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News 6/3/15

June 2, 2015 News 7 Comments

Top News


Partners HealthCare (MA) goes live on Epic at a cost of $1.2 billion, double its original $600 million estimate, making the project the single largest investment the health system has ever made. The Boston Globe article quotes a Tufts professor and Health Policy Commission member as saying, “We will ultimately all pay for it. Will we get dividends back in terms of better care and greater efficiencies? We don’t know yet.”

Reader Comments


From Around St. Louis: “Re: SLU Hospital. The university is buying their hospital back and conjoining with SSM to run it. SLU Hospital was the only Tenet hospital with Epic – all others are on Cerner.” The 356-bed hospital wasn’t happy that buyer Tenet, which paid $300 million for the hospital, failed to establish a regional network. The city will lose $6 million in annual tax revenue that for-profit Tenet was paying that SSM won’t, although the mayor’s office say it’s happy with the hospital providing “quality healthcare, jobs, and expansion,” thus neatly illustrating that it’s tough to control healthcare costs when everybody likes the huge employment it creates at public expense.

HIStalk Announcements and Requests



Mr. K sent a photo of students with the Bluetooth speaker we provided to his Wisconsin PE class via DonorsChoose, which apparently was a great student motivator for our $178 donation. Mrs. F’s Ohio first graders are using their STEM kits in summer school sessions where they learn “while they think they are playing,” she reports. Meanwhile, companies donating $1,000 or more to our DonorsChoose project get mentioned and double their impact via matching funds provided by an anonymous HIT vendor executive – contact me.

I was thinking about complaints that providers don’t make EHR data available to patients vs. the tiny percentage of patients who actually request it. Someone should perform a study to determine the level of demand and the reasons people aren’t requesting their information. I haven’t seen anything to suggest that providers are denying those requests, so targeting them as the villain doesn’t make sense. Proponents should be taking their case to the public, not to providers and EHR vendors. I’ve never requested my own information or changed providers just because I couldn’t get it easily – have you?

I was also thinking that among all the unrealistic expectations placed on health IT to improve health, a big one is caused by consumers who think a huge problem is misdiagnosis. That’s a minor issue compared to lack of consistent, evidence-based treatment of easily diagnosed conditions in which the patient accepts full responsibility for their outcome. Improving outcomes and cost for obvious conditions such as COPD, diabetes, and heart disease unfortunately isn’t as sexy as uncovering a gene for an obscure disease or using Watson to suggest treatments. The transition to a public health mindset is slow and patients don’t like hearing that the answer to their problems is willpower, moderation, and acceptance rather than a decisive, inconvenience-free prescription or procedure.


June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.

Acquisitions, Funding, Business, and Stock


Post-hospital care coordination systems vendor Careport Health closes $3.8 million in financing.


McKesson sells its Care Management business, which offers case and disease management services to payers, to investors who will rename it AxisPoint Health.

Premier acquires CommunityFocus, a community health needs assessment management solution jointly developed by UNC-Charlotte and Premier that will be incorporated into PremierConnect.



Kingsbrook Jewish Medical Center (NY) will use CipherHealth’s Echo to provide secure, online audio recordings of verbal discharge instructions to visually impaired patients.

Kentucky Medical Services Foundation chooses MedAptus Enroll for managing provider credentialing.



Payor platform vendor Healthx names Sean Downs (Enclarity) as CEO.

Government and Politics


Vermont Governor Peter Shumlin says a successful software upgrade to the state’s troubled health insurance exchange system this week will reduce the time required for “change in circumstance” updates, but adds that consumers will still need personal staff help until more changes are made in the fall and that warns that it will take time to catch up on the 10,000 changes that have been backlogged. Optum met the May 31 deadline for applying the update but must clear the backlog by October 1 to keep the state from considering shutting down the exchange and moving to

Privacy and Security


Cottage Healthcare System’s (CA) cybersecurity insurer demands that the hospital repay $4.1 million it provided in settlement costs following a 32,500-patient data breach in 2013, saying the health system lied on its application in saying that it was applying patches, performing annual audits, and verifying the security capabilities of its outsourcers. The hospital failed to update the default FTP settings of servers, allowing patient information to display on Google searches.



County-operated 439-bed Riverside County Regional Medical Center (CA) requests $53 million to convert to Loma Linda University Health’s Epic system, which I believe would replace Siemens Soarian for inpatient and NextGen for ambulatory.


A Northwestern University study finds that 84 percent of teens have looked up health information online (mostly by Googling a topic and clicking on the first link presented) and 21 percent have download health-related mobile apps, although two-thirds of them say they didn’t change their behaviors based on health information or tools. Three-fourths of teens were at least moderately satisfied with the information they found, but a significant percentage also ran across negative information such as how to manufacture drugs, play drinking games, or create eating disorders. Only seven percent had ever used a fitness tracker. 

A New York Times analysis finds that hospitals are jacking up their list prices (paid only by uninsured and out-of-network patients) at double the rate of inflation, while their Medicare payments remain flat.

A study finds that 8.2 percent of ED patients returned within three days, with a third of them choosing a different ED and the second visit often costing a lot more than the first. The highest revisit rate involved skin infections that probably shouldn’t have required an ED visit in the first place, but of course most doctors in private practice work banker’s hours in rarely being available without an appointment and nearly never between 5 p.m. and 8 a.m., leaving the ED as the only medical “open now” sign on for well more than half the day unless you count urgent care clinics that actually expect patients to pay upfront instead of if and when they get around to it.

Your cutting edge, contemporary, and fresh HIMSS16 presentation proposal is due June 15, a mere 8.5 months before you’ll actually present it.


AOL founder Steve Case, now an investor, says healthcare is one of the big economic sectors that will be disrupted by startups, for which he advises perseverance, partnerships, and policy. On the other hand, Steve’s one hit was dumping AOL on the clueless and Internet-terrified Time Warner in a disastrous and scandal-driven 2001 dot-bomb merger, with his follow-up Revolution Health sinking without a trace and his current healthcare IT investments being companies I’ve never heard of. He spoke at HIMSS08 back when it still looked like he might disrupt healthcare.

Weird News Andy flipped over this story that he titles “spatuvula.” A woman tries to clear her allergy-swollen throat using a foot-long kitchen spatula handle, removal of which (and part of her esophagus)required emergency surgery. WNA loves the bonus story at the end that describes a doctor removing a fish from a boy’s throat on camera, leading WNA to question whether he was paid scale.

Sponsor Updates

  • Valence Health is named as one of Chicago’s fastest-growing companies with its 50 percent annual growth rate and 800 employees.
  • Cumberland Consulting Group’s Annamarie Lee will present “Navigate Complexities of Contracting and Government Compliance” at CBI’s Medicaid and Government Pricing Congress this week in Orlando.
  • Health Catalyst is named as one of the best places for millennials to work.
  • Forward Health Group CEO Michael Barbouche is interviewed by a Madison newspaper.


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

More news: HIStalk Practice, HIStalk Connect.

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June 2, 2015 News 7 Comments

Curbside Consult with Dr. Jayne 6/1/15

June 1, 2015 Dr. Jayne 2 Comments


I had lunch this week with some former colleagues. One of the topics of discussion was the 21st Century Cures initiative that was approved by the House Energy and Commerce Committee in May. Supporters such as Representative Frank Pallone state that it “will ensure that innovative treatments are getting to those who need them most, giving real hope to patients and their families.”

For those of you who may not have seen the non-IT details, the bill has significant goals:

  • Reauthorize National Institutes of Health (NIH) funding through FY2018
  • Establish an innovation fund at NIH
  • Require strategic planning and greater accountability at NIH
  • Increase funding for pediatric research
  • Require sharing of data generated through NIH-funded research
  • Standardize patient information across trials housed in
  • Establish a public-private Council for 21st Century Cures to “accelerate the discovery, development, and delivery of innovative cures, treatments, and preventive measures”
  • Increase patient-focused drug development
  • Require the FDA to issue guidance on precision medicine
  • Streamline policy to facilitate development of new antibacterial and antifungal agents
  • Formalize vaccine recommendation processes
  • Modify FDA review requirements for certain categories of drugs and devices

Most of us have heard about the language on ensuring interoperability and “holding individuals responsible for blocking or otherwise inhibiting the flow of patient information throughout our healthcare system.” There is also a section on expanding telehealth under Medicare.

As a primary care physician, I also liked the section addressing issues where Medicare beneficiaries can’t get certain services covered because care is delivered in the home setting. My favorite part, though, is Medicare site-of-service price transparency. I hope all the health systems doing so-called “provider-based billing” take note of this. It’s going to be harder to trick patients into paying exorbitant facility fees if this makes it through. Rebranding free-standing physician offices as hospital departments as a thinly-veiled cash grab is one of the more despicable practices I see among hospitals and health systems.

The Senate is working on its own version of the bill, so it remains to be seen whether all of this passes, and if it does, how much the individual sections are modified. Funding research and cutting edge therapies is important, as is dealing with various Medicare oddities that complicate care delivery. In talking with my colleagues, however, we all balk a little at the call-out for precision medicine. Although it’s an interesting concept, is it really going to be pivotal for the majority of patients?

I’m a huge fan of public health. Basic sanitation and preventive measures have made a tremendous difference in quality of life for people around the world. However, I’d like to see more discussion (and also funding) of the basic health services that many people either cannot access or lack understanding of their value. It is still difficult to get insurance companies to pay for nutrition counseling or sessions with a registered dietician except for certain disease states. We can try to get patients to self-pay for these services, but it’s a difficult proposition when some are already paying large premiums for minimal coverage.

I’d like to have the time and resources to try to convince patients of the return on investment for these interventions (both in quality of life and lower health costs), but it’s hard to make headway during a 10-minute office visit. Watching Congress debate legislation that impacts rare diseases and drug development is difficult when one realizes how much work is still yet to be done on diseases that have 19th and 20th century cures already. A good number of the diseases on which we spend the most can be markedly improved (if not cured) through behavioral and lifestyle interventions, but these are the most difficult to implement. It’s much easier to take a pill for many Americans.

