cybersecurity and Communications Integration Center, the new HHS center helps to fulfill the Cybersecurity Information Sharing Act of 2015, part of a broad initiative under the Obama administration to bolster the government’s offensive and defensive cybersecurity capabilities.

“HCCIC establishes the mechanism to provide proactive and anticipatory analysis of cyber threats to both HHS and the healthcare and public health sector,” says an HHS spokesperson. (The department declined a formal interview.) “The HCCIC will act as a clearinghouse to drive healthcare-relevant cyber indicators, briefings, and actionable intelligence to and from a wide variety of stakeholders – both public and private. HHS aims to begin initial operations this summer.”

The timing is apropos given the impending release of a report authored by the Health Care Industry Cybersecurity Task Force, a CISA-mandated group put together last spring tasked with:

  • Analyzing how other industries have addressed cybersecurity threats.
  • Reviewing the security challenges associated with networked medical devices and software connected to EHRs.
  • Developing and circulating cybersecurity best practices.
  • Establishing a plan the government can use to freely share real-time intel regarding healthcare cybersecurity threats.

While HHS would not confirm the HCCIC will help to implement the task force’s recommendations, one can only assume that the two resources will converge to some degree. Industry stakeholders are of course eager to collaborate and benefit from the new center’s deliverables, which are yet to be fully determined.

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“We are anxious to begin to see actionable data coming out of the HCCIC, including threat and vulnerability,” says Marc Probst, CIO of Intermountain Healthcare (UT), which formed a cybersecurity center last year with the University of Utah and several other partners. “The HHS goals around information sharing and analysis align perfectly with our organization and several that we are working with,” he adds. “We are anxious to contribute and develop automated feeds for the HCCIC.”

While emphasizing that long-overdue federal cybersecurity risk assessment and risk management efforts will provide good implementation guidance, Probst and his colleagues are reluctant to see cybersecurity become a compliance effort or a certification program. “Many of those currently participating are vendors or people with a product to sell,” Probst explains. “We hope the committees and chairs will seek more payer and provider participants.”

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While selling a product to providers in need would surely be seen as a positive outcome for any vendor involved, Divurgent CISO Stephen Watkins sees the benefit of an HHS-sponsored cybersecurity center as one of cohesive collaboration. “For advisory and consulting services organizations like ours,” he says, “these centers allow us to share and contribute our strategic, operational, and tactical insight from the field as well as act as both sounding boards and feedback loops for best-practice implementation guidance from the HCCIC, especially for small providers that may not have in-house IT security staff.”

Real-time cybersecurity guidance to the healthcare community will surely be welcome in light of today’s constant stream of data breach announcements, which have become so banal as to no longer incite the media hysteria it first engendered a year or two ago. While it may be too much to hope the center and its collaborators can help providers, payers, and vendors stay ahead of constantly evolving cyber threats, stakeholders no doubt hope HCCIC resources will become some of the strongest defenses in their cybersecurity arsenal.

Morning Headlines 5/8/17

May 7, 2017 Headlines No Comments

Warren Buffett, at Berkshire Meeting, Condemns Republican Health Care Bill

Warren Buffet comments on the recent House passage of AHCA, saying the bill amounted to “a huge tax cut for guys like me.” He also said rising health care costs, rather than high taxes, were the biggest drag on American businesses.

VA chief talks commercial Vista

Describing longstanding VA and DoD EHR interoperability issues, Rep. Thomas Rooney (R-Fla.) tells VA Secretary David Shulkin “You could be the best VA secretary of all time if you solve this one problem,” to which Shulkin agreed and affirmed that he would either replace VistA with a COTS EHR or hand development work over to a private firm, explaining "VA has to get out of the business of being a software developer. This is not our core competency, and I don’t see how it serves veterans.

Big Mega HIT Purchasing Report

A Reaction Data health IT purchasing report notes that inpatient and ambulatory EHR systems sit at the top of the shopping list for healthcare executives, followed by telemedicine solutions, patient engagement solutions, and MACRA implementation services.

Allscripts Healthcare Solutions (MDRX) Q1 2017 Results – Earnings Call Transcript

Allscripts Q1 earnings call affirms its positive Q1 results, noting a 13 percent increase in quarterly bookings, and announcing that it anticipates being accepted into the UK’s London Procurement Program, a sign of potential growth overseas.

Monday Morning Update 5/8/17

May 7, 2017 News 10 Comments

Top News

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Billionaire investor Warren Buffett says in the annual Berkshire Hathaway shareholders’ meeting that the American Health Care Act would be “a huge tax cut for guys like me,” adding that, “Medical costs are the tapeworm of American economic competitiveness.”

Buffett also complained that private equity firms load their acquired companies with debt, announced that the company has sold one-third of the IBM shares it holds, and joked in answering a question about how much his successor will be paid (Buffett is 86) that, “If the board hires a compensation consultant, I’m coming back.”


Reader Comments

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From Chiming In on CHIME: “Re: CHIME. You asked why people are quitting HIMSS. I’d like to see the same anonymous question about why people are quitting CHIME. I’m considering it since it has changed from a CIO networking organization to a vendor-driven one, where companies pay for CIO time.” I created a rather awkwardly worded survey here and will report the results next week. 

From 300-Buck Gyp: “Re: radiology report. A friend’s pelvic CT scan had this radiologist comment in the report: ‘CT pelvis. Reproductive organs – the uterus and ovaries are normal. I guess the fee includes copy/paste issues since the patient is a male.” Perhaps “normal” could be loosely construed as meaning that the lady parts are “absent” in male patients, thus streamlining the radiologist’s report template even more.

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From Privy Pathway: “Re: Brigham and Women’s. Any thoughts on the offering voluntary buyouts as a cost-cutting measure? It used to be that Epic only got the C-suite fired, but Brigham, MD Anderson, and Southcoast are proving a trend. I’ve also heard that a notable health system is cutting annual compensation increases for the rank and file given capital and operating constraints associated with their Epic go-live.” My cheap-seats view would be this. Epic is fanatical about forcing customers to budget the entire project’s expense. My survey of C-level execs of health systems that use Epic (which got pretty big participation) found that 75 percent of projects came in at or under budget, with just 15 percent saying they spent a lot more than they expected. Therefore, I’ll postulate that it’s probably simplistic to assume that Epic is guilty just because it was present at the crime scene:

  • Health systems that choose Epic should not be surprised by its upfront and ongoing costs. That would seem to be the case with most of its customers since few have had disastrous, permanent financial challenges purely because of Epic, especially those that have been live for a few years.
  • Leaders of financially challenged hospitals typically find a scapegoat, whether it’s unions, government payments, IT, or regulatory compliance costs. They haven’t blamed Epic all that often, but even when they did, the reality might not be quite so simple, especially if the executives are looking to justify unpopular decisions.
  • The type of health systems that choose Epic (large, aggressive, market-leading health systems) are those most likely to have had their bottom line hit by government, payment, and marketing challenges as the emphasis shifts away from heads in the bed and the extraordinarily high cost of hospital-provided care, especially in those with massive market clout that drives negotiation with insurers.
  • Timing is everything. Epic gained a lot of customers in the past 3-4 years and financial conditions have changed considerably since then, so those significant upfront costs may be hitting at an inopportune time for some health systems.
  • Having poor financial performance after Epic doesn’t necessarily mean Epic was the problem. Some hospitals screwed up their implementations with bad decisions, while others were poorly managed both before and after Epic. Sometimes you read about a high-profit health system choking on Epic and think to yourself, based on what I know about them, I’m not too surprised they managed to mess it up. Software ROI is usually more related to the client than the vendor.
  • Some of the hospitals are cutting back because of future expectations, not necessarily due to concerns about their current bottom lines.
  • It’s going to get a lot worse of the ACA is repealed and many millions of hospital patients go back to being charitable write-offs, shrinking health system profits.

HIStalk Announcements and Requests

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Nearly 80 percent of poll respondents haven’t bypassed insurance to pay cash for a better ongoing PCP. Stephen pays an $149 annual fee to belong to One Medical even though the actual visits are still covered by insurance. Nonsequitur took the concierge route for his father since few decent doctors in his area accept Medicare, adding that the new practice provides nearly 24/7 secure communications via Twistle. Amy says she hasn’t done it for a PCP, but does so for other services because some providers offer a cash price that’s cheaper than paying her high-dollar insurance deductible. Rose goes out of network to keep a particular PCP even as insurance contracts change frequently, although she’s cautious to get orders for expensive lab and rad tests ordered by an in-network provider since some plans won’t pay for them otherwise.

New poll to your right or here: what was your reaction to the House’s passage of the American Health Care Act last week? Feel free to elaborate further by clicking the poll’s “Comments” link after voting.

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HIStalk readers provided an Amazon Fire TV and accessories for Ms. D’s California elementary school class in funding her DonorsChoose grant request. She reports, “Technology is always changing, so my teaching strategies need to accommodate the needs of my students. Most of them are visual learners, so I play YouTube clips and videos all the time when I am teaching science. In addition, the Amazon Fire TV has allowed my students to visually see the concept as they are watching science videos on TV. Now, my students are extremely excited about science! On behalf of my students, thank you for supporting them as they continue to reach for their goals!”


This Week in Health IT History

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One year ago:

  • Theranos announces a reorganization that includes the retirement of President and COO Sunny Balwani.
  • HHS spells out details of its proposed MACRA program.
  • NextGen ceases development of its NextGen Now cloud-based PM/EHR as it moves focus to its acquired HealthFusion product.
  • The FDA rejects the application of the “digital pill” that uses technology from Proteus Digital Health.
  • Apple releases the CareKit developer’s framework.
  • Internal documents from University of Texas indicate that MD Anderson Cancer Center blames its Epic implementation for a nearly 60 percent year-over-year income decrease, although noting that it had already assumed some negative impact.
  • Siemens changes the name of Siemens Healthcare to Siemens Healthineers.

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Five years ago:

  • Partners HealthCare chooses Epic to replace Siemens Soarian.
  • ONC launches its Health IT Dashboard.
  • The Nashville Medical Trade Center names six companies that will join HIMSS as tenants.
  • Medseek announces plans to conduct a management buyout of the company.

Weekly Anonymous Reader Question

I asked readers to describe the best career advice they have received:

