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The War on Wearables

July 14, 2016 News 1 Comment

HIStalk looks at the bad rap wearables have been getting lately. From class action lawsuits against Fitbit to digital health snake oil comments, wearables have major ground to cover when it comes to winning over providers as medically reputable devices.
By @JennHIStalk

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Industry headlines would have you believe that it’s not the most opportune time to be in wearables. The consumer-friendly devices, most of them of the fitness-tracking variety, face abandonment rates of between 33 and 50 percent after the first six months of use, not to mention increasing scrutiny as to the accuracy of their measurements.

And then there’s the comment heard ‘round the health IT world: “From ineffective electronic health records, to an explosion of direct-to-consumer digital health products, to apps of mixed quality. This is the digital snake oil of the 21st century.”

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The comments of AMA CEO James Madara, MD during the association’s annual meeting last month was provocative to many. Although it did have a certain clickbait ring to it, his stance was born out of an underlying concern by many in the medical field that digital health tools — of which wearables take up an increasing percentage — have yet to be fully accepted by physicians. Whether it’s accuracy, usefulness, easy integration with EHRs, or reimbursement for time spent sifting through all that data, wearables haven’t achieved the panacea status many entrepreneurs would have providers and consumers believe they’re capable of.

The Physician’s Perspective

And yet there seems to be no going back. Companies continue to work wearables into their product roadmaps, even in the face of questionable data accuracy. Elmurst, IL-based Power2Practice, for example, announced Fitbit integration with its EHR for integrative medicine last month. UK-based personal health record company Medelinked has announced a similar arrangement with Jawbone.

Clinical researchers don’t seem deterred, either. The Dana-Farber Cancer Institute’s new breast cancer weight loss study has equipped all of its participants with Fitbits to track activity and weight. The examples of academic and corporate enthusiasm for wearables could — and likely will — go on, suggesting that, like the ancient medicinal properties of snake oil, there is a grain of truth to their purported value.

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Danny Sands, MD, a practicing physician at Beth Israel Deaconess Medical Center (MA), co-founder of the Society for Participatory Medicine, and chief medical officer at several healthcare companies admits to wearing a Fitbit because he likes receiving reminders that he needs to pick up the pace on a daily basis.

“I think that’s a positive step in the right direction, if you’ll excuse the play on words,” he jokes. “We have to remember that these are consumer devices. They’re not accurate clinical devices. For some people, having the Fitbit on is a motivator. I have seen firsthand how my encouragement to get a Fitbit helped one of my patients get moving and make profound changes in his life. Unfortunately, the vast majority of people who use these tracking devices don’t need to. They’re being used by the young, healthy, and wealthy, not by my patient with three chronic conditions who really should be wearing one.”

“As a primary care doctor,” Sands explains, “one of the things that is so hard and so frustrating is this issue of behavior change – how to motivate patients. If this is one more tool we can use to help motivate our patients, then I figure there’s something to it.” He adds, however, that not all physicians are comfortable recommending wearables and apps, either because they’re not familiar with what’s on the market or have no interest in diving into the back-end issues of receiving that deluge of data.

“You have to ask yourself, as a physician, is this data useful to me,” Sands says. “There it gets a little more complicated, because, first of all, there’s the issue of accuracy. Second, there’s the issue of integration with my workflow/EHR. Third, and perhaps most importantly, it’s about the volume of data that these things generate. This is only going to be useful to me in my practice if it’s information I want to see on a patient that I want to keep track of. Perhaps I’m in some sort of value-based payment contract where I have an incentive to try and keep my patients healthy. I need to figure out how to separate the signal from the noise. I need a system that’s going to show me just the data that’s important to me.”

Sands obviously isn’t convinced by the snake oil rhetoric. “Time and time again we’ve seen that a computer program in the absence of human beings providing something as well is not going to make a big difference in people’s lives. You need systems in place. You need some interface with the healthcare system. If you want to show measurable benefits, then you really have to have human beings there – some touchpoint with the healthcare system.”

The Quality vs. Quantity Conundrum

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ACT | The App Association, the Washington, DC-based nonprofit that represents software companies in the mobile app community, has been keeping a close eye on the evolution of wearables in the healthcare space. “Connected devices that we think of as wearables are undergoing a significant transition,” says Executive Director Morgan Reed. “As sensors and technology improve, these devices are rapidly blurring the line separating highly accurate medical devices and something you might pick up at an airport kiosk.”

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“The struggle,” he adds, echoing Sands’ comments, “will be taking all of that accurate information and presenting it to a care provider in a meaningful way. This is a place where the balance between quality versus quantity comes into play on the physician side. EHRs – loved or loathed – aren’t so much barriers, but instead have created a new paradigm in which medical apps and connected device makers must create technology that integrates seamlessly with those systems. An ideal interoperable system gives care providers access to a lot of data, but instead of just dumping it into one place, the system highlights the data that the physician needs the most, and makes it available in a usable format. Open APIs are a big part of the solution. The tech industry, regulators, and physicians need to work together to determine how best to create and implement these APIs and related standards.”

Workflow Integration will be Key

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Companies like Validic are helping physicians navigate the still-murky waters of wearables integration. The Durham, NC-based company recently partnered with SAP to enable its enterprise healthcare clients to easily access patient data from wearables, clinical devices, and consumer health apps using Validic’s digital health connectivity tools. Co-founder and CTO Drew Schiller believes partnerships like these will help wearables move past the early days phase they seem to be stuck in.

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“Consumer wearables as a market is still maturing, with only one IPO and a couple of exits,” Schiller explains. “We are still in the early phases of using these devices in healthcare. Given this, it’s unsurprising that there have been challenges getting adoption from providers. The ‘time to drawer’ is a concern, indicating that these devices may not have yet reached full utility.”

“The biggest barriers today have to do with presenting meaningful information in existing workflows,” he adds. “One barrier is that we are still working to understand the applications and necessary reporting mechanisms for healthcare. There are dozens of ongoing pilots, projects, and grant-funded studies looking to address these needs, and organizations like Node Health are working to bring these disparate efforts together in one place and disseminate learnings.”

“I wouldn’t say that categorically certain wearables are more conducive to integration,” Schiller points out. “However, having a single point of entry for all wearable data certainly makes things easier. Additionally, if an endpoint from the wearable already has a classification and a place in workflow, that makes the logistics of implementation much easier.”

The Biggest Impact

Despite their current shortcomings, wearables seem poised for improvement in terms of provider acceptance, ease of use and integration, overall sophistication, and, most importantly, impact on patient care.

“In the immediate term, wearables enable people to take a more active role in their health,” says Reed. “This represents a shift toward prevention instead of treatment once someone is sick. In the longer term, insights powered by mission-specific wearables and apps will be huge for physicians and patients. Patients can use connected devices to help manage chronic conditions like diabetes or complete post-operative physical therapy, all while physicians monitor progress and identify potential risks.”

Moore adds that one of the most critical issues facing the healthcare system is that of the rapidly aging US population. “By 2050, there will be 83.7 million Americans over the age of 65 – that’s more than double the number just four years ago,” he points out. “Eighty percent of them will have at least one chronic condition, and a large portion will live in rural areas far from family members that could offer support. Wearables and apps are key to empowering this population, helping them to live healthier – and independently – for much longer.”

“Looking forward,” he adds, “advanced personal emergency response systems will be wearables packed with sensors and enabled by mobile apps that can track blood sugar, blood pressure, heart rate, biomarkers for medication adherence, and geofencing for Alzheimer’s patients. The sensors in these devices will then connect to a loved one’s phone, a physician’s tablet, and a medical record system. This increasingly connected approach to healthcare will lower costs and empower aging populations to live at home longer.”

Schiller concurs that wearables will be key to helping care for an increasingly elderly population. He also points out that the devices will help make up for the physician shortage we’ve all heard so much about. “We face a generation of physicians preparing for retirement and a dearth of PCP replacements. We simply won’t have the skilled workforce to maintain business-as-usual practices in healthcare. We must better leverage technology to scale reduced healthcare resources with an eye toward preventing sickness before it becomes chronic. Wearables will play a central role in this revolution.”

Present Benefits are Possible

While the revolution is in the works, wearables, for all their documented shortcomings, are capable of offering near-term benefits to physicians and patients. “Those benefits will depend on the supporting infrastructure and tools the health system and/or EHR vendor has put in place,” Schiller says. “For example, Cerner and Meditech have built smart alerting and dashboarding into their patient portals leveraging a growing list of patient-generated data from remote monitoring devices, including wearables. Health systems such as Sutter Health have realized tremendous success with wearables in comprehensive remote patient monitoring programs for chronic diseases like hypertension. Programs like these will help a physician better treat patients by knowing precisely how well or how poorly a patient is progressing in their care.“

“Long term,” he adds, “physicians will benefit from a shift toward preventative and monitoring measures. This will enable PCPs to know how their patients are doing without physically seeing them, allowing them to spend more time with patients who need care the most.”

Time – and the Market – will Tell

“We are currently witnessing Moore’s Law as applied to wearable devices,” Schiller concludes. “Wearables on the market 18 months ago are significantly inferior to the capabilities of those on the market today, and we expect to see another jump in functionality and sophistication within the next six to 12 months. I could make some specific predictions, but it makes sense to instead state more generally that the consumer technology industry will rise above these challenges to make useful, compelling, and practical devices.”

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July 14, 2016 News 1 Comment

Monday Morning Update 7/11/16

July 9, 2016 News 6 Comments

Top News

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In what should be the death blow to lab processor and Silicon Valley technology wannabe Theranos, CMS bans CEO Elizabeth Holmes from any clinical laboratory ownership or involvement for two years and shuts Theranos off from receiving further payments from Medicare and Medicaid.

Theranos proved its incompetence even in its response to CMS’s warning letter: the company sent CMS five password-protected flash drives containing supporting information that was so screwed up that CMS couldn’t figure it out, with reports for the same accession number spread over multiple drives, information on the drives that didn’t match the contents of an accompanying paper binder, and random fax coversheets that were not associated with patient test reports (would you really want your specimens processed by a company that can’t keep documents straight?)

The company’s response to CMS’s death sentence inexplicably says it will keep Holmes as CEO, but hints that it might pivot away from the specimen processing business, possibly believing it can license its technology. That Theranos movie Jennifer Lawrence has signed up to do will either never be finished or it will hit theaters long after anyone still cares.

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Meanwhile, pathology informaticist  Bruce Friedman, MD of Lab Soft News raises a good question: the American Association for Clinical Chemistry couldn’t resist giving Elizabeth Holmes stage time to promote her dying enterprise at their annual meeting that starts July 31, but shouldn’t they be even more embarrassed now that she’s been banned from the industry in which all of those actual experts work and maybe think about rescinding their questionable offer? She’s an even worse choice than some of the awful ones HIMSS has made (Dennis Quaid comes to mind). I’m starting my campaign to bring Martin Shkreli to the HIMSS stage.


Reader Comments

From Captain Ron: “Re: Epic’s search for a data visualization suite. Microsoft PowerBI, Qlik, and Tableau were in the running. After doing bake-offs, Epic decided to choose none of the above. They will support customers on any BI product they choose. Guess it’s up to the customers to build content for themselves against Clarity and Caboodle.” Unverified. 

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From Neo Vespers: “Re: Glenwood Systems, Waterbury, CT. I’m a consultant looking for users of its GlaceEMR – my client is having problems and I can’t find other users.” I’ve never heard of the company or product, but perhaps someone will jump in.

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From DJ D-Deadly: “Re: Politico’s e-Health News. They called you are a dirt-disher!” I resent smug attempts at cleverness in dismissing what I do as being National Enquirer-like simply because I report rumors that usually turn out to be partly or fully accurate, especially when sites make that observation even while running something they read on HIStalk and thus calling into question their entire thesis. I consider it a wash since they described me as “oracular,” which I plan to use in casual conversation every now and then. They also linked to HIStalk, unlike most of the time when reporters simply regurgitate what they’ve read here in passing it off as their original reporting.

From The PACS Designer: “Re: AI versus RI. Here in mid-2016 we’re on the cusp of a huge change in how healthcare is practiced. While artificial intelligence (AI) has been championed for decades as a solution to improved learning, healthcare will be moving toward real intelligence through the greater use of ICD-10. With the more specificity, the last year under ICD-10 Clinical Modifications (CM) has given practitioners some experience with this new format. Now on October 1 this year here in the US, we’ll begin to see the benefits of real intelligence or (RI) using ICD-10 Procedure Codes (PCS). Eric Topol from Scripps has an article highlighting where we are going with changes in healthcare through increased levels of patient engagements.” 


HIStalk Announcements and Requests

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McKesson’s planned sale of its EIS business that includes Paragon will benefit Cerner the most, poll respondents say. However, nearly as many expect Meditech to gain ground from the sale. BP opines that McKesson made a mess of its acquisitions by sucking the energy out of them, noting particularly that the company spent $500 million developing Horizon Enterprise Revenue Management only to shut it down in favor of small-hospital Paragon. He or she blames offshore-onshore waffling, scope creep, cost, and competing internal projects that left provider executives disappointed and many McKesson employees bitter after never-ending waves of restructuring. Perhaps Kd’s wry comment is the most insightful – McKesson will benefit most because it’s dumping a cash sinkhole that it doesn’t really care about anyway.

New poll to your right or here: do HIPAA fines and settlements broadly increase privacy and security?

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Mrs. S from Georgia says her students are using the iPad and quiz contest software we provided in funding her DonorsChoose grant request to reinforce their math skills by competing with each other.

I can’t decide if I’m comforted or horrified that even as the headlines get worse and the potential demise of our democracy seems to be creeping ever closer, disengaged citizens who are isolated from the real world by a self-created fantasy aura of phone geegaws are now obsessed with Pokemon Go. Want to fiddle while Rome burns? There’s an app for that.


Last Week’s Most Interesting News

  • England’s NHS scraps its plans for a national database of EHR-extracted patient information after review committees criticizes its opt-out and consent policies.
  • A Congressionally-established review committee recommends that the VA replace its old software systems – including VistA – with commercial products.
  • NIH awards $55 million in grants for the recruitment of 1 million Americans for the long-term study of their personally collected data and gives Scripps Translational Sciences Institute a five-year, $120 million grant to develop apps, sensors, and processes for recruiting the “citizen scientists.”
  • Catholic Health Care Services of the Archdiocese of Philadelphia pays $650,000 to settle HIPAA charges from the 2014 theft of a company-issued iPhone that contained the information of 412 patients, the first time a business associate has been charged with HIPAA violations.
  • ONC announces its intention to measure national interoperability progress by using the responses to to existing AHA and CDC hospital surveys.
  • A security firm’s tests find that hospitals are not always keeping the PCs and servers that control biomedical equipment current with operating system and antivirus updates, creating a digital soft spot for hackers.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

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


People

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HHS promotes acting CIO Beth Anne Killoran to the permanent position, noting that her IT experience with the Department of Homeland Security gives her strong cybersecurity capabilities.

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NHS England names Keith McNeil as chief clinical information officer and Will Smart as CIO. McNeil, who is a physician, resigned as CEO of Addenbrooke’s Hospital last year just before Cambridge University Hospitals NHS Foundation Trust (which includes Addenbrooke’s and The Rosie Hospital) was placed on “special measures” for a number of patient care problems; he was also CEO when the Regulator Monitor investigated the trust’s financial challenges following its $300 million Epic rollout. Smart was CIO at Royal Free London NHS Foundation Trust, which is a Cerner shop.

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Genetic testing IT systems vendor NextGxDx names Rob Metcalf (Digital Reasoning) as CEO. He replaces founder Mark Harris, PhD, who will take a demotion to chief innovation officer.