I’m not sure what primary care will look like in the next century. I can’t wait for the next generation to be able to scan patients with a Tricorder and synthesize antidotes and treatments Star Trek style. That seems such a long way away, though, when we’ve yet to figure out how to implement some of the basics such as universal vaccination, healthy eating habits, and regular exercise.

Looking back through the Bill’s history, I did see a small step that actually will make an immediate difference. At the same time the House of Representatives Energy and Commerce Health Subcommittee was hearing about 21st Century Cures, they were also considering HR 1321, the Microbead-Free Waters Act of 2015. It caught my eye because I’ve been aware of the microbead problem for a while, especially the fact that the US lags other countries in banning them. I must say, this Act is probably the shortest piece of legislation I’ve seen in a long time – a grand total of two pages and 14 numbered lines. If only Meaningful Use was that simple.

What’s your favorite Act of Congress? Email me.

Email Dr. Jayne.

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June 1, 2015 Dr. Jayne 2 Comments

Startup CEOs and Investors: Bruce Brandes

All I Needed to Know to Disrupt Healthcare I Learned from “Seinfeld”: Part VI – A Festivus for the Rest of Us 
By Bruce Brandes


Is necessity still the mother of invention? Edison with the light bulb. Bell with the telephone. Ford with the automobile. Costanza with the Mansiere (or was it Kramer with the Bro)?  

Given the clear market need for all of these innovations, was there ever any question that these entrepreneurs would become wildly successful? Or were men content with candlelight, telegraphs, and horse-drawn carriages, which caused their man-boobs to jiggle as they rode along?

Today, conversely, as suggested by Jared Diamond, invention may be the mother of necessity. Did we know we needed an iPhone until Steve Jobs showed us the compelling device? Unfortunately in healthcare, too often it seems entrepreneurs and investors are introducing products believing they have invented the next iPhone-like phenomenon, to eventually realize that not only does the market not have a need, in many cases does not even have a want.

When looking to invest in an early stage venture which seeks to address a well-understood but yet-unsolved problem, how does an investor know with which one of the multitude of aspiring inventors to bet? 

An important consideration is understanding the motivation and passion of the founder to launch the undertaking in the first place. An example lies in the prolific innovator, Frank Costanza, and the remarkable global embrace of the sensation that is his Festivus, whose origin is summarized in the exchange below.


FRANK: Many Christmases ago, I went to buy a doll for my son. I reached for the last one they had, but so did another man. As I rained blows upon him, I realized there had to be another way!

KRAMER: What happened to the doll?

FRANK: It was destroyed. But out of that, a new holiday was born. "A Festivus for the rest of us!"

In Venture, we often meet bright entrepreneurs seeking funding motivated to build a company that will make them rich and famous. Each time we make this assessment, I am reminded of Philip Rosedale, founder of SecondLife, who once said, “If you have an idea and you know you won’t earn a dime from it but you have to pursue it anyway and solve the issue, then you’re a true entrepreneur.” 

While in hindsight most investors would prefer to have backed Mark Zuckerberg ahead of Philip Rosedale, I suggest that if becoming rich and famous is your primary goal, you are very likely going to fail. Financial rewards may be the result of a more noble primary goal being achieved, but should not be your first focus.  

I believe this is particularly true in healthcare. Two excellent examples (from reality rather than Seinfeld) of promising healthcare technology-enabled solutions that were founded by purpose-driven entrepreneurs and briefly their inspirations.

Wiser Together – Shub Degupta


In the fall of 2007, my wife and I went through a difficult pregnancy. In particular, the decision about whether to undergo invasive and expensive genetic tests daunted us. There were plenty of sources of information: friends, family, the Internet, helplines, genetic counselors, even academic literature.

In fact, in some ways there was too much information, often out of context. Our friends were helpful, but the information was anecdotal. Health websites had good information, but it was overwhelming, not actionable, and not personalized for our situation. It was nearly impossible to get to a decision that gave us peace of mind.

What we really wanted was the right information for us: What did other couples like us do? What tests did they have? What treatments did they seek? And, always lurking in the background, what was covered in our insurance plan?

We had to make some of the toughest decisions of our lives with insufficient information. Our experience was very stressful—and yet extremely common.

I realized this didn’t have to be the case. With new technology, extensive data, and a thorough understanding of how people make health decisions, WiserTogether was founded in early 2008, a few weeks after our eldest daughter was born. Today, WiserTogether helps millions make health decisions efficiently and intelligently, achieving better outcomes at a lower cost .. and with peace of mind.

Rallyhood – Patti Rogers


I created Rallyhood after witnessing the power of community and kindness during my long battle with breast cancer. The love and support from family, friends, and neighbors truly changed my life and made a significant impact on my ability to heal. The truth is I could not have done it alone. I needed my doctors and medicine to kill my cancer, but I needed my people to bring me back to life. 

While the people were amazing, my family and I experienced the frustration of trying to organize the support effort with fragmented, difficult-to-use tools. It added unnecessary stress and burden for all of us. After getting well, I was inspired to build a platform for purpose-driven communities that made it easy to rally around a person, event or any common cause. Blending the best of social and and the best of productivity in one place. 

Today, Rallyhood has helped more than 20,000 communities organize emotional, practical, and financial support in one place. By engaging the person’s trusted community, providers can now extend the continuum of care in a more holistic way—improving outcomes, enriching the patient (human) experience, and expanding their brand into the daily mobile lives of the people they serve. Everyone wins.

Ultimately, growing a viable new company and achieving valuable business outcomes takes more than just an inspired founder. There will be conflicts where your team must air grievances if there is any hope for a Festivus miracle. We all know that any success story, over time, will reflect fondly on the feats of strength required to achieve greatness.  

What is the mother of your invention? 


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

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June 1, 2015 Startup CEOs and Investors No Comments

Morning Headlines 6/2/15

June 1, 2015 Headlines 1 Comment

New Medicare data available to increase transparency on hospital and physician utilization

CMS releases its latest Medicare payment dataset, covering all inpatient and outpatient hospital billing and reimbursement figures for 2013. The latest data breaks down what hospitals charged, and what Medicare reimbursed, for the 100 most common inpatient DRGs and outpatient procedures.

AMA Weighs Ethical Telehealth, Doctor Care Via iPhone

At the 2015 AMA Annual Meeting this week, the AMA’s Council on Ethical and Judicial Affairs will debate and vote on a new telehealth policy that will advise doctors on everything from patient privacy, diagnostic procedures, and follow up care.

Providers want CMS to slow down EHR superhighway

Several provider organizations weigh in with their concerns over the proposed MU3 rules, with Catholic Health Initiatives saying “We are concerned that CMS is trying to force providers to move toward meaningful use of EHRs at a pace that is too fast and impossible to meet,” and the AHA saying “We do not yet have sufficient experience at Stage 2 to be confident that the proposals for Stage 3 are feasible and appropriate.”

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June 1, 2015 Headlines 1 Comment

Morning Headlines 6/1/15

May 31, 2015 Headlines 23 Comments

Federal Court rules in favor of Teladoc, blocking Texas Medical Board rule and preserving telehealth in Texas

Dallas-based Teladoc wins an early victory in its anti-trust lawsuit against the Texas Medical Board, which passed a rule earlier this month requiring a face-to-face consultation before any telehealth services could be provided in the state. A US District Court has blocked the rule from going into effect until after the trial.

Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs

The American Medical Informatics Association publishes the recommendations of its EHR 2020 Task Force in a report on the status and future direction of EHRs.

Erlanger spending $91 million on major IT overhaul

Erlanger Health System approves a $91 million contract to implement Epic across its system, with an additional $97 million budgeted to maintain the system over the next 10 years. The hospital’s selection committee, made up of clinical and operational leaders, voted in favor of Epic 28 to two over Cerner.

Big Data Beats Cancer

IEEE Spectrum profiles John Halamka, MD, CIO of Beth Israel Deaconess Medical Center, who helped pioneer several big data initiatives in healthcare and in 2011 turned to big data to help create a personalized treatment plan for his wife when she was diagnosed with stage III breast cancer.

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May 31, 2015 Headlines 23 Comments

Monday Morning Update 6/1/15

May 31, 2015 News 9 Comments

Top News


A judge approves an injunction requested by Dallas-based telemedicine provider Teladoc against the Texas Medical Board for its new rule that requires doctors to conduct a face-to-face patient visit before issuing a prescription.

Reader Comments

From Talking About BS: “Re: Athenahealth. Has spent almost $1 million on lobbying so far in 2014-15 and VP Dan Haley is listed in as a ‘revolving door’ lobbyist, described as federal employees turned lobbyists and vice versa. Athena’s cloud vapor simply isn’t selling to real customers and instead is being sold to Wall Street and Congress. Einhorn has this company pegged.”

From Travlinman: “Re: Epic. Guarantees ongoing interoperability with TeleTracking. Are they going to start playing nice with other vendors?”

HIStalk Announcements and Requests


More than half of poll respondents think Cerner is the HIT stock to buy. New poll to your right or here: who is most to blame for lack of patient data sharing among providers? Vote and then click the poll’s comments link to make your case.


I have no idea what a Rekenrek is, but Ms. S says her Indiana first graders are using the ones we bought via our DonorsChoose project daily for Math Warm-Up, adding that, “We had been using Rekenreks that we made on our own that are falling apart, so to see professionally made ones is wonderful!”

I seem to be especially cranky about grammar these days, so add these to my already long list: (a) starting sentences with the word “So” like a drunken bar patron launching into a long, dull anecdote; (b) sloppy use of geographic terms such as “a German doctor” that could mean a doctor from Germany, a doctor in Germany, or both; (c) using “less” rather than “fewer” in describing a collection of individual items, as in erroneously stating, “The event had less people than before”; (d) confusing “I” with “me” as in incorrectly proclaiming, “My brother came to visit Mary and I.” There, now I feel better.