  • You can do better without working more hours.
  • From Ben Franklin: ask people for help in order to make them like you.
  • From my first professional manager who that had been employed for our then-current employer for the previous 30 years, "Don’t make the same mistake as me and think that you need to stay with the same company your whole career."  Knowing what I know now, and having held various positions with several different employers over the course of 25 years, I would have loved the opportunity to have been given the option to stay put.
  • Perception is reality. It doesn’t matter what you think — if people perceive X, then X is true.
  • Always put yourself in the other person’s shoes — most people have good intentions, so if they don’t behave in a good way, understand why from their point of view.
  • When I was thinking of starting my own independent, HIT consultancy in 1985 — terrified every step of the way, but more terrified not to do it — my mentor at the HIT company where I was employed advised me that, so far, my track record for getting through rough days is 100 percent and that’s pretty good.
  • Be nice to the administrative assistants.
  • When you walk somewhere, go fast so you look like you’re actually on your way to do something.
  • Realize when it’s time to recalibrate. Your vision of your life when you were 18 is probably different than it has turned out to be when you reach 40, so focus on the accomplishments rather than regrets.
  • Being told that I was not a good writer, and as such would never be published in one of the B2B magazines owned by the publishing company I worked for. While not your typical piece of advice, I took it as a challenge to prove the naysayers wrong. I believe my ensuing track record of published pieces for a variety of media outlets speaks for itself.
  • My daughter just became an RN and has started working at our local hospital. In her first week or so, she was introduced in passing to an OB/GYN who happens to be my wife’s and also happened to be the doctor who delivered my daughter. She says "Hello, Dr. A," to which he replies "Get out of healthcare, kid."
  • People will always remember how you’ve made them feel. Don’t be a jerk.
  • Don’t listen to your parents. They really think they know you, but they can’t because you only become you by following your nose and that takes time, experimentation, trial and error, and the occasionally do-over. In fact, don’t listen to anyone. Do something that is new every day, and when it stops being new at least a little every week, then move on.
  • Listen. You may be the smartest person in the room. Listen anyway. You’ll learn something.
  • If it’s not going to matter in five years, it doesn’t matter now. Pull back and reconsider your response to the situation.
  • You need to read HIStalk.
  • When the horse has died, dismount. (Ross Perot)
  • Your boss cares about results, not the path you took to get there.
  • If you are young and take a travel job for the higher pay, have an exit plan. Otherwise, you’ll find yourself still on a plane traveling every week when you are 65 years old, having missed so many family and friends moments because you were always on the road.
  • You can love your job, but it will never love you back. No job — no matter how rewarding either financially or emotionally — is worth destroying your peace or sanity for.
  • Do not let one person ruin your job. (Advice I should have taken.) I left a job after 6.5 years because I could not stand my boss. Other people just ignored or tolerated him. Many of them are still there today, 15 years later. He has since retired.
  • Back in the early 1980s:  learn to type. Sounds dated now, but as my mother said, you can always fall back on being a secretary if needed. Thankfully I took four years of typing in high school, and went onto college to get my bachelors. I type for a living now in IT.
  • Earlier in my career, I was really ambitious and wanted a promotion after my direct manager left. I wasn’t ready to be the department manager but i met with the VP making the decision anyway. He learned more about my background and experience and said to me, "You have to ask for the job you want, otherwise no one will know you want it." It was a revelation to me. A plain spoken truth and something so simple would be the best career advice I ever received.
  • My first CIO taught me not to ever say “no” to my business partners. Say “how long” what they want will take to acquire and/or develop, and “how much” it might cost. This is our obligation as IT professionals serving an organization.
  • Taking the path of integrity and good character will not always result in promotion within an organization. You must be willing to stick to your professional values and be ready to move on to new adventures if your superiors do not like your answers.
  • You hold yourself back more than anyone or anything. You are good at what you do. Have faith in yourself, be heard, make a difference.
  • Spend more personal time with your team. Show your human side. Both will build more trust, which will make the team closer and stronger.
  • Never talk to a reporter. Your response should always be "no comment."
  • Don’t do anything rash.
  • When you have an issue with the way the organization is being run, address it by tying it to core values or customers, not by calling out the way a specific person does things.
  • You should spend 10 percent of your time looking for your next gig.
  • Do what you say you’re going to do, when you say you’re going to do it. Return the call or email promptly even if you don’t have the answer. In other words, be there. If colleagues and customers know they can count on you, you’ll be given more opportunities (and responsibilities) to grow your career and, at the same time, build a network that will be increasingly valuable.
  • Arrive at a meeting at least five minutes early, and if you are leading, a meeting ensure that it ends on time or earlier.
  • I was having trouble getting what I needed professionally from a boss. The advice I received from a mentor was, "She will never be the kind of boss you need. So how do you make the most of what she has to offer and get your other needs met elsewhere?"
  • Live on what you currently make so your employer will never "own" you. I stayed in positions because I wanted to be there, not to get a paycheck.
  • Worry about the sale. The margin will take care of itself.
  • Advice to a just promoted CIO: "Remember that you are a VP of the organization, not just of IT."
  • Don’t apologize if you have not done anything wrong. Said to me by the late great Steve Macaleer, of the Macaleer/SMS family, who died way too young at 49.
  • Every five years or so, change jobs. You have probably developed bad habits that are best discarded. You can do this within your current employer or by getting a new employer.
  • Ninety-five percent of the time you are right, but 95 percent of the time your delivery sucks. You need to work on your delivery AND timing.

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This week’s question: what specific event crystallized your decision to leave your last job? (or another previous job if you’ve got a good story from there).

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Welcome to new HIStalk Platinum Sponsor CSI Healthcare IT. The Jacksonville, FL-based company, which has offered services nationally for 20 years, provides training and implementation solutions for EHR and coding as well as IT staff augmentation, legacy system support, and infrastructure staffing. Case studies: Houston Methodist (CPOE activation), Norton Healthcare (a 300-contractor Epic go-live), Sutter Health (Epic training), and Grady (big-bang Epic go-lives). The company’s consultants voted it to Inavero’s Best of Staffing Talent List, which recognizes fewer than 1 percent of staffing agencies in North America. The company provides customized consulting and staffing solutions that provide unmatched results at a fraction of the cost. Thanks to CSI Healthcare IT for supporting HIStalk.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Last Week’s Most Interesting News

  • The House passes the American Health Care Act that would repeal most of the Affordable Care Act, sending the bill to the Senate.
  • Thoma Bravo buys Lexmark’s Perceptive Software business and moves it under its Hyland Software portfolio company.
  • Computer systems at University Hospitals (OH) go down for several days due to unspecified causes.
  • ONC launches a patient matching algorithm challenge.
  • Meditech announces Q1 earnings per share of $0.39 vs. $0.51 in the same quarter last year.
  • Internal medicine physicians at Canada’s Nanaimo General Hospital are disciplined for going back to paper orders in declaring patient safety concerns with Island Health’s Cerner system.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call, following the quarterly report in which the company beat expectations on earnings and met on revenue:

  • A strong segment was Payer and Life Science.
  • The company expects its acceptance into the UK’s NHS London Procurement Partnership to help it maintain UK momentum.
  • The Netsmart acquisition contributed around $50 million of the quarter’s bookings.
  • Paul Black says the company is watching the market evaluation being performed by the VA and Coast Guard, noting that the Allscripts loss in the DoD bid wasn’t due to technology, applications, workflow, security, or company background – it didn’t make it to the final round because of price.
  • The company is not seeing the decline in claims volume as reported by Athenahealth, although it notes that Athenahealth has greater exposure than Allscripts because of its business model.
  • Allscripts will focus on increasing the client base’s adoption of Sunrise Financial Manager rather than trying to roll out outsourced inpatient revenue cycle management services.

Decisions

  • Central Montana Medical Center (MT) will switch from Evident to Infor supply chain management in 2017.
  • Children’s Hospital Of New Orleans will go live with Epic in 2018.
  • New Orleans East Hospital (LA) will switch from Cerner/Siemens Soarian to Epic in 2018.
  • Thomas Memorial Hospital (OH) replaced Siemens with Meditech on March 1, 2017.

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


People

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New York-Presbyterian Hospital (NY) promotes Rosemary Ventura, MA, RN, DNP to the newly created position of CNIO.


Announcements and Implementations

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Reaction Data publishes its “Big Mega HIT Purchasing Report,” which finds that the top spending item of health systems and standalone hospitals in the next 12 months will be inpatient and ambulatory EHRs (Epic was #1 in mindshare for both, followed Cerner and Meditech that were nearly equal in score). Hospital-owned physician groups will focus on information security, while independent practices place telehealth as #1 with equal interest in four vendors.

Definitive Healthcare adds quarterly inpatient and outpatient Medicare claims data for hospitals, clinics, and long-term care providers to its provider data, intelligence, and analytics product line.


Government and Politics

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VA Secretary David Shulkin reiterates that he will announce the VA’s plans for VistA in July, choosing to either replace it with a commercial system or turn VistA over to a private company to convert it into a single, cloud-based, externally managed instance. When asked about the historic lack of technology cooperation between the VA and the Department of Defense, Shulkin promised better, saying, “We’ve always found ways not to do that.”


Privacy and Security

Hacker The Dark Overlord posts records of 180,000 patients online from medical practice hacks last year, most likely because those facilities declined to pay the extortion demanded.


Other

A Utah-based orthopedic surgeon is ordered to turn over 10 website domains to Intermountain Health Care, which complained that the doctor had no legitimate reason to have purchased domains related to Intermountain’s Cedar City Hospital and was instead was trying to use them to convince an insurance company to add him as an in-network provider.

 

Here’s the finale of Vince and Elise’s series on physician practice vendors, this time looking at the “other” ones.


Sponsor Updates

Blog Posts


Contacts

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

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Morning Headlines 5/5/17

May 4, 2017 Headlines No Comments

What’s in the AHCA: The Major Provisions of the Republican Health Bill

The House passes the American Health Care Act in a 217-213 vote. The ACA replacement bill will now head to the Senate for debate.

Allscripts Healthcare Solutions, Inc. (MDRX)

Allscripts reports Q1 results: revenue climbed 20 percent to $413 million, adjusted EPS $0.13 vs. $0.13.

Doctor On Demand Announces Lab Testing Services to Provide Patients Better Everyday Care

Direct-to-consumer telehealth vendor Doctor On Demand partners with both LabCorp and Quest Diagnostic. The partnership will give Doctor On Demand providers a way of ordering diagnostic tests that consumers can have run locally.

The world’s most valuable resource is no longer oil, but data

The Economist argues that data has surpassed oil as the world’s most valuable resource, and calls for antitrust actions against the technology giants that control the vast majority of data flow.

News 5/5/17

May 4, 2017 News 1 Comment

Top News

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The House votes 217 to 213 to repeal the Affordable Care Act, sending the American Health Care Act to the Senate. President Trump said afterward in a White House victory celebration, “We’re going to get this passed through the Senate. I feel so confident,” adding a promise that premiums and deductibles will go down.

No Democrats voted “yes,” while 20 Republications voted “no.” Two more “no” votes would have killed the bill. The House allocated 40 minutes for discussion before the vote.

The voting was held just before the House leaves for an 11-day recess. Congressional Budget Office scoring of cost and the change in the number of uninsured has not been completed.

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Just about every medical and consumer group urged rejecting the American Health Care Act, which would:

  • End Medicaid as an open-ended entitlement.
  • Give the wealthiest Americans a $300 billion tax break over 10 years.
  • Allow insurers to charge older citizens five times the premium rate of younger ones (increasing it from three times).
  • Allow states to eliminate the requirement that insurance companies issue policies without considering pre-existing conditions.
  • Eliminate the requirement that individuals buy insurance.
  • Remove the penalties for large employers who don’t want to provide insurance to their employees.
  • A change added to the bill in a last-minute amendment would allow states to remove the out-of-pocket maximums now required of employer-provided insurance.

The expected millions of people who would lose insurance under the proposal would leave hospitals at risk for providing their emergency care without payment since the Affordable Care Act reduced hospital Medicare payments on the assumption that more of their patients would be insured.

The Senate’s debate on the bill will begin in June.


Reader Comments

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From LongInTheTooth: “Re: Australia’s Telstra Health. You mentioned them as being shortlisted for an EMR tender in Northern Territory. After making over a dozen health IT acquisitions in the last few years, they have decided to trim down and focus solely on the Australian market. New Managing Director Mary Foley is trying to turn around a larger-than-required health vertical without a coherent strategy and has just announced a massive reorg which includes layoffs. Last week they sold their Arcus EMR business in Asia to private buyers. Their CTO Roy Shubhabrata (ex-Epic, GE Healthcare, Microsoft) couldn’t save the sinking ship. Another acquisition, Dr. Foster in the UK, is up for sale as well.” Telstra Health is a business unit of Telstra, the biggest telecommunications and media company in Australia.

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From Polite Patrician: “Re: Epic’s App Orchard. The site seems to be free of legal disclaimers. I’m wondering how the submission and approval process works.” I’ve heard concerns that Epic asks a lot of questions about submitted apps and could theoretically use that information to guide its own product development. Epic could also reject apps in claiming without proof that they encroach upon planned future Epic functionality. It seems farfetched to me that Epic would use App Orchard submissions to glean product enhancement ideas or that it would deny applications without a good reason, but at least some small companies seem to worry about that possibility. I’m interested in hearing (anonymously) from anyone who has experience in working with Epic on App Orchard since we’re otherwise just sitting around wringing our hands without facts.

From Old Relay Dev: “Re: McKesson. Sweeping layoffs in NewCo/Change starting last night.” Unverified. An anonymous post on TheLayoff.com quotes a claimed internal email indicating that 394 employees were let go along and 89 open positions were closed, predicting that another RIF will follow in June.


HIStalk Announcements and Requests

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HIStalk readers funded the DonorsChoose project of Mrs. F in Virginia, who asked for headphones for her kindergarten class. She reports, “During our group rotations, when students are not working with one of the teachers, then they are on the computer using a program that they sign into so that reading, word recognition, and spelling are at the student’s level. The headphones allow only the student who is on the computer to hear the program without distracting the groups the teachers are working with. The students on the computer are also not distracted by what the teacher is teaching. These headphones allow my classroom to run smoothly. The donors who help make my room complete are angels.”

