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Reader Survey Results 2015

January 18, 2015 News 5 Comments

Thanks to everyone who completed my reader survey. Congratulations to the three winners of $50 Amazon gift cards I’ve sent (I had fun writing an Excel randomization routine to make sure I wasn’t biased in any way in choosing the winners).

I run the survey once per year. It helps me plan going forward. I always like to share some of the interesting feedback I get from it.

I’ll chime in on a few of the comments and suggestions. I should mention that the most common recommendation was, “Don’t change anything.” I appreciate that.

I have a diverse readership, and while it might seem obvious that I should make a given change, that’s from one person’s viewpoint. People have different motivations for reading HIStalk – some want just the top news boiled down, some are scouring for competitive intelligence, and many want to be entertained along with their news. I don’t want to get in the trap of writing by committee no matter how well intentioned the advice, where I please nobody in trying to please everybody. My audience is self-selecting – you either like what I write or you don’t, and I have to make you want to come back every day. It’s harder than it looks sometimes given all the distraction that’s out there.

Some major points from the survey:

  • Readers mostly work for hardware or software vendors (47 percent); hospitals, health systems, and practices (27 percent), and 68 percent have at least 11 years of experience in healthcare IT and healthcare.
  • The most common job function is IT or vendor staff or management, nine percent are clinicians, and about six percent of readers are CEOs and the same percentage are CIOs.
  • The most-appreciated elements of HIStalk are (in order) news, morning headlines, rumors, humor, and Dr. Jayne. The least-liked element is Readers Write.
  • Eight-five percent of respondents say they have a higher interest in companies when they read about them in HIStalk.
  • The most important survey result is this one: 91 percent of readers said reading HIStalk helped them perform their job better last year.
  • More than a third of readers recommended HIStalk to a peer in the past month.

Here are some of the recommendations.

Separate out Dr. Jayne’s Thursday night contribution into its own post for easier reference.

Good idea. That’s easily done. Long-time readers may remember that when Dr. Jayne started five years ago, I ran her post at the end of Tuesday night’s news. Then I had the brilliant idea (that’s not exactly true – a reader suggested it in the reader survey five years ago) of moving her post to Monday nights on its own. Dr. Jayne is a busy lady, so I’ll have to coordinate with her schedule.

Don’t write so much about startup funding.

More people said I should write more about it. I haven’t changed my threshold for what seems interesting or newsworthy about funding — there’s just more of it to cover these days as investors chum the waters. Clinical readers sometimes yawn at the business news and vice versa, but at least the business section is easily skipped (the idea of breaking out posts with subheadings also came from a long-ago reader survey, in fact).

Stop putting so much emphasis on the HIMSS conference and the events you have there.

I agree, although many readers follow that closely. I’ll try to find more substance at the conference to write about, but it seems to be in short supply.

Don’t be so snarky.

The “be more snarky” camp has you outnumbered in their responses, I’m afraid.

Stop promoting Epic so much.

I’ve analyzed my mentions of Epic and they are balanced. Most of the time I’m reporting something newsworthy or that would interest my Epic-using provider readers (of where there are many), and in those cases where I editorialized, it was a pretty even split between positive and negative. Writing about Epic is a challenge because any time I mention them, people who (a) compete with them; (b) aren’t Epic users; or (c) tried to get a job there and failed scream “favoritism.” I write about Cerner’s new campus and nobody says a word, but I mention Epic’s new campus and smoke starts coming out of the ears of some readers who react to the word “Epic” as a bull does to a matador’s red cape. If you think something I say is biased toward Epic, say so in the comments and see if others agree. I do pay attention.

Stop calling Epic’s Judy Faulkner “Judy.” It’s demeaning because you don’t do that with males.

Sure I do. I write about Neal, Farzad, Vince, Ed, and JB (for Jonathan Bush) using only their first names for the same reason – just about everybody knows who I’m talking about because their names are uncommon, unlike Paul, Robert, or John. When I hear people talking about Judy Faulkner, 90 percent of the time they just say “Judy.” I’ve never heard anyone respond with, “Judy who?”

Expand the contributor group – not everybody seeks the spotlight.

The problem is that many people shun the spotlight. I’d greatly appreciate more contributors with different viewpoints, but the single best lesson I’ve learned in 12 years of writing HIStalk is that everybody likes to read, but almost nobody likes to write. I’m always encouraging different people to write Reader’s Write articles, submit their own series of articles, or be interviewed — what you see on the page is what I get (usually vendor people interested in the exposure, which is why people don’t like Reader’s Write). Non-vendors and lesser-knowns, get in touch if you are willing and able to contribute because I’m up for it.

Start a column with new perspective from a pharmacist, lab director, nurse, and others on the front lines.

See above. I’ve asked before, especially for a nurse who writes well and has interesting points to make, but nobody has volunteered and I can’t force them to do it.

Get the contributions of government contractors since they know what’s going on.

Dim-Sum’s contributions about the Department of Defense EHR have been outstanding. I would be thrilled to run more government-oriented pieces, even anonymously, if someone is willing.

Get the contributions of patients and consumers.

I’ve tried getting people for that too with no luck, but at least I’ll have something from HIMSS since I’m providing several scholarships to patients who will attend and write about their experience on HIStalk (more details to follow).

Offer a column, interview, or other collaboration with HIMSS.

We each tend to do our own thing, but I’m willing if they are, assuming it’s interesting to my readers and not just promoting HIMSS.

Offer a column to incubators like Rock Health.

I’ve started with startup CEOs and investors and an incubator or accelerator column would be fun, limited again by the willingness of someone to actually do it. And the complaints of those HIStalk readers who say they’re tired of hearing about startups.

Put on more non-commercial webinars like the Dim-Sum and Vince ones.

The rate-limiting factor is presenter willingness, not mine. All the presenter needs is a bit of time and expertise – we lead them through the process from abstract to delivery and of course I bear the expense gladly. Dim-Sum’s webinar on the DoD EHR has had 1,531 views on YouTube and Vince’s Siemens-Cerner presentation has been viewed 1,807 times, so demand exists for webinars that are more educational than commercial, which I had in mind from the start. I have the forum and platform if you have something educational to offer readers.

Perform more analysis of informatics literature.

I love doing that myself when I have the time and have the full-text of an interesting article. I’ve asked before for an academic type to be a “literature scout” to find good journal articles and summarize them, but I haven’t had any takers. I’m feeling like a looping recording in saying repeatedly that I don’t get volunteers, but I’m just explaining why it’s not quite like the engaged community anxious to contribute that you might envision.

Stop using blue font for the reader quotes.

I’ll have to think about how to best indicate that I’m quoting a reader.

Improve the search function.

That comes up in every year’s survey, but I don’t have a solution. It’s already a Google search that works well, but what some folks want is to be able to click on a word like “Cerner” or “genomics” and have a perfectly sorted list of articles by date pop up. It just doesn’t work that way with the format I use, which is intended for an easy summary read rather than to support discrete searches. HIStalk, technologically, is just a bunch of web pages with one per post, not a massively indexed database (it’s kind of like a free-text chart entry vs. individual EHR data fields). I’m open to technology suggestions if anyone has some. Lots of  health IT vendors offer tools that convert free-text documentation to structured and searchable, so maybe this is their test case.

Spell Meditech as MEDITECH.

No. There’s just no reason to make it all capital letters. I go by the AP Stylebook, as does the Boston Globe, which spells it Meditech. Companies can go marketing crazy with cute capitalizations and symbols within their names, but that doesn’t mean publications have to buy into it. Hospitals are getting into the act, such as NewYork-Presbyterian (no space) and Partners HealthCare. Apparently spelling a word correctly following civilized rules doesn’t sizzle enough to stand out.

Stop being so picky about grammar.

No. I hate it when people make up their own rules because following society’s rules is inconvenient. Many people worked hard to teach me English, so I feel no shame in using it correctly. Americans are bizarre in passing along to their children their bemused indifference to competence in English and math, so we’ll see where that gets us in a competitive world market.

Some of the interviews feel scripted – mark those that are done live.

I do every interview live by telephone. Also, the subject hasn’t heard the questions until I ask them and doesn’t get to approve the final transcription. Two exceptions: (a) the “HIT Moment With …” where five-question interviews are done by email, and (b) a couple of times over many years, my interview subject did not speak easily understood English and I knew both the subject and I would have to work a lot harder to complete the interview, so I begrudgingly allowed email answers. I’ve done many hundreds of interviews and all but a handful were me talking on the phone asking off-the-cuff questions (I do edit out the many times the subject says, having become accustomed to low-quality reporter interviews, “What a great question …”). It would probably be fun to listen to the actual recording that gets transcribed – I interviewed Premier CEO Susan DeVore while having fajitas and a Tecate in a Mexican restaurant since I was super busy that day. I started off by telling her that she was hearing my private mariachi band serenading me in the background, which she found amusing.

Respond when someone leaves a stupid comment on a post.

I don’t want to talk over a reader who leaves a comment, even one I don’t agree with or that is factually incorrect. I let other readers correct them as they see fit. If they don’t, then I assume the comment is at least somewhat justified even if it stings a bit (my skin’s not as thick as it might seem).

I would like to have a quick way to see quickly the comments left on a post and then jump to them.

I will look into commenting options. I had a good cloud-based tool that seemed perfect, but it didn’t work for reasons I never could figure out in multiple attempts.

Send the email blast in the middle of the night instead of at around 8 p.m. EST. It creates pressure to read and I’d rather have it pop up in the morning with the other news I read.

Readers in Pacific times zones jump on HIStalk as soon as the email goes out, so I would hate to hold it until the next morning, plus some people want to see the news as soon as they can. I remember clearly when Todd Cozzens ask for a show of hands from the stage of HIStalkapalooza in Chicago how many people drop everything when the HIStalk email arrives – a frightening number of them went up.

Develop a mobile app.

I’ve been looking into that, although the existing mobile format works OK. Real-time notifications might be useful, though.

Ed Marx never did write anything about the Ebola debacle. The omission makes me think that maybe HIStalk is not as impartial as it says it is.

Let’s be realistic: would your employer give you permission to speak off the cuff to a media outlet about an issue of great human, corporate, and legal sensitivity? Or if your spouse died of Ebola, would you want to see the hospital CIO prattling on about that tiny piece of the case that he knows something about? Ed contributes articles, but he’s not free to talk casually about his employer or the patients they see, no different than when nearly got fired by my hospital when I started writing HIStalk and a loser vendor complained to my boss that I was saying bad things about them (leading to my immediate interest in anonymity).

Keep up the music recommendations.

I’m heartened by several such comments since usually someone complains about anything even slightly off topic, always in the form of, “I don’t read HIStalk for …” as though I’m an HIT-posting robot banned from going off script. Sometimes I fantasize about starting a new, unrelated site about some topic I know next to nothing about just to see if I could make it interesting while learning about the topic.

Write shorter posts or write news daily to shorten the individual posts.

Both are tough for me. I only include items I think are interesting and I cover a lot of ground succinctly, so I’d have to cut something I think is worth reading. I used to write news daily, but readers observed that HIStalk wasn’t particularly special any more when it hit their inbox every workday. Lt. Dan posts morning headlines each weekday if you just want a quick skim to see the major news items without the usual commentary and snark.

It sounds like you think you need to change something. Whatever you do, keep the news, juicy gossip, and sly, somewhat jaundiced humor.

I’ve been writing HIStalk for 12 years, so sometimes I get the urge to try something different. Occasionally I see all of the movers and shakers out there doing cool stuff (starting companies, developing products, running think tanks, etc.) and feel a pang of regret that I’m a sideline reporter rather than a full-contact participant in those high-profile or society-benefitting activities. That usually passes quickly, though, and every day when I face that blank screen yet again with excitement and hopefully some creativity, I realize I how lucky I am to be able to something I enjoy in whatever way I want. I’ve learned to be happy with my place in the world.

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January 18, 2015 News 5 Comments

Morning Headlines 1/16/15

January 15, 2015 Headlines No Comments

Google joins PwC’s Vista-based bid for military health records

Google will join PwC, General Dynamics, Medsphere, and DSS in their bid to install VistA as the DoD’s next EHR.

Whistleblower Lawsuit Calls Billionaire Patrick Soon-Shiong’s Healthcare Startup ‘Fraudulent’ And Dangerous

Two ex-employees of physician billionaire Patrick Soon Shiong’s startup NantHealth file a whistleblower suit alleging that the company is “engaged in a multitude of fraudulent activities.”

The new 10-year standard: Find a more accurate EHR total cost ownership

Becker’s Hospital Review calls for a change to the way total cost of ownership is calculated during EHR procurements, saying that five or seven year timelines are not long enough when in reality a successfully installed EHR won’t be replaced for ten years or longer.

Philips and MIT investigators collaborate to give researchers unprecedented access to critical care patient data

Philips is collaborating with MIT to provide researchers access to the de-identified medical records of 100,000 ICU patients that received care in one of Philips’s eICU centers.

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January 15, 2015 Headlines No Comments

News 1/16/15

January 15, 2015 News 5 Comments

Top News

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PwC adds Google to its Department of Defense EHR bidding consortium that is pitching the VA’s VistA. Google joins, PwC, General Dynamics IT, DSS, and Medsphere. Google’s contribution would be collaboration and search tools, which seems to be more sizzle than steak as PwC tries to make VistA sound sexier to the DoD, whose contempt for that system is legendary. The group has also put up a web page to make its case.


Reader Comments

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From Weird News Andy: “Re: Iowa health insurance startup, the second-largest co-op in the country and heavily funded by the federal government, fails. The key is in this quote: ‘CoOportunity Health’s pool of people was larger than expected, was sicker than expected, so their risk became much greater than the funds that were available.’ That’s an economics lesson. Sicker people spend more and choose the one that saves them the most money, so you end up with a pool of sicker, more expensive members. If the founders of the organization did not see this going in and did not charge enough for their service, the fault is theirs. But then if they charged more, fewer people would select them and …” That’s a big problem with medical insurance. The fingers of insurance company actuaries fly over their Excel worksheets in their attempt to assemble a customer base that includes lower-risk, healthier patients to offset the expensive ones so they can bid competitively. However, individual patients sign up expecting to use more services than they’re paying for, to the point of not even buying insurance until they’ve accumulated enough problems to make it worth their while. It’s like a buffet restaurant eyeballing prospective diners at the door in trying to choose a profitable mix of picky eaters and starving chowhounds for a predetermined price, but their downfall is that few picky eaters will pay for an all-you-can-eat buffet knowing they’re subsidizing those who inhale everything in sight.

From RVA: “Re: concierge medicine. My PCP is moving to concierge practice, saying he doesn’t want to use Epic and that he can’t provide good care because his face is always in the computer ((FYI, he cashed his MU check). The concierge company touts their USB chart that allows you to take your important clinical information anywhere — apparently MyChart was not good enough (the guy sitting next to me joked that when they run out of USB drives, they’ll switch to 8-track tapes). He has approximately 1,200 patients (mostly Medicare) and a poorly-managed practice. They showed a scary video about how doctors are ‘forced’ to give up their practices and referenced the use of ‘mid-level providers’ in a negative way. A lot of people ate it up and started pulling out their checkbooks – oh, he has limited capacity, so it’s first-come, first-served at $2,500 per year. I’m worried that we’re creating a class system where those who can’t afford the fee get less than premium care.” It’s tough to ignore economics by suggesting that those who pay less should receive equally generous, excellent, and responsive healthcare services, even though we as decent people wish that were possible. All of us working in healthcare expect to be paid, so unless we turn it back over to the nuns and counties that ran hospitals as true non-profits using cheap and volunteer labor, those days are likely gone. The ED is the last foothold of healthcare democracy, where everybody is treated the same based on need, but then again, it’s a cost cesspool for that reason and hardly a poster child for open access to all. Healthcare economics is like a balloon – squeeze it in one place to cut costs and another part bulges out as providers who are understandably unwilling to reduce their personal standard of living figure out new ways to charge for their services. We’re at three tiers now: (a) those who use ED and public clinics or who don’t buy insurance because they don’t see the immediate value; (b) the large middle class who have insurance but are getting hit hard by out-of-pocket costs and sometimes facing bankruptcy because of huge and often questionable bills, with that group subsidizing the first one by paying excessive charges and taxes; and (c) those whose assets are adequate to self-insure and whose time is valuable enough to make it worth finding the best and most customer-friendly providers who don’t take insurance. It’s unrealistic to expect the care and outcomes to be identical across all three groups. It’s also reasonable to expect people in the middle group to move down rather than up, and it’s the loss of that group that threatens to implode the system. It’s just like the tax system: some percentage of people pay nothing, the wealthy pay a low overall percentage because of their small numbers and large accounting tricks, and those in the middle foot most of the bill.


