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News 5/6/15

May 5, 2015 News 3 Comments

Top News

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Cognizant reports Q1 results: revenue up 20 percent, EPS $0.62 vs. $0.57, beating expectations for both and boosting the stock to a record high Monday. The company’s healthcare unit, which includes its November 2014 TriZetto acquisition for which it paid $2.7 billion, increased revenue by 43 percent year over year. CTSH shares are up 32 percent in the past year. Cognizant says it has added 500 consultants and 300 developers to the former TriZetto business and was selected for $200 million worth of synergy deals, which it says proves its expectations of $1.5 billion in post-acquisition revenue synergies. TriZetto had closed 2014 at $729 million in revenue with single-digit growth rates before the acquisition. Cognizant CEO Frank D’Souza added that while the TriZetto integration continues, the company would consider another acquisition of similar size.


Reader Comments

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From Compadre: “Re: Athenahealth. Its core offering is data entry, not software. They have thousands of people scanning, typing, and following up on claims. The actual software is just a Web front end that drives little profit margin. Let’s do some math. One MD internist collects $25K per month. Athena charges 7 percent ($1,750) to perform billing services, allowing it to book annual revenue of $1,750 x 12 months so the top line revenue looks like it’s growing. However, the cost is $1,500, leaving $250 per month for busy work. That’s not cloud computing. The street has caught on to this and it’s starting to show in investor sentiment. Finance rule 101: not all revenue is created equal.” A Forbes analysis says Athenahealth, like Allscripts, is facing low and declining ambulatory EHR margins compared to Cerner and says ATHN struggles with “evaporating profits, competitive struggles, and fading tailwinds” even as its share price climbs, making it ripe for implosion.

From BestBets33: “Re: Dr. Jayne’s report on her friend’s hospitalization. I often wonder why discharge planning and education is so disorganized. They do these things every single day, yet everywhere I’ve been it is such a cluster. Think about confused patients and nurses chasing things that should have been taken care of with a short checklist.” It is ridiculous that award-bragging hospitals can’t drive their policies and technologies down to frontline staff, meaning patients are at the mercy of whatever the individual nurse or doctor decides to do given their other priorities. Any other high-volume, high-revenue business would collapse from the lack of standardization and consistency – can you imagine shopping at a Walmart or eating at a McDonald’s that is run like a hospital? I suggested to Dr. Jayne that she ask her friend to request a copy of her medical record to see how closely it matches reality, not to mention finding out the cost and time required to get it. The hospital has a $200 million EHR, but from Dr. Jayne’s account, they’re using it poorly. Here’s my theory: hospital executives all over the country have fooled themselves into thinking they offer great care because they’ve walled themselves off from reality. They don’t eat their own dog food — when they themselves are forced into the patient role, they either go elsewhere due to privacy concerns or they get the swanky suite treatment far away from the huddled masses who pay their huge salaries. I would bet that every one of us who has been hospitalized was appalled at the inefficiency, clinical errors, and lack of consistent humanity. We ought to be embarrassed as an industry at what we’ve let ourselves become while pretending otherwise, but on the other hand, just acknowledging the opportunity for improvement is the first step.

From Picky Eater: “Re: Jeremy Bikman’s comments about KLAS. One report I saw recently costs $16,000 and it surveyed only a few dozen people. That’s not sustainable, especially considering that its methods are not statistically valid.” KLAS’s business model is brilliant – by ranking vendors, it creates a profitable maelstrom as the higher-ranked ones pay it fees to brag on their accomplishment (no matter what its statistical validity) and the lower-ranked ones pay the company for whatever insight it can offer to help them move up the food chain. I contributed to KLAS as a provider almost from the day they opened and my summary is that I rarely quibble at their best- and worst-ranked vendors – it’s the ones in between that are always duking it out. It was most useful when I was looking at a product I knew nothing about because otherwise the reports only validated what I already knew. I wasn’t as interested in the rankings or even the scores as much as I wanted to read customer comments, but even then you can’t put too much stock in them since you don’t know either the organization or the background of the commenter.

From Sam: “Re: Ed Marx. I like reading his submissions because he seems like a CIO with a philosophy. I’m curious if he resigned to work for a new organization and which one it might be.” I’ve heard indirectly that he has a new job, but I’ll leave it up to him to announce it when he’s ready.


HIStalk Announcements and Requests

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This is Ms. Sheppard’s Texas third-grade class using the drawing tablet, response buzzers, and iPad projector adapter bought with our DonorsChoose donation. She says the students now want to do all of their work using the response system since they enjoy competing. Maybe the buzzers should be used at some of the HIMSS snoozer sessions, or perhaps at executive meetings after being wired to provide an electrical shock to the presenter if the majority of attendees are bored.

I also got a fun thank-you card from a high school student who is happy with the algebra calculators we purchased for the class. It reads, “You’re my hero. You’re like the Superman of my math class today. For years now my brain has had one thought … I hate math. But now it is a lot easier for me to do basic and hard math because of the technology you have donated. I still don’t like math, but it’s not the worst thing in the world.” It apparently isn’t, because the student ended with a PS that included a complicated math problem and the challenge, “See if you can solve this.” It’s great seeing the benefit of donations firsthand, knowing that the impact wasn’t diluted by middlemen salaries and wasteful corporate overhead (which is why I would never donate to a hospital).

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Meanwhile, Epic has generously donated $4,500 towards our classroom projects, so I’ll be funding quite a few new ones this week. I have to look at our total donated, but I think it’s $20,500, and that funds a lot of important activities. Thanks to Epic for helping a bunch of kids  – I will make it a point to look for Wisconsin teachers in need.

Listening: reader-recommended Tame Impala, a one-man band from Australia that sounds like Sergeant Pepper-era John Lennon jamming with the children of Pink Floyd at the home of Tears for Fears.

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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Webinars

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making.


Acquisitions, Funding, Business, and Stock

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Imprivata announces Q1 results: revenue up 32 percent, EPS –$0.28 vs. –$2.29, beating expectations for both.


Sales

Visiting Nurse Service of New York chooses Cureatr for secure messaging and care coordination.

CareMore Medical Group of Nevada signs up for the chronic care management program of Allscripts.

Grady Health System (GA) selects Strata Decision’s StrataJazz Continuous Cost Improvement.


People

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Penny Wheeler, MD, president and CEO of Allina Health, joins the board of Health Catalyst, replacing Larry Grandia.

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Kathleen Brenk (Trust Company of America) joins Recondo Technology as chief human resources officer.

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Former HHS Innovation Fellow Zac Jiwa joins healthcare API vendor MI7 as CEO. He had been an advisor to the company.


Announcements and Implementations

Raintree Systems will offer its customers patient billing solutions from PatientPay.

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Telehealth service vendor American Well releases a telehealth app for providers who want to see non-urgent patients via high definition video visits and Apple HealthKit connectivity. It also allows patients to choose a particular doctor or to take first-available and for doctors to invite their patients to a telehealth visit.

IBM, Epic, and Mayo Clinic will collaborate in using IBM’s Watson to analyze EHR information.

CompuGroup Medical announces CGM Analytics, a data aggregation and analytics solution.


Government and Politics

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Rep. Ted Poe (R-TX) introduces a bill that would prohibit HHS from implementing ICD-10. He’s been a hater from the beginning (mostly of anything Democrats favor), but his previous legislative attempts to stop ICD-10 haven’t gained traction and probably won’t this time either since he doesn’t have much Congressional clout. At least he’s apparently given up on his repeated attempts to prove that President Obama isn’t a US citizen.


Other

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Beth Israel Deaconess Hospital – Plymouth (MA) declares “Email Free Fridays,” urging employees to stop emailing each other for a least one day per week, get out from behind their desks, do real work, and communicate with co-workers face to face.

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Atul Gawande says in a New Yorker article that performing unnecessary tests and procedures is expensive and risky to patients, but it’s hard hit the sweet spot between doing too little and doing too much, especially in an environment that pays doctors for unnecessary care and penalizes them (via satisfaction scores and lawsuits) for lapsing into inadequate care territory. My interest is something he doesn’t emphasize much – what voice does the patient have in those decisions? We always assume patients want their doctors and hospitals to be aggressive with their procedures and prescriptions, but I suspect doctors aren’t always good at explaining the long-term benefit or recommending only those treatments that they themselves would choose.

A three-hospital study finds that while physicians often blame demanding patients for running up healthcare costs, less than 9 percent of oncology patients ask for specific tests or treatments, nearly all of those are clinically appropriate, and physicians very rarely comply with the inappropriate ones.

An MIT Technology Review article says Apple will recommend genetic testing to certain iPhone users, arrange for the tests to be run by academic partners, and then allow people to share their results with each other or with researchers via ResearchKit. UCSF and Mount Sinai Hospital are planning studies that will involve DNA collection.

The family of deceased Ebola patient Thomas Duncan says the donation of $125,000 by Texas Health Resources as part of its settlement with the family is “not nearly enough,” expressing shock that THR didn’t provide the $5 million the family asked for to build a hospital in Liberia.

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Legacy Health System (OR) goes to an emergency operations plan when an apparent power surge takes its systems down for 12 hours.

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A New York Times article covers the rise of air ambulance services that are raising their rates dramatically and pressing harder for patient payment even as insurance companies reduce coverage. A glut of medical helicopters has caused usage to drop and an industry trade group is trying to convince the federal government to increase their Medicare payments, warning that “it’s about access to healthcare.” Billion-dollar operator Air Methods, which operates 450 helicopters and airplanes in 300 locations, charges an average of $40,000 per flight. It’s another of those healthcare things that sounds like a fairly good idea to doctors and patients until everybody finally realizes what it costs.

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Weird News Andy offers a thumbs-up on the just-published “The Thrilling Adventures of Lovelace and Babbage: The (Mostly) True Story of the First Computer,” which he describes as “fun, smart, and very entertaining / informative.” It’s a mix of fact and fiction for “the whimsical intelligentsia,” a group to which we all surely aspire to belong.


Sponsor Updates

  • Extension Healthcare wins the Health Tech Award from Indiana’s TechPoint.
  • A team from Nordic will ride in the Madison Tour de Cure benefit for the American Diabetes Association on May 16.
  • PatientSafe Solutions CEO Joe Condurso is interviewed by The Wall Street Journal about health app development.
  • Ingenious Med is named as one of Atlanta’s 100 fastest-growing companies.
  • Medecision asks, “Who is Responsible for Patient Engagement?”
  • Cumberland Consulting Group Managing Partner Jeff Lee is featured in a PharmaVoice article on technology.
  • Culbert Healthcare Solutions offers “3 Strategies for Retaining and Attracting Top-Notch Physicians.”
  • Capsule Tech offers “Are your medical devices configured to reduce alarm fatigue?”
  • ADP AdvancedMD offers “Spring Cleaning for ICD-10” tips.
  • TransUnion Healthcare President Gerry McCarthy is quoted in an article that addresses uncompensated care.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 5, 2015 News 3 Comments

Monday Morning Update 5/4/15

May 3, 2015 News 3 Comments

Top News

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Henry Chao, the CMS CIO and deputy director who led the rollout of Healthcare.gov, has retired. He was little noticed until a September 2014 House report on the site’s failure, which quoted emails from former HHS CTO Bryan Sivak that characterized Chao as being in way over his head to the point that HHS plotted to hijack the project to try to salvage it. Chao reported to CMS CIO Tony Trenkle, who hightailed it for an IBM federal IT executive job just a handful of weeks after the site went down in flames (of taxpayer money).


Reader Comments

From Not So Lucky: “Re: McKesson EIS division. Big layoffs Friday.” Unverified.


HIStalk Announcements and Requests

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Around 17 percent of poll respondents think that HIT vendors intentionally stack the executive deck against women and unstated minorities, but most of them feel that companies have simply chosen the best people for the job and possibly only need ongoing reminders of the desirability of diversity. Some readers commented that perhaps companies can’t even see the benefit of executive diversity because they’ve never practiced it, while others commented that the “mommy track” may present a more attractive option for women who aren’t very interested in the never-ending hours, travel, and relocation required to move up the executive ladder. Cerner Europe GM Emil Peters referenced the poll on Twitter, saying, “Personally I think it’s a travesty. And I’m going to do what I can to fix it. However, I don’t think it’s by design.” New poll to your right or here: within the past two years, have you had to pay a medically related bill that created at least a modest degree of personal financial hardship?

Here another poll that interests me since I see a lot of people playing around with media in ways I don’t quite get: which would be the most attractive way to catch up on a weekly health IT news summary? I personally have never listened to a podcast and don’t anticipate a time that I ever will, so the results will help me figure out if I’m in the Bell curve hinterlands.

Check HIStalk Practice for the Population Health Management Weekly Roundup.

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I bought Regina Holliday’s brand new book “The Writing on the Wall” from Amazon and became so engrossed that I read it nearly straight through this weekend. My expectations are modest for healthcare IT-related books given some fairly lame ones, but this one is among the most moving things I’ve ever read, more of a story about love and family, overcoming adversity, and standing up for what’s right than the usual preachy, recycled facts about technology coming from someone who thinks of patients as people and/or customers different from themselves (the big secret: we’re all frightened, marginalized patients at one time or another). If your blood runs above room temperature, I predict you’ll laugh, cry, and get fighting mad at the very system you work within as you read about her life and the untimely death of her husband, but you’ll also find it uplifting and empowering. It would be a great read even without the IT connection. I’ll most likely write a full review shortly since to do less would be a disservice to people who either want or need to peruse it, but here are some excerpts that got me as I learned that Regina’s art is not limited to the visual variety:

We come into this world screaming and owning nothing. We grow and change. The years pass by and we fill with life experience as our homes fill with possessions. Time rolls on and on, but for all of us there is an end. Some will meet their end on highways and some in hospitals, but for most of us the end is the same. We are patients in the end. We pluck at cloth hospital gowns, left with only a few possessions: our watches, rings, and wallets … Hospitals can deconstruct a person as assuredly as I could lay bare a jewelry box. Take any professional adult and remove their clothes and their accessories. Dress them in a threadbare gown that is faded by thousands of wash cycles. Give them a number rather than a name. Confuse them with jargon while applying copious amounts of medication. Then watch them try to navigate the maze of care … I felt like a bright blue inconsequential bird in my Easter dress as I fluttered among the forests of polo shirts, hoodies, and business suits. Conference attendees in the world of medicine have a uniform look. You were welcomed if you wore a suit, tolerated if you wore a hoodie, and ostracized in a church dress. I was not wearing the correct uniform, but I took a deep breath and introduced myself. I would say, “Hello, my name is Regina Holliday. I want to paint about healthcare to improve health policy for patients.” I’d then say that I was inspired to paint by my late husband who very recently died of kidney cancer. I would give them my slip of paper masquerading as a business card. Then tell them to reach out to me via social media or email. Then I’d share the horrific things we had experienced during my husband’s 11-week hospitalization at five different facilities. I would see them step back from me with a brief condolence. A nervous half-laugh would often escape their lips. I was a widow fresh from the graveside asking questions that affect the lives of us all. I was not supposed to be there. They were having a ball and I was death walking among them.

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I’ll have more DonorsChoose project updates later, but here’s a photo from Ms. Classen’s intervention algebra class using the calculators we provided. She says, “What we’re able to do now with these calculators is amazing. Many more students are going to get the practice they need to graduate high school and learn to solve difficult problems thanks to you all.” 

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Here’s a photo of Mrs. Rowe’s third graders using the six iPad Minis we bought them for math study.

I was thinking about how hospital patient rooms often resemble hotel rooms in being littered with previously popular but now-useless technology components, which in the hotel’s case often includes iPod docking stations and dial-up ports that get used rarely and never, respectively.


Last Week’s Most Interesting News

  • CMS releases a gigantic Medicare Part D prescribing database for 2013 that includes details on $103 billion of drug spending.
  • Teladoc announces IPO plans and files an antitrust lawsuit against the medical board of its home state of Texas for requiring prescribers to see a patient at least once in person before issuing a prescription.
  • Anthem books $865 million in Q1 profit, up 25 percent despite its massive data breach during the quarter.
  • Imprivata acquires palm vein scanning biometric vendor HT Systems.
  • The chair and ranking member of the Senate’s HELP committee follow through on HHS Secretary Sylvia Burwell’s request for help identifying pressing but easily solved EHR-related issues.
  • A Brookings Institution report questions why patients are charged significant and inconsistent prices to receive copies of their own electronic medical records from providers.
  • CareCloud announces $15 million in additional funding and a new CEO.
  • Validic receives another $12.5 million in funding.
  • Vanderbilt University Medical Center announces that it will replace McKesson Horizon, some of which was developed internally by Vanderbilt, with either Cerner or Epic.

Webinars

None scheduled soon. Contact Lorre for information about webinar services.


Acquisitions, Funding, Business, and Stock

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Startup MORE Health receives $3 million in Series A funding for its multi-language EHR that connects doctors and patients in China with US specialists.

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From the Athenahealth earnings call, which followed Friday’s expectations-beating earnings report that for some reason triggered a 7.4 percent share price drop:

  • The company added 2,300 providers in the quarter, raising its total to 64,000.
  • The RazorInsights team has been moved into the Atlanta office and the company has made RazorInsights sales, cross-sold AthenaOne to a RazorInsights client, and sold both products to a new client.
  • Jonathan Bush says the urgent and convenient care market is the most important to him because it’s growing fast and is managing “worried well” lives.
  • Bush says of big, non-academic health systems buying Athenahealth, “These guys have done their homework, gotten out their protractors and done the math on the arc of their flight, and they see it not clearing the tree tops. Not clearing the tree tops due to lack of profit is a great way to make you for-profit … They know that they can’t put the kind of obscene amounts of capital against or manage internal IT systems in the way that the fancy pants universities can afford to do and they’re slowly coming around to us and it’s exciting.”
  • The company says it won’t talk about individual hospitals or sales of RazorInsights, but “When we look at our growth, first of all, we’re starting with a very new company with a small base, so it’s relatively easier to grow a lot on the small base. We don’t intend to talk specifically about the number of individual Razor deals or that sort of thing. We really bought RazorInsights as a strategic asset along with WebOMR to build out our full inpatient solution over time.” Bush added that RazorInsights got its clients to Meaningful Use but “the billing needs a lot of work, like a lot” and says by year-end Athenahealth will offer a full-service revenue cycle program to RazorInsights users.
  • In justifying the $40 million paid for RazorInsights, Bush says Athenahealth got the best deal it could since the VCs who owned the company were either going to re-fund it or step out, so he sees it as an “acqui-hire” play in buying a product, a founding team, and brave early customers, adding that he’d like to do more of that.
  • Bush responded to an analyst who asked how bookings revenue drove operating income improvement, “If you’ve been following us for a while, you’re following a caterpillar, right? There’s sometimes where the nose of the caterpillar doesn’t appear to be moving at all, but back in the ass, it’s building up potential energy which will turn into a great nose stretch. ”
  • Bush said of ICD-10, “Never has a Bush felt so longing for more federal mandates as I have felt since the dying down of Meaningful Use and ICD-10 and PQR and ABC and do-re-mi. It is so easy when some fearful group of federal apparatchik are going to come for your prospect if they don’t buy. We are currently in a period where there are no apparatchiks coming … if ICD-10 tightens up and actually looks real later in the year it will help our close rate. I will feel sheepish about it because it seems a silly reason to make a free market move. But it’s true that right now our close rates are lower and that the specific reason we can attributed to it is no urgent federal mandate to buy.”
  • Bush said that Athenahealth’s connection to CommonWell is in beta and that he’s OK with making EHRs interoperable via other methods because “otherwise we’re all going to be on some federally mandated ridiculous EHR.” He adds, “CommonWell could have been perceived as sort of a PR smite against Epic, which I assure you I would never want … I want to be anything that Epic’s in as well, even if we have to double pay. This is not the solution for interoperability by any stretch. This is just a service so that a patient can get their freaking chart and have the same patient match to all the different systems that their chart is in. So I don’t think you guys should think of CommonWell as some sort of silver bullet that fixes everything … I don’t think it’s a solution to the real challenge, which is the B2B interoperability … that’s kind of the new frontier that we’re doing most of our work on.”

Sales

Erlanger Health System (TN) chooses Epic in what the local paper says is a $100 million deal.

CoverMyMeds will use state-specific electronic prior authorization requirements information from Point-of-Care Partners.


People

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Valence Health hires Michael McMillan (Cleveland Clinic) as SVP of strategic solutions.


Announcements and Implementations

CVS says in its earnings call that its Epic rollout is on schedule and will be completed by mid-year.


Government and Politics

A Washington Post review finds that nearly half of the 17 health insurance exchanges created as alternatives to Healthcare.gov are struggling with high technology and call center costs along with less-than-expected enrollment numbers. They’re considering raising fees charged to insurance companies, sharing costs with other states, asking for state money, or shutting down and using Healthcare.gov instead.


Technology

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Consumer personal health record vendor LMG 3 Marketing and Development Corp. sues Apple, claiming that its Health and HealthKit apps violate its patents for technologies that it claims to have licensed to retailers such as Target. I found the original 2012 patent, which is a vague and seemingly unrelated description of a personal health record on a thumb drive. The primary inventor is Mike Lubell of Raleigh, NC, who developed MyPMR in 2000 while creating an EMR/PM business unit  for Canon Business Solutions. LMG 3 apparently still offers MyPMR for $34.95.


Other

Former National Coordinator David Brailer, MD, PhD says in a Wall Street Journal opinion piece titled “They’re Your Vital Signs, Not Your Medical Records” that Congress should ensure that individuals have unqualified ownership of their health information and be given legal control over who sees it. He adds that patients should be allowed to designate an “infomediary” who can manage their information on their behalf. He warns that EHR vendors and providers block interoperability to gain a competitive edge and because “whoever controls health information will dominate the healthcare marketplace and its vast profit pool.”

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Intermountain Healthcare CHIO Sameer Badlani, MD lists his favorite apps for reference guides (DynaMed, UpToDate, ACP Smart Medicine); drug reference (Epocrates, Lexicomp, and one listed as Medimex that I assume is supposed to be Micromedex); clinical calculators (MediMath, MDCalc, and one I haven’t heard of, OxCalc); and antibiotic guides (Johns Hopkins Antibiotics Guide, Sanford Guide).

