Recent Articles:

News 7/29/16

July 28, 2016 News 1 Comment

Top News

image

CMS adds star ratings to its Hospital Compare website, which also offers a data download option. Of the 78 New York City hospitals listed, one (Hospital for Specialty Surgery) earned five stars, while 29 hospitals have a one-star rating.

University of Miami Health System, which earned one star, predictably argues that the methodology is flawed and that its patients are sicker, complaining that academic medical centers and safety net hospitals are treated unfairly by the rating system.

Two hospital systems that made US News & World Report’s “Best Hospitals” list earned only two stars from CMS – UPMC and Barnes-Jewish Hospital. Both point out that scores vary among their similarly run hospitals, in their minds proving that ratings are skewed by patient demographics of the hospital’s geographic area.


Reader Comments

From Gordie Gecko: “Re: NantHealth. Check out its progressive tanking in the market. Patrick Soon-Shiong is trying to announce new deals, but one success doesn’t mean he’ll always be successful. People on the inside still don’t know what the future is.” NantHealth went public a couple of months ago with a first-day closing share price of $18.59, but shares have since dropped 45 percent to around $10. Allscripts bought 15 million shares right after the IPO, so the company is down around $50 million in just a few weeks. NantHealth hasn’t filed its first earnings report yet, but its IPO documents showed an annual loss of $72 million on $58 million in revenue.


HIStalk Announcements and Requests

image image

We funded the DonorsChoose grant request of Mr. D in Pennsylvania, who asked for three iPad Minis and cases. He reports that his students are using them to work on math and reading skills, to log their science activities, and to do research for their social studies assignments.

This week on HIStalk Practice: Cerner VP of Population Health Services Mike Heckman explains the role healthcare tech plays in managing on-site clinics for employers. Practice Fusion CMO & VP of Informatics Richard Loomis, MD shares interoperability advancement plans. Zoom+ VP defends the company’s executive exodus. AristaMD closes an $11 million Series A. Athens Orthopedic Clinic alerts patients to The Dark Overlord’s hack. Medstreaming acquires Physician Billing Partners. Epic, Allscripts, EClinicalWorks lead the vendor way in EP MU attestations. American Well CTO Jon Freshman outlines the ways in which vendors must differentiate themselves if they want to survive telemedicine’s bubble.


Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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


Acquisitions, Funding, Business, and Stock

McKesson announces Q1 results: revenue up 5 percent adjusted EPS $3.50 vs. $3.14, falling short on revenue expectations but beating on profit. Revenue for the Technology Solutions business was down 2 percent, but still generated a profit of $179 million. Shareholders again voted down a proposal that would have limited executive golden parachutes, which in CEO John Hammergren’s case, involves several hundred million dollars if the company changes hands. This is probably the last time I’ll report MCK’s earnings since they are scurrying quickly away from healthcare IT.

image

AristaMD, which offers a referral management system, raises $11 million.

image

Consumer health site Sharecare, founded in 2010 by Dr. Oz and WebMD founder Jeff Arnold, acquires the population health business of publicly traded Healthways. The business and its 1,700 employees will remain in Franklin, TN. Healthways announced in 2015 that it was exploring strategic alternatives.

Oracle will buy ERP vendor NetSuite for $9.3 billion. Oracle Chairman Larry Ellison already owned nearly half of NetSuite’s shares, having funded the company when it was founded by a former Oracle executive.

image

Leidos announces Q2 results: revenue up 2 percent, adjusted EPS $0.68 vs. $0.77, meeting revenue expectations but falling short on earnings.

image

Cambia Health Solutions makes a strategic investment of unspecified amount in medical procedure buying site MDsave. I tried the four-year-old site and found that few providers offer services on it – searching for a flu shot in Cleveland turned up a handful of doctors in Tennessee and Virginia and seeking a bargain-priced colonoscopy in San Diego showed the closest willing provider at 331 miles away in Nevada.

LabCorp will acquire prenatal genetic testing company Sequenom for $302 million in cash.

image

Struggling would-be health insurance disruptor Oscar will cut its New York provider base in half for 2017, trimming its network from 77 to 31 hospitals as it raises rates significantly. I predict Oscar will be gone within 24 months, with one of its big insurance competitors spending very little to buy the smoking wreckage.


Sales

I mentioned that Covenant Health (TN) has chosen Cerner, and based on information I found on the  Web, I concluded that the health system is a Meditech customer. I was wrong – while Cumberland Medical Center does indeed run Meditech as I had found, the rest of Covenant does not. Covenant bought CMC in 2014.


People

image

Dorothy Fisher, MD (Sentara Quality Care Network) joins Forward Health Group as chief clinical officer.

image

HBI Solutions hires Alan Eisman (Information Builders) as SVP of sales and business development.

Accretive Health names Doug Berkson (Berkson Consulting) as SVP.


Government and Politics

A state report finds that Oregon hospitals boosted their aggregate profit by 54 percent in 2015 because of the Affordable Care Act’s Medicaid expansion, which turned their charity care into revenue-generating work whose cost was mostly footed by federal taxpayers.


Privacy and Security

image

Fertility app vendor Glow urges users to change their passwords after it finds a problem with the “connect a partner” feature that could expose the user’s data to third parties.


Other

image

A review of the rates of mortality, readmissions, and adverse events in 17 hospitals immediately before and after their 2011-2012 EHR go-live finds no significant negative impact. That’s not really surprising since common go-live problems (late meds, missed charting entries, staff confusion) aren’t going to kill patients even though they make their encounter less pleasant.

image

A JAMIA article defines the work required for informatics research to support precision medicine:

  • Implement electronic consent and specimen tracking.
  • Develop data standards to support integration and exchange.
  • Develop ways to discover and translate clinically relevant biomarkers.
  • Use rules and technology to ensure the quality of large datasets to make sure they will continue to be useful in the future.
  • Create a precision medicine knowledge base.
  • Extend EHRs with APIs that can integrate external data and that will support the development of third-party workflow and data visualization tools.
  • Engage consumers outside of provider settings with user-friendly data collection tools.

image

Greater Madison Chamber of Commerce launches its HealthTech Capitol program and website, which “is working to establish Greater Madison as the world-class leader for health technology.” It lists 18 companies as members, with annual dues running $260 to $1,010 depending on membership level and company headcount.

ZDoggMD reflects on his medical career in his latest video, set to the tune of by Lukas Graham’s “7 Years.” EHRs get an unflattering mention.


Sponsor Updates

  • Crossings Healthcare Solutions publishes its Q2 newsletter.
  • Catalyze delivers HITRUST CSF certified compliant cloud solutions for Amazon Web Services workloads.
  • Besler Consulting releases a new podcast, “Auditing and monitoring for compliant physician documentation and coding.”
  • Boston Software Systems releases a new podcast, “Mass Updates to Your Meditech System.”
  • CompuGroup Medical will exhibit at the AACC Scientific Meeting & Clinical Lab Expo July 31-August 4 in Philadelphia.
  • Extension Healthcare will exhibit at the 2016 Defense Health Information Technology Symposium August 2-4 in Orlando.
  • The HCI Group is again listed on the Jacksonville Business Journal’s list of “50 Fastest Growing Private Companies.”
  • Healthgrades announces the 2016 Women’s Care Award recipients.
  • Healthwise is certified as a Great Place to Work.
  • Santa Rosa Consulting launches a Transition Management Office service.

Blog Posts


Contacts

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

125x125_2nd_Circle

View/Print Text Only View/Print Text Only
July 28, 2016 News 1 Comment

EPtalk by Dr. Jayne 7/28/16

July 28, 2016 Dr. Jayne No Comments

I’ve said it before, but those of us that work in the healthcare IT realm have a skewed sense of reality when it comes to participation in federal incentive programs. We tend to think that “everyone’s doing it,” but the reality is that just over half the eligible providers in the US were reflected in the 2015 Meaningful Use attestation data.

With that in mind, I wasn’t surprised that only half of practicing physicians have even heard of MACRA. Based on conversations in various physician lounges, I’d argue that even those who have heard of MACRA see it as a fix to the SGR problem with physician payment rather than another quality and incentive program. The survey seems to confirm this, with 32 percent of respondents only recognizing the name.

Not surprisingly, employed physicians were less aware than independents. However, physicians with large Medicare panels weren’t any more aware than those with smaller panels. Also not surprisingly, 80 percent of physicians prefer traditional fee-for-service arrangements.

Often people jump on this as proof that rich and greedy doctors just want to preserve their cash flow. For many in the trenches, though, it’s no different than any other occupation wanting to be paid for the work that they do. We wouldn’t have many car mechanics if their pay was linked to how well people maintain and drive their cars, and sometimes I think the practice of medicine has become a lot like being a mechanic lately. If nurses were docked part of their shift pay because their patients died or were otherwise noncompliant, you would see an open revolt.

I’ve been doing some long-term work for a health system that requires me to use their laptop and VPN connection. It also requires me to use their desktop support team, which has been a struggle. We open tickets via email and often it takes days for anyone to respond. Once they do respond, it’s often apparent that the technicians haven’t even read the ticket. This is particularly irksome for someone like me who puts lots of screenshots and attachments with their tickets, so that the problem is clear in the hopes someone can resolve it more quickly.

I’ve had some difficulty getting some of their applications to run correctly, since apparently they aren’t supported across browsers. One requires that you use Chrome, another Firefox, an another will only run on Internet Explorer. Doesn’t seem very 21st century to me, but the rest of the organization seems to be OK with it.

clip_image002

I’m always interested to see how other nations handle various healthcare delivery problems, so this headline about Finland’s newborns sleeping in cardboard boxes caught my eye. Finland’s infant mortality rate is less than half the US rate. The box is provided to all pregnant women, with the condition that they have a medical exam during the early months of the pregnancy. It also contains various baby care and clothing items, including those needed for chilly winters. (I’ve never seen a baby balaclava, but apparently there is such a thing.)