This week on HIStalk Practice: Compulink develops all-in-one HIS solution for ASCs. MDLive CEO hints at the important role telepsychiatry will play in its future business model. NCQA develops Oncology Medical Home recognition program. Charlotte Eye Ear Nose & Throat rolls out Epic. Practice Velocity announces ownership changes. Change Healthcare helps Saltzer Medical Group transition to independence. Kerri Wing, RN of IHealth Innovations outlines the IPPS proposed rule’s peace offering to physicians.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Acquisitions, Funding, Business, and Stock

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Private equity firm Thoma Bravo will buy Lexmark’s enterprise software business — which includes Kofax, ReadSoft, and Perceptive Software – and will then sell the Perceptive business (image capture, vendor-neutral archive, and a universal viewer) to its portfolio company Hyland Software. The Kofax and ReadSoft businesses will be rolled into a new Thoma Bravo company under the Kofax name. Lexmark acquired Perceptive Software for $280 million in 2010, bought competitor Kofax in 2015, and then sold itself to a China-based investor consortium for $3.6 billion in 2016.

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Allscripts announces Q1 results: revenue up 20 percent, adjusted EPS $0.13 vs. $0.13 as GAAP earnings swung to a loss, meeting earnings and revenue expectations. Shares were unchanged early in after-hours trading and are down 9 percent in the past year.

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Germany-based CompuGroup Medical reports Q1 results: revenue up 5 percent, EPS $0.27 vs. $0.22. Share price has risen 20 percent in the past three months.

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Analytics vendor Inovalon reports Q1 results: revenue up 5 percent, adjusted EPS $0.07 vs. $0.05. Share price is down 22 percent in the past year, valuing the company at $1.8 billion.

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EHR prescription drug coupon vendor OptimizeRX reports Q1 results: revenue up 22 percent, EPS -$0.03 vs. –$0.01. OTC-listed shares are down 29 percent in the past year, valuing the company at $22 million.

Analytics vendor Koan Health buys ZirMed’s value-based care analytics business.

China-based insurer Ping An launches a $1 billion investment fund that will focus on overseas financial and healthcare technology. The company’s health Internet subsidiary, which offers free online doctor consultations, raised $500 million in a Series A round last year,valuing it at $3 billion.


People

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Patient engagement technology vendor Conversa Health hires Chris Edwards (Validic) as chief marketing and experience officer and Becky James (WebMD Health Services) as VP of operations.

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Phil Spinelli (Visiant Health) joins Ingenious Med as SVP/chief revenue officer.

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Kyruus hires Scott Andrews (Athenahealth) as SVP of delivery.

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AdvancedMD hires Greg Ayers (inContact) as CFO.


Announcements and Implementations

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Video visit vendor Doctor On Demand integrates its system with those of lab companies Quest and LabCorp, allowing its doctors to order lab tests and for its patients to choose a lab based on insurance coverage, availability, and location. The company — co-founded by TV psychologist Dr. Phil and his TV producer son – has raised $87 million in three funding rounds, although the largest and most recent was nearly two years ago. Among its investors are Athenahealth’s Jonathan Bush and Virgin’s Sir Richard Branson. It offers medical sessions for $49 along with ongoing psychology and psychiatry counseling.

In Australia, Pulse+IT reports that a Victoria-wide implementation of Epic did not receive funding in the state’s new budget.

Surescripts extends its real-time medication history service to long-term and post-acute care facilities.


Government and Politics

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The CEO of insurer Molina Healthcare – the son of the company’s founder who, along with his CFO brother, was fired Tuesday despite improved quarterly results – says his criticism of the Republican repeal-and-replace movement may have cost him his job. He says, “People are afraid of the administration. Why take an aggressive stance if you think you have nothing to gain, or if you think you have something to lose?” He adds, “The most troubling development has been the attempt to get votes from the Freedom Caucus by allowing states to get rid of the ban on pre-existing conditions … The Trump administration is destabilizing [the marketplaces]. Health plans need to plan ahead. He can pull the rug out from the health plans at any minute.” Molina shares rose 25 percent on the news as investors speculated that the company is now an acquisition target, having jumped 41 percent in the past year and 152 percent in five years.


Privacy and Security

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DataBreaches.net reports that an anonymous hacker is running a “summer sale” on his or her inventory of 500,000 recently stolen patient records from pediatric practices, offered at $3 per child. The site verified the validity of a sample of the records even though no cumulative breaches of that magnitude have been reported. The hacker, “Skyscraper,” says he or she simply searches for “patients,” adding that, “For some stupid reason, entire databases show up” and clarifying that the searches don’t involve the known weaknesses of IoT-connected devices or FTP servers. Asked what practices should do to protect themselves, the hacker says they need to pay for their software: “You wouldn’t believe how many of those offices run on cracked / downloaded software and outdated 2015 versions.” 

University of California regents sue several doctors and pharmacies, claiming that they defrauded the student health insurance of $12 million over six months by running Facebook ads offering students $550 to participate in phony clinical trials for a pain cream and recruited other students as sales reps for a drug “startup” at a campus job fair. The 500 respondents to both solicitations were required to provide their student health plan numbers, which the lawsuit claims were used to bill prescriptions for custom compounded, Ben Gay-like creams that cost the student health insurance up to $5,300 per tube. The prescribers did not examine the students, who were unaware that they were being billed for the creams. One podiatrist wrote 600 prescriptions for the creams in a single day, costing the system $1.7 million.


Other

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Ever-increasing patient cost-sharing has hurt the collection rates of medical practices, according to a Health Affairs article co-authored by Athenahealth’s Jonathan Bush that studied the company’s practice data. Patients paid around 90 percent of balances that were less than $200, but once they owed more than that amount, the figure dropped to 67 percent. The article also notes that collection rates are lower for specialists (because they charge more) and that practices must wait weeks to receive an EOB from the insurance carrier to find out what the patient owes, greatly reducing the chances of getting paid once the patient has left the office.

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An article in The Economist says that data rather than oil is the world’s most valuable resource, suggesting an antitrust evaluation of the companies that are profiting massively from it (Google, Amazon, Apple, Facebook, and Microsoft). It notes that access to consumer data gives those big companies an early warning (“a God’s eye view”) of potentially competitive upstarts that they can either copy or buy, highlighting Facebook’s $22 billion acquisition of 60-employee, zero-revenue WhatsApp in 2014. The article suggests that antitrust regulators look not only at company size when evaluating the consumer impact on a proposed merger, but also the extent of the data assets of the companies. It also proposes that companies be forced to let consumers know what information about them they hold and how much money they make from it; that governments open up their own data vaults; and that countries require at least some industries (as is being done with banks in Europe) to share their customer data with third parties.

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A Wall Street Journal article examines whether public outcry over a company’s $89,000 drug (previously sold for $1,200) forced that company to sell the drug to yet another company and effectively put itself out of business. Marathon Pharmaceuticals bought a old UK muscular dystrophy drug, paid $370,000 to buy study data from universities, researchers, and the Muscular Dystrophy Association that it used to earn FDA approval, then set an $89,000 per year US price. The CEO’s previous company bought another rare disease drug and upped the price from $289 per vial to $1,950, a formula it repeated in buying “under priced” drugs from big companies and increasing US prices by an average of 500 percent. He made $60 million when he sold the company for $900 million. He expected to sell the current company, Marathon Pharmaceuticals, for several billion dollars before the pricing backlash, but even though he fell short, the company received $140 million in cash and stock, 20 percent of future sales revenue, and a potential $50 million payout, all  thanks to 20,000 young boys afflicted with Duchenne muscular dystrophy.

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A survey of 800+ health IT workers (two-thirds of them consultants, most of them working on Epic) finds that 86 percent of them feel optimistic about their career opportunities and nearly half say they make $100,000 or more per year. The most important factors in deciding whether to accept a contract are pay, company reputation, and the expense reimbursement model, with the least-important factor being the ability to work from home. Interestingly, two-thirds of consultants would consider a full-time role, which represents a huge jump over surveys from previous years, although salary expectations seem to be a barrier given the tiny number of respondents who say they’re willing to take a pay cut.

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Wilkes Regional Medical Center (NC) will convert from McKesson Paragon to Epic as its lease is turned over to Wake Forest Baptist Medical Center on July 2, when it will be renamed to a name that will surely almost never be used in its entirety, Wake Forest Baptist Health – Wilkes Medical Center.

An interesting study finds that parents who Google the symptoms of their child are much more likely to question their pediatrician and seek a second opinion because they don’t understand the differential diagnosis process the doctor used. The author suggests that physicians explain how they arrived at their diagnosis during the office visit to avoid treatment delays caused by patient second guessing.

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Vending machines are offering $4 HIV test kits as part of a government pilot project in China, where people often don’t undergo testing because homosexuality — and with it, HIV and AIDS — are taboo subjects and hospitals reportedly regularly turn away HIV/AIDS patients even though the law forbids such discrimination.

Weird News Andy says 50-times-faster brain surgery is fine as long as it isn’t done half-fast. University of Utah develops a robotic, CT-mapped surgical drill that may reduce surgery time from two hours to 2.5 minutes, although it hasn’t actually been tested on humans.


Sponsor Updates

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  • Impact Advisors delivers 200 backpacks filled with craft supplies and games to patients of Florida Hospital for Children.
  • EClinicalWorks will exhibit at the 2017 ASCA Annual Meeting May 3-6 in Oxon Hill, MD.
  • Nuance recaps recent hospital sales of its computer-assisted physician document system and publishes a new report titled “CAPD 2017: Improve physician documentation at the point of care.”
  • Evariant will host its third annual Converge User Conference May 7 in Austin.
  • ECG Management Consultants will present at the 2017 ASCA Annual Meeting May 4 in Oxon Hill, MD.
  • An Emory University research study finds cost savings for CABG surgery, supported by Glytec’s Glucommander for personalized insulin dosing.
  • The HCI Group publishes “Selecting the Right Interface Engine – Top 5 Considerations.”
  • Healthcare Growth Partners supports the sale of Clockwise.MD to DocuTap.
  • Imprivata will exhibit at the Canada Collaboration Forum May 8-10 in Whistler, British Columbia.
  • Influence Health releases a new whitepaper, “Healthcare Consumer Experience in 2017.”
  • InterSystems will exhibit at the Blue Cross Blue Shield National Summit May 9-12 in Orlando.
  • Kyruus publishes “Health System Call Center Experience Report: Are Top Health Systems & Hospitals Answering the Call to Provide a Better Patient Experience?”
  • Liaison Technologies begins accepting applications for its new Data-Inspired Future Scholarship.
  • NVoq will exhibit at the MGMA NE conference May 10-12 in North Falmouth, MA.
  • Experian Health will present at HFMA Eastern Michigan May 12 in Livonia.
  • Wellsoft will exhibit at the Rural Health Conference May 9-12 in San Diego.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 5/4/17

May 4, 2017 Dr. Jayne No Comments

A recent ONC blog post mentioned efforts to “demystify patient matching algorithms.” Patient matching continues to be challenging to many interoperability projects. The blog post makes the point that although matching is critical, there isn’t much transparency around how well current algorithms perform. There’s been a lot of debate about a universal patient identifier, and despite the restrictions around any federal initiatives to move towards such an identifier, many of us would like to see one move forward. Even if it’s voluntary, I’d rather take my chances with ID theft than risk misidentification. I’ve had recent issues with someone else’s data in my chart, so maybe that adds to my bias.

To aid in finding a solution for matching issues, ONC launched the Patient Matching Algorithm Challenge, which aims to develop new algorithms, benchmark the current state, and help organizations find common metrics. There will be six prize winners with a total payout of $75,000. There are several webinars upcoming and registration for the challenge opens next week, for those that are interested.

My pet peeve of the week is meetings that start late. I’ve been on multiple conference calls where I’ve heard phrases like, “Let’s just wait a few more minutes, there might have been some people with meetings before this who have not yet arrived.” It’s extremely disrespectful to those of us who adjusted our schedules to be on time, who get to sit there and wait. During several of the offending meetings, the latecomers never materialized, so it truly was a waste of time.