UnitedHealthcare will offer 24×7 video-based virtual physician visits to members enrolled in self-funded employer health plans, expanding availability to employer-sponsored and individual plan participants in 2016. It’s working with Doctor On Demand, Optum’s NowClinic, and American Well, with access through its Health4Me app. 

A Phoenix TV station profiles the local neurosurgeon who in 2008 developed The Medical Memory, which provides doctors with video recording equipment for recording patient encounters and posting them securely online for reference and sharing. I checked out the video link from the site showing his overview, but was kind of turned off that he got rather curt with whoever was running his slides (he’s a neurosurgeon, after all). It’s fascinating to me that on at least half a dozen occasions recently, I’ve had email or telephone conversations with healthcare IT people who came across as rude and clueless, leading me to question: could they possibly be that unlikeable in real life, or do they just come across poorly online without realizing it?

I’ll go out on a limb with this story: a Florida man sues a hospital for discarding his amputated leg in the trash, which he discovered when homicide detectives knocked on his door to inquire about what it was doing there.


Sponsor Updates

  • The SSI Group will exhibit at the Louisiana HFMA meeting May 3-5 in Lafayette.
  • Streamline Health will host the 2015 NEXT Summit Client Conference May 3-5 in Atlantic Beach, FL.
  • VitalWare shares “Five More Facts about ICD-10.”
  • Versus Technology recaps its HIMSS15 presentation on “Transforming Process Improvement through RTLS Data.”
  • Huron Consulting Group will sponsor the 2015 Cristo Rey Viva Event on May 7 to support the students of Cristo Rey Jesuit High School in Chicago.
  • Verisk Health offers“How Dollars Flow to Fight Medicaid Fraud.”
  • Sunquest Information Systems will exhibit at the Pathology Informatics Summit May 5-8 in Pittsburgh.
  • T-System President and CEO Roger Davis weighs in on EHR interoperability.
  • Team Hackasaurus Rex wins TransUnion’s first Hackathon, held at California Polytechnic State University.
  • Truven Health Analytics will host its Advantage Conference May 4-7 in Boca Raton, FL.
  • Valence Health will exhibit at Becker’s Review and Annual Meeting May 7-9 in Chicago.
  • ZirMed CEO Tom Butts shares his thoughts on IT trends and challenges, hospital CFOs on preventing claim denials before they happen, and ICD-10.
  • MedData exhibits at the MGMA Anesthesia Administration Assembly through May 1 in Chicago.
  • MediQuant President Tony Paparella is interviewed as part of the #TalkHITwithCTG podcast series.
  • Navicure exhibits at Centricity Live through May 2 in Orlando.
  • New York eHealth Collaborative will exhibit at the Crain’s Health Care Summit May 5 in New York City.
  • Nordic Consulting releases the fifth episode of its “Making the Cut” video series on Epic conversion planning.
  • NTT Data offers “It’s Beginning to Look a Lot Like Christmas … Thoughts on the Apple Watch.”
  • Oneview Healthcare will exhibit at Digital Health Live 2015 May 5-7 in Dubai, UAE.
  • Orion Health, Patientco, and PDS reflect on their HIMSS15 experiences.
  • PMD offers “There’s More to Health Than Being Happy: What a Patient Satisfaction Score Really Means.”
  • Qpid Health will exhibit at the Medical Informatics World Conference May 5 in Boston.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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May 3, 2015 News 3 Comments

News 5/1/15

April 30, 2015 News No Comments

Top News

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CMS releases a Medicare Part D prescription database for 2013 that includes details down to the individual prescriber for $103 billion in drug costs.


Reader Comments

From Ortho Doc: “Re: Meaningful Use. The ‘we can’t tell what the numbers mean yet’ for MU2 rear their ugly head in an Advisory Board report. Only 38,472 EPs have attested for MU2 to date. My guess is that only about half actually did Stage 2 as there was the Stage 1 reprieve. Even so, only 18 percent have successfully attested, which is a complete failure of MU. Someone ask CMS and ONC the tough questions, please. Now what are they going to do?” I’ve lost what little interest I had in MU – it’s a distraction to the real work that needs to be done, it encouraged providers to impulsively buy the same old EHRs they wouldn’t spend their own money on, and it put the federal government’s fingers in what should be private business practices and the patient-physician relationship. I’m actually encouraged that providers are bailing out since maybe they will refocus on what’s important.

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From Dan: “Re: DonorsChoose. We’ve noticed the recent activity on HIStalk and would like to participate. Your effort is very well aligned with our philanthropy and community involvement objectives, especially around STEM (science, technology, engineering, and mathematics). It’s great that you’ve topped $10,000 towards the effort and we’d love to make a $5,000 contribution. We’d also like to keep the contribution confidential – I’m simply reaching out on behalf of others who feel strongly about this topic and have worked to approve the funding.” I never disclose sources, but I’m making an exception this time because Cerner’s generous donation should be acknowledged (I warned Dan that I would probably name the company). I also suggested an interview with one of Cerner’s female engineers who mentors local girls about technical careers, so that’s coming soon. Thanks to Cerner, I’ll be funding another $5,000 worth of DonorsChoose projects with an emphasis on those related to STEM, which is vital to our global future as we fall behind countries that emphasize those subjects more than we do. Kudos to Cerner for stepping up with no expectation of recognition. 

Speaking of the DonorsChoose project, donating $500 for some time with Centura SVP/CIO Dana Moore is Holland Square Group, which provides contract help to Centura.  

From Ockham: “Re: Judy Faulkner. A rare panel appearance at the World Medical Innovation Forum put on by Partners HealthCare. I attended Day 1 and I was very impressed with the speakers. I also found it fascinating that even though the conference was on neurology, every panel and speaker ended up talking about genomics and how it is going to transform medicine. Unfortunately, I couldn’t be there for Judy. Epic clinicals and everything go live at Brigham and Women’s in 30 days. Boston should feel like a home town to Judy with almost all but BIDMC soon to be live on Epic.”

From Soul Survivor: “Re: Medfusion. 20 percent payroll downsize.” Unverified.


HIStalk Announcements and Requests

This week on HIStalk Connect: Teladoc files IPO paperwork, and simultaneously sues the Texas Medical Board for antitrust violations. Scanadu raises a $35 million Series B to fund clinical trials of its Tricorder-like Scanadu Scout. Validic reports strong Q1 results and raises a $12.5 million Series B that will be used to ramp up operations and meet growing demand for its personal health data interface engine. White coat hackers demonstrate a number of security vulnerabilities found in tele-operated surgical robots.

This week on HIStalk Practice: CareWell Urgent Care goes with Athenahealth. PatientlySpeaking integrates with Aprima. Iora Health CEO details the delight of developing a homegrown EHR for primary care. IOM rebrands. ICD-10 study shows physicians have their heads stuck in the sand. North Florida Women’s Care goes with Keona Health. Telemedicine price wars escalate. Tattooed community up in arms over Apple Watch’s heart rate sensor sensitivity. Sherpaa bypasses "old school" video for more effective text message consults. Thanks for reading.


Webinars

None scheduled soon. Contact Lorre for information about webinar services.


Acquisitions, Funding, Business, and Stock

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Dallas-based video doctor consultation vendor Teladoc will file an IPO. The company also files an antitrust lawsuit against the Texas medical board for passing a new rule that requires doctors to meet a patient face to face before prescribing medication.

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MedAssets announces Q1 results: revenue up 9.9 percent, adjusted EPS $0.31 vs. $0.32, beating expectations for both. Chairman and CEO Halsey Wise said in the earnings call that he’s not happy with the company’s financial performance and announces plans for a “data-centric future” as customers ask the company to offer more services than just group purchasing as health system emphasis partially shifts from inpatient to ambulatory where MedAssets has minimal presence. The company plans to combine its supply chain and revenue cycle data with insights from its Sg2 analytics group (acquired in August 2014 for $142 million) to provide customers with deeper analytics. Above is the one-year share price chart of MDAS (blue, down 3.8 percent) vs. the Nasdaq (red, up 20.7 percent).

Care, quality, and compliance software vendor MedHOK acquires Continuum Performance Systems, which offers Medicare process management software.

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Anthem shakes off its January 2015-reported data breach in booking Q1 profits of $865 million, up nearly 25 percent from a year ago, mostly due to increased Medicaid plan membership.

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Athenahealth reports Q1 results: revenue up 27 percent, adjusted EPS $0.24 vs. $0.12, beating estimates for both. ATHN shares are up 20 percent in the past year.

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Imprivata acquires HT Systems, which offers the PatientSecure biometric identification system, for $19.1 million in cash plus performance incentives worth up to $6.9 million. The company’s palm vein scanning patient ID system is used in 324 hospitals.


Sales

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Community Health System (IN) chooses Allscripts dbMotion for its clinically integrated network.


Announcements and Implementations

Surescripts expands its CompletEPA prescription electronic prior authorization coverage to nearly 100 percent of US patients by partnering with PDR.

Boston Scientific will integrate analytics software from TogetherMD into its cardiovascular products.

IBM, Apple, and Japan Post Group will deliver iPads to up to 5 million senior citizens in Japan by 2020. The IBM-developed apps include medication and lifestyle reminders, community services access, and electronic monitoring that extends Japan Post Group’s fee-based home visits.

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Apple revises its App Store review guidelines to require ResearchKit developers to obtain institutional review board approval for studies involving human research. The previous language recommended but did not require IRB approval.

New York-Presbyterian Hospital launches the self-developed NYPConnect staff communication app.

Athenahealth connects the lab hub of Liaison Technologies to its network.


Government and Politics

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Former Texas for-profit hospital chain CFO Joe White is ordered to pay $4.4 million in restitution for filing false Meaningful Use attestation reports, adding to his previous sentence of 11 years in prison for healthcare fraud. He also falsified the entries using another employee’s ID and faces up to seven years in federal prison for identity theft in his May 27 sentencing. Chain owner Tariq Mahmood, MD was sentenced to 11 years in federal prison a couple of weeks ago for Medicare and Medicaid fraud, with the US attorney cheering the decision by saying, “What we do not need is providers like Tariq Mahmood who masquerade as physicians and pretend to care about American healthcare but actually are determined to loot the Medicare Trust Fund.”

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Premier comments on the House’s 21st Century Cures, urging ONC to help liberate data “locked in proprietary software systems” by developing standards (including patient identifiers, security, and APIs) and publicly reporting measures of interoperability via ONC’s certification program. Premier’s comments are valid, but as an organization representing providers, it places the blame on vendors rather than providers who are neither demanding or using interoperability capabilities due to competitive concerns.

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Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) of the Senate’s HELP committee make good on their promise to help HHS Secretary Sylvia Burwell with ideas for EHR improvement by inviting their Senate colleagues to join a working group that will identify ways to improve care, interoperability, and patient access to their own information.


Privacy and Security

A security guard at Mercy Health Saint Mary’s (MI) apologizes for looking up the EHR record of a 19-year-old female patient and then sending her a Facebook friend request.


Innovation and Research

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Sensiotec wins an innovation award from the Technology Association of Georgia and the Southeastern Software Association. The company’s Virtual Medical Assistant offers FDA-approved, non-contact patient monitoring for post-acute care patients, with a monitoring panel placed under a patient’s bed or chair to continuously stream biometric information to the cloud.


Technology

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Ron Kloewer, CIO of Montgomery County Memorial Hospital in Red Oak, IA, sent over a link to a Verizon story about the hospital’s Heartland Mobile Health unit, which connects the mobile exam room by 4G LTE to the hospital’s EHR.

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Microsoft releases a software development kit for its Band smart watch that providers app developers access to its body sensors and notification tiles.


Other

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Sitka Community Hospital (AK) says one of its top priorities in trying to survive financially is to fix its software problems, especially those that are causing delayed billing. Googling suggests that the system they installed last year is Healthland.

Deaconess Health System (IN) will install and maintain Epic for Good Samaritan Hospital (IN) via the OneCare ACO. I believe the system getting replaced is McKesson Horizon, which Good Samaritan bought in 2007.

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Sensationalistic US news sites love crises that keep eyeballs coming back, milking the latest plane crash, natural disaster, or civil unrest for all it’s worth. Good news doesn’t sell in the “if it bleeds, it leads” style, so here’s a counterpoint: the folks at Baltimore-based Salar were at Inner Harbor Wednesday handing out food to whoever was around – National Guard, police, locals, and visitors. Scour the web and you’ll find pictures everywhere of locals helping looted business clean up, protecting police from those intending to harm them, and reminding opportunistic criminals that torching a CVS and stealing lottery tickets hurts rather than helps.


Sponsor Updates

  • Microsoft announces Office plug-ins for DocuSign.
  • Mobile charge capture vendor pMD will become a PQRS registry for 2016.
  • Extension Healthcare offers “Reducing Clinical Noise and Solving the Challenge of Interruption Fatigue – A Nurse’s Perspective.”
  • PatientSafe Solutions hosted a 40-participant HIMSS15 breakfast event discussing smartphone-based clinical communication and collaboration.
  • Galen Healthcare offers part 1 of “Management-friendly policies we’ve taken to improve information security … and why you should too.”
  • The HCI Group interviews ERP Practice Director Lane Tucker in its latest blog.
  • ZeOmega hosts its client conference May 4-6 in Plano, TX.
  • Healthcare Data Solutions unveils a new brand and website.
  • First Databank adds natural health products to FDB MedKnowledge Canada.
  • Holon Solutions will exhibit at the National American Hospital Association Meeting May 3-6 in Washington, DC.
  • Influence Health will hold its Influence Client Congress May 3-6 in St. Louis.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 30, 2015 News No Comments

News 4/29/15

April 28, 2015 News 3 Comments

Top News

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Vanderbilt University Medical Center (TN) will replace its McKesson Horizon system — the CPOE portion of which it developed in-house as WizOrder starting in 1995 — with either Cerner or Epic. That’s one of the last homegrown systems to bite the dust, both at Vanderbilt and everywhere else as McKesson puts its commercialized version out to pasture after a 12-year run. It’s also interesting that Vanderbilt is echoing the general market trend of considering only Cerner and Epic to be viable choices, showing no interest in looking at Allscripts, Meditech, or McKesson Paragon.


Reader Comments

From Willow: “Re: Xerox Midas+ layoffs. Four laid off so far, apparently prompted by the first poor quarterly earnings report in the company’s history, which appear to have been caused by the high consulting and infrastructure costs spent on its Juvo product.” Unverified.

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From Concerned CC Client: “Re: new CEO at CareCloud. Positioned as great new, but in reality not. Since they were founded in 2009, under Santalo’s direction, they have gone through $80.5 million, are not making money, and now need $15 million to stay afloat.” EHR/PM vendor CareCloud announces Ken Comee as CEO, replacing Albert Santalo, who will remain as chairman and chief strategy officer. The company also announced $15 million in additional funding from existing investors. Technology executive Comee has been on CareCloud’s board since 2012, and according to his LinkedIn profile (which features the overly arty “more chest, less head” look above), he has no other healthcare-related experience.


HIStalk Announcements and Requests

We’ll have HIStalk Practice posts Monday through Thursday going forward (instead of just twice weekly) and Jenn will also write a Friday summary of population health management news. Sign up for short, fun, and informative updates and see what’s new in ambulatory, practice, and PHM.


Webinars

None scheduled soon. Contact Lorre for information about webinar services.


Acquisitions, Funding, Business, and Stock

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Private equity firm Francisco Partners will acquire healthcare talent management solutions vendor HealthcareSource from majority owner Insight Venture Partners.

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Merge Healthcare announces Q1 results: revenue up 6.9 percent, adjusted EPS $0.05 vs. $0.04, beating earnings estimates but falling short on revenue.

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Validic raises $12.5 million in Series B funding from investors that include the venture arm of Validic customer Kaiser Permanente.

The Raleigh, NC business paper says Allscripts will build a new 18-story building for its 1,260 local employees, although the company hasn’t confirmed. The article mentions that Allscripts recently “rebalanced” 3 percent of its workforce.

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The Chicago business paper profiles referral management software vendor Fibroblast.

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Scanadu raises $35 million in a Series B round to further develop its Scout tricorder-like body scanner.

CTG announces Q1 results: revenue flat, EPS $0.08 vs. $0.19. The company blames soft healthcare IT services demand as providers delay projects or staff them internally.

Aetna announces Q1 results: revenue up 8 percent, EPS $2.20 vs. $1.82. Chairman and CEO Mark Bertolini said in the earnings call that its Medicity business is “seeing a lot of growth.”

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Roper Industries, which owns many companies that in healthcare IT include Sunquest and Strata Decision Technologies, reports Q1 results: revenue up 4 percent, adjusted EPS $1.55 vs. $1.46, falling short on analysts’ revenue expectations but beating on earnings. The company announced in the earnings call that it has changed its name to Roper Technologies to emphasize that it isn’t just an industrial company but rather a collection of businesses that deliver 60 percent gross margins. Above is the one-year share price chart of ROP (blue, up 24 percent) vs. the Dow (red, up 9 percent).


Sales

Consolidated Laboratory Services chooses McKesson Business Performance Services for billing.

Star Medical Center (TX) contracts with Anthelio Healthcare Solutions for revenue cycle optimization.


People

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Medical kiosk vendor HealthSpot hires Gail Croall, MD (Anthem) as chief medical officer; Eric Eichensehr (Levitate Technologies) as CTO; and Bruce Roberts (RxEngage Partners) as COO.


Announcements and Implementations

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In Qatar, Al Khor Hospital goes live on Cerner Clairvia for nursing staff management.

The CEO of Henry Ford Health System (MI) says that while the system took an initial financial hit in 2013 after its $353 million Epic implementation, using Epic helped it save $65 million in 2014 and HFHS will cut $300 million in cost by 2016 as its financial turnaround continues. Meanwhile, UNC Health Care (NC) also credits Epic with its stronger-than-expected operating income.

Wellcentive, SpectraMedix, and eClinicalWorks are pilot testing NCQA’s eMeasure electronic clinical quality measure program for Meaningful Use and HEDIS reporting.

T-System announces its tablet-based T Sheets Digital for Urgent care that includes 45 chief complaint-based templates.

MedAptus releases Premium Analytics for its charge capture suite.  

QPID Health is named a Gartner “Cool Vendor.”


Government and Politics

The Institute of Medicine will rename itself to National Academy of Medicine effective July 1, 2015.

National Coordinator Karen DeSalvo, MD says in a Health Affairs blog post (which appears to have been taken verbatim from her HIMSS conference presentation) that ONC will use Medicare payments and the DoD’s EHR contract bid to push interoperability.


Privacy and Security

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A security researcher finds data from Hilton Head Hospital (SC) for sale on a hacker marketplace, apparently exposed during a 2014 breach caused by PST Services, a McKesson subsidiary that provided billing services to Tenet’s hospitalist contractor and inadvertently opened up its billing records to Internet searches.

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Seton Family of Hospitals becomes the latest organization to expose patient information via employee-targeted email phishing attacks. Hackers accessed the information of 39,000 Seton patients in the December 4 breach.


Other

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Pella Regional Health Center (IA) opens a 24×7 nurse hotline as part of its patient-centered medical home efforts. Anyone can call the hotline to discuss concerns or make appointments with nurses who have access to the EHR.

Partners HealthCare expects to double the $80 million in annual revenue it receives from licensing and spinoffs.

Former National Coordinator David Blumenthal, MD says in a Wall Street Journal editorial that healthcare IT will fall short of its potential unless security and interoperability are improved.

A Brookings article highlights the maximum “reasonable cost” providers can charge patients for providing 75 copied pages of their records, which ranges from $19 in California to $101 in Georgia. It mentions that providers in many states can charge patients the same per-page amount for copies of their digital records even though the provider cost is essentially zero.


Sponsor Updates

  • Amerinet extends through 2018 its member discounts to revenue integrity products from Craneware, also adding the company’s InSight Medical Necessity tool.
  • Zynx Health and Meritage ACO will present “Using a Mobile Tool to Create a Virtual Caregiver Huddle” at the NPSF Congress April 29 – May 1 in Austin, TX.
  • Cueatr posts a photo slideshow of its experience at the HIMSS conference.
  • ADP AdvancedMD announces the launch of its SmartPractice e-letter for independent practices.
  • AtHoc details its integration with Apple Watch.
  • Besler Consulting outlines how “CMS-1498-R2 gives hospitals option to have their SSI Factor recalculated.”
  • CareSync offers “Here’s How CareSync Changes Lives for the Better.”
  • CareTech Solutions takes a look at how The Metro HealthSystem used the company’s solutions to realize SEO advantages and budget benefits.
  • The local paper looks at how several HIStalk sponsors — CenterX, Forward Health Group, Healthfinch, and Nordic Consulting – are making an impact in their native Madison, WI.
  • Team CoverMyMeds shares personal highlights of HIMSS15 in its latest blog.
  • MedCPU looks back on its HIMSS15 experience.
  • Health Care Improvements Institute announces its partnership with xG Health and interviews xG Health CEO Earl Steinberg, MD and President/COO Ray Herschman.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 28, 2015 News 3 Comments

Monday Morning Update 4/27/15

April 26, 2015 News 14 Comments

Top News

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HHS Secretary Sylvia Burwell, testifying on the department’s $84 billion 2016 budget request, is challenged by Sen. Lamar Alexander (R-TN) who stated that half of doctors don’t like their EHRs to the point that they’ll accept Medicare penalties rather than deal with workflow disruption, adding that the AMA found that 70 percent of doctors say their EHRs weren’t worth the cost and that EHRs are the leading cause of physician dissatisfaction. Burwell responded that HHS will work with Congress on a list of administrative action items related to EHRs, which seems to refer to the work of the HELP committee that most recently talked about interoperability and interviewed Epic’s Peter DeVault. What worries me most about the entire exchange is that nobody questioned whether HHS or Congress have any business involving themselves with how doctors use EHRs, where Burwell’s response might have logically been, “Respectfully, our job is making taxpayer payments to providers who choose to participate in Medicare and HITECH, but otherwise the EHRs that providers buy, use, and complain about really aren’t under the government’s purview. We should be monitoring the outcomes, not prescribing the process, which is how government works with all other industries.”