HIStalk Announcements and Requests

Last year right before the HIMSS conference I supported Donors Choose by offering companies a large, short-term banner that appears beside the HIStalk title on every page, using the proceeds to fund a bunch of projects for classrooms in need. It felt good and it was fun, so I’m doing it again this year. Contact Lorre if you’d like to book the most prominent ad on the page and help needy students in the process. Like last year, I’ll write up the projects we funded and share the student comments and photos that result.

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I followed through on a reader’s suggestion of an HIStalk Book Club sort of thing where I review an HIT-related book and invite readers to share their thoughts. I reviewed Eric Topol’s “The Patient Will See You Now” and next up is “America’s Bitter Pill.” Read along, add your thoughts, and suggest what book I should read next. I have a copy of John Halamka’s “GeekDoctor: Life as a Healthcare CIO” that HIMSS sent me in return for completing a survey, so maybe that should be next.

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I’m sure we’ll see this at the HIMSS conference: every hip meeting now includes a “graphics facilitator” who documents everything on a flipboard, compelling attendees to proudly tweet out photos of the drawing afterward. I don’t want to attend a conference where a cartoonist understands the presenter better than I do.

Here’s one last appeal for you to complete my once-per-year HIStalk reader survey, which takes just a couple of minutes but helps me immensely.

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This is a fond farewell to Agilum Healthcare Intelligence, whose marketing person told us, “I’ve never even heard of HIStalk” in declining to renew their sponsorship after many years. They’ve been supporters for a long time and I appreciate it. I also appreciate the service of the marketing guy, who though he has zero health IT experience, is a former Army infantry captain who led a field artillery battery in Iraq, according to his LinkedIn profile.

This week on HIStalk Practice: Telehealth reimbursements are set to go live in New York. Tulane University Medical Group implements eCW’s CCMR. Etherapi takes advantage of the Kaiser strike in California. HHS breaks down its own silos, and enjoys flying first class. Dr. Gregg looks into the future of healthcare IT, circa 2037. Third-party patient portals go head to head with vendor-specific options. Thanks for reading.

This week on HIStalk Connect: 23andMe finds a new source of revenue as it closes a $60 million deal with Genetech in which it will use its dataset to support Parkinson’s disease research. Athenahealth acquires cloud-based inpatient EHR vendor RazorInsights, and confirms that it will move into the hospital space. Augmedix raises $16 million to scale a promising Google Glass-based telecharting business. 


Acquisitions, Funding, Business, and Stock

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Todd Cozzens of Sequoia Capital is featured on Fox Business’s “Opening Bell” live from the JPMorgan Healthcare Conference. He mentions his firm’s investment in Health Catalyst (analytics) and MedExpress (retail clinics). A Forbes profile of Sequoia Capital mentions its 40-plus year history, including its 1980 investment in Apple’s IPO (the founder thought the 22-year-old Steve Jobs “looked like Ho Chi Minh”) and its recent gains from Airbnb, Dropbox, and WhatsApp. The firm’s partners make a fortune, apparently, as the article mentions a 2003 fund that returned gains of 41 percent per year for 11 years, with the firm’s partners pocketing $1.1 billion as “Sequoia is turning its own partners into billionaires while keeping outside investors purring.”

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I mentioned that Athenahealth has acquired small-hospital EHR vendor RazorInsights for a rumored $40 million to give it an inpatient foothold. I really like what RazorInsights is doing in giving small hospitals an inexpensive, cloud-based system that covers both clinicals and financials, but I don’t see the benefit to Athenahealth in buying a four-year-old company with only a couple of dozen small customers. RazorInsights has much larger competitors (Meditech, CPSI, Medhost, NTT DATA, McKesson Paragon, etc.) with established infrastructure and most hospitals have already spent their money on a Meaningful Use dance partner, some of them even choosing to run Epic or Cerner as provided by another hospital (or to be acquired by those hospitals). Athenahealth has choked on its previous acquisition Epocrates, which is highly regarded but is stumbling even more than before under Athenahealth’s ownership. I think Athenahealth wants desperately to crack the inpatient market (after insulting that market for years), realizes it doesn’t have the expertise to build a new hospital system from scratch, and decided to spend money instead of time to get a name-plated product quickly to market and then ramp it up. The challenges are many:

  • RazorInsights is small for a reason and not being owned by Athenahealth may not be it.
  • Both product and company scalability are unknown.
  • Few big companies have low-enough overhead to profitably roll out products to cash-strapped 25-bed hospitals.
  • Expected synergies may (as they often do) prove to be elusive.
  • Companies have been historically lured into unwise acquisitions because the product aroused them technically and filled a perceived immediate need at high expense (Allscripts buying Eclipsys).

I think Jonathan Bush will talk this up as though Athenahealth is the next Epic (or Salesforce or whatever high-flying comparison comes to mind), but the acquisition is just another distraction as the company tries desperately to keep its Wall Street plates spinning in the air despite concerning profits and a year-long share price stall.

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Aetna announces that it will raise its minimum wage to $16 per hour in April and will offer an enhanced insurance plan for employees who participate in wellness programs starting in 2016.

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Two former NantHealth executives file a whisteblower lawsuit against billionaire doctor Patrick Soon-Shiong’s company, claiming that NantHealth is “engaged in a multitude of fraudulent activities,” violates HIPAA requirements, has failed mock FDA audits, and offers products that harm patients. Stephanie Davidson (former SVP of professional services) and William Lynch (former senior director of marketing) also claim that several customers were prepared to stop using the company’s Clinical Operating System, citing an internal report that characterized that product as “10 years behind in technology capability” that “runs on LUCK.” The pair claims that NantHealth’s marketing material is misleading and that Soon-Shiong’s charitable foundation defrauded Medicare by donating millions to a hospital that would then use CMS matching funds to buy NantHealth’s products. NantHealth’s responds that the employees, who are in a romantic relationship and had worked for the company for only a few months, demanded that NantHealth pay them $2 million to prevent them from launching a pre-IPO smear campaign after NantHealth fired Davidson. Perhaps it’s not a coincidence that the lawsuit was filed just as Soon-Shiong gave the company’s investor pitch at the JPMorgan Healthcare Conference.

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Craneware says second-half sales for 2014 increased 10 percent and its board is confident of meeting 2015 expectations.


Sales

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Good Shepherd Health System (TX) chooses Strata Decision’s StrataJazz for decision support and cost accounting.

Healthfirst (NY) selects InterSystems HealthShare as its HIE and clinical portal.

Providence Health & Services expands its relationship with Kyruus, which offers a doctor web search tool. That’s how I would describe their business, anyway, but if you don’t get enough buzzwords, here’s theirs: “Kyruus is an enterprise healthcare provider solutions company that helps health systems optimize their Patient Access, Referral Management and Care Coordination operations. Leveraging the cloud and a proprietary Big Data approach, the company enables the integration of massive amounts of information to create a single source of truth of providers. Kyruus helps health systems create customizable protocols for referral and scheduling across all channels of patient engagement to improve patient access and patient experience.”


People

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Ralph Keiser (Deloitte) joins Recondo Technology as chief growth officer.

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John Glaser (Siemens Healthcare) joins the board of the American Telemedicine Association.

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Hayes Management Consulting hires Gay Fright (Coastal Healthcare Consulting) as VP of strategic services.

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Huntzinger Management Group promotes David DiChiara to CFO.

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Sachin Jain, MD, MBA (Merck) joins care plan CareMore as chief medical officer. He worked for ONC for a short time a few years ago. He said in a talk last week that most health IT startups offer products that are interesting but not really useful because (a) they’re trying to make a quick buck, and (b) they are mostly run by young, prosperous, healthy people and develop products in the context of their peers rather than for the sick, expensive patients that need help. He also said HITECH came about because everybody knew EHRs were good for patients, but hospitals put the interest of their resistant doctors first because they’re the ones who admit patients.

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Ken Pool, MD, co-founder of OZ Systems and co-chair of the HL7 Public Health and Emergency Response Work Group, has died, according to a posting on the group’s listserv.


Announcements and Implementations

An article by Brad Swenson of Winthrop Resources Corporation suggests that the total cost of ownership of hospital EHRs should use a 10-year forecast rather than the more common five or seven years. It quotes The Valley Hospital (NJ) VP/CIO Eric Carey, who used a 10-year timeframe to make an upgrade-or-buy decision: “We felt no one should be replacing an EHR platform in less than 10 years unless a catastrophe happens. Also, probably the most expensive part of an EHR project is the army of consultants, staff, and project managers you need to have to pull everything together. Our implementation has involved 20 FTE over at least one year. Most organizations can’t afford to do that more than once.”

McKesson announces Paragon Community Plus, a package that includes its Paragon system, implementation, training, and remote hosting.


Government and Politics

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A House Committee on Energy and Commerce work group creates a draft policy that would require HHS to pay for telehealth services at the same rate as in-person visits within four years.


Innovation and Research

Philips gives MIT researchers access to the de-identified records of 100,000 ICU patients who were monitored via its eICU program. The records, which represent about 10 percent of all US adult ICU beds, include vital signs, medication orders, lab results, and severity of illness scores.


Technology

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Google stops public sales of Google Glass and moves the product from its research lab to a separate business unit led by former fashion and eyewear designer Ivy Ross. Companies and developers will still be able to buy Glass units after the January 19 cutoff date. Google was supposed to release a new version of Glass in 2015 but hasn’t provided specifics. People seem to think this is the beginning of the end for Glass, but I’m not so sure: it desperately needed a reboot, graduation from beta status, and design help for its ugly form factor (which is true of most things Google), so perhaps this is its graduation into the real world, or even away from the consumer market and into the enterprise one.

A guest newspaper article by the CEO of a Missouri public policy organization says the state is still #49 in economic growth despite being one of nine labeled as “the corporate welfare kings of America.” He says of the Missouri’s $1.6 billion subsidy of Cerner’s $4.3 billion new campus, “If Cerner needs a corporate pleasure dome, it should pay for it on its own nickel.”

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I thought sure this was a spoof since it was heavy with Star Trek puns and one of the pictures features a nurse wearing a 1970s-style cap, but apparently the just-started IndieGoGo campaign for the $3,500 Warp 3 Medical Tricorder is for real. It’s not the X-Prize, Scanadu-type consumer Tricorder, though – this China-based one will be just for doctors and will provide vital sign, ultrasound, and EHR functions.


Other

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The local paper says that MultiCare Health System (WA) is not only represented on the advisory group IBM and Epic put together to help make their case to the Department of Defense as it selects its $11 billion EHR, but MultiCare will also serve as the pilot site should the IBM-Epic bid be chosen.

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A physician’s New York Times editorial observes that 24 of the 141 medical schools in America are now named after big donors, causing graduates to be “embarrassed that there was a rich person’s name on their diploma, with the university name tucked below in small print.” Naming rights cost from $8 million (East Carolina University’s Brody School of Medicine) to $200 million (UCLA’s David Geffen School of Medicine, above). 


Sponsor Updates

  • Imprivata integrates its Cortext secure communications platform with the Citrix XenMobile enterprise mobility management solution.
  • HealthTronics selects AirWatch for enterprise mobility for its 500 employees.
  • ZeOmega is named as one of the 100 fastest-growing Dallas companies.
  • John Stanley of Impact Advisors is quoted in a San Diego newspaper’s article on the pros and cons of EMRs.
  • Divurgent will participate in the HIMSS East Tennessee Summit in Knoxville on January 22.
  • DataMotion covers the important role e-mail plays in file sharing in its latest blog.
  • CompuGroup Medical will participate in the Critical Care Congress in Phoenix, AZ from January 17-21.
  • CommVault expands its relationship with NetApp to offer integrated data protection solutions.
  • TechGig outlines CitiusTech CEO Rizwan Koita’s predictions for 2015 healthcare technology trends.
  • CareSync publishes a new blog on the importance of taking charge of a family’s health records.
  • Dignity Health VP/CMIO David Lundquist, MD offers insight into how to keep patients in mind when discussing the future of healthcare at AirStrip’s Mobile Health Matters blog.
  • ADP AdvancedMD offers “4 surefire signs you need a new EHR for MU2 and beyond” in its latest blog.

EPtalk by Dr. Jayne

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It’s been a strange couple of weeks for me. We’re getting ready to go through some major changes at our hospital and everyone is on edge. Teams are being consolidated and it feels like the directors and VPs are playing a giant game of “Go Fish” only instead of cards, they’re playing with people. This comes right on the heels of our hospital’s push to reduce the number of accrued vacation days on the books, which had almost half of our employees taking significant time off during the last month or so.

Everyone is overworked and cranky as we try to make decisions based on forecast scenarios and half-developed plans. Sometimes we start to feel not only like the sky is falling, but that the world is burning down around us. We imagine it can’t possibly be this bad in other places. It’s difficult to reach out to colleagues at other organizations because we don’t want to admit that our own organizations are in frantic disarray.

It was in that frame of mind yesterday that I was trying to catch up on the ridiculous thing that is my inbox. I’m on staff at another hospital that’s not part of my health system. I almost got whiplash doing a double take at one of the emails I received. It was discussing the final steps of a system conversion they’ve been working on for years. They’ve been running dual platforms for the last six months during the transition and are finally pulling the plug on the legacy application.

Despite the robust features of the new system, the email wording left something to be desired. “Many fixes and enhancements have been done to NewApp to make it usable.” The email was sent out under the CMIO’s banner. Knowing him as I do, I’m pretty sure that’s not what he intended. I forwarded it to one of my colleagues – not as a way to humor ourselves at someone else’s expense, but as a confirmation that the people at our competitor across town are likely under the same pressures as we are. No matter how hard and how many long hours we work, things are falling through the cracks.

I thought about how fortunate I’ve been that during most of my time as a CMIO I’ve been surrounded by colleagues who are competent, confident, and motivated. I’ve always felt like they have my back and in turn I’ve had theirs. Over the last year and a half, however, it seems that everyone has been stretched thinner and thinner. We’re to the point where we can barely support ourselves, let alone each other. Although we’re certainly experienced in delivering the impossible, it’s become harder and harder to make it a reality.

Looking at the last few months in particular, not only has our energy been sapped, but we’ve lost some of our support structures. Our standing team meetings have been fragmented as we’re pulled in countless directions by competing demands. Those were our opportunity to update each other on our projects, potential risks, and needs. We received feedback and encouragement as well as ideas to remove blockers or handle difficult situations. Colleagues who had been in similar situations provided pointers and tips and lists of “gotchas” to look for.

I should have taken that email as a warning to stay vigilant. By the end of the day today, I watched one of my key projects go off the rails. In hindsight, I should have seen it coming, but I didn’t. Although ultimately it’s no one’s responsibility but mine, I can’t help but think that if we weren’t all so scattered and overwhelmed that someone else might have picked up on subtle signs that I missed. I spent most of the day with an impending feeling of doom and heartburn that made me want to eat a box of chalk.

I realized that given our current state of being overextended, under-resourced, and fatigued that it’s likely this isn’t going to be the last time something like this happens. This is an uncharted place that I’ve never had to operate in before. I’m officially working without a net and it doesn’t feel very good. But given the state of our industry today, I’m sure I’m not alone.

Do you have tips for how to work without backup? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
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January 15, 2015 News 5 Comments

Book Review: “The Patient Will See You Now”

January 14, 2015 Book Review No Comments

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I enjoy reading articles and tweets by technology fanboy Eric Topol, MD. He’s focused and intense. He’s always whipping out a smartphone-equipped EKG gadget on a plane or sticking a smartphone otoscope in Steven Colbert’s ear on TV. A lot of the tools he digs up seems to be of the “hammer looking for a nail” category and he’s created a nice gig for himself as a geeky critic of the medical establishment (even taking the AMA to task), but sometimes he comes up with ideas that might make a difference someday.

Topol is an undisputed thought leader. I like what he has to say even if I’m often skeptical.

Topol’s new book, “The Patient Will See You Now,” is an impressive (some might say “undisciplined”) romp through the healthcare technology garden. However, it fails to live up to its title, which suggests that savvy, responsible patients armed with cool smartphone EKG devices and fitness trackers have quietly wrested control of healthcare from the government, corporations, and providers of “eminence-based medicine” that make up the plodding and oppressive medical establishment. It’s a cute and gimmicky title, but it contains more hype than the book can deliver.

In fact, it sounds a lot like his earlier book (which I didn’t read) called “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care.” That one is three years old, so maybe everything in it came true and he moved on.

