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News 11/14/14

November 13, 2014 News 7 Comments

Top News

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


Reader Comments

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


HIStalk Announcements and Requests

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

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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


Sales

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

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

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

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

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

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

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


People

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

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

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


Announcements and Implementations

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

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

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

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

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

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

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

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


Government and Politics

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

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

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

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

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

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


Innovation and Research

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


Other

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

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

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

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

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

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

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


Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 13, 2014 News 7 Comments

Morning Headlines 11/13/14

November 12, 2014 Headlines 1 Comment

New VA chief may fire 1,000 staffers over healthcare scandal

Veterans Affairs Secretary Robert McDonald unveils a restructuring plan within the VA that he says will be the largest in the organizations history. As part of the shuffle, McDonald confirmed that 35 staffers will lose their jobs immediately as a result of the recent scheduling scandal, and that nearly 1,000 others are being pursued for “violating our values.”

Health Information Technology: An Untapped Resource to Help Keep Patients Insured

Researchers with Oregon Health and Science University publish a study in the Annals of Family Medicine that concludes that EHRs and health information exchanges are untapped resources that could be used as tools to support clinic-based efforts to help eligible patients maintain insurance coverage.

AMA backs interstate compact to streamline medical licensure

The American Medical Association calls on more states to adopt the recently finalized interstate provider licensure compact drafted by the Federation of State Medical Boards. The compact was written to help reduce barriers to telehealth programs, but only 10 states have adopted it so far.

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November 12, 2014 Headlines 1 Comment

Morning Headlines 11/12/14

November 11, 2014 Headlines 1 Comment

BULLETIN: HIPAA Privacy in Emergency Situations

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

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

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

KLAS Offers Performance Insights on HIE and EMR Interoperability

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

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

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

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November 11, 2014 Headlines 1 Comment

News 11/12/14

November 11, 2014 News 9 Comments

Top News

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


Reader Comments

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

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


HIStalk Announcements and Requests

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

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

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


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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

Sales

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

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

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

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

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


People

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

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

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Awarepoint promotes Tim Roche from CFO to CEO.

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

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

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


Announcements and Implementations

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

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

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

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

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

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


Government and Politics

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

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

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


Other

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

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

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

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

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

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

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

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

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

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 11, 2014 News 9 Comments

Morning Headlines 11/11/14

November 10, 2014 Headlines 1 Comment

CHIME, HIMSS Letter To HHS

In a just released letter sent to HHS on November 3, CHIME and HIMSS call on Secretary Sylvia Burwell to replace national coordinator Karen DeSalvo, MD quickly if her new appointment as Acting Assistant Secretary of Health is going to be permanent, citing the need for leadership that can focus on the ONC in a full time capacity.

Identification of undiagnosed diabetes and quality of diabetes care in the United States

Researchers with Oxford University were able to identify over 60,000 undiagnosed diabetic patients by developing a search algorithm to pour through a data set of 11 million electronic medical records.

AHA unveils toolkit to help hospitals hire veterans

The American Hospital Association partners with the White House Joining Forces initiative and unveils a new toolset designed to connect hospitals with medically trained soldiers now actively looking for civilian employment.

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November 10, 2014 Headlines 1 Comment

Morning Headlines 11/10/14

November 9, 2014 Headlines No Comments

Allscripts Healthcare Solutions’ CEO Paul Black on Q3 2014 Results – Earnings Call Transcript

Allscripts holds its Q3 earnings call after shedding 15 percent of its share price Thursday on disappointing earnings. CEO Paul Black and CFO Richard Poulton both acknowledged the poor performance, citing lower full system sales and hardware sales, and noted that Q3 is traditionally the slowest quarter for the HCIT industry.

Proposed EHR/Meaningful Use Regulations

The Massachusetts medical board presents its recommendations on how to implement a state law requiring physicians to demonstrate EHR proficiency as a condition of licensure prior to the law’s January 2015 effective date.

Nurse Value-Added and Patient Outcomes in Acute Care

Researchers with the University of Michigan compare data from the hospital’s EHR system and its HR system to evaluate individual nurses and the effect they had on patient outcomes. The study attributed 7.9 percent of variance in patient clinical condition to nursing skill.

Most people don’t know they have the right to view medical records online

In England, only three percent of practices have a patient portal in place despite an April 2015 federal mandate that requires all citizens be given online access to their medical records.

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November 9, 2014 Headlines No Comments

Monday Morning Update 11/10/14

November 8, 2014 News 3 Comments

Top News

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

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

HIStalk Announcements and Requests

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

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


Last Week’s Most Interesting News

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

Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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


Sales

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

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


People 

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

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Jay Deady (Awarepoint) joins Recondo Technology as CEO.


Announcements and Implementations

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

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


Government and Politics

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

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

Innovation and Research

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


Technology

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


Other

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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November 8, 2014 News 3 Comments

News 11/7/14

November 6, 2014 News 14 Comments

Top News

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


Reader Comments

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

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


HIStalk Announcements and Requests

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

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

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

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

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


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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

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

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

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

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

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


Sales

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

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

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


People

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

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

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

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


Announcements and Implementations

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

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

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


Government and Politics

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

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


Innovation and Research

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

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


Technology

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

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

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


Other

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

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

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

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

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

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

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

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

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

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


Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 6, 2014 News 14 Comments

Readers Write: A Practical Response for Ebola Relief

November 5, 2014 Readers Write 3 Comments

A Practical Response for Ebola Relief
By Paul Molingowski

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The noise surrounding the current Ebola outbreak is tremendous, with a Google search producing 385 million results. Hospitals, clinicians, NGOs, and governments around the world are scrambling to develop effective responses and put preventive measures in places.

Despite all of the attention – or perhaps because of it — there have only been four confirmed Ebola cases in the United States. Compare that to Sierra Leone, which has 3,778 confirmed cases (5,338 suspected) in a population of only 6 million people.

My point in writing this article is to help shed light on an overlooked problem that is a terrible side effect of Ebola: starvation.

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I was blessed to be able to travel to Sierra Leone early this year. It is a wonderful country. We know many men, women, and children who have been impacted by Ebola. Our group’s scheduled departure was just as the first Ebola cases were being diagnosed. Our friends in Sierra Leone with literal boots on the ground have done a tremendous job with limited resources to provide education, medical supplies, basic healthcare, and village support.

There is still a huge need for food for the suspected Ebola victims and their families who are quarantined. Normally in Sierra Leone, hospital food is supplied by the families of patients. Since the patients are isolated and often treated with fear, this sometimes means they are not fed.

When families are quarantined in their homes for 21 days, they are surrounded by armed guards and left with little food or water. Some escape to avoid starvation, spreading the disease to other villages. Also, the already fragile economy of Sierra Leone has been hurt by the epidemic, causing food prices to rise dramatically. Simply put, providing food to starving victims will help stop the spread of Ebola.

Other big needs are for medical supplies and effective transportation. Hospitals and treatment centers do not always have the resources to provide gowns and do laundry, so patients who are sick are often left dirty and naked to fend for themselves.

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I can personally attest to the poor condition of the roads in Sierra Leone. Most are dirt, which means they are severely rutted and can become almost impassable in the rainy season, making it very difficult to deliver aid. Motorcycles are a great way to get around and we are providing more.

The practical response is to donate to Ebola relief efforts.

Paul Molingowski is sales director of Skylight Healthcare Systems of San Diego, CA. He is on the board of EduNations, which builds and operates schools and digs wells in Sierra Leone.  One hundred percent of donations go directly to food, medical supplies, and motorcycles.