HIStalk Announcements and Requests

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Poll respondents grade the HIMSS conference with somewhere in the C-plus range. A consulting company vendor says it was successful in meeting with clients and networking with peers, while a CIO observes that the HIMSS conference is all sizzle and no steak as it keeps growing and ratio of vendors to providers seems to be going up as well. New poll to your right or here: what do you think about the fact that most health IT vendor executives are white men? (“I’m not thinking about it at all” is a poll option as well). Add a comment to support your position if you like.

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We were signing up for our microscopic booth for HIMSS in Las Vegas and were surprised to find that nearly all of the exhibit spaces have already been taken in the booth signup frenzy that occurs even before the previous conference is over. I don’t have the money or HIMSS points to play with the big boys, but even the 10×10 spaces in weird locations were mostly booked up. The tiniest parcels run around $5,500 and I declined the $2,500 extra HIMSS wanted for a corner space (they didn’t charge extra for our corner spot the past two years). We’ll be in #5069, with our presence probably annoying our next door neighbors Varian Medical Systems and Patient Prompt even though we’ll keep their area busier than it would be otherwise as we have a fun cast of characters running around. At least we don’t have much stuff to stick in there – we brought everything we used in our McCormick Place booth in one large duffel bag and set it up in maybe 20 minutes. There’s no ROI since we don’t have anything to sell, but we like just saying hello and giving our boothless friends a place to hang out.

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Speaking of our McCormick Place booth, patient advocate Regina Holliday wrote a nice summary of the time she spent there and her HIMSS experience in general.

I forgot to mention an unpleasant encounter Lorre had with the “HIMSS police,” who were a little bit snippy in confronting her at our booth and demanding that we stop using the name “HIMSS Bingo” in referring to a contest that we had nothing to do with other than allowing winners to pick up their prizes there. The HIMSS person was too busy scolding to hear that she had the wrong scoldee.

Most people think of Epic first on the list of Madison-connected companies. Here’s another that just came to me: John Holton, who graduated from UW in 1975, founded Atwork in 1983 and then Scheduling.com (now SCI Solutions) in 1999, although both operated out of California rather than Wisconsin.


DonorsChoose Project Updates

Feel free to skip this section if you aren’t following our project as it winds down – the normal stuff follows.

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Thanks to new participant The Breakaway Group, who donated $500 to get on Centura SVP/CIO Dana Moore’s dance card. I’ve funded $10,478.21 in projects, including these new ones, including some I chose in Colorado since that’s where Dana lives:

  • A printer, tablet supplies, and early literacy books for an elementary school teacher’s graduate courses in education, Los Angeles, CA.
  • A camera and photo printing equipment for creating a time capsule for a high school in Atlanta, GA.
  • Math games and learning activities for a second grade class in Garland, TX.
  • An iPad case and AV adapter for English language learners at an elementary school in Las Vegas, NV.
  • A TV and flash drive to promote newly arrived books in the library of a high school in Walden, CO.
  • Drums for rhythm and movement activities for special needs students at an elementary school in Centennial, CO.
  • Six iPad keyboard cases for a fourth grade class in Lone Tree, CO.
  • Globes, maps, and books for a K-2 class in Denver, CO.
  • A tablet with keyboard for English as a second language students at an elementary school in Fort Lupton, CO.
  • A Chromebook for an earth sciences class at a high school that can’t be accredited due to lack of hands-on learning tools in Norfolk, VA.
  • A complete library of high-interest, low-readability books for a class of severely intellectually disabled students at a middle school in Conway, SC.
  • Four boom boxes and 12 sets of headphones to create a literature listening station in the reading area of an elementary school in Seattle, WA.
  • A library of classic books for a third grade class in Clarksdale, MS.
  • Hand sanitizer and tissues for profoundly mentally disabled K-5 classroom in North Charleston, SC.
  • Baby wipes, diapers, a food blender, wheelchair supplies, and insect repellent for a handicapped K-2 students at an elementary school in North Charleston, SC.

Webinars

None scheduled soon. Contact Lorre for information about webinar services.


Last Week’s Most Interesting News

  • Infor signs an agreement to distribute its hospital data integration products in Cuba.
  • A RWJF study of personal health records finds that consumers value their own subjective narrative entries more than anything else, while doctors rarely even look at them.
  • Seven disabled veterans sue the VA for failing to deliver copies of their disability-related medical records for up to 25 months after their requests.
  • LabCorp announces a direct-to-consumer testing program.
  • Kaiser Permanente announces plans to open a 900-job healthcare IT campus in Atlanta.
  • A judge orders MyMedicalRecords to pay the legal defense costs of Allscripts and WebMD after those companies prevailed in two of a nearly endless number of questionable MMR patent infringement lawsuits.

Acquisitions, Funding, Business, and Stock

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Business Insider runs the first skeptical article I’ve seen about Silicon Valley lab darling Theranos and its $4.5 billion net worth, 31-year-old founder Elizabeth Holmes. Experts say they have no idea how the company’s technology works because Theranos won’t publish peer-reviewed studies about its tests, won’t let independent experts review its labs, and doesn’t acknowledge whether it’s actually using the same analytical machines as other labs in addition to its small-sample size equipment that other labs use as well. The article also questions whether can scale given its plans to perform 1 million tests in 2016, less than 0.2 percent of the number performed by Quest. Quest and other competitors are questioning whether tests performed by Theranos using capillary blood (microfluidics) are accurate.   


Sales

Children’s Hospital Association chooses Clinical Architecture’s Symedical for global terminology management for analyzing comparative data.

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Avera Health System (SD) selects Meditech 6.1 Web EHR for 33 hospitals and 208 clinics. The press release isn’t clear as to whether this is an all-new product and Googling the term “Meditech Web EHR” brings up a non-specific mention on the company’s website, which used to be a no-nonsense list of information but is now maddeningly glossy and detail-free, with artsy scrolling pages and oversized type crying for Internet attention without providing much value in return. Click “EHR Solutions” and you won’t see a list of them. I don’t fully understand how a product can be “groundbreaking” if it’s in version 6.1 or whether this is just a new Web front end for the same old products.


People

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Mark Young (StayWell Health Management) joins PatientSafe Solutions as COO.


Announcements and Implementations

Phynd Technologies will analyze the cost to Nebraska hospitals of managing their provider information manually vs. using its provider information management platform in a project funded by the state.


Government and Politics

The VA forms an 11-member medical advisory group to advise it on healthcare delivery issues.

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Here’s a pretty funny tweet from CMS Chief Data Officer Niall Brennan.


Technology

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Healthcare is always a lagging chaser of consumer technologies, so I’m not quite sure what to make of the just-announced Amazon Dash, a WiFi-connected, product-specific stick-on electronic button that lets users restock a particular product with a single press. It’s either a brilliant time-saver that creates even more loyalty to Amazon and the products it sells or, as The New Yorker opines, “an uneasy image of our homes as giant Skinner boxes, and of us as rats pressing pleasure levers until we pass out from exhaustion” that bypasses the brief thinking moment of “Why am I using all this stuff?” while driving to the store. I didn’t realize that Amazon already offers a speech recognition and barcode scanning version of Dash for users of its expensive AmazonFresh grocery delivery service in Seattle, California, and New York metro areas.


Other

USA Today profiles the involvement of patients in the EHR selection of Partners HealthCare (MA), which invited a patient who sits on its advisory board to help choose its $700 million system. I like the approach, although I can’t help but think of the economic strong-arming and brand name-brandishing Partners does to squeeze out competitors and force insurers to pay its exorbitant rates, which isn’t really in the best interests of patients or the healthcare economy in general.

An investigation has been underway in Texas to review the state’s issuance of a no-bid Medicaid anti-fraud system contract to a local bidder with zero experience. The Houston newspaper points out that the state was already using a similar system that had recovered $56 million against its original cost of $16 million, while the new $20 million system (with a pending $90 million extension) has recovered zero dollars. Nearly all of the funds came from all of us who pay federal taxes. State government was asleep at the wheel, with a prime example being that the contractor (21CT) billed it the full price of a $452,000 project the day after the purchase order was signed and the state paid it immediately. A few state employees have been fired and a criminal investigation is underway. The state’s HHS inspector general who arranged the deal lied to CMS by claiming that a competitive bidding process had been conducted and then resigned after local newspapers exposed the scandal.


Sponsor Updates

  • Nordic offers a recap of #HIMSS15 through its Twitter feed.
  • PatientKeeper offers thoughts on “HIMSS and hEHRs.”
  • MBA HealthGroup offers “Skin in the Game: Keys to Success in a Private Dermatology Practice”
  • MedData breaks down the 2015 PQRS payment adjustment statistics.
  • Wellsoft will exhibit at the EDPMA Solutions Summit April 26-29 in Amelia Island, FL.
  • Sandlot Solutions will exhibit at the Big Data in Healthcare Summit April 28-30 in Boston.
  • Netsmart’s e-prescribing solution attains certification for controlled substances.
  • TeleTracking asks, “Who’s Looking Out For Nurses?”
  • PDS offers “Five Tips for a Trend-Setting Healthcare IT Strategy.”
  • NTT Data offers “Wearables in the Enterprise – What are Industries Saying?”
  • Patientco adds 2.4 million patients to its patient revenue cycle platform.
  • PeriGen recaps last fiscal year in “Another 48,611 births powered by PeriGen.”
  • PMD offers “Keeping Priorities Straight and Scaling Support.”
  • QPID Health CMO Michael Zalis, MD is featured in “Diagnosing Imaging: Maximizing Appropriate Use with Smart Decision Support.”
  • Sagacious Consultants offers “ICD-10 Training for Providers, Coders, and CDI Specialists.”
  • New York eHealth Collaborative offers “The Healing Power of Your Own Medical Records and SHIN-NY.”
  • Stella Technology offers “HIMSS15 Conference Highlights and Takeaways.”
  • Summit Healthcare declares that “HIMSS 2015 Did Not Disappoint!”
  • T-System will exhibit at the UCAOA National Urgent Care Spring Convention April 27-30 in Chicago.
  • Truven Health Analytics offers “Appealing the CMS Risk Adjustment and Reinsurance Calculations: Making Sense of the Discrepancy Regulations.”
  • Versus Technology publishes “Reflections on the Oklahoma City Bombing, from a Nurse Who Was There.”
  • Huron Consulting Group is named one of America’s best employers by Forbes.
  • Winthrop Resources will exhibit at Interop Las Vegas 2015 April 27-May 1.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 26, 2015 News 14 Comments

News 4/24/15

April 23, 2015 News 8 Comments

Top News

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Two New York-based, healthcare-related organizations strike deals that will make them some of the first US firms to conduct business in Cuba now that sanctions have been relaxed. Roswell Park Cancer Institute (cancer research) and Infor (hospital data integration) announced their plans following a trade delegation visit this week led by New York Governor Andrew Cuomo.


HIStalk Announcements and Requests

I decided to follow through on looking at female representation on vendor executive teams as listed on company webpages since it came up on HIStalk last week. Companies have the incentive to hire the most qualified people regardless of demographics, but just in case you’re interested for whatever reason, here’s the percentage of females they’ve chosen.

Percentage of Females on Leadership Team (highest to lowest)
Wolters Kluwer Health 50
Meditech 41
Merge 33
TriZetto 25
Advisory Board 25
Optum 23
Athenahealth 22
Quality Systems 22
InterSystems 22
Cerner 19
Nuance 18
Greenway Health 18
Leidos Health 17
GE Healthcare 15
Premier 15
Surescripts 12
Philips North America 11
MModal 10
Emdeon 8
Allscripts 0
McKesson Technology Solutions 0

Some other percentages:  Facebook (20), Microsoft (19), Google (15), and IBM (27). HIMSS comes in at 17 percent.

I was reading a tweet that referred to pilot turned safety expert (and 2010 HIMSS keynoter) Sully Sullenberger as a “national hero.” The cynic in me (which has a significant presence) cringes at how we’ve devalued the term “hero” to label anyone who experiences adversity (including the randomly applied kind) rather than reserving the term for those who exhibit bravery or noble deeds in intentionally sacrificing themselves on behalf of others. Sully landed his plane safely in the Hudson River, but he was saving himself as well as his passengers. He was cool under pressure, humble, and performed the job he was being paid to do better than most would have done, but “hero” might be a stretch, just as it is when referring to athletes, victims of violence, someone who calls police to report a crime in progress, or groups that may well contain some but not all heroes (firefighters, service members, or even clinicians, for instance).

This week on HIStalk Practice: interoperability melancholia sets in after HIMSS. Matter Chicago CEO previews AMA physician office of the future. Radiology practices select new rev cycle technology. Azalea Health takes on telemedicine. Physicians’ Alliance of America looks for PCP feedback on EHR charting productivity. New study finds that online physician reviews don’t have much to do with clinical expertise. Modernizing Medicine CEO Dan Cane dives into the company’s relationship with IBM Watson. StatDoctor CEO Alan Roga, MD outlines the benefits of video in telemedicine.

This week on HIStalk Connect: Tech-savvy health insurance newcomer Oscar Health raises a $145 million funding round on a $1.5 billion valuation in just its second year in business. Ernst & Young creates a digital maturity index focused on quantifying the sophistication of telehealth programs. Color Genomics unveils a $259 genetic screening test that looks for 19 key mutations, such as BRCA1 and BRCA2, that are known risk factors for developing breast or ovarian cancers. Gravie, a private health insurance exchange startup, raises a $12.5 million Series B to expand its presence into Texas and Illinois.


DonorsChoose Fundraising Project Update

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Our total now stands at $10,000 thanks to new participation from ZirMed, TransUnion Healthcare, BlueTree Network, and Orchestrate Healthcare. BlueTree Network was notable in donating $1,000 instead of the requested $500, while TransUnion Healthcare VP Patrick Gilmore missed the chance to meet with Centura SVP/CIO Dana Moore at the HIMSS conference but said he wanted to donate anyway. Dana will provide a summary of his conversations with these companies later. I’ve funded $6,656 in projects and will get the remaining $3,344 out to classrooms by this weekend.


Acquisitions, Funding, Business, and Stock

Navicure announces a 32 increase in year-over-year sales of its billing and payment solutions.

India-based Wipro expects its healthcare business to hit $2 billion in annual revenue by 2018, double its 2015 expectations, mostly due to increased technology spending triggered by US healthcare reform. The company will target acquisitions in the $100-$200 million range, saying it passed on acquiring TriZetto (acquired by Cognizant for $2.7 billion) because of the price.

The Illinois Hospital Association will merge with the Metropolitan Chicago Healthcare Council effective January 1, meaning the state hospital association will be running an HIE (MetroChicago HIE) and insurance company.

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A federal judge orders the legally prolific MyMedicalRecords to pay the defense fees of WebMD and Allscripts, which beat some of MMR’s bottomless patent infringement lawsuits after refusing to pay “licensing fees” for ubiquitous technologies.

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Jeff Bezos discloses the financial performance of Amazon Web Services for the first time in the unit’s nine-year history, stating that it’s a $5 billion business that’s growing fast.

A Wall Street Journal article finds that universities (Vanderbilt, Emory, and University of Arizona) are cutting ties with their cash cow academic medical centers as their high costs threaten to exclude them from exchange-based insurance networks.


Sales

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Swedish Cancer Institute (WA) chooses the Synapse Precision Medicine Platform to provide oncology clinical decision support using patient genomic information.

Mount Sinai Health System (NY) selects the InterSystems HealthShare interoperability platform.

CareWell Urgent Care chooses Athenahealth’s EHR and practice management system for its 49 providers.

LTPAC EHR vendor SigmaCare chooses Liaison EMR-Link hub to connect with lab and imaging vendors.

Augusta Health will use Meditech performance monitoring tools from Goliath Technologies. The company’s press release doesn’t bother to mention where its new client is located (who writes this stuff, anyway?), so I’ll take a Google-inspired guess and say Virginia.


People

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Davide Zaccagnini, MD (Nuance) joins SyTrue as CMIO.

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Dominick Bizzarro (Value Informatics) joins insurer MVP Health Care as EVP of business development and informatics.

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Cerner co-founder and Chief of Innovation Paul Gorup is retiring, insiders tell me. He helped develop PathNet in the 1980s, left Cerner in 1987 to run a radio station monitoring company, then returned to Cerner in 1999 to develop its hosting business. Gorup said in a 2013 interview, when asked why Cerner succeeded in healthcare while IBM and GE fizzled, “That’s easy. What does the head of IBM get up and think about every morning? I guarantee you it’s not healthcare. Same with the head of GE. He might think about energy or finance, but not healthcare. You have to think about it 24 hours a day. It’s not a part-time business. If healthcare becomes a part of something else, you’ve lost your focus.”


Announcements and Implementations

Referral software vendor EHealth Technologies announces a partnership with Box to support PDF viewing, medical image display, and structured document viewing.

Craneware announces enhancements to its Chargemaster Corporate Toolkit that include a single consolidated view, corporate chargemaster change distribution, and advanced workflow integration.

Capsule releases its Early Warning Scoring System for its SmartLinx Chart Express charting solution to alert clinicians of patient deterioration based on real-time vital signs analysis.

Zynx Health enhances the secure text messaging capabilities of its ZynxCarebook mobile coordination platform.

A TransUnion Healthcare analysis finds that increasing healthcare expenses and lower consumer credit lines have left consumers less able to pay their medical bills than last year. A big driver of the increased patient cost involves joint replacement procedures, which are 20 percent more expensive than they were a year ago.


Government and Politics

In Australia, the Victoria medical association calls on the state to spend $39 million to improve connectivity between hospitals and practices, hoping to at least enable delivery of discharge summaries and lab results after several expensive IT projects failed to deliver that capability.

Minnesota’s health commissioner says he’s concerned about pushback on the state’s 2008 requirement that all providers use EHRs by the end of this year. He debunks four privacy myths that are apparently the crux of the unstated opposition’s campaign.

A New York Times investigative report finds that the VA’s wait times scandal cost only three jobs vs. the 60 firings the VA claimed. One VA employee was fired for accepting gifts not directly related to wait times, one retired to avoid being fired, one is awaiting termination, and five employees were reprimanded. The VA often transfers problem employees and those who appeal their terminations can collect their paychecks for up to two years while awaiting a decision. 


 Innovation and Research

HHS will support three projects via its Ventures Fund: a website that allows providers to crowdsource possible new uses for existing drugs, an evaluation system for funding disaster preparedness, and a smart phone based diagnostic tool for malaria.

A Robert Wood Johnson Foundation study of personal health records finds that while consumers believe the most important information contained in PHRs is their own recorded daily observations (diet, exercise, mood, medication response), physicians usually don’t even look at them, instead turfing such review off to nurses and health coaches. The study also found that consumers think their information is valuable enough to outweigh any privacy concerns. It also concludes that demand for PHRs is surprisingly low because nobody is sure what problems they’re supposed to solve. I’ll extend my own musing: technology-powered lusting for discrete data capture and big data analysis cannot overwhelm the essential nature of the encounter, which is to listen to what the patient (and not necessarily their data points) is saying. Not everything that’s health related can be described by passively collected data dropped into convenient little buckets, and not everything that’s important will come up without skilled engagement of the “tell me how things are going” variety. My takeaway is that we need to make sure that technology enhances rather than limits the use of the patient’s own voice in the participatory guiding of their health.


 Technology

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Heal releases a house call app for the Apple Watch that allows users to request a doctor visit with a single touch. Doctors equipped with mobile diagnostic apps such as the AliveCor ECG and CellScope otoscope arrive at the desired location within an hour and spend as much time as needed for a fixed fee of $99. One of Heal’s investors is Lionel Richie.


Other

Hospitals are moving inner city hospitals to suburbs where better-paying patients live, a Kaiser Health News article reprinted in Newsweek points out. Hospitals defend the practice by saying it’s cheaper to build a new suburban hospital than to renovate a old, land-locked downtown facility, but city officials say their core areas are being medically abandoned as hospitals chase patients who have better insurance.

Oxycodone-related deaths dropped 25 percent following Introduction of Florida’s doctor-shopping database of controlled substance prescriptions, a University of Florida study finds. However, deaths were already decreasing after the state shut down hundreds of pill mills posing as pain management clinics.

A study finds that 28 percent of Americans did not perform even one physical activity in 2014, increasing the “totally sedentary” number to the highest it’s been since 2007. Experts blame reduced physical education time in school and the competitive nature of school sports that leaves most students on the sidelines.

HealthLoop founder Jordan Shlain, MD says he started the company when he realized as a doctor that his mental model was wrong – inviting a patient to contact him when in need is not the same as proactively checking up on them, which he summarizes as invalidation of the “no news is good news” attitude since that means the same as “no data is good data.” He also says hospitals dehumanize their treatment failures by giving them the blame-free, dumbed-down label of “readmission.” He warns that probability-challenged people often make bad decisions in using data and algorithms as a blunt instrument without paying attention to what it means for individual patients.

An Australian blogger who built a business (including a wellness app) by claiming she cured her terminal brain cancer by diet and lifestyle alone admits that she was lying – she never had cancer. She was caught when she failed to donate $300,000 in app sales to charity as promised.

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Weird News Andy titles this article as “A Rocky Experience in the OR.” A professor and facial surgeon in England loses his license after punching an anesthetized patient in the face 10 times to correct a broken cheekbone. The doctor admits that he “manually reduced the fracture” because the patient wasn’t fit for surgery, adding that doctors punch patients all the time while doing CPR. The patient is fine, while the surgeon is now offering his services in Dubai.