The book wanders around so much that the only overall sense I could make of it required me to summarize each chapter, as follows:

  1. Technology is widely adopted. Patients know their own bodies better than anyone.
  2. Doctors are trained to feel superior and to control the flow of medical information.
  3. The smart phone is like the Gutenberg press in democratizing and disseminating knowledge.
  4. Angelina Jolie’s decision to undergo a double mastectomy because of genetic testing was earth-shattering, but the FDA tried to shut down 23andMe because that testing completely ignored FDA’s inquiries about its marketing and its offer to help the company comply with US laws.
  5. I glazed over on Chapter 5 because it was a complex and questionably relevant primer on how genes work and how they can be used to personalize medicine. The bottom line: we should be doing more genetic testing for research and individualizing treatments.
  6. Silicon Valley darling Theranos is revolutionizing lab testing. People have the right to see their own information. They should also be informed about the radiation dosage in diagnostic imaging.
  7. Patients should be able to see their medical records. OpenNotes and Blue Button give that capability, but only 36 percent of patients can access their records and EHRs are primitive.
  8. Prices for hospital services and drugs are irrational and vary widely, especially when comparing high US prices to those the rest of the world pays. We have a lot of waste and spend a lot on treating complications.
  9. Telemedicine is cost effective and convenient, but doctors resist new technology just as they did the stethoscope when it was invented.
  10. Hospital stays, which are expensive and error-prone, are declining as surgeries move to outpatient. Technology allows care and monitoring to be moved to the home.
  11. People are willing to share their medical data for research, which will allow collecting and collating information to discover new research and best practices.
  12. People are selling and stealing medical data.
  13. Sensors can predict and track medical conditions.
  14. Cheap smartphone-connected technology will democratize medicine to less-developed countries.
  15. People own their medical data. Big employers should be using it to squeeze big insurance companies, but none have actually done that. Consumers haven’t mobilized. CMS and other administrative waste takes a lot of resources out of the system. Other countries will do better because of our archaic payment and regulatory model.

My frustration is that while the exhausting scattershot of technology nuggets is interesting (although hardly original since I’d heard of nearly all of them), it doesn’t prove the title’s hypothesis. It may well be that a few tech-savvy and demanding patients can convince their individual providers to let them get more involved in their care, but nothing suggests the presence of an unstoppable movement. In fact, while healthcare takes heat for being episode-based, a significant portion of consumers are even more episodic – they pay attention to their health mostly when something is bleeding, hurting, or swelling and then show up expecting a TV-like quick fix. The majority (especially the medically expensive ones) aren’t quantified-selfers or fully engaged participants.

A lot of people have smartphones, health apps, and fitness trackers, but those gadgets haven’t proven to make them healthier. Capturing and tracking information is just a tiny and easy part, as evidenced by the significant penetration of bathroom scales in the homes of overweight people. Patients (or consumers or whatever you want to call the 100 percent of us who will seek medical care at one time or another) can make consumer-like demands on their doctors, hospitals, and insurance companies, but I’ve heard few examples of where that actually accomplished anything other than possibly getting themselves labeled as a troublemaker.

People who receive medical services aren’t really pure consumers, so it’s not realistic to assume that the healthcare cheese can be massively moved by technology as happened in banking and entertainment. Patients don’t usually pay all their own bills. They go to whatever doctor and hospital the party that does pay (the insurance company) dictates, so threats to take their business elsewhere are usually hollow no matter how unpleasant or Luddite their doctors may be. Strap 10 smartphones with cool apps on your belt, pass out OpenNotes articles in the waiting room, and warn hospitals that they had better not make a medical mistake during your admission – your influence is still minimal despite being informed.

Topol’s broad observations and complaints aren’t really actionable. Patients have little control over the items listed above. The book title suggests that patients are in charge, and yet it’s still insurance companies authorizing payments, doctors entering orders and performing procedures, and the much-maligned medical establishment standing between patients and their maker. The healthcare system (or more correctly, the healthcare industry) was built around everybody except the patient. That establishment isn’t just going to step aside because patients carry iPhones. Any plan that requires people to voluntarily stop doing what they’re well paid to do will fail.

A few tech-powered concierge practices, retail clinics, and drug chains are threatening the status quo. They aren’t really scaring anyone. They may cherry pick a tiny bit of profitable business, but they aren’t much of a threat to health systems that keep buying up more providers and using their political influence as big employers to make sure they aren’t pushed away from the table. That’s the best hope for quick innovation that will reverberate through the hallowed walls, such as the real threat that Theranos will force high-margin hospital labs to either increase their efficiency or survive on a fraction of their current business.

Healthcare is like your car (at least if your car was built in this century). Your car is loaded with sensors (some of which, like the speedometer, you may conveniently ignore) and requires a computer to analyze its internal computer data stream. You can’t diagnose and fix it yourself when the idiot light comes on. You can study up all you want, but your only real decisions involve (a) whether you want to get it fixed, and (b) who you choose to fix it given your available options. You sit impatiently until the mechanic hands over a grease-stained list of procedures he or she performed along with a bill (as in hospitals, the computer that creates the bill is the most powerful one). All of that technology and data didn’t benefit you very much – it just generated more business for the mechanic, allowed him or her to work more effectively, and maybe avoided even more expensive repairs down the line. That’s pretty cool, but it’s hardly a revolution in empowering car owners.

That’s my takeaway from the book. Most of the technologies listed help doctors provide better care, assuming they are willing and able to use it. The role of their patients is, at best, to push for them to actually think about using genomics, following evidence-based medicine practices, reviewing their own outcomes information, and staying current on new medical developments. Patients, however, won’t usually voluntarily leave a doctor just because they don’t use an EMR or other gadgetry – that’s the art rather than the science of medicine – so it’s not really much of a threat.

Consumer choice in healthcare involves choosing the “best” provider to interpret, order, and perform procedures (or at least the “best” one willing to see you that your insurance covers). A doctor might be willing in the seven minutes you’re allotted for a return visit to look at your fitness tracker information, sit beside you as you Google your condition, or describe their charges to the price list from the MinuteClinic down the street. Don’t count on it. You’re only as empowered as is convenient for them.

Cardiologists make a great living and Eric Topol is no doubt excited to see his Scripps patients embracing technology and participating in their care, but it just doesn’t work that way for most doctor-patient encounters. People don’t get as broadly excited about health-related technologies as they might with social networking or music since the personal payoff is slower and less certain. Fitness trackers motivate and inform people who are already motivated and informed. Those aren’t the folks running up most of the country’s medical expenses.

Topol’s confidence that abundant technology will upend the US health system in favor of patients seems wildly simplistic. We can all – as patients and industry insiders – make a long list of what’s wrong with healthcare. That doesn’t mean we can change it through our individual actions. Healthcare is like the government in that it’s easy to identify what’s wrong, but hard to even agree on a solution, much less impose it against the will of far more influential people and corporations who are pretty happy with the present arrangement.

That doesn’t mean the book isn’t worth reading as a concise overview of what technologies are on the horizon. It’s good for that, at least for the next six months until it becomes outdated. It also doesn’t mean that Topol isn’t a passionate visionary because clearly he is. However, he could raise an army of fist- and smartphone-waving readers of his book who are upset with how most of us are treated as patients and health-seekers, but that alone won’t get our broken healthcare system fixed.

That’s my disappointment with “The Patient Will See You Now.” Reading it makes it easy to see what the future could be while knowing it probably won’t really happen, at least not in this country. I give it 3.5 stars out of five, docking it a half-star for an unrealistic title. Each chapter would have made a great blog post or magazine article, but I’m not finding them as compelling or entertaining in aggregate.

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January 14, 2015 Book Review No Comments

CIO Unplugged 1/14/15

January 14, 2015 Ed Marx 3 Comments

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

Leadership and the Paradox of Shame

Ninety percent of successful business executives are driven by shame. Psychology Today defines shame: the painful feeling arising from the consciousness of something dishonorable, improper, ridiculous, etc., done by oneself or another. It’s an attitude toward self. Nobody needs to look long to see the roots and vines of shame snaking through my life.

Shame is a powerful motivator. I was afraid to being a failure, so I graduated in the top 20 percent in the corps of engineer officer academy. I dreaded being last in any race, so I drove my body until I reached Team USA status. I feared disappointing my parents, so I strove to be a senior vice-president. One boss told me I wore the wrong clothes, so I revamped my wardrobe to keep from being harassed. Shame became my identity.

It begins in youth. We are shamed by parents, educators, coaches, friends, and clergy. If we chose to believe the lies, our identity falls prey to …

The paradox of shame. On one hand, it’s an emotional prison. On the other, it’s a fuel for success.

I was led to believe I was never good enough. Never as smart as my eldest brother and sister. I never could score as many soccer goals as my middle siblings. For every mistake and failure to meet his expectations, Dad shamed me. If a scoop of ice cream slid off my cone, Mom called me an idiot. They labeled my adolescent tomfoolery criminal. They didn’t know any better.

The year I earned my master’s degree and got promoted to Army captain was a big deal for me. Yet my mother exclaimed, “You still have to prove yourself.” Shame was my parents’ subconscious method of motivation.

Following their ingrained model, I leveraged shame to my advantage. I had to prove to men that I was a man. I had to prove to women that I was desirable. I had to prove to the world that I was worthy of accolades. Shame drove me to accomplish some amazing things. In order to feel good about myself, I had to be number one in everything. All false beliefs.

I even used shame in my leadership practice. I’d shame others to get the results I desired. I subtly made people feel bad under the label of motivation. While the intent was OK, the technique was pitiful. I would belittle and criticize others openly. Often, it was not so much what I said but my body language. I would make others feel bad until they relented and did things as I wanted them done.

The day someone exposed my shame, I embraced it. Twisted thinking! I loved the benefit. The power. If I let go of shame, what would happen to my drive? How would I motivate my staff? Would I still be number one? Would I still accomplish great things? Would men still admire me and women find me attractive?

Crazy, right? It’s called deception.

Shame infiltrated my DNA. Can I reverse the curse? Yes! But at what cost? At what benefit? Is it worth the risk? What if I fail? What if I lose the admiration of friends, family and industry? What if it costs me all that I have gained?

I’ve really been searching and examining myself. How do I escape shame? How do I stop shaming others?

It comes down to releasing myself and others to be who they were created to be. If that means I’m not president of the United States, so what? If I don’t make the team, so what? If people no longer seek me out, so what? Easier said than done.

Truth: better to live in freedom than in bondage to a lie. Shame creates a void that will never be filled despite the drive it creates. And for a leader, the higher status you attain, self-deceit can spiral out of control. The only way to escape this vortex of deception is to jump. Forget what others think. It is about you and me being who we really are, despite title.

Then how do we fill the void once we denounce shame? It zeros back to identity. Figure it out and live who you were created to be. To be self-reliant is to dig a deeper hole and still never be good enough. Instead, reach out for help. Continuously explore faith. You’ll be a work in progress, as am I. Messy, yet loveable. Redeemable. Worthy.

Thoughts on work relationships and the keys to escape:

  • Acknowledge shame-driven ways (you might need to ask a friend).
  • Apologize for manipulating through shame.
  • Replace shame with sincere encouragement.
  • Do not tolerate shame from others.
  • Exhort your teams to be all they can be, no strings attached.
  • Tell them it’s OK to be something different than what you may have wanted
  • Surround yourself with truth-tellers who will call you out on shame tactics.
  • Hold fast to your true identity.
  • As you become free, they will become free
  • When you remain imprisoned, so do they.

One more thing. I believe it is probable that by operating in the opposite spirit of shame, your teams will shine brighter than you ever envisioned! They may not look or act like you, but they’ll be free to be their best. Better to be mortal and free rather than super successful and emotionally imprisoned.

Shame is the new “Hotel California.” You can check out any time you want, but you can never leave.

Thankfully, there is an escape route out of the vortex. Break free with me.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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January 14, 2015 Ed Marx 3 Comments

News 1/14/15

January 13, 2015 News 2 Comments

Top News

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Pundits and associations won’t stop banging the “Meaningful Use is a failure” drum in pointing out low participation numbers, but ONC partially contradicts their grim calculations in reporting that 77 percent of MUS2-eligible hospitals have attested, as have 60 percent of MUS2-eligible practices. Those providers still have another one month and three months left, respectively, to attest. Those aren’t great numbers, but they’re a heck of a lot better than you might think, and as a taxpayer it’s nice to know that my money at least has minimal strings attached.


Reader Comments

From Poignant Moment: “Re: non-disclosure agreement. If a vendor requires a hospital to sign one for beta testing, how long does the vendor have to keep the NDA after testing is complete?” I’ll ask knowledgeable readers to help out, but I would say the signed copy should be retained at least until it expires since an NDA should cover a stated time period. That’s for making sure the agreement is followed – I doubt there’s any legal requirement to keep a copy at all.


HIStalk Announcements and Requests

I’m enjoying the articles written by startup CEOs and investors (Brian Weiss of Carebox, Bruce Brandes of Martin Ventures, and Marty Felsenthal.) Those authors and others will contribute ongoing articles on their experiences and lessons learned when working directly with startups. I appreciate their contribution. I’m learning from them since I’ve mostly only worked for non-profit hospitals and theirs is a foreign land to me.

Please take a couple of minutes to complete my once-yearly reader survey. I plan my entire year around the responses, so your time will be not only appreciated, but also well spent in my never-ending quest to reduce my level of suckitude.


Webinars

John Olmstead, RN, MBA, director of surgical and emergency services at The Community Hospital of Munster, IN delivered an absolutely perfect HIStalk webinar on Tuesday, “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” He was interesting, informative, and funny in describing technology used in his ED, including RTLS from Versus (who sponsored the webinar without turning it into a sales pitch), Epic EHR, Ascom phones, and Rauland nurse call. It did something that few webinars do in holding my rapt attention throughout and it wasn’t just me – the webinar’s control panel showed that 98 percent of attendees were hanging on to his words instead of checking email or web browsing. The average is more like 60 percent of people paying attention (and for companies that decline our webinar improvement suggestions, it’s as low as 15 percent). I’m confident that anyone with the slightest interest in ED challenges, quality improvement, and what happens when CDC shows up to investigate an infectious outbreak will enjoy this one a lot.


Acquisitions, Funding, Business, and Stock

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Athenahealth adds two companies to its More Disruption Please Boston-based accelerator program: CredSimple (credentialing) and RubiconMD (referred remote consults). Athenahealth also announced that the accelerator will open a San Francisco office.

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Augmedix, which offers Google Glass-powered physician documentation system, raises $16 million in Series A venture capital.

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Kit Check, whose OR medication kit tracking system is live in 144 hospitals, raises $12 million in a Series B round led by Kaiser Permanente Ventures, increasing its total to $22 million.

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Digital mental health solutions vendor Ginger.io raises $20 million in a Series B round.

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Cary, NC-based SmartLink Mobile, a spinoff of referral coordination software vendor Infina Connect,  raises $2.5 million in funding for its secure patient-doctor texting platform.

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Israel-based startup MediSafe, which offers a medication reminder app, raises $6 million and opens a Boston office. One of its new investors is 7wire Ventures, run by former Allscripts executives Glen Tullman and Lee Shapiro.

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IT services provider Syntel sues Cognizant and TriZetto over the former’s acquisition of the latter for $2.7 billion last year, with a Syntel business unit saying TriZetto refuses to pay rebates to which it is entitled because of the acquisition. Syntel claims contract interference and misappropriation of confidential information and wants $3.4 million plus $6.1 billion (with a “b”) in punitive damages.

Alere completes the sale of its Alere Health business to Optum for $600 million in cash, announced in October.

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Madison, WI-based population health software vendor Forward Health Group raises $5.7 million in funding.

AARP issues a call for startups with apps targeting the “50 and over” market for its May 14 pitch meeting in Miami. Applications are due by February 20, 2015 with no fee required. Companies will deliver a four-minute pitch, answer six minutes of questions from judges, and then have their idea voted on by consumers in attendance based on need, marketing, usage, and value.


Sales

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Zwanger-Pesiri Radiology (NY) chooses the Visage 7 Enterprise Imaging Platform for its 58 Long Island radiologists, integrated with the practice’s vendor-neutral archive and enterprise workflow engine.

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Eisenhower Medical Center (CA) chooses Mobile Heartbeat’s CURE clinical communications platform following its pilot project.

Good Samaritan Hospital-Southwest (CA) chooses Medhost’s remotely hosted clinical and financial solutions.

Mercy Health (OH) selects ProVation Care Plans from Wolters Kluwer Health for evidence-based care plan management.


People

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Jamie Coffin, PhD (Clarify Healthcare) joins SourceMedical as CEO.


Announcements and Implementations

Wellcentive releases an analytics and reporting solution for providers participating in CMS’s Delivery System Reform Incentive Payment (DSRIP) program for Medicaid population care improvement.

HealthLoop releases an iPhone app that sends push notifications to a physician when a patient triggers a clinical alert or when another physician sends a triage handoff. It’s part of the company’s package that costs $199 per physician per month.

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Bon Secours St. Mary’s Hospital (VA) goes live on Vox Telehealth’s OrthoCare program, which sends hip and knee replacement patients daily pre-op education and reminders and allows them to relay questions or concerns afterward.

Iatric Systems announces Auditor’s Desktop, which performs a daily risk analysis of potential privacy violations across multiple IT system audits.