I’m also annoyed by the expression “EHR mandates.” Nobody requires doctors to use EHRs except perhaps their employers – they just pay them extra if they do.

Last Week’s Most Interesting News

  • HHS names Susannah Fox as its new CTO.
  • Two entrepreneurs who sold DiagnosisOne to Alere in 2012 buy back the business – now known as Alere Analyics – to form Persivia. 
  • Athenahealth VP of Government and Regulatory Affairs Dan Haley said in a New York Times article titled “Tech Rivalries Impede Digital Medical Record Sharing” that customers typically pay EHR vendors $1 million upfront, $500,000 per year, and $2 per patient record to exchange information with other systems.
  • Forbes names Epic CEO Judy Faulkner as the wealthiest women in all of technology with an estimated $2.6 billion net worth.
  • Cerner told shareholders that it recorded $4.25 billion in sales for 2014.


June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.



Tim Theriault, global CIO of Walgreens Boots Alliance (the former Walgreen), resigns for personal reasons. He will be replaced by Anthony Roberts, SVP/international CIO. Roberts came on board with the December 2014 Boots acquisition.


Former Meriter CIO Peter Strombom died May 18 at his home in Costa Rica. He was 75.

image image

Jeremy Delinsky, chief product officer at Athenahealth, resigns after five months in the position to take a CTO position with an online furniture company. ATHN shares dropped more than 5 percent Friday following the announcement.  His interim replacement will be VP Kyle Armbrester. ATHN shares are down 20 percent so far in 2015.

Announcements and Implementations


Athenahealth offers athenaCommunicator Enterprise to new customers who participate in an ACO for a flat 10 percent of their MSSP shared savings payouts.

Government and Politics


Florida Governor Rick Scott, former CEO of for-profit and fraud-admitting Columbia/HCA, wants to hold the state’s non-profit hospitals more accountable for their huge profits, topped by Lee Memorial Health System’s $230 million.



Ashish Jha of Harvard tweeted out rave comments about Doc Stats, an app that shows the approximate number of procedures a doctor performs as derived from CMS data.


A Bay Area recycling firm is looking for a woman who dropped off garage junk following her husband’s death that included an Apple I computer, one of only 200 that were hand built by Steve Jobs and Steve Wozniak in 1976. The company wants to give the woman $100,000, her half of the amount a private collector paid to buy it from them.


AMIA’s EHR 2020 task force publishes its recommendations. Many of them are observations of the current state or non-specific ideas about long-term changes that I didn’t find especially compelling or novel, but a few actionable items are:

  • Use natural language processing to convert free text notes to discrete data and reduce reliance on documentation templates.
  • Spend government money to study data entry methods and encourage the use of those that improve provider efficiency.
  • Slow down or freeze the Meaningful Use and certification requirements.
  • Eliminate requirements for providers to enter EHR information that isn’t used for direct patient benefit.
  • Eliminate E&M codes and checkbox-driven data entry that fails to capture the patient’s voice.
  • Allow vendors to meet MU certification with less-prescriptive methods and require them to post video recordings of their system so that EHR purchasers can see how they work.
  • Create the national Health IT Safety Center.
  • Require vendors to offer APIs to earn certification.

The board of Erlanger Health System (TN) approves its $91 million Epic contract, which will also require $97 million in maintenance costs over the next 10 years. The CFO says Epic beat Cerner on price and the selection committee preferred Epic 28 votes to two.

The Indianapolis business paper profiles ICUcare, which puzzling offers both a smartcard-based PHR (the company owner says he spent $25 million to develop it) and a telemedicine platform. The owner says the company has 12 employees and $3.5 million in revenue, some of which should probably be directed to updating the website, whish announces plans to release new technology in June 2010 and that lists Windows Vista as the required operating system (those are just the tip of the “ice-burg,” it says).

A Florida hospital tests the Internet lag time in performing telesurgery using the da Vinci surgical robot, finding that surgeons can’t tell the difference whether they are a few feet or a few states away from the patient.


Influential healthcare IT expert Jess Jacobs of Aetna’s Innovation Labs recounts her recent and current experiences (with photos) as an inpatient of a hospital that can’t do anything right – a bathroom sink clogged for three days with her roommate’s bloody vomit, having to use her own cellphone to coordinate the work of several attending doctors who hadn’t talked to each other, mixing up mouthwash with handwash, a nurse call system that didn’t work, the nursing staff’s disregard of her roommates sickle cell crisis pain, and the barring of her patient advocate (who is a medical student at the same organization) from participating in her care. She complained to hospital administration after an earlier visit and received a halfhearted apology blaming her being housed in a treatment room as due to unplanned admissions, an acknowledgment that it was “unfortunate” that the hospital didn’t allow her friend to serve as her patient advocate (without offering an explanation as to why), and defense of her roommate’s pain management as being appropriate based on medical evidence. She’s back in as an inpatient for intractable vomiting and says nothing has improved – the hospital missed her abnormal lab results, security guards confiscated her prescribed drugs and supplies and threatened to arrest her for objecting, and the hospital assigned a “sitter” who sleeps, talks loudly in the hall, and eats bacon in her room. The scary thing about her story is that it’s not unusual from my experience – everybody who lives through an inpatient stay can relate equally horrifying stories about the incompetence and indifference they encountered.


A good article in IEEE Spectrum describes how BIDMC CIO (and gentleman farmer) John Halamka, MD helped develop early big data platforms I2B2 and SHRINE that later may have saved his wife’s life as he researched the best treatment options for her newly diagnosed cancer based on historical outcomes. He adds in describing future innovation, “All these big companies are fine, but do we really think the next cool innovation is going to come out of an 8,000-person company? No. It’s probably a two-person garage operation.”

Another interesting IEEE Spectrum article addresses the healthcare uses of IBM’s Watson, which it concludes isn’t ready for prime time and may not be for some time because: (a) it not only has to find existing answers in existing content but also has be trained to think like a doctor; (b) journal articles Watson uses as source material aren’t always current or based on actual medical practice; (c) EHR databases are full of errors and focus more on billing rather than clinical usefulness. The article mentions other companies working on medical artificial intelligence such as QPID, DXplain, and CancerLinQ.

A small study of Facebook users finds that those with low self-esteem post often about their romantic partners, while those who brag about diet, exercise, and achievements are often narcissists who crave “likes” and positive comments from annoyed “friends” just trying to be nice.

Sponsor Updates

  • Medicity posts “ICD-10: Are We There Yet?”
  • MedData will exhibit at the Coastal Emergency Medicine Conference June 5-6 in South Carolina.
  • First Databank customer Joshua Schmees, PharmD of Hospital Sisters Health System describes the organization’s success in reducing alert fatigue by using FDB’s AlertSpace.
  • Quest Diagnostics employees raise over $11,000 in the American Cancer Society’s Relay for Life.
  • WeiserMazars posts pictures from its nationwide community service day.
  • NTT Data offers “Predictive Intelligence Brings Increased Value to Data.”
  • Versus Technology will exhibit at AAMI 2015 June 5-8 in Denver.
  • Truven Health Analytics posts “Understanding Your Exchange Population: Are You Asking the Right Questions?”
  • Microsoft summarizes the origins of Oneview Healthcare as part of its Customer Stories series.
  • Orion Health and Passport Health will exhibit at AHIP Institute 2015 June 3-5 in Nashville.
  • Patientco offers “Out-of-Pocket Costs are Increasing Faster Than Expected.”
  • PatientPay Founder and CEO Tom Furr asks “What Would Steve Jobs Say?”
  • ZirMed posts “Leveraging Data Analytics, Keeping Up with Value-Based Care, and Rev Cycle Success at Stanford Children’s Health.”
  • PMD offers “Reusing Code to Improve Care Coordination.”
  • Wide River will host an educational event, Health IT: Compliance & Innovation, June 4 in Lincoln, NE.
  • Sagacious Consultants posts “What You Don’t Know Can Hurt You: the Importance of Measuring Productivity.”
  • Huron Consulting will sponsor the 2015 Aria Health Golf Classic June 1 in support of Philadelphia-based Aria Health’s ICU renovations.
  • The Nashville Business Journal features Shareable Ink CEO Hal Andrews in its “The Boss” video series.
  • Streamline Health will exhibit at the 2015 CHIA Convention & Exhibit June 8-10 in Palm Springs, CA.
  • T-System will exhibit at NYHIMA’s 2015 Annual Conference June 7-10 in Syracuse, NY.
  • TeleTracking offers “Making Interoperability a Commonplace.”
  • Valence Health Project Manager Jacob Krive will present a session on big data and population health at the University of Illinois College of Medicine Chicago June 3.
  • Verisk Health, West Corp., and ZeOmega will exhibit at the AHIP 2015 Institute June 3-5 in Nashville.
  • Voalte offers a new blog showcasing the successful deployment of its smartphone solution at Massachusetts General Hospital.
  • Winthrop Resources will exhibit at the NY Tech Summit June 4-5 in Verona.
  • Xerox offers “The Best Kept Secret in Healthcare.”


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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.


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May 31, 2015 News 9 Comments

Morning Headlines 5/29/15

May 28, 2015 Headlines No Comments

I’m the New CTO of HHS

Patient advocate and former associate director at the Pew Research Center Susannah Fox is named the next CTO of HHS. Fox will be the third person to hold the position, following Bryan Sivak and Todd Park, and will be the first female CTO.

The Wealthiest Female Techies In America

Judy Faulkner is named the richest woman in technology, with a net worth of $2.6 billion.

Allscripts to build 12-story tower at North Hills

Allscripts will move its 1,000 Raleigh, NC-based employees into a new 12-story, 250,000 square foot office tower, scheduled to open in early 2017.