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November 5, 2014 Readers Write 3 Comments

News 11/5/14

November 4, 2014 News 9 Comments

Top News

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


Reader Comments

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

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

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


HIStalk Announcements and Requests

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


Webinars

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

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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

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

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

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

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


Sales

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

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


People

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

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

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

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


Announcements and Implementations

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

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

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


Government and Politics

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

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

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


Innovation and Research 

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

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

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


Technology

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

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

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


Other

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

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

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

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

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

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

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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November 4, 2014 News 9 Comments

Morning Headlines 11/4/14

November 3, 2014 Headlines No Comments

Bids are in for $11B DOD health records system

The deadline to submit a bid on the DoD’s EHR search passed Friday, with submissions from teams proposing Epic, Cerner, Allscripts, and VistA making up the competition.

Oregon’s transition to federal exchange on track

After scrapping its health insurance exchange website after a failed launch in 2013, Oregon reports that it is on track to merge with Healthcare.gov by the November 15 enrollment period.

Onward and upward: Big news at Rock Health

Health IT startup accelerator Rock Health announces that it has raised a new $250 million investment fund and that it will begin offering $250,000 in seed capital to startups accepted to its program, up from $100,000.

CDC National Health Report

The CDC releases its National Health Report which shows a one year jump in life expectancy over the past ten years, topping off at 78.7 years. The increase is attributed to lower heart disease and cancer-related deaths.

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November 3, 2014 Headlines No Comments

Morning Headlines 11/3/14

November 2, 2014 Headlines No Comments

Revisions to Payment Policies under the Physician Fee Schedule

CMS updates its 2015 Medicare Physician Fee Schedule, adding a requirement that providers use certified EHRs to support Chronic Care Management, a newly created reimbursable service.

Which electronic health record is better: A or B? Realities of comparing the effectiveness of electronic health records

A Future Medicine article discusses the feasibility of comparing EHR systems through comparative effectiveness research, concluding that there are too many variables that would need to be controlled for in the healthcare setting to be able to make an accurate comparison. The authors suggest that the best route would be comparing specific EHR features, rather than entire EHR platforms.

Epic Systems Corporation v. Tata Consultancy Services

Epic files a lawsuit against India-based Tata Consultancy Services alleging that a Tata employee logged into the Epic’s UserWeb and stole documents containing sensitive intellectual property. Epic says the company intends to use the information to improve its own medication management application.

Castlight Health Announces Third Quarter 2014 Results

Castlight Health reports Q3 earnings: revenue jumped 238 percent to $12.2 million, but despite the increase the company recorded a net loss of $20.3 million for the quarter, EPS -$0.23 vs -$1.58.

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November 2, 2014 Headlines No Comments

Monday Morning Update 11/3/14

November 1, 2014 News 7 Comments

Top News

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CMS adds a scope of service element to the final version of the Medicare Physician Fee Schedule for Calendar Year 2015 that would require providers who bill for Chronic Care Management services (a new reimbursement item) to use certified EHRs and patient-centered electronic care plans for demographics, problem list, meds, allergies, and a structured clinical summary record, using that technology to manage care transitions. The schedule also provides payment for several types of telehealth visits, including annual wellness and psychotherapy.


Reader Comments

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From BigDeal: “Re: Epic lawsuit against Tata. Filed quietly Friday evening.” Epic sues India-based Tata Consultancy Services, seeking an injunction and damages for what it alleges is misuse of Epic’s confidential information. The lawsuit claims that Tata’s people downloaded information from Epic’s UserWeb in an “elaborate campaign” that could give that company an advantage in its project to develop a competing product. Epic’s lawsuit says that a Tata employee based in Portland, OR downloaded at least 6,477 documents from an India-based IP address after claiming to be a Kaiser employee and using a KP.org email address. Epic says that it questioned the employee and he first claimed that he didn’t download anything, but when presented with the audit log, admitted that he shared his UserWeb credentials with two other Tata employees. The lawsuit says Epic won’t identify the material it claims Tata stole unless the court grants a protective order to keep it out of the public record.


HIStalk Announcements and Requests

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Ebola diagnosis is made harder by reliance on a patient’s self-reported history and a lack of hospital preparedness, poll respondents said, with only a small percentage blaming the EHR. New poll to your right or here: CommonWell Health Alliance is 20 months old – what will be its impact on interoperability? Add a thoughtful comment to impress others that you’re not just a reactionary poll-clicker.

Yes, it’s November already. The clocks have been turned back all over the US, excluding non-observers Arizona, Hawaii, and a few counties in Indiana. Stalwart hospital IT people gained an hour Sunday to make up for the sleep they lost in babysitting their systems just in case something went wrong. Thanksgiving (and thus RSNA shortly afterward) is three weeks from Thursday.

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

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Listening: new goosebump-inducing blood harmonies from Indianapolis-based Lily & Madeleine, who sing together as only sisters can. They sound eerily similar to First Aid Kit, which is a good thing.


Last Week’s Most Interesting News

  • McKesson announces that its RelayHealth unit has signed a multi-year agreement as the technology provider for CommonWell Health Alliance.
  • Google X Life Sciences says it hopes to bring a swallowed sensor to market within five years that can detect molecular-level health problems.
  • California’s attorney general issues her 2014 breach report that says healthcare lags only retail in exposing the information of individuals, largely because many provider organizations don’t encrypt mobile devices.
  • HHS, responding to negative industry reaction to a nearly complete loss of ONC leadership over the past few months, announces that Karen DeSalvo will continue to oversee ONC’s work even while reassigned as Acting Assistant Secretary for Health.
  • CCHIT announces that it has shut down effective immediately after losing its primary revenue source by exiting the certification business in January 2014.
  • The first UK hospitals go live on Epic.
  • Reuters suggests that Salesforce is about to make a major push into healthcare.

Webinars

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

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

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

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

Recordings of recent webinars are available on YouTube:

Electronic Prescribing of Controlled Substances Is Here. What Should You Do?
Data Governance – Why You Can’t Put It Off
Using BI Maturity Models to Tap the Power of Analytics
Electronic Health Record Divorce Rates on the Rise- The Four Factors that Predict Long-term Success
Meaningful Use Stage 2 Veterans Speak Out: Implementing Direct Secure Messaging for Success 


Acquisitions, Funding, Business, and Stock

A New Mountain Capital fund acquires release of information vendor HealthPort. CompuGroup bought the company’s IT solutions business for $24 million in late 2010 as HealthPort had been rumored to have been exploring both an outright sale of the company and an IPO.

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Castlight Health reports Q3 results: revenue up 238 percent, adjusted EPS –$0.18 vs –$1.58, beating analyst estimates of both. Shares dropped nearly 4 percent Friday after Thursday’s announcement. Above is the one-year CSLT share price (blue, down 69 percent) vs. the Dow (red, up 8 percent).


People

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Oncology decision support vendor COTA names Eric Schultz (Quantia) as CEO.


Announcements and Implementations

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Philips extends its Lifeline medical alert service to Lifeline GoSafe, a mobile service that uses multiple GPS location technologies to locate users who need help while away from home. A press of the button initiates two-way communication with the monitoring station via AT&T’s network. The system also automatically detects falls and places a call for help. Monthly services starts at $55. I’m a lot more interested in technology like this than wearables that monitor questionably useful body data.

Cleveland Clinic’s annual “Top 10 Medical Innovations” list includes only one healthcare IT-related item, but it came in at #1: mobile stroke units in which ambulances connect with hospital-based stroke neurologists via broadband-connected video. The list’s track record from prior years is pretty good: it previously included private sector HIEs (2009), telehealth-based CHF monitoring (2011), mobile device apps (2012), and big data analysis (2012).


Government and Politics

A report from the HHS OIG finds that Medicare keeps paying for expensive prescription drugs after the patient has died, following a CMS policy that allows prescriptions to be filled at its expense for up to 32 days after death. The report urged an immediate policy change, saying that post-death prescriptions “clearly are not medically indicated.” Some of the drugs are expensive and are feared to have been diverted to the black market. CMS says it’s fixing the problem. Perhaps there’s an ICD-10 code for normal respiration — not holding your breath.  


