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News 12/17/14

December 16, 2014 News 4 Comments

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The massive Sony Pictures data breach forces the company to warn employees that hackers have their personal information (including Social Security numbers, government identifiers, and compensation information) as well as HIPAA-protected health information collected by the company’s health plans. Celebrity PHI was among the information downloaded, which should provide interesting gossip when it inevitably leaks out. A worksheet listing the company’s highest-cost health plan patients (above) was one of the documents hackers posted to the Internet as a warning. Sony Pictures hires a law firm to threaten newspapers and websites that might otherwise post embarrassing hacker-released information, a tactic that legal experts say probably won’t work since the publications would be obtaining the information legally.

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Meanwhile, the movie that apparently stoked the ire of the North Korea-based hackers premiered in LA Thursday night, with early mediocre reviews of “The Interview” raising the question of whether it was worth it, especially since the breach exposed emails in which a Sony Pictures executive griped to peers that the film is “desperately unfunny.” At least the movie will get curiosity box office revenue. Perhaps as the ultimate closing of the loop, Sony Pictures can make a movie about its own breach, featuring the “minimally talented spoiled brat” Angelina Jolie. After all, she starred in 1995’s “Hackers” before donning jewelry containing Billy Bob Thornton’s blood and then finally rebranding herself into a pouty-lipped Mother Teresa. Sony Pictures could use the ticket sales to help pay for the fines, privacy lawsuits, loss of business from exposure of its trade secrets and intellectual property, and general damage caused by incriminating emails. If they survive, that is, which should be in serious doubt at this point. The job you should be glad you don’t have is that of David Buckholtz, SVP of corporate IT at Sony Pictures Entertainment, who will never work in that town again.


Reader Comments

From Shag Dancer: “Re: HIStalk. How long does it take you to write it?” I spend at least eight hours on Tuesdays and Thursdays, sometimes more and sometimes less on the Monday Morning Update, since I research and write every word. That’s only for the heads-down writing and not all the stuff in between … I’m a fast writer, but it takes forever to wade through all the meaningless junk that I don’t mention and to make sense of the sometimes poorly presented information that I do. My job as I see it is to make it look easy and to disguise a lot of work into a quick and entertaining read.


HIStalk Announcements and Requests

I decided to add a new subcategory called “Privacy and Security” to each post since breach and threat news is frequent. I’ve placed it below the “Government and Politics” section below.

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I’m running an end-of-year special on promoted and produced webinars for those signed by December 31, so it’s a great time to contact Lorre to book a slot before the HIMSS conference.

Some company tossed a telephone book in my driveway this morning, reminding me that they still exist even though I haven’t opened one for at least five years (and when I did, I was only seeking pizza coupons). It reminded me of my first cell phone, which was not only large and sporting a walkie talkie type antenna, but also came with an downsized phone book for stashing in the glove box (where, curiously, no gloves have ever been placed).

Listening: new soulful and honest R&B crooning from K. Michelle. I listened unaware that she’s been in some trashy reality TV shows, thankfully, since the music soars despite her iffy career and lifestyle decisions.

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I’m a recent coffee convert after years of making fun of Starbucks lines and bizarre morning rituals, so I need to know whether I’ve found belated enlightenment or whether I’ve instead crossed over to the dark side. Take my poll here – what do you enjoy drinking most at work? I usually hit all the hydration checkboxes with coffee, water, and soda in the mornings and I’d still find it hard to choose a favorite, although there’s nothing like coffee to get me going (and it’s not just the caffeine – there’s something about the warmth that just works). I’m not a snob about it, though – the giant $1 cup at McDonald’s is fine.


Webinars

December 17 (Wednesday) 1:00 ET. There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future of Predictive Analytics in Healthcare. Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Predictive analytics is more than simple risk stratification. Once you identify an individual’s risk, what are the odds that you can change their behavior and what will it cost to do so? This presentation, geared towards managers and executives, addresses scenarios in which predictive models may or not be effective given that 80 percent of outcomes are driven by socioeconomic factors rather than healthcare delivery.

December 18 (Thursday) 1:00 ET. Virtual book launch for “Extraordinary Tales from a Rather Ordinary Guy,” a new book by “CIO Unplugged” contributor Ed Marx. Ed will go over the principles contained in the book, read a couple of tales that haven’t been shared until now, and accept live questions. Attendees who use the webinar’s interactive features will be eligible to win free copies of the book as well as a Kindle.


Acquisitions, Funding, Business, and Stock

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Google’s venture capital fund is moving its investments from consumer Internet startups  to healthcare and life sciences, with a special interest in companies that focus on health data.

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Orion Health completes its New Zealand IPO, raising $97 million.

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Neos Technologies acquires wearables monitoring vendor AFrame Digital. I don’t know anything about the former except that it writes a bad press release, including misspelling its own name. I’ve only heard of AFrame when it received a 2011 NIH grant to study falls in the elderly. Its “About” page obscures whoever is involved with the company, so my initial “who cares” reaction is that two unsuccessful companies are trying (against all odds) to merge into one better one. I lose nearly all interest in a company whose website fails to (a) list its executives; (b) indicate the location of its headquarters; (c) showcase recent announcements; or (d) make it clear on the home page exactly what it does in a succinct, buzzword-free tagline or paragraph. If they can’t accomplish those trivial tasks, why would I want to buy anything from them?

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Lightbeam Health receives an unspecified capital investment from former Allscripts executives Glen Tullman and Lee Shapiro.

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A report published by Good Jobs First names Cerner as #3 on the list of companies linked to the Forbes 400 list of richest Americans (Neal Patterson at $1.55 billion) that have received more than $1 billion in subsidies from state and local governments trying to boost economic development. Cerner at $1.7 billion worth of taxpayer gifts trails only Intel ($5.9 billion) and Nike ($2 billion). I say blame politicians rather than the companies that were voluntarily offered taxpayer money for reasons that may or may not make good fiscal sense.

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Singapore- based RingMD, which offers consumers live video access to a global network of doctors, will establish its North American headquarters in Charleston, SC in preparation for an expanded US presence. Former programmer and founder Justin Fulcher, who is 24, started the company with the financial support of the Singapore government.  


Sales

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Massachusetts Eye and Ear (MA) chooses Medarchon’s Quarc for secure messaging.

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Hunterdon Healthcare (NJ) will use secure communications from Practice Unite.

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Genesys Health System (MI) signs up with PerfectServe for clinician communication.


People

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Mary Jahrsdoerfer, PhD, RN (Philips Healthcare) joins Extension Healthcare as chief nursing officer.

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Remote monitoring vendor Sentrian hires Lance Myers, PhD (Vivonoetics) as CTO.


Announcements and Implementations

The non-profit American Telemedicine Association launches an accreditation program for providers offering direct-to-consumer consultations, with the cost and requirements of the three-year certification disclosed only after submitting an application. Part of the package includes being able to use ATA’s accreditation seal and being listed in its consumer guide.

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Allscripts certifies the Patient Engagement Solution of non-profit Healthwise for integration with its TouchWorks EHR.

Kaiser Permanente Hawaii launches a teledermatology service in which primary care physicians can send patient photos to dermatologists for diagnosis. 

The 300th hospital goes live on Medhost’s YourCareCommunity vendor-agnostic patient portal.

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The folks at Forward Health Group got permission for me to use the above summary graphic from KLAS’s just-released “Population Health Performance” report in which Forward Health Group scored at the top of several categories and #2 overall. Phytel, Forward Health Group, and i2i Systems led the pack, while eClinicalWorks and McKesson were the only two vendors in the low-performing category.

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Wellcentive joins the CommonWell Health Alliance.


Government and Politics

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The Senate finally confirms Vivek Murthy, MD, MBA as surgeon general, filling a position that has been vacant for 17 months. President Obama nominated him in November 2013, but his statements labeling guns as a public health hazard drew opposition from the influential National Rifle Association, which ended up on the rare wrong side of a political decision.


Privacy and Security

An interesting study seems to suggest that patients think the specific use of their health information is more important than whether their consent was given in advance. That’s surprising given that our entire desired state is is driven by opt in/opt out via consent signatures. Respondents said research use is OK in most cases, but using their information for marketing (even with their consent) is not OK.

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Clay County Hospital (IL) calls the FBI after receiving an extortion email demanding cash to prevent stolen patient information from being disclosed (of which a sample was included as proof of possession). The 22-bed hospital says its servers haven’t been hacked, which would suggest that responsibility rests, as it often does, with an employee.

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Virginia Commonwealth University Health System (VA) notifies patients that the used CDs donated by one of its employees to a children’s art project contained PHI, including full clinical records and Social Security numbers. 

In Canada, Ontario’s privacy commissioner orders Rouge Valley Hospital to upgrade its computer systems, appalled that a year after several employees were found selling patient information, hospital still can’t review access records going back further than two weeks. A fun tidbit from the article: one of the employees who was selling information to Registered Education Savings Plans (RESPs) changed jobs and lost his access to the computer, after which he pulled the brilliant move of sending a formal request to IT asking to have his access restored so he could look up patient phone numbers to “sell them to RESPs in the course of his part-time employment.”


Innovation and Research

A tongue-in-cheek observational study finds that physician waiting rooms contain old, boring magazines because patients steal the others, especially newer celebrity gossip magazines. A couple of years ago I picked up a new-looking travel magazine in the lobby waiting room of one of our hospitals while waiting for a co-worker. I wondered why it featured now-defunct countries and photos of vintage automobiles until I checked the cover date, which was 1995. If only it could talk.

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”Which surgeon you get matters – a lot,” says a profile of surgical outcomes software Amplio, developed by Memorial Sloan Kettering Cancer Center. The system combines post-op patient feedback with EHR information to tell surgeons how they’re doing, which they rarely know since they assume all similarly trained surgeons have similar outcomes with any variation explainable by how sick their patients are. The article references an earlier study in which it observers could easily and accurately determine who was the better surgeon by simply watching videos of their procedures. It also cites the startling results of a 2007 study: cancer returned in 10 percent of patients whose prostate was removed by inexperienced surgeons vs. in only 1 percent of those operated on by experienced surgeons. A snip from the brilliantly written article:

There’s something powerful about having outcomes graphed so starkly. Vickers says that there was a surgeon who saw that they were so far into the wrong corner of that plot — patients weren’t recovering well, and the cancer was coming back — that they decided to stop doing the procedure. The men spared poor outcomes by this decision will never know that Amplio saved them.
 
It’s like an analytics dashboard, or a leaderboard, or a report card, or… well, it’s like a lot of things that have existed in a lot of other fields for a long time. And it kind of makes you wonder, why has it taken so long for a tool like this to come to surgeons?
 
The answer is that Amplio has cleverly avoided the pitfalls of some previous efforts. For instance, in 1989, New York state began publicly reporting the mortality rates of cardiovascular surgeons. Because the data was “risk-adjusted”—an unfavorable outcome would be considered less bad, or not counted at all, if the patient was at risk to begin with — surgeons started pretending their patients were a lot worse off than they were. In some cases, they avoided patients who looked like goners. “The sickest patients weren’t being treated,” Vickers says. One investigation into why mortality in New York had dropped for a certain procedure, the coronary artery bypass graft, concluded that it was just because New York hospitals were sending the highest-risk patients to Ohio.


Technology

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The CEO of Withings apologizes to purchasers of its Aura sleep device, acknowledging that in its rush to get the product on the market, the company left out important features such as heart rate tracking and the ability to view results immediately. They’re trying to fix some of the problems with updates.


Other

The Portland, OR newspaper covers the failure of a local interoperability project that started eight years ago, concluding that it didn’t work even though most hospitals are on Epic because: (a) hospitals bear the cost while insurance companies reap the benefit; (b) hospitals get paid for the procedures they perform rather than those whose duplication they avoid; (c) even information that is successfully exchanged doesn’t always make sense to the recipient. Thus reads the boilerplate RHIO epitaph.

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A new Consumer Reports survey of recently hospitalized patients finds that those who didn’t feel respected by staff during their stay were 2.5 times more likely to experience a medical error, with an alarming 30 percent of those surveyed saying they actually did. A third of respondents say they weren’t treated like responsible adults, while 40 percent report that doctors and nurses interrupted them instead of listening. The article, which will appear in the February 2015 issue, suggests that patients choose a hospital carefully, invite doctors to sit down and talk, write things down, and bring along a trusted ally to help. I asked Consumer Reports about the survey’s methodology, with the positives being that it was a national representative sample with a high confidence level. The negatives that I can determine (without seeing the actual survey instrument that I asked for) are that patients self-reported whether an error occurred and nothing was mentioned about error significance (getting a daily aspirin an hour late might be reported as a medical error by some patients). Interesting but not surprising to me is that all of the lowest-safety, lowest-respect hospitals (listed above) are in big metro areas, with a heavy Chicago representation. As I always say, go to a big academic medical center if you require tricky diagnosis or surgery; otherwise, a mid-sized community hospital that does a lot of whatever you need is your best bet.