Cambia Health Solutions Leads New Round of Investment in lifeIMAGE

LifeImage, a medical image exchange platform vendor, closes a $17.5 million funding round led by investor Cambria Health Solutions. The company will use the new funding to grow its support staff and further develop its functional capabilities.

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May 28, 2015 Headlines No Comments

News 5/29/15

May 28, 2015 News 26 Comments

Top News


Patient advocate Susannah Fox (Pew Research Center) is named CTO of HHS. She replaces Bryan Sivak, who stepped down last month.

Reader Comments


From Publius: “Re: DoD EHR bid. Consulting firms are already contacting Epic consultants in regards to the IBM/Epic DHMSM bid. The communication is that the decision is anticipated to be made August 1, 2015, and consulting firms want to have a list of consultant resources ready to present as soon as the decision is made.” Unverified, but logical. The DoD project could be the equivalent of HITECH in spurring consultant demand, at least for those chosen to work on the project.

From Frank Poggio: “Re: Mr. H’s observation that patients aren’t Meaningful Users. That’s an idea for a new CMS program since it looks like ONC is struggling to find its next life! Everyone says that patient participation is a key to controlling healthcare costs, so ONC should develop a book of Meaningful Use criteria that is tied to a patient’s insurance premiums. If they don’t hit all criteria each year, their premiums double (or triple?), but if they hit them all, their premiums are cut in half. Since ONC would have to deal with some 100 million participants, they should easily be able to justify massive department budget increases.” I like it. When it comes to health, the customer definitely isn’t always right.


From Freddie Paris: “Re: New York Times article on interoperability. Wonder if Dan Haley would respond to a truth challenge to come up with any references to his assertion?” Athenahealth VP of Government and Regulatory Affairs Dan Haley was quoted in “Tech Rivalries Impede Digital Medical Record Sharing” as saying that IT vendors have business models that impede data sharing, a typical arrangement that he says costs customers $1 million to connect to another system, $500,000 per year to maintain the connection, and $2 each to send records to another system. Dan sent this response to my inquiry, which still doesn’t provide the $1 million vendor and client details the reader seeks:

The information I shared with Mr. Pear came from conversations with our clients and prospects who’ve told us firsthand and on countless occasions over the years about the exorbitant costs imposed by market-dominant vendors for out-of-platform information sharing. These costs are imposed in a number of ways: via one-time interface fees that can total more than a million of dollars for even a medium-sized health system; via annual interface maintenance charges that extend and compound that initial cost; and via per-transaction fees of the kind that one major vendor recently resolved to stop charging under pressure from Congress and others. The specific amounts vary, but are all large. The point is that any significant imposed cost for out-of-platform communication effectively discourages true interoperation and impedes progress toward the bipartisan societal goal of information fluidity in healthcare. As many in the industry know, vendor contracts are usually protected like the crown jewels, but they are sometimes obtainable via Freedom of Information Act requests directed at institutions that benefit from significant federal contracts. Enterprising reporters interested in this issue to should check for themselves. Clearly ONC gathered ample evidence of these business practices when preparing their recent information-blocking report. We are glad that both ONC and Congress are taking action.


From Carrollton Outsider: “Re: Lightbeam Health Solutions. Acquired by Greenway to be their population health solution.” Not true, said CEO Pat Cline when I asked him about the rumor, and he’s not talking to any entity about selling the company, either. Lightbeam announced a non-exclusive partnership with Greenway last year, one of several such agreements it has with EHR vendors to provide a PHM platform, but that’s it. I interviewed Pat a year ago if you want to know more about the company.

HIStalk Announcements and Requests


Welcome to new HIStalk Platinum Sponsor Boston Software Systems. The company revolutionizes how healthcare works by providing error-free automation for any application or purpose – EHR migration, streamlined business processes, and improved productivity. Its automation products are the most sophisticated available, giving customers the peace of mind that their critical data is 100 percent error free as it bridges the gap between their technologies. BSS’s reputation for ease of use and customer support is stellar. Check out the interviews with customers CVSHealth (onboarding new MinuteClinics), Unity Health System (improving discharge workflow), Methodist Houston (validating Medicare accounts), Fauquier Hospital (mass Meditech updates following a hospital acquisition), and CIO Kent Henriksen describing how his health system used BSS to migrate millions of clinical records to Epic. Thanks to Boston Software Systems for supporting HIStalk.

My latest grammar pet peeve is when people say something like, “If you have questions, please don’t hesitate to call,” the latter part of which can be equally clearly stated by just saying “call.” How many people would ever use the word “hesitate” except in this awkward form, and why can’t I hesitate if I want to? Peeve #2: a phrase such as “20 different physicians,” where nobody really needs the “different” part to understand that it’s not 20 of the same physician.

I was having odd, persistent “waiting on …” browser site loading messages that I fixed by reinstalling a solution I’ve used previously: OpenDNS. It’s a free, 30-second network connection change that bypasses slow, unreliable DNS lookups in replacing them with its own. It improved site load times quite a bit.

This week on HIStalk Practice: HHS awards $112 million to help primary care practices optimize EHR utilization to improve cardiac health outcomes. Morrow Family Medicine launches NeighborAide app for elderly patients and caregivers. Minnesota will no longer force solo docs to implement EHRs. The Illinois Gastroenterology Group rolls out new technology for Crohn’s patients. Physician practices show cloud-based EHRs some love, but still have reservations about data security. American Well CEO Roy Schoenberg, MD explains why the future of telemedicine is already in physician pockets.

DonorsChoose Project Updates


image image

Ms. N from California shared photos of her disabled high school seniors using the Chromebook we provided as a DonorsChoose grant to type their essays, complete college applications, and apply for jobs. The second graders in Ms. A’s class in Texas are using the math games we bought to learn to count money, write fractions, measure objects, and tell time, and she adds that they are so popular that the kids make a beeline for them during indoor recess.

The $10,000 Challenge


A vendor executive who shall remain nameless was so moved by the participation and classroom reports that I’ve mentioned here that he/she is putting up $10,000 to match new DonorsChoose donations. If your company donates $1,000 or more (I’ll set up a credit card payment), I’ll feature it here and also apply matching funds from our anonymous benefactor, which will provide double bang for the buck (actually quadruple bang for the buck potentially, since I often find requests that will be matched by charitable groups such as the Bill & Melinda Gates Foundation). DonorsChoose is a stellar charity that spends 94 percent of its income on projects rather than overhead, paying its CEO and genius founder only $240K (and that’s New York city money, a rounding error in the salaries of health system CEOs there). Centura SVP/CIO Dana Moore, who conceived this HIStalk project in the first place and donated his time at HIMSS to encourage donations, has ideas to keep it going as well.


June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.

Acquisitions, Funding, Business, and Stock


Cloud computing services vendor ClearData closes a $25 million Series C funding round.


Medical image exchange platform provider LifeImage closes a $17.5 million investment round led by non-profit insurance and health solutions company Cambia Health Solutions, which owns several healthcare technology vendors.


A construction company confirms that Allscripts will move its 1,000 Raleigh, NC employees into a new 12-story office tower that will open in the spring of 2017.

Forbes names Epic CEO Judy Faullkner as the wealthiest female in all of technology. The assets of the top 11 women combined ($10.6 billion) is 3 percent of the wealth of the top 11 men.


Community Hospital of the Monterey Peninsula (CA) and University of New Mexico Health Sciences Center choose revenue cycle management products from Experian Health/Passport.

Lakeland Health (MI) chooses ProVation Order Sets for clinical content management.

Announcements and Implementations

Nuance announces PowerScribe 360 Reporting v3.0, which allows radiologists to create higher quality reports using real-time, evidenced-based guidance developed by the American College of Radiology.


ToSense’s CoVa body-worn sensor (thoracic impedance, heart rate, heart rate variability, respiration rate, skin temperature, and posture) earns FDA 510(k) clearance. Elderly patients wear the necklace-type device in their homes for a few minutes each day to allow remote monitoring for heart failure.

CompuGroup Medical US and rehab services company Weston Group will partner to develop rehab modules for CGM’s webEHR.

Privacy and Security

Ohio’s medical board reprimands a radiologist for violating HIPAA by looking up the electronic medical records of a colleague for unstated reasons.



Weird News Andy would enjoy captioning this photo of a virtual butt being used for medical student prostate exam training. In slightly related news, a Florida college will stop requiring female sonography students to perform vaginal probes on each other for ultrasound training and will instead move to simulators.

Bizarre: a father and son in their 70s are married after 52 years together, with the “bizarre” part being that in order to game the system in a state that doesn’t recognize domestic partnerships, one had adopted the other in 2000, a parental status the court agreed to vacate prior to their nuptials.

Sponsor Updates

  • First Databank President Chuck Tuchinda, MD provides advice for career success in a San Francisco TV interview.
  • Nordic posts a video of its Community Giveback Day activities on May 22. Check out the 1:00 mark when the guy recording Nordic employees working on a Habitat for Humanity house asks one of them, “What do you think your KLAS rankings for hammering upside down would be?”
  • VMware posts “New Research Highlights Clinical Benefits of Virtual Desktops.”
  • Healthfinch asks “How does a 21.7 hour work day sound to you?”
  • Impact Advisors posts “The Good, the Bad and the Ugly of Meaningful Use Stage 3: Objective 2 – ePrescribing.”
  • E-MDs will exhibit at the Texas Medical Society event June 1 in Austin.
  • Extension Healthcare and Iatric Systems will exhibit at the AAMI 2015 Annual Conference June 5-8 in Denver.
  • Healthgrades recaps its experience at the Colorado Digital Health Summit.
  • Galen Healthcare posts “Point-to-Point vs Interface Engine: Does your interface setup suit your needs?”
  • InterSystems and Intelligent Medical Objects will exhibit at the e-Health Conference May 31-June 3 in Toronto.
  • Glytec presents several research studies at the AACE 24th Annual Scientific and Clinical Congress.
  • HCS will exhibit at the LeadingAge CA Region Meeting June 3 in LA.
  • The HCI Group posts “PeopleSoft ALM is as Important to Patient Safety as it is to Cost Control.”
  • HDS asks “Are Text-Only Emails Obsolete?”
  • Healthwise will exhibit at the AHIP Institute 2015 June 3-5 in Nashville.
  • InstaMed will present a session at the AHIP Institute 2015 on June 4 entitled, “Positive Member Payment Experience is Critical – See How Health Plans are Delivering.”