Government and Politics

The Department of Defense gives Cerner another no-bid contract for hosting its MHS Genesis EHR project, raising the project’s hosting costs from $50 million over 10 years to $74 million through the end of 2017. DoD says the extra cost won’t affect the overall $4.3 billion project budget. The Pentagon seems annoyed by the higher cost and says it may recompete the hosting contract next year. 


Technology

I’m questioning the quality of Wired’s breezy reporting in claiming that medical records are a “hot commodity” on the Dark Web, or as it dramatically intones, “the hidden recesses of the Internet” (accompanied by unrelated pictures lifted from Flickr users). They might well be a hot commodity as has been amply reported elsewhere, but this story adds nothing to the discussion. The reporter didn’t uncover a single new fact in simply reciting uncredited headlines from elsewhere and taking as gospel what some IBM guy told her about the Dark Web. She makes the puzzling assertion that hackers intentionally delete patient allergies from their medical record, which I’ve never heard of. She claims that doctors “are reluctant to use dual-factor authentication” without citing any source. She finishes by rambling off topic about steps patients can take to protect their information: don’t email information forms, make sure someone is standing by the fax machine if you fax something (does anyone really do that?), and ask why providers need your Social Security number. The overripe headline is like a movie trailer that baits movie-goers with the best scenes in ringing up their ticket purchase without delivering anything in return once they’ve settled into their seats. It’s pretty scary to see the low standard to which journalism is held these days, where desperate tricks to lure temporary eyeballs somehow continue convincing clueless advertisers to underwrite dumbed-down work.


Other

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Ambulatory physicians at  University of Michigan Health System weren’t any more satisfied with Epic than with the homegrown CareWeb it replaced, a two-year study finds, refuting the common belief that post-implementation physician satisfaction improves over time in a J-curve. Instead, most measures exhibited L-curve behavior where they dropped and stayed below baseline. Physician job satisfaction decreased after Epic went live and didn’t catch up in the 25 months afterward; a majority of the doctor respondents believed throughout the two years that Epic hadn’t improved patient safety over the old system; and the EHR’s positive contribution to physician job satisfaction dropped from 62 percent with CareWeb to 8 percent with Epic.

I’ve received several “vote for me” messages via people on LinkedIn and Twitter who desperately want to be named to the pointless HIT100 list of prolific tweeters. Are they really going to be proud of winning, sprinting breathlessly to update their resumes with a faux award and feeling good about their place in the universe for having won it by strong-arming their social media contacts to support them, which suggests that those folks probably wouldn’t have chosen them otherwise?

A Wall Street Journal report says anger is building among patients who are treated in an in-network hospital but who are stuck with non-covered bills from the hospital’s out-of-network specialists. Three-fourths of ACA-issued policies provide no out-of-network coverage at all except in emergencies, and since out-of-pocket maximums don’t apply to out-of-network charges, the patient faces unlimited costs at the non-discounted rates that nobody else pays. ED doctors complain that insurers have reduce their payments knowing they have to treat their patients anyway, while insurance companies say that ED docs reject in-network rates so they can charge whatever they want on out-of-network bills.

China launches a year-long campaign that urges angry patients and their families to refrain from attacking the employees of its overloaded hospitals.


Sponsor Updates

  • Valence Health will exhibit at the AHA Leadership Summit July 17-19 in San Diego.
  • Huron Consulting Group will present at the AHA Leadership Summit July 17-19 in San Diego.

Blog Posts


Contacts

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

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July 9, 2016 News 6 Comments

News 7/8/16

July 7, 2016 News 8 Comments

Top News

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England’s NHS scraps its plan to create Care.data, a huge national database of patient information that was to be extracted from provider EHRs.

NHS planned to sell the partially de-identified information of patients who didn’t opt out to drug companies and other willing purchasers, but decided to end the program after two commissioned reports criticized its opt-out and consent policies as being less than transparent.


Reader Comments

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From Jolter: “Re: Athenahealth. The company is not immune to the same challenges as competitors, as feedback on this software rating site about their Streamlined upgrade says. I had caught wind on their last investor call that Streamlined isn’t well regarded within their customer base. Instead of worrying about unbreaking healthcare, they should be unbreaking AthenaClinicals.” Physician customers say Streamlined has changed Athenahealth’s EHR into a click-intensive “opaque, cumbersome product” that “has made a mockery of the Athena system” that is now “the worst system I could have ever imagined,” with Athena’s support reps blaming Microsoft or whatever browser the customer is using for their many problems. A pulmonologist says Athena is “crippling my practice” and claims the company is censoring its client forum. Athenahealth is also getting publicly ripped by many customers on Facebook over the forced upgrade. One doctor summarizes Streamlined as, “When it works, it stinks. When it does not work, it really stinks.” It’s tough to keep riding the “disruptor” horse when you’re a publicly traded company worth $5.5 billion, have an installed base of customers to maintain, and need to fawn to impatient investors who constantly demand improving profits. Imagine the outraged fun Jonathan Bush would have with this seemingly major stumble if he ran Epic or Cerner. Athena has quite a few product and acquisition balls in the air, so this is where they get to prove that they earned their seat at the Wall Street table as something more than a future-promising puppy nipping at the heels of dowdier but much larger and experienced competitors.


HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Mrs. D from Nevada in providing math learning games for her kindergarten students. She reports, “As I pulled each math activity out of the box, they cheered, begging me to open it! …  the students thought it was ‘amazing’ and ‘so cool’ that a complete stranger would give us math games … The real gift within that box was the gift of knowledge and understanding. For some of my students, these math games are more than just math games, they are clarity and a road to success and confidence. I have witnessed so many ‘light-bulb-moments’ while using these games. Knowing my students are grasping complex mathematical concepts (for their age) is the greatest experience!”

This week on HIStalk Practice: Sciton gets into practice support. MyIdealDoctor adds behavioral health to its telemedicine services. VITL presses for a less burdensome patient opt-out policy. HHS ramps up opioid prevention efforts, including mandatory PDMP use at FQHCs. Urgent care clinic closes in the face of telemedicine competition. AAPS caves to Brexit clickbait.


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

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


Acquisitions, Funding, Business, and Stock

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Scotland-based Craneware announces record sales for the year ending June 30, with revenue rising 60 percent on $58 million worth of contracts.


Sales

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UC Irvine Health (CA) chooses Infinite Computer Solutions and Optimum Healthcare IT for EHR migration.


People

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Nat’e Guyton, RN, PhD (Trinity Health) joins Spok as chief nursing officer.

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Bob Sullivan (IBM Watson Health) joins interactive patient technology vendor Sonifi Solutions as GM of its healthcare division.

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Bob Kyte (Adventist Risk Management) replaces the recently retired Don Kemper as CEO of Healthwise.


Announcements and Implementations

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Validic joins SAP’s Connected Health ecosystem, offering users of SAP Health Engagement the ability to integrate patient-generated health data.


Government and Politics

ONC issues a white paper contest for the potential uses of blockchain in healthcare, with submissions due July 29. Up to eight winners get their  travel expenses paid to present their paper at a NIST-hosted workshop September 26-27 in Gaithersburg, MD.

The government of South Australia finally funds the initial planning project for the migration of SA Health’s long-sunsetted patient administration software. The system’s vendor, Global Health, sued the government for breach of contract after it repeatedly refused to stop using the 1980s-era system, of which it is the only remaining user. The SA government has been focused on its troubled Allscripts EPAS rollout, but the state’s rural hospitals aren’t included in the implementation plan and also haven’t committed to upgrading to the current Global Health product.

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Peer60 is doing research on Brexit’s impact on England’s NHS. I was curious about its preliminary results even though they’ve surveyed only 80 hospital leaders so far (out of 200+ responses expected). Respondents offered some interesting comments:

  • “Prior to the referendum, both campaigns threatened Armageddon if we left/stayed in EU. They both also said we’d each receive a puppy and have champagne for breakfast if we left/stayed in EU. We’d also be better looking and lose weight if we left/stayed in the EU. None of these have come true. The distinct lack of definitive outcomes, even now, make it difficult to have an opinion, apart from the long-standing one that Westminster is full of liars and has absolutely no interest in the well-being of UK citizens.”
  • “Welcome to the third world.”
  • “More likely to have positive impact as will help with controls re: EU residents who do not pay UK national insurance and taxes from using NHS resources –  this service will need to be funded in the future. We can work through the staffing issue by working differently, researchers will find ways to continue to collaborate. Impact is in needing to find work around and other change.”

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John Halamka suggests that CMS eliminate existing EHR certification requirements and instead require vendors to demonstrate only five specific EHR capabilities:

  • Use OAUTH2/OpenID to verify trusted exchange partners.
  • Use a FHIR-based query to request an electronic endpoint address.
  • Use a RESTful approach to push data to an endpoint.
  • Use a FHIR-based query to request the location of a patient’s records.
  • Use a FHIR-based query to exchange a common data set of key elements.

The Federal Trade Commission drops its anti-trust challenge of the proposed merger of the only two hospitals in Huntington, WV following the state’s passage of a law that was intentionally written to shield hospital mergers from federal scrutiny. The FTC walks away with a warning that hospitals can work together to deliver clinical integrated care without buying each other in reducing competition, noting specifically that while it rarely intervenes in such hospital mergers, its quality and cost red flags were raised in the Huntington market.

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The independent Commission on Care, established by Congress to review the VA following the wait times scandal, includes among its recommendations that the VA replace its “antiquated, disjointed clinical and administrative systems” with commercial software products and that it establish a VHA Care System CIO position reporting to the chief executive. The chair and vice-chair of the commission are both CEOs of provider organizations that use Epic (Henry Ford Health System and Cleveland Clinic).


Privacy and Security

A federal appeals rules that anyone who shares a password may be violating the Computer Fraud and Abuse Act, which is intended to address hackers. The case in question involved an employee who gave his company password to former employees, but the ruling could technically allow people to be prosecuted under federal law for sharing their Netflix log-ins.


Innovation and Research

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NIH awards $55 million in precision medicine grants to study the self-contributed data of 1 million volunteers, with the lead recruiting centers being Columbia University Medical Center (NY), Northwestern University School of Medicine (IL), the University of Arizona (AZ), the University of Pittsburgh (PA), and the VA. Vanderbilt, Verily, and the Broad Institute will provide data analytics. In addition, Scripps Translational Science Institute and Eric Topol, MD (whose summary of the project is above) will  get $120 million over five years to develop apps, sensors, and processes to recruit the “citizen scientists” and give them the ability to share their collected information with their physicians. The scientist in me loves the idea, but the public health angel on my other shoulder wishes we would focus on the less-sexy blocking and tackling of reducing infant mortality, managing expensive chronic conditions, addressing social determinants of health, and resolving the ugly dichotomy of expensive “healthcare” vs. “health” in applying equal vigor to chasing goals that move the overall health needle further without having as their primary motivation the eventual lining of someone’s pocket.


Technology

The Wall Street Journal suggests that Apple fanboys resist the urge to pounce on the just-released public beta of iOS 10, warning that it’s buggy (not surprising for a beta release) and a pain to revert back to the prior version if things go wrong. The article tries to talk up a few new features, but they seem lame.


Other

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Mylan Pharmaceuticals has jacked up the price of decades-old emergency allergy auto-injection EpiPen to nearly $600 per two-pack over the past few years, giving cash-poor, high-deductible insurance consumers and public service agencies the choice to either go without the drug or draw up the much-cheaper generic ampules into syringes as needed for emergency doses. The drug was prescribed 3.6 million times last year as Mylan turned its 2007 acquisition into a billion-dollar product that provides 40 percent of its profits, pushing federal legislation that encourages schools to stock the injections and to recommend two doses instead of one per allergic episode. Mylan, which has a market cap of $22 billion and makes a lot of money selling drugs to the federal government via Medicare, shifted its headquarters offshore in 2015 to dodge US taxes.

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The number of HIEs has dropped from 119 to 106 as federal funding ended, a study finds, with half of the surviving ones reporting that they are not financially viable. The most prevalent HIE problems include lack of a sustainable business model, the inability to integrate HIE information into provider workflow, and lack of funding.

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Another study in Health Affairs that reviewed AHA’s IT survey data finds that hospitals that use their area’s dominant EHR (usually Epic or Cerner) engaged in a lot more data exchange than their competitors that run other EHRs, which the authors speculate is because it’s easier to exchange information with other Cerner or Epic shops and that those vendors will help make it happen. My takeaway is that hospitals in a mostly-Cerner or mostly-Epic region that use different EHRs have to spend more money to exchange information and are thus less likely to do so, especially if their competitors are indifferent or hostile to the idea.

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AdvancedMD tweeted out this photo of their team-building Lego derby. It’s always fun to see the folks in the trenches.

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Smokers are less likely to buy health insurance than non-smokers, apparently because they are unwilling or unable to pay the higher smoker premiums allowed by the Affordable Care Act. The penalties levied for not being insured don’t seem to be working, especially when they represent only a small fraction of the cost of insurance.

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I’m not entirely convinced that this Microsoft email is genuine even though he company has apologized for it, but it’s still funny to picture some low-level, corporately oppressed recruiter (whether it be at Microsoft or Epic) trying to relate to the kids he or she is recruiting by inviting them — in their cringe-worthy, baby-talk vernacular – to stop by for “hella noms” and  “dranks” just like someone’s white bread mom scanning Urban Dictionary looking for hip phrases to drop at the most embarrassing moment possible.


Sponsor Updates

  • Aprima announces that its EHR/PM meets MACRA/MIPS requirements.
  • ID Experts will present at the SANS Data Breach Summit August 18 in Chicago.
  • Navicure will exhibit at Mississippi MGMA July 13-16 in Biloxi.
  • Experian Health will exhibit at the Nebraska Association of Healthcare Access Management July 14-15 in Grand Island.
  • The SSI Group will exhibit at the FSASC Annual Conference & Trade Show July 13-15 in Orlando.

Blog Posts


Contacts

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

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July 7, 2016 News 8 Comments

Morning Headlines 7/7/16

July 6, 2016 Headlines 1 Comment

Legal (Fraud and Abuse) Barriers to Care Transformation and How to Address Them

An AHA report suggests that the Stark Law is becoming an impediment to care coordination and the expansion of value-based payment adoption, arguing that “The risk of overutilization, which drove the passage of the Stark Law, is largely or entirely eliminated in alternative payment models.”

Island Health presses ahead on electronic record system in Nanaimo

In Canada, Island Health’s $174 million Cerner implementation moves forward amid a unanimous no confidence vote from representatives of the health system’s medical association.

HealthyCT crumbles under ACA risk adjustment charges

HealthyCT, Connecticuts co-op insurer, will shut down because it is unable to pay a $13.4 million ACA-mandated risk adjustment payment.

Valeant’s New CEO Brings Familiar Prescription

The Wall Street Journal recaps the past business decisions of Joseph Papa, the new CEO of Valeant Pharmaceuticals, as he works to turn around falling stock prices without resorting to drug price gouging.

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July 6, 2016 Headlines 1 Comment

Readers Write: Election 2016

July 6, 2016 Readers Write 5 Comments

Election 2016
By Donald Trigg

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A provocative Atlantic magazine cover this month headlines, “How American Politics Went Insane.” Jonathan Rauch explores our current reality where “chaos has become the new normal — both in campaigns and government itself.”

As we struggle to draw rational signal from the noise, one can’t help but wonder if Trumpian chaos is resident in our favorite podcasts, journals, and websites. Are byzantine rule-makings not regularly bemoaned on HIStalk?  Do we not hear classes of readers singled out (particularly for using HIPPA and HIMMS)? Are we not struck by the rather small hands on the original HIStalk graphic?  