Sponsor Updates

  • Valence Health is convening its second annual Pediatric Collaborative for Value-Based Care forum in Chicago this week.
  • DocuSign is named among Silicon Valley’s “Best Places to Work 2015” for the fourth consecutive year.
  • E-MDs will exhibit at the MGMA regional meeting April 29 in Galveston, TX.
  • Galen Healthcare recaps the “Top 5 Themes from the Super Bowl of HIT.”
  • Hayes Management Consulting offers “Planning for the Unexpected EHR Downtime: 4 Key Steps.”
  • HCS will exhibit at the National Association of Long Term Hospitals 2015 Annual Meeting April 30-May 1 in Washington, DC.
  • HCI group offers “7 Essential Items Every McKesson Horizon Customer Should be Considering.”
  • Healthfinch’s Karen Hitchcock offers “A First-Timer’s First Impressions.”
  • Healthwise will exhibit at the Annual NPSF Patient Safety Congress April 29 in Houston.
  • Holon Solutions offers “RightFax End of Life Support Dates: Are You Ready?”
  • Impact Advisors offers its top 10 takeaways (and HISsies Award coverage and predictions) from HIMSS15.
  • The Atlanta Business Chronicle recognizes Ingenious Med as one of the city’s top 100 fastest-growing privately held companies.
  • PDR will exhibit at the National Association of Chain Drug Stores Annual meeting April 25-28 in Palm Beach, FL.
  • LifeImage celebrates five years in business and 1 billion images exchanged.
  • LifePoint Informatics offers a new white paper explaining “Why Access to Lab & Diagnostic Data is Important to Providers, Payers, and Patients.”
  • Logicworks explains why it sells managed cloud services rather than consulting services.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 23, 2015 News 8 Comments

News 4/22/15

April 21, 2015 News 10 Comments

Top News

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Seven disabled veterans sue the VA, claiming that they’ve waited 10 to 25 months for copies of their medical records, delaying their eligibility for benefits.


Reader Comments

From CIO: “Re: patient engagement survey. Do CIOs really think they own it?” A HIMSS-sponsored poll finds that nearly half of health system CIOs believe they own patient engagement in their organizations, but I think there’s a definitional issue here. CIOs often mislabel the tools vs. the program when it comes to analytics, population health management, and patient engagement. The software is just one part of the initiative even though Meaningful Use muddies the picture with its purely technical requirements for patient engagement. I’m fairly certain CIOs don’t really believe they’re in charge of the entire program, but if they do, either they or their employer have a big problem. Non-clinicians (especially IT and marketing people) should not be trying to engage patients.

From Nasty Parts: “Re: Allscripts. What’s going on? Lots of recent senior departures: Diane Bradley, John Dragovits, Peter Mcclennen, Perry Sweet, and Chad Baugh, to name a few.” Unverified. The LinkedIn profiles of all of these folks still list Allscripts as their current employer, although I’ve found that in general people don’t update their profile until they get another job.

From Little Suzie: “Re: [publicly trade vendor name omitted]. I’ve heard from a not-necessarily-reliable source that they may be acquiring [publicly trade vendor name omitted]. True?” Lips are typically and justifiably sealed when publicly traded companies are involved in M&A talks. This one would be huge. I don’t see the synergy, but the first vendor is on a roll and the second is wheezing, so it’s possible that a fire sale is being discussed.

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From Pirate Wench: “Re: interesting sexual harassment lawsuit against a healthcare IT executive.” It’s juicy, but keep in mind you’re reading only one of the inevitable two sides of the story. The lawsuit, filed by a demoted employee, says Quality Systems, Inc. (parent of NextGen) protects its male employees who harass female employees. The real story will be how the lawsuit is disposed of, which I strongly suspect will be by a sealed settlement since a trial would be unpleasant for both sides.

From Candid Cameron: “Re: females at HIMSS. I saw a big drop in booth babes, which I think is due to pressure from publications such as HIStalk. I’d like to see recognition of companies with at least 40 percent female executives or 40 percent female speakers at the conference.” I’m wary of assuming intentional bias (gender, age, nationality, etc.) in observing executive team demographic composition, but it would be interesting to see the percentage of VP-and-up females in each company.


DonorsChoose Project Updates

This isn’t directly related to healthcare IT, so feel free to skip on down to the next section if it’s not your thing.

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Our DonorsChoose project donations have jumped as another company offered a $500 donation in return for 20 minutes of Dana Moore’s time by telephone and our anonymous matching vendor agreed to match this donation as well. That brings our total to $8,000. I’ll be funding new projects as a result. Meanwhile, above is another of the many teacher thank you emails I received, this one from a kindergarten classroom for which we donated a projector. I was so moved that when I saw that Mrs. Henry had an open grant request for an AV cart to house their new projector that I funded that as well.

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Meanwhile, here are a couple of student-written thank you notes from an earlier project we funded. DonorsChoose defaults the option to receive student notes to “yes” when you fund a project, but I unchecked it this last time because it’s a fair amount of work for the students and we funded so many projects I would be overwhelmed by all their notes anyway. Still, it’s gratifying to hear from the students who are actually benefitting from the donations.


HIStalk Announcements and Requests

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One of the more disturbing things I saw at the HIMSS conference was people running around wearing giant red noses, courtesy of a Walgreens fundraiser for children’s poverty. I like the cause but not the noses, which make me think of Stephen King’s evil clown in “It.”


Webinars

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

Israel-based drug maker Teva will pay $512 million to settle charges that it paid competitors $200 million to delay rollout of a generic version of its sleep disorder drug Provigil. The company  also offers an unsolicited $40 billion bid to acquire generic competitor Mylan, which recently moved its headquarters to the Netherlands to avoid US corporate taxes and to take advantage of anti-takeover laws.


Sales

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St. Luke’s University Health Network (PA) chooses Strata Decision’s StrataJazz Continuous Cost Improvement.

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University of Florida Health (FL) chooses Visage Imaging’s Visage 7 Enterprising Imaging Platform for both Shands and UF Jacksonville.

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Beth Israel Deaconess Hospital-Plymouth (MA) selects Voalte for caregiver communication and secure texting on personal smartphones.

IntegraMed Fertility chooses the Patient Pulse portal from Anthelio Healthcare Solutions.

University of Vermont Medical Center chooses ReadyDock’s disinfecting device docking station for its NICU.

Erlanger Health System (TN) will implement an unnamed $100 million EHR, replacing the current system that the CEO says is the #1 source of hospital dissatisfaction. I found their RFI online, which says they are running Siemens Invision in the hospital and GE Centricity in most of the practices, but I didn’t run across anything that says which system they’ve bought.

Henry Mayo Newhall Hospital (CA) chooses Summit Healthcare’s Provider Alert solution for ambulatory information sharing.


People

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Awarepoint names Thomas Warlan (Medlee) as SVP of software engineering.

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Besler Consulting hires John Slaby (Siemens Healthcare) as VP of product strategy and Heather Swanson (Wolters Kluwer) as regional VP.

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Ahmed Haque, ONC’s director of the office of programs and engagement, will join former National Coordinator Farzad Mostashari’s Aledade.

Source Medical names a new leadership team that includes former executives of Dell, Allscripts, and NextGen.


Announcements and Implementations

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Extension Healthcare announces upgrades to its alarm management solution that include enhanced voice-annunciated alarms, enhanced RTLS-enabled care team availability, extended iOS and Android device support, and a way for physicians to view their patient’s care team members and contact them securely from outside the hospital.

LabCorp will launch a direct-to-consumer lab testing business to compete with drug chains and other competitors that have offered those services for years, many of which were using LabCorp to draw and process their samples. Patients won’t need a physician’s order if their state permits them to request their own lab tests. LabCorp hasn’t said which tests it will offer or how they will be priced. Sounds great for patient empowerment, but then again, so did the idea that drug companies should be allowed to advertise directly to potential patients.

Netsmart enhances its vendor-agnostic HIT Value Model that helps providers develop IT adoption strategies and benchmark progress.


Government and Politics

Congress finally acts on a 2004 GAO recommendation to remove Social Security numbers from Medicare cards to prevent identity theft despite CMS complaints about the effort involved. The mandate was included in the SGR doc fix bill.


Technology

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Software vendors always state that you legally don’t own their software – you’re just licensing it. Tractor maker John Deere takes it to the next level, telling the Copyright Office that farmers aren’t actually buying their tractors, they are instead purchasing an implied lifetime license to the John Deere software that runs them. It’s an important argument as companies try to favorably position their products as being software that end users or potential competitors can’t tinker with under the Digital Millennium Copyright Act.

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Color Genomics announces a $249 saliva test kit that detects 19 genetic markers for breast and ovarian cancer. The company, sensitive to the limited population for which screening is indicated and the potential patient concerns about the results, requires that one of its designated physicians order the test and then provides a board-certified genetic counselor to explain what the results mean. Similar tests were priced at up to $4,000 until the US Supreme Court denied a competitor’s assertion that nobody else should be able to perform such testing since it held a patent for naturally occurring genetic sequences such as the BRCA1 and BRCA2 genes.


Other

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Emails exposed in the Sony Pictures breach show TV huckster-physician Dr. Oz trying to get Sony to sign him up as a pitchman for its wearables line, although his interest seems entirely commercial rather than medical.

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Health Catalyst SVP David Burton, MD provides six predictions in an HFM Magazine article: (a) health systems and payers will address at-risk contracting as strategic thinkers, bet-hedgers, or ostriches with their heads in the sand; (b) population risk evaluation will shift from reviewing actuarial buckets to being driven by delivery systems that focus on improving specific clinical areas where they can perform optimally; (c) virtual shared accountability networks will form as ACOs and clinically integrated networks realize the cost of out-of-network services; (d) the emphasis on quality and safety improvement will spur development of analytic software and best practices starter sets; (e) providers will focus cost reduction efforts on the 80 percent of patients for whom evidence-based guidelines apply; and (f) sponsors will seek more flexible analytics systems that can respond more quickly to external changes.

Reporter Joe Goedert shares my disdain for turning marketing and PR people loose to make illogical decisions, specifically as related to the HIMSS conference: (a) CPSI not only changing its name questionably, but providing a confounding buzzword-heavy and thoroughly unconvincing explanation of the need to do so; (b) an unnamed analytics vendor that bussed reporters offsite for a roundtable discussion but then informed them that the discussion was off the record and nobody could leave until it was over, which means it was a complete waste of their work time; and (c) President Bush and HIMSS telling reporters 90 minutes before his keynote that his remarks and the softball questions asked by HIMSS CEO Steve Lieber (the guy who wrote him a huge check – his speaking fee is around $150,000) were off the record.

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A vendor friend gave me a $200 Microsoft Band smart watch at the HIMSS conference. I gave it a try yesterday but put it back in the box after an hour or so. It is huge, bulky, and rigid (since it has a touch screen) to the point I couldn’t even get it under the cuff of my long-sleeved shirt and it barely fit around my wrist besides. It has a continuous pulse monitor, which is interesting but of marginal value for most people, and it pops up calendar and message alerts provided you’re willing to leave your phone’s Bluetooth turned on at all times. I gave it to an initially enthusiastic friend for a second opinion and got the same feedback: it’s cool, but not cool enough to be worth permanently hanging a heavy handcuff on your wrist even though it packs the heart sensor, GPS, light sensor, skin temperature sensor, and galvanic skin response measurement. I think my friend may end up reconsidering, though, after using it for a workout and seeing the results in Microsoft Health.

A judge issues a temporary restraining order that prevents Texas Health Resources from filing a worker’s compensation claim on behalf of Nina Pham, the Ebola nurse who is suing the health system. THR says such a claim should settle her issues and that Pham’s claims against it are unjustified since she’s an employee of one of its hospitals, not the corporation itself, and she’s not suing the hospital. 

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Weird News Andy says “Some day my prints will come – you can bank on it.” A NEJM case study profiles a woman whose chemotherapy treatments caused her fingerprints to disappear, which she discovered when her bank’s biometric ID system rejected her transaction.

I’m sure WNA would have caught this story: an Irish bank presses charges against customers who discovered that a temporary bug in the bank’s ATM software allowed them to withdraw more cash than they had in their accounts, inspiring one woman to make 115 ATM withdrawals totaling $60,000 in one afternoon to pay a Nigerian man to donate a kidney to her father.


Sponsor Updates

  • Medicity Network 5.6x earns Healtheway Vendor Validation.
  • CenterX Co-Founder and CEO Joe Reinardy will moderate a session on real-time benefit verification and electronic prior authorization at this week’s CBI conference in Philadelphia, PA.
  • Kareo announces a new version of its outsourced billing solution.
  • SyTrue publishes a story  about how healthcare organizations are unlocking the value of unstructured data.
  • Accreon’s work on the NB Cancer Network project is nominated for a 2015 Kira Award.
  • ADP AdvancedMD offers “Recent enhancements to the EHR charge slip.”
  • CommVault posts the second part of its series on “Disaster Recovery: Past, Present, and Future.”
  • Aventura posts a brief explanatory video on awareness computing.
  • Caradigm staff offer reviews of HIMSS, one featuring a great pic of HIStalk friend Regina Holliday.
  • CareSync offers “The Top 6 Reasons Why CareSync is For You.”
  • CitiusTech exhibits at Bio-IT World 2015 through April 23 in Boston.
  • ZeOmega releases its annual content update of best practices in evidence-based medicine care management.
  • Columbus CEO ranks CoverMyMeds as a Top Small Employer Workplace in Central Ohio.
  • Culbert Healthcare Solutions offers  “A Consultant’s Perspective: Teach ‘Em How to Fish.”
  • HIMSS15 attendees help Divurgent raise $5,000 for Lurie Children’s Hospital.
  • Peer60 offers a new report on mobile health and patient engagement.
  • Burwood Group is named to The Channel Company’s CRN Tech Elite 250.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

 

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April 21, 2015 News 10 Comments

Monday Morning Update 4/20/15

April 18, 2015 News 7 Comments

Top News

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Kaiser Permanente chooses midtown Atlanta for a $20 million IT campus that will create 900 jobs.


Reader Comments

From Justa CIO: “Re: HIMSS. Do you think it’s becoming irrelevant for people in HIT leadership roles? I find it much less compelling since I can find product information or call someone who has experience with something without being away for a week and spending thousands of dollars of my employer’s hard-earned money while plugging away at real issues. I would like to know what you and others think. Your coverage is excellent – it was enough to make me post this question as I realized that the only things I miss was networking and your choice party.” I’m mixed on the value of attending the conference. Networking can be overrated if you aren’t a vendor selling something – I sometimes think CIOs should stop talking to each other entirely (except to check vendor references) and do creative rather than imitative things since healthcare IT sometimes looks like lemmings following each other off the cliff. HIMSS is efficient in bringing people together so they can schedule time together, but otherwise it’s a horribly inefficient mess of social events, glitzy exhibits, job seeking, and glad-handing and you might be better off just buying the education session recordings (which are included free with conference registration). I’m not convinced that the non-profit health systems that spend fortunes to send people there (often more as a personal reward than a business necessity) show measurable ROI or demonstrate care improvement as a result. Here’s a challenge to health system CIOs that I will report anonymously if you respond: list the immediately actionable items you took away from the conference that you couldn’t have done without attending. Or, the actions you took in the past year that were driven entirely by your 2014 HIMSS attendance. Our HISsies “best CIO” winner John Halamka keeps BIDMC running despite his non-attendance this year.

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From Texas Rules: “Re: Next Wave Connect healthcare-specific social collaboration solution. It continues to purge staffers – Drex DeFord and most of the Seattle team are gone.” Drex’s LinkedIn profile indicates that he left the company in February. I asked Chairman Ivo Nelson, who replied,“ It’s pretty common for startups to go through some turnover in the first few years. As you know, I’ve been through this before and getting the right team in place is a sign of health, not illness. Next Wave Connect has steadily grown its staff and will continue to grow this year. We have a good team in place under the leadership of Jim Jacobs and I’ve been very pleased with our progress. Just our March To HIMSS campaign garnered over 15K hits and MyCHIME is has been a huge success.”

From Concerned Tester: “Re: [health system name omitted]. An IT director is under investigation for accepting an Aruba vacation from their [vendor name omitted] rep. That director and his former boss hid a problem with orders that didn’t match after an EHR upgrade. He also pushed out an update that broke the connection to the HIE that caused slowdowns and lost data. The good news that the vendor is being kicked out and Epic will happen in 10 months, but the bad news is that the director was successful in getting them to switch to the previous vendor’s HIE.” I’ve omitted names since I couldn’t verify, but I’m interested in who’s doing the investigation.

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From Magnum PI: “Re: Meaningful Use data from Jamie Stockton at Wells Fargo Securities. The numbers don’t seem to match what CMS provides. I also thought CMS stopped including vendor names in their numbers due to ongoing inaccuracies.” Jamie provided this response: “The only hospitals that needed to attest for Stage 2 in 2014 were the ones that originally entered the program in 2011-12. That cohort of hospitals is 2,600 facilities (vs. the 4,800 that have registered for the program through today). If we look at net attestations (adjusting for the fact that sometimes more than one vendor is listed by a hospital when they attest and therefore one hospital occupies multiple rows for the same attestation year in the CMS spreadsheet), then we calculate that 1,800 hospitals have attested for Stage 2, which roughly matches the number your reader quoted. If you just took 1,800 and divided it by 2,600, then you would get about 70 percent of hospitals having successfully attested for Stage 2. I probably need to make that 70 percent number much more clear in the future and we also need to add a line to the bottom of our Stage 2 table that adjusts the gross number of attestations (which was 2,900) down to the 1,800 net. When we look at vendor success rate, we are excluding the hospitals that have switched vendors since 2011-12. If we didn’t, Epic would have a 130 percent success rate because many McKesson, Meditech, and Siemens hospitals that first showed up in 2011-12 with those vendors have subsequently switched to Epic and would not be in the denominator of the calculation for Epic. Excluding all 400 hospitals that have switched vendors, we get to an average vendor success rate of 55 percent. Obviously that penalizes vendors in their success rate if they have lost market share, but I think that is OK. There is a reason that the hospitals moved away from them. At least with the February data set that powered our most recent analysis, CMS continued to publish the vendor names associated with each attestation.”

From The PACS Designer: “Re: medical 3D printing. At the Washington University School of Medicine, cardiothoracic surgeons are using 3D printing to prepare for heart operations. Recently they used the 3D method to prepare for a difficult heart repair for a 20-month-old toddler at St. Louis Children’s Hospital.”


HIStalk Announcements and Requests

I feel sorry for the housekeeping people who had to discard all the junk HIMSS conference attendees left in the overflowing trash cans of their hotel rooms at checkout. Every year most of the booth swag and handouts that seemed worth grabbing in the exhibit hall fail to earn their luggage space back in the hotel, so rather than pack it and haul it home, it’s easier to just chuck it. Somewhere in Chicago there’s a landfill full of Caradigm-provided HIMSS backpacks, although I actually brought mine home since it’s a nice one. I also brought back the pair of insulated coffee mugs that First Databank cheerfully provided.

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Arcadia Healthcare Solutions provided the most useful handout ever, a conference essentials pack that included a bottle of water, a coozie, breath mints, ibuprofen, foot bandages, antacid tablets, and vitamin C fizzy drink powder.

The conference reminded me of an observation I had years ago after sitting in on a variety of VC and executive meetings. Mid-level executives and startup CEOs always wear impeccable suits and frown at everything to make sure people take them seriously, while the folks with real money and power wear casual clothes and joke around because they’ve earned the ability to do whatever they want and don’t care what the suited second string thinks. I like that a lot. Big-time VC guy Peter Thiel famously says that his fund will never invest in a technology company whose CEO wears a suit.

Speaking of the conference, I didn’t hear any comments or see any tweets quoting something interesting that was said by the keynote speakers. Did I miss anything by not attending any of them? I’m also interested in more definitive comments about what you liked and didn’t like. Did you go to any educational sessions? Did you meet anyone who was particularly impressive or obnoxious? What vendors raised your interest?

Here’s an odd expression I’ve heard quite a few times over the years: “a piece of software.”

Phrases that need to be expunged from the healthcare vocabulary: mobile health, population health, and patient-centered. All of those be assumed when talking about health. They don’t require being defined as a separate novelty category as they once might have been.

I was annoyed at a video interview with Karen DeSalvo conducted by a young HIMSS Media person with unstated credentials (she includes nothing about education or background in her LinkedIn profile) who repeatedly referred to the national coordinator (and acting assistant secretary for health)  as “Karen.” Even if she’s your BFF, she should be referred to as “Dr. DeSalvo” when interviewing her on video – that shows basic respect for her education, role, and age. 

Thursday beat Wednesday’s HIStalk readership record with 14,658 page views from nearly 11,000 unique visits.

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The folks who didn’t attend HIMSS expected their workload to be about the same last week, although a fourth of them admitted that it’s easier when their bosses aren’t around. New poll to your right or here: if you attended the HIMSS conference, how would you grade it?

Lorre has posted some of the interviews DrFirst did at the conference. Here’s one with our HIStalkapalooza host, Forward Health Group’s Barry Wightman.

Here’s another DrFirst HIMSS conference interview, this one with DrFirst CEO Cam Deemer on the one year delay of mandatory electronic prescribing in New York.

For those who attended HIStalkapalooza: what would you do differently? How would you make it more attractive to potential sponsors for a 2016 version? I haven’t decided if I’ll do it again next year, but Lorre has confidently placed a hold on a Las Vegas venue thinking I’ll re-up.

Listening: The Suffers, big-horns Gulf Coast melting pot soul from Houston. This is your chance to tell people about a great band they’ve never heard, but will almost certainly like once they do.

Welcome to new HIStalk Platinum Sponsor xG Health Solutions of Columbia, MD. The clinician-led company brings to the national market healthcare transformation tools and knowledge developed by Geisinger Health System. The company offers care management services (including population health analytics) and offers help with transition to a fee-for-value environment. XG Health solutions announced at the HIMSS conference EnrG, a suite of advanced interoperability software modules that use Geisinger-developed care models to improve acute and chronic care management, connecting via SMART on FHIR to work seamlessly with any FHIR-enabled EHR (the initial partners are Athenahealth, Cerner, and Epic). The evidence-based care modules address procedures and conditions such as CABG, hip fracture, COPD, diabetes, and chronic kidney disease. EnrGRheum, which addresses rheumatologic diseases, will be released in Q3 2015 with six additional apps following. Thanks to xG Health Solutions for supporting HIStalk.


Webinars

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

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CPSI renames its EHR business line Evident. or at least that’s what the verbose yet uninformative press release suggests. It will continue to run its services business under the TruBridge name. The Evident name seems rather generic, not particularly relevant, and likely to get lost in Google searches. Apparently the CPSI name survives as the parent and in the company’s Nasdaq listing. Vince Ciotti tipped me off with the photo above that he took in the HIMSS exhibit hall.