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The latest article in the New York Times series “Paying Till It Hurts” reviews the cost of diagnostic tests, which it describes as “what liquor is to the hospitality industry: a profit center with large and often arbitrary markups.” Example: an outpatient EKG done by a community hospital’s technician took 30 minutes and was billed at $5,500, while the same test performed by a Harvard hospital and cardiologist over 1.5 hours was billed at only $1,400 (the article should have mentioned what the graph shows, that Medicare didn’t pay the funny money in either case, instead reimbursing around $400 for each). Eric Topol, MD summarizes the economic incentive as, “At many hospitals, the threshold for ordering an echocardiogram is the presence of a heart.”

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The bonds of 109-bed Mayers Memorial Hospital District (CA) are downgraded, primarily because of EHR-related capital expenses and resulting lower cash collections. The hospital, which implemented McKesson Paragon, is down to 3.5 days of cash on hand.

A New Zealand coroner warns doctors to pay attention to the clinical warnings generated by their EHRs after ruling that a patient died after his doctor prescribed quinine inappropriately. The coroner also noted that hospital records aren’t available to physician practices.

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In England, a lead nurse in an endoscopy unit hangs himself after expressing concerns about staff shortages and the introduction of a new hospital computer system that was causing a patient backlog, forcing him to work 80 hours per week.

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Also in England, doctors at Royal Free Hospital warn that patients are being endangered by its implementation of the OpenText document management system that has created scanning backlog, causing patients to arrive for new visits while their paper records are still piled up in a scanning contractor’s warehouse. The hospital was bragging just a few months ago about the problems that OpenText solved in sending scanned records to its Cerner EPR system.

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Duke University Health System (NC) hospitalist Ricky Bloomfield, MD provides the remote chronic monitoring billing codes he mentioned at his mHealth Summit session on Apple HealthKit: the new E&M 99490 for  monthly chronic care management ($42.60 per month) that could be combined with CPT 99090 or 99091 to yield $99.52 per month. He warns that nobody has actually tried billing Medicare or any other insurer using these codes yet, so it’s a work in progress.

Only in America: the family of an Ohio inmate who raped and killed a woman who was 30 weeks pregnant sues just about everybody for his painful execution that was performed using the untested two-drug combination of midazolam and hydromorphone. Named in the lawsuit are the manufacturer of the drugs (Hospira) and their distributor (McKesson), companies the family says should have known would cause suffering. In an interesting twist, a prison guard says the inmate told him before he died that his attorney urged him to feign suffocation with a prearranged “thumbs up” signal as the injections were started in the hopes that the governor would stop the execution.

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Weird News Andy says, “They really do have skin in the game.” Scientists develop artificial skin for prosthetics that can feel warmth and other attributes. Or as WNA adds, “for Terminator v0.1.”


Sponsor Updates

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I invited sponsors to send photos of their holiday activities since I like to put faces with company names. The folks from Direct Consulting Associates providing shots of their company gathering.

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Employees of PerfectServe collected donations for the Florence Crittenton Agency in Tennessee, donating clothing and 10 suitcases for the agency’s “Wheels of Hope” campaign that allows children who arrive carrying their belongings in a trash bag to leave with their own suitcase.

  • Visage Imaging posts its “RSNA 2014: Visage’s Top Five.”
  • RazorInsights doubled its client base, increased revenue by 200 percent, and hired 80 new employees during 2014.
  • GetWellNetwork Ambulatory earns ONC-ACB 2014 Edition Modular EHR Certification. The company also announces that CEO Michael O’Neil will present at the 2014 HIMSS Middle East Integrated Health Innovations Conference this week. 
  • Nuance announces that KLAS rated it #1 for regulatory reporting in “Quality Management 2014: The Race Gets Closer.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

 

Get HIStalk updates.
Contact us online.

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December 16, 2014 News 4 Comments

News 12/5/14

December 4, 2014 News 10 Comments

Top News

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HL7 launches the Argonaut Project to address the standards recommendations of the federal government’s JASON group, including HL7’s FHIR (fast healthcare interoperability resources). Working with HL7 will be athenahealth, Beth Israel Deaconess Medical Center, Cerner, Epic, Intermountain, Mayo, Meditech, McKesson, Partners HealthCare, SMART from Boston Children’s, and The Advisory Board Company. HL7 says the group will create FHIR-based EHR data sharing API specification by the spring of 2015. The big news here: (a) the second JASON report called for a big vendor to propose an open API standard instead of waiting around for the government to do it; (b) FHIR and APIs are a heck of a lot better than today’s document-based interoperability standards and probably better than the customized jungle that the HL7 standard has become; and (c) getting Epic, Cerner, Meditech, and McKesson together at the same table covers nearly all of the hospital EHR market and Epic, particularly, is a key member given its non-participation in CommonWell (and Epic and Cerner already have customers using APIs).

I asked an expert who shall remain unnamed to summarize Project Argonaut:

Project Argonaut is beginning the hard work of not only formalizing the API calling sequence (the easy part and something most vendors already do), but to formalize a set of vocabulary objects – Problems, Allergies, Notes, etc. with controlled vocabularies and predictability. To make FHIR really work, both must be done well. If FHIR succeeds, it will allow third parties to create an “app” and be able to run it in any FHIR-compatible system without the meet and map exercise with each implementation. What we’ll need to do with FHIR is to ensure people don’t get ahead of themselves and customize the “resources,” otherwise we’ll be back in the same boat as HL7 v2. FHIR is at the peak of inflated expectations. It will be great as a minor plug-in where there’s a UI or visualization, but not so great for machine-to-machine communication where one of the endpoints might not always be reliable for high-volume transfers at scale – some of the simpler web service configurations can be horribly inefficient, like making separate grocery store trips for each item on your list. There may be audit and security issues as well.

I asked another expert how the Argonaut Project might relate to CommonWell:

There is no immediate connection, but over time, CommonWell could add services that are based on the FHIR standard that the Argonauts are trying to speed up. For example, CommonWell today uses XCA to move CDA documents around, but that can be cumbersome if all the doctor wants is to get a list of known allergies from some other site. FHIR makes the later query much easier than using XCA to move a "fake" document that contains only allergies. So, CommonWell will benefit from the success of the Argonaut work (assuming it’s successful!) But otherwise, there is no direct connection, though some of the same people are involved with both.


Reader Comments

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From Ken L. Ration: “Re: HIMSS. Our designer got a good laugh from this HIMSS15 promotional graphic. One thought it was an attempt to be edgy, but the general consensus is that it’s a marketing fail.” I think it’s an insightful graphic: those benzene ring-shaped items are probably snowflakes burying HIMSS attendees who would much rather be almost anywhere else — Chicago came in seventh of 11 desired HIMSS cities last time I surveyed, with the clear winners being San Diego, Las Vegas, and Orlando.

From Roy G. Biv: “Re: physician billing services. Do health systems keep using them after implementing Epic? Could you ask your readers if, for instance, the keep using athenahealth’s PM and billing service post-Epic?” Readers have been duly notified – responses are welcome.

From HIT5982: “Re: Medhost. Let 71 people go Wednesday all at once. HR cleaned out their desks while they were being told. I was one of them – I worked in the department division (EDIS, Patient Flow, perioperative) and was told the emphasis will shift to Enterprise (clinicals, financials, patient access, revenue cycle). Departmental sales were down this year.” Reported by two readers. I reached out to the company for a response but didn’t receive one. Nothing says Christmas like being laid off.

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I shall digress and pontificate on the topic of layoffs. I’ve seen both sides over the years: (a) I was literally on my way out the door before getting a last-minute reprieve in my one and only vendor job many years ago, where layoffs every quarter were a given as executive bonuses became threatened by poor financial numbers mostly due to their own poor decisions; and (b) I have personally marched at least 20 people out of the hospital IT department through a gauntlet of their peers as I served as judge, jury, and executioner for high-level decisions that I neither made nor agreed with. Both situations were largely created by clueless, spreadsheet-circulating executives who were shockingly indifferent to the havoc they were wreaking on the lives of people and their families. While some of the folks who get axed deserved it and should have been canned a lot sooner, many of them had been given perfectly fine performance evaluations but were singled out for factors beyond their control: changing organizational strategy, their own demographics, higher salaries that they had been voluntarily offered to them, and doing their jobs every day instead of kissing executive butt and backstabbing their co-workers. Readers regularly send me personal stories about being cut loose and I always provide the same response: you’ll be better off in the long term because who wants to work for a company that lays people off? To people all over the industry who have to face the holidays (and their families) with uncertainty, fear, and feelings of personal inadequacy for whatever reason, I am truly sorry. It will get better.

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From Pierre Dukane: “Re: slimy companies. This site [URL omitted] charges consultants $300 per quarter to be on the ‘elite’ list for go-live job notifications, using information it gathers from other members and online job postings (duh). The ‘About’ page doesn’t say who runs it and the domain registration information is blocked. I can’t believe people pay for this garbage. Also, an HIT consulting firm’s recruiter is sending emails offering entry into a gift certification drawing if they ‘forward any email you receive from another recruiter or company regarding current opportunities or referral incentives.’ What happened to working the old-fashioned, honest way? No wonder clients and consultants feel so negatively about consulting firms.” It wasn’t hard for me to track down the operator of site you mentioned, which doesn’t seem to be offering much for $1,200 per year. But hey, it’s a free country, and he’ll either get business or he won’t depending on the value he provides. I’ve had both good and bad experiences with recruiters that I’ve either hired or been placed by, but I agree that quite a few questionably motivated people see it as nothing more than making easy money by matching Resume A to Job Posting B. Nearly everything in life can be explained by supply vs. demand.

From Elsa: “Re: BJC’s core clinicals replacement. Vendors were to have been notified Friday. I was shocked that it wasn’t Cerner – my source says it’s Epic. Not sure how they’ll justify the cost when they laid off staff, cut charity care, and froze raises.” Unverified.

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From Not Quite: “Re: JASON report. ONC is putting a lot of stock in it, but it’s a fake that is partially plagiarized from Wikipedia. The report lists many references, but fails to list Wikipedia, from which many things were copied. ONC should ask for our money back!” No report should ever reference Wikipedia since it’s not a vetted reference, but hopefully the JASON folks cited their primary references properly, at least where a source contained something that isn’t common knowledge.


HIStalk Announcements and Requests

Voting for the US capital of healthcare IT has been heavy, with Madison leading the pack and Nashville and Boston pulling up as a distant second and third. Voting ends this weekend – my poll is here.

This week on HIStalk Connect: Data scientists with athenahealth are monitoring the onset of the 2014-2015 flu season and note an early uptick in flu-related visits. Google is said to be revamping the internal components of Google Glass in an effort to boost battery life. Personal genome testing startup 23andMe will begin selling genetic tests in Canada and the UK after a year of trying and failing to secure FDA approval for US sales. 

This week on HIStalk Practice: Payers in Colorado build online claims data-sharing tool for physicians. HIPAA compliance at physician practices is found to be woefully lacking. Gila River Health Care goes with NextGen, while Advocate Community Partners selects eClinicalWorks. Practice Fusion VP argues for net neutrality, while Amazon takes advantage of lightning-fast consumer Internet connections. AMA winner Nancy Adams asks, “Interoperability? How about achieving operability first?” Thanks for reading.


Webinars

December 17 (Wednesday) 1:00 ET. There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future of Predictive Analytics in Healthcare. Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Predictive analytics is more than simple risk stratification. Once you identify an individual’s risk, what are the odds that you can change their behavior and what will it cost to do so? This presentation, geared towards managers and executives, addresses scenarios in which predictive models may or not be effective given that 80 percent of outcomes are driven by socioeconomic factors rather than healthcare delivery.


Acquisitions, Funding, Business, and Stock

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Integrated payments network vendor InstaMed raises $17 million in a private placement, $2 million more than it was seeking.


Sales

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Rio Grande Valley Health Alliance (TX) and Lakewood Health System (MN) choose Lightbeam Health Solutions for population health management. I interviewed CEO Pat Cline a few months ago. 

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Western New York’s HEALTHeLINK HIE chooses Stella Technology’s clinical data access technology for analytics and reporting.

Children’s Hospitals and Clinics of Minnesota chooses Strata Decision’s StrataJazz for decision support and cost accounting.

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Granite Health Network (NH) selects athenahealth’s athenaCoordinator Enterprise Population Manager.

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The Medical Center at Bowling Green (KY) chooses ProVation Medical for its cardiac cath lab.


People

CompuGroup Medical US promotes Navid Asgari to VP of service and support for its ambulatory information services division.