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HIStalk has been, all kidding aside, a thankful escape for many of us from a campaign that has been abysmal even by our diminished US standards. Fortunately, there are just 125 or so days left. And with few exceptions, these conversion dates hold.  

Here is the quadrennial cheat sheet.  

A proper understanding of the 2016 election starts with the massive advantage Democrats have in the Electoral College. The Democrats have a safe hold on 19 states (plus DC) representing 242 Electoral College votes. (Note: If you still are suffering under the delusion that the popular vote selects the president, let’s email about a couple of ideas for your trip to the Albert Gore Presidential Library). As a quick civics reminder, you only need 270 Electoral College votes to become president.  

So, with a probable shortfall of just 28 Electoral College votes to get to 270, the Democratic path is far easier. As an indicative example, a Republican could win every “swing” state from Ohio to Virginia, but lose Florida (29 EC) and thereby lose the presidency. It is not quite as challenging as running a health system with an antiquated MUMPS technical architecture, but it is still a daunting task for the GOP.         

The statistician-turned-blogger Nate Silver places the odds of a Hillary victory at 80 percent with one of his two models factoring in GDP (Q1 GDP was 1.1 percent) for a lower 75 percent chance. He probably has that about right and (spoiler alert) decisions like the Trump VP pick aren’t going to radically change that.

No matter the outcome at the top of the ticket, neither Democrats nor Republicans are likely to dominate the breadth of the electoral landscape. Republicans have a fairly solid grasp on the US House (247-188) and they also control 31 governorships. As Barron’s wrote over the long weekend, ongoing divided government will offer a muted welcome to any agenda this January.  

As for healthcare, the issue significantly trails the economy/jobs and terrorism when it comes to top voter concerns. Moreover, opinions are very settled and polarized. Forty-two percent favor the ACA, while 44 percent oppose it.  

Consequently, Clinton and Trump will use talking point level rhetoric, predominately to drive turnout. Hillary will take on big pharma, calling for caps on prescription drug costs. Trump will bemoan premium increases, call for ACA repeal, and assure us he is going to do something “fantastic.” You will feel like you are watching “Saturday Night Live.”

Notably, there is an important piece of emerging voter sentiment that we shouldn’t miss amid the posturing and platitudes. According to the June KFF poll, 90 percent are worried about the amount people pay for their healthcare premiums, while 85 percent are worried about increased cost of deductibles. Consternation over cost is growing and will be reinforced during open enrollment this fall. 

As we look out to first 100 days of the new administration, we will see a level of change on health policy that is more incremental than historic. Importantly, MACRA will continue to advance at the agency level, buttressed by solid bipartisan opposition to fee-for-service. At the state level, ongoing programmatic Medicaid changes move forward. Finally, even with the the Cadillac tax delay, employers experiment further with wellness incentives and alternative (and narrower) network design.  

In the Atlantic, Jonathan Rauch makes a lonely case for a renewed establishment that can impose some modicum of order. Few will like that treatment plan. His Chaos Syndrome diagnosis, however, is inarguable, as is his view that in the near term, “it will only get worse.”  

Donald Trigg is president of Cerner Health Ventures. In a previous life, he worked for President George W. Bush starting on the 2000 presidential campaign in Austin, Texas, and then after a brief Florida detour, in Washington, DC for the first half of Bush’s first term. 

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July 6, 2016 Readers Write 5 Comments

Monday Morning Update 7/4/16

July 4, 2016 News 6 Comments

Top News

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A security firm’s research finds that PCs and servers controlling hospital medical equipment often run outdated operating systems that are vulnerable to old malware such as the Conficker worm, giving hackers an easy back door into the hospital’s network. The report notes that hospitals are usually zealous in protecting end user PCs, but sometimes forget the computers that run CT scanners, dialysis machines, and other FDA-approved medical devices.

A case study involves a top hospital whose X-ray equipment was running Windows NT 4.0, which the security firm observed being penetrated in time to stop it. Honeypots created at another hospital found hackers hitting Windows XP-based systems for radiation oncology and fluoroscopy.


Reader Comments

From Orlando: “Re: Epic’s non-compete provisions. I wonder if they’ll try this in California?” California’s position on non-competes is that anything that restrains competition is automatically void. However, we’re back to the fundamental problem: no matter how questionably enforceable a non-compete agreement is, the employee has to decide whether to sign it and hope it will all work out when they leave because their only other option is to mount a long, expensive legal challenge either before or after their departure. Readers have pointed out that both Epic and Cerner have aggressive, mandatory non-compete agreements with employees but rarely enforce them if the employee leaves in a civil manner. Another challenge is that Epic could kill an employment offer from a third-party consulting firm or a health system by simply placing an off-the-record phone call. “You’ll never work in this town again” is pretty much true if you cross someone at Epic an try to jump ship to work for someone who relies on Epic’s goodwill, regardless of what legal terms you did or did not sign.


HIStalk Announcements and Requests

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McKesson’s health IT legacy will be modest, suggest poll respondents who characterize its contributions as poor (45 percent) or fair (43 percent). Commenters blamed disconnected and poorly managed acquisitions, a lack of healthcare IT focus similar to other companies that entered health IT with a big splash and later slunk out quietly (Siemens, GE, AT&T, IBM, and Oracle), and leadership pulled from the sales ranks. New poll to your right or here: which company will benefit most when McKesson sells its EIS business that includes Paragon?

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

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We funded the DonorsChoose grant request of Mrs. Robles from Arizona, who says the iPad Mini and multimedia receiver we provided to her middle school class has been “a game-changer for all of us” as the students have been more inspired to work harder at math using the lessons and discussions she assigns.

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Also checking in is Miss V from Utah, who had said in her grant request that she was “sometimes embarrassed as their teacher because we are a STEM school and yet I don’t have a single math manipulative in my classroom.” We bought her several sets, leading to her update: “The manipulatives you donated are more versatile than I ever thought possible, we use the counters for language bingo, shapes, math, and much more. Since we have received your donation, math in our classroom has become a lot more interactive and hands on. Miss V. and the math detectives will be solving hard math problems for years to come thanks to your amazing gift!”

Here’s how you know you’re in a low-growth geographic area: the clerk at Walgreens asks for your telephone number to look up your Balance Rewards Card and enters it wrong as you’re reciting it because they weren’t expecting a non-local area code. That suggests: (a) the area hasn’t grown enough to need more than one area code, and (b) they don’t get many people moving in since most would keep their old cell number containing their original area codes.


Last Week’s Most Interesting News

  • A hacker offers the patient databases of three providers for sale after those organizations decline to pay him or her to keep them private.
  • Teladoc announces plans to acquire consumer engagement software vendor HealthiestYou for $155 million in cash and stock.
  • AMIA announces the requirements for taking its informatics certification exam.
  • McKesson announces that it will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare and that it will exit the business following the new company’s 2017 IPO. McKesson will also seek strategic alternatives for its Enterprise Information Solutions business, which includes the Paragon hospital information system.
  • Allscripts brings back three original executives from its EPSi financial planning business and files a lawsuit against competitor Strata Decision Technology, accusing the company and former Allscripts chief marketing and strategy officer Dan Michelson – hired by Strata as CEO in 2012 – of using confidential Allscripts information to improve the KLAS rankings of StrataJazz in displacing Allscripts’ EPSi from the #1 spot.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

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


Acquisitions, Funding, Business, and Stock

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UK-based Network Locum, which matches hospitals with available locum tenens doctors, raises $7 million.

Xerox will lay off 95 employees of its Orlando-based Medicaid administration program due to “the business decision of a single client.” 


Sales

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East Jefferson General Hospital (LA) chooses NThrive – the former MedAssets, Precyse, and Equation – for revenue cycle outsourcing.


Government and Politics

The Brexit-induced devaluation of the British pound could leave NHS unable to afford expensive drugs manufactured elsewhere, experts fear.

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Go Andy Slavitt. You’re going to miss him when he leaves his federal job soon.

The federal government erases $171 million in loans made to students of bankrupt, for-profit Corinthian Colleges, which at its peak ran 100 campuses serving 75,000 students who received $1.4 billion per year in federal student loans. The students who voluntarily chose the aggressively marketed but questionably useful training programs (some healthcare-related) offered by Corinthian Colleges get to walk away from their debt as does the company itself, leaving federal taxpayers holding the bag for the unwise decisions made by everyone except themselves.


Other

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Vancouver’s Island Health will press on with its $135 million Cerner implementation despite last week’s unanimous no-confidence vote by its medical staff, who warn that the system’s electronic order entry is changing, cancelling, and overriding their orders. ED and ICU physicians have already gone back to paper orders after voicing similar patient safety concerns.

Catholic Health Initiatives will get out of the health insurance business after incurring big losses, adding big non-profit health systems to the list of organizations that believed they could compete with much-hated big insurers despite having minimal expertise in assembling a good risk pool and managing member health. 

Endocrinologist Joseph Aloi, MD of Wake Forest Baptist Medical Center (NC) describes in an interview how he uses Glytec’s Glucommander software to manage diabetic ketoacidosis. He notes that the #1 concern in treating older diabetic patients is hypoglycemia and it’s often caused by inpatient transfers out of dialysis, patients who aren’t eating, or NPO patients whose routine insulin dose isn’t adjusted. They’re looking at using Epic as a teaching tool to warn physicians if an insulin drip is discontinued and there’s no order for basal insulin, a practice used successfully used by Sentara.

I was wondering while watching fireworks Sunday night if any NFL’ers blew their fingers with firecrackers off this year.

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This is a pretty funny tweet, although I wouldn’t have been as kind in not calling out the fact that there’s no such thing as EST until the clocks move back in November. Why do Americans struggle so much with the simple concept of EST in the winter, EDT in the summer? (or just plain ET year round for those who just can’t keep them straight.) I’m not clear on what the HIT100 is, but it seems to reward and excite the Twitterati. I used to feel proud when a big company re-tweeted me until I realized it was a 24-year-old marketing assistant charged with tweeting something positive about the company. It’s not like Neal Patterson is manning or even reading Cerner’s Twitter since most decision-makers have more important things to do than screwing around with social media.

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This must be doubly digital medicine: a robotic rectum developed by Imperial College London for practicing rectal exams.


Sponsor Updates

  • Over 500 WeiserMazars employees volunteer at over 20 community organizations in five states during its second annual “Days of Service.”
  • ZeOmega receives a perfect SOC 2, Type 2 Report following an audit of its IS services.
  • Xerox is named a leading contact center outsourcing service provider in Everest Group’s 2016 report.

Blog Posts


Contacts

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

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July 4, 2016 News 6 Comments

News 7/1/16

June 30, 2016 News 13 Comments

Top News

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Massachusetts General Hospital (MA) notifies 4,300 patients that their information was exposed in a February 2016 breach of dental practice systems vendor Patterson Dental Supply. Dental system security guy Justin Shafer notified the company in February that all instances of its Eaglesoft software are insecure because the database uses a default username of “dba” and a password  of “sql.”

The company expressed its thanks in May 2016  by filing a Computer Fraud and Abuse Act claim in which it notified the FBI that Shafer had illegally accessed its server, leading to a pre-dawn raid on his home by a dozen armed agents who hauled him away in handcuffs.

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SRS commented on the screenshots I ran showing hacker TheDarkOverlord (who I’ll refer to as “he” even though he or she hasn’t divulged gender) sitting on an SRS EHR log-in screen as he apparently used Remote Desktop Protocol (RDP) to steal their client’s patient data:

Protecting our clients’ patients’ information is a top priority at SRS. Upon receiving notification that patient data from one of our clients may have been compromised, we immediately launched an investigation. While our investigation has concluded that the SRS system itself was not compromised, we are working in partnership with our client to assist in any way we can. At this time, the matter has been turned over to the appropriate authorities.

The hacker published several SRS screen shots showing full patient information. SRS is right, though – accessing a system by breaching RDP isn’t taking advantage of a vulnerability of any system other than RDP. It’s just logging in using someone else’s credentials. The real question is how he obtained the log-in information. RDP can store system usernames and passwords that can be displayed with readily available utilities. It would be interesting to know whether the clinic had set up RDP for its own users or whether a software vendor had configured it for remote support use.

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Justin Shafer (see above) speculates that the SRS client is Athens Orthopedic Clinic (GA) based on partially readable information in the SRS screen shots. DataBreaches.net contacted the clinic and received this response from its CEO:

In the last 48 hours, we were made aware of a potential data breach relating to our online patient records. Today, we also received an email requesting that we comply with the hacker’s request (which has been published in various forms online.) We take the privacy of our patients very seriously, as well as the laws that guide patient privacy, and we are investigating what may have happened through the proper channels. When we have more information to share with you and your readers, we will be in touch. Kayo Elliott, CEO, Athens Orthopedic Center.

TheDarkOverlord also named the Midwest provider from whose system 98,000 records were stolen and then listed for sale: Midwest Orthopedic Pain & Spine in Farmington, MO.

The hacker says he contacted each provider and offered to destroy his copies of their records if they paid him, with the alternative being that he would offer their records for sale. All of the providers declined. Note that this is extortion rather than a ransomware attack since he didn’t lock the users out of their own databases – he just demanded money in return for not publishing the records. He also apparently accessed the systems using manual intrusion methods rather than automated malware.

I scoured the Web for how to secure RDP:

  • Use strong passwords.
  • Keep both client and server versions current since older versions have many vulnerabilities.
  • Enable network-level authentication.
  • Administrator-level users can run RDP by default, so either remote unneeded administrator access or remove the administrator account from RDP access and add a technical group instead.
  • Set a local security polity limiting the number of password attempts.
  • Change RDP’s listening port so it can’t be easily seen in hacker network scans.

Here’s a chillingly factual description of how to hack RDP to steal the sysadmin password. The hacker uses address resolution protocol scanning software to find device IP addresses; captures the data stream when an RDP client connects to the RDP server (such as when a vendor connects to provide technical support); and then looks for passwords in the sniffer file, visible as individual user keystrokes (or the hacker can use a brute force password cracker).

Vendors, you might want to give your customers some emergency security guidance about configuring RDP, TeamViewer, LogMeIn, or any other remote support tool your support agreement requires.


Reader Comments

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From Green Tomato: “Re: forcing consulting firm employees to sign Epic’s non-compete agreement. Here’s a copy of what my employer insists we sign. Interesting contents: (a) it completely restricts access to Epic code without ‘pursuant to a customer schedule’ language, so the company has already run into engagements that require review of Epic code; (b) it restricts access to the Chronicles database, again costing my company a couple of engagements because they needed to query Chronicles to support a customer; and (c) it includes the hugely overreaching and offensive clauses declaring that we can’t work for an Epic competitor for one year after leaving our current jobs. I’ve heard that other consulting companies have signed agreements without the non-compete clause. I am standing up to my employer in not signing the agreement and will likely lose my job in the next few weeks. Without getting a group together for class action lawsuit, I’m essentially screwed, and even with a group it would be an uphill battle.”I don’t have the expertise to evaluate the legality of a company requiring its employees to sign another company’s non-compete agreement, but firing someone for declining to sign would seem to sit in wrongful termination territory. The fact that your employer even put this in front of you is indicative of just how scared companies are of getting on Epic’s bad side. I invite legal opinion, although I think you are correct that, right or wrong, you would need a lot of time and money to mount a challenge, and by the time you prevail, you will have moved on. You also have the document in Word, so you could add “not” in a key place (such as, “This restriction will not apply to you”), print it, and sign it hoping that nobody notices your edit.