Finland offers a lot of other benefits for parents, including a paid 10 month leave and a guarantee that full-time caregivers can return to their jobs within the first three years of the child’s life. At the urging of a non-profit organization that provides boxes in Minnesota, that state’s legislature considered a bill to provide them for low-income women. Seeing a baby asleep in a box reminds me of my grandmother’s story that she slept in a dresser drawer for the first few months of life, having been born early with no nursery preparations. Necessity is definitely the mother of invention, whether your baby sleeps in a box, a basket, or a drawer.

clip_image004

Medicare’s Hospital Compare “star ratings” are now live, and as expected, creating confusion. Now that we’ve had a chance to actually review the data, I agree with most detractors that it doesn’t really help consumers. I plugged in the three excellent hospitals in my area where I would actually have care or send a family member and couldn’t find any appreciable differences despite the fact that they received two, three, and four stars respectively. The two-star hospital is actually ranked top 10 in the nation for dozens of clinical programs, and if I ever had a serious medical problem, that’s where I’d want to be. Small community hospitals in my area scored highly despite the fact that they have no recognizable differentiators.

The star ratings do nothing to help patients evaluate quality of care for specific clinical programs, such as oncology or cardiovascular surgery, where volume and expertise really matter. I searched up quite a few specific hospitals, including every one where I’ve worked. Some that received four or five stars fall on the list of places I would never want a family member to go to for care – but not every family has a physician, so I feel for the patients who actually take the star ratings seriously.

The best part of the ratings is reading the reader comments in my local newspaper:

  • This rating system is crap. (from a patient who goes on to explain the life-saving care, research protocol, and ultimately the organ transplant they underwent at a two-star hospital).
  • This hospital rating system is misleading, especially when lives depend on it. My husband picked his hospital by ratings and it cost him his life.
  • So according to this list, if I have a life-threatening illness, I should seek care at Tiny Community Hospital instead of at Big Medical Center which happens to be affiliated with one of the best medical schools in the world…. Seems legit.
  • What does the government know about running and rating hospitals…. They run the worst hospitals in the country. #VA.
  • The only government run hospital (VA) in the area didn’t get rated. The irony….
  • Until Big Medical Center can get the uninsured patients that swamp their ED to follow up, they will continue to score low. The onus was put on the hospitals to manage their patients, but you can’t manage patients outside the hospital. The same people show up over and over for the same thing. Even with call centers making hundreds of calls a day trying to get patients to go get a test, get an exam, exercise, eat right, check on their mood and behaviors, it still comes down to the people on the other end to do what they’re asked.
  • CMS couldn’t find its butt if its hands were glued to it.

That last comment gave me my smile for the day, so I’m going to sign off on that note.

What’s your favorite local comment about star ratings? Post it below, or email me.

Email Dr. Jayne.

View/Print Text Only View/Print Text Only
July 28, 2016 Dr. Jayne No Comments

Morning Headlines 7/28/16

July 27, 2016 Headlines No Comments

First Release of the Overall Hospital Quality Star Rating on Hospital Compare

Despite industry pushback on its methodology, CMS publishes its “Overall Hospital Quality Star Rating” on the Hospital Compare website.

Solutionary SERT Q2 Report: 88 Percent of All Ransomware Is Detected in Healthcare Industry

A cybersecurity report finds that 88 percent of reported Q2 ransomware attacks targeted the healthcare industry because the industry tends to pay ransoms to retrieve patient data quickly, and because hospitals rely on an abundance of systems, each of which represents a potential access point.

Huron Consulting moves to acquire IT consultant HSM

Chicago-based healthcare management consulting firm Huron Consulting will acquire health IT firm HSM Consulting for an undisclosed sum.

Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time

A Health Affairs study finds that hospitals that are successful in reducing admissions may be penalized as their inpatient populations become sicker and therefore have higher readmission rates.

View/Print Text Only View/Print Text Only
July 27, 2016 Headlines No Comments

Morning Headlines 7/27/16

July 26, 2016 Headlines 12 Comments

HHS issues funding opportunities for Information Sharing and Analysis Organization for health and public health sector

ONC announces availability of a $250,000 grant for cyber threat information sharing services, authorized under the recently enacted Cyber Information Sharing Act. Karen DeSalvo, MD and national coordinator for health IT, explains that “Establishing robust threat information sharing infrastructure and capability within the Healthcare and Public Health Sector is crucial to the privacy and security of health information, which is foundational to the digital health system,”

Athenahealth Announces Industry’s First MIPS Guarantee

Athenahealth guarantees that its clients will meet MIPS national performance thresholds and avoid payment penalties, and promises to reimburse any MIPS penalties incurred.

Certified Health IT Vendors and Editions Reported by Hospitals Participating in the Medicare EHR Incentive Program

ONC publishes new MU hospital attestation numbers by vendor, showing that Cerner has the most attestations, followed by Meditech and Epic.

AMA, Omada Health, Intermountain Healthcare Partner to Reduce Incidence of Type 2 Diabetes

Omada Health partners with Intermountain Healthcare and AMA to begin

offering digital diabetes prevention programs designed to support the population health management efforts of large health systems across the country.

Covenant Health Selects Cerner’s Enterprise-Wide Clinical, Financial and Population Health IT System

Covenant Health (TN) will implement Cerner across its 9 acute-care hospitals and 100 ambulatory centers.

View/Print Text Only View/Print Text Only
July 26, 2016 Headlines 12 Comments

News 7/27/16

July 26, 2016 News 1 Comment

Top News

image

ONC issues $250,000 in funding opportunity announcements for a cyber threat information sharing service. The application package indicates an award date of September 16 and indicates that it will choose an organization that is already performing similar cyber threat services. It expects the program to be self-funding since those organizations already charge fees for their services.

A second $150,000 cooperative grant has been issued from the Assistant Secretary for Preparedness and Response.

The grants were issued is response to a 2015 executive order that promoted private sector cybersecurity information sharing via Information Sharing and Analysis Organizations.


Reader Comments

image image

image image

From Pierre La Terre: “Re: health IT rag pointless stock photos. Who’s the miscreant in the green shirt?” Publications think we’re not smart enough to read news unless there’s a picture, so they struggle when there’s nothing relevant to run given that they’re just re-wording press releases and crafting zippy headlines from afar. This particular well-worn photo of a green-shirted volunteer undergoing a mock sobriety field test in 2009 came from Wikimedia Commons and lives on as an uncredited breaking health IT news photo. Any resemblance to anyone involved in the HHS fraud case is unintentional.

From Grammar Warrior: “Re: grammar pet peeve. To ‘insure’ is to protect against financial loss. To ‘ensure’ is to make sure something happens. Ensure you get it right, people!” My recent peeves aren’t new: the use of “anymore,” which despite appearing in some dictionaries, will never look right to me instead of “any more.” I’m also annoyed at the phrase “build out” in trying to give physical attributes to some abstract IT concept, like “building out the EHR” (even if you like the analogy, which I don’t, the “out” is superfluous). Also, using “that” to refer to people (“people that complain bug me”) or using “who” to refer to organizations (“the vendor who screwed up is well known.”)

From Todd Margaret: “Re: top health IT Twitterati. One of the winners lists HIStalk among ‘critical community leaders’ whose primary means of disseminating information isn’t Twitter.” I glance pretty regularly at Twitter to get a quick read on what people are thinking, but most heavy Twitter users aren’t all that influential except maybe to each other. The “influence” equation must address reader reach, reader decision-making authority, and the writer’s ability to provide information that changes the minds of those decision-makers. Twitter is best at quickly capturing prevailing opinion about big-bang events rather than influencing anyone directly.


HIStalk Announcements and Requests

image image

We provided the elementary school class of Ms. Johnston in Colorado with five tablets and headsets in funding her DonorsChoose grant request. She provides an update: “My students could not believe that someone would give us such a great gift and they took great pride in the care of our technology. In fact, one of my students, was so moved by the donation that she was designated as a classroom tech. She was excited to carry the role as she checked on their battery powers every morning, she cleaned the technology station, she wiped the headphones down at the end of the day, and she took leadership to ensure that other students were being careful. Thank you so much for this wonderful gift. These students have been given a rare opportunity to learn and apply technology in new and creative ways. This was a memorable experience for each of us. Thank you.”

Vince Ciotti is putting together “Rating the Ratings,” a series that will review the services offered by KLAS, Black Book, HIMSS Analytics, and others. Vince would be happy to incorporate your anonymous thoughts and experiences if you send them my way. Readers have made quite a few comments over the years about their company being suspiciously overlooked, being asked to buy something to be included, and wondering why specific clients were chosen when participating in some of the services.


Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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


Acquisitions, Funding, Business, and Stock

image

Recode profiles Nomad Health, a startup whose site matches doctors to temporary assignments.

image

Huron Consulting Group will acquire Healthcare Services Management, with HSM CEO David Devine joining Huron as managing director. 

Venture capital-backed Boston hospital operator Steward Health Care earns its first profit, although all of it came from changes in how it funds pensions. The company still refuses to submit state-mandated financial statements, however, saying its information is proprietary.


Sales

image

Covenant Health (TN) chooses Cerner’s clinical, financial, and population health management systems. I think they’re a Meditech shop.

Memorial Sloan Kettering Cancer Center chooses HealthLoop for patient engagement in its newly opened surgery center.

Meditech lists several customers that are moving forward with its new Web EHR.


People

image

Former Military Health System CIO Eric Huweart joins government contractor Apprio as VP of military and veteran healthcare.

image

Wyman F. Bowers, JD, MBA (Midlands Orthopedics) is named the first CEO of the South Carolina Health Information Partners HIE.

image

Staffing provider AMN Healthcare hires Matt Zubiller (McKesson) as SVP of corporate strategy.