Announcements and Implementations

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Lehigh Valley Health Network (PA) announces that its physician group will move to Epic.

Levi, Ray & Shoup announces release of a new user interface for Epic users of its VPSX output management solution.

Imprivata announces OneSign 5.0, a new version of its authentication and access management product.

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Children’s National Health System (DC) opens an Innovation and Learning Center to house Bear Institute, its partnership with Cerner. The announcement is confusing, but I think it’s just a new physical space to house the existing project, which was announced just over a year ago.

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CareSync launches its Chronic Care Management service that allows providers to earn Medicare’s monthly CCM payments.

Perceptive Software launches Perceptive Interact for Google Apps, which allows users to integrate Gmail content into Perceptive Content for review, routing, and collaboration.


Government and Politics

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ONC names Jon White, MD from AHRQ as acting deputy national coordinator and acting chief medical officer, taking over for the recently departed Jacob Reider, MD.

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Someone tweeted out this fascinating article from March called “Sinkhole of Bureacuracy,” which describes the 600 federal government employees who push paper in the abandoned limestone mine run by Iron Mountain in the middle of nowhere in Pennsylvania at a cost of $56 million per year. Previous federal government automation efforts of the government’s retirement program failed despite spending well over $100 million. A former employee described the manual process as, “I used to chase people for months — literally — for one signature on one piece of paper. You want to talk about an egregious waste of taxpayer money? … On a daily basis, we would get from five to 50 e-mails, asking everybody to take time out of their day to search their desks for case files.” The article says the old mine is legend in the federal government, quoting former CTO Aneesh Chopra as calling it “that crazy cave.”

Massachusetts says it has repaid most of the $2.1 million in Medicaid EHR incentives that were incorrectly given to 19 hospitals that were identified by the HHS OIG. The state blamed requirements that are hard to understand and hospitals that reported incorrect data to the federal government.


Innovation and Research

A small study finds that a computerized symptom questionnaire that was turned into a History of Present Illness narrative using computer algorithms created a better HPI than physicians doing it themselves.


Other

Hospitalists at two Oregon hospitals form a union, hoping to remain as hospital employees rather than being outsourced to a national firm.

A review of a tiny sample of the 100TB (!!) of data hackers took from Sony finds medical information, in the form of doctor letters for medical leaves of absence. The responsible hacker group, possibly from North Korea, has posted some of the information publicly, including salaries, scripts, and video files of unreleased Sony movies. The hackers also released a Word document titled “Passwords” that some idiot Sony executive had used to store all of his computer passwords and credit card information. Sony was burned by hackers in 2011 who stole credit card numbers and took down its PlayStation network for weeks. 

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New York police arrest radiologist James Kessler, MD, MPH for copying the information of 97,000 patients of his former employer onto a portable hard drive with intention of starting a competing business.

Singer and cancer survivor Melissa Etheridge, just announced as a keynote speaker for GE Healthcare’s Centricity Live user conference, creates a line of prescription-only “cannabis-infused fine wines” that provide “a delicious full body buzz.”


Sponsor Updates


  • An Imprivata video provides an overview of electronic prescribing of controlled substances.
  • HCS provided 50 tickets to the Los Angeles screening of the overwhelmingly positively reviewed Glen Campbell documentary “I’ll Be Me” in support of Alzheimer’s awareness. The company will be contributing to the Salvation Army through the holidays on behalf of its clients.
  • DataMotion earns accreditation as a Certification Authority and Registration Authority from DirectTrust.org and EHNAC, allowing it to issue and manage digital certificates in addition to its role as an accredited Health Information Service Provider.

EPtalk by Dr. Jayne

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ONC will hold its annual meeting February 2-3, 2015. The email announcement caught my eye in mentioning that “the two-day meeting will gather over 1,200 health IT fans,” but on the registration website, it had been toned down to “health IT partners.” The event includes “an exciting panel of ONC’s former National Coordinators,” according to the email. I’m not sure if that’s enough of a draw to convince me to head to Washington in February. If you’re planning to attend, keep us in mind for rumors and newsy tidbits.

GE Healthcare announces its Centricity Live 2015 meeting April 29-May 2, 2015 at the Walt Disney World Dolphin Resort. Keynote speakers include Atul Gawande, Melissa Etheridge, and LeVar Burton. That lineup looks pretty good compared to some I’ve seen. I stayed at the Dolphin a couple of nights before HIMSS and it’s in a minimally mousey part of the Disney compound. Given the recent weather in my neck of the woods, I’m sure by April I’ll have a complete deficiency of Vitamin D, so if anyone wants a sassy traveling companion, let me know.

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My good friend Anjali called last week asking for a favor. The annual Christmas Party at her hospital (it’s a faith-based institution, hence the name) was looming. Her husband had to travel and she didn’t want to go alone. She’s run three half marathons with me and has had my back in countless clinical situations, so how could I say no? She works at a hospital across town where I only know a handful of medical staff members, so I was looking forward to a holiday party where I could have a couple of glasses of wine without being interrogated about our EHR.

We were a little late heading out. She had picked up a dose of flu vaccine from the local retail pharmacy and was planning to vaccinate her daughter. The pediatrician’s office was already out of vaccine and the pharmacy won’t vaccinate children under 8 even with a physician’s order, so she decided to get creative. Unfortunately, she’s a surgeon with few pediatric vaccine skills, so I was persuaded to step in.

It’s a sad commentary when you have to work the system to vaccinate your child. Most parents don’t have that option, but I was happy to help. Needless to say, that vaccine won’t be making it into the state immunization registry, but I did email her the Vaccine Information Statement so I don’t run afoul of the feds.

The tables were packed when we arrived. We grabbed the first open space we found. We were next to a husband/wife physician couple – she’s a radiologist on staff and he’s an internal medicine physician elsewhere in town. The odds of a physician conversation (regardless of setting) eventually turning to EHRs and healthcare IT is nearly 100 percent if you talk long enough, and tonight didn’t disappoint.

The radiologist is pretty happy with the hospital’s system. She appreciates being able to view the entire patient chart when there are questions about what an ordering provider hopes to achieve with a diagnostic test. She also enjoys not having to help the radiology staff decipher cryptic physician handwriting.

Anjali told them she preferred handling patient messages from home after her daughter goes to bed rather than having to stay in the office. A couple of other people chimed in and I thought for a brief moment that the EHR love fest might continue in the spirit of holiday togetherness.

The bubble was burst when the internal medicine physician started complaining about his EHR. He complained of the burden of data entry with little return. He said he didn’t understand why there wasn’t any data exchange with other practices or hospitals or why he doesn’t have access to reports on his patients’ health status.

I asked a couple of questions about his practice and his system and was able to deduce that he is actually on my hospital’s platform, through our affiliate subsidy program. Anj picked up on this as well and gave me a little eyebrow raise. She knows I led deployment of our private HIE more than six years ago and that our users regularly exchange data between owned and affiliate practices as well as our multiple hospitals.

She’s also on the same ambulatory EHR although on a different platform, so was able to provide some positive counterpoints to keep him from going too far. I didn’t want to reveal myself as the owner of the platform due to the potential for turning a holiday gathering into a debate, so I excused myself for another glass of wine.

Most of our providers are satisfied with our system and are seeing the benefits of our patient registries, actionable reports, and interoperability. I’m going to need to get to the bottom of why his practice isn’t having a good experience and figure out what we need to do to get them to the same level satisfaction. I’ve reached out to our affiliate program manager so that I can review his implementation documentation and support tickets to try to identify what might have gone awry. I just wish I had heard about it through or formal processes rather than as an aside at a party.

Anj has never seen me in full Administralian mode and told me she was impressed at how I kept my cool while the physician was ripping apart the system I’ve spent the better part of a decade implementing, optimizing, and personally ensuring that practices receive value for their efforts. I must say I haven’t always been unflappable in these situations, but they have become easier over time. I’ve learned to pick my battles and not let situations get out of control.

We did enjoy some seafood and a nice string quartet, as well as good conversation with other physicians.

Have any strategies for enjoying the company holiday party? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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December 4, 2014 News 10 Comments

Morning Headlines 12/3/14

December 2, 2014 News No Comments

Health Data Outside the Doctor’s Office

National Coordinator Karen DeSalvo, MD publishes a blog post touting a JASON report that HHS commissioned to explore “how to create a health information system that focuses on the health of individuals, not just the care they receive.”

Electronic patient records systems not ‘good enough’, says NHS CIO

In England, David Walliker, CIO of Liverpool Women’s NHS Foundation Trust says that he will pursue an electronic document management solution, rather than upgrading to a modern EHR, because the current systems available from CSC, Cerner, and Meditech are not yet viable options for the hospitals specialists.

Epic Systems backs down on noncompete clause

Epic backs down from an earlier decision to up its non-complete cause from one year to two for any recently departed employees that were trying to join Vonlay, a local health IT consulting firm. The employees in question had already left Epic and had only signed a one-year non-compete when they were hired.

Promoting Innovation; Protecting Patient Safety: Advancing Use of Technology in Health Care

The Bipartisan Policy Center will live stream a six-hour meeting on Wednesday called “An Oversight Framework for Assuring Patient Safety in Health Information Technology.” Speakers include National Coordinator Karen DeSalvo, MD, and McKesson CEO John Hammergren.

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December 2, 2014 News No Comments

News 12/3/14

December 2, 2014 News 13 Comments

Top News

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An ONC blog post by Karen DeSalvo, MD called “Health Data Outside the Doctor’s Officer” references a new JASON report titled “Data for Individual Health” (JASON is a highly regarded independent science advisory group run by DoD contractor MITRE Corporation). The report addresses the steps needed to move to “a system focused on health of individuals rather than care of individuals” in creating a learning health system. Some of its recommendations:

  • HHS: take action on previously created reports and measure progress.
  • HHS: adopt interoperability standards and incentives.
  • HHS: support open API standards and pay providers more (the report suggests a 0.25 percent bonus in CMS’s Hospital Value-Based Purchasing Program) for using “ecosystem-friendly EHRs” that follow those standards.
  • HHS: encourage non-profits (such as disease-specific advocacy groups) to mark consumer apps with their stamp of approval to increase their adoption.
  • Joint Commission and professional schools: add informatics training requirements.
  • FDA: loosen control of product services that could be construed as practicing medicine, for example, allowing apps to report their information to both provider and consumer as a risk mitigation strategy.

With regard to interoperability, JASON says the market is moving in the right direction and specifically notes that Epic (which the report says is regarded as “among the most closed systems”) has announced that it will develop APIs to allow external programs to interact with its systems. However, it says that initiatives are not complete because systems sometimes only export entire documents, omit patient information, or provide APIs whose use is contractually limited to customers rather than entrepreneurs. The new report suggests that the government encourage “an incumbent vendor with significant market share” to propose an open API standard to encourage the market leaders to step forward rather than being forced to follow a competitor-proposed standard. It also says FHIR is a significant improvement over CDA document-based exchange.


Reader Comments

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From Enumerator of Legumes: “Re: Laurens Albada. You mentioned that he appears to have left as CFO of Greenway Health. He’s now managing director of financial services with the consulting group of Vista Equity Partners, Greenway’s owner.” Verified, according to his LinkedIn profile. That’s a nice move up.


HIStalk Announcements and Requests

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Reminder: I’m collecting questions for CommonWell. If you want more information about its interoperability technology or strategy, send me yours

“Utilize” has been at the top of my “most annoying words” list for a long time since it is just a needlessly complicated way to say “use.” However, its top position has been recently threatened by “leverage,” which in a remarkable coincidence is yet another pompously pointless way to say “use.” Give marketing people their way and system users will be renamed “leveragees.”

Listening: Green River, an obscure mid-1980s hard-rocking Seattle band that arguably created what would later be known as grunge. They’re angry and armed with loud guitars that require me to provide air drums accompaniment. Two of the members later formed the similarly intense Mudhoney. I’m also enjoying the amazing Dinosaur Jr., late 1980s indie rock that remains fresh (and loud).


Webinar

December 17 (Wednesday) 1:00 ET. There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future of Predictive Analytics in Healthcare. Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Predictive analytics is more than simple risk stratification. Once you identify an individual’s risk, what are the odds that you can change their behavior and what will it cost to do so? This presentation, geared towards managers and executives, addresses scenarios in which predictive models may or not be effective given that 80 percent of outcomes are driven by socioeconomic factors rather than healthcare delivery.


Acquisitions, Funding, Business, and Stock

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Microsoft acquires 18-month-old, 20-employee Accompli — which developed a slick, free, Exchange-enabled smartphone email management app — for $200 million. I’ve tried it with my Gmail accounts and it has some nice features, such as smart messaging organization, easy calendar access, Dropbox enablement, and one-swipe conversion of an incoming email to a calendar event. I don’t know how Accompli planned to make money other than by being acquired, so maybe it cleverly noticed Microsoft’s mobile email weakness and figured MSFT would eventually wave money in its direction with hopes of renaming it Outlook Mobile. Accompli had raised only $7 million of VC money in its short history, so that’s quite a score.