Technology

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Google fine tunes its Flu Trends tool to include CDC data, acknowledging research from earlier this year that showed that the accuracy of Google’s own “big data” approach was improved when combined with even bigger data.   

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Nintendo creates a health division and is working with sleep disorders product vendor ResMed to develop a “quality of life” sleep and fatigue tracker that it will sell as a subscription service. The hand-sized device will use microwave-based sensors to collect information from the bedside. It won’t be available for several months. ResMed announced its S+ product a month ago that offers “the world’s first contactless sleep sensor.” Its bedside monitor measures breathing, body movements, and room conditions, sending the information to apps that track sleep scores and recommend changes. Nintendo says the health division, which appears to include the Wii Fit and Brain Age, will be profitable in the 2015/2016 financial year.


Other

Dean Sittig and Hardeep Singh observe in a Future Medicine editorial that too many factors exist to make comparison of one EHR vs. another possible in comparative effectiveness research, proposing instead that they be evaluated by how they’re used in the field. They provide some examples, although I found them to be insufficient to picture the possibilities the authors envision. I would also see more value in using that kind of framework to assess how a given user implements their EHR of choice since in hospitals at least, the new/replacement market has consolidated into just A and B – Cerner and Epic, with some Meditech in the mix for smaller, non-academic health systems, reducing the need to compare the short list of products. My bottom line: treat EHRs as the ubiquitous medical tool or device they have become by letting providers make their own choices, but then hold them accountable for the patient outcomes that result, no different than for a patient monitor or IV pump that can’t be evaluated in a vacuum other than for safety and usability. All the certifications, rankings, and independent evaluations don’t mean a thing if a hospital implements a highly regarded system without seeing improvements in outcomes measures – otherwise, why bother? (other than to rake in more revenue) I never cease to be amazed that hospitals rarely publish their pre- and post-EHR quality metrics after spending dozens or hundreds of millions of dollars to implement systems they assured would do exactly that. The article’s examples:

  • Convert free-text entries using natural language processing instead of forcing users to choose from drop-downs.
  • Perform drug-lab interaction checks at the point of care and not just during order entry.
  • Assess the usefulness of on-screen clinical warnings by measuring how often the provider cancels the order that triggered the alert.
  • Evaluate whether implementing Meaningful Use data entry requirements improves outcomes.

Epic will pay $5.4 million to settle a class action lawsuit brought by 45 quality assurance employees who claimed they should have been paid overtime wages. Each employee will be paid for their clocked hours plus 3.7 hours per week in assumed off-the-clock time. Money left over in the fund after the employees and attorneys have been paid, if any, will be donated to Access Community Health Centers.

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Awards given at CHIME’s Fall CIO Forum:

  • Neal Patterson, chairman and CEO, Cerner — Industry Leader Award
  • Truman Medical Centers, Kansas City, MO — CHIME/AHA Transformational Leadership Award
  • Frank Fear, VP/CIO, Memorial Healthcare, Owosso, MI and Iatric Systems – Collaboration Award
  • Intermountain Healthcare and VMware – Collaboration Award

Researchers find that less than half of the dermatologists listed in the Medicare Advantage provider rosters of insurance companies are actually available. Forty-six percent of doctors were listed twice, 18 percent weren’t reachable, 9 percent were dead or retired, and 9 percent weren’t accepting new patients. The average wait for a new patient appointment was 46 days.

More on Epic’s newly built hosting data center: it was started a couple of years ago, but wasn’t announced until the recent UGM. It’s online now and being used to host client build copies. Live client hosting will start next fall. A hosted Epic option is not good news for Cerner since that’s a big differentiator for them.

A former patient registration specialist at Parkland Memorial Hospital (TX) will plead guilty to Medicare and Medicaid fraud, accused of using insurance information from the hospital’s computer system to bill the government for services he claimed to have performed for 3,000 patients in his home health business. He also bribed patients with cash, food, and gift cards to perpetuate his scam . His wife and business partner, a Baylor nurse, was accused of looking up patient information from the hospital and falsifying clinical documentation.

Interesting: the cash-strapped, currency-controlling socialist government of Venezuela implements food rationing, requiring grocery store customers to verify their ID via fingerprint biometrics to limit black market resale in neighboring countries. The government does the same at gas stations, scanning windshield bar code stickers to prevent people from filling up on $0.01 per gallon, government-subsidized gasoline and driving next door to Colombia to resell it for $4.50 per gallon. The country finished worse than the US in WHO’s ranking of healthcare systems, coming in at #54 vs. our #37 (even Cuba finished #39).


Contacts

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

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November 1, 2014 News 7 Comments

News 10/31/14

October 30, 2014 News 3 Comments

Top News

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Booz Allen Hamilton acquires Boston-based Epidemico, stating its intention to delve deeper into population health analytics and following the recent trend of consulting companies getting into the software business. The company – a 2007 spinoff of Boston Children’s Hospital, Harvard Medical School, and MIT – analyzes large population health datasets to look for problems such as disease outbreaks, drug safety problems, and supply chain vulnerabilities. The company’s HealthMap shows disease outbreaks and alerts, which surely caught the Ebola interest of suitors. One of the founders, Clark Freifeld, is a PhD candidate and was a software developer at Boston Children’s, now apparently working for MIT Media Lab.


Reader Comments

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From Capezio: “Re: CMS MU request website. Any idea why they took it down? We used it to get MU clarification until a week or two ago. A message says to use CMS’s main site instead, which has been improved but is infrequently updated and doesn’t cover emerging issues. Can you find out if this is a temporary hold or whether it’s gone for good?”

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From The PACS Designer: “Re: end of Windows Server 2003 support. Just eight months away — migration planning should already be in the works.”

From Blue Hawaiian: “Re: service management best practice. Would love to see more. Healthcare seems slow to move in that direction, just as it was for quality management best practice (aka patient safety) for so many years.” It would be fun if a CIO with expertise on this topic would write something up about what they’re doing.

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From See Sh*t: “Re: CCHIT. Funny that they’re leaving their minimal assets to the HIMSS Foundation.” My macro view is that HITECH money is losing impact and the hangers-on created to tap into it (certification bodies, HIEs, RECs, even ONC itself) are finding it tough to pay the bills as the taxpayer trough dries up. As I said in reacting to CCHIT’s bizarre January 2014 announcement that it would exit the certification business and turn into a thought-leader non-profit with unstated revenue streams, “The most recent Form 990 I could find was from 2011, at which time it was paying Chairman Karen Bell $409K, Executive Director Alisa Ray $250K,  and five other employees over $100K. It would seem to me that given CCHIT’s genesis, mission, and name, it should just go away rather than trying to morph itself into the already overcrowded thought leadership business. It probably would if HIMSS wasn’t riding in on a white horse to save it, not surprising given that HIMSS formed CCHIT (along with partners AHIMA and NAHIT) in 2004.” Consulting firms and software vendors have already moved on from MU to the next government-incented shiny object: analytics and population health management, emboldened by the continued willingness of providers to focus their entire agenda on whatever Uncle Sam is writing checks for at the moment.

From Sponsor President: “Re: your site. You mentioned our company in a post that just went out a few minutes ago at 10 at night Eastern time. I’ve received 12 emails in the past 15 minutes. You are the best marketing value in all of HIT.” I appreciate that, although all I’m doing is putting out concise, factual information that I think is relevant and readers are free to use it however they like. Their response means the company has interesting offerings. 

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From Tipper: “Re: Epic. This week, Judy Faulkner said, ‘We do not like to participate with organizations that are going to sell the data because we’ve always felt the data is confidential. That’s another thing that has always bothered us about CommonWell.’ This seems to be CommonWell’s response.” A CommonWell blog post says the notion that it would sell data is “absurd” and “especially inaccurate,” adding that it will never sell personal health data and in fact as a broker doesn’t even have access to clinical data. The post adds that CommonWell will charge fees of 0.1 percent of each member’s annual revenue above and beyond membership dues.