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From ThisChangeIsNotGood: “Re: McKesson and Emdeon. They fall short in integrating acquired products and their customer service lacks. Change Healthcare and Relay have KLAS scores that lag almost 10 points behind their competitors. Why will bringing two challenged organizations together be good for customers? The obvious answer is that it won’t – it’s just a very profitable transaction for Blackstone. They acquired Emdeon for $3 billion and used at least $1.5 billion in debt, so this deal gives them $1.75 billion in cash ($250 million in profit) plus they still own 30 percent of the resulting entity. The release mentions $150 million in cost reductions which has to be mostly employees – the companies are huge cash generators because their customer contracts are old and those customers are drastically overpaying. The question is how long hospital CFOs will tolerate out-of-market prices with mediocre solutions and customer satisfaction.” There’s also the question about the degree of alienation felt by McKesson Technology Solutions customers and whether they see that getting better or worse once they’ve been dealt off to NewCo since, most importantly to McKesson, they buy a lot of non-IT stuff that McKesson actually cares about.

From HIStalkFan: “Re: [vendor name omitted.] VP of operations is leaving after the international sales VP left in the past month as well. The company has fired 20 folks in the past few months and seems to be losing business fast.” I left out the name of the cardiovascular information systems vendor for now since the VP is still listed on the company’s executive page. 

From Luke: “Re: VistA. Says its 40-year-old code is hard to manage, unlike that of commercial products.” Maybe, but Epic has been around nearly that long and Cerner Millennium was built in the 1990s. All three products have been enhanced continuously since they were developed, so it’s not like running an un-updated copy of Windows 3.11. The problem with both the DoD and the VA is that they’re going to hand billions over to contractors no matter what product they use and will probably botch their implementations via poor planning and oversight.


HIStalk Announcements and Requests

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Mr. H says his Texas after-school STEM class is “beyond excited” about the STEM kits we provided in funding his DonorsChoose grant request. The students have built a robot arm and analyzed pond water, with one student proudly exclaiming while experimenting with a marble roller coaster, “We are engineers in the making!”

Listening: Gary Clark, Jr., accurately characterized by the reader who recommended him as “born two generations too late, Jimi Hendrix crossed with Stevie Ray Vaughn.”

This week on HIStalk Practice: ManagementPlus launches revenue cycle solutions for eye care practices. Jonathan Bush waxes lyrical about his political plans. Allergy Partners develops app to help its patients track meds, triggers, symptoms. VillageMD partners with New Hampshire-based practices to assist with value-based care transitions. HHS selects 200 physician practices to participate in its Medicare Oncology Care Model. "Dr. Trump" promises perfect healthcare for all.


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

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


Acquisitions, Funding, Business, and Stock

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Marketing intelligence vendor Definitive Healthcare acquires competitor Billian’s HealthData.

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Teladoc will acquire telehealth consumer engagement platform vendor HealthiestYou for $155 million in cash and stock. Scottsdale, AZ-based HealthiestYou lost money on $10 million in FY2015 revenue, while Teladoc confirms that it will lose around $50 million in 2016. HealthiestYou offers price comparison and provider search. It seems like a ridiculous multiple for Teladoc to pay for an app that doesn’t seem all that interesting or related to its core telehealth business, but they must know what they’re doing.

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Google Capital takes a $46 million position in publicly traded marketplace Care.com, which matches families with caregivers.

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Allscripts sues its former chief marketing and strategy officer Dan Michelson – hired by competitor Strata Decision Technology as CEO in 2012 – as well as Strata, claiming that Michelson “has in his possession an external hard drive containing highly confidential and trade secret Allscripts documents and information.” Allscripts claims that Michelson has disclosed its information to Strata employees in violation of his Allscripts employment agreement. The lawsuit also notes that Strata hired several other Allscripts employees, several of whom worked in sales for EPSi, the Allscripts financial planning product that competes with Strata’s StrataJazz. Allscripts contends that it lost the #1 KLAS spot for Decision Support – Business in 2014 to StrataJazz because of the exposed information, causing EPSi to drop to fourth place in the 2015 report.


Sales

GoHealth Urgent Care chooses Orion Health’s Rhapsody integration engine to connect with its health system partners.


Government and Politics

Vice President Biden, questioned at a cancer summit about why medical institutions that receive government grants don’t always publish their research data, responds angrily, “I’m going to find out of it’s true. And if it’s true, I’m going to cut funding. That’s a promise.” NIH Director Francis Collins says the 2008 law requiring taxpayer-funded researchers to submit their clinical trials data to NIH-run ClinicalTrials.gov does not provide an enforcement mechanism, but he expects changes that will allow NIH to levy fines on those who don’t comply or the power to ban them from receiving further grants.

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The Wall Street Journal says health insurance deductibles should become the next health policy debate now that 91 percent of the US population has coverage. Since 2004, co-pays have dropped, worker wages have increased modestly, and deductibles have jumped 256 percent to become the #1 health cost concern of consumers as well as the preferred tool for employers trying to rein in annual premium increases.

Congress works on a financial bailout of Puerto Rico, where 9 percent of its population has moved to the US, causing its hospitals to struggle with unfilled beds and an exodus of clinicians that may cause a further downward spiral in employment and business investment. Puerto Rico’s governor observes that its residents pay the same Medicare tax as mainland residents, but it gets less federal funding than the states. Lenders have cut off further loans as debt soars, with one surgeon noting that the hospital’s electricity was turned off for non-payment in the middle of a surgery he was performing.


Other

AMIA announces the eligibility requirements to take the exam for its Advanced Health Informatics Certification, an alternative to the physician-only clinical informatics subspecialty. Until an unspecified time until which the majority of graduate informatics programs are accredited, the requirements are:

  • Employment in an operational health informatics role.
  • Attainment of a health professions graduate degree plus a master’s in health informatics (for which 36 months of informatics experience in the US or Canada can be substituted). Examples of acceptable degrees are MSN, MPH, NP, PA, DDS, DNP, PharmD, DO, and MD.
  • 18 months of informatics work experience.

AMIA’s next steps are to develop the exam’s core content, choose a certifying entity, and launch the accreditation of graduate health informatics programs.

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Commonwealth Fund President and former National Coordinator David Blumenthal, MD, MPP says that instead of trying to convince providers to share their patient information, a better way to eliminate information blocking is to put patients in control of their own records as a “consumer-mediated health information exchange.” Patients or their paid vendors would manage and distribute their own information to parties they specify, which could include researchers or public health authorities. Blumenthal says the next steps would be to certify and/or regulate the organizations that will help patients share their information and to give those organizations access to provider EHRs.

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Informaticist Harris Stutman, MD ended his “Jeopardy” run Wednesday, earning second place for the day but taking home three-day winnings of $63,500.

BMJ ponders whether it’s OK for conferences to ban live-tweeting of their educational sessions. Arguments for: (a) presentations may include unpublished results and preliminary conclusions; and (b) the presenters may have granted a copyright to journal that is publishing their work. The author suggests that conferences make their tweeting policy clear and that speakers indicate on their title slide whether they are OK with having attendees tweet out photos of their other slides and handouts.


Sponsor Updates

  • Audacious Inquiry announces that its Encounter Notification Service is delivering1 million ADT notifications per month.
  • Boston Software Systems launches an EHR migration and optimization podcast series.
  • Netsmart helps prepare health and human services providers for CARF and The Joint Commission accreditations.
  • Representatives from 30 healthcare organizations in Canada visited Toronto’s Humber River Hospital, which claims to be North America’s first full digital hospital, to learn about its Meditech 6.1 system.
  • CloudWave is named by Hewlett Packard Enterprise as Preferred Healthcare Network Partner.
  • Red Hat will host its annual summit will take place May 2-5, 2017 in Boston.
  • Sagacious Consultants releases the June 2016 edition of its Sagacious Pulse newsletter.
  • SK&A publishes its annual pharmacy compliance report.
  • Sunquest Information Systems hosts a Cancer Moonshot Summit in Tucson, AZ.

Blog Posts


Contacts

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

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June 30, 2016 News 13 Comments

News 6/29/16

June 28, 2016 News 5 Comments

Top News

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McKesson will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare (the former Emdeon), with plans to take the new company public sometime in 2017. McKesson will own 70 percent of the new company and Change Healthcare will own 30 percent.

McKesson will retain its RelayHealth Pharmacy business as well as its Enterprise Information Solutions division, but will “explore strategic alternatives” for the latter, which includes its remaining go-forward hospital information system Paragon along with less-attractive products like Star, HealthQuest, and OneContent. McKesson seems to have lost most of its Horizon customers to Epic or Cerner after they declined to move to Paragon under McKesson’s Better Health 2020 program, so this latest move will likely cause more defections.

The new company will take on up to $6.1 billion in debt to fund the transaction.

Blackstone Group bought publicly traded Emdeon, which operated under the WebMD name through 2005, for $3 billion in 2011 and took it private in a leveraged buyout. It renamed the company Change Healthcare in September 2015 after January 2015 plans for a $5 billion IPO never materialized.

McKesson struggled from the beginning with its $14.5 billion acquisition of HBOC in 1998, dogged by a massive accounting scandal, the resultant firing of several executives who were involved, aging product lines, and a lack of corporate focus. The company, like several before it, dabbled in health IT dispassionately but with the added baggage of having wildly overpaid for an immediately impaired asset. MCK share price dropped and didn’t recover for 12 years under John Hammergren, who was quickly promoted to co-CEO in the leadership void in 1999, eventually becoming the country’s highest-earning CEO.

This transaction, along with the eventual disposition of Enterprise Information Solutions, will once again remove McKesson from the software business.

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… but not the day after the transaction closes.

Your trivia questions for today:

  • Who was named as Hammergren’s co-CEO in the 1999 announcement that McKesson Chairman Charlie McCall and CEO Mark Pulido had been fired over HBOC’s accounting irregularities?
  • What was the name of McKesson’s short-lived online business that was launched in the heady dot-com days of 2000 and led by Hammergren’s former co-CEO, giving Hammergren full control?
  • What accounting company failed to detect widespread fraud as the auditor of both McKesson and Enron?

Reader Comments

From ProGoogler: “Re: Change Healthcare. Blackstone finally dumps Healtheon / WebMD / Emdeon / Change onto McKesson? Surprising that Change would dump all assets into a company they’ll only have a 30 percent stake in. HIStalk followers–what’s the take on this?”

From Silly Boy: “Re: McKesson and Change. Throwing their trash into a doomed-to-fail company, ridding themselves of all liability, and getting $1.5 billion each in cash out of it? Wow.” You forget to mention the advantageous tax accounting McKesson will use to walk away.

From Robert Higgins: “Re: dress while traveling. See this LinkedIn post, which says everybody should dress up while traveling on business because they represent the company and you should be extraordinary rather than ordinary.” I can’t imagine anything more mind-numbingly ordinary than a bunch of mid-level company hotshots wearing suits everywhere they go hoping to impress strangers who apparently value cloth over character. Real power players wear whatever they want (see: Mark Zuckerberg, Steve Jobs, etc.) while their un-creative, lemming-like underlings choke on ties. I’ve attended venture capital sessions at the HIMSS conference and my biggest takeaway was that the real money guys looked like they had just dropped by after a family cookout, while back at work my fellow IT management team members would illogically don their always-handy suck-up jackets for internal meetings or restroom trips.


HIStalk Announcements and Requests

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The Tennessee elementary school students of Mrs. Jones have shown “amazing growth” in benchmark assessments, she reports, after practicing reading and math on the the three Kindle Fires we provided in funding her DonorsChoose grant request.

I don’t really do anything with LinkedIn except look up people’s job histories, but you are welcome to join the 2,477 people who have connected with me there, of which 351 have written me really nice recommendations. There’s also the HIStalk Fan Club created by Dann many years ago, now up to 3,617 members, many of them CEOs, CIOs, CMIOs, etc. I might tell my mom about it just to see her puzzled double take since surely she views me fondly and accurately as her low-profile ne’er-do-well.


Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Ask Lorre about her “Summer Doldrums Special” sale.

This Tuesday’s webinar by West Healthcare Practice drew nearly 500 registrants and will no doubt generate many YouTube page views after the fact. I always give my first-pass critique of our webinars and rarely have any change suggestions for West. Lots of readers are apparently interested in what Henry Ford is doing with contact centers (including me).


Acquisitions, Funding, Business, and Stock

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Allscripts acquires RealCost.io — a decision support company founded by former EPSi executives Tim Rutledge, Ralph Keiser, and John Gragg – and will put the three men back on the Allscripts EPSi financial planning product line to serve as chief product architect, CEO, and COO of Allscripts EPSi, respectively. Eclipsys acquired EPSi in 2008 for $53 million in cash, followed by the acquisition of Eclipsys by Allscripts for $1.3 billion in 2010. All three left Allscripts from 2008 to 2011.

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VistA vendor Medsphere and ambulatory PM/EHR vendor ChartLogic will merge.

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EHR data sharing vendor Medal raises $3.8 million. Co-founder and CEO Lonnie Rae Kurlander is a 27-year-old medical student at Boston University.

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MedAssets-Precyse renames itself nThrive. Pamplona Capital Management bought MedAssets for $2.7 billion in November 2015 and combined its RCM business with Precyse, another of its recent acquisitions.


Sales

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Mercy Technology Services adds three clients: Riverview Health (IN) for Epic hosting, McLeod Health (SC) for data analytics, and Peninsula Regional Medical Center (MD) for Epic implementation support.


People

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Medical informaticist Harris Stutman, MD (MemorialCare Health System) returns as “Jeopardy” champion Tuesday night following his wins on the Friday and Monday programs that earned him $39,700.

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Premier promotes Leigh Anderson to SVP/CIO, replacing the departing Keith Figlioli.

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Microsoft promotes Simon Kos, MBBS to chief medical officer. It appears he went to work for industry (InterSystems, then Cerner) directly out of residency without actually practicing medicine.


Announcements and Implementations

Analysis by TransUnion Healthcare finds that patients experienced a 13 percent increase in their deductible and out-of-pocket maximum costs in 2015 at $1,278 and $3,470, respectively. “Patients are becoming the new payer,” the report concludes.

Vital IMages launches its application-neutral archive that connects proprietary data sets for interoperability and workflow.


Government and Politics

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In England, Health Secretary and “Remain” supporter Jeremy Hunt calls for additional Brexit referendum votes or other “democratic endorsement of the terms” by which the UK will extricate itself from the European Union. He is considering running for Conservative leadership as prime minister, urging full trading access but with immigration restrictions. Hunt said previously that NHS would face budget cuts and staff shortages should the UK exit from the European Union, a statement pro-Brexit supporters characterized as fear-mongering. Meanwhile, “Leave” campaigners appear to be backtracking on their assertion that withdrawing will free up $467 million each week, of which they had promised that a large portion would be sent directly to NHS to improve healthcare services.


Privacy and Security

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A hacker offers for sale the records of 655,000 patients from three unnamed US provider databases and reports that some of the information in them has already been sold. DeepDarkOverlord says he or she exploited an unstated vulnerability in RDP (remote desktop protocol) to take control of the provider computers and steal their patient data, after which he or she offered to return the data for a ransom that the providers elected not to pay. The prices range from $100,000 to $411,000 for each of the three databases:

  • An Access database of 48,000 patients from an unnamed healthcare organization in Farmington, MO.
  • A plain text database of 210,000 patient records stolen from a Midwestern provider
  • A plain text database of 397,000 patient records retrieved from an unnamed Georgia provider.

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Apparently one of the hacked providers uses the SRS EHR, based on the hacker’s screen shot of  him or her taking over a Windows 2008 server at the unnamed Georgia site.

The same hacker is also offering a 9.3 million patient record database from an unnamed insurance company, stolen using the same RDP exploit. Security researchers tested sample data and believe it’s an old database since many of the telephone numbers and email addresses it contains are no longer valid.