Surgical Information System’s  anesthesia information management system is ranked #1 in a new KLAS report.


Government and Politics 

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Congresswoman (and nurse) Renee Elmers (R-NC) reintroduces the Flex-IT act that would reduce the 2015 Meaningful Use reporting period from 365 days to 90.

A Washington Examiner investigative report finds that HHS spent $31 million on first-class flights between 2009 and 2013, including 253 trips that cost more than $15,000 each way. HHS executives taking the first-class flights claimed 70 percent of the time that it was necessary because of a medical disability. CMS officials paid $1,000 each for first-class tickets to fly from Charlotte, NC to Charleston, SC, which is a three-hour drive.


Other

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Odd: Sentara Healthcare (VA) launches a web shop selling books, vitamins, exercise equipment, and non-prescription drugs, explaining it as “a branded option that offers a higher trust factor and unique patient experience.” A 200-tablet bottle of Advil is $27.99 vs. Walgreens online at $16.49; an Omron 5 blood pressure monitor is $95.99 vs. $45.95 on Amazon; and the book “Yoga Heals Your Back” is $19.99 vs.  $11.69 on Amazon (or $2.99 for the Kindle edition). Anyone smart enough to find and use Sentara’s site will also be web-competent enough to check prices elsewhere, so the site’s success will depend on how highly those people value the “unique patient experience” of clicking the “buy” button there vs. mainstream sites they’re already using. The underlying technology is from Paquin Healthcare, which also offers a system that integrates with EHRs to generate “lucrative new revenue streams” to “monetize major investments made in mandated EMR systems” by using the patient’s information to suggest that the doctor upsell items such as vitamins, wearables, and books. As the company explains, “If a patient’s medical record shows they have had heart disease, Embrace automatically recommends vitamins, pedometers, weight management tools, blood pressure monitors, and other such products suitable specifically for patients with that condition. When a patient purchases the recommended products or services, revenue from the sale is paid to the care provider.” 

Alibaba Health Information Technology settles its licensing dispute with Oracle. NYSE-traded, China-based e-commerce vendor Alibaba Group, whose shares are worth $255 billion and which has been predicted to be the world’s most valuable company in the next few years, bought and renamed the former Citic 21CN drug information business in early 2014.

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A clinical documentation position paper from the American College of Physicians published in Annals of Internal Medicine says that EHRs provide minimal improvement over paper records because they were designed around billing and regulatory requirements and the practice of defensive medicine rather than improving patient care. It warns that the EHR is as overloaded with useless information as its predecessor paper chart (and will get worse with data from patient wearables) and that narrative entries are being unjustly devalued in favor of discrete data entry. The authors add that E&M guidelines forced data formatting rules that caused “coding and compliance trumping clarity and conciseness, as well as a harshly negative ‘gotcha’ mentality that saps the professionalism out of physicians.” The position paper says CMS overreacted in its condemnation of copied-pasted information, explaining that while copy-paste causes documentation bloat and perpetuation of originally incorrect information, physicians should not necessarily be required to create every new EHR entry manually – in other words, it’s the user and not the EHR function that should be of concern. The paper expresses tepid support for the Open Notes concept of letting patients review clinical documentation, saying it’s too early for a big rollout and that providers should be able to hide individual notes that could cause patient harm.

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Huffington Post covers the growth of retail clinics. CVS alone plans to have as many MinuteClinics in operation by 2017 as exist overall today. Meanwhile, mall operators expect to fill empty spaces left by dying retailer chains such as Sears and RadioShack with walk-in clinics, of which more than a third of the 9,400 total are located in shopping centers.

I enjoyed these tips for making meetings more productive:

  1. Don’t invite more than 10 people.
  2. Schedule meetings for only 15 minutes, set a timer, and stop the meeting when the timer goes off.
  3. Take away the chairs to encourage creativity instead of passivity.
  4. Don’t allow laptops or phones – studies show taking notes by hand leads to greater understanding.
  5. Assign every task to a directly responsible individual.
  6. Take a two-minute silence break to think about a decision or issue.
  7. Ask each attendee to answer the “why are we meeting” question in five words or fewer to make sure everyone expects the same outcome.

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Weird News Andy understands that, “It’s hard to re-member.” A woman in China cuts off her husband’s penis after catching him sexting with his lover, but surgeons successfully reattach his manhood. The wife, obviously still unhappy, sneaks back into her recuperating husband’s hospital room and cuts his penis off again, this time throwing it out the window of his hospital room. The couple was caught on camera fighting in the street outside as the man was naked and bleeding, but he won’t be reorganized a second time – the hospital says a dog or cat must have run off with his severed penis because they couldn’t find it. However, he may yet have a happy ending since his lover says she will marry him anyway.


Sponsor Updates

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  • TransUnion unveils a new brand identity platform and logo.
  • MedAptus joins Athenahealth’s More Disruption Please program.
  • Forbes profiles the use of Strata Decision’s StrataJazz to reduce hospital costs.
  • Zynx Health will exhibit at the HealthIMPACT Southeast event on January 23 in Tampa.
  • Huron Consulting Group’s efacs software is selected as University Business Readers Choice Top Product.
  • Voalte offers advice for setting goals in 2015 in its latest blog post.
  • Verisk Health blogs about why value-based care will work.
  • T-System Director of Documentation Solutions Robin Shannon, RN offers tips on how to maintain efficiency and throughput during high patient volumes in flu season.
  • CEO/CFO Magazine interviews SyTrue CEO Kyle Silvestro on transforming medical data into refined smart data.
  • Surgical Information Systems will participate in the MUSE Executive Institute in Amelia Island, FL on January 19-20.
  • Summit Healthcare blogs about its preparations for the IHE North American Connectathon, taking place January 28 at the HIMSS Innovation Center in Cleveland.
  • SRSsoft offers four key ways to make and keep resolutions in the new year.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

 

Get HIStalk updates.
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January 13, 2015 News 2 Comments

Morning Headlines 1/13/15

January 12, 2015 Headlines No Comments

FDA puts interoperability guidance on back burner

The FDA has published its list of priorities for 2015, which includes clarifying regulatory guidance on clinical decision support software, but does not include any short-term efforts to improve interoperability.

eLearning as good as traditional training for health professionals

Researchers at Imperial College in London, carrying out a study commissioned by the World Health Organization, review findings from 108 research studies and conclude that online learning is likely to be as effective as traditional education for training health professionals.

Health Poll: Data Privacy, Part 2

In a survey of 3,000 Americans conducted by Truven Health Analytics, only 53 percent of respondents report that they would be willing to anonymously share their medical data to support research.

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January 12, 2015 Headlines No Comments

Startup CEOs and Investors: Bruce Brandes

Startup CEOs and investors with strong writing and teaching skills are welcome to post their ongoing stories and lessons learned. Contact me if interested.

Why Your Pitch Makes You Sound Like Charlie Brown’s Teacher
By Bruce Brandes

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Mr. HIStalk was kind to offer me this opportunity to periodically share anecdotes, observations, and insights from my career at the intersection of healthcare and information technology. My goal in writing for HIStalk is two-fold: to support  life-long healthcare folks charged with transitioning from a fee-for-service to a fee-for-value healthcare proposition, and to encourage young tech entrepreneurs who are building important solutions that accelerate healthcare transformation by giving them the best opportunity to succeed, given an array of unique challenges and historical realities.

My first job out of business school, over 25 years ago, was as a sales rep at IBM, which just so happened to assign me to the healthcare vertical. I thought then, “Healthcare is really screwed up. Certainly technology should be able to fix this mess.” While over the past quarter-century we have made some progress moving around the deck chairs on the Titanic, for the first time ever, it is clear that long-awaited, meaningful disruption is beginning to happen.

Subsequent to IBM, I have held sales, strategy, and leadership positions at early and growth stage companies including ESI, Eclipsys, HealthStream, AirStrip and Valence Health. Recently I joined Charlie Martin, a lifelong hospital operator and the founder and CEO of Vanguard Health Systems (now Tenet) to develop Martin Ventures. The Nashville-based firm invests in ideas and innovations that apply integrative approaches that simultaneously improve care, improve health, and reduce the cost of healthcare. Being a part of Martin Ventures has lifted the curtain for me on the venture capital and provider mindsets, which entrepreneurs must appreciate to build a successful business.

Having delivered thousands of presentations over the years, I am now on the other side of the table. I sit in the audience with my "investor hat" alongside long-time healthcare executives. The first observation I feel compelled to share is about your pitch deck (this also applies to sales presentations from vendors to prospects). 

To you, your message is unique and compelling. To your audience, this is the 20th presentation they have sat through this week with people who look just like you and are saying the same thing. Add to that, they have had a history of being misled by exaggerated claims, so skepticism is in the air even if they manage to stay awake while you read your slides.

At a recent conference with rapid-fire presentations from aspiring and emerging digital health entrepreneurs, Charlie (who has been building bricks-and-mortar hospital systems for 50 years) leaned to me and commented, “I don’t understand why anyone in the US still has diabetes. All these people have already solved the problem.” That is my point — you all sound the same!

My favorite TED Talk is a popular one from Simon Sinek, who reminds us that, “People don’t buy WHAT you do, they buy WHY you do it.” Reflecting on and embracing this idea may help set you apart.

When I was at AirStrip, shortly after our founders presented behind Steve Jobs at the 2009 Apple Worldwide Developers Conference, we had the opportunity to meet leading investors as we searched for our first round of growth capital. Prestigious Silicon Valley venture capital firms had a placeholder for several years for a portfolio company to address mobility in healthcare, having passed on everything before AirStrip.

As we built a relationship with the partners of a prominent Sand Hill Road firm, I later learned that it was not the content of our presentation (which we painstakingly developed for weeks) that attracted them to the company. Our allure was less about how we had built a broad platform for mobility specifically for healthcare or that we had proven the concept in obstetrics with a compelling value proposition.  

The investors were more interested in investing in the technical and clinical credibility, passion, and commitment of the founders to eliminate the geographical and informational boundaries that had historically hindered doctors, nurses, and patients from delivering and receiving the best possible care. People don’t buy what you do, they buy why you do it.

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As a call to action, focus on how to set yourself and your organization apart from others – at your core, not just in your presentation – but, good grief, for the sake of your audience, at a minimum step up your game in how you present!  

A little guidance: 

  • Understand your audience well enough to meet them at a common baseline so you do not waste time telling them information which they already know.
  • Cut the number of slides in your deck in half (if you must use them at all) and ensure their purpose is to support your having a conversation with your audience, not to distract from it.
  • Tone down wildly speculative claims about the market, potential ROI, forecasted revenues, etc.
  • Be honest and realistic. Sincerity, insight, and integrity make a much stronger impression than telling your audience what you think they want to hear

Most importantly, read your audience to see if they are hearing what you are trying to convey, or if instead you are coming across as Charlie Brown’s teacher: “Wah, wah wah, wah wah wah."

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

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January 12, 2015 Startup CEOs and Investors No Comments

Startup CEOs and Investors: Marty Felsenthal

Startup CEOs and investors with strong writing and teaching skills are welcome to post their ongoing stories and lessons learned. Contact me if interested.

The JPMorgan Healthcare Conference
By Marty Felsenthal

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It’s bigger than the Super Bowl, the World Series, the World Cup, and the Winter and Summer Olympics. It’s more important than the BCS Championship game (particularly if you’re from Florida or Alabama) and maybe even the Famous Idaho Potato Bowl, the Scottish Highland Games, and the Cooper’s Hill Cheese Rolling and Wake Competition combined (unless you are from Idaho, Scotland, or, of course Gloucester, England).   

My name is Marty Felsenthal. I’m a middle-aged, workaholic healthcare venture capitalist with thinning hair and a thickening mid-section. Mr. HIStalk asked me to write a little bit about the JPMorgan Healthcare Conference taking place this week in San Francisco and to describe it for readers who have never attended. 

My life’s greatest joys and accomplishments are increasingly defined by (a) finding great post-holiday sales online; (b) the "sports" achievements of my nine-year-old, boy-girl twins, and occasionally, my seven-year-old daughter; and (c) by the nights my wife actually laughs at a joke I make rather than thinking I’m a workaholic, balding, overweight man who she periodically tries to pull a Chief Bromden on and pillow-suffocate for snoring in my sleep.

Since that is increasingly my life, the JPMorgan Healthcare Conference is actually a big deal for me. But it wasn’t always that way.

The conference has been taking place for decades. In fact, it used to be called the Hambrecht & Quist Healthcare Conference prior to H&Q being acquired by JPMorgan. But for decades, it was really dominated by drug companies, biotechnology companies, and medical device companies. On a relative basis, there was just less growth and innovation in healthcare services and healthcare information technology and, as a result, less investor interest.  

For clarity’s sake, I should point out that I’ve been a healthcare-focused venture capital investor for 18 years and work exclusively with what we hope are innovative healthcare services and healthcare information technology companies. This year, our firm will be hosting a reception during the conference for other venture capital firms who invest in healthcare services and healthcare information technology.  

This will be my twelfth consecutive year of co-hosting this reception. There were years when we had fewer than 30 venture capital investors show up. There was just nothing sexy about investing in venture-stage healthcare services and healthcare information technology. I was like the Kevin James of the JPMorgan Healthcare Conference.  

This year, however, we have over 150 venture capital investors attending and had to turn a number people away at the threat of the fire marshal. This year, I’m like the Kate Upton of the conference — actually, let’s say the David Beckham of the conference (and maybe with a lot of help from Photoshop, that could actually be the case). 

When did it change and why? That’s easy.  2009 and 2010 when the HITECH Act and Affordable Care Act were passed. They were catalysts for innovation in "my" sectors unlike anything I’ve experienced since I first got involved in healthcare in 1992.

The conference itself is held at the Westin St. Francis on Union Square. It’s a forum for hundreds of public healthcare companies and an increasing number of not-for-profit healthcare systems and health plans with public debt to present to mutual fund and hedge fund investors. These companies include drug and biotechnology companies, diagnostic companies, medical device companies, healthcare services companies, and healthcare information technology companies.  

JPMorgan is also increasingly inviting a number of still-private companies to present. My firm is fortunate to have a few of these — Teladoc, Redbrick Health, and Vet’s First Choice. I unfortunately don’t have a chance to actually go into the conference and listen to these companies present any more. I wish I did.  

The presenting companies are among the largest and most influential players in the US healthcare ecosystem. They include UnitedHealthcare, Wellpoint, Aetna, Cigna, Centene, and all the major health plans. They include large health systems such as HCA, Tenet, Geisinger, and Banner; pharmacy chains and PBMs such as Walgreens and CVS Health; and most of the country’s most influential health information technology companies, such as Cerner and Athenahealth.  

These companies are talking about much more than their financial performance. They are talking about their strategies and how they are evolving in the face of the huge changes sweeping across our health care system. They are talking about their efforts to help reduce healthcare costs in our country, to improve quality, to improve the consumer experience, and to help lay (or take advantage of) the healthcare information technology backbone so we can transition to a more value-based environment. They understand that, in the current environment, they have to adapt and innovate to survive and thrive, and this is what some of the largest players in the US healthcare ecosystem are presenting and discussing.

Unfortunately, I don’t have time to go into the conference any more. I won’t even have a chance to see our portfolio companies present. As the customers of our portfolio companies (broadly speaking, health plans, hospital systems, pharmacy chains, HCIT companies, distributors, etc.) have started needing and demanding more innovation, more innovative companies have formed to address these needs. These companies need capital. They need investment bankers. They need management teams. They need executive recruiters.

All of these constituents — many of whom are old friends from my days as "Kevin James" and many new to the industry as we became cool — descend upon San Francisco during the conference to network, to catch up, to search for new jobs, to craft business partnerships, to look for capital. There is as much if not more action taking place outside the Westin St. Francis as there is taking place in the actual conference.

At Mr. HIStalk’s suggestion, I took a look at my calendar. This is my week. I start at 5 p.m. on a Sunday, and from there, I am booked solid every hour on the hour, breakfast through dinner, until Friday at 10 a.m. 

I am meeting with seven investment bankers. These investment bankers know and represent many wonderful entrepreneurs and companies who are in need of capital (capital that we can provide). They are also looking to represent companies we invest in when they need more capital and/or want to sell their businesses or go public.  

I am meeting with six other venture investors/firms. These are organizations that we co-invest with already or that we would like to co-invest with. We talk about opportunities to work together within our existing portfolios, companies we are currently evaluating where there might be an opportunity to invest together, and areas of innovation of mutual interest.  

We have more than 20 meetings with executives from some of the largest health plans, pharmacy chains, distributors, HCIT companies, and hospital systems in the country. We’ll talk about innovation. We’ll discuss our portfolio, trends we’re seeing in the marketplace, and interesting companies we’re seeing. 