HIStalk Announcements and Requests

This week on HIStalk Practice: Day 1, 2, and 3 show updates from MGMA. Dr. Gregg takes healthcare IT to the land of Oz. MGMA members show no love for Medicare’s quality reporting programs. Spring Creek Family Medicine goes live on its eCW patient portal. HHS announces the four-year, $840 million “Transforming Clinical Practice Initiative” incentive grant program. Thanks for reading.

This week on HIStalk Connect: Dr. Travis covers Chicago’s newest digital health accelerator, Matter, and its first class of startups. Google unveils its newest X Labs project: a nanoparticle-filled smart pill programmed to enter the blood stream and search for early-stage cancer tumors. Fitbit releases two new activity trackers and a full blown smartwatch with a focus on health metrics. Salesforce is rumored to be optimizing its customer relationship management platform as an outreach and population health tool.

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Welcome to new HIStalk Gold Sponsor Clockwise.MD, which is also sponsoring HIStalk Practice. The Atlanta-based company’s online reservation system lets patients skip the wait – they make an appointment (online or mobile), show up on time knowing their place is reserved, and then watch the wait times and queue order in real time on an iPad (I really like that idea – nothing is worse that fuming in a crowded waiting room wondering if you’ve been forgotten). Providers users gain interesting benefits: they can fill in their less-busy schedule times, keep patients informed about wait times via automatic text messages, and target delayed patients via a real-time dashboard so that appropriate customer service actions can be taken (like furtively slipping a slowly fuming Mr. H a current-issue Popular Science magazine that will otherwise age for months in the practice’s climate-controlled magazine cellar until it’s ripened enough for the waiting room coffee table). Here’s a fun idea: when a patient cancels their appointment, the open slot is broadcast by text message and whoever jumps on it first can take that appointment. The company’s founder and CEO is Mike Burke, who founded informed consent system Dialog Medical and sold it to Standard Register in 2011. Thanks to Clockwise.MD for supporting HIStalk and HIStalk Practice.

A quick YouTube search turned up this brand new Clockwise.MD explainer video.

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My task following Dim-Sum’s amazing HIStalk webinar “DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project” (over 1,000 people have watched the YouTube recording) was to see if there’s interest in the sub-topic of military theater medicine, and if so, to enlist experts from Epic, Cerner, and Allscripts to join Dim-Sum in a follow-up webinar panel discussion. He doesn’t have a horse in the DoD’s EHR race, but is passionate about the topic as a military health advocate and veteran. Your thoughts are welcome.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Lockheed Martin will acquire privately held government health IT provider Systems Made Simple for an undisclosed sum. The company does a lot of work for the VA and had $278 million of revenue in 2013.

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From the McKesson earnings call:

  • The company’s quarterly revenue was $45 billion.
  • John Hammergren says he’s pleased with improved margins in Technology Solutions business, although revenue was down 6 percent in the quarter.
  • Hammergren says CommonWell Health Alliance is demonstrating real-world interoperability progress in adding new members, and running four successful pilots.
  • Hammergren said of the Technology Solutions business that “We’ve had the biggest challenge with in the EMR kind of space,” repeated that growth won’t return to previous levels until the transition from Horizon to Paragon is complete, and says that McKesson’s imaging business has been hurt as customers focused on buying products to meet Meaningful Use requirements.

 

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In an apparent admission that CommonWell’s work will be commercialized as he hinted in the last earnings call, Hammergren said in the McKesson earnings call that CommonWell has signed “a multiyear agreement for nationwide commercialization of the services, with the core services being provided by RelayHealth.” I don’t know if CommonWell is the altruistic, non-profit, vendor-driven interoperability project it claims to be or a way for McKesson to sell RelayHealth services through Epic-scared EHR competitors anxious to launch a pay service for interoperability. The fact that it came up in McKesson’s earnings call suggests that the company is looking forward to new RelayHealth revenue.

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BIP Capital sells its original fund’s stake in Ingenious Med to another private equity firm for a nine-fold gross return, but will continue to hold company equity in a second Fund.

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Merge Healthcare posts Q3 results: revenue down 6 percent, adjusted EPS $0.05 vs. $0.02, beating expectations for both.  

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MedAssets turns in Q3 results: revenue up 5.6 percent, adjusted EPS $0.34 vs. $0.31.

IBM and Twitter, both desperately seeking new revenue sources, announce a partnership in which IBM will analyze tweet data for “business decision-making.” I don’t have access to big data that would support my theory that this project will go nowhere – tweets are such a uncategorized, free-text mess that surely no sane business would pay IBM to sell it Twitter-powered business advice.

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MedStar Health (MD) expands its Cerner relationship with a seven-year agreement.


Sales

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North Shore-LIJ Health System (NY) chooses Explorys for Hadoop-based analytics and risk models.

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St. Luke’s University Health Network (PA) picks Nuvon for medical device integration.


People

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Member engagement software vendor Healthx names Michael Gordon (iTriage) as chief product and strategy officer.

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Voalte hires Suzanne Shifflet (ONR, Inc.) as CFO.

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Randy K. Hawkins, MD (Glytec) joins Connance as chief medical officer.

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Eric Johnson (Informatica) joins DocuSign as SVP/CIO.


Announcements and Implementations

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Allscripts introduces Sunrise Mobile Care, an iPhone/iPad app that lets nurses review and input patient information (allergies, vitals, I&O) with alerts and bi-directional updates from Sunrise. It’s curious that the vendor claiming to be the most “open” (whatever that means) supports only Apple devices.

Kaiser Permanente adds what it calls “medical selfie” capability to its patient portal, which allows patients to securely send digital pictures to their doctor for review. A copy also goes into their patient record. Patients can also send PDF files, such as scans of work-related forms that require the doctor’s signature.

RazorInsights will offer its laboratory information system customers instrument interfaces and workflow tools from Data Innovations.  

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In India, the renovated Sir HN Reliance Foundation Hospital will deploy Google Glass to its ED doctors, who will be able to review the patient’s history (including images) without looking away. SAP connected Glass to the hospital information system for two-way information exchange. According to SAP, “With the help of the Google Glass, doctors can attend to multiple patients, engage with them and see almost twice as many patients during the rounds. Doctors can take accurate notes on the Google Glass itself. The data is stored automatically and can be accessed when required.” Another hospital in India is creating a Glass-powered telemedicine application.

EClinicalWorks chooses Exostar’s ProviderPass SaaS-based identity proofing and second-factor credential authentication to meet the DEA’s e-prescribing requirements for controlled drugs. The company uses Experian-provided identity challenge questions or live webcam video.

In Canada, Nova Scotia’s Meditech hospital information system will go down next Tuesday and Wednesday for a software upgrade, with hospitals and clinics shutting down all non-emergency services, including surgeries, lab work, and diagnostic imaging.

Audacious Inquiry and Johns Hopkins Community Physicians sign a collaboration agreement to enhance the company’s encounter notification service.


Government and Politics

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Former Massachusetts “Obamacare czar” Sarah Iselin, who in February was drafted to try to save the failed Massachusetts Health Connector health insurance exchange, quits to become executive-in-residence at Optum, which was awarded a no-bid contract to fix the exchange. She says there’s no conflict of interest since she hasn’t been involved in the project for the past six months, she was hired before Optum got the business, and technically she worked for the governor rather than Health Connector.

FCW covers the odd open source pitch of PricewaterhouseCoopers and General Dynamics in bidding on the $11 billion DoD EHR contract by offering up VistA, the very mention of which probably causes Pentagon brass to make mock retching sounds given that the VA developed it. They wouldn’t even interface to it, so the odds they’ll implement it surely are near zero, especially when they want a commercial system whose single vendor is committed to supporting and enhancing it. PwC and GD obviously were late to the taxpayer-funded party and found all the available EHR dance cards filled (those bidders that chose Meditech and Siemens later pulled out of the running). If the bid were being handicapped as a Presidential election, it would be Epic (Democrat), Cerner (Republican), Allscripts (Libertarian) and VistA (Green Party).