Technology

Comcast Business creates its largest Eastern US network in providing 100 Gbps Ethernet connectivity between the campus of Penn State Health Milton S. Hershey Medical Center (PA) and the university’s data center.


Other

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A survey finds that EHR-using physicians are less satisfied and more burned out, with physician satisfaction low for performing both EHR documentation duties and CPOE. Family medicine, ED, and orthopedic surgery are big trouble spots, while surgeons and ever-affable pediatricians are happier. Interestingly, the method of documentation didn’t affect the burnout rate much – it was about the same for dictation, voice recognition, handwriting or typing, and using scribes. Only 36 percent of respondents said the EHR has improved patient care and just 23 percent said it has increased their efficiency.

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Bob Wachter, MD cashes in on the success of his book “The Digital Doctor” in hiring himself out as a thought leader and video star to malpractice insurer The Doctors Company, a role he describes as, “My partnership with The Doctors Company will provide its 78,000 members and other physicians nationwide with the tools and information needed to thrive in today’s rapidly changing digital landscape.”


Sponsor Updates

  • FormFast publishes a new white paper, “Delivering ROI: The Case for Electronically Capturing Patient Signatures.”
  • FujiFilm will exhibit its Synapse product line at SIIM 2016 June 29-July 1 in Portland.
  • A study finds that hospitals that use Nuance’s clinical documentation improvement solutions score better in patient mortality ratings.
  • Meditech held its Nurse and Home Care Forum June 15-17 in Foxborough, MA.
  • Glendora Community Hospital (CA) goes live on electronic forms from Access and signature pads from Wacom in the ED and admission areas.
  • Bernoulli CIO John Zaleski will speak at the IEEE Chase 2016 Conference on Connected Health June 29 in Arlington, VA.
  • Besler Consulting wins a B2B Marketer Award for Best Contribution to Sales Account-Based Marketing.
  • Carevive Systems shares its latest poster presentation, “Implementation of Survivorship Care in a Network Hospital Setting.”
  • CTG and Catholic Health Systems will co-host a symposium, “Exploring the Impact of Security Threats: Is Your Organization Prepared,” June 29 at CTG headquarters in Buffalo, NY.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
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June 28, 2016 News 5 Comments

Monday Morning Update 6/27/16

June 26, 2016 News 7 Comments

Top News

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HHS considers running an ethical hacking program to identify cybersecurity vulnerabilities, encouraged by results from the Pentagon’s recent pilot program. The concerns of such a program are that, (a) hackers would by definition be encouraged to seek exposed confidential patient information, and (b) they are likely to find a lot of it, thus requiring someone to take action.

“Hack the Pentagon” was the first bug bounty program run by the US government. It drew 1,410 participants this past April and May and paid $71,200 in bounties, or an average of $588 for each verified vulnerability. Most of the reported vulnerabilities involved cross-site scripting, but one participant discovered a significant SQL injection bug.

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The DoD used the HackerOne bug bounty program that provides hacker invitations, a leaderboard, hacker messaging, payments, and workflow.


Reader Comments

From Venus de Milo: “Re: Epic’s new product name. Userweb shows a whole treat titled, ‘We are excited to announce Caboodle as the new name for Epic’s enterprise data warehouse.’” It’s a quirky name, but I like it. At least they don’t use eye-rollingly unoriginal names like Insight.

From Brownian Movement: “Re: Epic. The company forces the individual employees of consulting firms sign a non-compete directly with Epic. If you work for a consulting firm and have access to an Epic client’s system, you can’t work in software or sales for an Epic competitor for one year after leaving the consulting firm.” The non-compete agreement that Epic requires its own employees (and those of its customers) to sign is almost certainly not legally defensible, so it’s even more likely that such agreements signed by the employees of other companies couldn’t withstand a legal challenge. However, Epic’s industry clout and legendary legal firepower cause everybody to sign the paper anyway. Most of the griping happens only when someone wants to change jobs, but the sit-out period would be over before any expensive legal challenge could be completed. Think about Epic’s heavy-handed control – Epic’s new customers are required to let the company administer tests to their employees who want to work on their Epic project. Epic scores the tests secretly, providing only a hire/no hire recommendation. If you score well, you get to work on the Epic project team and thus get to retain your job. Score less well (by whatever standards Epic uses) and you’ll be banished to the legacy maintenance team with all the other rejects, thus assured of losing your job once Epic is live and your legacy system babysitting skills are no longer needed. It is reasonable to expect companies to stack the deck in favor of their own interests unless someone musters a challenge.

From Follow the Money: “Re: DOJ’s bust for a measly $900 million in Medicare fraudulent billing. Reminds me of a poem by James Roche.”

The Net Of Law

The net of law is spread so wide,
No sinner from its sweep may hide.
Its meshes are so fine and strong,
They take in every child of wrong.
O wondrous web of mystery!
Big fish alone escape from thee!

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From Stiffie: “Re: healthcare IT writers and reporters. I looked up their lightweight credentials and made you a table of who is out there dispensing analysis and advice.” I don’t necessarily agree since most publications simply rewrite press releases to resemble original reporting, so it would be a waste for them to hire someone with actual industry experience. If these folks can find and keep an executive-level audience, more power to them because it’s not easy.


HIStalk Announcements and Requests

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Two-thirds of poll respondents disagree with the AMA’s opinion that technology reduces the efficiency of care delivery. Some of those respondents correctly noted that “efficiency” is in the eye of the beholder, whose personal data capture efforts might – like paying income taxes — detract from their own performance in deference to the greater good. New poll to your right or here: how would you characterize McKesson’s contribution to health IT?

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Mrs. Riley’s Maryland second graders are using the 25 sets of headphones we provided in funding her DonorsChoose grant request to access Internet tools and educational games. They are less distracted by the noise of what other students are doing and she can differentiate the simultaneous activities being pursued by her special education subgroups.

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My WiFi range extender was performing erratically, so I replaced it with the $30 Netgear N300. You just plug it into a wall jack near the end of the wireless coverage range of your router, connect your smartphone or tablet to the newly created network (whose name, unless you change it, is your existing network’s name plus _EXT at the end), then enter the network password on the setup page.  I’m getting five bars and high speeds far from the router and it’s never hiccupped even once in several weeks. It’s a great solution for coverage problems (distant bedrooms, garage, workshop, or patio) or if you want to stream Netflix from a spot where coverage is too weak to support a high-quality picture. The little gadget even has an Ethernet port if you need to hardwire something.

Listening: Eye Empire, an apparently defunct band that offered the compelling combination of alt metal chops with understandable vocals rather than screaming and grunting, not that there’s anything wrong with that. For an even harder edge with a biker bar vibe (since they love featuring strippers in their videos), there’s always Southern hard rockers Texas Hippie Coalition, which sounds and looks like Charlie Daniels fronting Pantera.


Last Week’s Most Interesting News

  • The newly installed president of the American Medical Association says his practice doesn’t use an EHR, preferring to pay the penalty rather than participate in Meaningful Use.
  • An HHS OIG analysis finds that one-third of Medicare recipients were prescribed potentially addictive opioids last year at a cost of $4.1 billion.
  • HHS credits analytics for helping it identify the 301 people it arrested for Medicare fraud.
  • The VA continued its hints about eventually de-emphasizing or replacing of VistA in favor of a commercial product.
  • McKesson is reportedly trying to sell its health IT business to Change Healthcare (the former Emdeon).
  • A federal report recommends national quality reporting, real-time data sharing, use of best practices, and civilian-military cooperation in reducing 30,000 unnecessary trauma patient deaths each year.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Ask Lorre about her “Summer Doldrums Special” sale.


Acquisitions, Funding, Business, and Stock

How health IT stocks performed in Friday’s Brexit-triggered selloff, which I expect to be reversed Monday as investors realize that several mechanisms exist to reverse the UK’s decision and that the timeline is long in any case:

Dow: down 3.4 percent
Nasdaq: down 4.1 percent
S&P 500: down 3.6 percent
Allscripts: down 2.7 percent
Athenahealth: down 0.8 percent
Cerner: down 3.1 percent
McKesson: down 3.8 percent
Quality Systems: down 3.1 percent


People

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Paula McCann, VP/CIO of East Texas Medical Center Regional Healthcare System, is appointed to the Texas Health Services Authority board.

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Rosanna Morris, RN, MBA, chief nursing officer and Epic EHR implementation co-leader of Nebraska Medicine, is named CEO of Beaumont Hospital (MI).


Announcements and Implementations

IDC Health releases yet another worthless health IT vendor revenue ranking with methodology unspecified. Assuming its information is correct – which I don’t when privately held companies are involved – I don’t know exactly what anyone would do with that information other than, (a) the PR people in companies named to the list who brag on the bestowment of questionable awards; and (b) the uncritical health IT rags that milked this anemic “news” for several paragraphs of slightly reworded press release text. As a customer, I wouldn’t necessarily be delighted that my vendor has more revenue than its competitors, especially if the portion I contributed wasn’t worth what I received in return. Bigger is definitely not associated with better. Perhaps it is appropriate that IDC in text messaging parlance stands for “I don’t care.”

Austin-based revenue cycle technology vendor DaVincian Healthcare, which has raised $50 million in funding, wins a contest for using Amazon’s Alexa to solve financial payments problems. The winning system allows patients to receive prescription refill reminders, ask questions about their prescriptions, and send messages to their providers. I think a lot of people are like me, though – I bought Alexa but never use it since the benefit is unclear if you’re already near a phone and I don’t really know what all it does since Amazon is cool like Apple in not providing a manual. It seems to be best suited for ordering even more stuff from Amazon. The video features a robotic phony doctor decked out in the obligatory scrubs, white coat, and the doctor ego elevation tool (a stethoscope) sitting in what looks like a spare bedroom in front of a desk full of books puzzlingly turned around backwards (they probably didn’t have any actual medical books handy). In fact, the windows in the doctor’s office look exactly like the ones in the patient’s living room and in his daughter’s house, so perhaps they all live together in Alexa-powered health IT communal bliss. Fun aside, it’s a nicely done video and the product is interesting if someone can validate the extent to which Alexa customers have integrated it into their daily lives.


Government and Politics

HHS names Aaron Miri, CIO and VP of government relations of Imprivata, as the privacy and security representative of the HIT Policy Committee. Appointed to the HIT Standards Committee are new members:

  • Rajesh Dash, MD (Duke University School of Medicine)
  • Kay Eron (Intel)
  • Peter Johnson (retired)
  • Kyle Meadors (Drummond Group)
  • Terrence O’Malley, MD (Massachusetts General Hospital)
  • Andrey Ostrovsky, MD (Care at Hand)
  • Wanmei Ou (Oracle)
  • Larry Wolf (Strategic Health Network)

In Australia, the CIO of Queensland Health and CEO of eHealth Queensland resigns after just seven months on the job to take a private sector position. He was placed under investigation three weeks after taking the job following a nepotism complaint. He was hired by his wife, a Queensland Health executive.

China uses the death of a student from treatments he found from Internet searches to tighten the government’s control over the Internet, requiring search providers to censor “rumors, obscenities, pornography, violence, murder, terrorism, and other illegal information” along with limiting the display of paid ads. That won’t affect Google, at least for the moment, since the Great Firewall has blocked it almost continuously in the years after the company declined to censor search results.

A Vermont citizen advocate wants to know, “What does Vermont have to show for its $50 million investment in VITL?” in referring to Vermont Information Technology Leaders. He questions why patients don’t own their data and claims that VITL’s contract with its technology vendor Medicity requires it to transfer all of its intellectual property and patient information to the company.


Privacy and Security

A newly signed Illinois law requires covered entities that report a data breach to OCR to also notify the state’s attorney general even if the incident doesn’t meet the state’s definition of a breach.


Technology

Here’s your “Jeopardy” question for the week. The answer is, “A study surprisingly finds that you really can go blind from playing with this in the dark.” The correct question: “What is a smartphone?”


Other

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A Peer60 medical image sharing report finds that McKesson is leading in installations and recommendation scores, with LifeImage leading the pack by a wide margin among vendors being considered by first-time adopters. The least-desirable image sharing technology is, thankfully, CDs, while cloud networks toped the list and site-to-site sharing came in #2. The highest-risk vendors for replacement are Sectra and Philips, with their  biggest threat being customers who are pursuing a single-vendor strategy and superior technology.

PBS covers the ordeal of a heart bypass patient who verified that the hospital and surgeon accept his insurance, only to get stuck with a $2,200 bill from an ICU doctor who doesn’t. The patient asks reasonable questions of an unreasonable healthcare non-system: “Out of nowhere, somebody who you never heard of, I don’t remember meeting, sends a bill. Why is he not accepting the insurance?  Why is he out of network?” The answer isn’t so simple, of course – hospitals take hundreds of insurances whose coverage varies widely, with the real problem being that hospital bills aren’t all-inclusive even though you might logically wonder why not. The article profiles another patient who was left on the hook for a $5,000 out-of-network plastic surgeon’s bill after rushing to the ED with deep ankle cuts. The hospital answered the reporter’s inquiry with a dry, concise response: “The current system is not optimal.”


Sponsor Updates

  • Sunquest will host the Tucson Cancer Regional Moonshot Summit on July 29.
  • Craneware will exhibit at the HFMA ANI conference in Las Vegas this week and will co-present a session about pharmacy revenue integrity.
  • Optimum Healthcare IT joins CHIME as a foundation partner.
  • T-System celebrates 20 years of advancing care delivery and financial outcomes for EDs, freestanding emergency centers, and urgent care.
  • ZDoggMD will make an appearance at TeleTracking’s annual conference, October 9-12 in Naples, FL.
  • TierPoint is recognized in Gartner’s June 2016 “Magic Quadrant for Disaster Recovery as a Service” report.
  • TransUnion, VitalWare, Huron Consulting Group, and Zynx Health will exhibit at the HFMA ANI Conference June 26-29 in Las Vegas.
  • Valence Health Chief Strategy Officer Phil Kamp will speak at the HFMA ANI Conference June 26-29 in Las Vegas.
  • Visage Imaging and Vital Images will exhibit at SIIM 2016 June 29-July 1 in Portland.
  • Wellsoft EDIS publishes a new case study on its work with Kingston General and Hotel Dieu Hospitals.
  • ZirMed client Baptist Health will share how it leveraged the company’s revenue cycle solutions at the HFMA ANI Conference June 26-29 in Las Vegas.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
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June 26, 2016 News 7 Comments

Monday Morning Update 6/20/16

June 19, 2016 News 2 Comments

Top News

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A government report estimates that 30,000 US patients die unnecessarily from trauma each year since trauma center death rates vary widely such that “where you are injured my determine whether you survive.” It urges creation of a national trauma system driven by best practices that includes both military and civilian systems and pre-hospital providers such as ambulance services.

The leading cause of death among people under 46 years old is trauma (motor vehicle accidents, gunshots, and falls).

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The report from the National Academies of Sciences, Engineering, and Medicine recommends that trauma centers create real-time access to patient-level data that would also be used in a national quality improvement program.


Reader Comments

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From Former Westminster, CO Employee: “Re: McKesson. I worked on Horizon for 15 years. Upper management refused to listen to QA, support, implementation, and development and would demand that change requests be closed with known software bugs shipped to clients to meet project deadlines. Hospitals would then report the bug, which would be re-opened as a Hot Fix Solution as the cycle repeated. Management was more concerned about running a tight ship and laid off many critical people. Paragon will suffer the same because the management culture has not changed.” Unverified.