I have meetings with three entrepreneurs who just want to network or who are looking for new opportunities. I’m getting together with Pete Hudson, the very talented founder of iTriage/Healthagen, with someone who was formerly a senior executive at McKesson, and with a former senior executive from HCSC. 

We also have an opportunity to meet with more than 10 innovative companies that are seeking capital. For obvious reasons, I can’t name them, but they are providing analytics for health systems and provider groups, and they are developing novel insurance exchange platforms. They are developing tools that deliver better provider quality information to consumers. They are helping health plans manage patients with certain types of high-cost chronic diseases (in one case we’re particularly excited about, a very large problem that no one has previously tried to target), and they are helping hospitals lower labor and equipment costs and are also facilitating better patient collection efforts.  

Unfortunately, the meetings during the conference are always too rushed, but there are two highlights of the week for me. The first is getting to sit down with these great entrepreneurs seeking capital and learning about their businesses. Occasionally this leads to an investment, as was the case with a digital pathology company called Aperio that we met with at the conference in 2007.  

The other highlight is getting together with the large healthcare companies and learning about where they are looking for innovation. One of the most satisfying aspects of our job is when we actually help young companies develop relationships with these large players. It’s a lot of fun to try to marry the young, nimble, aggressive (and sometimes naive) startups with the large, sophisticated, complex, highly influential (and sometimes slower-moving) titans of our industry.  

Unfortunately, there are also lots of people and companies I don’t get to meet with during the conference. People have started reaching out to schedule meetings during the conference as early as November now (for a conference that takes place in January). This leads to a lot of calls the first and third weeks of January with the people I couldn’t meet.  

So in short, it’s a hugely productive week of networking. We learn a lot. We get to help drive revenue to our portfolio companies on occasion. We reacquaint with old friends. We meet new friends who might someday work with our portfolio companies or partner with them. If we’re lucky, we find a new investment.

When the week is over, I go home feeling like the rock star that is David Beckham. I grab a drink. I crack a joke to my wife, I get ready for my Posh Spice, and then I usually fall asleep and start snoring, which often coincides with her trying to suffocate me.

Marty Felsenthal is a long-time venture capital investor who invests in and works with growing healthcare information technology and healthcare services companies and has been attending the JPMorgan Healthcare conference since the 1990s.

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January 12, 2015 Startup CEOs and Investors 1 Comment

Monday Morning Update 1/12/15

January 9, 2015 News 12 Comments

Top News

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HLM Venture Partners, which made several health IT investments in its first three funds, is raising up to $150 million to launch a fourth fund. Its portfolio companies include Nordic Consulting, Aventura, Medicalis, Phreesia, and Teladoc.

The investment challenge, it seems to me, is that in the frenzy to throw money at unproven healthcare IT startups, we’re well past the wheat and deep into the chaff. It’s good that demand for new technologies seems strong, but too many no-name companies confuse the market and many of them will fizzle out quickly. Companies that are thrown together purely to chase money usually don’t find it and there’s only so much proven management talent to go around. Incubators and accelerators are encouraging a lot of shaky startups that will experience the inevitable Darwinism. Still, a few of them will avoid enough minefields to get market traction or sell out to a bigger player.


Reader Comments

From Frustrated Surgeon and Developer: “Re: big health IT. Epic and Cerner are using strong-arm techniques to counter any move to interoperability. Congressman Dave Camp (MI) testified before Congress that he was being pressured by lobbyists paid for by Epic to remove interoperability from MU 2 ( and now 3) to secure their business position. Cerner said they weren’t interested in interoperating with my cloud-based system that several hospitals are using. APIs and licensing fees never came up — they just won’t do it. Cerner’s representative to ONC’s Jason Task Force is pushing hard to stop MU 3 interoperability requirements. We should not look to Epic and Cerner to open the doors. We need a HIE which Epic, Cerner, and all other permitted applications should use. It’s the data, not the application.” Unverified. I searched the Congressional Record for Epic-related comments by Dave Camp (who is now retired) but didn’t see anything relevant, although the search isn’t exactly Google quality.

From Jack Gutenberg: “Re: HIStalk book club. You should invite readers to read along and add their comments to yours.” I like the idea. I’m just starting Eric Topol’s “The Patient Will See You Now” in case anyone wants to start it along with me and then add their comments once I’ve posted mine. I’m not only interested in critiquing the book itself, but also discussing the interesting ideas inside. Books I’ve summarized here previously include “Connected for Health,” “Your Medical Mind,” “Safe Patients, Smart Hospitals,” and “Where Does It Hurt?

From The PACS Designer: “Re: Windows 10 browser. Rumors have been swirling for months about the next version of Windows 10 and its browser style since Internet Explorer and Bing have such a small market share compared to Firefox. The leaked browser is called Microsoft Spartan.”


HIStalk Announcements and Requests

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More than three-fourths of poll respondents agree with a popular stock expert’s characterization of the Athenahealth as a “bubble stock” that won’t be “the backbone of anything” rather than the company’s stated high-flying ambition to be the Salesforce of healthcare. New poll to your right or here since I ask every year: what are your HIMSS15 attendance plans compared to HIMSS14?  

Ready for your input: the HIStalk reader survey and HISsies nominations. Thanks for participating. I’ll also randomly draw three reader survey responses for a $50 Amazon gift certificate.

I was thinking about Uber’s surge pricing model, where the app tells you in real time that local demand is high and you’ll have to pay more. I’m frustrated when I get that message, but it makes perfect sense from a supply and demand point of view. When cars are in short supply, the higher price does two things: (a) it allows price-sensitive consumers to seek alternatives to Uber such as taking a cab or walking, increasing Uber car availability for those willing to pay more; and (b) it encourages more Uber drivers to get out on the road and start picking up fares. (obviously it does a third thing: it raises Uber’s profits, so you have to trust them to proclaim surge pricing only when they really are swamped). An Uber model would work in medicine if it were a pure science instead of an art and if people actually paid cash for their services – you could have doctors willing to provide telemedicine consults at a given time and price via an Uber-type service and let patients decide what it’s worth to them, with an app setting the intersection of supply and demand. That leaves those unable to pay out of the picture, but medicine is already heading toward a two-tier system where cash-paying patients have better options anyway.


Last Week’s Most Interesting News

  • IBM and Epic enhance their DoD EHR bid pitch by announcing that they’ve already installed an Epic model instance in a DoD-hardened environment for testing and also formed an advisory committee.
  • Walgreens adds health management, real-time health coaching, and wearables connectivity to its website and mobile app, offering users reward card points for using the tools to meet their health goals.
  • The AMA says EHRs, ICD-10, prior authorization, and Medicare fraud detection are barriers to care that it will target in 2015.
  • Sue Schade of University of Michigan Hospitals and Health Centers wins the Gall CIO of the Year award.
  • Analytics vendor Inovalon files for a $500 million IPO.
  • Allina Health and Health Catalyst announced an analytics technology and quality improvement partnership, explained by Allina President and CEO Penny Wheeler, MD in my interview.
  • Only 24 percent of respondents to my poll said their impression of HIMSS is positive.

Webinars

January 13 (Tuesday) 1:00 ET. “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” Sponsored by Versus Technology. Presenter: John Olmstead, RN, MBA, FACHE, director of surgical and emergency services, The Community Hospital, Munster, Indiana. Community Hospital was the first US hospital to treat a patient with MERS (Middle East Respiratory Syndrome). It used clinical data from its EHR and staff contact information from a real-time locating system to provide on-site CDC staff with the information they needed to contain the virus and to study how it spreads. Employees who were identified as being exposed were quickly tested, avoiding a hospital shutdown.


Acquisitions, Funding, Business, and Stock

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Francisco Partners makes an unspecified investment in Olathe, KS-based revenue cycle solutions vendor eSolutions.

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The Columbus paper profiles Lyntek Medical Technologies, whose PatientStorm Tracker software provides a weather radar-like display of an inpatient’s overall condition. It’s being beta tested by OhioHealth Riverside Methodist Hospital. Founder and pulmonologist Lawrence Lynn, DO says the outdated fire alarm model of medical monitoring systems doesn’t provide useful information until vital signs hit specific limits. He adds, “You can be in the hospital dying of sepsis with a smartphone in your pocket that can detect the pattern of a song just by listening to it, but this sophisticated-looking monitor above you can’t detect a single pattern of evolving death.”


Sales

Atlantis Health Group chooses Influence Health’s Navigate population health management solution.


People

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UMass Memorial Medical Center (MA) appoints Pam Manor, RN, MSN, DNP (St. Francis Hospital) as chief nursing informatics officer. 

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William Hersh, MD (Oregon Health & Science University) is named the winner of the 2014 HIMSS Physician IT Leadership Award.

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Streamline Health promotes David Sides, who has been with the company for five months,  to president and CEO. Sides, on the left above, replaces Bob Watson, who will leave the company to become president of NantHealth but will remain on Streamline Health’s board. NantHealth announced in November that it will use Streamline Health’s analytics product in its system.


Government and Politics

The American College of Physicians urges Congress to: (a) repeal Medicare’s SGR formula; (b) continue Medicare’s 10 percent bonus for primary care; (c) restore the Medicaid program that pays primary care physicians no less than Medicare rates; and (d) provide relief from “burdensome and unrealistic” Meaningful Use requirements and “other excessive regulatory burdens.”


Other

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An opinion piece slated for publication in Academic Medicine examines whether it’s ethical for medical students to use an organization’s EHR to track their former patients so they can match outcomes to the students’ original diagnosis and treatment. The authors conclude that the benefits outweigh the harms. I couldn’t agree more – it’s hard to believe that an intelligent argument could be made otherwise. The opportunity would only arise in teaching hospitals and I see no potential ethical or HIPAA conflicts since patients understand that their treatment has an educational component. The practice should not only be allowed, it should be mandatory, and perhaps not just for medical students. Medicine (and ancillary fields) are literature-based and that always involves aggregated, de-identified research, but what could be more educational than seeing how your care decisions impacted a particular patient’s life and whether your actions were ultimately right or wrong? The patient has to live with the impact, so  why shouldn’t the professionals who made those decisions? It would also be interesting to look at a patient’s overall perception of health and well-being (perhaps via a self-survey with results trended over time) instead of just a problem list if we’re really interested in improving their lives and not just their medical conditions. We have to leave the “treat ‘em and street ‘em” mindset behind.

The Wall Street Journal runs an essay by Eric Topol, MD titled “The Future of Medicine Is In Your Smartphone” in which he again predicts that technology will alter the patient-physician relationship, reduce costs, and empower patients. He thinks that doctors will still have a role, just not as today’s paternalistic “priestly class.” He has vested interests, however, even going beyond pitching his new book: he lists consulting engagements with Google, AT&T, Walgreens, Quanttus, and Sotera Wireless. A skeptical WSJ commenter weighs in: “I am in atrial fibrillation, now what? That is the rub. All these carnival barkers for the utopian vision of the smartphone/connected world are simply exhausting. For all its many benefits, the Internet is rife with misinformation when it comes to healthcare and the burden is now shifting to the consumer to sort out what is real and what is bogus.”

Ebola vaccine researchers face a surprising challenge: a sharp drop-off in the outbreak could make it hard to find enough victims to test new vaccines.


Sponsor Updates

  • HCI Group CMIO William Bria, MD will present at IMN’s HealthIMPACT Southeast on January 23 in Tampa.
  • Passport/Experian Health will exhibit and present at the HFMA Region 11 Healthcare Symposium January 11-14 in San Diego.
  • nVoq releases a case study on the success Teleradiology Specialists (AZ) experienced with its SayIt cloud-based speech recognition technology.
  • SCI Solutions VP of Business Development Bill Reid shares his thoughts on price transparency and how to equip patients with the right tools to understand the financial consequences of care.
  • Netsmart will participate in the New York Coalition of Behavioral Health Agencies conference on January 27.
  • Patientco outlines three healthcare finance game-changers for 2015 in a new blog.
  • MedData will participate in the ACEP Reimbursement Trends and Strategies in Emergency Medicine Conference in Las Vegas from January 13-15.
  • RazorInsights will exhibit at the Texas Hospital Association Annual Convention in Austin January 22-23.
  • PMD recaps the previous week in healthcare in a new blog post.
  • Nordic Consulting offers a new white paper, “Beaker Lab: Planning for Meaningful Use Stage 3.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

 

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January 9, 2015 News 12 Comments

News 1/9/15

January 8, 2015 News 2 Comments

Top News 

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IBM and Epic start background work on the $11 billion Department of Defense EHR project for which they are bidding even though the award won’t go out until summer, saying they need a head start to meet the DoD’s aggressive timelines. IBM has installed an Epic model system in one of its government-level security data centers so that it can test an integrated in a DoD-like environment. The companies also announce that they have formed a 17-member advisory group that includes former Kaiser Permanente CIO Bruce Turkstra and military patient advocate Major William Lyles.


Reader Comments

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From Dan Nigrin: “Re: wayfinding apps. We’ve had Meridian’s technology in place for years at Boston Children’s.” Dan is the CIO at Boston Children’s, whose MyWay app offers a nice package of services for visitors and patients. I think hospitals that offer way-finding apps assume that everybody uses them, I bet the penetration is tiny. It would be nice as a patient to be able to get turn-by-turn instructions from the parking garage to a particular hospital department or physician office. Hospitals have the most consumer-unfriendly access that I’ve seen in any industry, starting with dreary pay parking garages and inadequate spaces for their huge numbers of employees. Tip: if you’re a vendor trying to get a meeting with a mid-level hospital IT executive whose non-CIO status doesn’t come with a reserved parking spot, offer to pick them up and drop them off curbside at their location – they’ll accept since they otherwise rarely leave campus for lunch because of the trek to get their car followed by endless cruising for an open space upon returning.

From Fracker: “Re: Meditech. Terminated its distribution agreement with Riyadh, Saudi Arabia-based National Technology Group.” Unverified.

From Vegas Baby: “Re: conferences CMIOs attend. Which ones are popular other than AMDIS?” The HIMSS conference probably has more CMIOs attending than any other conference, although obviously they make up a small percentage of attendees overall. AMIA would have a higher percentage but lower number, I’m guessing. Anyone have insight?

From Malice Cooper: “Re: HIStalkapalooza. Are you taking requests? I am sure demand is high, but I would love to be part of the event.” I haven’t yet put up the “I want to come” page. I need to finalize who’s sponsoring the event to figure out how many people I can afford to invite. That will tell me when I’ll have to cut off requests, assuming that demand exceeds supply, which has happened every year since the first (tiny) event in 2008. I’ll also have a great HIStalk sponsor networking event the Sunday of HIMSS week and will send details about that shortly for those looking to swap war stories or strike deals.


HIStalk Announcements and Requests

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It’s time for my once-yearly HIStalk Reader Survey, which helps me picture who’s reading and to get your advice. I would really appreciate your participation since, as usual, I’ll plan everything I do this year based on the results. I’ll also randomly choose three respondents to win a $50 Amazon gift certificate. Thanks for taking a handful of minutes to help me out.

Early January also means its time for your HISsies nominations. Tell me the worst vendor, the smartest vendor action taken in 2014, the industry figure of the year, and the all-important “Industry figure in whose face you’d most like to throw a pie.” The final ballot will contain the most-nominated entries, so think of this as the primary election that precedes the general one by a couple of weeks.

This week on HIStalk Practice: New Hampshire pediatricians sound off on the state’s non-existent vaccine registry. HealthTap CEO brings telemedicine back down to Earth. HHS looks for vendors to run its National Data Warehouse. Healthcare gets New Jersey physicians down in the dumps. EHRs create threats to confidentiality. 23andMe sees investment revival. Thanks for reading.

This week on HIStalk Connect: The year’s biggest digital health stories are recapped, including: unprecedented VC funding levels for digital health startups; Apple, Samsung, and Google all expanding their presence in the digital health sector; 3D printing finding more uses in healthcare, DNA sequencing breaking through the long-awaited $1,000 price barrier, and IBM doubling-down on its Watson supercomputer despite a slower than expected road to profitability. During this week’s CES conference in Las Vegas, Withings unveils its newest fitness tracker, Alterica introduces a smartphone-connected EpiPen case, and Cambridge Consultants shows of breakthrough technology in sensor-laden sportswear.


Webinars

January 13 (Tuesday) 1:00 ET. “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” Sponsored by Versus Technology. Presenter: John Olmstead, RN, MBA, FACHE, director of surgical and emergency services, The Community Hospital, Munster, Indiana. Community Hospital was the first US hospital to treat a patient with MERS (Middle East Respiratory Syndrome). It used clinical data from its EHR and staff contact information from a real-time locating system to provide on-site CDC staff with the information they needed to contain the virus and to study how it spreads. Employees who were identified as being exposed were quickly tested, avoiding a hospital shutdown.