The AMA should probably just call up Sylvia Burwell instead of issuing a daily statement about ONC, but for what it’s worth (not much), AMA says it’s happy (or at least as happy as AMA can get) that Karen DeSalvo will still lead ONC in whatever fashion HHS decides is necessary to prevent pundits from predicting ONC’s impending irrelevance. It feels like HHS panicked at the ONC-negative response to her transfer and came up with a lame “she’ll do both jobs” excuse.

The House Science Committee on Science, Space, and Technology subpoenas former US CTO Todd Park to describe the security capabilities of Healthcare.gov.

The United States sues New York City and CSC for Medicaid billing fraud, claiming that the city used the default settings of CSC’s billing system to bypass Medicaid’s secondary payor requirement and used generic ICD-9 codes that they knew Medicaid would pay more quickly. 


Technology

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The 100-researcher team of Google X Life Sciences is developing a Tricorder-like early warning disease detection system in which patient-swallowed sensors send notice of tracked nanoparticles to a wristband. The project is being run by a renowned molecular biologist who used to work for LabCorp, in partnership with MIT, Stanford, and Duke. He says that healthcare is reactive and transactional, with diagnosis – especially for cancer – coming too late once symptoms are apparent (he calls this the “wait until you feel a big lump in your chest before you go to the doctor” approach). He also suggests that the big data possibilities could be enormous as therapies can be targeted to molecular profiles. This is tied into the company’s Baseline Study, in which it is attempting to quantify the measurements that signify good health. The technology is nearly ready for human testing, a flurry of new patents will come out in the next month, and the company expects widespread usage in 5-10 years. Google will license the technology as they did for their smart contact lens. Another Google group, Calico, is attempting to extend longevity, which he explains as, “We’re helping you live long enough so Calico can make you live longer.”

A Canada-based startup receives approval to sell its on-demand DNA testing device in that country, where frontline providers in any care setting (including pharmacies) can instantly determine whether a patient should receive the anticoagulant drug Plavix based on a known genetic problem that renders it less effective. More test types will follow. The company has earned FDA approval to sell its product in the US, but only to hospitals. The device costs $9,000 and each test is $225, but the company says it will tweak the price to make it affordable.

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Microsoft announces Microsoft Health, a platform and app for collecting information from fitness wearables, planning to eventually add connectivity to share the information with providers via HealthVault. It claims its Intelligence Engine will provide insights such as fitness performance by time of day and after meals. In other words, it’s Microsoft’s answer to Apple’s Health and HealthKit with equally limited capabilities given that the information it can collect isn’t worth a whole lot except to quantified self fitness fanatics –your doctor doesn’t really have the time to monitor your step count or sleep patterns that have minimal immediate effect on the current problem list.

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I’m not excited about Microsoft Health, but Microsoft also announces its $199 Microsoft Band, which is immediately available (kudos for not pre-announcing stuff that won’t be out for months – looking at you, Apple Watch). Kudos, too, that Band works with Android and iOS devices in addition to Windows-based mobiles and includes a GPS, heart rate monitor, and a two-day battery life vs. the imaginary Apple Watch’s one-day charge. It also uses a Bluetooth phone connection to display text messages, emails, and social media updates. It looks like a winner to me, with the only real competition being Apple (its fanboys are both loyal and patient) and Android Wear. I haven’t been tempted by any fitness tracker since my Fitbit Force was recalled, but Microsoft Band seems worth a look for those willing to pay for extra capabilities beyond the usual tarted-up pedometer.


Other

A piece in Madison’s hippie weekly (as I always call those left-leaning papers that feature mostly music reviews, sex-related ads, and pathetically predictable anti-establishment rants) covers Epic without saying anything new or insightful except one thing: the company confirms that it has built a data center in Verona for client hosting. That’s a pretty big deal: Cerner has gained many small or remotely located customers (and made a lot of money) from its remote hosting services, while Epic, like Meditech that inspired it early on, has stubbornly avoided the obviously smart move of making its systems available as a service to let hospitals avoid the capital costs and personnel requirements of running it from their own data centers. That policy made sense when Epic sold only to academic medical centers with big IT budgets and big IT egos, but now that it’s moving down-market, hosted systems are likely to be a hit. I’ll follow up for more information.

The iMDsoft Metavision software bug that was characterized in a risk assessment as being potentially lethal to ICU patients in Australia turns into a political issue. Opposing political parties in Queensland debate the extent to which patients have been warned and invoke unpleasant memories of Queensland Health’s 2010 payroll system implementation, in which IBM turned a $5 million fixed-price bid into a billion-dollar project with a little help from company-friendly bureaucrats (which got the company banned from future Queensland work). It’s one of three health-related examples that come to mind when enumerating the biggest IT debacles in government IT history, along with England’s NPfIT and Healthcare.gov. Meanwhile, iMDsoft says Queensland Health is testing a fix it provided, explaining somewhat mysteriously that the problem came up during testing, perhaps tactfully declining to throw its client under the bus for their role in going live with a known problem.

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Cerner expects 11,000 participants from 26 countries at its annual conference in Kansas City, MO next week, with attendance up 20 percent over last year.

Columbiana Family Care Center (OH) closes temporarily after the computer system of its owner, Salem Regional Medical Center, goes down after an unspecified software problem.

The Chinese engineer charged with stealing proprietary MRI programming information from his former employer GE Healthcare and sending it back to China will plead guilty to stealing trade secrets, facing 10 years in prison, a $250,000 fine, and deportation.

It’s not completely health IT related, but Genentech angers hospitals by changing the way it distributes three cancer drugs – Avastin, Herceptin, and Rituxan – to six regional distribution centers rather than the usual drug wholesaler, citing the need to increase drug supply chain security. Hospitals say they won’t be able to get those meds daily as they always have so they’ll have to stockpile the expensive drugs, they’ll have to rely on overnight shipping companies in emergencies, they will lose traditional discounts, and on the data side won’t get wholesaler-provided benchmarking information and convenient 340B accounting. Similar events have happened on the consumer side, where drug companies declare an expensive item a specialty drug, meaning patients have to get their supply from mail-order pharmacies that focus on expensive drugs for chronic conditions.

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Louisiana state health officials tell doctors planning to attend a New Orleans tropical medicine conference this weekend to stay home if they have visited Liberia, Guinea, or Sierra Leone within the past 21 days. The conference, ironically, was to feature presenters talking about their work in fighting Ebola in Africa, but now those experts won’t be allowed to attend. The letter admits that even infected people don’t spread the disease if they aren’t showing symptoms, but adds that, “We see no utility in you traveling to New Orleans to simply be confined to your room.” Science and politics just don’t mix.

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California’s attorney general issues her 2014 data breach report, which finds that the number of records exposed in healthcare breaches was higher than in all other sectors except retail. The AG points out nicely that healthcare is an outlier because most of its breaches involved stolen hardware that wouldn’t have been a breach at all had their owners simply encrypted the devices. Here is my advice to healthcare CIOs: if you aren’t encrypting all laptops because you haven’t asked for the money, you should be fired. If you aren’t encrypting all laptops because administration won’t give you the money, you should quit. Either way your name is going to be up in quite embarrassing lights when someone loses a laptop (probably after violating a hospital policy in taking it home after storing PHI on the local drive) and your boss has to sheepishly admit to the local community that it wasn’t encrypted. On the bright side, that one exposure usually results in the board coming up with encryption project money, albeit after the fact.