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Streamline Health reports Q4 results: revenue up 1.2 percent, adjusted EPS –$0.04 vs. –$0.13. Shares dropped almost 7 percent Friday on the news. Above is the one-year price chart of STRM (blue, down 49 percent) vs. the Nasdaq (red, up 20 percent).


Announcements and Implementations

Tallksoft launches its Survey+ patient survey app that allows medical practices to benchmark their patient experience and practice performance.

Cerner will offer Healthwise health education content to Millennium users and via its HealthLife Engagement module.

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Ernst and Young announces development of its Telemedicine Adoption Model.


Government and Politics

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The estimated cost of opening the new Denver VA hospital rises to over $2 billion vs. the original VA estimate of $630 million. It’s also two years behind schedule.

The Atlantic says hospitals are chasing CMS patient satisfaction scores that focus on making people happy rather than making them well, encouraging hospitals (even those with low clinical ratings) to redirect funds toward putting in valet parking, live music, and VIP loyalty lounges. They’re also scripting nurse interactions to troll for higher survey scores and tying clinician pay to the results even though everybody knows that the patient isn’t always right. A previous version of the survey allowed comments, where patients complained that their dying roommate was making too much noise and that their sandwich didn’t contain enough pastrami. Experts worry that hospitals trying to appease patients might avoid talking to them about unpleasant topics such as losing weight, seeking mental health treatment, or stopping smoking. Most amazing is that patients with the highest reported satisfaction had higher hospitalization rates, higher costs, and a higher mortality rate.


Other

Here’s the final installment of Vince Ciotti’s vendor revenue review for 2014, this time covering small-hospital vendors.

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I missed that Athenahealth’s Jonathan Bush tweeted this last Tuesday, including a HIStalkapalooza photo taken back stage at the House of Blues.

The latest drug of abuse: amphetamine-based ADHD drugs such as Adderall (aka “mommy crack” or “productivity in a pill”), which mostly young career go-getters are using to increase career competitiveness through short-term improvement in focus and attention. Interestingly, the anonymous executive profiled in the New York Times article is a health IT startup CEO, who says she has no choice but to take the drug because it is “necessary for the survival of the best and the smartest and the highest-achieving people.”


Sponsor Updates

  • HCS sponsored the “Arc of Monmouth Walk and 5K” on the Asbury Park Boardwalk in New Jersey last week and raised more money than all other teams for people with intellectual and developmental disabilities.
  • Strata Decision Technology will add Yale-New Haven Health’s quality indicators into its StrataJazz platform to help providers understand the high cost of quality variation.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 18, 2015 News 7 Comments

Jenn’s HIMSS Day 4 4/15/15

April 16, 2015 News 2 Comments

The end of my fifth HIMSS marked the first time I’ve ever had a flight cancelled. My unexpected stay in a Howard Johnson 20 minutes from O’Hare with just the clothes on my back and the electronics in my HIMSS book bag gave me extra time to mull over the rest of my HIMSS experience.

The fourth and final day of the conference for me was a bit more scheduled, with a few media briefings and a good chunk of time spent walking around the exhibit hall in one last attempt to get a flavor for what this year’s product offerings were all about. Buzzwords seen on booths and heard in show-floor conversations included value-based care, population health management, interoperability … the usual. Not much has changed in that area from an exhibit hall perspective, with the exception of EHRs no longer being the big-ticket item. They have turned into the backbone for everything else.

I chatted with the folks from Health Care DataWorks, which spent the bulk of its HIMSS promoting a variety of knowledge packs, pre-built dashboards build into its enterprise data warehouse that address 16 hospital areas including ER, OR, and patient-related analyses. HIStalk contributing author and Cedars-Sinai CIO Darren Dworkin made an appearance at a HCD roundtable early in the week to discuss how the health system used HCD business intelligence and analytics to achieve HIMSS Analytics Stage 7 status..

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The folks at biometric identification company M2sys caught up with me to show me their first foray into mobile health. The RightPatient platform includes a mobile health app and wearable integration server that caters to both consumers and providers. The server takes data from consumer wearable devices and delivers it to the appropriate EHR, while the accompanying mobile app is the first I’ve seen that combines many most of us already have on our phones – personal health record, appointment scheduling, activity tracking, medication reminders, alerts, mood and health monitoring, and health games, to name a few. It can even be configured to accommodate the health data of multiple family members, with all data seamlessly transferred to their provider’s EHR.

I’ve been fairly vocal about the problem of having too many patient portals to log into, so it’s interesting to see the similar problem of having too many apps figured out via the aggregation of many into the distillation of one. President Michael Trader tells me that the platform will launch in July, with a mental health version already in the works.

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My last show-floor one-on-one was with the Xerox and HealthSpot team. I have been interested in the HealthSpot remote-consultation kiosk for some time, and was happy to get a personal tour. My big question for CEO Steve Cashman was, “How is this a better option than picking up my phone while at home for care via a telemedicine app?” He confidently told me that going to a kiosk location offers benefits that a telemedicine app can’t match: reimbursement; a pipeline of HealthSpot physicians who also work for local hospitals and health systems; better quality of care; regulatory benefits (he kept bringing up the fact HealthSpot can operate in Texas); and automatic integration of health data via Xerox back-end technology into the patient’s EHR. The company is looking to launch its kiosks in 25 Rite-Aid stores in June. I’d definitely like to give it a try if they ever come to Georgia.

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My inaugural visit to the Interoperability Showcase was an interesting one. The area was divided into a number of different “vignettes,” scenarios of patient care featuring family members going through different medical events. After a brief introduction by a healthcare IT magician in a central seating area, audience members dispersed to one of the vignettes, where we listened to three different docents run through the technologies involved in that particular family member’s diagnosis and treatment.

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I decided to visit the oncology/clinical trials visit of 38 year-old patient Isabel, which involved technologies from Epic, InterSystems, and the CDC. As any hard-working member of the press would do, I whipped out my camera phone to document my experience, only to have the Epic rep immediately tell me that no pictures were allowed. He even followed me out of the presentation afterwards to ask that I delete any screenshots I may have taken. The one above is the only one I managed to get.

I walked over to a different vignette to see if they were as strict with their photography restrictions, only to find out they had no problem with photography. I snapped a few shots, but did notice that the rep working the video screen logged out of whatever application he was demoing as I snapped away. The whole experience left a bad taste in my mouth. Isn’t interoperability at its core about sharing data?

A few other random observations as I attempt to wrap up my coverage:

Interviews with Dana Moore: I heard from Lorre that it was his most worthwhile HIMSS experience, and it was certainly in demand. I love knowing that money raised from Mr. Moore’s time and expertise is going to a good cause like Donors Choose. It’s great to work for an employer that places importance on helping others. I saw several other companies highlighting their charitable efforts, including Dell and QuadraMed. HIMSS attendees also got the chance to spin Divurgent’s vibrantly colored Trivia Charity Wheel. Their spins helped the company raise $5,000 for Lurie’s Children’s Hospital of Chicago.

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Customer service in the Windy City: It was fantastic, especially at McCormick Place. Everyone had smiles on their faces, and one security guard even chased after to me to ensure I went the right way to the West Hall.

Size and scope of the conference: I found the exhibit hall strangely confining despite its expansiveness. The press room was too far away from the exhibit hall to warrant my making the trek once or twice a day for a free meal, reliable WiFi, and quiet workspace to gather my thoughts and plan my show reviews. I’m not sure who thought putting zero restrooms in the exhibit hall would be a good idea – it certainly wasn’t for me. Like Mr. H and 35,000+ of our closest friends, I probably spent more time walking from point A to point B than in meetings, talking with vendors, or attending keynotes combined. For the record, I went through 10 Band-Aids on my poor blistered feet over my four days there.

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Exhibitors: I managed to run into HIStalkapalooza sponsors Divurgent and Sagacious Consultants during my exhibit hall trek. Both teams kindly squeezed together for group shots. I can’t wrap up conference coverage without mention our gracious neighbors in the exhibit hall – Medisas and Oxford Healthcare IT. The Medisas team put up with a variety of shenanigans in and around the HIStalk booth, while the Oxford team kept us well fed with their daily buffet of Chicago-style hot dogs and Garrett’s popcorn.

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Overall, I felt like I barely scratched the surface of what the show had to offer. I didn’t make it to any educational sessions other than Monday’s keynote, a similar experience to many of the providers I spoke to. It seems most people prefer to spend their time at HIMSS connecting with colleagues, and visiting vendors they otherwise wouldn’t be able to get to throughout the year. Perhaps next year I’ll take a different approach and spend most of my time in sessions rather than on the show floor. Given that it’s in Las Vegas, I can only hope the House of Blues there will be happy to host our next HIStalkapalooza. I hear Lorre is already entertaining sponsorship requests.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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JennHIStalk

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April 16, 2015 News 2 Comments

Jenn’s HIMSS Day 3 4/14/15

April 15, 2015 News 2 Comments

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My third day at HIMSS started off with the #HITchicks tweetup at the HIMSSpot in between the exhibit halls. A group of about 50, including a smattering of men, attended to talk and tweet about the role of women as patient advocates and the highlights of HIMSS15 thus far. It didn’t take long for the “booth babe” conversation to take off, with one audience member shouting out HIStalk for bringing attention to the unfortunate trend a few years ago, and consistently calling out those companies that choose to hire pretty faces in tight-fitting spandex to shill their products. I thought it was especially fitting that me, Lorre, and friends of HIStalk added the badges below to our HIMSS15 wardrobes. Kudos to HIStalker Steve Blumenthal, business and corporate law attorney at Waller Lansden, for supplying them. He’s got a pretty sharp sense of humor for a lawyer.

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The tweetup had not one but three highlights for me: University of Michigan Hospitals and Health Centers CIO Sue Schade – CHIME’s CIO of the Year – stopped by the voice her support for the group. Kym Martin, a four-time breast cancer survivor and patient advocate (not to mention the lovely wife of HIStalk Blues Brother Ross Martin, MD), shared her story of patient advocacy and journey as a four-time breast cancer survivor. Last but not least, ONC National Coordinator Karen DeSalvo, MD stopped by to share her experience as a woman who has worked in academia, public health, and now on the national political stage.

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My next stop was the ONC press briefing, where staff gave a run down of the office’s accomplishments over the last year. Interoperability and partnerships were definitely the overarching theme. DeSalvo took the briefing as an opportunity to announce the availability of $1 million in grant funds to support health IT projects for the Community Interoperability Health Information Exchange Program. The program will award funds to 10 organizations, including those that are not eligible for MU incentives. Applications for the program are due June 16.

We didn’t get too far into the Q&A before someone brought up the patient engagement crowd’s (including Farzad Mostashari, MD’s) uproar over the decision by CMS to change the Stage 2 requirement so that providers now have to show that one patient, rather than 5 percent of their patients, accessed their information online. DeSalvo calmly stressed that ONC is absolutely committed to ensuring that patients have access to their health data, adding that she is encouraged that a dialogue is taking place on the issue. She also reminded reporters that this is a proposed rule, and that formal comments on the rule are encouraged. I understand why some might call this a step backward for the MU program, but I can’t help but think many providers are breathing sighs of relief. You can’t force people to use the Internet, especially those that don’t have access to a computer or reliable WiFi. As DeSalvo reiterated throughout her response to this question, the true challenge will be a cultural one, not necessarily one solved by technology, which is why it’s so important for the ONC to partner with other federal agencies as they attempt to evolve their focus beyond EHRs.

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My next stop after a quick lunch in the press room as at the Emdeon booth, where I moderated a panel discussion with Emdeon’s Gene Boerger and CareCloud’s Albert Santalo on fueling product innovation with big data. I was slightly jealous of the stylish and super-comfy shoes the Emdeon staff were sporting, not to mention the cushioned carpet in their booth. I enjoyed wandering around both sides of the exhibit hall afterwards, snapping pictures of those that had unique designs, catchy marketing gimmicks, and bustling crowds.

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My remaining time at the conference was spent at our booth, where I got the chance to witness The Walking Gallery converge, courtesy of HIStalk’s good friend Regina Holliday. I especially loved the vibrant color of Farzad Mostashari, MD’s jacket. Let the data flow ….

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My day concluded with a quick stop by the Patientco party, where I ran into Caroline Wood and Sherry Farrugia of Georgia Tech. Talk soon turned to a company called Evidation Health, launched last month by GE Ventures and Stanford Health Care to improve health outcomes with evidence-based digital health tools. Their excitement about the startup was palpable, so I may have to crash the road trip they’ve got planned to go out there later this year.

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After that it was on to the Edifecs #HIMSSandHers meetup, where I happily talked shop with Politico’s Ashley Gold. I left with a T-shirt and a selfie stick, my favorite piece of HIMSS swag so far. Despite being thoroughly exhausted, I’m already looking forward to seeing what my final day of HIMSS will bring.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.
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April 15, 2015 News 2 Comments

Jenn’s HIMSS Day 2 4/13/15

April 14, 2015 News No Comments

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I can’t even begin to break down my second day at HIMSS without first mentioning the highlight: the now-epic pie-throwing incident at HIStalkapalooza involving Judy Faulkner and Jonathan Bush. Both were good sports, and both had only gracious things to say to one another as they accepted their respective HISsie Awards. More on the party towards the end of the post.

My second day at HIMSS started off with a quick trek in the rain to the shuttle stop, followed by a pleasant conversation with Intelligent Medical Objects President and CTO Regis Charlot. (Note to HIMSS newbies: Shuttle rides, elevator rides, and lines can be great opportunities to strike up a conversation with your next client. A simple “Good morning. How are you enjoying the show?” typically kicks off great conversation.) Charlot waxed poetic about the challenges providers are facing when it comes to transitioning to ICD-10, though he did reiterate that IMO’s clients (and the general populace) are in good shape. Providers have accepted their fate and seem to be working diligently to prepare for the October 1 switch. His crystal-ball predictions for healthcare involves Intel’s Edison platform, a “[h]igh performance, dual-core CPU and single core micro-controller that supports complex data collection,” and that seems like it will help drive super-computing in the wearables space. Seems like it might have a unique play in telemedicine and the quantified self movement.

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My next stop was the morning keynote, which included a rousing performance by a local gospel choir and a not-quite-so rousing introduction from HIMSS Paul Kleeberg. “This sounds like an infomercial,” was one audience member’s description of Kleeberg’s contribution. The real meat of the keynote was given by Alex Gourlay, executive vice president of Walgreens Boots Alliance and president of Walgreens . It was engaging, as keynotes go. He emphasized the role of retail clinics and pharmacists in achieving the Triple Aim, outlining the many partnerships Walgreens has entered into (WebMD, PatientsLikeMe, Qualcomm Life, MDLive) in an effort to take e-prescribing, telemedicine, medication compliance, and better outcomes to the next level. Gourlay also announced that the company will be launching a medication reminder app for Apple Watch next month.

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I had the pleasure of sitting next to two women from MultiCare Health System (WA), both of whom seemed very excited by what Walgreens is doing in the mobile space. Debbie Embree, director of applications, and Brenda Bowles, RN director of clinical informatics, told me they were going to spend their time at the conference looking for ways to push their patient engagement strategy beyond their Epic MyChart portal and out into the retail space. Personal device integration via mobile apps is likely their next step.

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After a mind-numbingly slow exodus from the keynote with 3,000 of my closest friends, I made it to the HIStalk booth. I spent a great five hours in the exhibit hall meeting and greeting loyal readers and attendees who had never heard of us but just couldn’t resist picking up a bag of Garrett’s Popcorn, courtesy of our friends at nVoq. I finally got the chance to spend time with The Walking Gallery Founder Regina Holliday and our HIStalking patient advocate scholarship winners, who, despite a few hiccups with registration, seemed very excited to be at HIMSS. Regina’s live painting was definitely a crowd-pleaser, and I appreciated the opportunity it gave us to talk with attendees about the importance of patient advocacy in the world of healthcare IT.

Several hot topics bubbled up in my booth conversations with providers: The majority of them seemed to be wandering the exhibit halls looking for solutions and strategies around security and privacy, patient engagement, and ICD-10. Not a one had anything positive to say about the education sessions. As Dr. Jayne explained to me, the sessions suffer from the fact that they had to be submitted nearly a year ago, and have likely lost their luster in the preceding 10 months or so.

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Other booth drive-bys included a chat with AJ Montpetit from the Mayo Clinic Center for Innovation, looking quite dapper in bowtie and pink mustachioed socks.

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I also had a chance to meet Modernizing Medicine CEO Dan Cane and his colleagues. The company, which made headlines a few weeks ago for its partnership with IBM Watson, is busy expanding office space and hiring new staff. You can read my interview with Cane about the Watson partnership here.

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I managed to do a quick walk-about, and ran into the #IHeartHIT meetup at the HIMSSpot. It was great to see patients and HIMSS15 social media ambassadors like Linda Stotsky share their healthcare IT stories. There definitely seems to be a stronger patient presence at this year’s conference. I’m really looking forward to reading about the HIMSS15 experiences of our HIStalking team.

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It was great to see the Georgia Dept. of Economic Development and the Metro Atlanta Chamber, sponsors of the morning keynote, proudly displaying the sign we awarded them earlier this year for being nominated as “the Nation’s Capital of Health I.T.”

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After my jaunt through .05 percent of the exhibit hall, I spent a final hour at our booth then rushed back to my hotel to change into HIStalkapalooza-worthy attire. As I mentioned above, the party was amazing. (Check out the #HIStalkapalooza hashtag on Twitter for great pictures and recap.) Our sponsors did a tremendous job of making sure everyone got in, got fed and watered, and got on the dance floor. Party on the Moon was phenomenal. I must have danced for an hour-and-a-half straight, which does not bode well for my feet during the rest of my time in Chicago!

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I even managed to snag a few dances with “Jenn’s Secret Crush” Cynthia Porter, who, despite holding the stuffy title of president of Porter Research, really knows how to have a good time.

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Lorre and I were not the only ones decked out. This year’s HIStalk King and Queen were definitely worthy of their titles, and displayed just as much dancing prowess as they did fashion savvy. All in all, my second day at HIMSS was a blast. I appreciated the opportunity to chat with readers at our booth, dance with sponsors at our party, and finally rest my swollen feet at the end of the night.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.
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JennHIStalk

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April 14, 2015 News No Comments

Jenn’s HIMSS Day 1 4/12/15

April 13, 2015 News 1 Comment

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Ah, HIMSS. This year marks my fifth, and like the previous four, I doubt it will disappoint. There’s just no other event that can offer up such a unique mix of nonstop networking, educational sessions catering to every HIT acronym under the sun, exhibit hall #HIMSSanity, sleep deprivation, and over-the-top caffeine consumption. I genuinely enjoy it every year, mainly for the relationships made and fostered. HIMSS 2010 in Atlanta was, in fact, where I first heard about HIStalk and Mr. H’s predilection for walking around with a paper bag over his head to keep his anonymity in tact.

Speaking of Atlanta, my day started well before the sun rose on an overbooked Delta flight full of folks en route to HIMSS. Honeywell, Oneview Healthcare, Patientco, McKesson, and Gozio Health were all represented. I didn’t even attempt to enter the always notoriously long taxi queue at Midway in Chicago, instead opting to reach my hotel via a 20 minute subway ride that cost all of $3. I found myself further impressed with Chicago when the clerk at my hotel allowed me to check in at 10:30 a.m. A 30-minute lie-down after a 4:45 a.m. rise wound up being essential to staving off the aforementioned #HIIMSSanity.

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Refreshed, and with a few hours to spare, I spent time wandering around Chicago’s Museum campus and nearby lakefront. The weather was slightly warm and sunny, with just a hint of the city’s famous wind. I had a thoroughly enjoyable time eating my first “Chicago-style” hot dog while people-watching on a park bench. It’s not often that I get to while away an hour and a half doing not much of anything. The lure of the convention center came soon after lunch, and I found myself walking three short blocks to grab the shuttle to McCormick Place. (Is it just me, or does the shuttle drop off in the dark bowels of the trade center remind anyone else of the Lonely Mountain?)

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After grabbing my press pass, I ran into Sara Zellner at Health Data Consortium giving away “I Love Health Data” buttons. (I’m a sucker for fun “pieces of flair.”) She reminded me that HDC’s annual Health Datapalooza is coming up at the end of May in Washington, D.C., with HHS Secretary Sylvia Burwell and Acting CMS Administrator Andy Slavitt scheduled to speak.

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From there, it was a quick quarter mile (kidding, it was probably only a fifth) to the Venture+ Forum, a day-long event featuring startups pitching in three-minute lightning rounds to a panel of devil’s advocates. I came in at the tail end of the forum, only getting to see full pitches from Heal, Medivizor, Sensentia, and Open Health Networks. Heal’s app for on-demand house calls caught my eye, as did the realization that anyone thinking of speaking in public should avoid saying “um” at the end of every sentence and remember there is a slide deck to scroll through at the beginning of the presentation, rather than halfway through. It seemed like the Forum was at capacity of around 150 or so, which probably means it will warrant a bigger space next year.

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A number of other pre-conference symposia took place on Sunday, including the inaugural Revenue Cycle Solutions Summit. Patientco’s Josh Byrd sent me this report:

The Revenue Cycle Solutions Summit provided over 200 attendees with thought-leading presentations from providers who are paving the way for what the revenue cycle of the future will look like. The common thread weaved throughout was a focus on patient-centered care after the episode of care. Highlights included:

  • Mike Simms, VP of revenue cycle at Cone Health talking about how to choose vendors who align with your key revenue strategy;
  • Leigh Williams, director of revenue cycle at University of Mississippi, who shared how they engaged physicians in using HIT to achieve financial success;
  • Andrew Ray, manager of physician revenue cycle operations at Stanford Children’s Hospital, who talked about how to centralize and automate the revenue cycle to increase reimbursement and decrease denials; and
  • Key members of the HIMSS Revenue Cycle Improvement Task Force, who shared insights on how they are working together to bridge the gaps between payers, vendors, banks, providers, and other key stakeholders to create a better patient financial experience.