I’ve said it multiple times, but organizations that want to be high-performing need to look at how they schedule meetings and make adjustments if people are constantly late or double booked. Condemning people to daily runs of back-to-back meetings is not only inhumane, but non-productive. The best organizations I’ve worked in have policies in place to limit meetings to 25 or 55 minutes so that participants can transition to another meeting if needed. They also have active agenda management within their meetings to ensure that time is used well and that they don’t run over. I preach this constantly during my consulting engagements and can usually get my clients to make progress. Lately I’m involved in projects, though, where I’m just a small piece of the puzzle, so I’ve been feeling the pain of poorly managed meeting schedules.

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US prescription drug spending continues to rise, potentially crossing the $600 billion mark in the next four years, according to a Reuters article. The annual increase of 4-7 percent is less than the 6-9 percent increase in spending growth that was originally forecast, partially due to fewer approvals of new medications and pharmaceutical companies facing pricing pressures. The piece mentions that “several drug makers have pledged to limit annual price hikes to under 10 percent.”

I understand price increases have to keep up with inflation and manufacturing costs, etc. but it seems most manufacturers are going to keep increasing prices as much as the market (and public opinion) will bear. I continue to cringe when I review patient medication lists during patient care shifts. It’s increasingly rare to see patients on fewer than 10 medications unless they are pediatric patients. I see people on the “latest and greatest” branded medications when generics are available that have virtually identical side effect and risk profiles.

It takes a lot of work and effort to have conversations with patients around whether switching from medication X to generic Y is a good idea and what the cost savings could be over the course of a lifetime of chronic treatment. Patients with low health literacy aren’t going to understand relative risk reductions and how a medication being 1-2 percent more or less effective is going to make a difference for them. Physicians often don’t have the time to have those conversations, either.

The best resources I’ve seen for these conversations are pharmacists who are embedded in the clinical practice, but we don’t see a lot of those in the workforce. We also need to get past the cultural idea that being on the latest and greatest medication is best. How many drugs have we seen that have serious issues that aren’t found until they are on the market for a year or two? More than I care to remember.

It’s also more of a challenge to have the conversations and interventions around lifestyle modification than it is to just give another medication, especially when physicians are being graded on their outcomes. I’d like to see insurers or pharmacy benefits managers providing these kinds of direct-to-patient interventions. They could keep a share of the savings from the lower-cost interventions to motivate them. Of course, it would cut into the overall profit margin, but it would be better from a societal standpoint because polypharmacy is a real issue. It’s easier though to push the work to the physicians and other front-line providers, who I guarantee aren’t getting payment increases that are hovering under 10 percent.

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Lots of people were impacted this week by a Google Docs phishing scam. When I saw identical emails come through from almost a dozen unrelated people in the course of a few minutes, I knew something was up. It quickly made its way through several local school systems that use the Google Classroom applications, and from there to their parents and out into the community. It’s a good lesson for the younger set, that there are bad actors out there and they have to be suspicious.

The things that kids have to worry about in this day and age are sad, however. My local school district just announced a program starting in the fall where every middle school student will be issued a personal Chromebook for use at school and at home. Although it might keep family computers from being impacted by scams accepted by unsuspecting children, it increases the burden for tech support for the schools.

The rapid growth of technology is also a bit of an experiment on our society as a whole. Social media creates stress for adults and youth alike, and the social media-related suicides and bullying are truly tragic. I was fortunate to grow up in a location and as part of a generation that could run around the neighborhood until the street lights came on, and most of our worries were around flat tires on our bikes. Even in middle school, the pace of bullying was limited by the passing of folded pieces of notepaper and whispering in the hallways between classes, where now hundreds of people can be involved in negative interactions at the touch of a button. Add in the recent boom in murders, suicides, and assaults broadcast live for the world to watch and it makes you wonder where we’re headed. Maybe patient matching challenges aren’t such a big deal after all.

Email Dr. Jayne.

Morning Headlines 5/4/17

May 3, 2017 Headlines 3 Comments

US Hospital EMR Market Share 2017

KLAS publishes its 2017 report on EMR market share finding, not surprisingly, that Epic and Cerner lead, with a fairly even split of 25.8 percent and 24.6 percent respectively, followed by Meditech with 16.6 percent.

Statement of the Honorable David J. Shulkin, Secretary of Veterans Affairs

VA Secretary David Shulkin testifies before members of the House Appropriations Committee noting that the agency will make a decision on whether to implement a commercial EHR or continue with VistA by July 2017.

Growing Insurance Coverage Did Not Reduce Access To Care For The Continuously Insured

A Health Affairs study concludes that the increased insurance coverage brought about by ACA did not impact access to care for those that were already insured.

Genomic Testing and Precision Medicine in Cancer Care

A Medscape survey of 132 medical oncologists and hematologists finds that most patients do not benefit from genetic testing because results rarely point to evidence-based, clinically actionable changes to a treatment plan. Despite this, 61 percent of respondents still believe the tests are useful.

Morning Headlines 5/3/17

May 2, 2017 Headlines 3 Comments

University Hospitals struck by computer outage

University Hospitals (OH) is working through a network outage that began Monday. Details surrounding the cause of the outage have not yet been disclosed.

Cancer patients in limbo as five hospitals suffer ‘major’ IT crash

In England, five major NHS trusts have started cancelling chemotherapy treatments and surgeries after widespread failures within radiology, PACS, dictation, and chemotherapy systems.

Demystifying Patient Matching Algorithms

ONC announces a $75,000 challenge soliciting patient matching algorithms.

Baptist Memorial and Mississippi Baptist Merge

Baptist Memorial Health Care (TN) and Baptist Health Systems (MS) complete their merger, creating a 21-hospital not-for-profit health system.

News 5/3/17

May 2, 2017 News 9 Comments

Top News

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Computer systems at University Hospitals (OH) remain down following unspecified connectivity issues that started Monday.

Hospital executives say the lack of computer access is not affecting patient care.


Reader Comments

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From Nantwatcher: “Re: NantHealth. President Robert Watson has been separated, effective immediately. Co-Presidents Mark Dudman and Gary Palmer, MD are also gone.” The company hasn’t responded to my inquiry. However, those three folks have been expunged from the company’s leadership page. The year-ago cache of that page shows that of the eight executives listed then, only three remain – the CFO, chief people officer, and general counsel. The LinkedIn pages of Watson and Dudman remain unchanged, but that of Gary Palmer – NantHealth’s chief medical officer and president of its GPS Cancer division – says he left in January and is now chief medical officer of genomic sequencing and analytics vendor Tempus. The slide in NH share price continues – it’s down 40 percent in the past month and 85 percent in the 11 months since the company’s IPO.

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From Conjoined Triplet: “Re: Huron Consulting. Completed its fifth round of layoffs in two years Friday, this one targeting revenue cycle and technology consulting teams. They paid $30 million to acquire Vonlay three years ago and there’s hardly anyone left on the Epic team.” Unverified. The company hasn’t responded to my inquiry. Huron’s earnings and revenue beat expectations in Monday’s quarterly report, but CEO James Roth said in the earnings call that healthcare revenue (52 percent of the company’s total) was down 14 percent, mostly due to “softness in our revenue cycle offering within the performance improvement solution” as projects shifted to smaller engagements. He says that Huron “will continue to make adjustments in our cost structure to manage our profitability in this segment.” Shares rose Monday following the earnings announcement before the market’s opening, but are still down 19 percent in the past year.

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From Seal Flipper: “Re: speaking invitation. Check out this health IT magazine’s ‘invitation’ to pay to speak at its conference.” I can’t say I’m shocked that revenue-desperate health IT sites are brazenly selling pay-for-play article space on their sites and speaking slots at their conferences, no doubt encouraged by the similarly commercial behavior of HIMSS. I can only assume that providers will eventually wise up that they’re being fed vendor commercials and will push back, especially if the underlying content isn’t very good.

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From Kermit: “Re: algorithms. This comic makes me think of all the non-HIT firms that have jumped into HIT thinking they can ‘solve’ healthcare with their years of business experience.” There’s an uneasy tradeoff (in healthcare, politics, the arts, and other endeavors) in bringing in a fresh set of outsider eyes that can provide either: (a) brilliant insight and fresh inspiration; or (b) embarrassingly inept floundering while confidently trying to use a hammer to pound in a screw.

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From Jump Back: “Re: HIMSS. Their buy one-get one offer seems to be a sign of trouble in paradise.” I think it’s probably a sign that HIMSS members fuel its revenue not by paying dues, but rather by making themselves available as a target for big-vendor marketing. That was made clear when HIMSS announced its Organizational Affiliate program years ago in which everybody in a participating company can join at no incremental cost. The “Ladies Drink Free” model makes HIMSS a fortune as an intermediator and explains why they cater to vendor members and exhibitors rather than employees of non-profit health systems. I’m not sure there’s much value in joining HIMSS (and thus directly supporting some of its questionable behaviors) other than to earn a discount on the annual conference registration.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Mrs. B in Washington, who asked for building blocks for her kindergarten class. She reports, “The kids were over the moon about them, and though we don’t know who you are, they all think you are the best ever. While they are just thinking about playing, these skills (persistence, trying even when something goes wrong, working in a team, asking for help) learned in play now can help support them in the future in math classes, science classes, reading, and in their relationships. Now that is a lot from just a few more sets of toys! This is something I couldn’t have provided my kids without your support and I hope you understand how overwhelmingly grateful I felt when I got the email that said this project was funded (it actually came Christmas morning). Thank you so much, again.”

I tested my new cheap phone’s speed over AT&T’s cellular network and was shocked to see 60 Mbps down and 15 Mbps up. I got the same result testing in different locations on different days, all while connected via VyprVPN. Perhaps I missed some mobile speed developments while using my ancient iPhone 5 that I bought when LTE had just been rolled out.

Replacing my old phone was my #1 priority, while replacing my equally old laptop was #2. I ordered one from Amazon at a great price, but it was delivered yesterday with a giant gash in the package and a cracked display (thanks, US Post Office). I had the issue resolved in a couple of minutes – click Return on the online order on Amazon.com, provide a reason, choose refund or replacement, and print a UPS-paid return label (or schedule a free pickup). Today I got an apologetic email from Amazon’s Akshay, who fast-tracked my replacement to two-day shipping, passed my problem on to “the higher authorities at Amazon,” and wished me “a beautiful day.” You want to know why Amazon is killing retailers, look no further.

I’m enjoying the responses to my “best career advice” survey, so much so that I’m encouraged to remind you to respond if you are so inclined. 


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Here’s the recording from last week’s HIStalk-sponsored webinar, “3 Secrets to Leadership Success for Women in Healthcare IT,” presented by Nancy Ham (WebPT) and Liz Johnson (Tenet Healthcare).


Acquisitions, Funding, Business, and Stock

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India-based outsourcing firm Infosys will hire 10,000 Americans over the next two years and will open four technology and innovation hubs, the first in Indiana. Perhaps the company hopes everyone will forget that it paid $34 million a few years back to settle charges of widespread US immigration fraud. Several offshore companies, worried about President Trump’s “Hire American” policies, have announced similar hiring programs, although experts question whether the highly publicized plans will ever materialize.

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The board chair of EpiPen maker Mylan was paid $164 million last year, will receive $1.8 million per year now that he’s no longer an employee, and was given another $37 million worth of stock. Even though he’ll remain as board chair, he received a $22 million termination benefit, including $4.6 million to use the company’s jets for three years. I tried listening to music by his son Tino Coury, who is signed to the record label owned by good old Dad, and it’s really no better or worse than most of the other imitative, sterile, computer-enhanced dance music out there. Dad was caught in 2012 using Mylan’s jets to haul Tino around to concerts, but that shouldn’t be an ongoing problem since Tino’s musical career seems to have died young.

Baptist Memorial Health Care (TN) and Mississippi Baptist Health Systems (MS) complete their merger to form a 21-hospital, 16,000-employee health system. The president and CEO of Mississippi Baptist says, “With the cost of technology, it makes sense to spread that over 22 hospitals.” Baptist’s Epic system is being installed at Mississippi Baptist.

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The Chicago business paper profiles 13-employee care coordination software vendor PreparedHealth, which just raised $4 million in its first significant funding round. The co-founders came from Medicity.