Sponsor Updates

  • Forward Health Group will participate in the IHI National Forum on Quality Improvement in Healthcare December 7-10 in Orlando.
  • Clinovations shares Dennis Glidewell’s thoughts on areas of opportunity in the revenue cycle in Ask the Expert.
  • IHT2 announces the speakers and topics for Health IT Summit Houston December 10-11.
  • EClinicalWorks signs an additional 37 CHCs and FQHCs.
  • Washington Business Journal names GetWellNetwork to its “50 Fastest Growing Companies of 2014.”
  • CareTech Solutions will discuss hospital website security threats at the 18th Annual Greystone.Net Healthcare Internet Conference November 3-5 in Scottsdale, AZ.

EPtalk by Dr. Jayne

Cleveland Clinic announces its list of top medical innovations of 2015. Since the list was compiled by people in the patient care trenches, it’s not surprising that it was heavy on drug and treatment technologies and light on health IT.

We hear a lot about alarm fatigue, so I was interested to see this article on “decision fatigue” as showing that physicians prescribe more antibiotics later in their workdays, even when the drugs may not be appropriate. It’s a research letter that doesn’t have the same weight as some other studies, but it is interesting nevertheless. I know I get tired at the end of a full day of seeing patients and definitely don’t feel as sharp as when I start. I’d be interested to see an analysis of allergy and interaction alerts stratified by time of day and how our physicians reacted to them.

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I had the privilege of moderating a hospital community forum last Saturday morning. I posted some of the questions/comments in Twitter, but I can’t say I’m a fan of live tweeting. I was impressed by the level of patient engagement (and the knowledge) around Ebola. To be fair, there were plenty of questions about other key community health priorities, including diabetes and a couple of questions about childhood vaccinations.

Discussing a disease for which there is no vaccine in the same session as diseases for which there are vaccines that people refuse was a bit surreal. A couple of the attendees mentioned the polio scares of the 1950s and hearing the perspective of people who watched their schoolmates become ill and disabled was moving. I found this NPR piece the other day that talked about the polio vaccine trials and why they could never be done today. If nothing else, we live in interesting times.

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I finally registered for HIMSS this week. I waited too long last year and am happy to report that there are still plenty of good hotels left. Although I’m not crazy about Chicago as a site for conferences, it’s a fun town. I’m already scheming with a good friend for some potential pre-conference fun and am keeping my eye out for just the right HIStalkapalooza shoes (although this charming Louboutin handbag is a little out of my price range).

In the Breach of the Week, hundreds of medical records were lost when they blew out of the back of a truck in Omaha, NE. Apparently the medical waste disposal company didn’t secure them properly. I was impressed by volunteers that were helping pick them up, even reaching into a storm sewer to gather documents. The news report indicates they were on their way to be “stored” in Lincoln, NE which makes the fact that a waste disposal company was transporting them a bit curious.

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I’m off to CME this weekend and have blown my conference budget for the year. I wish I had saved up some cash to attend the mHealthSummit in December and particularly the Gala Reception for Disruptive Women in Healthcare. If nothing else, it would be a great opportunity to pick up swag and take pictures for my desk that would drive my boss crazy. Maybe someday I’ll make the list of Disruptive Women to Watch.

Who are your favorite disruptive women? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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October 30, 2014 News 3 Comments

Readers Write: Stuff Doctors Leave on Workstations in the Doctor’s Lounge Late at Night (And Other Times)

October 29, 2014 Readers Write No Comments

Stuff Doctors Leave on Workstations in the Doctor’s Lounge Late at Night (And Other Times)
By anotherdoctorgregg

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The image above caught my eye when I sat down at a workstation in the doctor’s lounge. I bet whoever left it there thought he or she was making a completely anonymous search, though I could see everything, including visited hyperlinks. We do try to teach our medical staff about using shared workstations, but there is a strong feeling of anonymity even as we are told there is no privacy at work.

One of our gastroenterologists is unhappy with his current employment, at least as judged by the number of versions of his CV on various workstations, complete with cover letters to other institutions. I don’t know whether he is unaware his CV and job hunt letters are on not only one, but multiple workstations, or if he is making a not-so-subtle statement about his job satisfaction to his current employers. I have also seen bankruptcy documents, child custody agreements, wrong-headed letters of complaint to Audi dealerships, and adorable pictures of kids dressed up for prom.

If you think you can’t be tracked and you are not leaving a trail of the most personal information on semi-public workstations, you are probably wrong. In 1997, a graduate student was able to identify Massachusetts Governor William Weld’s health information — even though the state medical database was supposedly de-identified — by correlating the elements of the medical database with voter registration rolls in Cambridge. Although this was probably a fluke, re-identification in a doctor’s lounge might be easier.

We do try to clean up the desktop screens of hospital workstations, mostly so it is easy to find the icons that we want to be found. In a parallel effort to raise awareness about not leaving personal (sometimes very personal) information on workstations through saved files and browser histories, I collected a little data.

The doctor’s lounges require keycard access, so the workstations in there are used almost exclusively by physicians. The information I gathered came from the histories of Internet Explorer (purged every couple of days) and other browsers (Chrome and Firefox) installed by users as non-administrators. With those disclosures, here is a sampling of what doctors look at, at work.

There were 1,052 entries over three days. The first thing to notice is the complete absence of porn. Overall, searches were at worst only mildly embarrassing, with nothing to trigger HR’s attention.

Forty-eight percent of visits were to a practice portal or billing system, 21 percent were to sports sites (cricket scores beating football scores, which either speaks to our physician demographics or penetration of the ESPN mobile app), and 13 percent were visits to medical sites (UpToDate and Medscape being the most common.) The remainder were visits to Google and foreign language and news sites that reflected our demographics.

There were a few visits to the county probate court, checking on malpractice and divorce cases (the search terms are displayed if you reopen the window from the history). One person Googled, “I have water coming into my basement right now.” I know it was a she since she discussed night call plumber’s fees at lunch the following day.

I could also identify my plumber-needing friend by her search history. Users leave sequences in their histories like <foreign language site><another site><same foreign language site>, narrowing the presumptive visitors to just the doctors who speak that language. Also, site visits bracketed by practice EMR portal visits linked the sites in between to specific individuals if you look at the call schedule. The call schedule will generally narrow down the potential users to just one.

Overall, I estimate about 40 percent of the browser history in doctor’s lounges can be associated with a specific person. This is an estimate since I only asked a few directly. The message is that even an otherwise anonymous Google search can probably be linked directly back to a hospital user, even by non-administrators, so surf accordingly.

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October 29, 2014 Readers Write No Comments

News 10/29/14

October 28, 2014 News 3 Comments

Top News

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An ONC blog post says that National Coordinator Karen DeSalvo, MD will continue to lead ONC while under reassignment as Acting Assistant Secretary of Health, saying she will continue to chair the Health IT Policy Committee and work on ONC’s Interoperability Roadmap. ONC seems to be trying to reassure observers of its leadership exodus in adding, “The team that is ONC is far more than one or two leaders. The team of ONC is personified in each and every individual – all part of a steady ship and a strong and important part of HHS’ path toward delivery system reform and overall health improvement.”


Reader Comments

From Pedro Fumar: “Re: hospital handwashing video. This kind of thing gives me a douche chill, but I’m sure it can be effective.” It’s awful but annoyingly hard to turn off, sort of like “All About That Bass,” but anything that elicits an obscure “Arrested Development” reader quote is OK with me.


HIStalk Announcements and Requests

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Jenn’s magnificent daily MGMA conference recaps on HIStalk Practice will make it feel like you’re there, especially if you actually are. I’m enjoying them.

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Welcome to new HIStalk Platinum Sponsor TransUnion Healthcare. The 46-year-old Chicago-based company offers patient-centric patient access and collections systems that create a better, more transparent financial experience and reduce bad debt. Hospital solutions include ID and address verification, eligibility, patient payment estimation, ability to pay determination, medical necessity, and charity care determination. For collections and reimbursement, the company offers insurance coverage discovery for self-pay accounts, reimbursement optimization, Medicaid re-verification, presumptive charity care, and claims statusing. Most of these services are offered through strategic partners as well. TransUnion also offers data breach services – they will get a campaign up and running within two days that provides a case manager to identify and report fraud, notify affected patients, provide customer notification templates, and optionally stand up a toll-free telephone breach hotline. TransUnion has a #1 KLAS-ranked solution, five HFMA peer-reviewed solutions, 1,000 hospital clients, 75 partners, and 500 million consumer credit histories under management. Thanks to TransUnion Healthcare for supporting HIStalk.