Josh told me that the attendee mix was mostly CEOs and CIOs, so it will be interesting to see how many CFOs attend next year’s event. Could HIMSS be looking to give the HFMA ANI conference a run for its money?

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After a quick change into Roaring 20s-inspired flapper garb, I put in an appearance at the opening reception, which I found surprisingly well attended given the amount of smaller HIMSS symposia receptions taking place at the same time. The jazz band was great, and definitely got me excited about performances by Ross Martin, MD and Party on the Moon at HIStalkapalooza.

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My next and final stop of the evening was the HIStalk Sponsor’s Reception, which was a great opportunity to meet and greet the people behind the companies whose support makes HIStalk happen. I can’t thank them enough. Special thanks to the lovely folks at Aventura who gifted me with these classic kicks, which I may have to put on tomorrow once the HIStalkapalooza red carpet shoe-judging festivities have concluded and the dancing is ready to begin.

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Stay tuned for more updates. I’m off to get some shut-eye, still debating whether or not to start my morning off with some YogaEspresso. Down dog and healthcare IT seem like a natural combination, don’t you think?


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

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April 13, 2015 News 1 Comment

From HIMSS 4/12/15

April 11, 2015 News 7 Comments

Top News

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HHS proposes to shorten the Meaningful Use attestation period to 90 days for 2015 in an announcement released, as always, late on a Friday (they also seem to like to put out big news right before the HIMSS conference). It also proposes removing requirements that are duplicative or no longer needed. Interestingly, HHS wants to reduce the five percent threshold for view/download/transmit to just a single patient – if even one patient retrieves their information, then the capability has been proven and the requirement is met. That addresses the argument that providers can’t force patients to access their data who are unwilling or technically unprepared to do so.


Reader Comments

From Hermanically Sealed: “Re: Evan Nordgren lawsuit against Epic for not paying overtime. Stories reported that the employees were encouraged to donate their settlement money to the health center where Judy Faulkner’s husband works as a physician.“ Unverified. I haven’t seen anything about donation requests. Sounds unlikely to me and easy enough to prove if you’ve received such suggestions.


HIStalk Announcements and Requests

I’ll be posting differently this week, with less emphasis on the clutter of questionably interesting announcements and more on the conference. I may post more than once daily and Jenn will post separately, but I’ll probably send just one email blast daily to avoid overloading inboxes.

I VRBO’ed a little apartment  in Bridgeport, south of downtown within a few blocks of US Cellular Field (the unfortunately and opportunistically renamed Comiskey Park, which was a replacement for Old Comiskey Park). It costs less than a boxy hotel room, is in a cool neighborhood with interesting restaurants within walking distance, and is a short Uber ride to downtown or McCormick place. It’s much better having a kitchen, plenty of room to spread out, and a bay window looking out at White Sox fans heading down the sidewalk to the game than sitting in an airless room in a sterile building packed to the gills with lost, badge-wearing geeky HIMSS peers clogging up slow elevators and chattering way too loudly from being jacked up on exhibit hall adrenaline.

Saturday was stunningly beautiful in Chicago, with temperatures in the mid-60s with blue skies and sunshine. The trees are still denuded, but the grass has greened up and daffodils are poking up. I did some site checking of the House of Blues (looking great there), walked around the river, took a boat ride, and went to the Bulls game courtesy of a reader who invited me. I even Uber’ed back after the game, got picked up quickly near United Center, and didn’t even get hit with the dreaded surge pricing.

I downloaded the HIMSS15 mobile app and found it to be pretty buggy, requiring a bunch of iPhone restarts and confusing password prompts that didn’t make it clear whether it was the HIMSS website password or a new one (I’m still not sure since I had to do a password reset just to get it going). It has pretty good information, although I’m not sure the educational session list will replace the need for the little spiral-bound book that I always carry, assuming they’re still printing them. I used to study the agenda carefully and plan which educational sessions to attend weeks ahead, but they’ve been disappointing in the past few years (too much vendor involvement, boring presenters, too much reliance on PowerPoint, etc.) and I’m going to fewer and fewer of them.

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Response has been brisk to the gracious offer of Dana Moore, CIO of Centura, to meet in the HIStalk booth with anyone willing to donate $500 to DonorsChoose.org in return for 20 minutes of his uninterrupted attention. Six companies have donated and I’ve funded the first wave of classroom projects that their $3,000 is supporting. The donations paid for the full cost of these projects, all of which are for classrooms in high-poverty areas, most of which involve Teach for America teachers, and many of which include matching funds from other charitable organizations:

  • Two Fire HD devices for a middle school reading program in San Diego, CA
  • A projector for a kindergarten class in Erie, PA
  • Professional development books for kindergarten teachers in Charlotte, NC
  • A Chromebook for an elementary school class in Toppenish, WA
  • Algebra calculators for a high school class in Auburn, WA
  • A sand and water table for K-2 children, all with multiple disabilities, in Rosamond, CA
  • Headphones for K-2 classes in Portland, OR
  • A drawing tablet for the iPad for grades 3-5 in Lockhart, TX
  • Three iPad Minis for a sixth grade class in Oklahoma City, OK

I’ve already received appreciative emails from most of the teachers (it seems to be a pattern that good teachers work through the weekend) and I’ll follow up with photos, teacher comments, and student thank you notes once they put the materials to use. I also have quite a few more projects to fund given the generous response. A couple of companies have taken the “top spot” banners at the top of the page in the next week and most of that money will go to DonorsChoose as well.

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Poll respondents favor disbanding ONC’s certification program after Stage 3, although a few folks wouldn’t mind seeing ONC keep the program alive but with more input from previously attesting users. New poll to your right or here, for those who aren’t attending the HIMSS conference: will you be working more, less, or about the same this week?

I’m puzzled at companies (HIMSS Analytics, among them most recently) that proudly boast via a grandiose press release of having redesigned their websites. People who already follow the company will see for themselves, while those who don’t aren’t likely to rush to the nearest browser to gaze in wonderment. More self-congratulatory marketing run amok.


Last Week’s Most Interesting News

  • The Texas Medical Board, protecting the interests of its members, prohibits prescribing medications for patients who have been examined only by telemedicine.
  • Health IT issues once again make ECRI Institute’s list of top patient safety concerns.
  • Allscripts agrees to pay $10 million to settle a shareholder class action lawsuit claiming the company’s executives misled investors with overly positive comments following its 2010 acquisition of Eclipsys.
  • FTC warns ONC about unintentionally limiting consumer choices in setting or approving interoperability standards.

Webinars

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

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Patient engagement solutions vendor PatientBond acquires consumer profiling company C2b Horizons.

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SSI Group will announce Monday that it has acquired patient access management software vendor Provider Advantage. Readers who reported the rumor earlier almost got it right – the only part they missed is that SSI Group was the acquirer rather than the acquiree (and SSI’s response to my inquiry was truthful – they weren’t going to be acquired). I call that a win all around.


People

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Parallon promotes Curtis Watkins to CEO of its technology business unit.

Truven Health Analytics hires former CMS Healthcare.gov official Kirk Grothe as VP of its federal government business.


Announcements and Implementations

MedEvolve, Salar, and Net Health choose VitalWare’s ICD Sherpa as their ICD-10 partner.

Aprima announces a mobile app for its products.

ARC Devices and Orchestrate Healthcare launch ARC VitalConnect, which transmits readings from ARC’s non-touch digital thermometer to EHRs.

Senior care software vendor PointClickCare joins the Surescripts network.


Government and Politics

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ONC delivers its congressionally mandated report on information blocking, defining the term as when “persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information.” I’m not quite sure how a company could “reasonably” interfere with information exchange, although ONC later mentions possible patient safety concerns that I would take to mean mental health information. ONC admits that it doesn’t really know how extensive information blocking is since stories are anecdotal or how that practice could be assessed other than by in-the-field product reviews. ONC is clear on practices it considers detrimental to information exchange, including contractual restrictions, charging for information exchange, developing or implementing systems in non-standard ways that increase interoperability difficulty or cost, and practices that lock users in with regard to a particular technology (from  vendor’s standpoint, good business practices, in other words). ONC’s recommended actions: start in-the-field testing as part of certification, tighten technical standards, increase product and vendor transparency (although ONC admits it can’t do much in that regard), mandate sharing, clarify to providers what information sharing is allowed under HIPAA, and refer obvious cases for review under anti-kickback statutes or even to law enforcement agencies where appropriate.

The problem with provider information blocking is that only patients could report it and they’re not likely to call up ONC to complain. Vendor practices, whether contractual or technical, are easier, so it seems to me the most effective way to move the market is to call them out publicly (800.ONC.BLOK, anyone?) It would also be nice for ONC to provide suggested contract boilerplate language for providers, especially medical practices that seem inclined to sign everything shoved in front of them by a exuberant salesperson without even reading it, much less altering it favorably. That’s assuming that providers even care about sharing information, which is the biggest unknown of all. I’d like my local paint store to electronically exchange information on textures and shades with their competitors so I have more freedom of choice, but I doubt they share my enthusiasm.


Sponsor Updates

  • Medicity CEO Nancy Ham pens a blog for HFMA entitled, “Do You Know Where Your Patients Are?”
  • MedData launches major upgrades to its client reporting portal and iPhone app.
  • Navicure releases an upgrade to its billing and payments platform.
  • NVoq offers “The Link Between the Simple Checklist and Improved Patient Safety.”
  • Experian Health/Passport launches a video contest to show how its solutions have helped improve client organization’s patient access processes.
  • PatientPay produces a video detailing its new solution that enables practices to get real-time pricing for patients who call to request estimated visit costs.
  • A PDS blog, “When I Was Your Age: The Challenge of Generational Patient Engagement,” is featured in the HIMSS15 blog carnival.
  • PMD offers “Apple’s Most Important iOS Security Update.”
  • Talksoft’s Hamilton, NJ office is featured in the local paper in a piece about recycled office spaces.
  • TeleTracking asks, “Are U.S. Hospital Operations in Need of an Operation?”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 11, 2015 News 7 Comments

News 4/10/15

April 9, 2015 News 8 Comments

Top News

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The Federal Trade Commission likes ONC’s interoperability roadmap for the most part, but observes that interoperability will continue to be hampered by the competitive interests of providers and vendors. It also gently warns ONC that its strategy of using policy and funding levers to create interoperability demand might encourage less innovation than if the government instead created market forces as a payer (i.e., Medicare). FTC says that its experience shows that vendor participation in creating standards and certifying products causes anti-competitive behavior, such as withholding certification from a competitor, excluding new products from meeting prior standards, rigging the standards-setting organization with vendor-friendly members, and not paying enough attention to patient rights. FTC is also worried that vendor-recommended standards will lock consumers onto a platform that may have been created with the intention of stifling competition. Lastly, FTC is concerned that any standards ONC chooses will be treated as law, so if they really want to get into the standards-setting business, they had better choose carefully.


Reader Comments

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From Pulpit Bully: “Re: Georgia Medicaid Fair. Here’s a free training event for those who want to get some insight into why our industry is hopelessly complex. I hate to sound like a curmudgeon, but this is an ENTIRE DAY of sessions about how insurance companies and the government make it difficult for people to manage their health.” It doesn’t sound like a target-rich environment for booth swag.

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From Nasty Parts: “Re: CPSI. Heard there is an ‘all hands on deck’ meeting on Monday and they have rented a large facility. Wonder why would they do this during the HIMSS conference?” Unverified. At least some of their hands won’t be on deck in Mobile unless they vacate their HIMSS exhibit. It’s probably their user group meeting in Sandestin, which is also next week.

From Beaker: “Re: self-ordered lab tests. This should end well.” A just-signed Arizona law that will take effect in July will allow people to order their own lab tests without a doctor’s involvement. It was pushed by Silicon Valley lab high-flyer Theranos. I like the patient-centered aspect, although certainly Theranos has executed a smart business coup in removing physicians as its sales bottleneck. The obvious unknown is how consumers will react to receiving abnormal results – treat themselves inappropriately, pester their doctors, or demand that their insurance pay for tests of questionable medical usefulness. Doctors serve both as clinical and utilization gatekeepers and it’s a brave new world when those roles are removed and consumers are turned loose with minimal knowledge.

From Epic Doesnt Market: “Re: Epic marketing. Not sure if you’d consider the $2 million that Epic pays KLAS as marketing, but I do.” I would. Every company does marketing. Epic is different only in that it’s a bit lower key about it and it doesn’t place actual ads most of the time. Marketing isn’t the same as advertising, as everybody who has taken an MBA marketing class knows, and while Epic does little or none of the latter, it does quite a bit of the former under the label of “events.” It milks its KLAS results hard, as anyone who has seen the giant displays plastered on its HIMSS booth knows, and those billboards didn’t just jump up on the wall without help.

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From Epic Does Too Market“Re: Epic marketing. If they don’t market, someone forgot to tell their employees, or maybe they don’t control the ones who have left. At least eight former Epic employees identify themselves as marketing people on LinkedIn and one career marketer (who has since moved to another vendor) says she reported directly to Epic’s CEO. They’ve had several spokespeople quoted. I see the work Epic produces on their website, fact sheets, slide presentations, dance numbers, etc. Whether they call it marketing or not, they must have full-time people engaged in producing it all.” 


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Recondo Technology. The Denver-based revenue cycle technology company’s patented, no-touch ReconBots find and assemble critical payer information to speed up eligibility, authorization, and claim status transactions. Its business office products cover claim data integrity, claim adjudication status, and payer follow-up, while the company’s patient access solutions include eligibility, registration quality assurance, point-of-service patient financial responsibility statements, prior authorization, and a real-time dashboard for reporting KPIs. Recondo’s rules, legacy integration, and data mining are used by 900 hospitals and 500 payers to ensure proper payments and financial clarity. You probably know industry long-timers CEO Jay Deady and Chief Growth Officer Ralph Keiser. The just-released Gartner report “Cool Vendors in Healthcare Providers 2015” notes Recondo as providing health systems with innovative technologies to help solve their evolving problems. Thanks to Recondo for supporting HIStalk.

Also supporting HIStalk as a Platinum Sponsor is Practice Unite, which offers a customizable, HIPAA-compliant mobile platform for delivering real-time care (secure communications, clinical data display, and customized workflow). Clinician-friendly communication and collaboration tools include consults, secure text, lab results, patients, on-call and hospital directory, news, events, and several others. Customers have reported six-times-faster inpatient-related communication, a 20 percent ED wait time reduction, easier MU Stage 2 compliance, and reduced network leakage. Check out the case studies. Thanks to Practice Unite for supporting HIStalk.

Here’s an overview video of Practice Unite that I found on YouTube.

Every year I tell vendors how stupid they are in listening to clueless marketing people who advise them to hold their big announcements until HIMSS conference week, which ensures they’ll sink without a trace in all of the confusion and real news happening there. Finally they’re seeing the light and making significant announcements this week instead. Reporters are too busy partying excessively or wasting time doing cookie cutter executive interviews to pay attention to self-serving HIMSS week announcements.

This week on HIStalk Practice: PointNurse partners with Swarm Fund to offer clinicians new telehealth business model. New York’s physician profile website stays alive. Montana Primary Care Association taps eCW for HEDIS help. AMA makes no bones about who it won’t support in the presidential election. Maryland creates a new accelerator for healthcare IT startups. Aledade CEO Farzad Mostashari, MD hints at the EHR features he’ll be looking for at HIMSS15. Thanks for reading.

This week on HIStalk Connect: ONC launches a resource center for states interested in incorporating digital health tools into care delivery. Rock Health releases its quarterly funding report on the digital health industry, noting a slight decline in funding this quarter compared to Q1 2014, but still generating $600 million in new investments. An MIT student is building the Stack Overflow for mental health in his new startup Koko. Weight Watchers acquires fitness social media platform Weilos for an undisclosed sum.

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Dana Moore, SVP/CIO of Denver-based Centura Health, has generously offered to collaborate with me on a purely charitable HIMSS conference project. He’ll be in our booth (#5371) Wednesday morning 10 until noon. Vendors (or anyone else, for that matter) can have 20 minutes of uninterrupted one-on-one time with Dana in return for a $500 donation (I chose that value) to DonorsChoose.org since Dana and I both like funding education projects. Then, he and/or I will recap his impressions about your pitch right here on HIStalk to a pretty big audience. Contact me if your company is interested and we’ll book a time. It’s a heck of a lot cheaper than trying to get his attention and then flying to Denver to meet there, you’ll be benefitting a classroom, you’ll get prime HIStalk real estate, and Dana just might be interested enough in your pitch to want to speak further (startups take note).


Webinars

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

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Specialty EHR vendor Modernizing Medicine signs a lease for new office space in Roseville, CA to expand headcount from 24 to up to 70 for the former Aesyntix Health, which it acquired in December.

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NextGen parent Quality Systems, Inc. acquires healthcare analytics vendor Gennius.

UnitedHealth Group will pay $12 million in damages after a federal jury finds that its OptumInsight subsidiary infringed on physician efficiency calculation patents held by Cave Consulting Group, which offers several products including the CCGroup EfficiencyCare physician efficiency measurement module.


Sales

YourCareUniverse chooses VisionWare for master data management.

EvergreenHealth Partners (WA) selects Wellcentive to coordinate care of 400,000 residents served by the 500 physicians of the clinically integrated network.


Announcements and Implementations

McKesson announces Conserus, a vendor-neutral diagnostic imaging interoperability lineup that includes workflow, work lists, image repository, and data exchange.  

Cerner will integrate visual analytics from Tableau Software into its enterprise data warehouse and analytics products.

Validic announces that it integrated with 27 additional digital health devices in Q1 and is beta testing its connectivity with Apple HealthKit. The company has also released a developer platform that provides API access to its marketplace.

MEA-NEA adds HIPAA-compliant email encryption from Virtru to its information exchange, storage, and attachment solutions.

ZeOmega adds a medication management module to its Jiva population health management system.

Awarepoint announces a Bluetooth Low Energy RTLS platform.

Caradigm’s latest release includes new modules for condition management and utilization management.

Greenway Health announces a new patient portal.  

Aventura will offer biometric authentication for electronic prescribing of controlled substances.

Lifepoint Informatics offers free trial of an API toolbox for medical necessity validation and ICD-9 to ICD-10 crosswalk.

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The non-profit, hospital-focused Center for Medical Interoperability, funded by a $10 million grant from the Gary and Mary West Foundation, names its initial board of directors.


Government and Politics

The Texas Medical Board is considering barring doctors from generating prescriptions for patients they haven’t met in a face-to-face visit, although the wording seems vague on whether “face-to-face” excludes video consultations. Dallas-based telemedicine provided Teladoc says the state is moving backward in prohibiting use of a technology that can help solve access and cost problems, but others think it’s the state’s job to avoid creating a double standard that devalues the traditional office visit and relies on new technology.  


Privacy and Security

A painfully long and overwrought Wired article with the obligatory “click me please” headline (“Drug Pump’s Security Flaw Lets Hackers Raise Dose Limits”) prattles at length about the purely theoretical possibility that hackers could alter the drug libraries of smart IV pumps, meaning they couldn’t do much of anything other than altering the minimum and maximum allowed doses (not a given patient’s actual dose). Sometimes security analysts find real, previously undocumented security holes of major importance, but sometimes their announcements are more boastful than useful.


Innovation and Research

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NPR covers the use of telemedicine by Houston firefighters, who instead of driving people with non-emergent needs to the ED, can instead connect them with a doctor using iPad video. They can assess the patient and connect with a doctor in real time to decide whether an ED visit is warranted, and if not, schedule them for a regular doctor’s appointment (including a free cab ride). The project addresses the fact that 40 percent of Houston ED visits are for non-emergent primary care issues.


Technology

Surescripts and Accenture join HL7’s Argonaut Project.

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Box integrates with Carebox to support EHR integration and patient portals.

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Doximity announces a secure clinician communication app for the Apple Watch that sends the user to their iPhone for more detailed information (since Watch does nothing without being connected to an iPhone). In a bizarre “only in healthcare” intermingling of old and new technologies, it will alert doctors when they receive a fax.

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Cerner will release an Apple Watch version of its HealtheLife that will offer consumers push notification health reminders and data tracking while collecting biometric data to send to Millennium.


Other

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In an HIStalk Practice interview, former National Coordinator Farzad Mostashari, MD (now CEO of Aledade) says he’s surprised that the certified EHRs he now has to deal with personally “can’t perform in a real clinical setting” and he’s happy that ONC is considering field testing and a mechanism to deal with EHR customer complaints. He says he’ll be cruising the HIMSS exhibit hall to look for systems for his participating practices that create “practice happiness,” meet MU requirements in a workflow-friendly manner, and are sold by vendors who are willing to work with third-party health applications. He adds that EHR vendor interfacing charges are “outrageous” and that every public and private HIE should offer ADT notifications. On fuzzy, buzzwordy topics like patient engagement, population health management and precision medicine, Mostashari says vendors should have embraced Meaningful Use enthusiastically as a roadmap that would have gotten them there, but instead took a compliance-only approach that frustrated their users.

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Here’s a smart idea from HCS since HIMSS badges don’t make it clear what kind of organization an attendee works for: they’re offering badge ribbons that denote long-term care, behavioral health, and long-term care acute hospitals so that attendees with similar interests can find each other. Not to take away from HCS’s efforts, I had a similarly great idea for identifying attendees by their personal characteristics, but I’m hampered by limited attendee demand for badge ribbons that indicate “Self-Important Douchebag,” “Incompetent Despite Appearances,” “Obliviously Intellectually Challenged,” and “No, This Isn’t the First Sales Job I’ve Lied In.” Perhaps I should instead have them manufactured in the “Kick Me” back-attached variant that could be applied by observers who are more situationally objective than the wearer.

A New York Times article examines the trend of insurance companies trying to boost lagging life insurance sales by offering premium discounts to customers willing to share electronic data that includes real-time tracking of gym utilization and overall physical activity via a monitored Fitbit. A privacy expert questions how all of that consumer data will be used, while a law professor ponders whether the program is just a way for life insurance companies to weed out less-healthy customers: “The people who have the time to devote to jumping through all the hoops are likely to be better off than average, and those healthy enough to do wellness activities may be unrepresentative of the chronically ill. I believe that is one reason why there is empirical research severely questioning the value of wellness programs.”