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Madison’s alternative weekly newspaper says that Epic has backed down from its plan to extend its non-compete term from one year to two for employees who quit to join consulting firm Vonlay after its acquisition by Huron Consulting Group. The paper says that Epic got involved with the acquisition at the last minute by insisting that Huron not hire any Epic employees within two years of their resignation from Epic, meaning Epic would be enforcing a requirement to which its employees hadn’t agreed. The article says local speculation is that Epic is beginning to fear being held liable for violating antitrust laws, especially after Silicon Valley software engineers filed a successful class action against big-name tech companies for conspiring to not poach each other’s employees. According to the paper, Epic has also warned consulting firms that they can’t put up Madison area billboards or advertise within 50 miles of its Verona no-fly zone, also extending its workforce control by giving hospital clients maintenance fee discounts for honoring Epic’s non-compete agreement. Epic’s only official response to the non-compete issue was, “This is being reverted to a one-year term. We’d rather not comment on the policy as a whole.”


Sales

Gila River Health Care (AZ) chooses NextGen’s ambulatory PM/EHR.

Advocate Community Providers (NY) chooses eClinicalWorks for population health management and interoperability to support its Delivery System Reform Incentive Payment program for 437,000 patients.

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Grand View Health (PA) chooses Cornerstone Advisors Group to upgrade its Meditech Client/Server 5.6 system to 6.1 and to support its early adoption of Meditech’s web-based ambulatory product.


People

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Anthelio Healthcare Solutions names Gary Trickett (Allscripts) as SVP of IT services.

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Anthony Caponi is named VP of healthcare IT at Direct Consulting Associates.

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Allana Cummings (Northeast Georgia Health System) joins Children’s Healthcare of Atlanta as CIO.

Payer software vendor Healthx names Sal Gentile (TriZetto) as CEO.


Announcements and Implementations

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MedAssets will use Procured Health’s data intelligence and workflow solution in its product value analysis services.

Jackson General Hospital (WV) goes live with CrossChx’s SafeChx biometric patient identification solution in its registration area.

NextGen connects its Share platform with Merge Healthcare’s iConnect Network to allow NextGen Share users to send orders to Merge systems and receive images back.

The American College of Radiology and Massachusetts General Hospital (MA) will use Nuance’s PowerShare Network to present clinical guidelines in radiologist workflow and to automate PQRS data collection.

Ricoh will offer Levi, Ray & Shoup’s VPSX software to its healthcare enterprise output management customers.

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Hosted infrastructure vendor SingleHop had me all impressed with their announcement that they would sign Business Associate Agreements with healthcare customers, at least until I hit the part of their press release that said HIPAA is “also known as the HITECH act.” Close enough for government work, I suppose, and it is kind of confusing.

EHR vendor CureMD chooses DrFirst’s EPCS Gold to add e-prescribing of controlled substances (EPCS) to its system. DrFirst reports that EPCS volumes jumped by 200 percent in the most recent three-month period, likely boosted by New York’s I-STOP mandatory e-prescribing requirement for all drugs beginning March 27, 2015.

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Lawrence Memorial Hospital (AR) goes live with electronic forms from Access.

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PeriGen is awarded a patent for its software that assesses fetal descent in helping OB-GYNs determine when it’s appropriate to perform a C-section delivery. I really like the company’s laser-sharp focus on fetal monitoring and the innovations it has introduced there. One of my favorite interviews was with CEO Matt Sappern a couple of years ago, when he succinctly explained the company’s products as, “Our ability to apply technology to what has been a subjective part of labor and delivery is important. Probably 80 percent of medical malpractice comes back to bad interpretation of the fetal monitoring strip. We’ve figured out a way to apply technology to help interpret that strip. ” 

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Boston-area Gillette Stadium, home of the New England Patriots, announces plans for an upscale, expensive, members-only end zone suite that will be called Optum Field Lounge, named for the healthcare IT division of UnitedHealth Group that’s sponsoring it.


Government and Politics

The Bipartisan Policy Center will live stream a six-hour meeting Wednesday titled “Promoting Innovation; Protecting Patient Safety: Advancing Use of Technology in Health Care” with participants that include Karen DeSalvo from HHS and McKesson’s John Hammergren. The former is not surprising; the latter, a bit so.


Technology

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Google Glass is a consumer bust that hasn’t even made it out of beta status, but it appears that Intel will get involved in selling it to enterprises, according to a Wall Street Journal report. A new Intel-powered version of Glass will be released next year and Intel will promote it to workplaces that include health systems. The new Glass is expected to have a longer battery life because of Intel’s power-conserving chips.

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Victoria’s Secret launches a sports bra that includes hidden heart rate monitor sensors.

Dropbox will launch its business API on Wednesday, which will allow third-party developers to create enterprise applications on top of the storage service using their own rules for security, compliance, and workload integration.

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An investigation by cybersecurity firm FireEye finds that an apparently US-based hacker group called FIN4 is using email phishing (without the usual obvious mistakes made by non-native speakers) to obtain insider information from 100 publicly traded companies, two-thirds of them in healthcare and pharma, that it then uses to play the stock market. Two of the identified targets are unnamed healthcare providers. The hackers embed VBA code in a copied document that mimics the Windows authentication prompt, leading the user to think they’ve lost their network connection and need to log on again. Those credentials are then used to probe the victim’s email for useful information and then to use that account to send compromised documents to colleagues at other firms. They even create Outlook rules to delete incoming emails containing words like “hacked” or “malware” that might have been sent as warnings from associates or IT departments. Recommended security actions include disabling Office VBA macros, blocking specific domains the group uses, and checking OWA logins from known Tor exit nodes since real users don’t use Tor (an anonymity network) to read email.


Other

USC cardiologist Leslie Saxon, MD provides some fascinating quotes in discussing her rather startling recommendation that patient biometric data should be placed on Facebook for doctors to review and share.

Oftentimes, you’ll see a patient and they have a vague symptom. You see them for 0.00001 percent of their life and you have to contextualize, use your experience, do some guesswork and diagnostics to understand what’s going on. Your car has over 100 sensors. They’re wireless, it’s continuously monitoring itself and telling you when it’s going to get sick, providing you with this A.I. so people’s cars don’t break down as often any more. One of the things that’s really interesting about digital health and sensors is that we haven’t seen a lot of the data that’s being captured before, so we’re not sure how to contextualize it. I’ve been doing cardio electrophysiology for over 25 years. Now that I’m monitoring some of my patients all the time, I don’t know what some of this stuff means. We’re going to have to build these data sets, track clinical events, then go back and contextualize it—say, oh, okay that was a sign of that.

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In England, the CIO of Meditech client Liverpool Women’s NHS Foundation Trust says EHRs from CSC, Cerner, and Meditech can’t handle hospital specialty areas such as neonatology and OB-GYN and he’s putting efforts instead into implementing the open source Alfresco electronic document management system. He says, “As long as you’re seeing all the information pertaining to a patient, why should I put it in a single box and sacrifice the good things on the specialist systems so it’s all in one place? I think I could do a lot more good for patients with the money it would cost.” Once Alfresco is live, Microsoft Sharepoint will get the boot because he says it’s too expensive. Alfresco is available as a free online trial or download.

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In Australia, Royal Children’s Hospital, which will go live on a $41 million Epic implementation in 2016, is looking for a medical device integration vendor.

The Russian economy continues to tank (no pun intended) beyond mass doctor layoffs and hospital closures as sagging oil prices and Western sanctions apply a double chokehold, with Apple raising prices up to 25 percent to offset the devalued ruble, which dropped 6 percent against the dollar on Monday alone and 42 percent in the past year. That puts the ruble as the world’s worst-performing currency behind only the subject of its aggression, Ukraine. Food prices are skyrocketing and banks have restricted the swap of rubles for other currencies. Up to 10,000 healthcare reform protesters took to the Moscow streets Sunday morning, carrying signs saying “Save money on war, not doctors” and demanding that the city official in charge be fired.

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Highland-Cashiers Hospital (NC) mails letters to 25,000 patients explaining that its HIM contractor TruBridge made a configuration mistake that opened up some of their information to the Internet.

A literature review finds that while HIE usage probably has reduced ED visits and cost in some cases, no studies have been conducted that prove any particular benefit even though the government has subsidized their operation with $600 million in taxpayer money.

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Several children’s hospitals will offer their patients televisits with Santa in the eighth year of the Cisco Santa Connection program that uses the company’s Telepresence system.

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Bizarre: a corporate guy buys a USB-chargeable e-cigarette from an eBay user in China. He plugs it in and the cigarette phones home and plants malware.


Sponsor Updates

  • TeraRecon offers an upgrade program for its enterprise imaging customers.
  • Perceptive Software is demonstrating new features of its Acuo Vendor Neutral Archive and the newly announced Clinical Archive this week at RSNA. 
  • University of Arkansas for Medical Sciences reports significant nurse time savings from using Capsule’s SmartLinx to send medical device data to Epic.
  • PerfectServe posts a blog entry titled “Evolving Healthcare: Six New Realities for the C-Suite.”
  • Extension Healthcare CEO Todd Plesko will present a session on alarm management at the mHealth Summit in National Harbor, MD December 7-11.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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December 2, 2014 News 13 Comments

Advisory Panel: Favorite Vendor

November 24, 2014 Advisory Panel 1 Comment

The HIStalk Advisory Panel is a group of hospital CIOs, hospital CMIOs, practicing physicians, and a few vendor executives who have volunteered to provide their thoughts on topical industry issues. I’ll seek their input every month or so on an important news developments and also ask the non-vendor members about their recent experience with vendors. E-mail me to suggest an issue for their consideration.

If you work for a hospital or practice, you are welcome to join the panel. I am grateful to the HIStalk Advisory Panel members for their help in making HIStalk better.

This month’s question: Who is your favorite healthcare IT-specific vendor (product or services) right now and why?


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IMO, Intelligent Medical Objects. They have a team that we’ve seen be proactive in finding ways to help ease our physicians’ jobs. Their products are cost effective, especially when we point to amount of provider happiness they return. We’ve partnered with them for at least one beta partnership and are currently considering another, in part because of how easy they are to work with.


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I’m pretty happy with Allscripts right now. It’s a completely different company under Paul Black vs. Glen Tullman. Now that I’ve said that out loud, I’ve probably jinxed the relationship. 


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Epic delivers an adequate documentation system that automates workflow, can be integrated with other clinical and administrative systems, and scales to our very large care delivery system.

Epic. Sorry, that might not be the politically popular answer. But they are continuously focused on making their products better and making their customers successful. And the idea that they are trying to block interoperability in some way is frankly nuts. The recent back-and-forth in the press on interoperability and who is the best or the most committed is mostly posturing in advance of the impending DoD contract. Could Epic do better in this area? Absolutely. Could Cerner and the rest of “CommonWell?” Absolutely. We need a common standard.

Epic. They are the most focused on healthcare reform and the most ready to adopt and support the changes.


I don’t have a favorite company right now as I am dealing with too many that I would like to get rid of.


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Favorite is Wairever. They offer Plexina, which is a content management tool that we use for developing and managing order sets. The tools they provide are fantastic and their responsiveness has been great.


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Fortified Health Solutions. They partner (and I do mean partner) with us to provide security monitoring and consulting. We’re much safer than we were a year ago because of their recommendations and guidance.


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My favorite vendors lately are Vocera and small nurse call vendor called Critical Alert Systems. They have been extremely engaging and get it – they both have engaged individually and collaboratively to figure out how we achieve our desired result. They have been candid, direct, and honest. I wish larger vendors would get off their high horse and act like they did when they were half their size. Every CEO should ask themselves: how did we act when we had half the customers and market share? My favorite services company lately is Beacon Partners. Ralph is easy to do business with, easy to interact, with and hasn’t let me down yet!


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Cerner is my favorite vendor as they are rescuing Siemens from the mud.  (I am a Siemens customer.)


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EClinicalWorks. They have many shortcomings, but are delivering a usable ambulatory EMR at a decent ROI. Their support folks respond and often can help solve problems.


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I am absolutely overwhelmingly impressed with Salesforce.com. They are not an HIT vendor, but they have shown me an ability to provide a malleable platform along with a team of leaders who really get it.


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Meditech. Provides the best level of support, especially with their task management system. Meditech has also become more proactive and letting clients know about software issues and severity of the issues. The stability of the system is still topnotch, with no unplanned downtime in our environment in over two years. Meditech also has a lower maintenance cost then many of our other vendors. Not that you asked, but the vendor that we struggle with the most is eClinicalWorks. Communication with eCW is very, very difficult and they don’t use their task management system very well.