Listening: new from Johnny Marr, who was the other songwriter (with Morrissey) of The Smiths and guitarist for Modest Mouse. It’s not amazing and his singing isn’t great, but he gets a pass for being a semi-legend.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Optum will acquire Alere Health for $600 million, with Alere President and CEO Namal Nawana stating that the company wants to focus on the rapid diagnostics market. The Alere Health business includes clinical decision support, care management, home monitoring, and connected device technologies acquired over the years from DiagnosisOne, MedApps, and Wellogic.  

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Revenue cycle and analytics solutions vendor MediGain receives $38 million in funding from Prudential Capital Group.

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Portland, OR-based Bright.md closes a $1 million funding round to further develop its telemedicine platform. Co-founder Ray Constantini, MD was formerly a regional medical director for Providence Health & Services.

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Bellevue, WA-based corporate wellness platform vendor Limeade receives a $25 million investment from Oak HC/FT’s venture fund. That might be the best startup name ever, chosen purely because it’s memorable though irrelevant.

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IBM shares have dropped sharply in the past few weeks. Above is the one-year share price of IBM (blue, down 11 percent) vs. the Dow (red, up 7 percent). Maybe they can get Watson to develop a new corporate strategy (or maybe they already did).

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Sunquest parent Roper Industries announces Q3 results: revenue up 7 percent, adjusted EPS $1.55 vs. $1.42, missing expectations on revenue but beating on earnings. Chairman, President, and CEO Brian Jellison said in the earnings call, “We had great performance, just great performance in both Sunquest and MHA. Sunquest continues to drive execution around the Meaningful Use implementations and upgrade which is finally getting us out at some of the backlog that we had experienced last year with Sunquest. So productivity is up sharply here.”

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In New Zealand, Orion Health registers for its IPO of $119 million, valuing itself at around $792 million. However, the company declined to provide financial information in its prospectus, which the COO justified by saying that only a third of its revenue is recurring, making forecasts unreliable due to its ongoing reliance on big-dollar new sales.

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McKesson announces Q2 results: revenue up 36 percent, EPS $2.79 vs. $2.30, beating analyst expectations for both. Horizon Clinicals continued to drag down the Technology Solutions segment, whose revenue was down 6 percent.

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CCHIT has shut down effective immediately after 10 years and will donate its assets to the HIMSS Foundation.

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Cerner co-founder Cliff Illig joins Neal Patterson as the second Cerner-created billionaire as the company’s shares hit an all-time high that values it at $22 billion.


Sales

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Beaufort Memorial Hospital (SC) replaces pagers with the Imprivata Cortext communications platform.

Palmetto Primary Care Physicians (SC) selects the eClinicalWorks EHR and care coordination system for its 250 providers and 34 locations.

Priority Management Services (LA) chooses HCS Interactant for three of its long-term acute care facilities in Louisiana and Texas, which will implement the company’s revenue cycle, financial, EMR, mobile, and Insight modules.  

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Wake Forest Baptist Medical Center (NC) chooses Omnicell pharmacy, nursing, and analytics tools for medication management.

Agnesian HealthCare (WI) joins Premier, Inc. to make group purchasing, supply chain analytics, and ASCEND available across its enterprise.


People

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Experian promotes Scott Bagwell to president of Experian Health.

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Payment solutions vendor Altegra Health names Bob Drelick (Lovelace Health System) as CIO.

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Analytics vendor Clearsense hires former PeaceHealth CIO Ryan Ball as CEO.

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David Miller (University of Arkansas for Medical Sciences) joins Optimum Healthcare IT as CIO.


Announcements and Implementations

Emdeon announces retirement of the CaparioOne technology platform brand, replacing it with Emdeon One following its just-completed $115 million acquisition of revenue cycle vendor Capario. The company also added a denials management service to the system.

CareCloud launches an analytics suite for its medical practice users.

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Cambridge University Hospitals-affiliated Addenbrooke’s Hospital and The Rosie Hospital go live with Cambridge’s $355 million Epic system, stated to be the first Epic go-live in the UK.

SCI Solutions releases a new version of its Schedule Maximizer enterprise scheduling system.

Vocera launches two products — appointment reminders and delivery of 12-lead ECGs to physician smartphones — and announces new EHR integration with its Vocera Collaboration Suite.

ADP AdvancedMD launches a patient portal, financial dashboard, and mobile e-prescribing capabilities.


Government and Politics 

An AMA statement says that the mass departure of ONC officials “leaves a significant leadership gap which could jeopardize the growing momentum around interoperability,” adding its stump speech components that EHRS are “poorly performing” and that ONC should follow its recently announced framework to improve Meaningful Use.

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Perhaps self-proclaimed public health expert New Jersey Governor Chris Christie should be focusing on this instead of traveler quarantines: 98 percent of New Jersey’s hospitals have been fined for readmissions, by far the largest percentage in the US.

Meanwhile, The New Yorker runs a satirical piece called “Christie Sworn In as Doctor”:

Dr. Christie said that, beginning on Monday, he would begin a series of random “house calls” to check New Jersey residents for Ebola and assign them for quarantine. “I can usually diagnose someone with Ebola in under a minute,” Dr. Christie said. “Even faster if I don’t actually see them.” The doctor said that before moving forward with his plan to quarantine scores of New Jersey citizens he suspects of having Ebola, he consulted with other prominent epidemiologists, including Dr. Rick Perry of Texas.

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An MGMA survey of 1,000 medical practices find that around 85 percent of them think Medicare’s quality reporting programs detract from patient care and reduce physician productivity. More than three-quarters of respondents say the programs are too complicated, irrelevant to specialty care, expensive to implement, and include unachievable thresholds.


Innovation and Research

A Netherlands university graduate student designs a defibrillator-carrying drone that can be quickly dispatched in response to 911 calls. The device’s GPS allows it to land at the patient’s location, where it will initiate a live video session with emergency services to provide instructions. The student says the drone’s faster response (since it isn’t impeded by traffic) will increase the heart attack survival rate from the current 8 percent to 80 percent. He estimates that the “flying toolbox” will cost $20,000, but adds that  it will take a few years to fine-tune its object avoidance system. It’s also not legal to fly automatically directed drones in his country.


Other

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St. Bernard Parish Hospital (LA) blames Healthland’s systems for its failure to collect $3 million, with the CEO explaining, “We have two systems, a billing system and a patient system, and those two systems didn’t communicate with each other.” The hospital’s lawyers are negotiating with Healthland to get some of their money back.

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The CVS and Rite Aid pharmacy chains stop accepting the week-old Apple Pay, joining several large retailers that are developing their own mobile payment network to avoid paying Apple Pay’s 1.5 to 3 percent fees. They likely also have an unstated interest in continuing to collect data on shoppers using systems they control, possibly reacting to this Apple statement to consumers: “We are not in the business of collecting your data. So, when you go to a physical location and use Apple Pay, Apple doesn’t know what you bought, where you bought it, or how much you paid for it,” which of course is because it really can’t since it only knows who was paid and how much, not what items were purchased.

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Cerner’s Neal Patterson pays $200,000 for the prize-winning steer at the American Royal Association’s Junior Premium Livestock Auction fundraiser. No word yet on whether he pardons it like a White House Thanksgiving turkey, turns it into a freezer full of beef, or sends it to Judy Faulkner to live out its days grazing on Epic’s farm.

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CHIME’s Leslie Krigstein tweeted out this picture of conference attendees volunteering at the San Antonio Food Bank.