Announcements and Implementations

image

Athenahealth issues its MIPS Guarantee that its customers won’t lose money under the final MACRA rule, but the terms contain catches: (a) it’s only for new AthenaOne clients who go live on AthenaNet; (b) the customer gets only monthly service credits rather than cash and the total can’t exceed the amount of their monthly payment; and (c) if the customer drops Athenahealth, they forfeit their remaining credit. It’s a good marketing strategy to ramp up the customer count that Wall Street is watching intently.

SNAGHTML10a38d9e

Medication management app vendor Medisafe releases a version of its product for drug companies that addresses adherence, patient engagement, dose reminders, and study recruitment.

image

HealtHIE Nevada will offer community-based providers such as diabetes educators and behavioral health therapists subscriptions to Kno2, which will allow them to exchange documents with doctors and hospitals via Direct messaging to improve continuity of care. The Boise-ID-based company offers a $20 per month, one-user plan that provides a Direct address, allows address book searches, supports messaging and document routing, and allows creation of Direct messages from scanners and multi-function printers.

image

Crossings Healthcare Solutions will resell Cerner real-time end user experience monitoring from Goliath Technologies. 

image

Intermountain Healthcare, the AMA, and online health coaching vendor Omada Health will work together to offer diabetes prevention programs for the at-risk patients of large healthcare systems across the country.


Government and Politics

image

An HHS OIG survey of 400 hospitals finds that half have experienced unplanned EHR downtime, and of those, one-fourth report that it delayed patient care. Software was not the cause of downtime in any reported case – the most prevalent downtime issues were hardware failure, loss of Internet connectivity, and power failure. Only a third of respondents have a read-only EHR backup system in place that alerts users visually that the main system is down. OIG repeats its previous recommendation that OCR implement a permanent audit program to assess HIPAA compliance.

image

ONC updates its Health IT Dashboard with the latest count of MU-attesting hospitals by inpatient system vendor. Cerner, Meditech, and Epic lead the pack.

Former National Coordinator and Aledade CEO Farzad Mostashari, MD says in a an editorial in The Hill that MACRA will speed up consolidation of hospitals and practices without necessarily improving cost or outcomes. He recommends that CMS allow small practices to join together in virtual networks, compare small practices only against each other, and cap the potential losses under MACRA that as written can be more than 100 percent of a practice’s Medicare revenue.


Privacy and Security

Healthcare leads all industries in ransomware infections, according to a security firm’s quarterly report, making up 88 percent of all detected ransomware incidents.


Innovation and Research

image

The California Cancer Registry pilots real-time data collection of de-identified patient data from pathologists at 12 hospitals. They are using electronic reporting forms developed by the College of American Pathologists to capture discrete data elements rather than free text information. Public health officials hope to publish real-time surveillance data, identify cases for research, and improve quality.


Other

The Pharmaceutical Research and Manufacturers of America, which has tried to convince Congress that drug companies charge high prices only to support desperately needed research, accepts as members two companies that spend next to nothing on R&D. Horizon Pharmaceuticals bought an old drug and raised its price 600 percent the same day, with the former $2 pain pill now costing nearly $40. New member Jazz Pharmaceuticals makes nearly all of its money from a single drug whose price it doubled in two years. Actually neither company should be admitted to an organization that includes “of America” in its name since both “moved” to Ireland after acquiring companies so they could dodge paying US taxes.

In Australia, a newborn dies and another suffers permanent brain damage after a hospital contractor mistakenly installs nitrous oxide in an oxygen outlet.

image

image

In England, NHS geriatrician Kate Granger, MBChB dies of cancer at 34. Her cancer experience with an impersonal health system motivated her to create the widely adopted #HelloMyNameIs campaign that urges doctors and nurses to introduce themselves to patients and to make eye contact before treating them. She donated all of the proceeds from sale of her books and other activities to Yorkshire Cancer Centre, having hit her $328,000 goal just three days ago. She had previously received the MBE and, just before she died, a handwritten thank you letter from England’s new prime minister that started with, “My name is Theresa.”


Sponsor Updates

  • Lexmark Healthcare is selected as one of eight imaging technology vendors to participate in RSNA’s Image Share Validation Program.
  • PM/EHR vendor MedEvolve will offer its physician practice customers payment solutions from InstaMed.

Blog Posts


Contacts

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

125x125_2nd_Circle

View/Print Text Only View/Print Text Only
July 26, 2016 News 1 Comment

Morning Headlines 7/26/16

July 25, 2016 Headlines No Comments

Hospitals Largely Reported Addressing Requirements for EHR Contingency Plans

HHS OIG surveys 400 hospitals on EHR downtime procedures, finding that only two-thirds of respondents had a plan that included “having a data backup plan, having a disaster recovery plan, having an emergency-mode operations plan, and having testing and revision procedures.”

Humana dumps ACA plans as feds blast its Aetna deal

Humana announces plans to significantly reduce the number of health plans it offers on ACA exchanges starting in 2017, a decision that comes on the heels of a Justice Department effort to block the company’s proposed merger with Aetna.

HHS awards more than $36 million for health center adoption of health information technology

HHS will spend $36 million to fund 50 Health Center Controlled Networks in 41 states to continue supporting local health systems as they implement EHRs and improve interoperability capabilities.

CMS needs to halt the march to health care gigantism

Former National Coordinator Farzad Mostashari, MD publishes an op-ed in The Hill discussing the impact consolidation in the healthcare industry is having on the cost of care, noting that MACRA’s proposed rule will “further neglect the power of physician independence and create strong incentives for further consolidation in health care.”

View/Print Text Only View/Print Text Only
July 25, 2016 Headlines No Comments

Curbside Consult with Dr. Jayne 7/25/16

July 25, 2016 Dr. Jayne 4 Comments

The last couple of weeks have been a bit rough. Usually my personal life and work life have very little to do with each other, but a perfect storm of events has pushed them too close for comfort.

As a family physician and clinical informaticist, I’ve dedicated the better part of two decades to advocating for quality care. I’ve also spent a fair bit working on ways to leverage technology in order to deliver that care, as well as to help manage costs so that our healthcare system doesn’t topple under its own weight.

One of the hallmarks of trying to maintain that balance is the idea of evidence-based medicine. That approach is a data-driven way to try to comply with the physician’s prime directive of “do no harm;” it allows us as clinicians to try to make better decisions. Data that comes from research has a stronger impact than that arising from expert opinion or case reports. It doesn’t prevent us from taking the latter into consideration, but provides a framework for trying to make the best choices from the information available.

Evidence-based data is used to create clinical practice guidelines, which in turn helps physicians determine how to manage groups of patients. It’s the backbone of population-level health policy and has been a key component in US healthcare in that evidence is often used to determine whether Medicare or other payers will cover a particular treatment or service: whether it is considered to be medically necessary and/or clinically appropriate. To achieve the highest level of integrity in an evidence-based schema, data has to be peer-reviewed and reproducible.

This can be in sharp contrast to how most patients view the world. Often patients have heard about someone’s cousin, sister, or friend who had X condition and Y treatment, and stories about whether something worked or not travel at an amazing speed. The grocery store checkout lane is full of magazines talking about health-related issues and what various celebrities or other public personas have been through or done regarding a given condition. Walk into the average beauty shop in middle America and you will find a variety of armchair medical quarterbacks. The general public, especially when they are patients themselves, doesn’t care about evidence-based medicine, but rather about what is happening to them and the people around them.

When you have a patient — or family member, as in my case — who has had a bad outcome despite following the evidence, it makes things extremely difficult. That is where my worlds have been colliding, and it feels pretty disjointed. As someone who has taken more statistics classes than I ever cared to have taken, I know that there are always statistical outliers and the potential for chance alone to influence a given situation, especially when multifactorial disease processes are involved. We can only make recommendations based on population-based data and previous outcomes. Although the push towards precision medicine continues, using existing population-based data is going to be the reality for most of us for the foreseeable future.

We as physicians have to follow the best information we have, and sometimes it’s going to lead to poor outcomes. There’s no way to beat the statistics for every single patient. We use evidence to determine when it’s going to be cost-effective to do a particular screening service or treatment for a given population; we use it to determine when it is likely to be more harmful to do a procedure than not. In effect, this becomes a bit of a healthcare rationing mechanism, but with good intentions and well-reviewed evidence. The fact of the matter, though, is that it doesn’t make a bit of difference if your physicians followed the best evidence if you’re the statistical outlier.

What exactly should we tell the patient who didn’t have a screening service because it wasn’t indicated for her age group based on the evidence, but who developed cancer and doesn’t understand “why no one cared enough to make me have that test?” It’s not that no one cared, it’s that the risk / benefit / cost / value factors didn’t make the case to order the test.

On the flip side, what do you tell the patient for whom you performed a test based on clinical suspicion, but Medicare denied it because it didn’t meet criteria, and now the patient is calling you to apologize because she knows you can’t even balance bill for the services that you ordered based on the individual situation and shared decision-making? As physicians, how do we reconcile when we did all the right things, but bad outcomes still happened?

If we were to perform every test for every patient, the healthcare system would go bankrupt even faster than it already is. We’d also cause a fair amount of harm, because with increased testing comes increased anxiety, increased false positives, and increased follow-up testing. Treatments cause complications and sometimes disability and death. But what do we do with the patients who are ready to “fight like hell” –because that’s what our society says you should do whenever you are diagnosed with a disease — but as professionals. we know that such a fight is probably going to cause more suffering, disability, and expense than the patient is really prepared to endure? It takes a lot more courage to take the less-aggressive approach, but it’s often rejected as “throwing in the towel” or “giving up.”

When our own loved ones are in that situation, it’s incredibly difficult to reconcile the science with the reality of what real people are going through. It’s even worse when you have to preach the evidence every day but you know that even the best evidence will still have negative outcomes. Although it’s no one’s fault. it will still feel like it is.

Depending on age and other demographics, it’s doubly challenging dealing with this type of situation with patients who came of age when the US was considered a superpower. These patients watched us vanquish polio and smallpox. They see “modern medicine” as being just short of a miracle, and that we should be able to continue to cure and conquer the diseases around us.