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Microsoft Azure and Office 365. Removes a heavy load of keeping the lights on. CommVault — best solution to backup to Azure and have the ability to preform legal/investigative searches.


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There are two I would highlight. The first is the best staffing firm in the world, iMethods Inc out of Jacksonville, FL. They are the only firm I have worked with that realize that is a person with a resume versus a resume that happens to come with a person. The other company is dbMotion. We are working on a project with them right now where we will connect all of our community data and make it actionable at the point of care, where it is needed most. Great stuff there that will put our community in a great position for the future.


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November 24, 2014 Advisory Panel 1 Comment

Monday Morning Update 11/24/14

November 23, 2014 News 9 Comments

Top News

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Beth Israel Deaconess Medical Center (MA) will pay $100,000 to settle a state complaint over the 2012 theft of a laptop that contained the health information of 4,000 employees and patients. The attorney general said the hospital broke the law in failing to encrypt the device. CIO John Halamka says the hospital has since started encrypting all devices and requires employees to verify annually that their personal devices are encrypted.


Reader Comments

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From Sam Lawrence: “Re: CommonWell. I read through their website to understand what exactly they offer and was unsuccessful. Tons of reference to ‘services’ and appears to be written entirely in vague marketing-speak. What can the two endpoints exchange? CCDAs? Discrete data? If so, what data? Can it be viewed and pulled directly into the EHR at either end? Do users have to query for data or is it passively making connections behind the scenes? Maybe this is coming, but instead of some fluff quotes, I’d like to understand what the provider actually gets and how it’s helpful.” Their website has specific use cases and refers to documents that members receive, so I assume it’s really just non-members who are still in the dark. CommonWell gets a pass for their hastily prepared HIMSS13 publicity rush, but for a group that talks a lot about transparency and openness, they aren’t very good at either when it comes to explaining their business model, technology, and the status of their offering to the industry as a whole (they’re kind of like Epic in that regard, in fact). The latest announcement looked like a committee-edited PR fluff piece. I suppose that’s inevitable when you ask several EHR vendors to collectively agree on anything. Loftily stated benefit to mankind notwithstanding, I fully expect that McKesson and Cerner expect to make money or gain competitive advantage from their participation, so I would just like them to say so.

From Donald: “Re: health IT consulting. We’re seeing a huge downturn. Rates are down a bit and opportunities are way down. Every consultant and recruiter I’ve talked to says the same thing.”

From Mr. Ron Anejo: “Re: health IT consulting. The market is dead. Very few large implementations remain, providers aren’t chasing MU $, and uncertainty surrounding possible repeal of the ACA has Medicare heavy hospitals and health systems freezing spending. In speaking with many consultants, they’re terrified because recruiters are no longer calling them 10 times a day with offers and aren’t sure how long they will be without work. Supply (consultants) definitely outweighs demand for services right now — consulting firms should be able to drive down pay rates and hospitals should push for lower rates.”

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From Deborah Kohn: “Re: ICD-10 phase-in. I contacted Sue Bowman, AHIMA’s Senior Director, Coding Policy and Compliance (Public Policy & Governmental Relations), who confirmed and articulated what I suspected. Per Sue: It’s not just a matter of accepting both code sets – someone has to process the codes, be able to analyze and compare data, etc. With different providers on different code sets, it would be a nightmare. And there is also the matter of coordination of benefits. Our healthcare delivery and reimbursement systems are too inter-connected to allow different entities to use different code sets for the same date of service.” CMS is abound with botched, expensive IT projects (Healthcare.gov being just the most visible one), so I wouldn’t be optimistic that the checks will keep flowing without interruption. Here’s a free tip for mainstream reporters looking for a big story: start sleuthing around in the spring to see how confident CMS’s contractors and project people are about their ICD-10 readiness and how thoroughly they’ve tested. I bet they, like providers, just moved on to something else while waiting out the year-long delay.

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From Jello Biafra: “Re: CareTech Solutions. Has it been sold to Mr. Madhava Reddy?” Weekend confirmation is hard to get, so I’ll stick with facts: (a) the Federal Trade Commission approved on November 20 the acquisition of CareTech Solutions, Inc. by Madhava Reddy; (b) Madhava Reddy is president and CEO of IT/BPO outsourcer HTC Global Services; and (c) both companies are located in Troy, MI.

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From Dan: “Re: Dr. Oz. Invites fans to send him questions via Twitter, getting gems such as ‘I just got my flu shot — when can I expect to develop autism?’" America’s favorite daytime TV huckster doctor should have known better to take to the Twitterverse given the flack he takes for touting bizarre miracle drugs and refusing to have his children vaccinated. My favorite questions asked of him: (a) “What has been your most profitable lie for money so far?”; (b) “Is snake oil gluten free?”; and (c) “Why have you not been censured or fired from Columbia Surgery for conduct unbecoming a physician, scientist, and gentleman?”

From The PACS Designer: “Re: Office 365 sharing. The Garage Series for Office 365 ProPlus highlights a nice upgrade called shared computer activation, which can enhance productivity for multiple users of any computer.” It uses Remote Desktop Services to allow multiple users to connect to the same remote computer simultaneously to run Office 365 ProPlus programs like Word or Excel. It was announced using hospital nurses as an example.


HIStalk Announcements and Requests

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Most poll respondents left their most recent jobs because of problems management could have resolved, with 50 percent saying they didn’t like management, were overworked, or lacked opportunity. A surprising 9 percent said they were fired from their last position. New poll to your right or here for hospital or practice people: how much IT consulting will you use in 2015 vs. 2014? Vote and then click Comments to explain – I’m curious about what seems to be a consulting downturn and I’d like to learn more.

Some interesting comments from last week’s poll:

  • Laid off. Other hand-picked layoffs included people who had worn out their welcome at the company after on-the-job injury, bereavement, and of course, cancer.
  • Competition was eating our lunch nationally, and their response was to constantly cut staff and raise prices; classic short-term thinking.
  • The software company where I worked for many, many years sent me to India to train developers. After I returned, the company decided they didn’t need the experienced local staff and our jobs were outsourced to India.
  • I left, not because I was unhappy or underpaid at my last job, but because I saw an large challenge in my new job… this new job came a’-calling and the offer was intriguing. Essentially the same money, but in a warmer climate. The job though was to start a program from scratch, accelerate it as quickly as possible. I wanted to see if I could do it.
  • When I turned in my notice, management went after me. They contacted Epic to look into if I might be trying to go into consulting. Epic found I was. My management told them to blackball me in an attempt to get me to stay. The job which I was to start in a few weeks disappeared. The site and recruiter were told by Epic that they could not do business with me since I was leaving an active installation, which was untrue.
  • Individuals in management roles tended to be those who stuck with the company the longest, rather than individuals who were talented or forward-thinking. There was no official training that management received, as far as we knew, so most managers didn’t know how to grow their team members or keep them at the company (most managers had no idea how to handle HR issues either, like what to do when an employee told them they wanted to quit).

I was frustrated at not being able to see a journal article because it’s behind the paywall of a for-profit journal publisher. My conclusion: journals should continue providing a service in vetting and editing submitted research articles, but perhaps the authors should pay a submission fee and let everybody read the resulting article for free. That would serve several purposes: (a) it would reduce the number of crap articles that are accepted only because the journal is desperate for content; (b) journals could stop accepting ads if they haven’t already, or they could all start running ads as long as the editorial process is separate; and (c) human knowledge would be diffused to everyone, not just high-paying subscribers. That’s especially true of articles written from government-sponsored research or by government employees: why should I as a taxpayer have to pay to see them? It’s the author that gets bragging rights and personal benefit, so let them pay. I’d also like to see an impartial panel of experts grade the methodology, originality, and applicability of each article, which might shame sloppy authors or journals into not wasting reader time.

Listening: new from Gerard Way, the former singer of My Chemical Romance. Not bad, although MCR was a lot better.


Last Week’s Most Interesting News

  • CVS Health announces plans to open a 100-employee technology development center in Boston that will create consumer-engaging technologies and work with health-related startups.
  • EHealth Initiative’s “2020 Roadmap” calls for the federal government to refocus Meaningful Use on interoperability, get EHR vendors to offer API access to their systems, and align federal agency interoperability efforts.
  • Cleveland Clinic creates Adeo, a for-profit company and website that will sell software developed by it and academic medical centers in the Healthcare Innovation Alliance.
  • Emdeon announces that it will acquire consumer engagement tools vendor Change Healthcare for $135 million.
  • A Salesforce blog post describes how Johns Hopkins Healthcare is using its platform to manage high-risk patients, seemingly confirming a big healthcare push by the company.
  • UPMC takes a $9 million gain by selling a procurement systems software company it created to a private equity firm.

Webinars

Webinar recordings recently added to YouTube:

Improving Trial Accrual by Engaging the Digital Healthcare Consumer

Cerner Takeover of Siemens, Are You Ready? Vince and Frank have hit over 1,000 YouTube views in four days, giving them a good shot at surpassing Dim-Sum’s all-time record.


Government and Politics

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Karen DeSalvo tweeted out this farewell photo with Jacob Reider in a nice gesture. They have something in common: both are doctors who used to work full time for ONC.


Technology

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US News profiles Health Heritage, developed by NorthShore University HealthSystem (boy, do I hate that multiply conjoined words name created by marketers run amok – why create a dumb name that 99.9 percent of your customers couldn’t spell in a bar bet?). It’s a genomic decision support system that combines family history to information from Epic, developed by the founder of Apache Medical Systems. Of 3,000 people who signed up and downloaded their NorthShore information, 13 percent were flagged as being high risk for cancer.


Other

An Advisory Board survey lists the reasons doctors are worried about retail clinics:

  • They will siphon off the profitable and more easily managed simple cases.
  • Patients don’t understand the value of provider continuity and will seek convenient access instead.
  • Retail clinics will move up the food chain in offering ever-expanding services that threaten the medical group model.

My reaction as a patient:

  • If a practice can’t survive without cranking through expensive but mindless sore throat and fever encounters that trigger an automatic (and often clinically inappropriate) antibiotic prescription, then we have too many practices.
  • Providers haven’t in most cases demonstrated the value of continuity to their patients, treating each encounter like an impromptu hooker visit where the patient describes what they have and what they want in 10 furtive minutes of bartering and eventual consummation of a clumsy balance of compassionate care and bare-knuckle capitalism.
  • If retail clinics can threaten the overpriced, underperforming, and often patient-indifferent healthcare system and that system refuses to change, then I’ll happily go to Walgreens or CVS where I get treated like paying customer and can park for free close to the door. I feel perfectly safe as long as the provider (whether it’s a PA, NP, or telemedicine doc) knows when to turf me off to experts when they’re in over their head.

It’s really odd to me that retail clinics made a big splash, were seemingly on the verge of extinction, and now are seen as a big threat to entrenched providers (the “odd” part being why it took so long).

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Florida’s Blue Cross Blue Shield company installs a HealthSpot telehealth kiosk in its Miami center to allow members to access doctors from Miami Children’s Hospital. HealthSpot even did a nice job Photoshopping MCH’s logos onto stock photos of its device.

In Canada, a Montreal newspaper’s editorial says Quebec’s EHR project is “an abysmal failure,” adding that its health minister agreed in an interview. The project was supposed to cost $500 million US and be finished by 2010, but is now targeting a $1.4 billion cost and 2016 completion date. The editorial blames the variety of EHRs that were approved (nine for practices, four for hospitals) that can’t exchange information.

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Weird News Andy says this article on the privacy-invading possibilities of 90-minute DNA criminal profiling creates should also have addressed potential medical uses, such as finding genetic disorders that mimic MS or identifying people with genetic sensitivity to warfarin or chloroquine.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 23, 2014 News 9 Comments

Morning Headlines 11/19/14

November 19, 2014 Headlines No Comments

John Glaser to join Cerner upon acquisition close

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

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

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

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

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

HSE sets up internal audit into awarding of hospital contract

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

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November 19, 2014 Headlines No Comments

News 11/19/14

November 18, 2014 News 4 Comments

Top News

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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

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

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


Sales

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

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

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

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

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

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

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

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


People

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

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

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

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

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

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

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


Announcements and Implementations

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

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

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


Government and Politics

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

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

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

Innovation and Research

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

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

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

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

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


Technology

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

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



Other

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

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

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 18, 2014 News 4 Comments

Monday Morning Update 11/17/14

November 15, 2014 News 2 Comments

Top News

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

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


HIStalk Announcements and Requests

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


Last Week’s Most Interesting News

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

Webinars

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

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

Recent webinar videos on YouTube:

Keeping it Clean: How Data Profiling Leads to Trusted Data

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


Acquisitions, Funding, Business, and Stock

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

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


Sales

Mercy chooses Emmi Solutions to provide patient information tools.