HIStalk Announcements and Requests

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Most poll respondents would struggle to pay an unexpected medical bill of $5,000 to $25,000, which is a lot better than the 47 percent of Americans that a federal study found would struggle to pay a $400 emergency bill. New poll to your right or here: do digital tools reduce the efficiency of care delivery as the AMA contends?

Here’s a fun enhancement idea for the new iPhone patient data EHR query: let the app automatically file an HHS data-blocking complaint for unsuccessful requests.

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Mr. Martinez is using the document camera we provided in funding his DonorsChoose grant request to record his live presentations so that students in his California high school classroom can review portions they missed or to keep up when they’re absent. He’s recording additional examples and placing them on his website so that students can follow along on their own time.

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Also checking in is Mrs. Evans from Florida, who says many of her elementary school’s students had never used a tablet until we provided six of them for her gifted class.

Listening: new from Radiohead, slower and more melodic (some might say “wimpier”) than previous masterworks like “OK Computer,” but sometimes you have to let good bands evolve and give their new stuff a multiple-play chance to grow on you.


Last Week’s Most Interesting News

  • Apple adds C-CDA records import capability to iOS 10, giving iPhone-using consumers the theoretical ability to request and capture their basic medical information from provider EHRs.
  • AMA passes a resolution supporting creation of an ONC-administered health IT safety center.
  • Doctors in Australia demand that patient update access to their own medical records be revoked, saying they can’t trust the information.
  • The AMA’s EVP/CEO lashes out at “digital snake oil,” broadly panning the health-related software that is available to doctors and consumers.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Lorre’s getting bored because of the industry slowdown that kicks in every year right about now, so ask her nicely for her “Summer Doldrums Special” that we always run through Labor Day and you’ll get a great deal.


Acquisitions, Funding, Business, and Stock

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TransUnion acquires Auditz, which offers point-of-service patient revenue products.

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Cerner shares continue their recent slide, closing at prices not seen since July 2014. Above is the one-year price chart of CERN (blue, down 22 percent) vs. the Nasdaq (red, down 6 percent).


Announcements and Implementations

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LeadingAge Center for Aging Services Technologies creates an EHR adoption model for long-term and post-acute care providers.


Government and Politics

The government of South Australia continues its years-long legal pleading to software vendor Work Systems, whose 1990s-era, DOS-based patient records system is still being used by 64 of South Australia’s health sites. The vendor demands that state government stop using its software since its license for a retired version has expired, but the government argues that forcing it to stop using the system would endanger patients. South Australia is in a bind because its Allscripts-powered EPAS project is behind schedule and over budget with only three sites live amidst widespread doctor protests that the system endangers patients.

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Karen DeSalvo, MD, MPH and her HHS team wore blue to support Men’s Health Week last week.

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An independent analysis finds Healthcare.gov to be the second-most secure consumer website.

The VA engages Underwriters Laboratories to help improve the cybersecurity of its medical devices.


Other

It’s been said that “a true test of a man’s character is what he does when no one is watching,” which is an apt summary of a new study that finds increased rates of hospital hand-washing when clinicians know they are being observed. Easy-to-spot infection prevention nurses saw a 57 percent rate of hand-washing compliance, while less-recognized volunteers saw staff washing their hands when they should only 22 percent of the time.

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An excellent analysis by Arcadia Healthcare Solutions that I hadn’t previously noticed until NPR ran a story on it finds that the cost of care provided to dying patients in their final 30 days varies widely by where they die. Patients who expire in a hospital consume $32,000 worth of services, while those who pass away in nursing homes, hospices, and at home cost $21,000, $18,000, and $5,000 respectively. Saddest of all is that 40 percent of patients died in a hospital, something that few people want. The company offers several interesting dataset visualizations on its site.

I also missed this New York Times op-ed piece from a few weeks back in which a University of Oslo professor pans the idea of a “cancer moonshot,” saying the Catch-22 of cancer is that it can’t be cured and thus keeping people alive longer means they’re more likely to get cancer again. He recalls that President Nixon called for a cancer moonshot of his own in 1971 and the National Cancer Institute has spent $90 billion since then even as cancer rates increased. He concludes that the effort wasn’t wasted, however: “We’re a lot better at fighting cancer. We just can’t cure it,” but warns of “the rhetorical spin that drives the cancer enterprise.” He urges that doctors save lives via the “boring stuff” of getting patients to stop smoking, use sunscreen, eat better, and exercise, saying that will do more good than “promising the moon.”


Sponsor Updates

  • Vital Images will exhibit at SCCT 2016 June 23-26 in Orlando.
  • Zynx Health will exhibit at AMDIS 2016 June 21-24 in Ojai, CA, as will LogicStream.
  • Integris and The Chartis Group will present “Centralized Scheduling for a Physician Enteprise” at the HFMA National Institute June 26-29 in Las Vegas.

Blog Posts


Contacts

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

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June 19, 2016 News 2 Comments

News 6/17/16

June 16, 2016 News 1 Comment

Top News

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Apple’s iOS 10 will allow users to request copies of their medical records from their smartphones, provided their provider’s EHR can export a Continuity of Care Document. Users can also import records from Safari and Mail. The translated medical summary can be stored directly in Health.


Reader Comments

From Meltoots: “Re: CMS and EHR vendor snake oil. MU was an unmitigated disaster for safety, security, usability, efficiency, and physician burden, yet it continues with a new name. Everyone wants to move away from fee-for-service, yet we have no idea how to attribute quality care from multiple doctors to a single patient. This is a not-so-secret CMS push to put providers into large practices so they can crank down on payments. Providers have had enough.” The other concept at work is that hospitals, which have performed so pitifully and indifferently in coordinating patient care and managing populations, are figuring out how to reap the lion’s share of the money that will be spent to improve it. It’s also interest that just as it’s hard to detect Medicare fraud because providers work under the NPI of other providers in group settings, it’s equally hard to determine using billing data which of them is individually responsible for wise or unwise care decisions.

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From Gray Sky: “Re: Medhost. Has had outages for the past two weeks for all hosted applications. Inside information points to a storage information where customer data has been erased. The company continues to investigate options to restore the data to a reasonable point in time.” I ran this rumor Tuesday with the vendor name omitted pending the company’s response, which Medhost has provided:

Medhost supports software applications in over 1,100 facilities across the United States, Canada, and Puerto Rico. Over the past several weeks we have experienced system outages impacting a total of three hosted facilities. In one instance, the outage was extended for several days. Medhost utilized both system vendors and consultants as well as its internal resources to determine the cause of these outages and to act to prevent any future outages. The extended outage was due to failure of the operating system. Medhost applications were not a contributing factor to this system outage and no customer data was lost. All customer systems have been restored and are working as designed. While we view any outage as unacceptable, we will use this as an opportunity to improve availability and resiliency of the Medhost systems. Medhost Direct historical uptime availability exceeds 99.99 percent, and no hosted facility has experienced an outage of more than 14 hours in over two years.

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From  Credenza Cowboy: “Re: Martha Jefferson’s errant EHR click that mistakenly labeled the patient as deceased. They aren’t live on Epic yet.” I didn’t realize that, although I attended a years-ago Cerner user meeting at which their IT director was present, so maybe they are on Cerner. Either way, it’s an interesting tip-of-the-iceberg type user error that fortunately, in this case anyway, had no clinical impact. Sentara bought the Charlottesville, VA hospital in 2010.

From Pensive Moment: “Re: digital snake oil. Do  you agree with the AMA?” Mostly no. The AMA’s solution to all problems is to put doctors in charge of everything despite their poor track record of following evidence-based guidelines, delivering whole-person health, and serving as patient advocates without bias toward their personal incomes. They have also demonstrated their own snake-oil gullibility in letting drug and medical device companies dictate their clinical behavior via shady but effective sales tactics that sometimes result in sub-optimal or even dangerous medical decisions. You will notice minimal reference to care teams in the AMA’s impassioned stand that, as usual, assumes the “Doctor as God” position in excluding all other clinicians and in pushing AMA’s commercial interests. The AMA is right that many apps (especially the consumer-facing ones) are of questionable value and that doctors have been shafted in being expected to document everything for the benefit of bureaucrats. They’re also correct that much of what doctors don’t like was handed down to them from insurance companies and the government (whose checks they don’t mind cashing, however, as evidenced by their continued participation). The AMA’s bloviating is what you get when each clinical profession has its own membership organization looking out for the interests of its dues payers while claiming to represent patients who are – along with the 80 percent or so of US doctors who aren’t AMA members, including a bunch who quit after AMA endorsed passage of the Affordable Care Act — invariably absent from its proceedings. All of the solutions offered by the AMA for “digital dystophia” involve AMA-led products and services, so from now on, let’s blame them.

From Limelight Seeker: “Re: our event. Please promote the upcoming tweetchat, webinar, or video I’m involved with.” I will say only this: quite a few overexposed pontificators — especially social media self-gratifiers and cheap-seats observers — are short on credentials to be educating the rest of us. My accomplishment-driven twit filter is powered by LinkedIn.


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor Catalyst Healthcare Advisors. The eight-year-old company offers consulting services in strategy, finance, operations, and technology (IT strategy, system selection, contract negotiation, and system implementation, optimization, and integration). The company led Yale-New Haven’s expense reduction project in helping the health system save $350 million annually. Among its other 200 clients are Baylor, Indiana University Health, Community Health Network, and Good Samaritan Hospital. You may know founder and CEO Steve Furry, who has been in healthcare consulting for 35 years, and senior advisor Parker Hinshaw, who founded maxIT. The company just announced the hiring of two new sales executives covering the West and Midwest. Thanks to Catalyst Healthcare Advisors for supporting HIStalk.

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Ms. Marlowe says her North Carolina kindergarten class is benefitting greatly from the Chromebook we provided in funding her DonorsChoose grant request, with the students specifically enjoying listening to stories online.

Listening: reader-recommended Richmond-based singer-songwriter Lucy Dacus, an up-and-comer who sings thoughtful and warm indie folk music that reminders the reader of the magnificent Cowboy Junkies and me of Kristin Hersh of Throwing Muses

This week on HIStalk Practice: CMS announces $10 million in grants to help practices transition to new payment models. Midwest Orthopaedic Consultants goes with care coordination tech from PinpointCare. AMA adopts long-awaited ethical guidelines for telemedicine practice. CureMD adds Izenda business intelligence tool to its PM software. Emergency Care Specialists launches joint venture with Answer Health Telemedicine. Facebook develops suicide prevention tools and protocols. Culbert Healthcare Solutions VP Randy Jones equates revenue cycle KPIs to “the ritual of the snipe hunt.”


Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

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


Acquisitions, Funding, Business, and Stock

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As I mentioned in an update to Monday night’s post following a response to my inquiry to Navicure, Bain Capital Private Equity makes an unstated strategic investment (presumably taking a majority interest that meets the definition of an acquisition) in the company. Among the sellers is JMI Equity, which took a minority position in Navicure in 2009. JMI bears the initials of John Moores Inc., whose other accomplishments (beyond being an IBM programmer) include founding BMC Software, serving as lead financier of Peregrine Systems and ServiceNow, and formerly owning of the San Diego Padres.


Sales

The soon-to-open Sacred Oak Medical Center (TX) chooses Medsphere’s OpenVista EHR.

In Scotland, NHS Fife chooses InterSystems TrakCare, the twelfth Scottish Health Board to do so. 


People

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Clinical rules modeling vendor Applied Pathways hires Steve Lefar (Sg2) as CEO. Founder and CEO John Feldman will continue as board chair.

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Madhu Sasidhar, MD (Cleveland Clinic) joins consumer engagement platform vendor Envera Health as CMIO.


Announcements and Implementations

Congratulations to the HIStalk sponsors who took 40 spots in the 2016 HCI 100:

The local paper notes that FHN Memorial Hospital (IL) is testing Meditech 6.1 in its $8 million OurFHN project, expecting an October go-live.


Government and Politics

The American Medical Association approves a policy supporting the creating of an ONC-administered National Health IT Safety Center. The policy proposal was submitted by Matt Murray, MD, chair of the Texas Medical Association’s IT committee, driven in part by work done by Texas-based health IT researchers Dean Sittig, PhD and Hardeep Singh, MD, MPH.

The US Supreme Court rules that the VA must always give exclusive preference to veteran-owned small businesses when issuing contracts, overriding the VA’s argument that it is only required to meet specific annual contracting goals. The court says the VA must show preference to veteran-owned bidders as long as the competition meets the Rule of Two (at least two bidders are expected to submit offers and the amount of those bids is expected to be reasonable).

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New York’s attorney general forces legal website Law360 to stop requiring employees to sign non-compete agreements unless the employee has insider knowledge of trade secrets. Law360’s terms required all employees, even those fresh out of college, to sit out a year before taking another job in the same industry. The attorney general of Illinois is also upset that the non-compete clause in the employment agreement of sandwich chain Jimmy John’s prohibits employees from taking a job with another sub sandwich company for two years after quitting.


Privacy and Security

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A former IT employee sues Aspen Valley Hospital (CO) and its privacy officer, claiming that the hospital’s HR director/privacy officer disclosed the employee’s HIV status over cocktails with the hospital’s HR recruiter at a conference after noting a large medical claim for his antiviral medications. The employee filed a complaint with the hospital and then HHS as a HIPAA violation, after which he says he was disciplined, demoted, and then fired after 11 years at the hospital.


Other

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The Australian Medical Association calls for the capability of patients to manage their own medical records to be removed, saying that doctors don’t participate in the national My Health Record data-sharing program because they can’t rely on patient-provided information. The AMA wants patients locked out of making changes to core set of database elements that includes the meds list, allergies, discharge summaries, pathology and imaging results, weight, height, blood pressure, and advance directives. They also want eventual restriction of patient changes to ECG results, blood type, vaccination history, infectious disease status, surgery history, and even the patient’s chosen emergency contact. The AMA says the changes will increase trust and therefore physician usage of the system, which is nearly non-existent.

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A Nielsen survey finds that 89 percent of PCPs claim they often remind patients about preventive screenings, but only 14 percent of patients say they receive them. Only 5 percent of the two-thirds of Americans who are overweight say their doctors suggested a weight loss program. Half of patients aren’t seeing doctors who can view their history via an EHR. Only one in four patients can contact their doctor by email or patient portal question submission, with older people more likely to avoid use of available technology.

This has a small amount of health IT relevance: the mold-breaking YouTube teen vlog series “lonelygirl15” is being re-launched after 10 years by its creators, which include Miles Beckett, MD, CEO of electronic credentialing vendor Silversheet. I interviewed him in April 2016.

Theranos CEO Elizabeth Holmes will present at the American Association for Clinical Chemistry’s annual conference in August, with her submitted abstract suggesting that her talk will be long on defensive self-promotion and short on offering the definitive clinical validation data that scientists long to see. I’m not clear about why a college dropout should be presenting at a clinical conference or why the education committee would accept a presentation titled “Theranos Science & Technology: the miniaturization of lab testing,” but it will probably be an overflow session. I will be disappointed if the attendees don’t boo her off the stage.

In China, a hospital janitor is arrested hiring friends to direct out-of-towners looking for the hospital to a specific room he had rented inside it, where he delivered ineffective but expensive treatments. The health department has closed the hospital as a result. That type of scam is common in China, where hospitals routinely rent out rooms to anyone willing to pay.