Limitations on technology can be somewhat understood, but limitations due to cost and statistical improbability are nearly incomprehensible to many of our patients. This dilemma is one that many of us face all the time, but having to process it on a personal level is still difficult. It’s hard to educate physicians on the use of clinical decision support and clinical guidelines when you know first-hand that they’re going to leave patients behind. Those patients are going to be someone’s grandmother, father, sister, or mother. Or maybe your child or your brother.

There is a high level of pressure for physicians to be perfect, to never miss a diagnosis or fail to recommend a treatment. Many patients don’t understand the external forces that drive our decisions outside of the evidence – including whether a service will be covered, whether the patient can afford it, whether they can get a sitter so they can go have the procedure, etc. Those are all things that need to be taken into account as we move forward caring for populations rather than individuals.

We also need the best and brightest working on the psychology of our approach – how to help patients cope when they end up on the outside of the protocols’ intent, as well as how to help the healthcare providers whose decisions (whether shared or not) put those patients on the outside looking in.

What’s next for evidence-based medicine? How do we reconcile it against precision medicine and within our healthcare system? Email me.

Email Dr. Jayne.

View/Print Text Only View/Print Text Only
July 25, 2016 Dr. Jayne 4 Comments

Morning Headlines 7/25/16

July 25, 2016 Headlines No Comments

Multiple alleged HIPAA violations result in $2.75 million settlement with the University of Mississippi Medical Center

The University of Mississippi Medical Center (MS) will pay a $2.75 million settlement stemming from a 2013 data breach that compromised the medical records of 10,000 individuals. Investigators concluded that the organization was aware of its security vulnerabilities as early as 2005, but took no steps to address the problems. 

Three Individuals Charged in $1 Billion Medicare Fraud and Money Laundering Scheme

A Florida man has been charged in the largest Medicare fraud case in US history after billing for more than $1 billion in medically unnecessary care through the 30 skilled nursing and assisted living facilities he owned. 

Athenahealth, Inc. Q2 Profit Advances 9 percent

Athenahealth reports Q2 results: revenue climbed 16 percent to $261 million, EPS $0.34 vs. $0.32. 

Health minister orders review of IHealth records system

In Canada, British Columbia Health Minister Terry Lake orders a third-party review of Island Health’s $174 million Cerner implementation after doctors at pilot sites began voicing patient safety concerns.

View/Print Text Only View/Print Text Only
July 25, 2016 Headlines No Comments

Monday Morning Update 7/25/16

July 24, 2016 News 2 Comments

Top News

image

University of Mississippi Medical Center (MS) will pay $2.75 million to settle HIPAA charges related to the 2013 theft of password-protected laptop by a visitor to the hospital’s medical ICU. OCR’s investigation uncovered the fact that entry of a generic WiFi username and password provided access to an unsecured Microsoft Access database that contained the information of 10,000 patients.

OCR concluded that UMMC’s “organizational deficiencies and insufficient institutional oversight” prevented it from undertaking risk management activities even though the hospital knew it was vulnerable. It also noted that the hospital did not perform the required patient notification following the laptop’s theft.


Reader Comments

image

image

From Sieve Crusher: “Re: US Digital Service. They’re actively recruiting. Experience in the EHR world is applicable to government work in many ways – long-time employees, legacy systems, and a culture of poor user interfaces. Silicon Valley experience isn’t needed – the government can use folks of talent. There’s also 18F, an earlier companion effort that allows remote work instead of relocation to DC, but they are backlogged with applicants.” It sounds pretty fun for someone without a family or already in the DC area since no relocation assistance is provided – it’s a one-year commitment with benefits provided and a casual work environment. Not everybody can say they spent time working for the White House.

From HER Auto Correct: “Re: article saying that EHR use decrease costs. I don’t believe it.” The 2014 article concludes that per-admission costs are 10 percent lower in hospitals that use advanced EHRs. I really dislike studies in which Database A is linked to Database B to reach a lofty conclusion implying causation vs. correlation. This is one of those. The authors sampled a 2009 inpatient treatment database and matched it up to the sometimes-accurate HIMSS Analytics database of what EHR each hospital uses. “Cost” was derived from applying the cost-to-charge ratio of each hospital to its billed charges, which is a pretty blunt measure of a hospital’s actual incremental cost, although it’s usually all we have to work with. There’s also the question of ensuring a representative sample of hospitals in all sizes and locations and selecting patients of similar complexity. All that aside, correlation is not causation and most hospitals are already using advanced EHRs, so I don’t see any practical application of the conclusions. A better study would have been to choose 10 hospitals that implemented EHRs and see how their individual costs changed afterward, although the huge problem persists in trying to factor out all other variables. One last observation: bias exists in even the topic of the study – do hospitals really expect to reduce costs by implementing EHRs? The fact that even the financially distressed hospitals don’t de-install them and go back to paper suggests a self-assessed positive ROI that may or may not be financial.


HIStalk Announcements and Requests

image

Poll respondents were evenly split on their opinion of the Affordable Care Act. Comments suggested that it worked fairly well if the goal was to people insured rather than to control costs or influence personal health choices. Mary C notes that ACA didn’t provide healthcare reform, only insurance reform, while Dave says insurance companies have had to resort to high-deductible plans to shield themselves from the unaddressed issue of cost control, although he also notes that individual patients benefited since ACA eliminated coverage denial of pre-existing conditions and lifetime limits. Most commenters noted that the “affordable” part is a misnomer since ACA policies cost a lot more with fewer choices and it’s just not possible to cover all of those newly insured people for the same cost, especially given that a lot of care involves expensive, late-stage interventions of limited value. HIT Project Manager boldly opines that Medicare and Medicaid should gradually phase out paying for treatment of chronic conditions that are caused by preventable behaviors, using EHRs to identify patients who ignore advice related to obesity and smoking and making them pay fully out of pocket for their treatments. Bill says just buying insurance for a bunch more people is running up the federal deficit without any evidence that quality or cost has improved. The most positive thread of commentary is that while ACA is a long way from perfect, it can be fine tuned over time.

New poll to your right or here: for those with a recent hospital visit: does the hospital allow you to electronically submit your own data into their records? I’m sure some hospitals provide a way to import wearable or questionnaire-type patient information to populate their EHRs, but I doubt it’s the 37 percent of them that a recent AHA survey found.

I was thinking as I reviewed the journal article above that I really bristle at using the word “reimbursement” to define payments to providers. You aren’t getting reimbursed – you are sending a bill and someone pays it. Especially if you run a private medical practice, a business no different than a auto body shop in expecting insurance companies to pay up.

image image

We bought a robotics kit and books for the North Carolina gifted class of Ms. S, who explains the photos above in describing how she put the materials to work immediately. “I gave the kids the option to participate in a district competition at the end of May, explaining that many students had a big head start on them — they had begun working last fall, whereas we had started months later. However, my students were willing to take on the challenge! They competed their work through a combination of quick understanding (impressive!) and teamwork. I’m pleased to say that the construction claw project won first place in the competition! All of my students said they enjoyed the experience and would like to participate in robotics again next year. That is wonderful news, especially from students who may not be able to attend robotics camps or programs outside of the school setting.”


Last Week’s Most Interesting News

  • ProPublica begins publishing the  letters OCR sends in summarizing and closing HIPAA complaints.
  • Philips acquires Wellcentive.
  • An HHS report to Congress identifies the lack of applicability of HIPAA to non-covered entities, such as app vendors, and outlines the non-HIPAA enforcement authority of the Federal Trade Commission.
  • ONC publishes an online tool that grades the interoperability readiness of a submitted C-CDA document.
  • The VA hires KLAS to provide an overview of the EHR vendor landscape.
  • AMIA cautions the FDA that EHR information is not necessarily of research quality, suggesting that it focus electronic data collection efforts on clinical data warehouses or HIEs.
  • Hacker The Dark Overlord posts for sale the digital assets of integration vendor PilotFish Technology and says he pushed an update to all of its clients that allowed him to steal their EHR information.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.


Acquisitions, Funding, Business, and Stock

image

The newly formed Providence St. Joseph Health acquires doctor house call scheduling app vendor Medicast, which had previously raised $2 million but hasn’t had new funding in the past two years.

image

Athenahealth announces Q2 results: revenue up 17 percent, EPS $0.34 vs. $0.32, falling well short of expectations for both.  The company also announced that EVP/COO Ed Park will leave his position by the end of the year, but will likely join the company’s board. Park holds $2.3 million in stock after selling $2.2 million worth so far in 2016. ATHN shares dropped 9 percent Friday following the announcements, having shed 3.1 percent in the past year.

From the Athenahealth earnings call:

  • The company has converted 40 percent of its clients to AthenaClinicals Streamlined, with those clients averaging a 10 percent improvement in same-day encounter close rate. The company notes, however, that it is working closely with a “minority” of clients who liked their old workflow better and hints that it expects to take a short-term hit on its Net Promoter Score.
  • Eighty hospitals are using AthenaOne for hospitals.
  • The company launched AthenaInsight.com to share information collected from its user network.
  • The company admits that it’s not sure whether sales are tracking against target due to seasonality and a bottleneck in servicing inpatient demand, but also notes that the HITECH wave of “I need an EMR or I’ll be shot” is ending and that it has to adjust to the pre-HITECH world of developing by its own schedule rather than just hitting MU-driven functionality dates.
  • Athenahealth notes that its population health management product has provided “a lovely little tailwind on our growth” since it can work with Epic and Cerner and that has allowed the company to add those users back to its prospect list.
  • The company’s hospital win rate is 32 percent.
  • Jonathan Bush says the company made a “terrible operational miscalculation” when it started allowing senior support reps to travel to client sites to provide go-live support, which caused longer telephone hold times just as Streamlined was being rolled out.
  • Of the Streamlined rollout, Bush said, “Streamlined’s big mistake was that it was not an agile deployment. This was not, you get a skateboard, and then you put it back out with a handle on it, then you put it back out with a little motor on it, then you put it back out with sides, and eventually it’s a car. This was, take a skateboard, hide it, and show back up two years later with something you think will be a car, and all of the feedback that all of the customers would have had along the way comes raining down on you at once. So, we’ve had to do a lot of tuning of Streamlined once it came out of the garage. We will not be doing that kind of hide it away for years and then do a great reveal of something radically different any more in the future.”
  • Bush allowed Ed Park to summarize his career in ending the earnings call, introducing him as, “The man who brought me here, who made every theoretical PowerPoint promise I made either go away or turn into actual functioning reality at scale, Ed Park.”