People

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

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

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


Announcements and Implementations

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

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

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

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

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


Government and Politics

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

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


Technology

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


Other

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 15, 2014 News 2 Comments

News 11/14/14

November 13, 2014 News 7 Comments

Top News

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


Reader Comments

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


HIStalk Announcements and Requests

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

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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


Sales

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

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

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

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

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

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

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


People

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

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

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


Announcements and Implementations

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

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

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

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

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

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

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

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


Government and Politics

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

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

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

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

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

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


Innovation and Research

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


Other

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

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

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

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

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

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

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


Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 13, 2014 News 7 Comments

Morning Headlines 11/12/14

November 11, 2014 Headlines 1 Comment

BULLETIN: HIPAA Privacy in Emergency Situations

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

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

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

KLAS Offers Performance Insights on HIE and EMR Interoperability

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

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

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

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November 11, 2014 Headlines 1 Comment

News 11/12/14

November 11, 2014 News 9 Comments

Top News

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


Reader Comments

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

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


HIStalk Announcements and Requests

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

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

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


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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

Sales

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

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

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

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

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


People

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

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

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Awarepoint promotes Tim Roche from CFO to CEO.

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

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

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


Announcements and Implementations

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

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

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

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

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

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


Government and Politics

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

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

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


Other

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

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

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

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

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

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

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

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

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

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 11, 2014 News 9 Comments

Monday Morning Update 11/10/14

November 8, 2014 News 3 Comments

Top News

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Allscripts shares dropped 15 percent Friday after turning in underwhelming revenue, earnings, and sales numbers after the market’s close Thursday. From the earnings call:

  • CEO Paul Black admitted that “we would have liked to have delivered a stronger performance.”
  • The company says it’s making big investments in remote hosting capabilities, but that effort has hurt short-term profitability.
  • CFO Richard Poulton said, “It’s not lost on us that the stock has gotten beaten up a little bit. It’s something we’re talking about.”
  • Black says Q4 is always a strong quarter and expects that to continue.
  • Of the DoD EHR bid, Black said, “They’ve made some very specific requirements in the RFP response that you have an innovative and interoperable platform with world-class content, workflows, and an open systems architecture. So we feel very good about where we are.”
  • Black said the hospital EHR business is all replacement sales now, adding, “The folks that are looking at the next 10 years are looking at organizations who have thought through and have invested in a long-term strategy and approach to having an open systems approach to and a very robust set of offerings for the multitude of caregivers that exist in a total population health-centric environment as compared to a traditional environment from the past years.”
  • Black said reduced sales don’t mean things have stalled, but rather that Q3 is always slower except for last year.
  • Black said the company won’t break out population health management sales as an overall percentage even though that’s the greatest demand area, saying, “We wanted to make sure our client base did not think that we are abandoning our foothold of being a core systems provider of EHR and rev cycle management solutions.”

HIStalk Announcements and Requests

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It’s a fairly even split among a large number of poll respondents as to whether CommonWell will have a significant impact on interoperability. It’s also interesting to see which IP addresses brought out the vote, with the big ones being CommonWell members McKesson and athenahealth as well as non-member Epic. New poll to your right or here: have you ever withheld information from a provider because of medical record privacy concerns?

Tuesday is Veterans Day, set aside to honor every person who has served in the US Armed Forces. If you served, thank you. If not, this is a good day (like every day) to thank someone who did. Military members don’t get to choose the locations or causes for which they are asked to put their existence on the line, which makes their service even more selfless. I observed the upcoming holiday by reading and enjoying “The Last of the Doughboys: The Forgotten Generation and Their Forgotten War,” in which the author interviewed the last World War I veterans before they all died shortly after, being 100 or more years of age. It’s not just a recap of World War I (which like the Korean War, tends to get lost in the shadows of World War II and even Vietnam), but rather a reminder of what it’s like to be on front lines that are full of confusion, irrational leadership, and the horrors of war.


Last Week’s Most Interesting News

  • Cerner and Epic exchange barbs about Epic’s interoperability capabilities and what CommonWell’s interoperability contribution will be.
  • The 2015 work plan of HHS’s Office of Inspector General indicates that it plans to extend its audits to include cloud-based EHR services and vendors as well as hospital downtime readiness.
  • Allscripts is hit with several negative news items: poor quarterly results that send its share price south, a $9.7 million judgment against it in a lawsuit brought by Etransmedia for deceptive trade practices, and public reports of Sunrise system problems at South Australia Health.
  • The Medicare physician fee schedule for 2015 adds several telehealth payment items and relaxes the EHR requirements for earning Chronic Care Management monthly checks.
  • The HIT Policy Committee reports that total Meaningful Use payments have reached $25 billion.

Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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MedAssets reports Q3 results: revenue up 5.5 percent, adjusted EPS 0.34 vs. $0.31, beating expectations for both.

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The Advisory Board Company announces Q2 results: revenue up 12 percent, adjusted EPS $0.43 vs. $0.31, beating earnings expectations but falling short on revenue. Shares dropped 11 percent Friday on the news. Above is the one-year share price chart for ABCO (blue, down 22 percent) vs. the Nasdaq (up 18 percent).

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CompuGroup Medical US will move its headquarters from Boston to Phoenix on January 1.

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Orion Health chooses Scottsdale, AZ as the North American and UK headquarters of its population health management division, expecting to hire 100 people within a year and up to 400 over the next three years. Incentives pushed Scottsdale past Nashville, Atlanta, and Raleigh.   

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Truven Health Analytics will acquire life sciences stakeholder management software vendor Heartbeart Experts. I spent several unsuccessful minutes perusing the company’s website to try to figure out what they do, which led me to conclude that it would probably be clear if I needed its services. 


Sales

Envision Medical Group (MI) chooses Aprima’s RCM services.

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Rite Aid will pilot the use of HealthSpot’s telemedicine kiosks in some of its Ohio markets.


People 

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Rick McCarthy, CIO of St. Vincent’s Health Services (CT) and a retired US Navy commander who served as a CIO and ran a medical unit in Afghanistan for a year, will deliver the keynote Veterans Day address in Trumbull, CT on Tuesday.

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Jay Deady (Awarepoint) joins Recondo Technology as CEO.


Announcements and Implementations

The 2014 Midwest Fall Technology Conference will be held November 12-14 in Chicago, organized by six Midwest HIMSS chapters. It’s offering a hefty provider registration discount in order to hit its desired 50-50 ratio of providers to vendors.

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Georgia Health Connect launches as a regional HIE using technology from Liaison Technologies. It plans to connect to the Georgia Health Information Network.


Government and Politics

The Massachusetts medical board makes its final recommendations for a law going into effect in January 2015 that will require all physicians to demonstrate EHR proficiency and Meaningful Use skills. The final wording hasn’t been approved, but proposed regulations would require physicians to meet one of the following:

  • Participate as an EP in Meaningful Use Stage 1.
  • Be employed, contracted, or credentialed by a hospital that is participating in Meaningful Use Stage 1.
  • Complete a three-hour accredited CME program on EHRs.
  • Sign up for Massachusetts Health information Highway.

Innovation and Research

A study finds that EHR information paired with human resources system data can be used to measure the value added by individual nurses, finding that individual nurse performance explained 7.9 percent of the variance in patient clinical condition changes. It concluded, not surprisingly, that a nurse’s educational level and work experience correlated positively.


Technology

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Iodine releases a Google Chrome browser extension that displays the definition of a medical term when the user hovers over the word on any web page.


Other

A New York Times article describes the difficulty that a featured patient had in getting his own medical records from the hospital, as it turned into a six-week ordeal of snail mail, phone calls, $100 in copying fees, and an eventual physical trip to the hospital to wait for a stack of paper documents to be handed over. A Harvard professor blames competition, saying that medical records are held hostage to prevent patients from going elsewhere. Former National Coordinator David Blumenthal, MD, weighs in: “When hospitals talk about HIPAA or charge for releasing records, what they’re really saying is, ‘I don’t want to do this and I have to find an excuse.’”

In the UK, a survey finds that 71 percent of citizens aren’t aware that they’ll be able to review their own medical records online by April as promised by the Patient Online initiative spearheaded by Health Secretary Jeremy Hunt. Only 3 percent of practices offer online access at the moment, but all are supposed to be ready by April. Doctors are worried about the time they’ll spend explaining medical records to patients given that 75 percent of patients want records written in plain while only 21 percent of doctors agree. The survey found that percent of doctors say the medical record is a reference tool for their use, not something intended for patients.

The widow of IDX co-founder Robert Hoehl donates $5 million to a variety of Burlington, VT non-profits.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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November 8, 2014 News 3 Comments

Morning Headlines 11/7/14

November 7, 2014 Headlines 13 Comments

Changes in Medical Errors after Implementation of a Handoff Program

A New England Journal of Medicine study finds that implementing a structured process for resident handoff procedures at nine hospitals led to a 23 percent medical error-rate decrease, and a 30 percent decrease in preventable adverse events.

Epic replies to comments made by Cerner CEO Neal Patterson at health conference

Typically media shy,  Epic’s media spokesman responds to charges from Cerner that her company shrugs off its interoperability responsibilities, claiming that, according to KLAS, it is an industry leader in this segment as well.

Allscripts Healthcare: Blue Harbour Group Won’t Go Lightly

Activist investor Blue Harbour Group has increased its stake in Allscripts from five to seven percent.

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November 7, 2014 Headlines 13 Comments

News 11/7/14

November 6, 2014 News 14 Comments

Top News

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The 2015 work plan of HHS’s Office of Inspector General includes several EHR-related items beyond the usual Meaningful Use payment audits. OIG will audit the security of cloud-based service providers (including EHR vendors) and will review the downtime policies of hospitals. OIG’s future efforts “may consider the significant challenges that exist with respect to overseeing expenditures for health IT, the interoperability and effective sharing and use of health care data for medical care, and emergency preparedness and response.”


Reader Comments

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From Zippy: “Re: Alameda Health System. The outgoing CEO removes the blame for its financial problems from Siemens Soarian.” The five-hospital system’s CFO told its board last month that its financial meltdown was caused by its $77 million Siemens/NextGen implementation, but the outgoing CEO says the system’s own managers — not Siemens — caused its problems. He specifically blamed two unnamed former health system executives.

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From Sauerkraut: “Re: Siemens. The hearing aid business sold for more than twice the HIT business with lower revenues and the usual higher multiples of software businesses. Perhaps Ben Rooks can explain.” Singapore-based Siemens Audiology Solutions posted $860 million in 2014 revenue and just sold for $2.68 billion, or three times revenue. The healthcare IT business had about $1.2 billion in annual revenue and sold for $1.3 billion. I would guess the revenue multiples are based on profitability, market position, and future prospects rather than revenue. My impression is that Audiology is a turnkey business while Health Solutions is a slightly shabby fixer-upper with a reputation problem. There’s also the issue of having few qualified buyers, which would have kept the price down and given Cerner a clear shot at picking it up for a bargain basement price.


HIStalk Announcements and Requests

This week on HIStalk Connect: Microsoft and Jawbone unveil new fitness trackers, Microsoft in an attempt to capitalize on the digital health trend and Jawbone trying to differentiate itself in the emerging smartwatch market. Rock Health raises its next investment round and announces that it will fund accepted startups with a $250,000 seed round. Google revamps its Flu Trends platform to include CDC data in an effort to boost accuracy.

This week on HIStalk Practice: Healthcare buzzwords reach a "tipping point." DuPage Medical Group begins offering e-visits. The Eye Institute of Utah implements a new patient portal. Portland’s healthcare IT accelerator scene doubles. 5 O’clock Records rebrands. ONC launches a new innovation challenge. Thanks for reading.

I was clearing out space on my phone for an iOS upgrade, which forced me to decide which apps to delete since some are data hogs. My “can’t live without” survivors are below. What are yours?

  • Yelp. Probably my most-used app.
  • Motion-X GPS Drive. The best GPS I’ve used and the only paid app on my list, although it barely qualifies at 99 cents.
  • Slydial. lets you call someone’s cell phone voicemail directly in case you just want to leave a message without talking to them.
  • Airline apps. American is my most-used one.
  • GateGuru. Helps me find decent airport food and check an airport’s flight board.
  • OpenTable. I will sometimes make a restaurant reservation an hour before eating just to make sure there’s a table waiting, plus I trust the reviews and lists (I often also look at TripAdvisor).
  • Uber. I use it occasionally, although I’ve been burned expensively a couple of times by the surge upcharge.
  • Kindle. I don’t mind reading books on my phone’s small screen.
  • Spotify. I subscribe to Premium so I can play music offline.
  • Speedtest. I check Internet speed the moment I set foot in a hotel or house where I need to work, although usually I can’t do much more than swear and fret at Stone Age speeds (less than 3 Mbps down and 1 Mbps up).