Sales

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Athenahealth chooses electronic prescribing legal updates from Point-of-Care Partners to ensure its compliance with state laws.

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HealthlinkNY selects Diameter Health for normalizing, de-duplicating, and enriching clinical data to enable interoperability and allow the HIE to advise members on the quality and completeness of their clinical documents.


People

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The board of UMass Memorial Health Care (MA) elects health IT entrepreneur Rick Siegrist, MS, MBA as chairman. He founded decision support vendor HealthShare Technology (sold to WebMD in 2005 for $31 million) and PatientFlow Technology (sold for an unstated price to Press Ganey in 2009, who made him CEO).

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Medicare and Medicaid fraud detection software vendor MedicFP names board chair and private equity firm owner Ruben Jose King-Shaw, Jr. to the additional role of CEO. He was formerly secretary of Florida’s AHCA and deputy administrator and COO of CMS. The company offers biometric identity validation.

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LifeBridge Health (MD) promotes Jonathan Ringo, MD to president and COO of Sinai Hospital of Baltimore. He joined health system in 2014 as its first CMIO. 


Government and Politics

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ONC announces a $75,000 patient matching algorithm challenge, apparently giving up on the idea of a national patient identifier that would make such fuzzy logic necessary.


Innovation and Research

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Johns Hopkins University’s venture arm opens FastForward 1812 — the latest of its several business incubator locations — which will support companies hoping to create products based on Hopkins patents and licenses. Baltimore-based EHR security vendor Protenus was launched in the original FastForward.

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MIT researchers develop WiGait, a wall-mounted sensor that can measure the stride length of multiple people over time to potentially detect injuries and gait-affecting conditions such as Parkinson’s disease


Other

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Friends and family members of patients in 150 NHS hospitals are forced to pay per-minute charges to call their rooms, which includes having the meter running while listening to a 70-second-long “please be patient” message. The government outsourced phone services to in-room entertainment vendor Hospedia, which says it uses a third party’s service that allows it to give each patient’s room its own telephone number instead of being routed through the nursing station.

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In England, five hospitals of Barts Health NHS Trust are cancelling surgeries and chemo treatments after the failure of its radiology, PACS, dictation, and chemotherapy systems. A hospital manager’s email said cancer teams had to rebuild patient records from scratch. Systems were restored Tuesday after being down for 11 days. Barts declined to describe the cause of the problem, but previously had major downtime in January caused by a Trojan malware attack

In Australia, Northern Territory budgets $60 million for the first year of its $195 million clinical systems replacement project, for which it will name a prime contractor this month from the short list of Telstra Health, Epic, Allscripts, and InterSystems.

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A study published in Health Affairs finds that high-priced medical practices – which charge an average of 36 percent more than low-priced ones – offer better care coordination and management, but don’t perform any better in overall care ratings.

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Weird News Andy concludes that in not focusing on the job at hand, “Now he’s broker.” Miami-based OB-GYN Ata Atogho, MD is hit with a $34 million malpractice lawsuit judgment for a series of mistakes he made in the delivery of a baby who was born with brain damage, one of which was to disappear from the mom’s room for eight minutes to consult with his stockbroker.


Sponsor Updates

  • LogicStream Health will host a happy hour Tuesday at The Great Dane Pub in Madison, WI during Epic XGM 2017.
  • Spok releases part two of its mobility in healthcare survey report.
  • Optimum Healthcare IT renames its go-live support application GoLiveSupport.com as Skillmarket.
  • CenTrak launches a charitable program to provide enterprise location services to cancer centers, with Vidant Medical Center (NC) the first participant.
  • Mediware will integrate CoverMyMeds electronic prior authorization into its CareTend specialty pharmacy software.
  • The Milwaukee Journal Sentinel names Nordic to its Top Workplaces for 2017.
  • Aprima Medical Software receives the 2017 United States Frost & Sullivan Award for Product Leadership.
  • Arcadia Healthcare Solutions publishes a Quick Guide on “Identifying Childhood Immunizations.”
  • AssessURhealth wins the GE Health Cloud Innovation Challenge.
  • Datica CEO Travis Good, MD will speak at the HITRUST Annual Conference May 8-11 in Dallas.
  • Besler Consulting releases a new podcast, “Coding clinic updates for first quarter 2017.”
  • CCSI employee Keith Yourg earns PMP certification.
  • Bottomline Technologies reports Q3 results.
  • Casenet announces the speaker lineup for its Connect event May 8-10.
  • CoverMyMeds will exhibit at the Oncology Nursing Society Annual Congress May 4-7 in Denver.
  • Direct Consulting Associates will exhibit at eMUG: Michigan User Group May 9 in Ypsilanti.
  • Diameter Health contributes to record growth at the University of Connecticut’s Technology Incubation Program.
  • The Virginia Chamber of Commerce includes Divurgent in its annual list of fastest-growing companies.

Blog Posts


Contacts

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

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Morning Headlines 5/2/17

May 1, 2017 Headlines 12 Comments

How science fares in the US budget deal

Congress passes a bi-partisan budge that will fund the government through the end of the fiscal year on September 30, including a 6 percent bump in NIH funding, and additional funding earmarked to establish a telehealth center of excellence.

Vanderbilt is a case study for the dreaded EHR conversion

Modern Healthcare profiles Epic’s $214 million implementation at Vanderbilt University Medical Center as it prepares for its November go-live.

VA partners with Department of Energy on big-data initiative to improve health care for Veterans

The VA is partnering with the Department of Energy to develop supercomputing capabilities that will analyze health and genomic data to help the VA improve its suicide prevention programs.

Cleveland Clinic CEO Toby Cosgrove talks about his decision to step down, time at the helm: Q&A

Cleveland Clinic CEO Toby Cosgrove announces that he will retire from his position by the end of the year.

Curbside Consult with Dr. Jayne 5/1/17

May 1, 2017 Dr. Jayne 3 Comments

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I’m doing some work with a health system that is migrating multiple hospital and ambulatory systems to a single instance of Epic. They have contracted with a number of third-party vendors to keep the proverbial lights on with their legacy applications while the core teams are incorporated into the Epic team.

At times, it’s been heartbreaking to watch. The Epic project team forced longstanding qualified employees to go through rounds of personality testing and interviewing, only to be denied an opportunity to join the Epic project. I’m personally happy to have these so-called “rejected employees” as part of the team that’s keeping things running because they have extensive experience and knowledge as well as being good people. It’s a shame that the health system has some mold they’re trying to fill for the Epic team because they’ve missed out on some talent.

I’m handling some clinical and regulatory work for the ambulatory applications, but another third party is handling any development work that is needed. There’s more development than I would have expected this close to a migration. The health system continues to purchase independent practices and wants to bring them live on EHR for reporting reasons. They are developing specialty-specific documentation templates that I’m pretty sure are never going to get used because they are for high-dollar subspecialists who prefer to dictate their documentation and aren’t going to sit and do a bunch of clicking just because an administrator asks them to. I’m confident their acquisition contracts didn’t include data entry, so the template development is a bit of a wasted enterprise to begin with.

The third-party development partner uses offshore resources and availability for meetings is an issue. I’m watching the stateside analysts pull their hair out because they’re being asked to get on calls at 10 p.m. local time to accommodate the offshore analysts, who have contractual limitations regarding calls during non-working hours. The US managers are aggravated because the most expensive resources are being stressed out by the hours. The analysts fear for their jobs if they don’t comply since they’ve already been passed over for slots on the Epic team and are likely to be candidates for a layoff after the go-live.

Apparently no one thought about these factors when they signed the agreement with the development partner, but I bet they will think about it next time. It’s just particularly sad because, again, they’re spending a lot of resources on templates that aren’t going to be used (and even if they are used, it will only be for a few months). They’re also burning out dedicated workers who have served the healthcare system for years and have a lot to offer.

I’ve made the suggestion that they should halt the development project, create a stripped down data entry template, and then hire a couple of medical students or nursing students to do the data entry from the providers’ dictated notes each day. It would be more cost effective and create better goodwill for everyone involved, but of course no one is listening to the person who is best positioned to understand provider psychology, habits, and workflows.

I have to say that one of the more frustrating aspects of being a consultant is being expendable. If I was the CMIO or a medical director, my opinions might have more impact. But when you have two consultants contradicting each other, there’s some cognitive effort required to untangle the issues, which it seems some health systems aren’t eager to do.

I find this situation particularly ironic. Where I’m trying to save them money, aggravation, and employee morale, the other consultant is trying to sell them something that’s going to cost money, time, and frustration. It should be an easy decision, but healthcare decision-making is often less than straightforward. It seems to be an easier decision to do what has already been started rather than raise questions.

This situation also illustrates something I’m seeing more often, which is organizations that have so many consultants in the mix that they need resources just to manage the consultants and their activities. Different parts of the organization may have their own consultants doing the same work, or it may be contradictory. I’ve watched the office equivalent of a steel cage match when consultants hired by the finance team face off against those hired by the clinical team. One of the combatants will inevitably tag out to the IT team, which may be allying itself with one or both of the other teams depending on which way the organizational winds are blowing.

There is a lot of time, money, and energy wasted in these non-coordinated approaches, but I’ve seen multiple situations where no one is willing to step in and stop the madness. I try to do my best (within the confines of my engagement and the personal relationships I’ve built at the organization, of course) to calm things down where I think I can make a difference, but it’s definitely challenging.

When I see these situations, it generally points to a larger problem with organizational leadership and a lack of executive sponsorship at the appropriate level. When organizations are having functional leadership meetings and various teams have a common understanding of organizational goals and budgetary and time constraints, the situations are much more productive. Teams with potentially competing initiatives can actually talk to each other and work together for a solution that creates common ground rather than succumbing to an “us vs. them” mentality.

With my current client, I’m hoping that while doing engagements to support their legacy software, I’ll be able to build relationships and the political capital needed to approach them with an engagement around the change leadership and management challenges that are the root of many of their struggles.

Unfortunately, it feels like they see the move to Epic as the be-all, end-all that is going to solve their problems. It may solve some problems, but it’s going to create new ones that they’re not expecting, or exacerbate underlying issues that they may have overlooked. History tends to repeat itself in these situations and I would love to see greater information sharing among those in the trenches so that they can avoid the pitfalls that I see over and over. There’s only so much I can do from the consulting perspective, but I’m going to keep trying.

How many consultants are involved at your organization? Email me.

Email Dr. Jayne.

Morning Headlines 5/1/17

May 1, 2017 Headlines No Comments

Athenahealth (ATHN) Q1 2017 Results – Earnings Call Transcript

Athenahealth shares fall 20 percent in trading Friday following its report of Q1 results. In its earnings call, CFO Karl Stubelis said that lower than anticipated claims and collections volumes, more aggressive sales promotions, and slower on boarding of clients were the primary drivers of revenue falling below expectation.

Meditech 10-Q

Meditech reports Q1 results: revenue remained flat at $117 million, EPS $0. vs. $0.51. Net income has dropped 23 percent compared to the same period last year, while dividends paid  per share has remained level.

Cerner (CERN) Q1 2017 Results – Earnings Call Transcript

On Cerner’s Q1 earnings call, CFO Marc Naughton reports that strong software license sales and technology resale drove its quarterly revenue up 11 percent to $1.26 billion.

U. Health Care CEO Vivian Lee resigns after cancer institute controversy

University of Utah Health Care System CEO Vivan Lee resigns following an incident in which she fired the director of the health system’s cancer institute via email. Lee has also been caught in the fallout from a recent STAT news investigation on NantHealth exposing questionable donations coming from Patrick Soon-Shiong, MD, passing through University of Utah Health Care System, and then almost entirely returning to NantHealth.