Queensland, Australia’s health minister releases a report stating that iMDsoft’s Metavision ICU software, installed at nine of its hospitals, creates a 60 to 90 percent chance of contributing to a patient’s death in the next 30 days. The report, citing several near misses, says that “monitoring of patient records by pharmacists has revealed several potentially serious prescription errors specifically caused by the system.” Queensland Health is manually overriding the system and reviewing charts daily for problems while waiting on a vendor fix.

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Jenn picked up this fascinating tidbit on HIStalk Practice: University of Texas Southwestern Medical Center is using Tabasco sauce in its Ebola precautions training for employees. Mock Ebola patients are anointed with hot sauce to simulate their bodily fluids, and if the skin of doctors and nurses burns as they remove their protective apparel, they know immediately that they’ve done something wrong. I use a similar technique to validate my hand-washing after chopping jalapenos for salsa, usually receiving a painful reminder of my sub-par technique conveniently close to the bathroom sink.

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Weird News Andy likes the idea of an announced iPhone-powered cancer detection device, adding his intrigue that the company is also release 3D-printable versions of the sample trays it requires. It’s interesting, but surely will never see the light of day in the US unless a bigger company with money to spend on FDA-required studies buys it.


Sponsor Updates

  • T-System client Dosher Memorial Hospital (NC) completes its pilot of a new version of EV that includes ICD-10 capabilities.
  • Medhost is showcasing its emergency care solution at ACEP14 this week in San Antonio.
  • Hamilton General Hospital (TX) meets Meaningful Use Stage 2 requirements using Medhost solutions to pull Q2 2014 data.
  • Health City Cayman Islands is featured in a documentary “From the Heart: Healthcare Transformation from India to the Cayman Islands.” Appearing is Dale Sanders, former CIO of Cayman Islands Health Services Authority, now SVP of Health Catalyst.
  • BJC HealthCare (IL/MO) is live on ZeOmega’s population health management solution Jiva.
  • Consulting Magazine recognizes Paula Elliott (Impact Advisors) and Nicola Johnson (Deloitte Consulting) in its “8th Annual Women Leaders in Consulting Awards” list.
  • ZirMed announces its User Group Conference and Partner Forum theme November 10-12 will be “Shatter Expectations.”
  • Craneware will co-present with NorthBay Healthcare at the 2014 HFMA MAP Event in Las Vegas on November 3.
  • Levi, Ray & Shoup will participate in the 2014 SAP TechEd && d-Code event in Berlin, Germany November 11-13.
  • Sutter Health (CA) describes how Validic helped get patient/client steps, heartbeat, and sleep patterns into Epic.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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October 28, 2014 News 3 Comments

Readers Write: Navigating EHR Disillusionment: Strategies for Maximizing Value

October 27, 2014 Readers Write 1 Comment

Navigating EHR Disillusionment: Strategies for Maximizing Value
By Joel French

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EHRs are a necessary but small component of what provider networks require to financially prosper in competitive markets being rapidly transformed by narrow networks, contracting reimbursement rates, and risk-bearing payment arrangements. As digitization proliferates, acute and ambulatory providers have become more vocal with EHR criticisms, including a lack of interoperability, workflow disruptions, and adverse impact to physician productivity. Many physicians now view themselves as data entry clerks.

Research from the American College of Physicians, Deloitte, and Physician’s Foundation finds that physicians have mixed opinions on EHRs, with significant downside sentiment. In the Deloitte study, 75 percent of physicians say EHRs are not cost-effective and do not save time.

One might assert the US health industry is suffering from Gartner’s Trough of Disillusionment regarding EHRs, defined as the period when “interest wanes as experiments and implementations fail to deliver.” This disillusionment exists because individual and organization expectations of EHRs exceed what they were actually designed to do. History abounds with examples of beliefs that were widely (if not universally) viewed as true, only to be later disproved by practical experience or fuller knowledge.

The point of view that integrated EHRs should be central to a health systems’ competitive strategy is one common view that is easily disproved by examining this assertion under the lens of basic business logic. By definition, a competitive advantage gives an organization an edge over its rivals and an ability to generate greater value (value is generally expressed in terms of market share growth, profitability, or enterprise value). The more sustainable the competitive advantage, the more difficult it is for competitors to neutralize the advantage.

As it relates to EHRs, once most or all hospitals in a geographic market have implemented such a tool, that tool itself ceases to be a competitive advantage. It should be better understood as a fundamental business input or asset, not materially dissimilar to facilities, medical equipment, or business licenses. Table stakes, as some might say.

Executives who have invested in EHRs hoping to derive investment returns above their cost of capital must first come to grips with the following truth: EHRs were designed to solve specific problems within the confines of a health system, but nearly all incremental revenue and contribution margin opportunities originate outside health systems in care communities. Trying to retrofit or adapt EHRs designed for use inside the walls of an enterprise for use outside the walls and across a community is fraught with risk and tantamount to believing the world is flat.

In 1837, Hans Christian Andersen wrote a fairy tale, now widely known, called “The Emperor’s New Clothes.” The metaphorical point applies to any situation wherein the overwhelming majority of observers willingly share in a collective ignorance of an obvious fact, despite individually recognizing the absurdity. The notion that implementing the same EHR as your competitors or peer group would somehow provide a sustainable competitive market advantage is completely devoid of classical business logic any first semester college freshman understands.

Today, an increasing cackle of honest voices are murmuring that the Emperor is naked. Those voices will only get louder as more organizations experience bond rating downgrades or executive removals attributable to expensive and unsuccessful EHR experiences.

To be sure, EHRs are necessary and are typically superior to the analog predecessors they replaced. They can be effective tools for clinical documentation, intelligent alerting, retrieval of patient data, and order entry/results return within the setting for which they were intended – the hospital or the clinic. Their deficiencies are exposed when care teams need to coordinate across not just physical settings, but differing organizational boundaries.

The migration to value-based care is accelerating, requiring fundamentally news ways of working to increase revenue while simultaneously keeping populations healthy. Nearly all at-risk payment models – such as episodic bundling, avoidable readmission penalties, Medicare Shared Savings, and ACOs – require better orchestration of care transitions across organizational boundaries. Successful health systems in the new health economy must therefore utilize technologies to integrate electronically and economically with scores of market trading partners, many of whom will have heterogeneous technologies and fragmented corporate ownership.

To grow, health systems must exploit all their channels – not just employed physicians, but also independent providers and other stakeholders – in order to access new referral sources, effectively coordinate care for patients with chronic conditions, and reduce unit costs. There are key EHR deficits critical to health system business objectives. These will require supplementary tools to bridge functionality gaps.

With average revenue from inpatient admission volumes down 4.9 percent in 2013, health systems need a technology strategy to support outpatient revenue growth. Health systems will live or die based on their ability to find technology solutions beyond the EHR, enabling them to uncover the economic value of independent providers in their communities by delivering differentiated value to those practices.

Introducing a network layer that smartly aligns the hospital’s capacity with the community’s demand for services is not only possible, but necessary. Today’s cloud-based tools for functions such as referrals, scheduling, and analytics can create attractive investment returns against EHR cost centers that some have come to view as permanent sink holes.

These tools extend the life of EHRs and introduce accretion by supplying what they lack – the ability to quickly grow outpatient volume, curtail network revenue leakage, and lift contribution margins. Integrating these tools with EHRs adds new value to the EHR, potentially creating the investment returns originally hoped for at the time of purchase.

The industry is still a long way from experiencing Gartner’s Plateau of Productivity with EHRs, but progressive health system executives are realizing limitations of EHRs and are increasingly turning to complementary cloud technology solutions that complement them and unlock value. Health systems that survive and thrive will be those that innovate to meet industry demand, which at this point requires thinking beyond EHRs. 

Joel French is CEO of SCI Solutions of Campbell, CA.

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October 27, 2014 Readers Write 1 Comment

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