A jury awards $1.38 million to a former billing supervisor of Harrison Medical Center (WA) who was fired after filing a whistleblower lawsuit in which she questioned why she was told to run a monthly Medicare billing program daily instead.


Sponsor Updates

  • VitalWare earns Service Organization Controls Reports (SOC) 2 Type 1 certification of its revenue cycle private cloud. It also announces that Epic consulting firm E-Volve Health will offer VitalWare’s revenue cycle solutions.
  • Medhost posts a video describing how its physician advisory board impacts product development.
  • Logicworks achieves Amazon Web Services partner network healthcare competency.
  • Extension Healthcare offers “Knowing is Half the Battle – Measuring clinical interruptions with advanced alarm management middleware.”
  • Impact Advisors posts “mHealth — The Newest Front Door to Your Organization.”
  • Galen Healthcare asks, “How does Mirth Connect stack up as an HIT Interface Engine?”
  • LifeImage writes “Medical Image Sharing for Trauma Care.”
  • Hayes Management Consulting offers “Making the Case for Physicians as Part of the EHR Project Team.”
  • The HCI Group offers “Technology Partnerships and Data Mergers: Challenges for Small and Medium-sized Hospitals.”
  • HDS CEO Bill Horne takes a pie in the face to raise money for the American Heart Association.
  • Healthwise earns certified status for data security and protection of health information.
  • Holon Solutions offers “Health IT Interoperability Must Be Built From The Bottom Up.”
  • Liaison Technologies offers “The Right Way to Address Today’s Data Challenges.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 9, 2015 News 8 Comments

News 4/8/15

April 7, 2015 News 8 Comments

Top News

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ECRI Institute names its top patient safety concerns for 2015:

  1. Alarm hazards.
  2. Missing or incorrect data in EHRs and other IT systems.
  3. Patient violence.
  4. Wrong IV line drug administration.
  5. Care coordination problems due to lack of medication reconciliation.
  6. Failure to perform double checks.
  7. Opioid events.
  8. Improper instrument sterilization.
  9. Inadequate handoffs during patient transport.
  10. Medication dosing errors due to weight confusion in kilograms vs. pounds.

Reader Comments

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From Nature Valley Sweet and Salty: “Re: Beacon Partners. Guess the acquisition is true.” I see the slide that contains both company names, but I’ll have to say “Unverified” until something more definitive comes out. Everybody is holding their big news for next week, so we’ll know soon.

From Consensual Sects: “Re: SSI Group. Acquisition by an unnamed company to be announced this week.” I heard that a couple of weeks ago, with the rumor reporter claiming the acquirer is Medhost. I asked my SSI Group contact and they flatly denied that anything is in the works, but then again companies always say that since “no comment” is the same as verifying the rumor. Consensual Sects was told it’s a West Coast-based patient access company with a recognizable name.

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From One M Dammit: “Re: HIMMS. Here’s another sighting.” There are many, unfortunately, with even mHealth News (published by HIMSS Media) managing to misspell it as HIMMS. Googling “HIMMS” for news sources turns up 157 examples.

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From Occupy HIMSS: “Re: Scripps. Check out the spelling on this LinkedIn article.” It was posted on April 1, so perhaps its Epic author, who looks almost old enough to buy his own beer, was going for subtle rather than unintentional humor.

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From Senor CMIO: “Re: Tennessee-based Mountain States Health Alliance and Wellmont merger. Wellmont just installed Epic under a year ago (and may be suffering financially, partly due to this). MSHA runs Siemens Soarian. MSHA will likely have final control of the merged company since its CEO is chairman of the merged board. It will be interesting to see if Epic will be replaced by Soarian or if efforts at HIE will be ramped up successfully between the two systems.”

From Panko: “Re: Epic. I read a site’s in-depth profile about Epic that struck me as odd since there was no really newsworthy item. It basically read as a press release touting Epic ahead of the DoD’s decision and brushed aside interoperability criticisms. I was wondering what your take on this is? Epic supposedly does not do press or marketing, but this article seems to me to be the result of a really carefully orchestrated media push.” Epic has been making itself slightly more visible to the press. Some of its people have been quoted in articles and there’s no way that happened without Judy’s approval. It hired a lobbyist. It is mentioned in announcements every now and then. All of this happened after the DoD bid came up and the interoperability and cost criticisms started getting potentially damaging airtime. I’m pretty sure Judy Faulkner still doesn’t do interviews although her words from quick email responses are sometimes passed off as an “interview” by sites hoping to give the impression that they’re so important that Judy took the time to sit down with them (you can recognize those articles because they contain dozens of paragraphs of regurgitated common knowledge along with about two actual Judy sentences inside quotation marks). Epic says it doesn’t do marketing, which I’ll generously interpret as being true since the company doesn’t have employees whose full-time job is marketing. Epic gets visibility when it wants it most, so while it keeps a lower public profile than most vendors, doesn’t advertise, and doesn’t fawn over the press, it also doesn’t just sit in a Verona barn and crank out MUMPS code while ignoring the fact that it’s a multi-billion dollar market-leading company whose interests have always been competitive, With the DoD bid and the involvement of prime bidder IBM, Epic seems to be slightly more active in managing the press as public opinion dictates, but often in a minimally visible way. 

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From Belle: “Re: Epic overdose warning. Here’s our setup and the error that displays with a massive overdose as UCSF ordered.” This hospital keeps it simple by configuring Epic to order Septra DS by the whole tablet rather than in either mg or mg/kg of the trimethoprim component alone, which probably works great for adult patients but maybe not so for peds. The overdose warnings are pretty clear and even offer the choice of just switching to the maximum dose of two tablets per day with a single click. UCSF’s resident and pharmacist both received similar overdose warnings, which they didn’t heed. We talk about alarm fatigue when referring to patient monitors, but it happens a lot with CPOE drug warnings (dose, allergy, drug interaction, etc.) I’m sure someone has done a presentation on how to analyze and detune drug warnings in a way that is appropriate for a given hospital and/or provider since, as illogical as it seems, one size doesn’t fit all when it comes to such warnings. Reducing the clutter is better than just shutting off all alerts as some doctors claim they would prefer (until they get sued for missing a conflict, of course).


HIStalk Announcements and Requests

The HIMSS conference crunch has officially begun. Vendors are queuing up their announcements for next week, people are flooding my inbox with issues they think are important (although I often don’t share their level of excitement), and lots of people are packing up for their migration to Chicago. The weather is looking great with daytime highs in the 60s predicted, so it will be brown but comfortable.

Here’s the schedule of who will be holding court in our value-sized HIStalk HIMSS booth (#5371) next week:

  • Monday 2:00: Niko Skievaski of Redox, signing copies of “ICD-10 Illustrated” and maybe “Meaningful Use Stage 2 Illustrated.”
  • Monday 3:00: Ed Marx, signing copies of “Extraordinary Tales From A Rather Ordinary Guy.”
  • Tuesday 11:00: Steve Blumenthal of Waller Lansden Dortch and Davis LLP, answering health IT legal questions, being way funnier than you’d expect for a lawyer, and giving away swag while Lorre attends our CMIO get-together lunch.
  • Tuesday 2:00: nVoq, dispensing Garrett popcorn and collectible pins.
  • Tuesday 3:00: Barry Wightman of Forward Health Group, signing copies of “Pepperland” and dishing on what it was like hosting HIStalkapalooza the night before.
  • Tuesday 4:30: The Walking Gallery get-together.
  • Wednesday 11:00: Ross Martin, MD of AMIA and the American College of Medical Informatimusicology, handing out ACMImimi pins and badge ribbons for current Fellows.

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We did a tweet chat Tuesday called “The Role of Patient Engagement and Advocacy in HIT” (the link goes to Jenn’s Storify recap). Thanks to those who participated, especially our patient advocate scholarship winners.

We’re doing video interviews with DrFirst at the HIMSS conference, asking folks for their impressions. Want to be included? Sign up here.


HIStalkapalooza

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The HIStalkapalooza timeline looks like this:

  • 5:00 House of Blues closes to the public.
  • 6:30 House of Blues outside doors open only for HIStalkapalooza registered guests. Security will turn away anyone who wasn’t invited, so don’t plan to crash or to bring an unregistered guest (I don’t have any more invitations, so please don’t ask).
  • 6:30 Pick up your badge, check your coat, and walk the red carpet to participate in the shoe and apparel judging. Visit the event sponsor tables and stake out a good spot. We’ll have caricature artists, a photo booth, videographers, and other activities to be checked out. Bars and food won’t be open yet – that way people can enter leisurely without trampling each other in a rush to get to the first visible bar.
  • If one of the event sponsors has invited you to their private opera box, use your sponsor-issued wristband to pass security to the third and fourth floors (everybody without wristbands will be limited to the first two floors). We’ll have food service on the third floor, bars open on both floors, plus cocktailer (that’s a new word I’ve learned) service to the opera boxes, which will also be stocked with appetizers.
  • 6:45 Jazz combo starts playing dinner music on stage.
  • 7:00 Bars and dinner buffet stations open in multiple locations.
  • 7:40 Stage activities start, include sashing, the HISsies, and special guests. Your hosts will be Jennifer Lyle, Barry Wightman, and Lorre Wisham.
  • 8:30 (approximate) Party on the Moon’s stage performance begins.
  • 8:30 House of Blues doors outside doors will be closed. No one will be admitted after 8:30.
  • 10:00 Bars switch over from open to cash. I’m buying until 10:00, you’re buying after.
  • 11:00 Event ends.

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If you can’t make it to HIStalkapalooza or didn’t receive an invitation, event sponsor PatientSafe Solutions will be live streaming video from the event via Periscope, a new Twitter-powered video service. Follow @PatientSafeSoln on Twitter, install the Periscope app, and watch for live tweets tagged #HIStalkapalooza. Next time maybe I’ll just stay home and throw a viewing party with a keg and some Italian beef sandwiches.


Webinars

April 8 (Wednesday) noon ET. “Leveraging Evidence and Mobile Collaboration to Improve Patient Care Transitions.” Sponsored by Zynx Health. Presenter: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health. With mounting regulatory requirements focused on readmission prevention and the growing complexity of care delivery, ACOs, hospitals, and community-based organizations are under pressure to effectively and efficiently manage patient transitions. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

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Livongo Health raises $20 million to expand its connected glucometer-powered diabetes management service. Former Allscripts CEO Glen Tullman started and runs the company.

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Lexmark will consolidate its acquired brands, including Perceptive Software, under the single name Lexmark and a new logo. Perceptive will be placed under the Lexmark Healthcare banner. 

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Mansa Capital Management acquires Accreon with a $5.5 million investment and the participation of the company’s founders and management team.


Sales

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Baptist Health (KY) chooses Capsule for medical device integration.

Meditech chooses Validic to integrate clinical, fitness, and wellness data into its applications.


People

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Gary Meyer (Financial Chief) joins Cumberland Consulting Group as CFO.


Announcements and Implementations

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A PerfectServe survey with decent methodology finds that 71 percent of doctors waste time trying to communicate with other care team members, the EHR is rarely used to communicate with external providers about complex issues, and respondents report extensive dissatisfaction with their clinical communications tools that often span telephone, texting, and other forms of messaging. Nearly two-thirds think HIPAA requirements impede care team communication.

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Cerner and Banner Health sign a collaboration agreement that would seem to cement the strong possibility that Banner’s new acquisition, Tucson-based University of Arizona Health Network, will eventually be migrated from Epic to Millennium.

Healthgrades announces its annual awards for patient experience and patient safety, naming the top hospitals based on analysis of claims data, HCAHPS scores, and reported patient safety incidents. It’s interesting that some questions that formerly well correlated with “likely to recommend” now don’t, suggesting that consumer expectations are changing.

TeraMedica will launch analytics and dashboard additions to its Evercore vendor-neutral archive next week.


Privacy and Security

Tulare County HHS (CA) suggests that 800 people change their email addresses after a county employee used CC: rather than BCC: in sending out emails to clinic patients. The department also disabled the exposed email addresses for its patient portal.


Other

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Jamie Stockton, CFA of Wells Fargo Securities sent over his latest slice-and-dice of Meaningful Use data. For hospitals, nearly every Epic user has reached Stage 2, while users of Cerner, Meditech, CPSI, and McKesson are congregated at around the two-thirds mark.

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Wells Fargo’s EP numbers suggest that Athenahealth customers lead the MUS2 pack at 71 percent, although not up to the 98 percent it boasted a couple of weeks ago that in reality measured the percentage of EPs that attempted MUS2, not the percentage of its overall customer base. Obviously EPs aren’t nearly as willing and able as hospitals to keep chasing HITECH money, and if they purchased these EHRs with intentions of getting it, they are likely not only disappointed, but potentially more likely to replace the systems they bought for that reason.

Carequality publishes collaboration and trust principles that data-sharing participants can legally agree to follow.

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A Minnesota couple hears music playing from their child’s bedroom, finally realizing that an Amsterdam hacker had taken over their nanny cam. Theirs was one of thousands of cameras that had screen shots and live stream links posted online because the parents did like many people in buying an IP security camera and ignoring the instructions for changing the default password.


Sponsor Updates

  • CitiusTech launches a healthcare practice focused on big data and Hadoop.
  • ADP AdvancedMD offers the “Top 4 claim exclusions & resolutions.”
  • AtHoc offers “Diversity Makes Us Stronger.”
  • Besler Consulting offers a new video on the clinical impact of readmissions.
  • Medecision publishes a video of Neil Kudler, MD, CMIO of Baystate Health, discussing how he uses the Aerial platform to engage patients.
  • PDS posts “When I Was Your Age: The Challenge of Generational Patient Engagement.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 7, 2015 News 8 Comments

Monday Morning Update 4/6/15

April 5, 2015 News 7 Comments

Top News

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Allscripts will pay $10 million to settle a 2012 class action lawsuit in which investors accused the company of hiding problems after its 2010 acquisition of Eclipsys. Allscripts unsuccessfully filed to dismiss the case, saying that its executives didn’t intend to deceive shareholders with their “unspecific puffery,” “immaterial optimism,” and “vague aspiration.” I didn’t realize until just now that the lawsuit extensively quoted parts of my 2010 interview with former Allscripts CEO Glen Tullman and former Eclipsys CEO Phil Pead right before the announcement.

The lawsuit accuses the company of painting an overly rosy picture of how Allscripts would absorb the Eclipsys people and integrate its products, pointing out the extensive head-rolling that followed (head of sales, CTO, COO, board chair, three directors, the CFO, the president, Pead, and finally Tullman) and revenue projections that required tripling Sunrise sales even as prospects held back because of a bad 5.5 release and uncertain integration progress. The suit also quoted internal company witnesses who said Allscripts canceled its reseller agreement with Medicity and chose instead what the witness said was the inferior product of dbMotion (which Allscripts acquired in March 2013 for $235 million) and laid out an ugly story of Tullman steamrolling those who questioned him, executives who believed the incorrect information being fed to them by subordinates, salespeople unable to make quotas because of product deficiencies, hospitals with increasing ambulatory needs either replacing their Allscripts practice EHRs or moving to Epic, Pead losing his job after failing to get Tullman fired, and customer unhappiness with product releases and integration. It’s a pretty fascinating read even allowing for the fact that it’s just one side of the story. It’s probably reflective of that tumultuous time in the company’s history that it won the HISsies “Smartest Vendor Action Taken” category in both 2013 and 2014 for taking the same action in both preceding years – firing its executive team.


Reader Comments

From Sturges: “Re: Epic-Mayo deal. Epic supposedly bought Mayo’s data center for $45 million and is leasing it back to them at an infinitesimal cost. Buying Mayo’s business?” Unverified.

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From Pickle Loaf: “Re: IBM’s new provider apps. I heard they developed these for Tenet originally. They look nice, but came out of nowhere and IBM didn’t commit to integration or ongoing maintenance. Companies, especially those new to healthcare, often jump to mobility as just another interface without considering the app itself.”


HIStalk Announcements and Requests

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Poll respondents say the most important reason they would avoid doing business with a startup is the fear that the company isn’t financially viable. That might be a surprise to startups that think they are failing mostly because they don’t have reference sites. New poll to your right or here: what should happen to ONC’s certification program after MU Stage 3?

Welcome to new HIStalk Gold Sponsor Burwood Group. The Chicago-based consulting firm’s healthcare business offers help with clinical collaboration, adoption, regulatory compliance, medical device strategy and integration, and strategic planning. The company’s client roster includes Palomar Health (which hired the company to develop the infrastructure strategy for its new 740,000 square foot hospital of the future) and North Shore-LIJ Health (for which the company created a far-reaching clinical collaboration and communications strategy). The company’s healthcare leadership team is available for meetings at the HIMSS conference. Thanks to Burwood Group for supporting HIStalk.

Interesting people will be meeting and greeting in our tiny HIMSS booth (it’s as small and sparsely furnished as my 11-year-old econobox car) including authors, CIOs, and other characters that I think are interesting. I’ll consider giving you an hour to meet your fans if you email me describing why you in fact have fans (or if you don’t have them, why you think you should). We don’t have anything to sell or business to conduct, so we’re just hanging out there as I try to forget how much it’s costing. I’ll run a schedule of who’s dropping by later this week. I know the Walking Gallery folks are meeting there.

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Find out what HIStalk sponsors are doing at the HIMSS conference by checking out our guide.

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Join Jenn and our patient advocate HIMSS conference scholarship winners for an #HIStalking tweet chat Tuesday at 11 a.m. ET. @LAlupuslady, @woodymatters, @leffet_papillon, @carlyRM and @bostonheartmom will talk about patient engagement, advocacy, and healthcare IT. You can brush up on their backgrounds here. They’ll be wearing their Walking Gallery tee shirts at the conference as they follow a busy schedule of interviews, meetings, and exhibit hall cruising.

I saw a restaurant menu the other day that had sections labeled “nibbles” and “drinkies.” I like to think it was intentionally self-ironic, but I passed anyway since maybe they’re just clueless. I’m not eating anywhere that leans hard on grammatical cutesiness, like writing “veggies,” “sammies,” or anything in the form of “Get your _____ on.” 


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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Last Week’s Most Interesting News

  • IBM releases four iPhone apps for healthcare providers, although the company offered no details about integration or validation testing.
  • Two visible CIOs, Chuck Christian and Ed Marx, resigned their jobs, as did HHS CTO Bryan Sivak.
  • CommonWell announced several new vendor members.
  • In Australia, 30 doctors resigned over patient safety concerns with its new Department of Defence EHR.
  • The Senate deferred its deliberation of the SGR doc fix bill, which so far is free of ICD-10 delay language, until after its two-week vacation.

Webinars

April 8 (Wednesday) noon ET. “Leveraging Evidence and Mobile Collaboration to Improve Patient Care Transitions.” Sponsored by Zynx Health. Presenter: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health. With mounting regulatory requirements focused on readmission prevention and the growing complexity of care delivery, ACOs, hospitals, and community-based organizations are under pressure to effectively and efficiently manage patient transitions. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

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Chicago Mayor Rahm Emanuel helps ZirMed celebrate the opening of its Chicago office, for which the company plans to hire 200 employees for its predictive analytics business.

Vince Ciotti covers mid-range vendors in his new series on 2014 company revenue.

Aetna SEVP Joe Zubretsky, who is in charge of the company’s Healthagen business, sells $22 million worth of stock and still holds shares worth $23 million.


People

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Pharmacy automation vendor Parata Systems promotes D.J. Dougherty to CEO. He replaces Tom Rhoads, who will become CEO of HAP Innovations, a Parata spinoff that is developing consumer medication adherence technologies.


Announcements and Implementations

Sacred Heart Hospital (FL) goes live on GetWellNetwork’s interactive patient care system.


Government and Politics

Premier’s comments on ONC’s interoperability roadmap suggest that ONC develop interoperability standards and add them to its EHR certification criteria, require EHR vendors to publish APIs, and prohibit EHR vendors from “data blocking” by charging fees to access standard information or by not providing adequate interoperability documentation. 


Privacy and Security

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Indian River Medical Center (FL) blames an unnamed software vendor for a mistake that exposed the records of 30 of its patient portal users to other patients. Their patient portal appears to be from RelayHealth, but the hospital’s broad description suggests that the problem was exporting information from another system rather than the portal itself. On the EHR side, I think they used to run McKesson Horizon but migrated fairly quickly to Paragon.


Technology

Walmart’s head of payments says chip-based credit cards won’t help much with fraud and says the US banking industry’s failure to adopt a PIN-based system for credit cards (as has already been done for debit cards) is “such a joke.” Experts blame the cost of adding PINs and the fear of banks that the extra user step might reduce the use of their high-interest credit cards.

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Microsoft co-founder Paul Allen tweeted this photo of the cover page of the source code from the company’s first product, BASIC, that was created 40 years ago. Microsoft was formed April 4, 1975. Allen is on the lower right in the 1978 company photo, with Bill Gates at the lower left. While you’re pondering just how long ago that was, recall that Meditech was formed six years before Microsoft in 1969.


Other

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I asked readers to send screenshots of how their system configuration would have handled the error that Bob Wachter, MD writes about in his book aimed at consumers, in which he mostly blames a ridiculous medication error on the IT systems his employer (UCSF) bought and configured rather than the people UCSF turned loose on patients with minimal experience and questionably effective training  (I wrote about the error, in which a nurse gave a peds patient 38.5 adult tablets, last week). Above is UCFS’s Epic screen, which forces the prescriber to order every drug by weight in mg/kg, a requirement they imposed along with their Epic implementation just over a year before the error. The resident was trying to enter a patient’s home med of one Septra DS tablet daily, which in UCSF’s laborious setup would require her to divide the home dose of 160 mg by the patient’s weight of 38.5 kg on a separate calculator, then enter the dose into Epic as 4.15 mg/kg to allow it to calculate the already-known dose. She screwed it up by entering the dose as 160, which as the screen plainly showed (and warned her about) would be a massive overdose (160 mg/kg x 38.5 kg, or 6,160 mg instead of the intended 160 mg). The resident and the pharmacist ignored Epic’s dose warning and the brand new nurse working on an unfamiliar unit was afraid to speak up, so she gave the patient 38.5 tablets, luckily without harm. Bob pretty much blames Epic specifically and EHR vendors generally for allowing people to make mistakes.