Monday Morning Update 5/1/17

April 30, 2017 News 1 Comment

Top News

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From the Athenahealth investor call, which follows disappointing revenue and earnings quarterly results that sent shares down 19 percent Friday:

  • CFO Karl Stubelis blamed the miss on lower-than-expected claims. lower collection volumes, and slow onboarding of new customers.
  • The company lowered revenue, earnings, and bookings guidance for the fiscal year and expects a lower operating margin for 2017.
  • Jonathan Bush says office visits and payment per visit are both down for the first time, bucking the trend caused by hospitals buying practices and increasing their prices. He attributes the drop to consumer uncertainty around the Affordable Care Act and higher deductibles that consumers are unwilling or unable to pay.
  • Bush said, “When we get into a meeting with a prospect and that prospect decides to do something, 80 percent of the time they go with Athenahealth. That doesn’t suck. That does not suggest retrenching, going to cash flow, ceasing the entry of the hospital market. It suggests breathing into the beating until things get better, which we believe they will.”
  • Bush says the company had planned for doubled customer attrition for the year after its rollout of the Streamlined clinical product, but Net Promoter Scores have since rebounded.
  • The company was not considered in some deals due to its lack of a viable inpatient product, but Bush expects that to change as it expands its inpatient EHR, which he describes as, “For a one-year-old product, kicking ass” that more than pays for itself with elimination of capital expenditures and an improvement in collections.
  • Future drivers of what Bush says will be a restored higher growth rate are improved scalability of the inpatient product implementation, a cost guarantee for doctors, and automating practice tasks beyond previous government-mandated functionality.
  • Bush disagreed with an analyst’s slightly combative observation that the company’s guidance is aspirational and often at odds with actual results, thereby reducing investor confidence, saying, “While our goals remain ambitious, our guidance is something that we think is a balanced handicapping of what we think will actually happen on the field. My goals, my team, the guys who are out there in the field still think they can get this number, but they’re not prepared to reassure you in that regard … One thing we all took for granted is that Athena would know its revenue a year out … The one place that we all need to get our confidence back is understanding the activity in the practice. And believe me, we’re studying it.”
  • Bush concluded the call with, “Metamorphosis hurts. We’re feeling the crunch of several coming-of-age moments all at once here at Athenahealth. Attrition hangover from last year’s Streamlined rollout and the customer service issues, adjustments to Trumphealth from Obamahealth, a totally new guard at our senior management team, a tale of employee disruption from the change to it. Adjusting guidance hurts us, but it’s mostly the shame of coming to grips with that hurt. Our strategy is right, our traction against our challenges is better than ever, and optimism at the senior-most levels of this company is at an all-time 20-year high. Hence we enter execution mode.”

Reader Comments

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From Carrot Bottom: “Re: MUMPS. Curious, you mentioned a blog post about developers complaining about MUMPS. It wasn’t very long after your post that you changed the link from Hacker News to some academic professor’s personal wiki on MUMPS. Now when I go to the original Hacker News link, it also has been taken down. Were you pressured to remove this information by an unknown legal team from Wisconsin?” I didn’t change the link in my original post from Hacker News and that link still works. However, in trying to figure out what you are referring to, I noticed that Lt. Dan (who writes the daily headlines) inadvertently used a different link in his headline. I actually didn’t get any private feedback on that post.

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From Harry Angstrom: “Re: Jonathan Bush’s Instagram. This was quickly removed a few minutes later.” Unverified. The screenshot shows JB’s comment to Friday’s huge ATHN share price drop as, “K Thanks Bye.” Regardless, his other photos provide a glimpse into what life is like being raised rich and living hyperactively smart and quirky (like being one of a tiny number of trust fund kids to commendably serve in the Army).

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From Causative Agent: “Re: charity for sale. Given your stance on charities, I thought you would find this highly offensive and in-your-face advertisement interesting.” An unnamed Dallas charity offers itself for sale for $2.4 million, urging prospects to “do the math” since they can “legally keep $200,000 as a salaried director.” Beyond enriching the new owner, the charity sends handicapped children to Orlando theme parks “and helps other charities as well,” with the owner helpfully suggesting expansion via new fundraising offices, telethons, squeezing business for donations, and running galas. I couldn’t figure out which charity it is, but I’d be curious about its reviews on Charity Navigator, Guidestar, and CharityWatch. Most surprising to me is that somebody can just “sell” a charity to whomever ponies up the cash, although I supposed the owner can simply install the buyer as board director and then resign even though the assets can’t be transferred short of a merger with another non-profit. For that reason, paying $2.4 million to buy a $200K job seems like bad financial planning, and hopefully the new owner will reap what they sow. 

From Soiled Skivvies: “Re: suck-up writers. This writer lost objectivity and it’s obvious they were star-struck.” Much of the health IT content out there is written by newbies, underachievers, and raging introverts who are way too easily influenced by the phony, smarmy charm of some Type A industry bigwigs who turn it on knowing they’ll get uncritically positive PR as a result. It’s kind of like being that cubicle-bound programmer who mistakes minor casual exposure to the boss as newfound social acceptance. The inhabitants of mahogany row did not ascend to the throne being unaware of the org chart caste system and they are not like you. Which is probably OK since someone has to have the swagger, however misplaced, to get everybody else to follow orders.


HIStalk Announcements and Requests

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Poll respondents predict that the VA’s biggest problem if it decides to implement Cerner or Epic will be budget overruns, with lack of internal resources being another potential problem. Red Tape goes with “none of the above” in predicting that governance and bureaucratic decision-making will create an impossible struggle to stay on track. Daddio62 warns Cerner clients that if the company wins the deal, it will pull their experienced consultants off to the VA and replace them with greenhorns. Art Vandelay (welcome back, Art) says VistA was built around requirements that have no equal in the rest of the healthcare world and says user acceptance of a COTS will be a problem, possibly requiring a wrapper solution around the core product to support the VA’s unique needs. Cerner User also warns of the limited availability of skilled Cerner consultants and the pressure on the VA to increase productivity that will conflict with clunky software workarounds that reduce productivity.

New poll to your right or here, based on a reader’s comment: Have you ever bypassed your insurance and paid cash to choose a better ongoing PCP? It’s often depressing to have to settle when choosing a new PCP from your insurance company’s provider list (which is usually not only outdated, but fails to note that most of the docs listed aren’t taking new patients for their particular low-paying plan). You are often out of luck if you want a doctor who’s been out of school long enough to not be dangerous yet who isn’t past normal retirement age; one who attended a decent US medical school and residency; or a PCP whose Healthgrades reviews are better than appalling. In other words, you might not want to join a club that would accept you as an insurance-wielding member, while plopping down cash opens up endless (but expensive) possibilities. I suspect most of us just grit our teeth and choose the best-sounding of the substandard choices who will accept our insurance.

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We funded the DonorsChoose grant request of Mrs. R in California, who asked for egg shakers and a rhythm set so her elementary school students can have fun with music as a break between tough subjects. She reports, “We have Fun Friday every week and I have been able to give a small music and rhythm class using the instruments and shakers. It is a hit! The students love it! Sometimes we make our own music and sometimes we follow along to child-friendly versions of today’s radio hits. Other teachers have noticed the fun and have borrowed the instruments and shakers to enjoy with their students. It has been a true blessing to have the instruments and shakers as a stress reliever for both the students and myself!”


This Week in Health IT History

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One year ago:

  • Nokia announces plans to acquire consumer health device vendor Withings to create Nokia Digital Health.
  • CMS releases the warning letter it sent to Theranos in which it stated that, “The laboratory’s allegation of compliance is not credible.”
  • Verks Analytics agrees to sell its Verisk Health business to Veritas Capital for $820 million.
  • Caradigm quietly announces that Microsoft has sold its 50 percent stake in the company to JV partner GE Healthcare.
  • A science publication questions the privacy and exclusivity terms contained in the agreement between NHS and Google’s DeepMind.
  • Quintiles merges with IMS Health.
  • Joint Commission gives its OK (later reversed) to send orders via text messaging.

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Five years ago:

  • Allscripts shares lose more than one-third of their value following announcements of poor quarterly results, the departure of its CFO, the firing of board chair Phil Pead, the resignation of three board members who supported firing Glen Tullman, Tullman’s erratic defense of his performance in the investor call, and the company’s loss to Epic in two UK decisions.
  • Merge Healthcare shares shed 36 percent on poor quarterly results, with the company announcing that it will divide itself into two operating divisions, the traditional Merge imaging business led by Jeff Surges and a consumer kiosk and clinical trials division under Justin Dearborn.
  • Chicago Mayor Rahm Emmanuel pressures the state’s attorney general to back off its investigation of Accretive Health’s strong-arm patient collection tactics.
  • New health system CIO hires include Jocelyn DeWitt (University of Wisconsin Health) and Pamela Banchy (Summa Western Reserve Hospital).

Weekly Anonymous Reader Question

I asked readers to who have either considering quitting HIMSS or who have actually done so what motivated them:

  • Almost useless organization. What Epic has done to hospital IT cost should never have happened. HIMSS needs to be more than a vendor show.
  • Simply cost vs. benefit. HIMSS motives are suspect anyway.
  • Annual conference was my main involvement. It’s gotten too big to be useful. One cannot do anything of substance on the exhibit floor. Classes have been good, but it’s just too much. I’d rather be involved in a more focused group, like ATA (telemedicine) or something like that. Cramming it all into one show dilutes things.
  • I have been an individual member for over 20 years. No longer! Not continuing membership or attendance at national events. HIMSS is just about money, vendors, and more money. But the main reason is association with Federal government and DOD has taken over focus. Government nerds are not technological leaders. They have nothing to offer healthcare technology … boring bunk. Finally just bored with the agenda.
  • Increasing irrelevance ever since HIMSS changed from a member-driven org to a "mission"-driven one. Individual members have little impact or recognition, even those who donate numerous hours on committees. Smaller specialty associations provide more return on the membership fee. Also hard to justify the annual conference cost when the only value is networking.
  • Retirement.
  • I considered quitting until I changed my expectations from education and knowledge acquisition to it being a huge shopping mall. It fits that bill, not the other. It’s a reasonable way to keep in touch with product domains.
  • It has become such a racket. It has become nothing more than a vendor forum, which is very disappointing.
  • I left HIMSS about 15 years ago because: (a) the organization became exceedingly political with no requests for input from members, and (b) the focus shifted from users to vendors and thus had little value to me.
  • I did not renew in 2017 because of the increasing power of the vendor. The last straw was that the head of my state chapter was a vendor who behaved very badly in my organization (e.g. contacted board members when he didn’t get what he wanted from me). I prefer CHIME over HIMSS because I don’t feel like I’m a sales target every time I am on a phone call or in a meeting.
  • Haven’t quit yet, but working at an HMO presently, I don’t see a lot of value in HIMSS other than interacting with members from the provider side. While that is of great value to me, over half of the new people I meet are consultants or contractors.
  • The cost outweighs the benefit.
  • HIMSS educational and networking offerings had value for me early in my career. Now, I have experience in the field and am not a decision-maker in IT investments. HIMSS repeats the same "Informatics 101" and "Learn about TIGER!" webinars every quarter and they seem to be efforts to market products rather than educate members. I don’t know if this is a change from past years, if I was less aware of the context in early days, or if I’ve just grown old and jaded. Now I only renew membership in years in which my employer sends me to the annual conference, since registration + membership is more affordable than registration as a non-member. Otherwise, I see no return on the investment. I’d rather pay membership dues to AMIA.
  • Former HIMSS member here. I quit because as an IS analyst supporting the revenue cycle side of operations, the HIMSS focus is clinical. I wasn’t seeing the value.
  • Too much focus on vendor revenue.
  • Worthlessness of HIMSS CPHIMS certification. They sell it relentlessly but don’t even support it with networking at the annual conference or advertising to employers.

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This week’s question: What’s the best career advice you’ve received that goes beyond the usual platitudes? In other words, not just “work hard, learn, market yourself” and other obvious recommendations.


Last Week’s Most Interesting News

  • Greenway Health is hit with a ransomware attack that affects customers of its hosted Intergy systems.
  • Cerner announces good quarterly results., while Athenahealth shares drop sharply on missed earnings and revenue expectations.
  • Leapfrog Group’s hospital patient safety participants report nearly universally available bar code medication administration scanning systems, but with inconsistent usage.
  • The Coast Guard issues an RFI for an EHR following its failed attempt to implement Epic.
  • Ambulatory EKG monitoring services vendor CardioNet pays $2.5 million to settle HIPAA charges following the 2012 theft of an employee’s laptop.
  • The Trump administration dismisses US Surgeon General Vivek Murthy, replacing him in interim with Deputy Surgeon General Rear Admiral Sylvia Trent-Adams, who is a nurse.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Acquisitions, Funding, Business, and Stock

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Meditech announces Q1 results: revenue flat, EPS $0.39 vs. $0.51. Product and service revenue were both basically unchanged over Q1 2016.