People

image image

CTG CEO Cliff Bleustein, MD resigns “by mutual agreement” after 16 months on the job. He has been replaced by SVP/GM Bud Crumlish. I interviewed Bleustein two months ago. CTG shares are down 18.5 percent in the past year, giving the company a market value of $88 million.

image

Video visit vendor MDLive names Sanjay Patil, MD (Care Connectors) as EVP/GM of health systems strategy and transformation.


Announcements and Implementations

image

A new Peer60 report on cardiovascular information systems finds that hospitals expect their procedure volume to increase significantly, with the biggest driver by far being their addition of service lines, but also due to adding more providers, population growth, an aging population, and better insurance coverage. Epic and Philips are the most-recommended CVIS vendors, although nearly half of respondents say they are considering replacing their current system. Epic is the most-often considered new system by far, while McKesson is equally dominant as the vendor most likely to be displaced.   


Government and Politics

image

The Department of Justice charges the owner of 30 Miami-area skilled nursing and assisted living facilities with running a $1 billion Medicare fraud scheme, the largest healthcare fraud case in US history. Philip Esformes, who is also a noted philanthropist, is accused of placing patients in his facilities who didn’t quality for that level of care, then billing Medicare and Medicaid for medically unnecessary services. He and his two co-conspirators are also charged with taking kickbacks to refer those patients to community mental health centers and home care providers who also rendered medically unnecessary services. Esformes paid $15.4 million to settle charges of exactly the same thing 10 years ago, but was able to hide his identity until HHS-OIG and the FBI used advanced data analysis and forensic accounting to unravel his current operation. His father, Rabbi Morris Esformes, was charged with taking kickbacks in 2004 when he boosted his $4,000 investment in a pharmacy to $7 million in profit when its was sold two years later by sending the pharmacy all of the business from his Chicago nursing homes, which were also the subject of complaints about poor care that he attributed to anti-Jewish sentiment.

image

British Columbia’s health minister orders an immediate third-party review of Island Health’s $132 million Cerner implementation following physician complaints that the system is endangering patients and the switch back to paper of one hospital’s ICU and ED in one hospital nine weeks after go-live.

image

Acting CMS Administrator Andy Slavitt is apparently not impressed with the EHRs out there.


Privacy and Security

Laser & Dermatologic Surgery Center (MO) notifies 31,000 patients that their information was exposed when its computer systems are hit with ransomware. The clinic declined to pay and instead successfully restored its systems.

The health information of nearly everybody in Denmark was exposed last year when a state office mailed two unencrypted CDs that the post office instead delivered to a China-owned bank. The CDs contained the cancer, diabetes, and psychiatric information of 5.3 million people. The bank employee realized the postal service’s mistake and took the package to the intended recipient.

Police arrest two Florida paramedics who were fired after posting pictures of themselves in their ambulances with incapacitated patients, sometimes posing them in humiliating fashion in attempting to one-up each other.

It appears the Twitter account used by hacker The Dark Overlord has been deleted and he hasn’t been heard from in a few days. I don’t know what that means


Technology

image

Microsoft adds appointment-booking capability to Office 365, allowing users to choose the service they need, search for for available dates and times, and book the appointment from their PC or mobile device with confirmation and reminders to follow. Users can also cancel or reschedule their own appointments. Microsoft stuff doesn’t always catch on and I doubt this product would pass HIPAA muster, but otherwise it cold be interesting for healthcare.

image

The Gates Foundation creates Chronos, a tool to help grantees meet the foundation’s open access requirement that their research be published broadly and with unrestricted access and re-use, including the underlying data sets. The service will pay publisher article processing charges, check compliance with policies, and track the impact of publishing activity, all to allow grantees to focus on their research rather than the processing of publishing it.


Other

image

The Cleveland business paper covers MetroHealth’s use of 25 EHR scribes in its ED, which reports higher-quality and more timely documentation completion.

An editorial in the Lancet ponders the role of peer-reviewed medical journals in a publishing world turned upside down by the Internet, the endless quest for profitable eyeballs, and technology that “has transformed artisans into professionals.” It frets about open access journals, research misconduct, and the lack of reproducibility in many scientific studies.

The government of Indonesia arrests 23 people, including three doctors, after finding vials of vaccine that actually contained only sterile saline in 37 hospitals and clinics. An estimated 5,000 children have received fake vaccine, inciting parents to mob a Jakarta hospital and beat one of its doctors. The government caught one person who had adulterated vaccines years ago, but fined him only $100, and had not acted on vaccine manufacturer complaints of counterfeit products going back to 2011. The government vows to re-vaccinate millions of children at no charge and has established a vaccine distribution oversight group. 


Sponsor Updates

Blog Posts


Contacts

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

125x125_2nd_Circle

View/Print Text Only View/Print Text Only
July 24, 2016 News 2 Comments

Morning Headlines 7/22/16

July 21, 2016 Headlines No Comments

The Secret Documents That Detail How Patients’ Privacy is Breached

ProPublica publishes 300 previously undisclosed warning letters that OCR sent to healthcare organizations found to be in violation if HIPAA in an effort to help the public “review details of these cases and track repeat offenders.”

Star Spangled Geeks

Backchannel profiles some early successes coming out of the US Digital Service, a group of Silicon Valley heavyweights recruited to help the government improve its technical infrastructure.

$42 Billion Saved in Medicare and Medicaid Primarily Through Prevention

A CMS blog describes how each dollar invested in Medicare fraud prevention programs returned $12.40 for taxpayers, resulting in a $42 billion savings over the past two years.

Chinese scientists to pioneer first human CRISPR trial

Next month, a team of researchers from China’s Sichuan University will begin administering a new treatment comprised of human cells modified using CRISPR-Cas9 gene-editing techniques to lung cancer patients that have not responded to conventional treatment.

View/Print Text Only View/Print Text Only
July 21, 2016 Headlines No Comments

News 7/22/16

July 21, 2016 News 5 Comments

Top News

image

ProPublica begins posting OCR’s “closure letters” indicating the resolution of HIPAA-related complaints, noting that most of the letters involve the VA and CVS Health.


Reader Comments

From Sharing CIO: “Re: Velocity Technology Solutions. My hospital was down also. They acknowledged a hardware failure that was exacerbated by human error, poor judgment, and a failed communication strategy. This is our second outage this year – the other one was Dell, who also had hardware failure combined with the fact that humans are not perfect.” More and more people are realizing that “cloud” is synonymous with “someone else’s data center” plus the hopes that a focused vendor will operate it better than they themselves. Most of the time that’s the case, but when things go wrong, the IT department is like end users in being stuck trying to get status updates, pestering the technicians who should be trying to restore systems rather than explaining why they’re down, and backseat driving the process.

From Stealers Wheel: “Re: my article. See this link!” I never know what to do when someone sends me the PDF of a book they’re working in, a LinkedIn article they wrote, or a link to a something they’ve written for a competing healthcare IT news site. I don’t really want to read someone else’s articles or using HIStalk to promote them, so I usually don’t reply because I know someone’s ego is involved.

image

From LinkedInGuy: “Re: Epic. An ex-Google VP disses it.” At least he’s assertive in his cluelessness in smugly dismissing the entire healthcare IT industry on the basis of a single screenshot he doesn’t consider pretty. He’s awfully proud of his former Google background (working on games and products I’ve never heard of), so perhaps he should consider the rousing failure of Google Health, or for that matter, the horrendously awful UI and user-unfriendliness of Gmail and Google Docs, which make most healthcare software look positively cool by comparison. He seems confused  by the screen shot that he found on the Web since “most docs” don’t use a single specific EHR and the screen he illustrates is not Epic –  it’s actually a 2011-era screenshot of the Chart Talk EHR, a minor EHR player. He probably felt well informed with his tweet, but anyone who knows healthcare would infer the opposite.

From Pointy Head: “Re: work-life balance. Shouldn’t you be willing to sacrifice early in your career for later payoff?” That’s reasonable as long as you realize that the payoff might never come. There’s also that point in your career where you have to accept the reality that your career altitude has reached its zenith unless you change employers or jobs. I once worked for a health system executive who gave rather blunt but accurate advice to director-level people that applies to most everyone: if you yearn to be a C-level executive and either (a) your employer has already passed you over; or (b) you’ve hit 40, adjust expectations accordingly or perhaps start your own business if you feel your potential has been overlooked. Right or wrong, people in their 40s and certainly 50s shouldn’t confuse the hamster wheel they’re on with a career ladder in thinking they’ll get called up to the big show since the odds aren’t great. Those are the folks I hate to see busting their humps thinking they’ll somehow be rewarded accordingly.


HIStalk Announcements and Requests

image image

We funded the DonorsChoose grant request of Ms. McMahon, who requested maker space materials for her North Carolina elementary school media center. She reports, “The STEAM activities in our media center have ignited the creative spirit in my students. They just can’t wait to show me what they have created and just love to have their creation up for display or to see their picture on our website or news program. I have noticed a great improvement in the children who were often discipline problems in the past. They are engaged and excited and just hate it when its time to leave. There is high time on task and with a few rules in place – they abide by them well so that they don’t lose the privilege of working in our Creation Stations!”