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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.


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May 28, 2015 News 26 Comments

EPtalk by Dr. Jayne 5/28/15

May 28, 2015 Dr. Jayne No Comments


Even though I’m not ready to jump into another CMIO position at the moment, I still keep up with job postings and am watching a couple of positions to see how long they take to fill. I know the health systems involved more deeply than I’d like to admit. It will be interesting to see who is brave enough (or naïve enough or desperate enough) to sign up for those kinds of adventures. I’ve subscribed to a couple of job sites and today’s email brought some laughs under the banner of “great new jobs found for you this week.”

They included: utility location technician, Uber driver, business analyst at Emdeon, inside sales rep at Thermo Fisher Scientific, data entry clerk, patient experience officer, chief technology officer, and my favorite – Deerpark Barn Supervisor at The Biltmore. When I hit that last one, I noticed that all the jobs were in Asheville, NC. Although it’s a beautiful city and I’ve had some fun times with good friends there, I’m wondering if my profile has been hacked.

Speaking of job hunting, I’ve received several recruiter mailings this year and find it curious that they have all mentioned what EHR system is used at the site. Having used many systems, I’m not sure having one vendor over another would really make or break an opportunity for me. I’d rather have a well-implemented version of a low-key system than a poorly managed version of one of the industry darlings. Even in the cloud or on standardized MU-ready versions, clients still seem to have enough configuration and workflow options to get themselves into trouble.

I started a consulting project this week training ICD-10 for a local group of independent providers. It’s been a lot of fun working with end users who aren’t used to having a clinical informaticist around. With their focus on clinical care, they haven’t been PowerPointed to death and actually seem excited about learning something from my traveling road show. I’m just doing introductory content now then will circle back in a month or so with actual workflow training on their EHR system.

We’ll see how enthusiastic they remain after we get into the gorier parts of the workflow. I knew it really clicked with at least one student, who sent a piece from MSN entitled “The Strangest Ways Americans Die in all 50 States.” She asked whether the “cause of death” information would be more specific once ICD-10 is live. I hope so, because some states have amazingly general categories listed such as “water, air and space, and other and unspecified transport accidents” in Alaska and “legal intervention” in Nevada.

I received a handful of “thanks for stopping by our booth at HIMSS” messages this week, mostly from booths I don’t remember visiting. I’m pretty meticulous about taking notes while I’m crawling the exhibit hall and none of them were on my list, either. I’m attributing it to a HIMSS technology glitch rather than faulty memory. Nonetheless, if I want to buy mounts for my flat screen displays, I know where to go.

The National Healthcare Innovation Summit takes place next month in Chicago. An advertisement for it asks. “How will you innovate healthcare this year?” Most of my CMIO friends aren’t going to be doing any innovation. It looks like 2015 is about catch-up and ICD-10 preparation. Especially with Meaningful Use Stage 3 howling at our door, I don’t foresee vendors doing a lot of innovation, either.

I hadn’t realized that Minnesota passed legislation in 2007 that required all healthcare providers to implement a certified EHR by January 1, 2015 and to connect to a state-approved HIE. I came across a blurb this week that the legislature has approved an omnibus bill containing an exemption for cash practices and solo practitioners. I’d be interested to hear from Minnesota readers who have an opinion on the situation.


One of my favorite shoe enthusiasts brought these to my attention. Controlled by a smart phone app, they change colors and patterns to match the wearer’s needs or possibly just her mood.


In a related link, we’re introduced to motion-capture ballet slippers constructed from Arduino components and conductive thread. I forwarded it to my nephews in the hopes that they might need a project to keep them busy this summer. Maybe we can combine the two technologies to put together a graphical representation of what really happens on the HIStalkapalooza dance floor.

Email Dr. Jayne.

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May 28, 2015 Dr. Jayne No Comments

Readers Write: The Internet of Things Can Revolutionize Healthcare, But Security is Key

May 28, 2015 Readers Write 3 Comments

The Internet of Things Can Revolutionize Healthcare, But Security is Key
By David Ting


The Internet of Things (IoT) holds tremendous promise in healthcare, potentially enabling a digital health revolution and support the future of care delivery.

Gartner estimates that approximately 3.9 billion connected things were in use in 2014. This number is expected to increase to 25 billion by 2020, a growth trajectory that will surely impact the healthcare industry, which is already being flooded with devices for generating valuable patient data.

However, the transformative potential of the IoT won’t be realized for healthcare unless data integrity and security are built into the foundations of the IoT movement.

The IoT’s network of IP-connected computers, sensors, and devices allows care providers and patients to share information to a transformative degree by:

  • Giving care providers access to a greater number of devices for accessing protected health information (PHI).
  • Allowing patients to generate real-time biometric data with low-cost devices and applications.
  • Changing the nature of encounters with care givers from episodic to real time.

For clinical staff, the ability to interact with EMRs or other applications containing PHI from any device is invaluable, especially in creating a push vs. pull dynamic for access to patient information and health records. Today’s care providers are highly mobile and the IoT can provide the ability to seamlessly use connected devices within a single session.

For patients, the IoT offers the ability to participate in their own care. Specific patient opportunities include:

  • Generating valuable health information from wearables and home health devices.
  • Allowing real-time voice, video, and data streaming for telemedicine.
  • Enabling more active patient engagement. Instead of requiring patients to take initiative to look up records or set appointments, messages can be proactively sent to patients informing them about updates or other relevant information

Some of these changes are already taking place on a small scale. But for the IoT to reach its full potential in healthcare, identity and data integrity will become critical as PHI moves from the hospital to the edge of patient care delivery, especially to assuage consumer concerns about privacy and security.

The data generated by a series of connected devices can only be captured, aggregated, analyzed, and put to meaningful use on a broad scale if the identities of providers and patients are verified. The data being generated, collected, and shared through networked devices must be protected with strong, usable authentication methods.

For providers, authentication is required to meet compliance and privacy regulations. If security considerations are baked into the IoT infrastructure, wearables or others devices can be assigned to particular users and leveraged to verify their identity. Similarly, proximity awareness technologies can simplify the user authentication process to access various devices and applications.

Patient authentication is also essential in the IoT paradigm because it ensures the correct information is being generated by and shared with the correct patient. Creating a one-to-one link between patients and their medical records can establish a foundation for additional forms of patient identification. As with providers, devices will become part of the digital credential set for patients, necessitating a secure enrollment process to bind one or more devices to unique patient identities.

Constructing the necessary infrastructure to properly manage and optimize the proliferation of connected devices in healthcare starts with security. A strong security strategy includes authentication technologies and processes to verify patient and provider identities to ensure that devices can only be used by authorized users. The communications channels between the devices within the IoT must also be secure to ensure the integrity of the information passing through them.

Putting these security building blocks in place will help create a closed-loop system in which patients and providers can securely interact in a more engaging, meaningful way. 

David Ting is chief technology officer for Imprivata.

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May 28, 2015 Readers Write 3 Comments

Readers Write: Trusted Data Is the Foundation for Advanced Analytics

May 28, 2015 Readers Write 2 Comments

Trusted Data Is the Foundation for Advanced Analytics
By Vicky Mahn-DiNicola RN


Much has been said about using advanced predictive analytics to improve the quality of healthcare. But one thing not receiving the attention it deserves is the pre-requisite of trusted data being sewn into the fabric of the healthcare organization. Every organization has data at its fingertips, but full value of that data can only be actualized if it is properly understood and trusted.

Take a relatively straightforward data element like a patient’s weight. While it is a simple, basic element, it can create havoc for analytics teams who discover there are upwards of 17 different places in their HIT systems where weight is captured. Weight is recorded in the emergency department flow sheets, nursing assessment intake forms, pharmacy profiles, ambulatory clinic records, and daily critical care flow sheets, just to name a few. Determining which weight field is the most reliable and appropriate to use is a difficult, lengthy process and one that is multiplied by hundreds of data variables required in advanced analytics projects.

Healthcare organizations are excited by the brilliant technology coming our way in the form of genomics, mobile health, and telemedicine. But too often, the cart is put before the horse. Just as bad ingredients guarantee a bad meal for even the best of chefs,  unreliable data in healthcare will inform inaccurate, even dangerous decisions.

Effective use of analytics is not something you can buy off the shelf from a vendor. Rather it is an organizational strategy, structure, and culture that have to be developed over time. While the technical and tactical execution is delegated to others, the chief executive in a healthcare organization is responsible for determining and overseeing this direction and progress.

The executive also needs to align the organization with data cooperatives and national groups that promote data standardization. National standards have historically been ambiguous, so it is important for providers to ensure they are not working in a vacuum, but have a common understanding of national guidance.

Diversity of systems and processes breeds confusion. Because there are many ways to express any given concept, there is a need for robust crosswalk, data mapping, and standardization to ensure data integrity within, between, and across organizations. This body of work is the responsibility of a designated data governance body within an organization.

Data governance implies far more than the maintenance of documents that describe measurement plans and reporting outputs.  It is a comprehensive process of data stewardship that is adopted by all data stakeholders across the organization, from the board room to the bedside.   Data governance is critical in order to standardize data entry procedures, reporting outputs, clinical alerts, or virtually any information that is used in clinical and business decision-making.  In the era of pay-for-performance and risk-based care, data standardization is mission critical for a true, accurate comparison to take place when evaluating an organization’s performance against external benchmarks and determining reimbursement based on value.