Sponsor Updates

  • InstaMed releases its annual report on trends in healthcare payments.
  • InterSystems, Intelligent Medical Objects, and Meditech will exhibit at AMDIS 2016 June 21-24 in Ojai, CA.
  • Liaison Technologies wins a Stevie Award for Favorite New Product from the American Business Awards.
  • Visage Imaging validates the interoperability capabilities of its Visage 7 Enterprise Imaging Platform at the IHE Connectathon 2016 held in Bochum, Germany.
  • MedData will host a job fair June 22 in Grand Rapids, MI.
  • The HIMSS SIIM Enterprise Imagine Workgroup publishes its second white paper.
  • Validic and Omnicom Health Group will partner to counsel healthcare companies on connected health.
  • Netsmart will exhibit at the Washington Behavioral Health Conference June 22 in Yakima, WA.
  • Nordic receives RightSourcing’s Gold Supplier Award.
  • Qpid Health and Streamline Health will exhibit at AMDIS 2016 June 21-24 in Ojai, CA.
  • The latest KLAS report ranks Sagacious Consultants as the highest-rated firm for revenue-cycle optimization.

Blog Posts


Contacts

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

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June 16, 2016 News 1 Comment

Morning Headlines 6/16/16

June 15, 2016 Headlines No Comments

Cerner chips away at building $4.5B campus

A local Kansas City newspaper reports on the progress Cerner has made on its 10-year, $4.5 billion Trails Campus construction.

Florida Blues collected $471 million profit on ACA plans in 2015

Florida Blue Cross and Blue Shield reports $471 million in profits from its insurance exchange business, unlike the massive losses reported by other major insurers like Highmark, Humana, and UnitedHealth Group.

Consumerism in focus at AHIP 2016 this week, organizers say

Former CMS Administrator and current AHIP President and CEO Marilyn Tavenner presents the keynote speech at this year’s AHIP annual conference, calling for an increase in technology as healthcare reimbursement moves away from fee-for-service payment models.

New Methodology To Examine Spending Patterns For End-Of-Life Care

According to a Health Affairs study analyzing end-of-life spending data for Medicare patients finds that costs run five times higher for patients with multiple chronic diseases during the last year of life.

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June 15, 2016 Headlines No Comments

News 6/15/16

June 14, 2016 News 5 Comments

Top News

American Medical Association EVP/CEO James Madara, MD, speaking at the organization’s annual meeting, lashes out at “digital snake oil” of clinically unproven software and technology products that “impede care, confuse patients, and waste our time,” adding that “interoperability remains a dream.” He says doctors – who mistakenly failed to participate in early digital health projects – need to separate the lame digital tools from the potentially magnificent ones, explaining the present state of “digital dystopia” as:

Direct-to-consumer digital health devices—which only in the fine print say ‘for entertainment purposes only’—to our clunky electronic records, to ICUs that sound like primitive swamps abuzz with a cacophony of  bells, alarms, and whistles.

However, many of the solutions that Madara offers involve products from which AMA benefits – an incubator, an innovation studio, and lobbying efforts.

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Meanwhile, John Halamka takes the counterpoint to the “digital snake oil” label, saying that more study rather than politician-like hyperbole is needed to understand that “we’ve achieved exactly the results we designed” in striving to simply replace paper charts with their electronic counterparts and to meet various government mandates. He provides examples in interoperability (e-prescribing, public health reporting, and lab reporting); population health (EHR patient panel queries); and consumer engagement (patient portals), all of which laid the foundation for the next generation of tools that will support team-based workflow, lifetime encounter records, care management workflow support, and family engagement tools. Halamka repeats the same advice he offered for Meaningful Use: focus on a small number of achievable outcomes.


Reader Comments

From Pomp and Circumstance: “Re: vendor press releases. Healthcare institutions are increasingly forbidding them to distribute press releases announcing new sales or contracts. This may distort the perception of success of companies that are compliant with the wishes of their customers.” It’s tough for a vendor to tout their successes when the client asks them not to, going beyond just not naming the client specifically, but prohibiting the sale from being mentioned at all. That practice prevents some much-need visibility into who’s buying what, but I agree that there’s no value to the new customer unless the sale can be crafted into a more self-serving announcement.

From Sticky Wicket: “Re: innovation award winners. You didn’t list those from the attached announcement.” I don’t consider press releases of these types worth mentioning since the average health system CIO would have minimal interest in companies whose enterprise readiness is years away at best even if they manage to avoid being among the 95 percent that will never be successful. Thus I’ve stopped running announcements of the following types, preferring to wait for actual customer success:

  • Company funding under $1 million.
  • New accelerators forming or companies joining an accelerator.
  • Tiny companies winning an app contest or submitting an innovative idea.
  • Startups offering a new consumer-facing health app whose outcomes have not been studied.

From Duluth: “Re: Navicure. Sold to Bain.” Unverified. I’ve reached out to the company for a response but haven’t heard back. UPDATE: Navicure confirms that it will receive an undisclosed strategic investment from Bain Capital Private Equity. Founder and CEO Jim Denny and the executive team will remain with the company.

From Gray Sky: “Re: [vendor name omitted]. Has had outages for the past two weeks for all hosted applications. Inside information points to a storage information where customer data has been erased. The company continues to investigate options to restore the data to a reasonable point in time.” Unverified. A company spokesperson responded quickly after hours and is trying to reach one of its executives for a response, so I offered to withhold the company’s name until my next post, which will also include any response the company provides.

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From DOSsier: “Re: US Department of State. Issued an RFI for an off-the-shelf EHR for diplomatic missions.” The RFI is here, but note that it covers EHR implementation project management services only – it’s not a RFI for an actual EHR. The original plan was for the Department of State to share the Coast Guard’s Epic system, but the Coast Guard has backed away from that project. Before that, the DoS was planning to roll out the DoD’s AHLTA, so perhaps this RFI involves the DoD’s Cerner rollout. I don’t know the source of the DoS’s existing eMED system. The RFI was posted June 3 with a two-week response date.

From Pickle Entry: “Re: ACA insurance. UnitedHealth Group is pulling out of the exchange in my state. I’ve had to change insurance companies every year since Obamacare was rolled out, paying multiples of the premium prices I paid before the ACA.” The administration touts decreasing levels of uninsured citizens. That’s good, but those newly insured people are spending a lot of insurance company money catching up on their deferred health needs while young, healthy citizens are going without insurance because they are unlikely to get a payback. You can’t blame insurance companies who are stuck with a money-losing risk pool of self-selected patients when they stem their financial bleeding by exercising the only option the government gives them – shutting down their exchange plans. You are fine if you have employer-provided insurance, have a low enough income to qualify for endless government insurance subsidies, are old enough for Medicare, have few assets and therefore little financial exposure to expensive uninsured services, or are rich enough to not care. Otherwise, you’re paying more to keep the insurance-funded profits flowing to providers, drug companies, and the endless bureaucracy of middlemen who make up most of the US healthcare non-system and who are happy that ACA gave them newly insured patients to bill without touching the real problems of unjustified prices, fraud, and the financial incentive to create overutilization.

From Dan Blocker: “Re: data blocking. John Halamka says he’s never seen it. I say he needs to look harder.” Lots of people (including ONC) claim  that providers and EHR vendors intentionally block the flow of patient information, but nobody is serving up real-life examples instead of poorly sourced anecdotes. Such proof can only come from patient complaints and those are rare because: (a) patients don’t know that their interoperability expectations should be higher; (b) the moment of need is when they are unwell; and (c) they don’t have the information or incentive to figure out who to complain to. I bet that if you asked 100 people who were in the process of being seen as inpatients or outpatients to ask those providers to retrieve their history from other providers, nearly all of them would be unsuccessful, but turning that into a data blocking complaint against either of the providers or their respective EHR vendors would require a lot of investigatory legwork. Most of what’s wrong with healthcare is due to indifference or ineptitude, not carefully planned evildoing.


HIStalk Announcements and Requests

Listening: reader-recommended Fantastic Negrito, raw Delta blues from the Oakland,CA solo artist who describes his music as “uncut realness and zero concern for pop anything” and whose background is uplifting. Mark my words: all things (especially musical ones) must pass and eventually audiences will tire of shimmery musical junk food crafted by false-prophet celebrity musicians who possess no life experience and whose primary musical instrument is Auto-Tune. 

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Ms. Westover says students in her inaugural high school microbiology course in Georgia are making good use of the lab supplies we provided in funding her DonorsChoose grant request, examining bacteria and analyzing water samples in discovering “a whole new microscopic world.” 


Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

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


Acquisitions, Funding, Business, and Stock

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Hearst acquires a majority stake in MedHOK, which offers health plan software including case management, utilization management, and medication management. MedHOK will be incorporated into Hearst Health, which includes First Databank, Zynx Health, MCG, and Homecare Homebase.

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A federal court dismisses the patent infringement lawsuit brought by telehealth provider American Well against competitor Teladoc, with the court finding that American Well’s patent is too abstract to be enforceable. Teladoc asked the patent office to invalidate American Well’s patients in 2015, after which American Well sued Teladoc just before Teladoc’s IPO. American Well will of course appeal. TDOC shares have dropped 33 percent in the year since its IPO.

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Hospital medical device spend management software vendor Procured Health raises $10 million in new funding. The Chicago-based company had raised $5.1 million, with its most recent round being completed in March 2014 with little news since. 

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Sunquest acquires patient flow technology from The Royal Liverpool and Broadgreen University Hospitals NHS Trust, which it will market to customers of its Integrated Clinical Environment. 

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Patient access and RCM services vendor MedData will acquire RCM services vendor Cardon Outreach for $400 million.

Microsoft inexplicably pays $26.2 billion to buy LinkedIn in its biggest acquisition ever. Microsoft always seems desperate to grab onto whatever is trendy at the moment, wildly overpaying to acquire companies with higher growth potential that it then runs into the ground in repeated and easily predicted examples of failed synergy. MSFT is paying a 50 percent premium to the share price of LinkedIn, whose luster has faded as its revenue stalled and the platform keeps finding new ways to annoy its users in between their rare bursts of job-seeking and self-promotional activities.


Sales

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Manati Medical Center (PR) and Mayaguez Medical Center (PR) choose Meditech 6.1, raising the company’s Puerto Rico hospital count to 21. 

Tampa General Hospital (FL) selects records aggregation and referrals management tools from EHealth Technologies.

Mainstreet Health will implement the HealthMedx Vision EHR for its transitional care facilities.


People

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Justin Barnes (Justin Barnes Advisors) is named partner and chief growth officer of IHealth.

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Extension Healthcare hires Ben Kanter, MD (Sotera Wireless) as CMIO.

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Eric Kretzer (Strata Decision Technology) joins SA Ignite as SVP of products.


Announcements and Implementations

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Boone Hospital Center (MO) lays off 26 transcriptionists following the decision by parent company BJC HealthCare to outsource transcription services to Madison, WI-based Amphion Medical Solutions, which was acquired by Atlanta-based IMedX in January 2016. 

The American Medical Association adopts ethical standards for telehealth and telemedicine at its annual meeting, noting that technology doesn’t change the ethical requirements for physicians to place the patient’s interests first. The guidelines also urges physicians to be cautious in making treatment decisions based on the limited information available in a telemedicine session and suggests that care coordination is essential.


Government and Politics

The SEIU healthcare employee union tries again to convince California to cap total hospital CEO compensation at $450,000, the same salary earned by the President.


Technology

Microsoft’s new XBox console eliminates the dedicated port for its Kinect motion-based controller, leading to speculation that Kinect is being phased out. Kinect is used by several innovative healthcare applications for pain assessment, physical rehabilitation, and patient-provider communication. My speculation would be that Kinect turned out to be less interesting (and less profitable) for consumer use but it will continue with a non-gamer focus.


Other

The former chief nursing officer of Sonoma West Medical Center (CA) sues the hospital and one of its board members, claiming she was fired after raising concerns about problems with the hospital’s new clinical software that was developed by the board member’s company. She says the hospital allowed the board member to use its patients as his EHR guinea pigs because he has donated $9 million to keep the previously closed hospital afloat, with the resulting buggy product mixing up patient records, providing incorrect medication information, and failing to display the code status of patients. The software in question appears to be from E-Health Records International, which claims that its tablet-based HarmoniMD hospital EHR can be brought live in single day. Its only users appear to be Sonoma West and a single hospital in Africa.

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A Commonwealth Fund-sponsored study finds that only 30 percent of behavioral health providers use EHRs, recommending that SNOMED and LOINC terminology be enhanced to address behavioral needs, incorporating IT costs in setting bundled payment policies, adding behavioral-specific clinical decision support and interoperability capabilities to existing EHRs, and requiring EHR vendors to beef up their security capabilities.

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A Peer60 report on payers finds that BCBS and Medicare are the ambulatory provider favorites by far, with UnitedHealthcare trailing the pack. Providers like payers that get them paid more quickly with minimal staff involvement, while their least-favorite attributes are time-wasting practices, denials, and poor customer service.

CMS Acting Administrator Andy Slavitt commits at the AMA conference that CMS will simplify its processes, involve physicians in decisions that affect them, focus on patients, support small physician practices, and make “healthcare technology a tool, not an industry.” Some snippets:

Off-the-shelf tools like Certified EHRs and clinical data registries can provide complete capabilities [for quality reporting], but other options exist as well, including most types of reporting that a physician is doing today. If CMS can get data automatically or through another source, we will do so … [CMS will focus on] putting more pressure on technology vendors and less burden on physicians, so physicians can do simple things like track referrals when a patient sees another specialist or visits a hospital … It’s also time to ask a lot more of the technology and technology vendors. This is particularly true in the area of what many call interoperability … the burden needs to be on the technology, not the user. EHR vendors and hospitals that use them will now be required to open their APIs so data can move in and out of an application safely and securely. This will also serve to help eliminate the ‘desktop lock’ that occurred based on early EHR decisions by allowing technology to more easily plug and play. Today’s data silos are more a function of business practices than technology capability and we cannot tolerate it any longer.

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Here’s a textbook example of how to write a bad press release. The boring headline contains glaring spelling and capitalization errors, oddly uses the past tense, and reeks of company self-importance in providing a “news item” that would interest no one except the unfortunate author who was charged with getting some company buzz out there despite a lack of buzzworthy events. It randomly capitalizes job titles and other words that are not proper nouns (“EHR Systems”) and uses awkward phrasing that suggests it was crafted by someone whose mother tongue is not English. My mom’s advice remains valid: if you don’t have anything good to say, don’t say anything.

A Virginia hospital blames a misplaced EHR click for sending a sympathy card to the family of a patient who was in fact still alive. Sentara Martha Jefferson Hospital says someone clicked “deceased” instead of “discharged to home” in Epic, triggering the obviously automated condolences. At least the errant checkbox entry didn’t create a medical error that actually killed the patient.

Athenahealth’s Jonathan Bush provides an impassioned video reaction to news that TV host John Oliver formed a fake debt collection company, bought $15 million in overdue medical accounts receivable for $60,000 cash, and then told those patients that he was forgiving their debt. I assume that buying debt at less than a penny on the dollar means it was uncollectible anyway, so it wasn’t really much of a gift.

The Minneapolis newspaper covers the problem in which patient advance directives are not easily located in EHRs. It cites a study in which less than one-third of ED doctors were confident that they could find patient preferences for resuscitation, feeding tubes, or ventilators.

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Eastern Maine Healthcare System (ME) offers voluntary early retirement to 43 of the 300 employees in its IT department, which is running $3 million over budget.

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The American Diabetes Association is embarrassed when it allows a drug company to present new, sensitive research data to thousands of doctors attending one of its conferences, warning them to hold the information for one hour until the public announcement and the inevitable stock market reaction. The itchy Twitter finger doctors were already blasting out photos of the presentation’s title slide even before the presentation began, after which they tweeted out the presentation’s data slides and charts despite pleas from the ADA to remove them. Novo Nordisk shares dropped 5.6 percent on the modestly positive news.

Here’s the final physician practice vendor overview from Vince and Elise, which includes tips for product selection.