Listening: new indie folk from Portland, OR-based The Decemberists, which sound a bit like R.E.M. Peter Buck has played on some tracks, although not on their pretty good cover of my favorite R.E.M. track, “Cuyahoga”.


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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Aspen Advisors will be acquired by healthcare management consulting firm Chartis Group, with Aspen’s Managing Principal Dan Herman joining the board of Chartis.

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Allscripts announces Q3 results: revenue up 4 percent, adjusted EPS $0.06 vs. $0.05, missing analyst expectations for both. Shares dropped sharply in after-hours trading following Thursday afternoon’s announcement, down around 15 percent to levels not seen since early 2013.

Meanwhile, activist hedge fund Blue Harbour Group increases its ownership in Allscripts to 7 percent of the outstanding company shares, up from 5 percent. Blue Harbour Group says it avoids public shareholder fights by investing only in companies that welcome its ideas for unlocking value, happy to make money from share price appreciation rather than selling off parts piecemeal. Its Allscripts ownership stake looks like around $170 million worth, right in line with its stated sweet spot of $100-$200 million. Allscripts shares have dropped 7 percent in the past year and 38 percent in the past five years.

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Healthgrades acquires digital marketing form COCG to enhance its strategic marketing services for hospitals.

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Siemens reorganizes its remaining healthcare lines into a separate business as it suggested it might do several months ago, which won’t do much to squelch the rumors that it wants to sell of the whole package and get out of healthcare completely. Siemens just announced that it will sell its hearing aid business for $2.7 billion. It previously sold the HIT business to Cerner and its microbiology line to Beckman Coulter. Like GE, Siemens is putting big money into energy-related product lines.

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Francisco Partners invests an unspecified amount in medication benefits network provider CoverMyMeds.

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Shares in Merge Healthcare hit a 52-week high Wednesday, having jumped 33 percent in the past two weeks. Above is the one-year MRGE share price (blue, up 23 percent) vs. the Nasdaq (red, up 18 percent).

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The Department of Defense awards Fulcrum a five-year, $13.9 million contract to update the systems used by DoD’s year-old Richmond, VA EHR testing facility and to open a second health IT testing center in West Virginia. Both will support DoD’s DHMSM EHR replacement project.

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Global Healthcare Exchange will acquire Atlanta-based procurement software vendor Vendormate.

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Etransmedia wins a multi-million award in its deceptive trade practices lawsuit against Allscripts. An arbitration panel ruled that Allscripts convinced Etransmedia to buy MyWay EHR licenses in advance to improve its own financial performance, but then “deliberately sabotaged” MyWay sales by retiring the product in October 2012, leaving Etransmedia holding millions of dollars in unsold licenses. Etransmedia has since developed its own Connect2Care product.


Sales

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Beaumont Health System (MI) chooses PHYND’s Provider Population Management Platform for 20,000 physicians.

Rhode Island awards 3M the analytics contract for its All-Payer Claims Database that will aggregate claims and provider data to publish consumer-facing quality and cost information.

The VA will add two service networks to its Philips eICU program, expanding its ICU remote monitoring service to 1,800 beds.


People

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Prison health provider Corizon Health names Andy Flatt (HealthSpring) as CIO.

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Fogo Data Centers hires William Esslinger, Jr. (Esslinger Tech Law) as CEO and board member.

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Peter Dolphin (PatientKeeper) joins Advanced Practice Strategies as EVP of sales.

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National Library of Medicine Director Don Lindberg, MD will retire in March 2015 after more than 30 years on the job. He was also the first president of AMIA.


Announcements and Implementations

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Cerner CEO Neal Patterson says in a blog post that the company will provide CommonWell services to its clients at no charge (after a “nominal setup fee”) through January 1, 2018. He adds that CommonWell will make its interoperability services available at a low cost, passed through from participating vendors to their clients. He emphasizes that CommonWell will never sell data.

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A new startup, MD Revolution, launches RevUp, which allows providers to collect Medicare’s new $40 per month chronic care management payment through team-based monitoring of a user’s fitness device data. The HealthKit-enabled RevUp supports provider-user messaging, personal health coaching, and an unspecified level of integration with EHRs. It appears that the company provides all of the coaching services. Founder Samir Damani, MD, PharmD is a Scripps cardiologist. Also on the executive team is CIO Jean Balgrosky (former Scripps SVP/CIO) and SVP of Business Development Parker Hinshaw (founder of maxIT). The company’s page also neatly summarizes the requirements to collect the monthly payment that starts in January 2015 — 20 minutes of non face-to-face care of Medicare patients with two or more chronic conditions. .

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Blood Bank of Alaska implements Mediware’s blood center management and donor recruitment systems.


Government and Politics

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An ONC survey finds that most consumers (75 percent) are concerned about the privacy of their medical records whether paper or electronic, but few (less than 10 percent) are worried enough to withhold information. Three-quarters of respondents want their providers to use EHRs and share their information with their other providers. Survey pluses:  it was a random-dial telephone survey that removes online-only and self-selected participant bias and it had a good number of responses, but the folks willing to take a cold-call survey may not be representative. Survey minus: it was conducted last year.

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CMS postpones its eHealth Summit, scheduled for December 5, until further notice.


Innovation and Research

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The Wall Street Journal highlights companies that are working on diagnostics that can detect Ebola quickly, including BioFire Defense (which I wrote about quite a bit last week), CorGenix Medical (a $15 non-instrument system that works like a home pregnancy test), Chemnio Diagnostics Systems (a $10 finger-stick test),  and OraSure Technologies (which is considering development of a mouth swab-based test like the one it offers for HIV).

A nine-hospital study finds that use of a structured patient handoff procedure among medical residents was associated with a 23 percent reduction in medical errors and a 30 percent drop in preventable adverse events. Residents used a mnemonic-driven checklist for both oral and written handoffs.


Technology

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Microsoft announces free versions of Office for the iPhone and updated versions for the iPad, with Office for Android coming soon.

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Qualcomm Life Director of Business Development Kabir Kasargod urges wearables developers to move from activity trackers to the real healthcare industry:

Go from the children’s table to the grown-up table. If you’re serious about this, embrace the FDA. Learn how HIPAA works. Make sure it’s connected to the [electronic medical record] and that all the health laws are observed. There’s a tremendous dearth of innovation here. I would move away from fitness and go hardcore into health. That’s where the money is.


Other

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A Pennsylvania business paper profiles Pittsburgh-based Health Monitoring Systems, whose service monitors hospital EHR information to provide real-time outbreak information to public health departments.

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PayPal co-founder and early Facebook investor Peter Thiel says he is skeptical about healthcare IT, big data, and cloud computing.

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Epic responds to Cerner CEO Neal Patterson’s calling the company “immoral” for being an interoperability “black hole” among EHR vendors at Cerner’s user group meeting. Epic’s statement:

Epic is No. 1 for interoperability performance as ranked by actual users surveyed by the highly respected firm KLAS. Epic can interoperate with any other electronic health record that meets government standards, regardless of vendor. We support open standards rather than private platforms such as CommonWell that further privatize and monetize exchange of health information.

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A Health Affairs blog post by MedStar Health’s influential informatics expert Peter Basch, MD says the Meaningful Use program is impeding interoperability by its rigid, metric-driven approach that fails to meet the needs of providers and patients. He adds that EHRs don’t work well for advanced primary care models that emphasize chronic disease management and care coordination and observes that today’s version of interoperability makes matters worse by more widely spreading clutter-filled summary of care and visit summary documents.

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S&P downgrades the bonds of Wake Forest Baptist Medical Center (NC) because of large receivables write-offs and the high ongoing expense of its Epic system.

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PeaceHealth (WA) ends affiliation talks with Ocean Beach Hospital (WA), with PeaceHealth’s CEO saying his organization is too busy and too far over budget on its Epic implementation to take on a new hospital.

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The tweets of Scripps cardiologist Eric Topol, MD have the highest signal-to-noise ratio of just about anybody even though he gets a bit app-happy at times, so I enjoyed this interview, in which he made some interesting points. He’ll be delivering a keynote presentation at the Digital Health Conference 2014 November 17-18 in New York City.

  • Patients will help diagnose and monitor themselves using algorithms, leaving doctors to focus on treatments.
  • Continuous monitoring will allow patients to stay at home, reducing hospital usage.
  • Virtual visits can help with the difficulty involved in getting a PCP appointment, which he says requires a six-week lead time in Boston.
  • A major shift to virtual visits will reduce trips to the doctor’s office.
  • Patients will bear much of the responsibility and cost of their health.

Weird News Andy expects this story to fill a void. A bus driver in Egypt attempts to dodge a mandatory urine drug screen by submitting a sample from his wife and is surprised to hear from officials, “Congratulations, you’re pregnant.”


Sponsor Updates

  • RazorInsights publishes a company video, a brilliantly done history that includes founder interviews.
  • Surgical Information Systems names Indiana Orthopaedic Hospital (IN) as a Center of Excellence.
  • HCI group posts “Meaningful Use to Meaningful Care” by William Bria, MD and Robert Steele, RN.

EPtalk by Dr. Jayne

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The November 30 deadline for eligible hospitals to report for the 2014 Medicare EHR Incentive Program is fast approaching. I haven’t been on the attestation site lately, but I am told that the 2014 Flexibility Rule options are available. If that doesn’t work, you can still apply for a hardship exception, but if you’re just now figuring out that you need one, I feel for you.

Speaking of Meaningful Use, several providers at my hospital forwarded links to articles about the dismal attestation statistics, demanding that we consider “stopping this nonsense” and “get back to practicing real medicine.” They’re not alone, although most national groups are focusing on shortening the reporting period for 2015 and adding additional flexibility. CHIME, the AMA, MGMA, and of course HIMSS are among the loudest voices.

With the Flexibility Rule slowing some organizations’ upgrade schedules, CMS also made some updates to the final 2015 Medicare fee schedule. Primary care practices can report Chronic Care Management codes on whatever certified EHR they were on as of December 31 of the previous calendar year, rather than being required to use 2014 CEHRT. Additionally those services can be billed using a CPT code instead of a G code. I’m not sure why that’s an advantage, but provider groups seem happy about it.

If you have nothing else to do this weekend, it’s 1,185 pages of glory and includes summaries of comments received while it was under consideration. Comments are being accepted through December 30 and it goes into effect January 1, so read up. Any document that includes five and a half pages of acronym explanations is bound to be a hit.

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I’ve been recovering this week from a Continuing Medical Education conference. I’m not a huge fan of Las Vegas, but it seems like a lot of conferences are held there. After learning about dermatological diseases in a drab hotel ballroom for two days, a conversation in the row ahead jogged my memory that the NextGen One user group meeting was starting at the tail end of my trip. A quick call to Bianca Biller confirmed that she was also in town, which improved my spirits. In addition to being one of the smartest revenue cycle experts I know, she is also the most fun.

She warned me that tight security was keeping non-registered people out of the conference center, but was able to score me a pass to the Navicure client event on Monday at the Hard Rock Live. I was feeling a little giddy when I got carded at the door until I realized they were carding everyone. We arrived fairly early, but the party was already in full swing. The Atlanta-based band was fantastic and it was fun to watch medical practice folks kick back to Journey and James Brown covers. Since MGMA had wrapped up a few days earlier, she said there were a lot of vendors staying over, so we headed out to hit a couple more get-togethers. We ended up with the obligatory wild and crazy taxi ride, during which Bianca received a marriage proposal from the cabbie.

We dialed it down a notch and stopped by the Intelligent Medical Objects suite at Mandalay Bay for a glass of wine and some much-needed time off our feet. There we ran into one of Bianca’s nurse informaticists, who lured us to the casino with the promise of riches to come. I was content to watch others gamble and to do some people watching – the number of folks still in Halloween costumes several days after the fact was pretty entertaining. Although I missed MGMA this year, I felt like I at least got my party fix and that will hold me until HIMSS.

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My new nurse friend was the big winner of the night, where I was lucky to walk away with the same $20 I started with. The Cerner conference was also this week, but I haven’t heard anything about it.

Do you have conference pictures or a crazy taxi story? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
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November 6, 2014 News 14 Comments

Morning Headlines 11/5/14

November 4, 2014 Headlines No Comments

HIT Policy Committee

At Tuesday’s HIT Policy Committee meeting, ONC released updated Stage 2 MU attestation numbers. 93 hospitals and 2,282 providers have attested for Stage 2, compared to the 4,000 hospitals and 266,067 providers that attested for Stage 1.

CPSI Announces Third Quarter 2014 Results

CPSI reports Q3 earnings: revenue was up 14 percent to $53 million, while net income jumped 29 percent, EPS $0.83 v $0.66.