I’ve been busy un-following dozens of people on Facebook who keep droning their heartfelt but one-sided and sarcasm-heavy political commentary. I really, really wish for enhancements to Facebook and Twitter that would force users to categorize their emanations into “work,” “politics,” and “114 photos of my angelic child,” allowing me to focus on the limited segments of their thought stream that I care about instead of just muting them completely. Social media have dumbed a lot of people down in filtering the news and opinion they follow, making them believe that nearly everybody thinks like they do and emboldening them to react with vitriol and personal contempt when faced with the inevitable other side of the argument. It’s like modestly talented executives who mistake the butt-kissing of their carefully chosen yes-men underlings as confirmation of their inherent brilliance. Unfortunately, real life is beginning to more and more resemble high school.

This week on HIStalk Practice: NASA deploys telemed technology in deep-sea expedition. HHS announces $9 million in grants to help improve opioid-addiction treatment in primary care practices. AHIP points to telemedicine to help alleviate physician shortages in certain states. R-Health launches independent, physician-led ACO in Southeastern Pennsylvania. Consumer sentiment reaches underwhelming levels of outrage over latest HHS privacy/security report. Surprise, surprise: Physicians do have favorite patients (and they aren’t even the most compliant.)

This week on HIStalk Connect: 2bPrecise Chief Medical Officer Joel Diamond, MD shares his thoughts on the future of precision medicine.

Listening: Cloves, who is actually 19-year-old Australian singer-songwriter Kaity Dunstan. I would say that she reminds me a lot of Adele, other than the fact that my fastest reflex is hitting “scan” on the car radio when a song by the ubiquitous Adele comes on and I’d actually stick around for Cloves.


Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

image

Oncology precision medicine decision support vendor N-of-One raises $7 million in a Series B round, increasing its total to $11.7 million. CEO Christine Cournoyer used to be president and COO of Picis.

Theranos hires a chief compliance officer and VP for regulatory and quality, the former being McKesson assistant general counselor for regulatory law Dan Guggenheim.


Sales

image

Tampa General Hospital (FL) chooses LogicStream Health’s sepsis bundle and clinical process measurement to reduce central line-associated blood stream infection.

image

Adventist Health System chooses MModal’s transcription and front-end speech recognition for its 41 facilities, where it will also pilot MModal’s computer-assisted physician documentation system. .


People

image

Pharmacy kit restocking software vendor Kit Check hires Cameron Ferroni (What’s Next Consulting?) as chief product officer.

image

Solid state storage array vendor Pure Storage hires Vik Nagjee (Epic) as VP/CTO of global healthcare solutions. He helped develop Epic’s hosting business.


Announcements and Implementations

Cambia Health Solutions will merge its HealthSparq and SpendWell Health offerings under the HealthSparq name, offering users the ability to compare procedures and providers and then use SpendWell’s “buy now” technology to book appointments.

image

University of Pennsylvania Health System (PA) will build a 540,000 square foot, 18-story Center for Healthcare Technology in downtown Philadelphia, with Penn Medicine’s IT department being a major tenant.

image

Scotland’s Digital Health & Care Institute innovation center hires Scottish tennis star Andy Murray as its ambassador.

image

The PillPack pharmacy uses APIs from PokitDok (Pharmacy Plan and Pharmacy Formulary ) to help its Medicare customers understand drug coverage and co-pays.


Government and Politics

image

A fascinating article profiles the White House’s  US Digital Service, a group of mostly former Silicon Valley engineers that bypasses government red tape and contractors in saving taxpayers many times its $14 million annual budget by creatively solving IT problems that have long stymied federal IT lifers. It mentions Digital Service at VA (photo above), another skunkworks project that developed a new VA benefits appeals system, created a consolidated website at Vets.gov, and figured out a way for the VA and DoD to exchange scanned documents. Everybody loves the groups except fat cat IT contractors and the internal federal government bureaucracies that created the messes the kids are sent to clean up. I liked this passage about how the group broke the VA-DoD document logjam in just a few weeks:

They did not pick a toy task, but embarked on a challenge that had bedeviled the military for years. Unbelievably (except for in government), the DoD and VA use different systems for medical records, and the two systems get along just about as well as North and South Korea. Moving a medical history from one to the other — a pretty common task, since service people by definition become veterans upon discharge or retirement — could only be done by physically scanning the military records and sending files to the VA. But even that often failed, because the VA system was very finicky about file formats … “We had good people working on that, some of our best people,” says Secretary Carter. But they hadn’t cracked the problem, and indeed, hadn’t shipped anything for over a year. Nor were they thrilled at the idea of a bunch of hacker-types appearing in medias res. “At first the people who were working on the program were insulted at the suggestion they needed help,” admits Carter. “So some of them needed to be nicely helped to understand that was a good thing.”


Privacy and Security

A corporate payroll employee of the Phoenix-based Sprouts supermarket chain falls for a phishing scam in sending the 2015 W2 statements of all 20,000 employees in response to an email disguised to look as though it came from a company executive, with some employees already reporting that the scammers are trying to steal their IRS tax refunds.


Technology

BIDMC CIO John Halamka, MD touts third-party apps that layer on top of EHRs, listing three cloud-based systems BIDMC will deploy:

image

The Right Place (electronic referrals for moving inpatients to post-acute care facilities).

image

PatientPing (encounter notification).

image

Collective Medical Technologies (team communication for managing patients who are regularly seen in multiple settings, such as EDs).


Other

South Shore Hospital (MA), whose proposed acquisition by Partners HealthCare was nixed last year due to anti-trust concerns, tries to raise $222 million in donations to pay for a campus expansion ($62 million) and its Epic implementation ($160 million).

Four noted experts offer their ideas for fixing healthcare:

  • Change the all-or-nothing FDA review of drugs into a a Consumer Reports-type rating of safety, efficacy, and degree of available evidence and let physicians and patients decide how to use them.
  • Give patients control of their electronic information as a “consumer-mediated health information exchange.”
  • Improve drug competition by speeding up FDA approvals and holding drug companies responsible for cost effectiveness by putting them at risk for outcomes.
  • Publish provider performance and cost data similarly to how businesses publish standardized accounting reports.
  • Pay hospitals based on quality in a more consistent manner, incorporating patient-reported outcomes and collecting data electronically.

Sponsor Updates

  • Winthrop Resources creates a light-hearted video about its new offering, a financial service for IT infrastructure for healthcare data centers.
  • GetWellNetwork announces that 35 hospitals and clinicals implemented its Marbella mobile rounding and patient experience solution in the first six months of 2016.
  • ZeOmega integrates Forecast Health’s patient risk analytics into its Jiva population health management product, adding the capability to perform predictive modeling based on social determinants of health.
  • Optimum Healthcare IT is recognized as one of Northeast Florida’s fastest-growing companies.
  • The St. Louis Business Journal profiles TierPoint CEO Jerry Kent.
  • Valence Health will exhibit at the MAHP Summer Conference July 20-23 in Acme, MI.
  • Verisk Health publishes the latest edition of The Globe newsletter.

Blog Posts


Contacts

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

125x125_2nd_Circle

View/Print Text Only View/Print Text Only
July 21, 2016 News 5 Comments

EPtalk by Dr. Jayne 7/21/16

July 21, 2016 Dr. Jayne No Comments

clip_image002 

I’m always on the lookout for FDA alerts on drug recalls and other issues of interest to my clients. Usually those come as a “Dear Health Care Provider” letter and often involve contaminated biologicals, poorly compounded pharmaceuticals, or counterfeit prescription medications. This notice caught my eye, however, because it notified health care providers of hair loss, itching, and rash caused by a cosmetic product rather than a drug. Sometimes we forget that the FDA does more than approve prescription drugs, so this was a good reminder.

clip_image004

Although the majority of providers hanging around the typical physician lounge don’t have a working knowledge of MACRA or MIPS, those of us who are knee-deep in the transition to value-based care have some pretty detailed conversations. One of my colleagues has been in a discussion group about how Accountable Care Organizations submit their quality measures. I have to admit that I haven’t been deep into the ACO regulations, so I was surprised to learn that submission using the CMS Web Interface typically uses the first 284 Medicare patient encounters of the year. How do they even come up with a number like that?

The discussion group had been spurred by some kind of advertising piece targeting practices that see a lot of snowbirds, since those patients (who are often more physically and financially healthy than their peers) typically head south after the holidays. This could theoretically skew quality numbers in the less-temperate zones based on the demographics and clinical status of the remaining patients. Of course, depending on the size of the practice and the number of snowbirds, the skew could be negligible. But it makes one wonder about the rationale behind such an arbitrary number as well as taking the sample from the first encounters of the calendar year rather than as a random sampling. I’d be interested to hear opinions from those that know more about ACOs.

I’ve seen a definite shift in the scope of consulting requests that I’ve seen over the last couple of years. Where they used to be strongly flavored with the need to find an EHR, replace an EHR, or optimize an EHR, I’m not getting many of those these days. Most of my potential clients want help transforming their practices, either into a patient-centered medical home model or in helping with general office efficiency. One of the most common discussions I get into during these projects is the idea of panel size, or how many patients a primary care physician should have under their care.

When I first came into practice as a solo primary care physician, the hospital that sponsored me wanted to target a panel of 4,000 patients. That was partly based on the demographic of the area, knowing that many of my patients would be young and healthy and wouldn’t need more than one or two visits a year. However, since I was the only physician within a 10-mile radius taking new Medicaid patients, the ridiculousness of that panel size quickly became apparent as my schedule was loaded with patients who would come in 12 or more times per year. Helping clients determine what the right panel size for their providers is can be tricky, and I try to keep up with articles that address it.

One of the first things I look at the wait for a patient to get an appointment. Regardless of your panel size, if your patients can’t get in, you have too many patients (or not enough appointments – either way something isn’t right). I also look at provider scheduling habits and whether they run on time or double book and how they cope with that. If they’re getting through the day by double booking and praying for cancellations, it’s more likely to lead to burnout, employee dissatisfaction, and patient dissatisfaction. I also look at whether the practice is running using a care team model or whether they’re running as a more traditional physician-run practice.