Another final step toward creating robust data governance structures is to create a data validation process. Data cleansing and maintenance should be automated, centralized, and transparent across the organization and should be designed to accommodate the needs of both clinical and business stakeholders.

A “data librarian” should be appointed to catalogue and oversee data elements across the healthcare system. The most mature organizations will implement a master data hub that is fully integrated into their application system environments so that changes are made simultaneously to all systems that need the same data. By doing so, a simple element like a patient’s weight will always be consistent in HIT systems.

Organizations need to recognize that the advanced analytics of tomorrow will only be achieved if the data we have today can be trusted. Those who succeed in establishing proper data governance will unlock the full value data can provide in our industry, beyond regulatory reporting and retrospective benchmarking initiatives to the more exciting prospects of predictive and prescriptive analytics.

Vicky Mahn-DiNicola RN, MS, CPHQ is VP of research and market insights with Midas+ Solutions, A Xerox Company.

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May 28, 2015 Readers Write 2 Comments

CIO Unplugged 5/28/15

May 28, 2015 Ed Marx 11 Comments

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

Time for Me to Fly

Speculation swirls as to the reasons for my departure from my Texas employer on April 20, 2015. It is really simple and drama free. The organization I served was awesome. The most amazing place I have ever worked. Loved it. What I can share with you is my resignation speech below.

I called you all here this morning to share something important with you in person. Most of you know what happened to me in January on my ascent of Aconcagua. I had every intent of summiting that beautiful and rugged peak, but it was not to be. I had to abandon my climb, although my team would successfully summit 10 days later.

In the same way, I won’t make our summit climb with you. But I know you will be fine without me. You are trained, you are equipped, and you know the path. The climb was never about me. It was about all of us fulfilling our calling here. You will climb to the top without me and continue to save lives.

It was exactly seven years, six months, and one day ago. I drove with my family down from Cleveland through Kentucky and Louisiana. And there it was — the vast flatlands known as east Texas. As we crossed the state line, a Ford 350 pulling a flatbed trailer carrying 20 head of cattle pulled in front of us in our yuppie Lexus.

My daughter was spinning the radio dial looking for travel music, but every station was playing Nascar or college football. Suddenly we were hit by a dust storm. No wait, that wasn’t a dust storm! We were being pelted by cow dung that exploded on the asphalt highway into shit shrapnel penetrating the wax of our freshly washed veneer. Welcome to Texas!

I showed up here not sure what I was getting myself into. Tumbleweeds? F150s? Country music? Cowshit? WTH!

I knew it would not be forever and I am thankful for the precious time I had to serve with you. My last day will be April 20. Seven years, six months and 20 days. Five years and 20 days longer than some of you thought I would last, or at least hoped for.

I am not leaving for another opportunity too good to be true. I am not unhappy here — quite the contrary. I am not looking for more time with my family. I am not trying to fulfill a promise made.

A leader knows when it is time to move on. Give others a chance to fulfill their leadership calling.

I am giving myself some time for reflection.

We have an amazing leadership team and you are part of it. I am so proud of all of you. I brag about you all the time. You are the envy of many.

My only frustration in leaving now is you don’t know how good you are. How good you have become. Those of you who have been to the CHIME CIO Boot Camp know what I am talking about.

What have we done together? What storms have we weathered? What challenges did we overcome? What have we innovated? How much did we grow? How much impact did we have? It is overwhelming to think about.

Trust me, I have focused on this the past 30 days. Sigh. When I think about us, I think about all our “one anothers.” You know, as in, “We served one another,” or, “We upheld the promise with one another.”

  • We labored with one another.
  • We danced with one another.
  • We did obstacle courses with one another.
  • We hopped on 3 a.m. severity one calls with one another.
  • We drank with one another.
  • We stayed up 24+ hours with one another.
  • We cheered and experienced joy with one another.
  • We engaged with one another.
  • We elevated with one another.
  • We excelled with one another.
  • We passed out with one another.
  • We cared for one another.
  • We rounded at every hospital with one another.
  • We got tattoos with one another.
  • We played soccer with one another.
  • We played volleyball with one another.
  • We played softball with one another.
  • We took grief from clinicians with one another.
  • We sang carols with one another.
  • We debated with one another.
  • We challenged one another.
  • We loved one another.
  • We broke bread with one another.
  • We listened to Ralph’s SEAL Team stories with one another.
  • We made meals for one another.
  • We took care of each other’s families with one another.
  • We read books with one another.
  • We supported go-lives with one another.
  • We did karaoke with one another.
  • We did way more than IT for our customers with one another.
  • We survived audits with one another.
  • We bared emotions with one another.
  • We rebounded with one another.
  • We were mesmerized by Ferdie’s chants with one another
  • We broke silly rules with one another.
  • We cried with one another.
  • We survived (name removed) with one another.
  • We endured Dale Carnegie with one another.
  • We discovered and learned with one another.
  • We worked from home with one another.
  • We climbed mountains with one another.
  • We preserved through RIFs with one another.
  • We celebrated weddings with one another.
  • We had all our expense reports rejected with one another.
  • We climbed ropes with one another.
  • We played jokes on one another.
  • We achieved the highest levels of physician satisfaction with one another.
  • We prayed with one another.
  • We laughed with one another.
  • We enabled the dignity of death with one another.
  • We won Davies with one another.
  • We visited many bedsides with one another.
  • We worked out with one another.
  • We held hands with one another.
  • We consistently achieved world-class customer satisfaction with one another.
  • We attended Leadercast with one another.
  • We lovingly tolerated security with one another.
  • We bar crawled with one another.
  • We improved business outcomes with one another.
  • We were with the family of Stacy with one another.
  • We were with the family of Dale with one another.
  • We were with the family of Fred with one another.
  • We were with the family of Renee with one another.
  • We were with the family of Carole with one another.
  • We spent time in my home with one another.
  • We received way too many texts from Jim with one another.
  • We yammered with one another.
  • We created TEDx with one another.
  • We suffered through ITSM classes with one another.
  • We improved clinical quality with one another.
  • We improve patient safety with one another.
  • But most of all, but most of all, we saved lives with one another!

@#%$@ I watched so many of you blossom into amazing leaders that enabled these one anothers!

The future is awesome. The summit is in your sights. You have what it takes. You are leaders, you got this! You will become stronger without me But be assured. I will be watching you. You better not @$#%!@ up!

Jeremiah 29:11 says, “I know what I am doing. I have it all planned out. Plans to take care of you, not abandon you, plans to give you the future you hope for.”

I have tried to live my life embracing the following verses. I fall short, but share it with you nevertheless. It is aspirational. I pray this for you.

I Corinthians 9:24-27: “You have all been to the stadium and seen the athletes race. Everyone runs; one wins. Run to win. All good athletes train hard. They do it for a gold medal that tarnishes and fades. You are after one that is gold eternally.

I don’t know about you, but I am running hard for the finish line. I am giving it every thing that I got. No sloppy living for me. I am staying alert and in top condition. I am not going to get caught napping, telling everyone else all about it, and then missing out myself.

I will miss you. #@!&&^% I will always love you. You have no idea the depth of the pride and love I have for each of you.

We will always be about…one another…and saving lives. That’s our legacy.

I then went one by one to every VP, director, and manager and laid hands on them and spoke to their soul. I knew my people. I asked God to give me the words to encourage each one. I gave each one a specific word.

And when the last person left the room. I wept.

Today I have the privilege to serve the people of the world’s greatest city working in public health. Through an arrangement with The Advisory Board Group/Clinovations, I am part of the NYC Health and Hospitals Corporation IT leadership team. I could not be happier. Perhaps a future post I will get into more details.

And yes, I still have my eye on my Texas colleagues.

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

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May 28, 2015 Ed Marx 11 Comments

Morning Headlines 5/28/15

May 27, 2015 Headlines No Comments

Medicaid rule could extend health IT support to behavioral health, long-term care

A newly proposed CMS rule governing Medicaid managed-care plans has implications on health IT. The rule authorizes state Medicaid programs to offer incentive payments for organizations that do not qualify to participate in the Meaningful Use program, like behavioral health providers and long-term care providers, to purchase and implement EHRs. The new rule also authorizes states to mandate participation in health information exchanges as part of their contracts with Medicaid managed care organizations.

Telemedicine exams result in antibiotics as often as regular exams, study finds

A new RAND corporation study published in JAMA Internal Medicine finds that antibiotic prescribing rates are comparable between office-based visits and telehealth visits, but notes that virtually-treated patients were more likely to be prescribed a broad-spectrum antibiotic, which is concerning because use of these drugs drives up costs and contributes to antibiotic resistance.

Antitrust Lawsuits Target Blue Cross and Blue Shield

Two antitrust lawsuits filed independently by health care providers and employers is advancing in federal court in Alabama. The suits charge Blue Cross and Blue Shield with acting as a single, illegal cartel, rather than as 37 independently owned companies to minimize competition. BCBS currently covers one-third of all Americans.

Early Marketplace Enrollees Were Older And Used More Medication Than Later Enrollees; Marketplaces Pooled Risk

Researchers assessed the medication needs of the 7.3 million Americans that signed up for health insurance through the 2014 Affordable Care Act marketplaces and found that marketplace enrollees had a lower average drug spending and were less likely to use most medication classes than an employer-sponsored comparison group.

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May 27, 2015 Headlines No Comments

Morning Headlines 5/27/15

May 26, 2015 Headlines 3 Comments

Chronic Care and Population Health Company Persivia Acquires Alere Analytics to Help Healthcare Organizations Manage Clinical and Financial Outcomes Risk

Chronic care management vendor Persivia buys back Alere Analytics, the population analytics solution that it sold to Alere in 2014 for $600 million, for an undisclosed sum.