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From the earnings call of Cerner, whose Q1 results beat expectations for both revenue and earnings and sent shares up 8 percent Friday:

  • Domestic revenue increased 13 percent, while non-US revenue was basically flat excluding currency fluctuations.
  • The company noted several wins over Epic, which it says is in a defensive stance following more coverage of its client cost overruns.
  • Cerner says its advantages over Epic are predictable total cost of ownership, more modern architecture, better ability to demonstrate value, and strong population health management capabilities.
  • The company says its Department of Defense work “is making Cerner better” in ways that will benefit all of its customers, adding that the remaining three DoD pilots are on track .
  • President Zane Burke says IT is the best way to drive down cost, which hasn’t been addressed by either party’s healthcare platforms that focus instead on access and insurance reform.
  • The company sold no new ITWorks IT management contracts in the quarter, but expects record sales of that product in 2017 as larger health systems conclude that some aspects of IT aren’t their core business.
  • Burke declined to specifically say if Cerner is taking ambulatory business from Athenahealth, saying only that, “We’re taking share from all competitors.”
  • Burke also declined to provide an update to previous comments that Cerner is seeking a CRM partner.

Sales

In the UK, Burton Hospitals NHS Foundation Trust expands its agreement with Summit Healthcare following its Meditech 6.1 go-live to include continued management of interface strategy, education, modifications testing, and developing additional interfaces as needed.


Decisions

  • OhioHealth Mansfield Health (OH) switched from Infor to Oracle PeopleSoft supply chain management in December 2016.
  • Franklin Memorial Hospital (ME) will replace Meditech with Epic in 2018.

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


People

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Nordic promotes Vivek Swaminathan to president of its managed services division; Katherine Sager to EVP of consulting services; and Matt Schaefer to EVP of strategic services. 


Other

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In Canada, 15 internists at Nanaimo Regional General Hospital go back to paper medication ordering in defiance of Island Health’s mandated use of its Cerner system dubbed IHealth. Doctors have long complained that the system causes medication errors. One of the internists was given a one-day suspension and another faces disciplinary action. The hospital says it can’t support paper orders and therefore has assigned other doctors to enter their paper orders into the EHR. Island Health previously tried bribing doctors to use IHealth, while the hospital’s ICU and ED doctors had gone back to paper in May 2016 — nine weeks after rollout — because of patient safety concerns. Island Health shut the CPOE system down in February 2017 following a 75 percent no-confidence vote by the medical staff, but restarted it a month later in saying it is too connected to other systems remain offline.

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University of Utah Health Care CEO Vivian Lee, MD, MBA resigns after she fired its cancer center director by email and following her acceptance of questionably motivated donations from NantHealth’s Patrick Soon-Shiong. Billionaire donor and cancer survivor Jon Huntsman’s threat to withhold his planned $250 million donation to the cancer center named after him forced the university to reinstate the fired director and to rearrange the org chart so that she reports directly to the university’s president. Huntsman called Lee a “one-person wrecking crew” and “the least ethical, least disciplined woman in the world.” Meanwhile, Utah House Speaker Greg Hughes has asked state auditors to review Soon-Shiong’s $12 million donation – which a STAT report suggested came with strings attached in requiring the university to buy products from his various companies – to determine whether a formal state audit is warranted.

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NBC News covers the often expensive consumer confusion between doc-in-the-box urgent care centers and freestanding emergency rooms, highlighting the case of a mother who pulled in what looked like a retail clinic in getting antibiotics for her daughter’s chest infection that ended up costing her $1,700 (later reduced to $1,000). She was flabbergasted when her insurer told her that PrimeCare Emergency Center is actually an ED, replying, “It was next to a nail place!” The report says 35 states allow freestanding ERs, most of them as off-campus hospital locations, but some are operated by for-profit companies. A class action lawsuit claims that now-bankrupt Adeptus Health, which runs 99 freestanding ERs, intentionally tricks patients into thinking they’ve entered a cost-effective urgent care center. A couple who took their child to an Adeptus ER racked up a $7,700 bill for an X-ray and pain reliever for what turned out to be constipation. 

Here’s Vince and Elise with their HIS-tory of the top 10 physician practice EHR vendors. 


Sponsor Updates

    • QuadraMed, a division of Harris Healthcare, will exhibit at the CHIMA Annual Meeting May 4-5 in Westminster, CO.
    • The SSI Group will exhibit at LA HFMA Annual Institute April 29 in Lafayette, LA.
    • SK&A publishes the “2017 Guide to Effective Email Marketing.”
    • GE Healthcare partners with Partnerships for Affordable Health Access and Longevity to address the healthcare needs of underserved communities in India.
    • Sunquest Information Systems releases a video celebrating Medical Laboratory Professionals Week.
    • Surescripts will exhibit at the annual Health Plan and Payer Summit April 30-May 4 in Washington, DC.
    • Wellsoft will exhibit at Emergency Medicine Update May 3-5 in Toronto.
    • ZeOmega will host its annual client conference May 2-4 in Plano, TX.
    • ZirMed will exhibit at ASCA 2017 May 3-6 in Washington, DC.

    Blog Posts


    Contacts

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

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    Morning Headlines 4/28/17

    April 27, 2017 Headlines No Comments

    Medication Safety

    Leapfrog Group publishes safety results on electronic bedside medication administration, finding that while 98 percent of hospitals have software in place to support electronic medication administration, only 30 percent fully utilize the technology.

    Greenway Health Reports Criminal Cyber Attack Affecting Certain Customers

    Greenway Health is hit with a ransomware attack impacting users of its cloud-hosted Intergy platform. The company says it plans to restore client data from backups.

    Cerner Reports First Quarter 2017 Results

    Cerner reports Q1 results: revenue climbed 11 percent to $1.26 billion, adjusted EPS $0.59 vs. $0.53, beating analyst expectations for both.

    Wanted: Feedback on Ways to Measure the Implementation and Use of Interoperability Standards

    ONC solicits feedback on its proposed interoperability standards.

    News 4/28/17

    April 27, 2017 News 8 Comments

    Top News

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    A Leapfrog Group report finds that while 98 percent of hospitals have bar code medication administration scanning technology connected to their EHR, only 30 percent of those hospitals are meet ingLeapfrog’s BCMA standard.

    The most common reasons for falling short are (a) not having all seven decision support elements available (most often missing were vital signs and allergies), and (b) not using the BCMA system in at least 95 percent of total bedside administrations.


    Reader Comments

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    From Dad’s Tie: “Re: David Butler’s article. That guy is terrific. What he describes is exactly what my hospital organization needs.” Agreed. Dave’s article on marketing IT, written from his health system CMIO perspective, is a breath of fresh air. I hope he contributes regularly.

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    From Industry Watcher: “Re: Caradigm. Another huge round of layoffs last week with nearly the entire senior leadership team included other than the CEO.” Unverified. The cached version of its leadership page from three weeks ago suggests that seven of the 13 executives have departed, including four of five SVPs. I don’t assume that executive turnover under a new CEO is necessarily a bad thing, though (except obviously it often is for the people who are gone). Companies usually bring in new blood to make changes, not to preserve the status quo.

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    From Unimpressed: “Re: Greenway Health. Working with the FBI after being hit by ransomware. Hosted customers on one of their platforms are still down, possibly until Monday. The company has had a long period of bad news and execs jumping ship.” Greenway says the attack affects its Internet-hosted Intergy customers, but adds that it expects to restore all their data from backups. The company was also involved in 2016 breach in which it misconfigured the patient portal of Florida Medical Clinic so that some patients could view the balance due statement of other patients. With regard to executives, the year-ago cached version of Greenway’s leadership page suggests that five executives remain of the 12 listed then. Greenway Health was formed in 2013 when Greenway Medical Technologies was taken private by Vista Equity Partners and combined with Vitera (the former Sage Software, previously Medical Manager) and SuccessEHS. Greenway’s HIMSS17 booth was noticeably downsized.

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    From Expired Mallow Cup: “Re: IT history. Forty years ago today, I started my first IT (data processing in those days) job at a hospital. I am showing people a 1977 photo of my desk with no PC in sight – I started with a mainframe with punched cards. Today I am working at a hospital converting from Soarian to Cerner Millennium. I’ve decided to stick around to support Soarian, but no Millennium for me. When they insist that we take our 390+ order sets that I have built on Soarian and duplicate those on spreadsheets for some young just-out-of-college person at Cerner to then transfer using the nice build tool in Millennium (that we’re not allowed to touch until August), I was out of here. Having to tell a physician that their problem entering medication orders is a known bug and they have to hand-write the order because it won’t be fixed for a few months — I’ve had enough of getting yelled at over the phone. Read your posts every day when I can. Thanks for letting me vent.”

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    From Dangling Participle: “Re: County of San Bernardino, CA. Has posted an RFP for a new EHR to replace Meditech C/S after halting efforts to connect to a neighboring hospital’s Epic system last year.” Looks right — I found this RFP for Arrowhead Regional Medical Center that also includes possible expansion throughout the county’s entities.  


    HIStalk Announcements and Requests

    One day after whining about the paucity of good Readers Write submissions, I received two excellent ones from David Butler and Joe Petro. I’ll use those a springboard to urge readers (especially non-vendors) to write pieces of their own. The process is good for organizing and presenting thoughts, the content is more important than writing perfectly, and the audience is substantial.

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    We funded the DonorsChoose grant request of Ms. S in Missouri, who asked for an Osmo coding set, a pencil sharpener, and five sets of headphones for her second grade class. She reports, “My class is able to stay engaged in their learning without distractions from those around them now that we have enough headphones for everyone. They are learning so much from the coding Osmo. They are becoming deep thinkers and problem solvers with this interactive tool. These skills will be lifelong necessities for them as our world becomes more and more digital. Thank you for being a part of creating an equipped tomorrow. We are extremely appreciative of people like you.”

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    The mental and physical decline of my four-year-old iPhone 5 was accelerating, with puzzling call failures, poor LTE connectivity, and sluggish performance. Since I don’t use my phone broadly (mostly just browsing, checking email, and GPSing while away from home), I just couldn’t get excited about spending $800 or more on an iPhone or Samsung Galaxy. I did a lot of research and concluded that beyond fanboy upgrades, the smartphone market has matured, with little innovation and sales that are propped up by user ego rather than added value. My solution: Motorola’s Moto G Plus from Amazon Prime for an astounding $240 (partially subsidized by Amazon lockscreen ads that I don’t find intrusive, plus I’m always using Amazon services anyway). Features:

    • It’s unlocked, so you can easily swap out the SIM at any time when traveling overseas or changing carriers. I popped my own AT&T SIM in without incident.
    • The Moto G has 4 GB of RAM and 64 GB of storage, plus it accepts a standard Micro SD card that allows adding up to 128 GB more storage for around $50.
    • It comes with a nearly stock version of Nougat, the latest version of Android (Google, thank you again for creating a competitive market in developing Android). The learning curve in moving from iOS is nearly zero.
    • Battery life is long and the TurboPower charging adds six hours of use after just 15 minutes of plugged-in time.
    • Content that’s connected to your Google account (Gmail, Maps, YouTube, Drive, Photos, etc.) is instantly available on the phone.
    • The fingerprint sensor works great to lock/unlock and is placed on the front of the phone where it belongs.
    • The camera is 12 MP and the front one offers a wide-angle selfie cam that I’ll probably never use (since as a curmudgeon, I find selfie-takers to be irritatingly vain and self-congratulatory).
    • It fits in my pocket even though the display is much larger, sharper, and brighter than that of the iPhone 5.
    • It’s so cheap that phone insurance or delayed future upgrades are unnecessary.
    • The only items I’ve missed: FaceTime (use Google Duo, Skype, or my choice, WhatsApp, instead) and “unread items” counter badges aren’t displayed on individual app icons – use a third-party app like Nova Launcher to add them or just pay attention to the notification bar and lock screen messages.