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A CMIO reader from a children’s hospital provided this screenshot, which shows the mistake-proof way his hospital configured Epic. Prescribers can click the most common doses in either mg/kg or the overall dose, so the UCSF resident would have simply needed to click the 160 mg button and everything would have been fine. This screen makes it easy for doctors to to the right (and most common) things (note that they put the preferred dosing method first on the screen, but didn’t prevent use of the other method). This CMIO says this is the way most Epic sites do it – UCSF created a cumbersome, error-prone screen just to force doctors to order in mg/kg even when it doesn’t make sense and they could have killed their patient as a result.

The UCSF error made me recall errors I’ve seen that were caused by faulty configuration assumptions, all of which mortified the application analysts who had failed to consider the oddball exceptions or the possibility of irrational prescriber behavior:

  • Invoking peds dosing pathways as deduced from patient location. Sometimes adults get moved to a peds bed and are inadvertently dosed using pediatric formulas.
  • Invoking a particular dosing pathway as deduced by age, which caused a problem in my hospital’s 14-year-old, 300-pound patient.
  • Assuming that only adults are assigned to a particular service, such as when our 12-year-old patient was overdosed on oxytocin while in labor.
  • Complex IV order entry screens that led some doctors to simply give up and enter plain IV fluids with their desired additives entered as free-text comments.
  • Accidentally moving acetaminophen liquid to the top of the pick list, driving its usage through the roof as doctors failed to notice that tablets no longer came up first.

As the CMIO commented, you have to be very careful with the assumptions you use in creating forcing functions that limit the doctor’s options.

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Forbes Hospital (PA) finally replaces paper charts and fax machines by implementing its first EHR. They’re the first Allegheny Health Network hospital to go live on Epic.The 350-bed hospital was supposed to implement Allscripts several years ago, but scrapped that plan when insurance company Highmark acquired the struggling West Penn Allegheny Health System in 2013 after an ugly ongoing fight with cross-town competitor UPMC.

A psychiatrist says patients sometimes show up for their first appointment with a folder full of Google search results about her that contain scarily personal details, also adding that ED psychiatrists often Google new patients before seeing them to make sure they aren’t dangerous or famous. She also says patients threaten doctors who refuse to give them drugs or special treatment by vowing to write negative online reviews. She adds a positive example of how overhearing patients on phone calls lets her see how they behave outside her office::

My patients arrive in my office and, like gunslingers in a saloon, unload their various electronic devices, laying them on the sofa, often two or even three, before turning them off. But there are times when the phones have to stay on: There’s a sick child at home or the boss may call. Hearing in real time patients’ responses to important figures in their lives gives me an unfiltered glimpse into those relationships. A man who sarcastically belittles his girlfriend to me is surprisingly tender speaking with her on his cellphone. An unhappy, self-deprecating executive is suddenly a confident and even commanding figure speaking with one of his subordinates. An aggressive lawyer becomes shy and awkward when speaking with his mother.

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An interesting New York Times article cleverly titled “When ‘Moneyball’ Meets Medicine” describes how health economists are measuring personal, public, and global health using a sports-like measure called disability-adjusted life years (DALYs), which count not only premature deaths but also the detractive effect that chronic conditions have on good health (example: being paralyzed is half-healthy). It sounds geeky, but it isn’t — car accidents, for example, are 2.5 times worse for humanity than lung cancer, which mostly affects older people and leaves few of its sufferers with lingering disabilities. Mexico used the calculation to prioritize medical treatments that reduced DALYs the most, while Australia allocated public health spending using the method. US figures highlight several high-impact, low-fatality conditions that don’t get the research and awareness money spent on less-impactful conditions such as stroke and breast cancer — low back pain, depression, neck pain, and anxiety disorders. I’m interested in the new book called “Epic Measures: One Doctor. Seven Billion Patients” about economist, physician, and public health professor Christopher Murray, MD, DPhil, whose “Global Burden of Disease” work was funded for $100 million by Bill Gates.


Sponsor Updates

  • Sunquest hosts its Point of Care Summit April 7 in San Francisco.
  • Versus Technology offers a blog on how wireless technology works to track the spread of infection.
  • NVoq describes “The Link Between the Simple Checklist and Improved Patient Safety.”
  • Zynx Health posts “Zynx Carebook: Real People, Real Impact.”
  • MBA HealthGroup offers “5 Ways to Optimize Your Revenue Cycle on Allscripts PM.”
  • MedData offers a sneak peek at its ICD-11 conversion tool.
  • New York eHealth Collaborative will exhibit at the Health 2.0 Mental Health Digital Innovation Challenge April 8 in New York City.
  • Perceptive Software offers the third of its series on “Tips for Sustainability Progress in 2015.”
  • NTT Data posts its top five takeaways from Mobile World Congress.
  • Oneview Healthcare offers “Eight Steps to Improved Patient Experience and Outcomes.”
  • Orion Health posts “Improving Patient Care, One eReferral at a Time.”
  • Patientco offers “The Future of Patient Engagement: Going Beyond the Clinical.”
  • PMD shares “On the Cutting Edge in Anchorage.”
  • Dodge Communications interviews Porter Research President Cynthia Porter.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 5, 2015 News 7 Comments

News 4/3/15

April 2, 2015 News 17 Comments

Top News

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The Apple-IBM partnership releases four healthcare-related apps in IBM’s MobileFirst for iOS series, although IBM is holding back the formal announcement until the HIMSS conference. The apps include an iPhone communication system for hospital nurses, an iPad workload app for hospital charge nurses, a notification and lab status app for hospital techs, and an app that allows home care nurses to upload information to an EHR.


Reader Comments 

From Mobile Gas: “Re: IBM’s MobileFirst for iOS Healthcare. It seems like smoke and mirrors since they didn’t provide a list of customers and looks like they just built a series of applications without considering apps already deployed. The hospital nurse needs tight integration with the hospital EMR and Epic and Cerner both offer point-of-care applications. They also need connections to secure messaging and alarm notification from companies like Voalte and Vocera. This will lead to further market confusion as Apple and IBM build products in the ivory tower and expect customers to figure out the integration. I think this is another sign that Apple doesn’t understand the healthcare enterprise – they could have addressed enterprise issues, such as iOS management and WiFi connectivity, and instead are building generic applications that will be hard to integrate with hospital core systems.” Most surprising to me is that IBM didn’t announce integration partnerships with Allscripts, Epic, Cerner, or Meditech and didn’t mention working with health systems to design and test their apps or to validate that they offer something important that EHR vendors don’t. I’m skeptical. Just because health systems run applications on IBM systems doesn’t mean IBM can grab EHR data indiscriminately and use it intelligently, although maybe the announcements that are being held for HIMSS contain more vendor-specific details.

From John: “Re: gender bias. Have you counted how many interviews you’ve done with men vs. women?” I haven’t counted, but it’s probably proportional to the gender ratio within the specific job roles (CEO, CMIO, etc.)  If your point is that men are disproportionately represented in those roles, then I obviously agree, although it’s a slippery slope to then propose fixing what is perceived as a societal problem based on the single factor of gender. I like to think I’m gender-blind since most of the people I’ve chosen to work with are female and some of the better interviews I’ve done were with women. I’ll interview anyone who has the potential to be interesting and who is willing to do it my way — don’t underestimate that second factor since it takes guts to be interviewed for a full transcript without knowing in advance what questions I’ll ask and not having the chance to review the answers before I publish them.

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From Kopecky: “Re: Mark Cuban. Getting flamed on Twitter for urging quarterly blood tests ‘for everything available’ as a baseline.” He’s well-intentioned even though he’s wrong. He assumes that frequent testing will create a personal baseline that will be more useful than population-based normal ranges when something changes. Here’s the problem: the more results doctors see, the more pressure they feel to do something about them because that’s how they are trained and they don’t want to get sued. Things start going wrong when patients get roped into the healthcare system … medical errors, polypharmacy, and compounded drug side effects. That’s the same problem with apps that create a continuous stream of questionably valuable medical data that someone has to review and react to. I suspect we harm far more people by providing unnecessary knee-jerk treatment than we do by not collecting enough data to support an early diagnosis. It would be great if “health” was a simple as automatically applying harm-free interventions in response to well-defined physiologic inputs or genetic analysis, but it’s not. Healthcare is often dangerous to your health.


HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor MedCPU. The tagline of the New York City-based clinical decision support company is “Accuracy is not optional.” Its MedCPU Advisor analyzes the complete electronic clinical picture (including both structured and free-text data) in real time against an algorithm matrix, providing case-specific prompting with minimal false alarms. No change in user worfklow is required since the system runs in the background with no separate logon or additional data entry required. The company’s experts build, configure, and maintain best-practice rules from its library of specialty modules with minimal client resources required. On the technology side, the company provides integration via reader technology that requires no IT resources and includes a patented Context Engine to process free text information. Founder and CEO Eyal Ephrat, MD is an obstetrician and previously founded E&C Medical Intelligence (now PeriGen). Thanks to MedCPU for supporting HIStalk. 

My YouTube search turned up a new explainer video for MedCPU Advisor.

This week on HIStalk Practice: Iora Health takes on primary care nationally with a homegrown EHR. Community Health Center serves as a model for a new telehealth program in Colorado. Australian physicians get no respect from their EHRs. Health information exchange in Georgia moves forward, as does telemedicine in Delaware. Spruce raises $15M from headline-making Kleiner Perkins. Health Informatics Director Karen Schogel, MD weighs in on MU3 at Genesis Medical Associates. Thanks for reading.

This week on HIStalk Connect: Google partners with Johnson & Johnson to co-develop a surgical robot that will integrate real-time image analysis and decision support into the surgeons workflow. In England, students with the Royal College of Art and the Imperial College London have created a self-stabilizing pen designed to help patients with Parkinson’s disease maintain legible handwriting. Apple and IBM unveil their newest batch of co-developed enterprise apps, including four apps designed for nurses. Fitbit finalizes its $18 million acquisition of Fitstar, a paid app that develops personalized workouts based on user’s fitness goals.

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If you want one of these pins, stop by our HIMSS booth # 5371 on next Monday since we intentionally ordered few enough of them to make them collectible (actually it was mostly to avoid the risk of lugging them back home). We suggested that our sponsors design their own buttons, although I don’t know which ones actually did.


HIStalkapalooza Sponsor Profile

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Visit Sagacious Consultants at HIMSS Booth # 1690 for a chat with some of the EHR industry’s smartest leaders, including founder and CEO Shane Adams and principal consultants Gordon Lashmett, George Evans, and Dr. Ron Jimenez. With experience as Epic CIOs and directors of clinical informatics, they will be available to dish out advice about your most pressing technical and operational challenges.

Sagacious Consultants will be rocking HIStalkapalooza as a Gold Sponsor. Guests can strut like rock stars on a red carpet at the House of Blues, grab a guitar or banjo prop, and strike a pose. Don’t leave without taking home a Sagacious rock poster commemorating this star-studded night for HIT.


Webinars

April 8 (Wednesday) noon ET. “Leveraging Evidence and Mobile Collaboration to Improve Patient Care Transitions.” Sponsored by Zynx Health. Presenter: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health. With mounting regulatory requirements focused on readmission prevention and the growing complexity of care delivery, ACOs, hospitals, and community-based organizations are under pressure to effectively and efficiently manage patient transitions. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.


Acquisitions, Funding, Business, and Stock

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VistA vendor Medsphere and IT solutions provider Phoenix Health Systems merge. The Medsphere name wins, adding consulting and outsourcing services from Phoenix.

Healthland acquires revenue cycle solutions firm Rycan.


Sales

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Cedars-Sinai Health System (CA) chooses HealthLoop for automating patient follow-up.

MultiCare Connected Care (WA) selects Sandlot Solutions to create a community-wide electronic information exchange.

Xerox will incorporate SyTrue’s natural language processing and medical terminology platform into its Midas+ analytics to generate diagnostic and procedure codes from clinical documentation in real time to calculate risk and outcomes for case management.

Kindred Healthcare’s hospital division chooses transcription, front-end speech recognition, and clinical documentation improvement from MModal.


People

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Dave Levin, MD (Nordic) joins PeraHealth as physician executive.

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Ed Marx resigns as SVP/CIO of Texas Health Resources.

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Chuck Christian (St. Francis Hospital) is named VP of technology and engagement of the Indiana HIE.

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Mike Waldrum, MD, MSc, MBA, president and CEO of the University of Arizona Health network, leaves quickly after the system’s acquisition by Banner Health to become CEO of Vidant Health (NC). He was CIO at UAB Health System from 1999 to 2004.

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CognitiveScale launches a healthcare business unit that will apply cognitive computing to chronic care management and names Charles Barnett (Seton Family Healthcare) as the healthcare group’s president.


Announcements and Implementations

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Joining the CommonWell Health Alliance are Meditech, Merge, and Kareo as contributing members and PointClickCare and Surgical Information Systems as general members.

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The Chicago business paper profiles MedDocLive, started by a former Epic project manager turned medical student, which provides medical students and residents to help hospitals with their EHR go-lives.

The New Mexico HIE goes live with technology provided by Orion Health.

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Here’s an interesting graphic tweeted out by KLAS as a teaser to buy its latest $15,980 health analytics report, which according to the graphic, involved only 77 respondents of which 28 said no vendors offer emerging capabilities. Health Catalyst and Truven are at the bottom with just three votes each? I’d have to see the methodology before I’d believe that.

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Practice Fusion enables doctors to print drug coupons right from its free EHR, no doubt charging the drug companies that provide them. Patients like prescription drug samples and coupons, not usually realizing the indirect cost to themselves or those paying for their care.

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MModal announces that transcription employment at its Coimbatore, India office has reached 1,000.

Vocera announces integration of its communications system with Epic for bed cleaning and availability updates, with similar integration with other EHRs planned.

Summit Healthcare partners with S&P Consultants to offer Cerner solutions that include domain compare and synchronization, blood bank validation, and a scripting toolkit for workflow automation.

CVS Caremark announces new affiliations with Rush University Medical Center (IL) and Tucson Medical Center (AZ) that includes sending CVS prescription and visit information to the EHRs of participating providers and offering patients services via its in-store MinuteClinics. Meanwhile, CVS filings show that its CEO earned $32 million in 2014 and added another $11 million in stock value. CVS share price increased 38 percent in the past year.  

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Non-profit health information provider Healthwise offers a course on shared decision-making.


Government and Politics

Texas lawmakers are considering a bill that would prevent providers from recording a patient’s gun ownership status in their medical records. The office of Rep Stuart Spitzer, who is a surgeon, says consumers are alarmed at being asked gun-related questions during visits and that he doesn’t trust the National Security Agency and other government agencies.

Athenahealth CEO Jonathan Bush will host a $10,000 per person fundraiser at his Massachusetts home for his cousin, presidential contender Jeb Bush.


Other

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Bob Wachter, MD is ubiquitous in plugging his new book (which I haven’t read), publishing endless excerpts all over the place including a series titled “The Overdose; Harm in a Wired Hospital.” It describes a single incident at UCSF Medical Center, his employer. It should be noted that despite the manufactured drama and hype-laden headlines (such as “How Medical Tech Gave a Patient a Massive Overdose”), the patient ended up being fine with no permanent harm from UCSF’s mistakes, although the salacious if inaccurate headlines might move a few more copies than just admitting institutional errors. Stripping away the novel-like prose leaves these facts:

  • A pediatric patient (16 years old) was given 38.5 Septra DS tablets due to a series of errors resulting from the resident’s botched attempt to re-order a home med of one tablet twice daily.
  • The incident happened in July 2013, just over a year after UCSF’s Epic go-live, but Bob  doesn’t say if the resident had just started her rotation on July 1.
  • The hospital had decided to require clinicians to dose medications by weight for children under 40 kg without exception.
  • UCSF had elected not to turn on Epic’s overdose limits because teaching hospitals use research protocols that don’t always follow published standards.
  • The pediatrics resident entered the order correctly, but then had to adjust it to match the available tablet strength per UCSF policy. She then re-entered the same order incorrectly, apparently failing to notice the mg/kg dosing that, according to hospital policy, should have been present on every single order she had ever entered into Epic, including the same order she had just entered for that same patient. She entered the dose as “160” in trying to enter the milligrams of trimethoprim instead and then ignored the resulting overdose message. The resident blames UCSF’s Epic setup for issuing too many alerts and for failing to highlight the most important ones.
  • The UCSF pharmacist accepted the resident’s order after ignoring his own dose warnings.
  • The hospital had floated a a newly-licensed night shift nurse from her normal PICU assignment to the general pediatrics floor because of short staffing, She didn’t question the dose and didn’t ask the charge nurse because she “didn’t want to sound dumb,” so she helped the patient swallow 38.5 oversized tablets.

The article series isn’t finished yet, but my conclusions so far are:

  • Bob’s working the author angle of being the technology-wary guy to consumers. He writes well, but his lay audience probably won’t understand that hospitals make mistakes constantly even without technology. Paper orders were no picnic, believe me, and UCSF has some obvious people problems in putting newbies on the front line with questionable supervision. If your kid driving on a learner’s permit wrecks the family car while speeding, don’t blame the car manufacturer for not making the speedometer bigger.
  • This is a classic example of the “Swiss cheese effect,” where an event occurred only because a normally reliable system of checks and balances fell apart due to alignment of failed links in the chain (new resident, new nurse working off her normal unit, nobody caught the mistakes made by others).
  • The Epic screen is busy and doesn’t highlight the magnitude of the alert very well. UCSF’s decision not to hard-stop overdoses (in my experience, that’s probably because they don’t want to annoy easily angered doctors, although their research rationale is valid) would have prevented this mistake.
  • UCSF’s “mg/kg dosing only” rule is commendable for most but maybe not all medications. They apparently decided to make this change universally when putting in Epic. It would be interesting to see what training was offered to prescribers before this change was made and how many of them were in favor of it.  
  • IT systems often lull people into a false sense of security since the screen always looks calm and rational. The alerts don’t, as Bob suggests, throw up a big skull-and-crossbones graphic – system designers assume that it’s the human’s job to understand the situation and not to cry wolf constantly.
  • I would be interested to know what steps UCSF took to reduce insignificant drug warnings both before and after the event since Bob thinks the number is excessive. How does UCSF compare with comparable users?
  • Epic could certainly redesign its screens to call more forceful attention to the biggest error outliers (or at least those it can detect with certainty), just like your PC says “Do you really want to do this?” before allowing you to accidentally format your hard drive. Perhaps Epic’s setup could (or should) require resident-entered orders that have seemingly big problems to be verified by an attending or chief resident before shooting them off to the pharmacy for immediate dispensing. IT-reduced turnaround time is not your friend when you make a mistake.
  • Professionals have to be responsible for their actions and their judgment in using software, whether they’re doctors, accountants, or stockbrokers. UCSF put a lot of very green people on the front lines and they screwed up in ways that would have been equally horrifying with or without a computer (38.5 oversized adult tablets for a kid? Come on, just-graduated nurse, use your critical thinking skills).
  • Errors usually happen when clinical employees are overworked, interrupted, or afraid of getting chewed out and all of these issues were reported by those involved.
  • Don’t go to an academic medical center unless you really need one (and I say that having worked a long time in both academic and community hospitals). The July 1 new resident screw-up phenomenon has been well documented. Huge size and specialization means that when they float nurses as in this case, they’re dumped into a complex environment where they don’t know the people or processes. Academic attending physicians often possess big egos and make anyone who questions them (including the software analysts who configure clinical alerts) feel shamed, so nobody challenges them. Doctors and staff see so many complex, throw-out-the-rulebook cases that questionable orders are overlooked. Handoffs and intra-department communications aren’t always efficient since so many people are involved and they don’t always even know each other. Bring someone to sit by your side the whole time and question everything. I doubt the mom would have allowed her child to choke down 38.5 pills knowing it’s supposed to be a single one like she’d been giving at home.

What do you think? Clinical folks, how would your system and your people handle a potential mistake like this? Here’s a challenge for you: enter the same order for a similar patient in your test environment and send me a screenshot of what the ordering physician would see (I’ll de-identify the image). Let’s see how other hospitals and other IT systems work.

Quite a few companies observed April 1 with phony commercials and news items. This one from Microsoft announcing “MS-DOS Mobile” is pretty good. Epic had its usual home page makeover.

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The teen whose parents publicly shamed an Atlanta hospital into giving him a free heart transplant in 2013 despite his history of not complying with prescribed therapy crashes a stolen car following a crime spree and dies.


Sponsor Updates

  • Arcadia Healthcare Solutions client Yakima Valley Farm Workers Clinic will receive an IT innovator award at the HIMSS conference.
  • ESD posts 25 days of its history as it commemorates its 25th anniversary. Check out Day 7, where you’ll see its video of HIStalkapalooza 2012 in Las Vegas, which it did a great job of sponsoring. I still watch that video every couple of months because it’s fun and full of familiar faces, maybe even yours.
  • Extension Healthcare releases version 5.0 of its clinical alarm safety platform.
  • Hayes Management Consulting posts “Patient Portals: How to Balance Privacy and Engagement.
  • Healthcare Data Solutions is named Concur’s App Center Partner of the Year for the third year in a row.
  • Healthfinch asks “Is Primary Care in Rural America at Risk?”
  • QPID Health President and CEO Mike Doyle will present on maximizing technology’s value to patients and providers at the ACHE Massachusetts Spring Conference on April 15 in Needham, MA.
  • Healthgrades offers “5 Lessons I Learned from 10.10.10 in Denver.”
  • Impact Advisors offers “Population Health Management Vendor Selection.”
  • Liaison Technologies offers “Winning Lab Information Strategies for Value-Based Care.”
  • Healthwise shares “The Secret Behind Serving Up the Right Information Every Time.”
  • Holon Solutions will exhibit at the Texas Organization of Rural & Community Hospitals Annual Conference April 7-9 in Dallas.
  • Intellect Resources offers tips on “Networking at HIMSS.”
  • Galen Healthcare Solutions wraps up its experience at the InterSystems Global Summit.
  • InterSystems recaps its annual conference, Global Summit 2015.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
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