Acquisitions, Funding, Business, and Stock

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Par8o, which grandly styles itself as “Healthcare’s Operating System,” raises $10.5 million in Series A funding. The referral management software company, whose name is a play on the word “Pareto,” was co-founded by Sermo co-founders Daniel Palestrant, MD and Adam Sharp, MD. Customers include hospitals that are part of the Harvard and Mount Sinai health systems.

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Entrepreneur and author Sramana Mitra profiles for her upcoming book those “Unicorn” companies that generate their initial funding from sales rather than from financing, listing among them eClinicalWorks, which she says has $300 million in annual sales and, “If it were valued, it would easily be a multi-billion dollar company.” ECW’s Girish Kumar is among the most astute, genuine, and interesting people I’ve ever talked to.

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HCS announces record sales in 2014 with 19 percent revenue growth and the addition of 30 employees.

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McKesson shares hit a 52-week high Thursday, valuing the company at $50 billion. Above is the one-year share price of MCK (blue, up 24 percent) vs. the Dow (up 9 percent).

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A venture capital firm increases its stake in Etransmedia with an unspecified investment that will support the company’s merger with physician practice services vendor DoctorsXL.

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Chicago-based health analytics and algorithm sharing marketplace vendor Apervita, known until last week as Pervasive Health, completes an $18 million Series A funding round. It’s an interesting concept – allowing people to buy and sell health-related databases, algorithms, and measures.


Sales

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Rush University Medical Center (IL) chooses Merge Cardiology PACS. MRGE shares have jumped 71 percent in the past 90 days vs. the Nasdaq’s gain of 8 percent.

Health Information Network of Arizona selects Quality Systems subsidiary Mirth to provide patient information exchange.


People

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GetWellNetwork hires John George (StayWell) as chief growth officer.

3-28-2011 7-44-12 PM

Tom Stampiglia (Origin Healthcare Solutions) joins Surgical Information Systems as president and CEO.


Announcements and Implementations

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Walgreens adds Your Digital Health Advisor, a virtual coaching program developed by WebMD, to its website and mobile app. The app includes programs for smoking cessation, weight management, nutrition, exercise, and emotional health and also offers real-time 24×7 coaching via Walgreens Pharmacy Chat. It will connect to WebMD’s iPhone app Health Target, which lets users upload their data from connected devices to receive physician-reviewed advice and tips. Users who meet their health goals earn Walgreens Balance Reward points.

Walgreens also announces that it will use Qualcomm’s medical device connectivity for remote patient monitoring and chronic care management, initially offering integration with Walgreens blood pressure cuffs and glucose meters. A new line of Qualcomm-branded devices will be announced in the next few months. This, too, will reward members with Walgreens Balance Rewards points for their participation. Walgreens is unbelievably ahead of just about everybody in healthcare in terms of technology use, consumer connection, and industry partnerships. Their technology creates revenue instead of just expense. I tried to connect with the company to interview its CIO, but they didn’t respond to my inquiry.

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Capsule announces GA of its SmartLinx medical device information system that includes patient surveillance, clinical decision support, alarm interpretation and alerting, and asset tracking.

InterSystems HealthShare is certified as an eHealth Exchange Validated Product.

BD Medical gets FDA clearance for its Intelliport Medication Management System, which provides real-time drug identification, dose checking, and allergy detection at the point of IV bolus injection and then wirelessly documents the drug’s administration in the EHR. The system, which includes an IV access site sensor, wireless base, and table software, will reach the market in spring 2015. It will be marketed for use in perioperative areas to reduce syringe swap, dosing errors, and manual documentation requirements. This looks like a very cool product, even smarter in some ways than IV infusion pumps, and bolus dose errors cause patient problems much faster than an IV.

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O’Reilly releases a freely downloadable e-book, “Data Driven: Creating a Data Culture,” that contains interesting business examples including a cool one that studied why people who had tried Twitter stopped using it. It’s a straightforward, hype-free overview of the possibilities of using data to do good work. I ran across it by accident – I like it a lot.

A DrFirst market share analysis of EHRs used in New York finds that 80 percent of the ambulatory EHRs and 85 percent of the hospital EHRs are ready for the state’s I-STOP law that takes effect March 27, 2015. The law requires that all prescriptions be sent electronically from prescribers to pharmacies. New York pharmacies aren’t as well prepared as prescribers, however, with only 58 percent of them ready to accept electronic prescriptions for controlled drugs.

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NantHealth announces a new version of its HBox medical device that collects and transmits real-time information from blood pressure cuffs, scales, and other personal devices using technology from BlackBerry.

Skylight Healthcare announces a secure videoconferencing solution that connects hospitalized patients with up to four other people simultaneously via the company’s interactive patient engagement technology.

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Erlanger Health System (TN) becomes the first US hospital to roll out AlarmNavigator from Excel Medical Electronics, which helps users analyze alarms from GE patient monitoring systems to support customizing settings to reduce alarm fatigue.

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The Michigan Department of Community Health launches a mobile app and portal so that Medicaid patients can access their medical information remotely.


Government and Politics

The FCC proposes updating its 2010 definition that said “broadband” has a minimum speed of 4 Mbps down/1 Mbps up to instead require 25/3 Mbps. The agency says rural and Tribal lands are underserved, with the proposed definition change upping the requirements for broadband providers that requesting federal grant money to add services. Both AT&T and Verizon had already objected to a previously proposed 10/1 Mbps minimum speed requirement, saying 4 Mbps is plenty for consumers.


Innovation and Research

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The Economist corrects yet another example of attention-seeking publications that create inaccurate headlines and stories hoping for salacious clicks. It turns out that despite the recent hype, getting cancer isn’t only due to bad luck. The original research paper said that two-thirds of the variation in cancer risk is caused by chance mutations, which is not the same thing as saying that two-thirds of the chance of getting cancer is due to luck (since not every mutation causes cancer in the given tissue). The authors explain that cancer is “a combination of bad luck, bad environment, and bad inherited genes” and people control 40 percent of the risk via their lifestyle decisions about smoking, diet, sunlight exposure, exposure to papilloma virus, obesity, exercise, and alcohol intake.


Technology

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A survey finds that while fitness tracker companies desperately try to outdo each other with added features and higher prices, 85 percent of consumers have no plans to buy one.


Other

Athenahealth says its network and previous years’ data suggest that the flu season has peaked, although CDC’s just-updated report says 29 states have high flu intensity. February is usually the worst flu month.

A new survey finds that nearly two-thirds of Americans couldn’t afford to write a $1,000 check for an unplanned ED visit. More than one-third of them would dip into savings, 26 percent would have to cut back elsewhere, 16 percent would borrow the money from family or friends, and 12 percent would charge the amount to their credit card.


Sponsor Updates

  • Allscripts will integrate Perceptive Software’s enterprise content management into its EHRs, giving customers a common infrastructure for storing and sharing patient content. 
  • Medicity publishes case studies on Trinity Health’s use of Medicity HISP to transmit information and Intermountain Healthcare’s lab results notification and public health reporting via Medicity Exchange. Brian Ahier, Medicity’s director of standards and government affairs, publishes an article with Wisconsin Statewide Health Information Network COO Jean Doeringsfeld titled “FHIR and the Future of Interoperability.”
  • Teramedica-sponsored Vendor-Neutral Archive Institute of Technology offers free online courses that include CPHIMS and CPHIMA credit.
  • Direct Consulting Associates will sponsor “Becoming a Game Changer in the World of Healthcare Technology” on January 29, 2015 in Scottsdale, AZ. Texas Health Resources SVP/CIO Ed Marx will deliver the keynote address.
  • Logicworks publishes a blog on healthcare security, highlighting three reasons why hackers target healthcare clouds.
  • Liaison Technologies publishes a new blog on next-gen data integration and management by Chief Marketing Officer Manish Gupta.
  • Local papers profile Ingenious Med President and CEO S. Hart Williford’s work with startups; and COO Mike Pickering’s work with the Atlanta All Stars Talent Show Network, a non-profit community outreach program he founded in 2004.
  • Impact Advisors offers a snapshot of its latest white paper, on population health management, in a new blog.
  • Huntzinger Management Group Client Executive Rob Tashiro will speak during a CHIME webinar on January 28 covering lessons learned from big bang implementations.
  • Optum’s latest blog looks at how providers use analytics to better manage their populations and reduce costs.
  • Healthfinch sets intentions for the new year in a new blog post.
  • Healthcare Data Solutions shares insight into the Walgreens-Qualcomm partnership in a new blog post.
  • HCI Group’s SVP of Delivery Operations Robert “Bob” Steele receives his HIMSS senior member certification.
  • Hayes Management Consulting posts a new blog on the advantageous countdown to ICD-10.
  • DocuSign will host the Tech Founders Forum in San Francisco on January 13.

EPtalk by Dr. Jayne

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While I share many of Mr. H’s pet peeves with regards to grammar, my top peeve at the moment is misleading headlines. It was bad enough when it was just Yahoo and MSN, but now the sensationalism is rampant in various physician publications. Medical Economics screams “Meaningful use penalties sear more than half of EPs in 2015.” Personally, “sear” wouldn’t be the verb I would choose for a 1 percent Medicare penalty. Tintoretto’s “The Martyrdom of St. Lawrence” illustrates what it would really look like to be seared.

Massachusetts physicians will need to update their own pet peeve lists with this one. The Massachusetts Board of Registration in Medicine recently adopted a regulation that requires demonstration of Meaningful Use as a condition of licensure. It went into effect last week. Fortunately, they’ve built some flexibility into the final requirement. Beyond successful attestation as an Eligible Provider, other options include:

  • Completing continuing medical education that discusses EHRs and the MU programs objectives and quality measures.
  • Employment, contracting, or credentialing by a hospital that is participating in MU.
  • Participating in the Massachusetts Health Information Highway.

Physicians renewing their licenses prior to March 31 can receive a single-use “get out of jail free” exemption. If you’re due for renewal within 60 days of the end of March, you can take advantage of it as well by applying early, so get those checkbooks ready.

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For those of us who wear many different hats (CMIO, practicing physician, anonymous blogger) time management is a constant challenge. If you’re as compulsive as me about it, you’ll want to consider blocking time on your schedule to peruse the proposed rule for Meaningful Use Stage 3. I highly recommend slotting a weekend evening with a roaring fire and a nice bottle of wine, as that worked well for me when Stage 2 was released. Given the state of my average work week, there’s no way it’s going to happen during normal business hours.

If you’re new to the game, the proposed rule currently sits at the Office of Management and Budget. It will be published in the Federal Register once the OMB review is complete. Stage 3 is supposed to focus on using the work done in previous stages to actually drive improvements in patient outcomes. According to statements from HHS, there will also be changes in the reporting period and program structure.

They also hope to clarify the definition of Meaningful Use (given confusion about requirements from multiple stages and multiple revisions) and to make sure the program is sustainable. I don’t have a crystal ball, but I hope there’s a 90-day reporting period involved and that they give vendors at least a year after finalization of the Rule to write code and physicians a year to install and upgrade.

Earlier this year, the Health IT Policy Committee recommended that HHS incorporate fewer objectives and reduce the burden on providers. Various other constituencies have pushed for further narrowing of the requirements. I’d bet we have the NPRM in the Federal Register within the next few weeks, so get your wine selections ready.

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HIMSS is releasing more information about the conference and several new offerings including a Cybersecurity Command Center, Disaster Preparedness Knowledge Center, and the HIMSS Health IT Value Suite. Another new offering is HX360 , a joint effort of HIMSS and AVIA to look at non-EHR technology that can benefit health systems and provider organizations. I was initially drawn to it, but seeing that they’re charging an additional fee to attend the “Venture+ Forum pitch competition for early stage companies” dampened my enthusiasm. I don’t think what they’re offering is worth an additional $225 (or $795 as a standalone) of my hospital’s money.

I’m a little more enthusiastic about the “HIMSS Speakeasy” theme for the opening reception, which is usually pretty vanilla. Who’s ready to bob their hair and pack their flapper dresses and dancing shoes? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

 

Get HIStalk updates.
Contact us online.

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January 8, 2015 News 2 Comments

Morning Headlines 1/8/15

January 7, 2015 Headlines No Comments

Stage 3 proposals go to OMB, hint at changes

ONC submits a notice regarding Stage 3 MU to the Office of Management and Budget that contains the following description of the yet-to-be-published rule: “Stage 3 will also propose changes to the reporting period, timelines, and structure of the program, including providing a single definition of meaningful use. These changes will provide a flexible, yet, clearer framework to ensure future sustainability of the EHR program and reduce confusion stemming from multiple stage requirements.” 

IBM, Epic already prepping for military EHR work

In pursuit of the DoD EHR contract, IBM and Epic announce the formation of an advisory group comprised of 17 medical informatics specialists, physicians, hospital administrators, and a former US Army Special Forces Major who lost his leg in combat and who will represent the patient perspective, detailing his experience transitioning from the Army’s care to the VA health system.

Avoiding Unintended Incentives In ACO Payment Models

An analysis of ACO shared savings reimbursement levels published in Health Affairs finds that the calculation used to establish benchmark spending level focuses too heavily on spending data from the year immediately preceding the transition to an ACO. Researchers suggest that this could encourage ACOs to ramp up their spending before transitioning to an ACO model so that benchmark costs are falsely inflated, resulting more substantial year-one savings.

Qualcomm announces new connected health collaboration with Walgreens

Walgreens partners with Qualcomm to bring medical device integration to its growing ecosystem of health applications.

Open Enrollment Week 7: December 27, 2014 – January 2, 2015

HHS reports that 6.6 million consumers have used the federal insurance marketplace to enroll in an insurance plan thus far, though many were automatically re-enrolled into their existing plans. The number does not include state-run marketplace enrollments. Open Enrollment ends on February 15.

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January 7, 2015 Headlines No Comments

Startup CEOs and Investors: Brian Weiss, Carebox

Startup CEOs and investors with strong writing and teaching skills are welcome to post their ongoing stories and lessons learned. Contact me if interested.

Delivering Opening Lines
By Brian Weiss

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My name is Brian Weiss and I’m the founder of a healthcare IT startup.

I’ve got these really great ideas about how to make everyone healthier, solve healthcare data interoperability, enable payment reform, advance clinical research, leverage big data to fix the US healthcare systems, make the world a better place, and create a billion-dollar company. Oh, and did I mention it all runs in the cloud?

You’re not really buying that, are you? I don’t blame you. It’s not a very good opening line.

Opening Lines

I’ve spent much of the last few months delivering opening lines – to (potential) investors, team members, strategic partners, pilot customers, editors of healthcare IT publications with proper-capitalization fetishes …

It’s not like I’ve never delivered an opening line before I became a startup founder. In everything we all do, there’s always a first line, a first slide, an opening paragraph, a first impression, a useless abstract class at the top of the object model hierarchy (what, I’m the only former software engineer in the room?)

I’ve had to pitch ideas, sell things, present solutions, and introduce myself many hundreds of times. No, I haven’t ever written a column in a publication like HIStalk (is there even such a thing?) But I’ve delivered really bad opening lines countless times! I’m even experienced enough to know it’s not the end of the world. At various times in my past, I’ve somehow managed to get hired, promoted, selected in an RFP, invited back to a conference, and even married, despite being opening-line-challenged.

So why am I having such a hard time writing this column’s opening?

Matchmaker, Matchmaker, Make Me A Match …

Today, I’m attending a “Matchmaking Session” in New York as part of the ONC Market R&D Pilot Challenge. To help encourage innovation around some of its strategic priorities, ONC is sponsoring a contest that will select six winning pilot projects. Each pilot proposal has to be presented jointly by an innovator (an early-stage healthcare technology company) and a host (an established healthcare organization operating in a clinical environment). To help match up hosts and innovators, there are three of these matchmaking events taking place over the next few weeks.

If “matchmaking session” sounds like something from “Fiddler on the Roof,” you’re on the right track. The format here is speed dating for startups, commonly used at events that bring together startups and investors. I will have 13 minutes to woo my date(s).

They also sent me a colorful one-page tip sheet to help me prepare. It seems they think I will do a better job if I make an effort to have a clue in advance about the company I will be meeting with, make my presentation engaging, explain what I do, and say something about my team and business model. And, they suggested that I practice in advance.

I’m being a tad cynical about their tip sheet. I suppose it’s pretty good advice… for presentation beginners.

My Kindergarten Artwork

My memory from when I was five years old is probably flawed, but I think this is close to being a direct quote from my kindergarten teacher to my parents about my artwork: “Brian is trying hard and we don’t want to discourage him. The important thing is to keep at it.”

A couple of weeks ago, I was in a meeting with a senior executive at an important partner of ours. It was a preparation meeting in advance of a larger meeting she had coordinated in which I would be presenting my startup to other leaders at her company.