    This week on HIStalk Practice: Prime Healthcare ACO (CA) implements population health analytics and benchmarking from Persivia. DiagnosisAI develops new Alexa medical advice skill. Salus Telehealth adds urgent care consult capabilities. Portland healthcare darling Zoom gets exits the health insurance business. Consumers keep their enthusiasm for AI-powered healthcare to a minimum. SimonMed Imaging signs with Zotec Partners. Oncology Consultants selects Navigating Cancer technology. US Oncology Network physicians discuss carrots versus sticks when it comes to VBC compensation.


    Webinars

    April 28 (Friday) 1:00 ET. “3 Secrets to Leadership Success for Women in Health IT.” Sponsored by HIStalk. Presenters: Nancy Ham, CEO, WebPT; Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC CIO, Acute Care Hospitals & Applied Clinical Informatics – Tenet Healthcare. Join long-time C-level executives Liz Johnson and Nancy Ham as they share insights from nearly three decades of navigating successful healthcare careers, share strategies for empowering colleagues to pursue leadership opportunities, and discuss building diverse executive teams. This webinar is geared toward female managers and leaders in healthcare IT seeking to further develop their professional careers. It’s also intended for colleagues, executives, and HR personnel who are looking to employ supportive techniques that ensure diversity in the workplace.

    Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


    Acquisitions, Funding, Business, and Stock

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    Health system supply chain technology vendor Jump Technologies raises $3.5 million in a venture funding round.

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    Urgent care PM/EHR vendor DocuTap acquires Atlanta-based Clockwise.MD, which offers patient queue management and survey systems.

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    Athenahealth reports Q1 results: revenue up 11 percent, adjusted EPS $0.32 vs. $0.34, missing expectations for both. Shares were pounded in early after-market trading following the announcement, down 16 percent.

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    Cerner reports Q1 results: revenue up 11 percent, adjusted EPS $0.59 vs. $0.53, beating expectations for both. Shares were up 4 percent in early after-hours trading.


    Sales

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    University of Michigan Health System chooses Phynd for managing the information of its 67,000 providers across its clinical systems.


    People

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    Dana Moore (Centura Health) will join Children’s Hospital Colorado (CO) as CIO.

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    Precision medicine technology vendor GNS Healthcare hires Ben Bielak, MS, MBA (Harvard University) as CIO.

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    Point of Care Decision Support names Jay Syverson, MBA (Coherent Solutions) as president.

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    Solutions vendor Formativ Health hires David Harvey  (Health Healthcare) as CTO.

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    Datica promotes Kevin Lindbergh to chief revenue officer.


    Announcements and Implementations

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    MedData launches MyMedicalMe, a mobile app that allows users to manage their medical bills.

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    Partners HealthCare’s Connected Health expands its Online Second Opinion Service to allow collecting medical records, radiology, and pathology results through West’s HealthAdvocate Solutions.

    A Kyruus study of 40 health system call centers finds that three-quarters of them can’t match callers with an available appointment within the following three weeks, 60 percent are unable to meet gender-specific provider requests, and half are incapable of matching a patient with providers in their desired location.


    Government and Politics

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    ONC seeks feedback on a proposed measurement framework for interoperability.


    Privacy and Security

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    Microsoft ends support of Windows Vista, which doesn’t necessarily mean that PHI-containing systems running on it constitute a HIPAA violation, but HHS says the resulting lack of security patches in unsupported operating systems warrants risk analysis (translation: you’re screwed if your old OS’s lack of security patches allows a breach). Windows 7 is the next to cross the rainbow bridge in early 2020 and then it’s Windows 8 in 2023.

    In England, a 20-year-old man who had made $300,000 from selling a distributed denial-of-service attack tool that he built when he was 15 is sentenced to two years in prison.

    A former Army sergeant pleads guilty to filing fraudulent tax returns using UPMC patient data that be bought from an online hacker marketplace.


    Other

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    Brigham and Women’s Hospital (MA) offers voluntary buyouts to 1,600 employees, warning that a lack of takers will require layoffs.

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    Moody’s affirms Vanderbilt University Medical Center’s bond rating, but observes that its financial performance will temporarily moderate with its November 2018 implementation of Epic.

    A NEJM opinion piece takes a mixed view from the “what problem are we trying to solve” perspective of requiring investigators who are running clinical trials to share their data with other researchers. It notes that data sharing increases clinical trial cost, assumes that whoever consumes the published data can really understand it since they weren’t involved in collecting it, and devalues the “currency of academic achievement” in giving investigators less opportunity to publish career-enhancing journal articles. The author also notes that participation in such sharing has been minimal and research benefits are uncertain despite the theoretical advantages.


    Sponsor Updates

    • Eye Care Leaders, which offers an EHR for optometry and ophthalmology practices, will integrate DrFirst’s medication management and e-prescribing into its products.
    • Phynd is exhibiting at NAHAM in Dallas, TX this week.
    • LogicWorks achieves AWS Service Delivery Partner status.
    • MedData will exhibit at the Advanced Institute for Anesthesia Practice Management April 29-May 1 in Las Vegas.
    • CloudWave’s OpSus Live infrastructure as a service earns its third annual Best Practice rating in the Meditech Infrastructure and Supporting IT Process Audit.
    • Meditech will exhibit during HIMSS UK e-Health Week May 3-4 in London.
    • ROI Healthcare Solutions will sponsor the Inforum Conference July 10-12 in New York City.
    • Zynx Health customer North York General Hospital wins the 2016 HIMSS Enterprise Nicholas E. Davies Award of Excellence.
    • Navicure will exhibit at the Oregon/Washington MGMA meeting April 30-May 2 in Spokane, WA.
    • Health Data Specialists sponsors the Cerner Southeast Regional User Group May 3-5 in Jacksonville, FL.
    • Netsmart will exhibit at the Care Coordination Summit May 1 in Baltimore.
    • Revenue recovery software vendor Ontario Systems adds the ReconBot claims automation from Recondo Technology. 
    • Obix Perinatal Data System will exhibit at the AWHONN Michigan Annual Conference May 5 in Frankenmuth.
    • CloudWave achieves a best practice rating for OpSus Live.
    • PatientKeeper will exhibit at Hospital Medicine 2017 May 1-4 in Las Vegas.

    Blog Posts


    Contacts

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

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    EPtalk by Dr. Jayne 4/27/17

    April 27, 2017 Dr. Jayne No Comments

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    I attended the Physician Compare Benchmark and 5-Star Rating webinar this week. The team shared information about their new ABC Benchmark methodology and asked for physician feedback on the proposed approach.

    Frankly, after attending the webinar, I’m disheartened. What they are proposing is complex and there is debate about whether a cluster method or equal-ranges method should be used to assign the ratings. There is also debate on what to do when providers are so high performing they can’t determine how to allocate fewer than five stars. For those measures, they’re discussing only displaying those providers who had five stars vs. not displaying those measures at all. It seems counterintuitive to not report something that people are good at. Not to mention, if it’s this complicated, it’s going to be less meaningful for patients.

    At the beginning of the webinar, the speaker specifically stated that sometimes when they use a five-point scale, that people see it like school grades: A, B, C, D, F. But that’s not what they’re trying to do here, etc. I challenge the people involved in this to understand that most of the public is still going to see this like school grades. Regardless of footnotes or explanations on the website, people see three stars and think you’re a C performer.

    These ratings become even more complex for measures where everyone is doing well. So how about this proposal: set benchmarks related to a grade scale and let patients truly compare not only from physician to physician, but across measures. Say we want 100 percent of diabetic patients to have a foot exam. Ninety percent is five stars, 80 percent is four, 70 percent is three, etc. Or heck, just use letter grades to make it easier. Maybe your physician gets As and Bs on everything relevant to your needs and you’re good to go. Maybe they get Bs and Cs and you need to look for someone else. Maybe all physicians get a C on some measures, which helps you understand that it’s difficult to achieve. It certainly would save the millions of dollars they’re spending to put this together and would create a system that fits into an already accepted cultural schema rather than creating something new that takes a statistician to explain.

    The slides are available here if you want to check them out yourself, and if you want to share feedback, it can be sent to PhysicianCompare@westat.com with a subject line of “5-Star Rating Feedback” prior to May 10.

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    NCQA announced a new Oncology Medical Home recognition program, following the Patient-Centered Medical Home and Patient-Centered Specialty Practice models already available. They’ll host a webinar on May 5 to discuss the new program and how to achieve recognition. I’ve assisted several organizations through the NCQA recognition process and it’s not for the faint of heart (or the light of pocketbook).

    Regenstrief Institute, along with the American Medical Association, has launched a mock EHR tool for use by medical students. It contains simulated patient data and allows students to practice documentation along with processing information in a typical EHR format. These kinds of tools are increasingly needed as hospitals institute fragmented policies around whether students are allowed to document in the EHR, and if they are, what kind of user rights and training they receive. My hospital allowed students to use the EHR, but didn’t give them full rights for ordering, writing scripts, or many of the other functions they had in the paper world.

    The Regenstrief EHR Clinical Learning Platform tool was co-developed with Indiana University School of Medicine and is also in use at the University of Connecticut School of Medicine and the University of Southern Indiana College of Nursing and Health Professions. AMA will assist in its distribution.

    Given the expansion of patient-generated health data through home monitors, fitness trackers, and more, ONC has created a challenge to find solutions to the problem of capturing data provenance. I know many physicians who are reluctant to allow patient-generated data into the EHR due to concerns about reliability as well as quantity. Anyone who has been faced with home blood pressure logs documenting five or six readings a day for three months knows what a burden this data can be. ONC recognizes that reliability and trustworthiness of data are issues.

    The $180,000 challenge is in two phases, the first involving submission of white papers describing current methods with the second phase requiring winners to develop and test their solutions. Information about the challenge can be found here and phase 1 submissions are due May 22.

    I’m enjoying reading Mr. H’s coverage of Missouri’s ongoing failed attempts to create a Prescription Drug Monitoring Program. Hopefully they’ll eventually arrive at a workable solution. Opioid addiction continues to be a national issue and CDC recently launched an online training series around opioid prescribing. The first of eight modules is now available. Future modules include patient communication, non-opioid pain management options, dosing/titration, and risk reduction. I’m still slogging through a bunch of online CME, so let me know if you’ve test driven the module and what you thought.

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    I subscribe to dozens of communications from various governmental organizations in an attempt to keep up with all the warnings, alerts, proposed rules, and dictates that impact physician practices. Every once in a while I see an email subject line that truly catches my attention, as did this one about “Mixing Kentucky Spirits with Food Safety.” We think about the FDA as regulating medications and foods, but it also has jurisdiction over veterinary issues. Grain byproducts of brewing and distilling are often used as livestock feed. The 20-member FDA team found their visits to various production facilities (including Woodford Reserve, Wild Turkey, and Jim Beam) to be “extremely productive” with there being “no substitute for actually seeing how these beverages are produced.” I can say that I felt the same after a recent pilgrimage to the distillery responsible for my favorite adult beverage. However, I wonder if the FDA tour ended with a complimentary drink and a souvenir glass, as mine did? I also wonder if the FDA sends as large of a contingent to less-exciting venues such as sunscreen manufacturers.

    Email Dr. Jayne.

    Morning Headlines 4/27/17

    April 26, 2017 Headlines 3 Comments

    The MacArthur Amendment Language, Race In The Federal Exchange, And Risk Adjustment Coefficients

    Health Affair’s Tim Jost, JD reviews the new AHCA amendment proposed that has won the support of the GOP Freedom Caucus, substantially improving its chance of passing both chambers of Congress.

    CMS notifying clinicians of MIPS participation status

    CMS announces that by the end of May it will send letters to practices to notify them that they are required to participate in MIPS in 2017.

    Sepsis Solutions Are Saving Lives and Enabling Better Care, According to New KLAS Report

    In a small survey, KLAS reviews sepsis surveillance solutions marketed by major EHR vendors and niche surveillance vendors. 69 percent of respondents reported improved outcomes, with some reporting up to a 50 percent drop in mortality.

    Prize-Winning DxtER “Tricorder” Makes a Public Appearance With Tech Legend Steve Wozniak

    Basil Harris, MD, the team leader of Qualcomm Tricorder X-Prize first place winner Final Frontier Medical Devices, demonstrates his team’s Tricorder design to Steve Wozniak at the 2nd annual Silicon Valley Comic Con.

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