Novant Health to cut pay for medical secretaries

Novant Health will demote and reduce the wages of 150 medical secretaries after its EHR implementation eliminates one of their core job functions, order entry.

Cerner will break ground Nov. 12 for $4.45B Three Trails Campus

Cerner will break ground on its $4.45 billion Three Trails Campus construction next week. The project will add 3.7 million square feet of offices and eventually house 16,000 employees.

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News 11/5/14

November 4, 2014 News 9 Comments

Top News

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The HIT Policy Committee reports that 93 hospitals have been paid Meaningful Use Stage 2 payments through September vs. nearly 4,000 that earned Stage 1 money. EPs had 2,282 MUS2 attesters vs. 266,067 who earned Stage money. None of that matters much since attestation runs all the way through 2015 and there’s not a lot of reason for providers to jump on early, but critics will miss that point in calling MUS2 a failure early in the game. The total of the Meaningful Use money handed out so far exceeds $25 billion.


Reader Comments

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From Popinjay: “Re: Remedy Informatics. Has apparently shut down, according to customer QOPI.” Oncology quality assessment organization QOPI cancels its fall reporting round, saying it has no choice after technology provider Remedy Informatics “unexpectedly ceased all business operations on October 21.” The Salt Lake City-based company, which provide registry and research informatics products, hasn’t responded to my inquiry. I interviewed CEO Gary Kennedy several years ago and was impressed with the technology, but the company’s business model changed a couple of times since then.

From Remy C: “Re: [company name omitted]. The company, one of the larger former-Epic consulting firms, is losing faith from its partners after ‘spreading itself too thin.’ Two of its staffing partners are withdrawing from offering subcontracts after the company’s problematic attempt at adding go-live support.” I’ve removed the company names since the rumor is so vague that there’s no easy way to confirm it, but I’m more interested in the overall trajectory of Epic consulting firms anyway. Epic go-live support would seem to be a good business line as long as there’s enough of them to keep people working.

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From Walkin’ Dude: “Re: Neal Patterson’s keynote speech at Cerner Health Conference Tuesday. He skewered Epic (without naming them) by saying that it’s immoral that they use their closed system for competitive advantage. He sais CommonWell will cover 50 percent (of patients? data? visits?) and that he’s reasonable sure Meditech will join and add another 25 percent of market share. He said that Epic, with 30 percent of the market share, is a data sharing black hole.” That’s Neal above on the right, sharing the CHC podium with John Glaser from Siemens Health Solutions, which will become part of Cerner early next year. Neal said GPS devices are an example of what can happen when proprietary standards are opened up.


HIStalk Announcements and Requests

Listening: reader-recommended indy folkers The Accidentals, two newly-graduated female high school students from Traverse City, MI who have written 45 songs, played 500 shows, scored two movies, and play 13 instruments between them. 


Webinars

November 5 (Wednesday) 1:00 ET. Keeping it Clean: How Data Profiling Leads to Trusted Data. Sponsored by Encore, A Quintiles Company. Presenters: Lori Yackanicz, administrator of clinical informatics, Lehigh Valley Health Network; Randy L. Thomas, associate partner of performance analytics, Encore, A Quintiles Company; Joy Ales, MHA, BSN, RN, senior consultant, Encore, A Quintiles Company. Data dictionaries, organizational standards, and pick lists for data entry fields may describe the intent of a particular data field, but don’t guarantee that the data captured in the source system actually reflects that intent. Data profiling is the statistical analysis and assessment of the data values in source systems for consistency, uniqueness, and logic to ensure that the data landing in a data warehouse or analytic application is as expected. Attendees will learn which projects benefit from data profiling and the resources needed to accomplish it.

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

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

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


Acquisitions, Funding, Business, and Stock

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Drug information provider PDR Network merges with LDM Group, which improves medication adherence by connecting patients, prescribers, and pharmacists via personalize messaging. PDR says its network will now include 250,000 prescribers and 16,000 retail pharmacies. Former LDM Group President and CEO Mark Heinold is named CEO of PDR, while former PDR President and CEO Richard Altus will join majority shareholder Lee Equity as operating advisor.

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Aetna will acquire Chicago-based retail health insurance platform vendor Bswift for $400 million to extend Aetna’s proprietary insurance exchange strategy.

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CPSI announces Q3 results: revenue up 14 percent, EPS $0.83 vs. $0.66, beating revenue estimates but missing on earnings. Above is the one-year share price chart of CPSI (blue, up 3.8 percent) vs. the Nasdaq (red, up 17.8 percent). President and CEO Boyd Douglas (above) said in the earnings call that 38 of the 200 hospitals that have attested for Meaningful Use Stage 2 are CPSI users, placing it behind only Epic. CFO David Dye, responding to an analyst’s question about CPSI’s KLAS scores, said, “Our KLAS scores have been hit or miss now for 25 years. We don’t have particularly good relationship there. But I’ll put our performance up against anybody else who’s been ahead of us over that time frame” and says the company’s churn rate is at an all-time low. Dye said in answering a question about CPSI’s CommonWell participation that it’s not opening up sales opportunities, but adds, “It’s probably a bit cheesy to say that we all did this out of the goodness of our hearts, but I think it’s closer to that. I think it’s going to help us with new business. I will say that we’ve got some competitors in our space that haven’t joined yet, and that we certainly aren’t afraid to mention that when we’re talking to the potential hospital clients. But to say that we expected and/or now expect that to benefit us competitively, I think would be a stretch … we didn’t think the government was ever going to do it.” 

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Imprivata announces Q3 results: revenue up 41 percent, adjusted EPS –$0.16 vs. –$0.34, beating earnings expectations and meeting on earnings.

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Physical therapy EHR vendor WebPT acquires WebOutcomes, which offers an online outcomes tracking tool for PT/OT.

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Release of information vendor Healthport, which entered into an agreement last week to be acquired by a New Mountain Capital investment found, announces its merger with competitor Supna Healthcare Solutions.

Truven Health Analytics acquires JWA Consulting, which offers Lean consulting that Truven will pair with its data analytics and consulting capabilities.

CVS Health reports Q3 results: revenue up 9.7 percent, adjusted EPS $1.15 vs. $1.06, beating expectations for both in a quarter in which it changed its name from CVS Caremark halted tobacco sales.

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In Canada, Clearwater Clinical raises $2 million in funding. The company, founded by an ENT surgeon, offers Clearscope (smartphone video recording for endoscopy) and Shoebox (an iPad-powered hearing tester). Mayo, Hopkins, Mass General, and CHOP are among its listed clients.


Sales

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St. Mary’s Hospital (CT) chooses Imprivata Cortext for clinical communications.

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Campbell County Health (WY) chooses Cornerstone Advisors to lead its Meditech Pathway Implementation project.


People

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Don Reed, VP/CIO of Crozer-Keystone Health System (PA), receives a lifetime achievement award from the Philadelphia business newspaper.

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UPMC’s Children’s Hospital of Pittsburgh names Srinivasan Suresh, MD, MBA (Children’s Hospital of Michigan) as CMIO.

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Jim Gibson (Jimenez Consulting Solutions) joins Hayes Management Consulting as VP of strategic services. 

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GetWellNetwork CIO David Muntz is awarded CHIME’s Board of Trustees Legacy Award.


Announcements and Implementations

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Cerner will integrate data from the smart glucose monitor of Livongo Health, launched by former former Allscripts CEO Glen Tullman in September 2014.

EHR vendor Amazing Charts announces GA of its new practice management system.

NextGen announces at its UGM a mobile version of its patient portal, native iPad EHR support, a population health management solution, a HISP Direct Secure Messaging connectivity offering, and a cloud-based version of its EHR/PM systems that will be released in 2015.


Government and Politics

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CHIME uses CMS’s new (and very early, like election returns an hour after the polls close) Meaningful Use Stage 2 numbers (17 percent of hospitals, 2 percent of EPs) to again urge the agency to reduce the 2015 reporting period from 365 days to 90 days. Parent organization HIMSS jumps with a melodramatic stretch in suggesting that raising the bar on taxpayer EHR handouts “hinders our nation’s ability to improve the quality, safety, cost-effectiveness, and access to care.”

An ONC-commissioned report finds that providers participating in accountable care models are hindered by lack of EHR interoperability, with more work also required on analytics and clinical decision support systems.

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HHS names Anjum Khursid, MBBS, MPAff, PhD (Louisiana Public Health Institute) as the public health representative to the HIT Policy Committee.


Innovation and Research 

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Microsoft opens the preview release of Skype Translator, which performs real-time speech translation between users. Translation is a big and expensive problem for hospitals, so it could be interesting.

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Microsoft again – the company opens up unlimited OneDrive storage for Office 365 customers (Home, Personal, and University users – coming soon for Business).

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Cerner will break ground on its $4.45 billion Three Trails campus in south Kansas City on November 12.


Technology

Nudge launches Nudge Coach, which combines information from a person’s wearable devices into a single “Nudge Factor” number that doctors can quickly review. The company was formed by two 2010 Wofford College graduates who played semi-pro soccer together. 

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Butterfly Network raises $100 million to create an iPhone-sized ultrasound scanner that it says will be as cheap as a stethoscope.

A three-subject study finds that Google Glass creates blind spots in the eyes of users.


Other

University of Colorado Health CMIO CT Lin, MD performs a non-model version of “House of the Rising Sun” for hospitals going live on Epic, recorded at UGM. He didn’t mention his ukulele when I interviewed him in April.

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In Australia, the opposing political party says the April 2016 opening of New Royal Adelaide Hospital at risk unless the government fixes its Allscripts Sunrise patient management system, rollout of which was put on hold in July following billing and medication errors, physician complaints, and lack of funds due to higher than expected legacy system maintenance costs. South Australia Health hinted originally that it might sue Allscripts because of rollout delays, but now says it expects to resolve its issues with the company privately

The Wall Street Journal covers EHR vendors that are adding Ebola-specific functionality. It profiles Mass General, which is using a new application from its own EHR-searching spinoff QPID Health that matches patient symptoms and travel history to alert users of potential infection.

In Canada, William Osler Health System holds its second competition for students to develop Android patient experience apps next week, offering a $10,000 first prize. Last year’s winner created HosNav, which gives diagnostic testing patients parking directions, way-finding, and test preparation instructions.

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A Boston news service highlights big Massachusetts campaign donors, with InterSystems billionaire founder Terry Ragon topping the list with $3.3 million in contributions to Democratic super PACS and candidates.

Novant Health (NC) will demote 150 medical secretaries to medical unit receptionists and cut their pay up to 10 percent following its EHR implementation that eliminated the position’s most complex task — order entry. The local paper notes that the timing could have been better given that executive retirement plan changes caused recent eye-opening lump sum payouts, such as the $8.2 million paid to CEO Carl Amato in 2013, of which $6.1 million was pension related.

A poorly written article in The Michigan Daily covers the student health service implementation by University of Michigan Health Systems of what it calls a “filing system” and then “MiChart,” not only misspelling MyChart but confusing the Epic patient portal with the provider-facing inpatient and ambulatory modules. The article says 50 percent of patients are using MyChart, but only 5 percent are using it to schedule appointments.

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Odd: a six-foot, iPhone-shaped monument honoring Steve Jobs at a St. Petersburg, Russia university is taken down, with an executive explaining that the announcement by Apple CEO Tim Cook that he is gay violates Russian law as “a public call to sodomy.”


Sponsor Updates

  • Strata Decision Technology is named a winner of the Chicago Innovation Awards.
  • ZirMed will host its user group meeting November 10-12 in Louisville, KY.
  • EClinicalWorks, Greenway Health, PerfectServe, RazorInsights, Sandlot Solutions, and Shareable Ink are named to CIO Review’s “20 Most Promising Healthcare Tech Solutions Providers 2014.” The publication’s “20 Most Promising Healthcare Consulting Providers” includes DataMotion, Leidos Health, and TrainingWheel. 
  • ESD wins a CHIME CIO Fall Forum award for best video.
  • KLAS ranks Premier’s ACO advisory services as #1 in best overall performance.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 4, 2014 News 9 Comments

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Reader Comments

  • FLPoggio: Poor guy had to survive the cow-crap in Tx, but now has to deal with the bureau-craptic mountains in NYCHH! Good luck E...
  • Nihar: Great article David, I was also reading somewhere how mobile apps focused around patients and the various connected devi...
  • ThePACSDesigner: I disagree RayD. The points in this Readers Write are to get others to focus on data as a bank of information no matter ...
  • Congrats: Interesting that you use scripture and profanity in the same article (out of the same mouth). Touching that you would...
  • MissMelissa: How in the WORLD does a harsh New England winter impact a medical center financially? People still get sick. Ambulance...

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