I showed her what I had prepared. In a very polite and cheerful way (curiously reminiscent of the disposition of my aforementioned kindergarten teacher), she told me (in not so many words) that what I had prepared for the meeting clearly showed I was trying hard and she didn’t want to discourage me, but the important thing was …

… to just say very concisely what the problem was we were trying to solve, what our solution was, why it was good for her company, why we could do a good job, and “then just show them the demo.”

I dusted off my ego, did my best to do exactly what she suggested, and I thought it went pretty well.

I’ve coached others with similar advice countless times. Why did I need to be told that now?

Introductory Presentations

Last week I had a call with the CMO of a very large healthcare organization, which I can barely allow myself to dream might one day be a partner of ours. The call lasted less than 15 minutes.

Just as I was concluding my build up to Slide 1, he said he was already on Slide 8 and asked me a couple of short questions. Then he told me it all looked pretty clear, sounded interesting, he would do some checking internally, and get back if they were interested in hearing more. He got back to me the next day about setting up a follow-up meeting to go into more detail. We’ll see where it goes.

I’ve done 10s of similar calls before that one. They run 30-60 minutes and my results generally weren’t as good. I now have a much better presentation than I had before and the obvious advice I got a few weeks ago was clearly something I needed to hear.

What’s Different/Special About That?

My column will only be worth reading if I have unique and valuable perspectives to share with you that emanate from the fact that I’m a healthcare IT startup CEO, not just some guy who has to get better at introductory presentations and opening lines.

Can I do that? I’m not really sure – and this might be a very short-lived column.

For now, I just want to share with you why (I think I’ve figures it out) I am now having experiences like the ones above that sound like something out of “my first days a junior salesman” – when I am quite certain I knew how to do an effective introductory presentation many, many years ago.

Starting Up Means Starting Over

Each step in our career generally lets us build on the previous ones. When I was EVP/SVP/pick-your-favorite-letterVP of products, my title, the company and organization I represented, the many people working for me, a ton of support infrastructure — all came through the front door with me.

But it’s even more than that.

Once you get your degree, you don’t have to pass your mid-term exams anymore. But could you if you had to? On the way to the where you are today in your career, you probably paid your dues on many rungs of the ladder. But could you go back and do a good job at each level again, now?

When you are given a new challenge today, is it really all that new? Or is it a natural evolution of what you do today that lets you relatively easily carry over your skills, expertise, experience, and credentials?

I’m no longer the exec who gives good advice to others about how to structure their presentations. I am the junior salesman getting better at making a pitch. I’m the guy at the ONC matchmaking event who needs the tip sheet. I’m the guy working on the template, the web site, the demo, the story. Everything I do starts with a blank piece of paper. I’m the guy who now needs the feedback that people who do that kind of stuff get.

The fact that I could do a good job presenting as a corporate exec doesn’t mean I can do a good job presenting in this context. The fact that I could give advice to others about the kinds of presentations I am now making doesn’t mean I don’t need to hear that advice myself from others, now.

Whatever I think I’ve learned or accomplished in my career to this point only matters if I can translate it into something concrete that helps me better do the stuff I need to do now. That’s always a true statement for all of us, but it takes on a whole new meaning when you have to do something that isn’t a natural evolution of what you did yesterday.

What Is This?

Two weeks ago, Mr. H put out a call for a "startup CEO or a venture capitalist who wants to share their keen insight and sharp writing skills with the world."His intent, I believe, is that this column provide interesting and different insights and perspectives for the many HIStalk readers who are employees in established companies and interested in getting an insider view of the world of healthcare startups.

I told him I qualified as, “A startup CEO who wants to share” and we could see about the rest.

The column I’m planning to write (exact frequency to be determined) will draw from both agendas – the healthcare IT topics we’re focusing on and the ups and downs of the stages in the growth (I hope) of a startup – with a special emphasis on where the two meet.

I’m a beginner column writer. I hope to not completely disappoint relative to Mr. H’s objectives. If you’re able to suggest topics, approaches, improvements, etc. that can help me do that – I’d be most grateful. You can write to me directly.

Brian Weiss is founder of Carebox.

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January 7, 2015 Startup CEOs and Investors 3 Comments

News 1/7/15

January 6, 2015 News 2 Comments

Top News

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The American Medical Association says EHRs, ICD-10, prior authorization, and Medicare fraud detection programs are “barriers to providing high-quality care” that it will oppose in 2015. AMA will continue its push to make the Meaningful Use program more flexible, improve EHR usability, and expand EHR interoperability. It will also “urge regulators to ease this physician burden” of the October 1 implementation of ICD-10, study the physician workload impact of prior authorization, and push CMS to overhaul its RAC-centered “bounty hunter” fraud and abuse programs.


Reader Comments

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From Hallway: “Re: smartphone wayfinding apps. I passed along information on Jibestream that you mentioned in June 2014. I agree that this type of application will offer competitive advantage, not only with patients and visitors, but for new hires, for patient transportation, and for ancillary staff that need to deliver services at the bedside, maybe even eventually to route robots delivering supplies (I can just picture R2D2s roaming the halls).”

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From Title Contender: “Re: smartphone wayfinding apps. Check out Logic Junction, whose solution works on both web and mobile with a single database that can be updated in real time.” The company lists Cleveland Clinic, LA County, Sarasota Memorial, and the VA as clients. The online demo is pretty cool and doesn’t require registration to run. If I were the company, I would white label the product and let hospitals sell ads or promote their own services to make it cost neutral.


HIStalk Announcements and Requests

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I’ve ordered Eric Topol’s “The Patient Will See You Now” and Steven Brill’s “America’s Bitter Pill,” so I’ll have book reports soon.

The latest in my long line of pet grammar peeves: starting sentences with “there.” The next-to-latest: sites that post articles with a question as the headline, indicating that the author isn’t confident enough to actually answer the question (meaning: the article is a complete waste of time). I’m curmudgeonly even in restaurants whose menus gets overly cute by offering “veggies” and “mashers.”


Webinars

January 13 (Tuesday) 1:00 ET. “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” Sponsored by Versus Technology. Presenter: John Olmstead, RN, MBA, FACHE, director of surgical and emergency services, The Community Hospital, Munster, Indiana. Community Hospital was the first US hospital to treat a patient with MERS (Middle East Respiratory Syndrome). It used clinical data from its EHR and staff contact information from a real-time locating system to provide on-site CDC staff with the information they needed to contain the virus and to study how it spreads. Employees who were identified as being exposed were quickly tested, avoiding a hospital shutdown.


Acquisitions, Funding, Business, and Stock

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Allina Health (MN) will take an equity position in Health Catalyst as part of a 10-year agreement in which the Allina will outsource its 60-employee analytics and quality improvement teams to Health Catalyst and will contribute its clinical expertise, while Health Catalyst earns a portion of its payment when Allina hits specific quality improvement targets as overseen by a governing committee. The organizations value the agreement at $100 million. I interviewed newly promoted Allina President and CEO Penny Wheeler, MD this week about the agreement and other topics.

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Lexmark acquires Toronto-based medical imaging technology vendor Claron Technology for $37 million in cash. Lexmark will position the company’s medical imaging viewing platform and zero-footprint viewer within its Perceptive Software business, which offers a vendor-neutral archive and medical content management.

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Staffing services company General Employment Enterprises acquires Jacksonville, FL-based medical scribe contractor Scribe Solutions.

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Baltimore-based hospital hiring software vendor Pegged Software, which claims to have reduced employee turnover in its customers by an average of 45 percent, raises $9.2 million to increase its sales and marketing efforts.

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Guided episode management software vendor Wellbe raises $2.42 million.

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Honeywell renames its HomMed remote patient monitoring business to Honeywell Life Care Solutions.

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The non-profit MedicAlert Foundation will reduce headcount and cut its budget “to better focus on its core mission of protecting and saving lives by serving as the global information link between members and emergency responders during medical emergencies and other times of need.” Beyond a variety of bracelet-type medical IDs, the organization offers an online health record linked to the medical ID number for an annual membership fee that starts at $19.99.


Sales 

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Saint Luke’s Health System (MO) chooses Phynd to create a single provider profile of its 15,000 referring and credentialed physicians.

Children’s Hospital of San Antonio (TX) selects Ingenious Med’s patient encounter platform.


People

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HIMSS adds four new board members who will serve three-year terms: Michael Nusbaum (MH Nusbaum & Associates); James Peake, MD (SVP, CGI Federal); Christopher Ross (CIO, Mayo Clinic); and Ferdinand Velasco, MD (CHIO, Texas Health Resources).  

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CHIME names University of Michigan Hospitals and Health Centers CIO Sue Schade as its 2014 John E. Gall, Jr. CIO of the Year.

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Rick Adam is named president and COO of analytics vendor Stanson Health. He has work for a variety of health IT vendors over the years, including Baxter, NEON, and Recondo Technology. The company’s board chair is Scott Weingarten, MD now with Cedars-Sinai after co-founding Zynx Health.

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Halfpenny Technologies hires Carl Smith (Airclic) as CFO.

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David Silberstein (Teradata) joins Leidos Health as service line director for analytics.

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The former HHS acting director of cybersecurity is sentenced to 25 years in federal prison for distribution of child pornography, including participating in discussions with another member of a private website that the two get together to fulfill their mutual fantasies of raping and murdering children. The FBI says Timothy DeFoggi used the technology expertise he gained in working for HHS to evade detection, ultimately unsuccessfully.


Announcements and Implementations

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Epic announces plans for Campus Five, a five-building expansion that will add 500,000 square feet of space, 1,600 offices, and 1,500 parking spaces, all with a children’s literature theme. The company says it needs the space because 45 percent of its employees are sharing offices. Epic’s Wizards Academy campus is already under construction and will open in about a year.

Connance adds a Claims Optimization platform to its predictive analytics solution.

The HCI Group creates a freely viewable e-book, “The Definitive EHR Go-Live Guide.”


Government and Politics

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Steven Brill, who wrote a lengthy Time magazine cover story two years ago called “Bitter Pill: Why Medical Bills Are Killing Us,” says in a new book that the Affordable Care Act won’t help control healthcare costs because Democrats struck too many industry-friendly deals to get it passed. He adds in a Washington Post interview that organizations like Cleveland Clinic should be allowed to sell their own insurance under tight regulation, such as limits on hospital profitability and CEO salaries. He thinks insurance companies are the victims of providers who overcharge, leaving those insurance companies to run a low-margin business by abusing their customers. He says about ACA-driven value-based payments:

Sure, I think there’s more focus, for example, on hospital readmission for Medicare patients, which is costly, but in the sum total of things, it’s kind of a drop in the bucket. There are little things like that, but there aren’t any big things, there’s nothing to control the price of drugs, there’s no tort reform, there’s nothing to control the profits of allegedly nonprofit hospitals. There’s nothing to deal with the profits and the secret contracts that device-makers negotiate with hospitals that buy their products.

It’s not just the lobbying influence. You combine that money with the emotional pull and fear that people have when they think about healthcare. People care more about their health than they do about healthcare policy. And then you add to that the multi-channel political power of the healthcare industry in every congressional district, because in about every congressional district, the largest employer is the local hospital. And the local hospital is again seen as a charity. You combine that kind of local power with the lobbying power, with the fear and emotion that’s attached to healthcare, and that makes for a toxic political stew.

How is that going to change? I think the only way it’s going to change relates to what the thinking was in Massachusetts when Romneycare passed. They’re very candid about this — we’ll give everybody coverage and then when people see how much it costs, there’ll be this huge political wave to say we have to reform this or we’re going bankrupt.


Technology

NPR’s “All Things Considered” covers the consumer medical devices being displayed this week at the International Consumer Electronics Show in a piece titled “Self-Tracking Gadgets That Play Doctor Abound at CES.” It mentions CellScope (a phone-powered ear camera that sends images to doctors for diagnosis) and Neurotrack (quiz-based Alzheimer’s diagnosis). The article wanders confusingly into thinking that phone apps have something to do with cyberattacks and telemedicine, so the only interesting aspect is that NPR wrote up the article in the first place.

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An interesting use of telemedicine: St. Joseph’s Regional Medical Center (NJ) connects ED victims of domestic violence with county court officers, allowing them to take out restraining orders within 45 minutes directly from the hospital. The program is being expanded to make an iPad-equipped judge available around the clock to handle night and weekend cases, which are the majority.


Other

Physicians responding to a Sermo poll name wearables-based remote patient monitoring and telemedicine as the top two expected trends of 2015.

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Surgeon and writer Atul Gawande, MD, MPH weighs in on technology in an interview with Bob Wachter, MD:

Information is our most valuable resource, yet we treat it like a byproduct. The systems we have – Epic and our other systems – are not particularly useful right now in helping us execute on these objectives. We’re having to build systems around those systems … the issues have less to do with systems than with governance … the residents feel they’re caught up in this world where everything they need to know is on the computer screen. That’s creating angst in their day-to-day life. You go up to the floor of the medical service in my hospital, and there are no doctors there. They come, they see the patients, and then they escape to this tribal room where all 15 residents hang out together, each doing his or her computer work. That means that many of the informal interactions that used to occur between the docs and the nurses, or the docs and the patients and their families, have withered away.

A veteran sues the Atlanta VA hospital that was treating him for PTSD, claiming that the single dose of antidepressant he was prescribed created a weeks-long erection that made him the laughingstock of doctors and nurses and resulted in improper treatment that left him disfigured. “One had mentioned that I should line up all the women. I haven’t had that many people who had seen it in my whole life until I went to that hospital.” His attorney (Mr. Johnson, strangely enough) cites another patient who took the same drug with the same result, to whom a jury awarded $10 million.

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Weird News Andy drives us into the new year with a story he titles, “Making a turn for the better.” Surgeons remove a turn signal lever from a 1963 Thunderbird from the arm of a man who had been in a car accident 51 years ago, unaware until now that he had a seven-inch piece of metal embedded there.


Sponsor Updates

  • Phynd publishes a blog post titled “Direct Addresses Are Yet Another Reasons Hospitals Need to Move to a Single Provider Profile (SPP) Model.”
  • ADP AdvancedMD will integrate its EHR with physician practice reporting from Iron Bridge Integration, giving customers access to pre-built connections to 57 registries in 48 states to help meet Meaningful use Stage 2 requirements.
  • Chadron Community Hospital (NE) successfully attests to Meaningful Use Stage 2 using NTT DATA’s Optimum product suite. I interviewed CIO/COO Anna Turman several months ago and it’s still among my favorites.
  • Netsmart publishes several new white papers: “In Transition: How Electronic Data Sharing Enables Improved Outcomes and Reduced Costs,” “5 Things to Consider When Selecting Your New (Next) EHR,” and “Transforming the EHR into a Knowledge Platform to Ensure Improved Health and Healthcare.”
  • Medhost describes the use by Larkin Community Hospital (FL) of its YourCareLink integration service to automate public health reporting for Meaningful Use Stage 2.
  • Amerinet will offer the interoperability and population health management solutions of Sandlot Solutions to its members.
  • A market research survey finds that VMware’s AirWatch enterprise mobility management solution is the #1 choice of decision-makers, handily beating out MobileIron.
  • Four Army National Guard locations will use AtHoc’s network-centric crisis communications system, which allows base officials to quickly send deployment orders and emergency notifications via text, phone, and desktop.
  • Besler Consulting offers a review of the FY2015 Hospital Outpatient Prospective Payment System.
  • A CareSync blog post reviews CMS’s chronic care management reimbursement program and how doctors can use the company’s CareSync CCM product.
  • Clinovations posts an article titled “Patient Access: What Does Failure Cost?”
  • CommVault announces the schedule of its “Hockey Helping Kids” fundraiser.
  • DataMotion publishes an article, “Want to ensure secure and compliant data exchange? Integrate security!”
  • Divurgent will participate in the HIMSS East Tennessee Summit on January 22, 2015 in Knoxville and the HFMA Florida Mid-Winter Conference January 26 in Miami.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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January 6, 2015 News 2 Comments

Readers Write: Leveraging Technology to Create Payer-Provider Collaboration

January 5, 2015 Readers Write No Comments

Leveraging Technology to Create Payer-Provider Collaboration
By Andrew Underhill

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Although providers and payers play a critical role in elevating US healthcare, these two entities have not traditionally worked collaboratively, especially when it comes to sharing information. Up to this point, the two groups have shied away from exchanging data, with providers holding on to patient clinical information and payers protecting patient financial information. However, the walls are slowly but surely coming down as more providers and payers begin to partner in delivering accountable care.

There are both operational and patient care benefits to smoother provider-payer information exchange. For example, when providers are given access to claims data, they are able to garner a more longitudinal perspective of the patient’s health and treatment to date. This enables more informed care decisions and also reduces the likelihood of duplicative or unnecessary tests. It also limits the reliance on patient memory and perspective, ensuring care decisions are based on facts rather than educated guesses.