Unfortunately, income goals tend to drive visit volume more often than other factors such as clinical quality or perceived workplace stress. I was recently wearing my EHR hat in a conversation with a practice management consultant whose opening comments to the physician asked how much she wanted to make per hour because that was going to drive patient volume and panel size. Although income is certainly a factor for most of us, I thought it was insulting to use that as the primary discussion point rather than asking the physician what kind of practice she wanted to have and how she saw herself and her team delivering care. My sense was that if this physician was about the money, she would have chosen something other than family medicine as a specialty, and leading with that aspect of practice management really put a damper on our ability to have a good discussion.

I came across an article this morning that addresses the concept of panel size as an issue in physician workforce planning. It addresses the idea that a panel size of 2,500 patients is often cited with little evidence to back it up. How far that is from my initial 4,000 patient target! The article goes on to look at practices that actively manage panel size (such as Kaiser Permanente and the VA) whose numbers are more in the 1,200 to 1,700 range. It also mentions that physicians in a “concierge or boutique” model care for between 900 and 1,000 patients, but my experience shows these to be even smaller – typically in the 500-600 range in the Midwest.

It’s no surprise that smaller panel sizes lead to reduced wait times and improved quality of care, as mentioned in the article. The trick is ensuring that primary care compensation allows smaller panel sizes so that physicians can truly get off the volume-driven hamster wheel. Compensation also has to allow for utilization of diverse clinical team members such as dieticians, social workers, care coordinators, and more, if that’s what our “value-based” system requires. I guarantee that if primary care physicians were compensated to the same degree that procedural subspecialists are (even if you adjust for years of training), you’d see people flocking to primary care.

We’re not there yet though – and we’re trying to use figures like $10 per member per month to drive change. It will be interesting to see what the next few years hold as we transition to new models of care and new models of payment.

What do you think about the transition to value-based care? Email me.

Email Dr. Jayne.

View/Print Text Only View/Print Text Only
July 21, 2016 Dr. Jayne No Comments

Morning Headlines 7/21/16

July 20, 2016 Headlines No Comments

Tackling Workers’ Mental Health, One Text at a Time

The Wall Street Journal notes the rise in companies offering their employees smartphone apps that allow them to find and receive mental health treatment, but also quotes those concerned about the potential privacy implications.

Failed merger doesn’t stop South Shore Hospital’s planned expansion

South Shore Hospital (MA), whose planned merger with Partners HealthCare failed last year after anti-trust objections, seeks $220 million in donations to cover $60 million in new construction costs and $160 million to implement Epic.

Philips to Expand Its Population Health Management Business with the Acquisition of Wellcentive

Royal Philips acquires population health management software vendor Wellcentive for undisclosed terms.

A Socio-technical Approach to Preventing, Mitigating, and Recovering from Ransomware Attacks

A new paper emphasizes user-focused strategies such as simulation and training.

View/Print Text Only View/Print Text Only
July 20, 2016 Headlines No Comments

Philips Acquires Wellcentive

July 20, 2016 News 6 Comments

image

Royal Philips announced this morning that it has acquired population health management software vendor Wellcentive. Terms were not disclosed.

Atlanta-based Wellcentive and its 115 employees has been placed within the Population Health Management group of Philips, which Wellcentive CEO Tom Zajac will lead.

Philips CEO Connected Care and Health Informatics CEO Jeroen Tas was quoted in the announcement as saying, “With this strategic acquisition, we will strengthen our Population Health Management business and its leadership, as health systems gradually shift from volume to value-based care, and provide more preventative and chronic care services outside of the hospital. Our sweet spot is at the point of care as we give consumers, patients, care teams, and clinicians the tools, such as remote monitoring solutions and therapy devices, to optimize care. Wellcentive’s solutions will provide our customers with the ability to collect data from large populations, detect patterns, assess risks, and then deploy care programs tailored to the needs of specific groups.”

I interviewed Wellcentive CEO Tom Zajac in August 2015.

View/Print Text Only View/Print Text Only
July 20, 2016 News 6 Comments

Morning Headlines 7/20/16

July 19, 2016 News No Comments

Examining Oversight of the Privacy & Security of Health Data Collected by Entities Not Regulated by HIPAA

An HHS report to Congress points out the lack of applicability of HIPAA privacy and security to non-covered entities such as app vendors, saying it will work with stakeholders to address gaps and adding that the FTC has some enforcement power.

Individuals’ Ability to Electronically Access Their Hospital Medical Records, Perform Key Tasks is Growing

An American Hospital Association survey finds that more than 80 percent of hospitals allow patients to view and download their medical record information, a significant jump since 2013.

How ‘digitizing you and me’ could revolutionize medicine. At least in theory

Eric Topol, MD of Scripps Research Institute defends the administration’s decision to give Scripps a $120 million precision medicine grant to collect and study the data of 1 million volunteers.

C-CDA Scorecard (Beta Release)

ONC creates an online tool that allows testing a C-CDA document to see how well it performs against certification criteria and advanced interoperability rules.

View/Print Text Only View/Print Text Only
July 19, 2016 News No Comments

News 7/20/16

July 19, 2016 News 3 Comments

Top News

image

A new HHS report prepared for Congress notes the obvious fact that non-covered entities such as wearable and app vendors are not regulated by HIPAA, a situation it calls “a gap in oversight” that people (including vendors) don’t always understand. That gap can’t be addressed by HHS since it has no power to regulate anyone other than covered entities.

The report suggests that the FTC identify best practices. It notes that FTC’s authority includes protecting consumers from possible relevant unfair or deceptive company practices such as not following their own privacy policies, failing to disclose how consumer information is used, or failing to secure the consumer information they collect.

It’s surprising to me how often knowledgeable industry insiders cry “HIPAA violation” when the party involved is clearly not a covered entity, such as when ESPN ran a photo of an NFL player’s medical records. Anyone can violate your privacy, but only a covered entity or their business associate can violate HIPAA.

The report notes that people who share their information with non-covered entities aren’t clearly protected by federal law. It also references the little-known FTC Health Breach Notification Rule that requires PHR vendors that are not covered entities to report breaches of their systems.


Reader Comments

From Lawson CIO: “Re: downtime. We experienced almost a week of downtime with our Lawson system running on Velocity Cloud starting July 1. It must have have hit many hospitals. How many others experienced it?” Affected readers using Velocity Technology Solutions are welcome to report. I reached out to the company but they declined to respond, saying they are contractually prohibited from disclosing information to anyone other than customers.

image

From Security Officer: “Re: The Dark Overlord’s most recent hack. The hacker gained access to a specific PilotFish dataset, but not for our environment. Do you have more information?” The Dark Overlord says he “used their [PilotFish’s] code to find exploits in all their clients … I signed a backdoor to get into their clients because I had access to their certificate signing. It got pushed out in an update a few weeks ago.” He also showed samples of the client EHR records he claims to have taken. The Dark Overlord has not previously overstated his accomplishments, so while there’s no proof so far that he breached every PilotFish client and took their PHI, I would operate under the assumption that he has and take action accordingly. I would expect his next move to be approaching those individual clients to demand payment since PilotFish turned down his demands. Confounding the issue is that some of PilotFish’s clients are HIEs and thus the information he claims to have stolen may have come from many providers, although maybe it cross-references a client table that he won’t bother linking to figure out the source.

image

From Kyle Smith: “Re: VA hiring KLAS to advise it on commercial EHRs. It was a sole-source selection, claiming that only KLAS can do the job. I’m sure KLAS loves the kind words, but this doesn’t really sound like an accurate reflection of the work of other folks in the industry.” What we taxpayers will get for our $160K VA payment to KLAS is a six-month membership and bringing in three KLAS people for four, half-day overview meetings. Apparently the VA thinks it needs KLAS to tell it to choose between Cerner and Epic. It is probably not realistic that they would just ask DoD how its Cerner implementation is going before deciding.

From Mr. Buyer Beware: “Re: Definitive Healthcare. For those using it as their hospital data source, they are doing automatic renewals, but they increase the price without notice. Thoughts, Mr. H?” I would have to see your agreement, but I would be surprised if it doesn’t include at least some provision for increases pegged to cost-of-living percentages or something like that. They can adjust the price however they want if the contract doesn’t name a fixed price for the agreement’s term, which then might be a good indication that you as a customer shouldn’t have signed it. Ditto the automatic renewal – if the contract doesn’t say it renews automatically, then you can refuse to pay assuming that you’re willing to stop using their services. Either way, it’s a nice courtesy (and good business) for a company let customers know about the new price well in advance so they can budget for it.

image

From Lifeline: “Re: taking time off from work. Like Dr. Jayne said, too many people associate their job with their identity and can’t give it up.” Job titles are like clothes – we hide behind them to prevent people from seeing us as we really are. When someone asks, “What do you do?” they are really asking, “Who are you?” with the assumption that your job defines your persona, and people often answer in that same mindset (especially executives who can’t bear the thought of not decisively differentiating themselves from us less-accomplished rabble). Folks who brag on being fully engaged in their jobs while on vacation have deathbed lessons to learn: (a) your employer and co-workers care much less about you than you think; (b) you are going to be devastated when you get fired or retire and realize all of that one-sided loyalty was misplaced as your work goes on without missing a beat in your absence; and (c) for the 99 percent of people who work at a particular job only because they need the money but would really rather be doing something else, spending more time working means spending less time living. It’s sad that people allow their identity to be subsumed into that of their employers in a form of self-enslavement. Employers have learned to maximize profits by swindling employees out of what should be their free time, now demanding their nearly undivided attention via an ankle bracelet posing as a smart phone and paying what seems like OK money for a job as long as you don’t do the per-hour math. We only think we’re immortal and the people crying graveside won’t be co-workers or customers (or in my case, readers). Welcome to the grand illusion.