Varian Medical Systems and Flatiron Health to Develop Next Generation of Cloud-based Oncology Software

Varian Medical Systems is partnering with Flatiron Health to develop a cloud-based oncology EHR.

The Triple Aimers have missed the mark

Former Beth Israel Deaconess Medical Center CEO Paul Levy writes an article claiming that the Triple Aim has been hijacked by ACOs and, more specifically, by the academic medical institutions that tend to be the dominant player in them.

Drugmakers funnel payments to high-prescribing doctors

Modern Healthcare publishes an article claiming that nearly one-quarter of Medicare’s top-prescribing physicians received non-research related payments from the manufacturers of the drugs they prescribed in 2013.

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May 26, 2015 Headlines 3 Comments

News 5/27/15

May 26, 2015 News 5 Comments

Top News


The two entrepreneurs who sold DiagnosisOne to Alere in 2012 buy back their former business, now known as Alere Analytics, to form Persivia. Alere bailed out of healthcare in the fall of 2014 by selling Alere Health to Optum for $600 million in an attempt to pay down company debt, with several of Alere Health’s products reverting back to their original owners. Alere is doing better after sticking with its diagnostics business – shares are up 43 percent in the past year after a price run-up that started in early January.

Reader Comments


From Stay KLASsy: “Re: Epic. The company has been abuzz in recent years about a downward trend in KLAS ratings. KLAS identified a distinct trend among Epic clients who have gone live in the past three years, who as a group are unhappy compared to customers that have been live longer. KLAS made the point in a presentation in Deep Space that was emphasized much more heavily in private meetings with Epic leadership. KLAS says Epic customers need Sherpas to help them up the mountain. Many of those recent go-live customers will be executing a ‘Sherpa Plan’ to make it all better. Let the flailing begin.” I’m always amazed that Epic’s high-paying customers happily accept full responsibility for helping the company solve its problems. Software is an ongoing relationship business – nobody who spends $200 million to implement software expects to just walk away with their purchase since they, too benefit from product improvements, but Epic excels at convincing passionate and heavily invested users to spend even more of their time to help it improve its products and services. Even Apple doesn’t have its own 11,400-seat underground auditorium.


From Truven Watcher: “Re: Truven’s Q1 results. Earnings are good, but increases in revenue were due solely to 2014 acquisitions. Debt has risen from $800 million at launch to $971 million today and lines of credit are decreasing from use with nearly zero free cash flow to invest in the business. No wonder Veritas Capital is looking to do an IPO – with lack of investor return, nobody would pay a premium to the $1.3 billion Veritas paid to buy the company from Thomson Reuters.” The great thing about IPOs in general (if you’re selling rather than buying, anyway) is that the army of calculator-fingering analysts who will later shred the company for missing revenue expectations by a tiny percentage are noticeably absent in critiquing whether the IPO price is fundamentally worth it – buyers are simply rolling the dice that the company’s story will be good enough to sell shares profitably to a greater fool down the road. The other great thing about being an IPO seller – other than making fistfuls of money – is that you as an expert insider know far more about what you’re selling than your buyer does, allowing you to set the price at which you’re willing to give up your shares to a seller who doesn’t have a clue. Veritas Capital paid $1.25 billion for what is now Truven in 2012 is rumored to be planning a $3 billion IPO, which would be a heck of a return after just three years of seemingly modest performance.

From Solemn Observer: “Re: Welltok’s acquisition of Predilytics. Welltok CEO Jeff Margolis was on the board of Predilytics, which has high-profile investors who may have seen Welltok as a higher-profile company with a better path to liquidity and value. All of these patient/consumer engagement companies are looking for an analytics angle.

From Jerry Aldini: “Re: Ontario eHealth program. Still dealing with the fallout after years of controversy.” Scandal-ridden eHealth Ontario and CGI go to arbitration over their dueling lawsuits related to CGI’s firing in 2012, as the parties blame each other for missed deadlines and deliverables on the $37 million diabetes registry contract.

From F.Y. Cannibal: “Re: Meaningful Use. The Society for Participatory Medicine has complained to HHS about the proposed change from 5 percent of patients to just a single patient who must view, download, or transmit their information to meet the MU threshold.” I support the ability of patients to access their own information electronically, but I don’t agree with the need to protest the proposed MU changes, for the following reasons:

  • Doctors can’t control what their patients do. The unintended consequence of requiring them to view their information electronically is that patients will be tricked or forced into doing so, which seems to run counter to the demand that patients be willing and empowered participants in their health.
  • Providers already can’t hit the minimal 5 percent of patients threshold, indicating a clear lack of patient interest that isn’t the practice’s problem.
  • The purpose of Meaningful Use (other than interfering with the EHR free market using taxpayer dollars to fund a clash-for-clunkers program) was to encourage provider EHR adoption, not to force patients to change their behaviors against their will. The proposed “one patient” standard proves that the provider offers the capability and that should be threshold enough. Patients aren’t Meaningful Users.
  • Patient advocates should be marketing V/D/T to patients to create demand, not holding doctors accountable for the lack of it.
  • Lack of a randomly chosen V/D/T Meaningful Use threshold isn’t a vote against patient access or patient portals. It just means consumers need to demand it, use it, and be willing to change providers if they don’t get it. There’s inherently nothing pro- or anti-patient engagement in letting the market determine how widely offered and used patient engagement tools are. Just because something seems inherently desirable doesn’t mean the government needs to get involved to ensure that it happens.

From Sassy Lassie: “Re: Washington HIMSS board elections. All candidates appear to be vendors.” I’ve served on a HIMSS state chapter board and disproportionate vendor representation is their biggest problem. Health system people don’t have the time or motivation to participate, so vendor employees who are anxious for resume-building activities and networking opportunities dominate leadership positions, presenter slots, and meeting attendance. I won’t attend any event where vendor presenters outnumber provider ones – my assessment (as unintentionally insulting as it may be to vendor people) is that I’m not willing to spend my time and money to hear a vendor employee speak. I don’t question their competence or experience, just their ability to deliver an objective and interesting message after being subject to subtle, non-stop  employer brainwashing and implicit muzzling. Chapter-level presentations aren’t usually very good in my experience anyway – chapters have to settle for whoever they can get and most of those folks are begrudging slot-fillers rather than brilliant, inspiring presenters who will take the time to craft a compelling message. My lessons learned as a chapter officer planning conferences are: (1) allow a ton of networking time; (2) schedule the day to end early since locals are more likely to sign up if they can get home by their normal quitting time; and (3) put most of your time and energy into feeding them.

HIStalk Announcements and Requests

My latest pet peeve: needy people who post dramatic Facebook non-sequiturs such as “I hate people” or “my life sucks,” desperately hoping one of their “friends” will urge them to elaborate so they can share an outburst of grammatically-challenged emotion in search of shallow empathy from people who aren’t interested enough to actually drop by or pick up the phone.


Hopefully it wasn’t lost in all the fun Memorial Day activities that the holiday is intended not for cookouts and car races, but rather to honor those who died while serving in the military.

image image

Mrs. B sent over photos of her California first graders with severe disabilities using the sand and water table provided via our DonorsChoose project, saying they love the sensory learning time that also improves their social skills. Ms. T says the excitement and reading participation her Oklahoma sixth grade class has been “astounding” as they use the three iPad Minis we bought them for reading programs and to record themselves delivering presentations. I defy you to look at those faces and convince me that the money wasn’t well invested.

I was thinking about how expectations that patient portals be de-siloed are unique to healthcare. Nobody would expect competing online retailers to happily contribute their proprietary customer information into a single, unaffiliated website no matter how beneficial and convenient it might be for customers. I am constantly reminded of the healthcare relevance of my favorite quote from the magnificent football movie “North Dallas Forty” that also describes the incompatible business and social missions of healthcare: “Every time I call it a game, you call it a business. And every time I call it a business, you call it a game.”

A term I don’t like is “revenue leakage,” describing the ambitious desire of supposedly non-profit health systems to keep their patients from seeking care where they want it, an entitlement expectation that wouldn’t even be spoken aloud by any other business (does the CFO of Chili’s have an intervention plan to address the revenue leakage caused by my desire to go to Chipotle once in a while?) The term also reminds of the olestra-cooked, fat-free potato chip (Lay’s WOW) craze of the late 1990s, of which customers became scarce after being warned of chip-induced “anal oil leakage.”

Listening: envelope-pushing, technically flawless inspirational Christian thrash-metalcore from Pennsylvania-based August Burns Red, whose lyrics are as profound as they are unintelligible. Also: new 1980s-sounding hard rock from the trio of metal virtuosos in LA’s Winery Dogs, which has me desk-drumming along with former Dream Theater drummer Mike Portnoy since I’m hopped up on iced tea and diet cherry cola.


May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.

June 9 (Tuesday) 11:30 ET. “Successful HIEs DO Exist: Best Practices for Care Coordination.” Sponsored by Medicity. Presenters: Dan Paoletti, CEO, Ohio Health Information Partnership; Brian Ahier, director of standards and government affairs, Medicity. Not all HIEs are dead – some, like Ohio’s CliniSync HIE, are evolving and forging a new path to successful care coordination. Brian Ahier will explain how HIEs can help providers move to value-based care models, emphasizing Meaningful Use Stage 3 and FHIR. Dan Paoletti will provide best practices in describing CliniSync’s journey to success in serving 6,000 primary care physicians, 141 hospitals, and and 290 long-term and post-acute care facilities. Attendees will learn how to use a phased approach, establish client champions, help providers meet MU Stage 2, create a provider email directory, deliver care coordination tools, and drive continued ROI.

Acquisitions, Funding, Business, and Stock

Varian Medical Systems, Flatiron Health, and UPMC will build an oncology EHR with analytics and decision support. One of the uncritical rags portrayed their motivation as the noble-sounding “fighting cancer” rather than the more closely aligned “hoping to make big profits” in which cancer is their widget of choice.