On the payer side, having access to clinical data allows the organization to adjudicate claims more effectively, improving efficiency and ensuring the most appropriate care for members. Clinical data also helps payers proactively manage their members’ care rather than responding to issues after the fact.

Despite the advantages, there are some significant roadblocks to payer-provider information exchange. Although some would suggest technology shortfalls have been the primary hurdle, it is the business barriers that present the greater obstacle. Providers in particular have been hesitant to share data with payers because it includes competitive and pricing information they would prefer to keep internal. Moreover, some physicians are concerned that making this kind of data available to payers may open the physician up to criticism on how he or she treated the patient.

To reap the benefits of information exchange while still acknowledging provider and payer qualms, organizations should take a well-considered approach to any data sharing arrangements. Following are a few tips to ensure these agreements meet all parties’ goals.

  • Appoint an advocate. To truly realize provider-payer data exchange, organizations must have an advocate who will push the idea forward and raise awareness of the strategic, financial and patient care benefits.
  • Develop a strategic roadmap. The advocate should work closely with organization leadership to identify the business drivers for data exchange and craft a strategic plan to lay the cultural and operational groundwork. Basically, this plan should be a roadmap that underscores the importance of provider-payer information sharing and defines how to achieve success.
  • Establish trading partner agreements. Before actually exchanging information, providers and payers must set up trading partner agreements that define the types of data to be shared, the appropriate data-sharing standards, and how the data will be used. This should be a customized agreement that reflects the unique needs and characteristics of the institutions involved. By setting the parameters upfront, both parties can be confident any data exchange will meet their needs and not violate internal strategic goals.
  • Define an exchange framework. Once organizations have a forward path, they can search out solutions to enable seamless information sharing. Providers and payers may want to consider using health information exchanges—such as those provided by the state or a local entity—to securely share data. A commercial product that facilitates payer-provider information exchange can also be a good option.

Greater transparency will ultimately drive better healthcare, and a key to transparency is robust data exchange between providers and payers. Organizations that embrace this idea now can be on the forefront of collaborative care, improving the patient experience and driving better health outcomes.

Andrew Underhill is a chief technologist at Systems Made Simple of Syracuse, NY.

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January 5, 2015 Readers Write No Comments

Monday Morning Update 1/5/15

January 3, 2015 News 11 Comments

Top News

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Healthcare analytics vendor Inovalon Holdings (known until a 2012 name change as MedAssurant) files for a $500 million IPO. The CEO and board chair is cardiologist Keith Dunleavy, MD. The company’s technology is used by NextGen, Greenway, Allscripts, and Walgreens.  


Reader Comments

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From KimJongDeux: “Re: Athenahealth. Interesting that Jonathan was the much celebrated, drunk, foul-mouthed (and most un-funny) host of HIStalkapalooza for a few years and the article above seems to indicate the bloom is off the rose. Guess he’s not on the program this year? We seem to have a company run by force of personality. The quote, ‘Those naysayers don’t understand the company’s business model’ is the same cry as we hear from self-styled ‘artists’ when their works are panned and from CEOs who either get no push back from their yes-men staffs or who weeds out or banishes anyone who disagrees. The fact that their corporate meeting involves officially sanctioned heavy drinking games tells me all I need to know. And the fact that the CEO openly supports it as a good thing is troublesome. I agree that if the force of personality ever left, the company would fold like a house of cards. Being brash, loud, and verbally overpowering others can keep the airplane aloft only so long.” The company has a new logo and website, I’ve noticed, moving away from the squint-inducing yellow and green color scheme to a more serious-looking purple and green.

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From PM_from_Haities: “Re: Epic’s going public. It would have very little effect. The capital structure of a company (i.e. going from private to public) impacts who owns Epic, but it’s leadership would likely be unchanged. Given Judy has plenty of cash, it would make very little sense for her to add that kind of public scrutiny unless it helped in gaining government contracts. Epic would continue to deliver on its promises and continue to grow. If anything, Epic might get BETTER by being publicly traded as they would typically have a stronger marketing department.”


HIStalk Announcements and Requests

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One-fourth of respondents to my poll expressed a positive impression of HIMSS, with 38 percent each having neutral or negative feelings. New poll to your right or here, triggered by last week’s Fortune article: which set of quotes best describes Athenahealth, the positive ones by CEO Jonathan Bush or the negative ones from a skeptical hedge fund manager? Vote and then click the “Comments” link in the poll box to explain yourself.

Attendees of our webinars have asked about the possibility of receiving continuing education hours. I looked into this years ago and concluded that the only way to accomplish that would be to connect with a university already set up to award CEUs to physicians, nurses, and pharmacists. I’m open to suggestions.

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I registered for the HIMSS conference this weekend since the early full registration rate of $745 is good through January 27. My impressions:

  • The online registration is slow because it tries to upsell you on extra-cost events, but it’s efficient otherwise.
  • The registration policies document says that HIMSS doesn’t share attendee email addresses and to report any email received from an exhibitors. I assume that means that, as usual, registrants will receive a barrage of promotional snail mail (some of it invariably arriving after the conference has concluded).
  • The registration policy references a “use of photographic images” clause in the same document, but the only related item involves “recording any educational session content,” so apparently the widely ignored ban against taking exhibit hall photos has been eliminated.

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Divurgent, Elsevier, Falcon Consulting, Sunquest, and Thrasys have signed on as sponsors of HIStalkapalooza, which will be held Monday of the HIMSS conference week at the House of Blues Chicago. It’s an expensive event to put on — the facility, food, bar, and band add up to more than $175 per attendee — and the number and level of sponsors dictates the number of people I can invite (and thus the number I can’t invite) without going deep into the red. We still have a couple of weeks to add new sponsors – let me know if your company is interested in standing out among all the conference noise that week.


Last Week’s Most Interesting News

  • An report looking at six ONC-funded state HIEs finds that large health systems can be either supporters or competitors, HIEs are beginning to embrace Direct despite its poor EHR integration, and the HIEs are still searching for use cases that the market wants.
  • A Wall Street Journal report finds that a significant portion of Medicare fraud is perpetrated by the 45,000 newly registered providers each month that CMS says it doesn’t have the resources to review.
  • CSC pays $190 million to settle an SEC fraud case that includes its UK NPfIT contracts.
  • A Fortune profile contrasts Athenahealth’s high-flying public image with the skepticism of investment advisers and managers who say the company’s tiny market share and flattening performance suggests otherwise.

Webinars

January 13 (Tuesday) 1:00 ET. “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” Sponsored by Versus Technology. Presenter: John Olmstead, RN, MBA, FACHE, director of surgical and emergency services, The Community Hospital, Munster, Indiana. Community Hospital was the first US hospital to treat a patient with MERS (Middle East Respiratory Syndrome). It used clinical data from its EHR and staff contact information from a real-time locating system to provide on-site CDC staff with the information they needed to contain the virus and to study how it spreads. Employees who were identified as being exposed were quickly tested, avoiding a hospital shutdown.


People

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OB/GYN EHR vendor DigiChart promotes Rodney Hamilton, MD to president and CEO.


Announcements and Implementations

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Terrebonne General Medical Center (LA) goes live in its admissions area on RightPatient facial recognition software from Atlanta-based M2SYS Technology.


Government and Politics

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The New York Times profiles US CTO Megan Smith, with insiders concluding that while she has a big vision and the president’s ear, she’s also in a position that comes with unclear mandates, minimal budget, and responsibility for outdated technology platforms. The article points out that the newly created United States Digital Service reports to the Office of Management and Budget instead of her office.

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A class action lawsuit filed by doctors against North Carolina’s Department of Health and Human Services over software that incorrectly paid practices Medicaid rates for services provided to Medicare patients lingers on a year later. A family practice doctor says the state owes him $100,000, adding that in his pleas to DHHS, “There was a complete lack of courtesy. Those people have no humanity.” The NCTracks system was developed by CSC at a cost of $484 million, with a significant portion copied from a similar system CSC built for New York City. The US Justice Department sued CSC and New York City in October for Medicaid fraud, claiming that the $1 billion New York system didn’t correctly bill Medicaid secondarily to private insurance. Neither system was related to CSC’s $190 million settlement with the SEC last week over accounting and fraud claims involving the company’s work on the UK’s failed NPfIT project.

Oregon’s proposed 2015-2017 budget includes $3 million for a prison system EHR, which is expected to go live in early 2016.  


Privacy and Security

The US Postal Service announces that a previously reported breach of its systems that exposed the Social Security numbers of 800,000 employees also included medical information on 485,000 current and former employees as well as retirees who had filed for worker’s compensation. The most interesting aspect to me is the huge number of injury claims filed with USPS.


Technology

I mentioned last week that John Olmstead, who runs the ED and surgery departments of The Community Hospital (IN), says in an upcoming Versus webinar that he would like to see a GPS-wayfinding type technology so that hospital visitors could navigate around campus using their smartphones. Readers sent information on two companies that offer such technology:

Connexient offers a smartphone app that provides turn-by-turn navigation to visitors at Robert Wood Johnson University Hospital and will bring six more hospitals live on it in the next few months.

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Madison, WI startup Solomo Technology is using similar technology to help conference attendees locate session rooms. It offers APIs so that developers can integrate its location and content services into their own apps.

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An excellent analysis of the fitness tracker market makes great points:

  • Courts are beginning to accept fitness tracker data in cases ranging from vehicular accidents to worker’s compensation, with resulting privacy concerns.
  • Wearable device manufactures use glossy marketing to position themselves as health and wellness brands instead of step counters. “You will never find a review for Jawbone or Fitbit that says ‘works as advertised’ because no one knows what they’re advertising.”
  • Trackers have penetrated only 3 percent of the market and the washout rate is high.
  • The Scanadu medical tricorder-type device holds great promise, as does senior monitoring app Lively.
  • Companies that have bought a single brand of fitness tracker for employees haven’t seen broadly successful results because people are motivated differently.
  • Users don’t want more data, they want to have devices tell them what to do and to simplify their technology interactions rather than to add new ones.

Other

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This headline from the Rome, GA newspaper succinctly describes a lot of what’s wrong with the US economy. Taxpayer-funded organizations that don’t pay taxes themselves shouldn’t be the only hope of employment growth. At least government hiring didn’t top the list.

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The Madison newspaper profiles Nordic Consulting co-founder Mark Bakken’s transition from entrepreneur to venture capitalist. He’s putting together a $10-$20 million venture fund that will invest $300,000 to $500,000 in Madison-area companies whose technologies work with Epic. He has raised $4 million so far (including $1 million of his own money) and says several Epic-using health systems have expressed interest in investing. The article mentions that he has personally invested in eight startups (Catalyze, Forward Health Group, Wellbe, Moxe Health, 100health, Quietyme, Healthfinch, and HealthMyne) and four of those have hit $1 million in annual revenue. Bakken, who stepped down from the CEO role at Nordic last month but remains board chair, says he “won the lottery with Nordic,” which had $81 million in revenue in 2013.

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A fundraising project for the children of The Johns Hopkins Hospital senior software engineer and bike shop owner Tom Palermo that included a 1,000-participant New Year’s Day ride has raised $60,000 so far, well beyond its original goal of $10,000. Palermo, 41, was killed last weekend when he was run over while bicycling by an Episcopalian bishop with a previous drunk driving arrest who fled the scene. She has been placed on administrative leave pending possible criminal charges following her admission that she hit Palermo, who leaves behind his wife, six-year-old daughter, and four-year-old son. The bishop had previously received probation for her 2010 DUI arrest (before she was hired by the diocese) in which she was driving a car with a tire shredded to the rim, told police she had drunk alcohol and smoked marijuana, and recorded a 0.27 on a blood alcohol breath test.

Five Michigan health systems receive $25 million in value-based payouts from Blue Cross Blue Shield of Michigan, which says the hospitals and physicians are communicating better because of EHRs and HIEs. The systems will also receive $500,000 each over three years to improve their IT systems and care coordination. The chief medical officer of Henry Ford Physician Network says he gets immediate notification if his patient is is seen by any provider in the network or at an area hospital that uses Epic, but otherwise he won’t know about it until he sees the patient next, so he’s looking forward to using the money to improve HIE connectivity and to improve data capture from physician practices.

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Lenox Hill Hospital (NY), embarrassed by international press coverage of a British couple unfortunate enough to have their premature baby delivered in the US at a cost of $200,000 instead of free in England, hints that it will simply write off the bill, sticking less-publicized patients with the burden of its profitability. It really annoys me that when media outlets publicize a ridiculous hospital bill involving a feel-good patient, the hospital nobly agrees to cancel the bill as though it doesn’t really need the money. The rest of us who get equally absurd hospital bills are turned over to collections for every dime. Somehow the public never sees through this PR scam to realize that we’re all paying for it. The same hospital annoyed patients and families three years ago by restricting visitor access so that Beyonce and Jay-Z could have their baby in the manner to which they have become accustomed, with the star couple adding their own private security force to guard the VIP suite (the hospital denies rumors that the couple spent $1.3 million to upgrade their room). The CEO of North Shore-LIJ Health System, which owns the hospital, was paid $4.3 million in 2013.

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The Sioux City paper describes the interoperability situation between UnityPoint Health – St. Luke’s and Mercy Medical Center, running Epic and Cerner, respectively, and still faxing scanned chart images back and forth. The hospitals are bringing up Iowa Health Information Network with hopes of electronically exchanging at least summary records.

Tennessee doctors are diagnosing and treating people with flu by telephone or telemedicine, telling them not to come to the office for fear they’ll spread the virus to other waiting patients.

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A ProPublica investigative article exposes the billing practices of the for-profit debt collection agency run by non-profit health system Mosaic Life Care (MO), which has filed 11,000 lawsuits in five years to collect money from uninsured hospital patients and to garnish their usually low wages. The part of the story that always drives me crazy: uninsured patients are sued for the full (phony) list prices hospitals make up in order to give 90 percent discounts to insurance companies, so people are losing their homes to pay for $12 Tylenols and the ever-accruing interest charges and attorney fees. It seems reasonable that hospitals be required to charge cash-paying patients their lowest prevailing contracted prices.

A JAMA opinion piece written by informatics people from Christus Health points out the rising numbers of medical scribes, the number of companies (22) offering their services, and the creation of a scribe aptitude test and a vendor-led member association. It says that overuse of scribes to make up for EHR inefficiency can lead to compliance and clinical issues, concluding:

The answer to today’s inadequate EHRs is not scribe support. Instead, physicians should demand improved products, should educate vendors to ensure that they understand how physicians think clinically, and should clarify what is needed for an intuitive, quick, and navigable user interface. If such usual market forces are vibrant, and physicians engaged robustly, EHRs will evolve rapidly. Yet even after a decade of use, some EHRs and CPOE may not compete with the speed of a paper checklist, and may never.

The New York Times notes that a doctor whose office was raided by federal agents for writing oxycodone prescriptions for $200 in cash was caught only because neighbors complained about the traffic outside his unmarked office that was guarded by an armed bouncer. The doctor made $2.6 million in cash over two years writing narcotics prescriptions to patients who then turned the drugs over to “crew chiefs” to sell on the street. The practice created false medical records that included MRI reports and urinalysis results.

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Dr. Oz makes a lot of headlines, most of them negative. His ABC TV show, “NY Med,” takes heat when a female viewer watches her husband die in an episode filmed at New York-Presbyterian Hospital without the family’s permission. Producers blurred the man’s face in the video, but the woman recognized him and heard his last words as the cameras rolled. Her son has filed complaints with the hospital, the state’s Department of Health, and HHS’s Office for Civil Rights. The hospital and ABC claim the patient isn’t identifiable, ABC says news is protected by the First Amendment, and the hospital says the man’s privacy rights ended when he died and blames the family instead for calling attention to his identity by complaining.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 3, 2015 News 11 Comments

Morning Headlines 12/30/14

December 29, 2014 Headlines 1 Comment

Accenture wins $563M contract to continue with HealthCare.gov

Accenture signs a $563 million five-year contract extension with HHS to manage and continue developing healthcare.gov.

ICD-10 Testing Results and DMEPOS Competitive Bidding Registration Reminder

CMS reports that during its November ICD-10 open testing period more than 500 providers, suppliers, billing companies, and clearinghouses submitted test claims, resulting in a 76 percent claim acceptance rate. The test checked that claims had a valid diagnosis code, ICD-10 companion qualifier code, national provider identifier, and date of service, and returned an automated acceptance notification when all criteria were met.

Startup Health Insights Annual Report 2014: The Year Digital Health Broke Out

Startup Health reports that $6.5 billion in startup funding flowed into the digital health sector during 2014, a 125 percent increase over 2013.

The National Patient-Centered Clinical Research Network: Clinical Data Research Networks (CDRN)—Phase II

PCORI will award $87 million to establish 13 clinical data research networks and $26 million to establish 22 patient-powered research networks as part of the second phase of its PCORnet project.

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December 29, 2014 Headlines 1 Comment

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