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Weird News Andy loves good customer support even if it comes from sophisticated ransomware hackers who now provide live-chat operators to walk victims through the payment process in an effort to differentiate themselves professionally by improving usability. WNA suggests the hacker’s customer support agent be prepared to answer questions such as:

  • How do I buy bitcoins?
  • How do I know you will actually unlock all our data?
  • Do you provide training on how not to click suspicious links?
  • How’s the weather in Romania?

Sponsor Updates

  • Impact Advisors is named as  one of the 500 largest technology integrators in North America.
  • AirWatch announces updates to AirWatch 8.4.
  • Bernoulli CNO Jeanne Venella is featured on RN FM Radio.
  • Carevive Systems will host a tweet chat on the oncology care model on June 21.
  • Cumberland Consulting Group will exhibit at AHIP June 15-17 in Las Vegas.
  • Fast Company features CTG Technical Recruiter Kate Orngard in an article on recruiters.
  • Extension Healthcare will exhibit at the ONL Annual Conference June 16-17 in Newport, RI.
  • FormFast publishes an infographic on the real cost of paper-based informed consent processes.
  • Healthfinch will exhibit at the AMDIS Annual Physician Symposium June 21 in Ojai, CA.

Blog Posts


Contacts

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

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June 14, 2016 News 5 Comments

News 6/10/16

June 9, 2016 News No Comments

Top News

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Practice Fusion settles with the FTC over charges that it misled consumers by asking for reviews of their physicians without adequately disclosing that those reviews would be posted publicly online. The reviews were published in 2012 as part of the company’s efforts to develop a public-facing healthcare provider directory. “Practice Fusion’s actions led consumers to share incredibly sensitive health information without realizing it would be made public,” says FTC Bureau of Consumer Protection Director Jessica Rich. “Companies that collect personal health information must be clear about how they will use it – especially before posting such information publicly on the Internet.” The settlement, which seems to carry no fine, prompted the FTC to publish six privacy pointers, with perhaps the most relevant being, “Disclosures should reach out and grab consumers,” and “Don’t bury key facts in a hard-to-understand privacy policy.”


Reader Comments

From EMR Expert: “Re: Financial trouble in the Middle East. Like many other vendors in various sectors, Cerner, Epic and InterSystems are having tough times collecting their money from existing clients. One of the executives of those companies stated that their Accounts Receivables of the value of more than $15 million is overdue by more than six months. Support contracts are not being renewed and payments for implementation are not honored. It is a catch 22 situation when all their clients were oil rich and now cash strapped governments/government entities.”


HIStalk Announcements and Requests

This week on HIStalk Practice: AMN Healthcare acquires Peak Health Solutions. CancerLinq announces new collaboration and practice sign-up milestones. North Carolina Medicaid reform will include the development of a statewide HIE. South Carolina lawmakers pass telemedicine-friendly legislation. SingleCare partners with American Well. Closed-door meetings in Texas could lead to more telemedicine-friendly legislation. Medfx and Falcon Physician develop software for nephrology practices. FastMed Urgent Care rolls out TouchCare telemedicine services at 57 clinics. Tandigm Health Medical Director Leslie Saltzman, DO shares the hurdles physician groups face when implementing telemedicine tech.


Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

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


Acquisitions, Funding, Business, and Stock

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Xerox launches Virtual Health Solutions, a new service line that will offer providers telemedicine consulting, interface design and development, and virtual clinic services.

Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers chose health plans. Financial terms were not disclosed.

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Southcoast Health (MA) reports that its $100 million Epic implementation boosted the local economy by $3 million, mainly through hotel room costs, car rentals, gas, and dining. Nearly a third of the health system’s budget for the project went to costs associated with expenses for Epic staff and consultants.

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Martin Shkreli jeeringly pleads not guilty to an updated indictment – one that adds a new conspiracy charge to original December allegations that he illegally took stock from a biotechnology firm he launched in 2011 and was fired from three years later. Not surprisingly, the “habitually unavoidable-for-comment Shkreli unloaded as he spoke to customers at a Manhattan Dunkin’ Donuts outlet while live-streaming on Periscope.” In related (and absurd) news, Shkreli blocks presumably reputable reporters from his Twitter stream, and lauds an upcoming satirical musical about his purchase of a $2 million single-copy Wu-Tang Clan album. It will no doubt give Hamilton a run for its money.


Announcements and Implementations

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Radiology Associates of Macon (GA) extends its RCM agreement with Zotec Partners.

Meditech develops a sepsis management toolkit for select EHR customers.

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St. Vincent’s Medical Center (CT) rolls out telemedicine services from Zipnosis.

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The Guam Dept. of Public Health and Social Services partners with Good Samaritan Hospital in Los Angeles to roll out a specialty care telemedicine program for island residents.


Sales

Houston Methodist (TX), Meadows Regional Medical Center (GA), and Shore Medical Center (NJ) sign on for Unified Provider Management software from Phynd Technologies.


People

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North Mississippi Medical Center promotes Shannon Fryery to director of telehealth for North Mississippi Health Services.

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Callie Shaver (Greenville Regional Hospital) joins Jersey Community Hospital as HIM director.

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Ed Mercado joins Crux Quality Solutions as CEO.


Government and Politics

The VA fires three more administrators within the Phoenix VA Health Care System. Lance Robinson, assistant director at the Carl Hayden VA Medical Center; Brad Curry, chief of health administration service; and Darren Deering, DO the hospital’s chief of staff; were all terminated for “negligent performance of duties and failure to provide effective oversight.” The terminations come more than two years after the exposure of the cover up of a huge backlog in medical appointments that severely impacted veteran care.

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The House passes the Helping Hospitals Improve Patient Care Act, excluding ambulatory surgical centers from Meaningful Use and MIPS penalties.


Innovation and Research

Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.

A Health Affairs study correlates the use of prescription drug monitoring programs with a 30 percent reduction in the rate of prescribing Schedule II opioids, a change that continued in the second and third years following the launch of the program.

A small Health Catalyst survey of hospital executives finds that 62 percent have between zero and 10 percent of their care tied to the value-based contracts CMS hopes to have hospitals converted to by 2018. Just 3 percent meet the CMS goal of 50 percent value-based reimbursement today, and only 23 percent expect to meet it by 2019.


Technology

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Avizia adds the patient-facing MyCare app to its AviziaOne telemedicine and secure messaging solution.

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Experian Health’s Coverage Discovery uncompensated-care alert tool can now integrate with Epic’s EHR.

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Influence Health develops new digital presence management technologies that include directory listings, reputation, and online provider review ratings tools.


Other

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Jennifer Lawrence signs on to play Theranos founder Elizabeth Holmes in an Adam McKay-directed drama about the now-infamous blood-testing startup.

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A mother in Australia uses Siri to call emergency services when she discovers that her sleeping baby had stopped breathing. While the digital assistant may have contributed to saving the girl’s life, it likely had more to do with the mom’s administration of CPR, given that the ambulance took 20 minutes to arrive.


Sponsor Updates

  • Impact Advisors achieves top overall performance score in the KLAS Healthcare IT Advisory Report.
  • InterSystems and PDR will exhibit at AHIP June 15-17 in Las Vegas.
  • LiveProcess will exhibit at the SC Hospital Association Hospital Preparedness Summit June 8 in Columbia, SC.
  • MedData will exhibit at the Southern Coastal Emergency Medicine Conference June 10-11 in Kiawah Island, SC.
  • Medecision signs on as a founding member of the Accountable Care Learning Collaborative.
  • Navicure will exhibit at the Arizona NextGen UGM June 10 in Phoenix.
  • Nordic and Stella Technology will exhibit at the HIMSS New York State meeting June 16 in the Bronx.
  • Millward Brown names NTT Data to its 2016 Brandz Top 100 Most Valuable Global Brands.
  • Obix Perinatal Data System will exhibit at the 2016 AWHONN National Convention June 11-15 in Grapevine, TX.
  • Experian Health will exhibit at the Georgia Society for Managed Care meeting June 12-14 in Jekyll Island.
  • PatientMatters will exhibit at the Ohio Hospital Association Annual Meeting June 13-15 in Columbus.
  • The SSI Group will exhibit at the Gulf States ASC Conference June 15-16 in New Orleans.
  • Catalyze achieves a second HITRUST CSF Certification.

Blog Posts


Contacts

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

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June 9, 2016 News No Comments

Morning Headlines 6/9/16

June 8, 2016 Headlines 1 Comment

Connecture buys exchange competitor ConnectedHealth

Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers chose health plans. Financial terms were not disclosed.

Will genetic tests help prevent chronic diseases?

Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.

Three more Phoenix VA officials fired in aftermath of wait-time, retaliation probes

The VA has formally fired three more administrators within the Phoenix VA Health Care System. Lance Robinson, assistant director at the Carl Hayden VA Medical Center; Brad Curry, the chief of Health Administration Service; and Dr. Darren Deering the hospital’s chief of staff were all terminated for “negligent performance of duties and failure to provide effective oversight."

Prescription Drug Monitoring Programs Are Associated With Sustained Reductions In Opioid Prescribing By Physicians

A Health Affairs study correlates the use of prescription drug monitoring programs with a 30 percent reduction in the rate of prescribing Schedule II opioids, a change that continued in the second and third years following the launch of the program.

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June 8, 2016 Headlines 1 Comment

Morning Headlines 6/8/16

June 7, 2016 Headlines No Comments

Cerner’s Burke: Patterson is ‘fully engaged’

Cerner President Zane Burke reports that CEO Neal Patterson remains fully engaged in day-to-day operations as he undergoes cancer treatments.

Theranos Says Only One Percent of Results Affected; Some Doubt Tests

Theranos says that less than one percent of its blood test results have been voided or corrected, a clarification on earlier reports that it would need to cancel or amend tens of thousands of results.

‘Silicon Valley arrogance’? Google misfires as it strives to turn Star Trek fiction into reality

Verily, Google’s life science business unit, comes under fire as a number of its high profile projects flounder, including a cancer-detecting wristband and glucose-sensing contact lenses.

Back to Meditech: Delta Regional Hospital to Deliver Quality Care at a Lower Cost with Meditech 6.1

325-bed Delta Regional Hospital (MS) will implement Meditech, replacing Cerner.

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News 6/8/16

June 7, 2016 News No Comments

Top News

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Vice President Joe Biden launches the Genomic Data Commons at the University of Chicago with $70 million from the National Cancer Institute. As part of the Cancer Moonshot and Precision Medicine initiatives, the commons will receive, store, and organize clinical and genomic data, and offer it to cancer researchers in user-friendly formats.


Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

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


Acquisitions, Funding, Business, and Stock

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Cerner President Zane Burke tells the Kansas City Business Journal that CEO Neal Patterson “remains very active and involved” during his treatment for soft tissue cancer, for which he was diagnosed in January. “In many respects, this will help both him and us as he focuses on his next chapter at Cerner and for Cerner. I think … being a consumer of healthcare will have significant impacts as he comes back into the day to day. I think the consumer is going to have a much stronger voice as we move forward.”

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HCS moves to expanded office space in Wall Township, NJ.

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Hospital purchasing analytics startup Valify raises $2 million in Series A funding led by Frist Cressey Ventures and Step 5 Capital. The Frisco, TX-based company, which has raised $2.75 million since launching in 2014, will use the funds to hire additional sales reps and developers, and for R&D.

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Theranos reports that it has voided or corrected less than 1 percent of blood test results, seemingly a far cry from the tens of thousands of results it said it was planning to cancel or change last month. Perhaps the math adds up, though it’s not likely the secretive company will release exact numbers.

Madison, WI-based healthcare API vendor Redox joins the six-month Cisco Entrepreneurs in Residence (Cisco EIR) program in Silicon Valley.

Google’s Verily Life Sciences venture comes under fire as development of its much-hyped cancer-detecting “Tricorder” device, smart contact lens, and Baseline human health study continue to flounder. Several anonymous Verily employees claim that the Tricorder, originally scheduled for launch more than two years ago, has been touted internally more as a buzz generator than as a project capable of true clinical impact.


Sales

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The California Emergency Medical Services Authority signs a contract with Audacious Inquiry for the ONC-funded development of a Patient Unified Lookup System for Emergencies. The standards-based system will leverage the state’s existing HIE infrastructure when activated during disasters, and ultimately build new connectivity between providers .


People

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Virginia Mason Medical Center (WA) promotes former CIO and CFO Suzanne Anderson to CEO.

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Jay Lechtman (Quantros) joins Riskonnect as senior director, market strategy and development.

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Patrick Flynn (Phytel) joins Aventura as COO.

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Apple hires Rajiv Kumar away from Lucile Packard Children’s Hospital (CA), presumably to work on healthcare-related activities. Kumar developed a HealthKit-enabled diabetes monitoring system last fall in his role as medical director of clinical informatics.


Announcements and Implementations

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Cardiology Associates of North Mississippi goes live on MedAptus charge capture software for services provided at North Mississippi Medical Center.

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Delta Regional Hospital (MS) switches back to Meditech, confirming a late-April reader rumor that the 325-bed acute-care facility was in the process of ripping out Cerner.


Government and Politics

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CMS issues a nearly 300-page final rule on MSSP ACOs outlining changes to the program’s benchmarking methodology, a new alternative participation option that encourages participants to enter performance-based risk arrangements sooner, and policies for addressing payment corrections.


Technology

Presidiohealth adds T-System’s EDIS software to its new PM technology for freestanding emergency centers.


Other

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This article highlights the social media fame several plastic surgeons have attained thanks to their love of Snapchat and penchant for posting graphic procedures. Michael Salzhauer, MD (aka Dr. Miami) attempts to put an educational spin on his soap opera-like snaps: “A good percentage [of those watching] are people either in the medical field or interested in pursuing careers in medicine — maybe 30 percent, based on the messages we get. Another 30 to 40 percent are people who are thinking about having surgery, either immediately or sometime in the future.”


Sponsor Updates

  • AirStrip President Matt Patterson will speak at MD&M East June 14-16 in New York City.
  • IDC ranks AirWatch as the largest enterprise mobility management vendor in terms of market share for 2015.
  • Aprima will exhibit at Sleep 2016 June 13-15 in Denver.
  • Audacious Inquiry offers its “Health IT Framework to Support Alternative Payment Models” for download.
  • Besler Consulting releases a new podcast, “How to Fix Common Physician Documentation Mistakes.”
  • CapsuleTech will exhibit at the HIMSS New York State meeting June 16 in the Bronx.
  • Carevive Chief Clinical Officer and co-founder Carrie Stricker, RN will speak at the Biennial Cancer Survivorship Research Conference June 18 in Washington, DC.
  • CitiusTech will exhibit at AHIP June 15-17 in Las Vegas.
  • CoverMyMeds will exhibit at the American Diabetes Association Scientific Sessions June 11-13 in New Orleans.
  • Cumberland Consulting Group Managing Partner Rachel Wixson is featured in the Forbes self-made women issue.
  • Elsevier Clinical Solutions CEO Ron Mobed is featured in STEMconnector’s “100 CEO Leaders in STEM.”
  • Healthwise is honored with a 2016 When Work Works Award for its workplace strategies as part of the national When Work Works project.
  • Spok releases a new infographic highlighting customer success statistics and the ROI of communication technology.
  • Wellcentive will host its annual National Consultant and Analyst Summit June 8-9 in Atlanta.
  • The latest KLAS advisory report recognizes Nordic as a top performer, and The Chartis Group as one of the top five comprehensive firms.

Blog Posts


Contacts

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

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Reader Comments

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  • FLPoggio: Fred, Couldn't agree more. From my HISTalk piecein 2013: "The real world keeps changing. Yet many of the predictive ...
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