HIStalk Announcements and Requests

image image

The DonorsChoose grant request of Ms. Hughes from South Carolina was simple: her fourth graders just needed dry erase boards and markers, which we provided. She reports, “The resources provide an easy way for the students to practice drawing models, pictures, and equations all of which are used to solve a variety of math problems. The students were so excited to see the new materials when they arrived. They kept going on about how nice it was of someone to give them to us!”


Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

image

Cerner names its $4.45 billion, 10-building Kansas City office park that’s under construction the Innovations Campus. The first of 3,000 software engineers will move in next year, although the project won’t be finished for 10 years. The 4.7 million square foot complex — Cerner’s seventh campus outside its headquarters — was designed to house 16,000 workers. The company announced several campus design features:

  • A staircase whose metal perforations contain quotes from Cerner’s founders in binary code form (I assume one of them won’t be “Tick, tock.”)
  • A 100-person staircase “collaboratorium.”
  • A metal panel for each of the company’s 340 patents.
  • A 188-foot tall outdoor statue depicting DNA.

image

Sweden-based exercise and diet tracker Lifesum raises $10 million.


People

image

Alan Eisman (Information Builders) joins HBI Solutions as SVP of sales and business development.

image

Cerner hires Jeff Hurst (Florida Hospital) as SVP of RCM and president of RevWorks.

image

LifeImage names Janak Joshi (Deloitte) as CTO.

image

Santa Rosa Holdings promotes Tom Watford to CEO. He replaces company founder Rich Helppie, who will remain board chair. The company’s businesses include Santa Rosa Consulting, Santa Rosa Staffing, InfoPartners, and Fortified Health Solutions.

image

Gerald Greeley (Lahey Health) joins Signature Healthcare (MA) as CIO.

image

Janet Guptill (Tatum) joins the Scottsdale Institute as executive director. She replaces Shelli Williamson, who will become vice chair of the board.


Announcements and Implementations

image

In England, Wrightington, Wigan and Leigh NHS Foundation Trust  goes live on Allscripts Sunrise.

Catalyze earns HITRUST CSF certification for Amazon Web Services.

Meditech implements Access Passport for its internal electronic forms and signatures.


Government and Politics

The VA awards Leidos a prime T4NG contract in which 24 contractors are eligible to compete for $22 billion worth of IT services, network engineering, cybersecurity, and other IT work. Leidos was not included in the original list of 21 winners announced in March 2016.

image

An American Hospital Association survey finds that 92 percent of hospitals allow people to view their medical records online, up from 43 percent in 2013. The most widespread adoption of technology for patients is the ability for them to pay their bills online, which is offered by 74 percent of hospitals, and two-thirds of hospitals say patients can securely message providers.

A Health Affairs blog post notes that while insurers can’t be required to submit their claims to a state’s all-payer claims database, many still will do so, giving researchers a good-enough set of information. It also notes that there never was an “all” claims database since they don’t include services for which insurance wasn’t billed.

AMIA warns FDA that while most providers are using EHRs, their data is not necessarily of research quality. AMIA suggests that FDA focus its research data collection on data warehouses, whose information has been better standardized and encoded, as opposed to relying on EHR information that was intended primarily to support individual patient encounters.

image

ONC offers a C-CDA Scorecard that evaluates an electronically submitted C-CDA document in two ways: providing a pass/fail score to indicate whether it meets 2015 Edition Health IT Certification for Transitions of Care, and (b) issuing a letter grade indicating conformance with HL7’s advanced interoperability rules, which means the system’s vendor is more likely to be able to support interoperability.


Technology

Drug maker GlaxoSmithKline launches a mobility study of 300 rheumatoid arthritis patients using Apple’s ResearchKit.


Other

image

The San Francisco paper finds that UCSF Medical Center CEO Mark Laret earns an average of $556,000 each year from serving on the boards of two of the hospital’s vendors, Varian Medical Systems and Nuance Communications, who have paid him more than $5 million on top of his $1.6 million annual compensation from the hospital.

Eric Topol, MD answers tough questions about precision medicine and the $120 million in NIH grants his employer, Scripps Research Institute, has received to recruit volunteer study participants. He says about the idea of  addressing patient-specific health risks instead of sequencing their genomes,

Look, we’ve had all this risk factor and lifestyle knowledge for decades. Do we have everybody practicing a healthy lifestyle? No. I don’t want to diminish the importance of it, but a lot of people have the healthiest lifestyle in the world and they get struck by things like autoimmune diseases and Alzheimer’s.  It’s not either/or, but we need to take advantage of the fact that we can know so much about any given human being — what they are at risk for, or the environmental factor that’s causing the risk.

image

Kaiser Health News notes the upswing in micro-hospitals that offer EDs and primary care services but only a few inpatient beds. Sounds swell except they are usually built by big health systems trying to squeeze out competitors and bolster their bottom lines since companies that buy fancy medical equipment or build new buildings always find a way to create the demand to pay for them (not to mention the inherent inefficiency in staffing an always-open but potentially low volume building in the unfocused factory model). Walmart puts profit-boosting, scaled-down versions of their stores only where well-off people shop and hospitals are no different, so don’t expect to see mini-hospitals springing up in the downtrodden part of town. As one of my previous health system employers always said, we serve all, but market to few. As much as everyone likes to think it isn’t true, you won’t find the best hospitals and best doctors in poor or rural areas. Also true is that we’re all paying for those fancy health system buildings, the big salaries they hand out, and the enormous employee headcount that sucks up all the parking spaces for miles.

A report finds that 70 percent of physician assistants are working in specialties rather than primary care.

image

A drunk, off-duty NYPD officer is charged with running over four pedestrians, killing 21-year-old MIT student Drew Esquivel, who was also working on an EHR for underserved areas.

HIMSS is running a hospital CMIO’s video pitch that claims to answer the question of why being named EMRAM Stage 7 was valuable to the hospital. The answer: it let the hospital’s IT employees feel good about their accomplishments. In other words, the hospital received no value whatsoever except IT bragging rights, about which the locals who are footing the bill could not care less. Magazines and websites create a lot of vanity-driven contests and awards that providers puzzlingly don’t see as pointless.

image

Maine’s HHS typos the hotline number on the debit cards it gives to food stamp recipients, with the listed number actually ringing up a telephone sex line. Most surprising to me (beyond the fact that food stamps are now issued by debit card, which is a great fraud-tracking idea) is that such services still exist, although they apparently now charge directly via toll-free numbers instead of those 1-900 lines that funded a lot of late-night TV advertising in the 1990s.


Sponsor Updates

  • Bernoulli Enterprise is nominated for the Health 2.0 10-Year Global Retrospective Awards in the category of Tech Company.
  • Besler Consulting releases a new podcast, “Skyrocketing Costs and the Emergence of Rate Setting.”
  • CapsuleTech and Direct Consulting Associates will exhibit at MHealth + Telehealth World 2016 July 25-26 in Boston.
  • The local business paper features CoverMyMeds in a profile on startup jobs and spending.
  • Galen Healthcare Solutions publishes a new case study, “Critical Clinical Information Demystified with Database Training.”
  • Healthfinch joins the Matter community of healthcare entrepreneurs.
  • Meditech recaps its history in the acute care market in Canada.
  • Forbes interviews Healthgrades SVP and Head of Digital Mayur Gupta.
  • InstaMed publishes a new case study, “Pediatric Practice Automates 90 percent of Patient Payment Collections with InstaMed.”
  • Medecision CMO Ellen Donahue-Dalton joins the Women Business Leaders of the US Health Care Industry Foundation’s advisory board.
  • ITx honors Orion Health Product Strategist David Hay with the Excellence in Health Informatics award.
  • Patientco funds treatment for six patients through a partnership with Watsi.
  • The local business paper profiles the applicants for Cincinnati health commissioner, including Robyn Chatman of Sagacious Consultants.
  • Stella Technology announces its rebranding.

Blog Posts


Contacts

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

125x125_2nd_Circle

View/Print Text Only View/Print Text Only
July 19, 2016 News 3 Comments

Morning Headlines 7/19/16

July 18, 2016 Headlines No Comments

AMIA Sees Value, Complexity in Using EHRs for Clinical Investigations

The American Medical Informatics Association applauds the FDA’s interest in mining EHR data to advance clinical investigations, but warns “we strongly caution the FDA from assuming EHRs are readily configurable for clinical investigations, even among more advanced institutions.”

How ‘digitizing you and me’ could revolutionize medicine. At least in theory

In an interview with STAT, Eric Topol, MD discusses the administration’s Precision Medicine Initiative and the role he will play leading a $120 million project at Scripps Research Institute focused on recruiting, collecting, and analyzing health data from 350,000 volunteers.

An Insurer’s Care Transition Program Emphasizes Medication Reconciliation, Reduces Readmissions And Costs

A Health Affairs study finds that a CVS Health-run care transition team offering medication reconciliation support to discharged patients reduced relative risk of readmission within 30 days of discharge by 50 percent, saving two dollars for every one dollar spent on the program.

Providence notifies 5,400 Oregon patients of records breach

Providence Health & Services (OR) notifies 5,400 patients that a former employee inappropriately accessed their medical records between 2012 and 2016. The employee has been fired, and the health system is reiterating that the employee used or shared the information.

View/Print Text Only View/Print Text Only
July 18, 2016 Headlines No Comments

Subscribe to Updates

Search


Loading

Text Ads


Report News and Rumors

No title

Anonymous online form
E-mail
Rumor line: 801.HIT.NEWS

Tweets

Archives

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reader Comments

  • TheAlchemist: I apologize to HIStalk. Did not realize that the HIT community was such a left-wing advocate group, i.e., 57.52 %. Tha...
  • Whitney: I would love to see an updated version of this!...
  • ICU Nurse: We are going from bad to worse. HHS is focused on mu and macra, while the data is being compromised. HHS has failed...
  • TheAlchemist: If you are CIO | CMIO and asked by the CEO to delete patient data from the hospital server, do you comply?...
  • BV: Loved the "Operation" game image with that story!...

Sponsor Quick Links