New Zealand-based Orion Health files its first financial update following its November IPO on the NZX, reporting a one-year loss of $44 million despite a 7 percent increase in revenue. The company’s North America business dragged down its numbers as the company blamed (as companies often do) the move to a recurring, subscription-based revenue model.

Penny stock sleep apnea and infrared thermometer technology vendor Sanomedics acquires addiction treatment EHR vendor ZenCharts, which it characterizes as “developmental stage.” Hopefully the price was right for the bizarre acquisition given that the most recent Sanomedics quarterly income was less than $200,000 vs. losses of $500,000 and its overall financial position is laid out in its most recent quarterly report as, “The Company currently has a working capital deficiency, limited revenue, and is experiencing recurring losses which have caused an accumulated deficit of $20,937,278 and a working capital deficit of $4,618,649 as of March 31, 2015. These factors raise substantial doubt about its ability to continue as a going concern. Management has financed the Company’s operations principally through the issuance of convertible debt instruments and loans from an affiliate of a former officer of the Company and a principal shareholder.” Imagine how desperate ZenCharts must have been if this was their best potential buyer.


Two UK trusts sign up for Allscripts PAS, which the announcement questionably fails to explain is the company’s UK-specific Patient Administration System.

Cedars-Sinai Health System chooses Bottomline Technologies for privacy and security technology.



Indianapolis-based onsite clinic provider OurHealth hires Sherry Slick (AchieveEHR) as CIO.

Announcements and Implementations


I missed this UCSF article from last month that describes technologies used at UCSF Medical Center at Mission Bay, which includes the interactive patient care system of Oneview Healthcare and employee communications provided by Voalte.  

Health Catalyst announces its Health Catalyst Academy educational program for clinical quality and efficiency.

Government and Politics

Part of the proposed 21st Century Cures legislation calls for FDA to capture and consider patient feedback as it reviews medical devices for approval.

Senator Joe Manchin (D-WV), stung by reports that 200 million doses of hydrocodone and oxycodone were shipped to the state’s 1.85 million residents over six years (that’s 18 doses of “hillbilly heroin” per year per person) demands that drug wholesalers to provide lists of where the drugs were sent so the state can look for “pill mills” (hint: look for the long but fast-moving lines). The large number of doses doesn’t include those bought from the country’s largest wholesaler, McKesson, since that company as well as second-largest Cardinal Health have declined to provide their numbers.

The VA says the 13 malware-infected medical devices it reported in January is down to four, but it still has problems with equipment that requires Windows XP and by technicians who scan for vulnerabilities using laptops that were also used for Web surfing.



Apple and IBM announce Apple Watch support for their Hospital RN app that I assume nobody is actually using yet.

A group of Kansas City high school and college students develops a wayfinding app for Children’s Mercy Hospital that brilliantly works around the lack of GPS signal penetration in hospitals by calculating routes based on the user’s manually entered “what do you see around you” visible landmarks, such as a room number or department name.


An interesting Modern Healthcare analysis finds that 23 percent of doctors who prescribed at least $1 million worth of a given drug to Medicare patients were paid directly by the manufacturers of those drugs via consulting fees. For example, a since-indicted neurologist who directed $6.4 million in taxpayer spending for a pain relief drug was paid $56,000 by the drug’s manufacturer for various non-research services. It’s easy to determine which doctors hold an unhealthy appreciation for a given drug despite lack of evidence of its superiority, although much harder to peg their motivations to personal benefit.

USA Today profiles patient advocate Regina Holliday.


The FDA approves the marketing of InvisionHeart’s mobile, cloud-based ECG solution.


The Houston newspaper covers the practice of suing patients by Memorial Hermann’s Texas Medical Center. An uninsured oncology nurse patient who didn’t get a bill from the hospital found a lawsuit notice taped on her home’s front door but even then couldn’t get an itemized bill because the hospital’s two-year-old records had been archived. She finally found out that she had been charged $32,000 for two nights of observation, which the hospital wanted paid along with legal fees and interest. An attorney who represents the patients the hospital sues (it files more patient lawsuits than all other area hospitals) says nobody told them about charity care while they were in the hospital and the lawsuit documents always have the itemized medical charges redacted.

Former Beth Israel Deaconess Medical Center CEO Paul Levy names names in saying that the noble Triple Aim has been hijacked by big hospitals to suit their own ambitions, such as ACOs that are usually formed by economically inefficient health systems that wrest patient control from physician practices that might otherwise help them choose a hospital based on outcomes and costs, sticking consumers with the resulting loss of choice and higher costs. The places he calls out but also warns that it’s not just them by any means:

Places like Mayo Clinic, investing $180 million in a proton beam facility when there are similar facilities within easy traveling distance for those very few families who can benefit clinically from them. Places like North Shore-Long Island Jewish, belying its stated strategic objectives ("to realize cost efficiencies and ensure patient safety through adherence to best practices") by providing space, support, and publicity for a prominent doctor who affirmatively advocates overuse of diagnostic tools. Places like the University of Illinois-Chicago, the University of California, and dozens of others who gladly accept "walking around money" for themselves and their surgeons from a medical equipment supplier to invest in market-share-growing robotic surgery.

Levy explains from one of his previous posts:

It’s not that the doctors and nurses are any less caring or dedicated, but rather that the leaders of these centers have become calcified with regard to their social mission. They focus instead on expanding market share, growing margins, and attracting philanthropists to contribute to unnecessary and flamboyant edifices. They have no real interest in reducing costs, but rather in obtaining and securing revenue streams to cover ever-increasing costs. Most importantly, they neglect the harm they cause to patients in their facilities, preferring to assert that they deliver high quality care without being willing to be transparent with regard to actual clinical outcomes.

Weird News Andy calls this story “worst nurse cursed.” A London hospital nurse gets a life sentence for overdosing 21 hospital patients with insulin, killing two of them, by injecting it into stock IV bags and allowing other nurses to earn undeserved guilt by unwittingly administering them.

Sponsor Updates

  • VBP Monitor publishes “Exchange and Narrow Network Dominance: Market Implications for Healthcare Providers” by Valence Health Co-Founder/COO Todd Stockard.
  • Divurgent will host a cybersecurity dinner discussion with John Gomez of Sensato May 28 in New York City.
  • MEA/NEA CEO Lindy Benton publishes an article announcing that CMS records show that the company has exchanged 425,000 unique medical records via esMD (electronic submission of medical documentation), more than any other vendor.
  • PatientKeeper will showcase its physician workflow software at the 2015 International MUSE Conference that started Tuesday in Nashville.
  • AirStrip offers “Keeping Up with (and Getting Ahead of) an Every-Changing Healthcare Model.”
  • Caradigm offers “Rethinking the Business of Healthcare.”
  • Inc. takes a look at the ways in which CommVault keeps its employees happy and healthy.
  • CoverMyMeds will exhibit at AMIA’s iHealth 2015 Conference May 28-29 in Boston.
  • CitiusTech, CTG and Cumberland Consulting Group will exhibit at AHIP 2015 June 3-5 in Nashville, TN.
  • Baystate Health CMIO Neil Kudler, MD breaks down his four-pillared approach to population health management in a new Medicision video.
  • Besler Consulting explains that “Rebilling Medicare claims outside of timely filing is possible.”
  • An Israel-based business website covers MedCPU’s participation in a delegation of Israeli digital healthcare companies visiting the US.


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

More news: HIStalk Practice, HIStalk Connect.

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May 26, 2015 News 5 Comments

Morning Headlines 5/26/15

May 25, 2015 Headlines No Comments

EHRA Recommends Changes To ONC’s Standards Advisory Proposal

The HIMSS EHR Association responds to ONC’s Standards Advisory Proposal, citing concerns that the newly established standards, and their intended uses, could be unintentionally misinterpreted without explicit clarifications.

America’s Health Rankings Senior Report

The United Health Foundation publishes a report on senior’s health, finding that preventable hospitalizations within this sub-group have dropped 6.8 percent since 2014, and 11 percent since 2013.

Why We Need Design Thinking In Healthcare

Deonard D’Avolio, PhD and Director of Informatics at Airadne Labs, a joint venture between Harvard School of Public Health and Brigham and Women’s Hospital, authors a piece in InformationWeek calling for better design in healthcare, rather than a re-engineering of systems and processes. He uses the recent debacle at Texas Health Presbyterian Hospital Dallas in which an ER doctor missed the travel history of a patient with Ebola and sent him home, and argues that the systems being implemented work as designed, but the design is not always inline with clinical workflows or expectations.

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May 25, 2015 Headlines No Comments

Morning Headlines 5/25/15

May 24, 2015 Headlines No Comments

Patterson: No intersection has ‘more potential than what we’re at’ — health care, IT

Cerner booked $4.25 billion in new sales in 2014, beating its previous record of $3.8 billion. The company also reports that it expects its Siemens acquisition to return $1 billion in revenue in 2015.

Thompson and Rangel Introduce Veterans E-Health & Telemedicine Support Act of 2015

Representatives Glenn Thompson (R- PA) and Charles Rangel (D-NY) introduce H.R. 2516, the Veterans E-Health and Telemedicine Support Act of 2015, which would expand access to telehealth services for veterans by authorizing VA clinicians to practice medicine across state lines without running afoul of state or local regulations.

Connecticut Senate adopts major health care changes

Connecticut’s state Senate has passed a bipartisan bill that funds the development of a health information exchange for the state, replacing its failed $4.3 million first attempt.

eQHealth Solutions Selected by Colorado Department of Health Care Policy and Financing to Provide Medical Management Services

Colorado selects non-profit population health vendor eQHealth Solutions to provide solutions for Colorado’s Medicaid program.

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May 24, 2015 Headlines No Comments

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