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Morning Headlines 10/23/19

October 22, 2019 Headlines No Comments

Leading Talent Solutions Provider ettain group Acquires Global Employment Solutions and Leidos’s Commercial EHR Consulting Business

Recruitment and consulting firm Ettain Group acquires Leidos Health, announced in parallel with Ettain parent company NMS Capital’s sale of its Ettain stake to A&M Capital.

Medicomp Systems Secures Patent for its Method of Displaying Clinically Relevant Information Within Physician Workflows

USPTO awards Medicomp Systems a patent for its Quippe platform technology that identifies and filters relevant clinical data for presentation to clinicians at the point of care.

Clinical Trial Technology Startup SignalPath Announces Successful Close of $18M Series B Funding Round

Clinical trials platform vendor SignalPath raises $18 million in a Series B funding round.

Agfa Gevaert expects multiple bids for healthcare IT unit: sources

Reuters reports that digital imaging company Agfa has begun accepting bids for its health IT business.

News 10/23/19

October 22, 2019 News 3 Comments

Top News

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Recruitment and consulting firm Ettain Group acquires Leidos Health, announced in parallel with Ettain parent company NMS Capital’s sale of its Ettain stake to A&M Capital.

Leidos Health, formed by the merger of Vitalize Consulting Solutions and MaxIT Healthcare, will be renamed Ettain Health.

I confirmed and published a reader’s accurate rumor report on September 18. Leidos said at that time that 850 employees will transfer to the new company.


Reader Comments

From NI: “Re: informatics nurses. How are they perceived in health systems?” Very well, in my experience of having had those folks report to me. Physician informatics is a tougher job because it’s a small number of people, often just one, and peers are suspicious of a doctor who has crossed over to the “dark side.” This is often amplified by specialty rivalry, in which big-ego specialists scoff at the idea that an informatics doc from a different specialty can understand their needs. In contrast, nurses seem to appreciate their peers who have moved into nursing (applied) informatics, with no feelings of resentment that I’ve ever seen (they are still respected nurse colleagues regardless of job description). It helps that health systems wisely choose informatics nurses who are  experienced process change leaders and patient care advocates. They also benefit from their greater team numbers and their deeper process knowledge since they are usually hired from within. Lastly, they love patients more than computers and thus aren’t seen as token IT geeks stumbling around blindly on the floors. Informatics nurses are the unsung heroes of any health system’s IT successes, with “unsung” meaning that clueless doctors, ancillary departments, and executives often override them just because they can. I blame organizational culture and some degree of bias in that 90% of nurses are female in a male-dominated culture, they were not taught in nursing school to be Type A backstabbers and gunners, and they are usually less interested in organizational politics and ladder-climbing than they are in patient care. As I often say, without skilled bedside nurses, a hospital is just a consumer-hostile, poorly run, but fabulously profitable hotel.

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From Rich Mandarin: “Re: grammar peeves. One of my favorite aspects of HIStalk is hearing your latest. As it’s been a while since you’ve posted some, are any currently at top of mind?” First, I promise that I didn’t make this comment up just to pontificate. I’m not a mistake-free grammar zealot who corrects others individually for their casual writing, but rather someone who respects the time and intelligence of business readers who don’t necessarily know me personally, which is why I might open Christmas presents wearing rumpled sweatpants and a King Crimson tee shirt that wouldn’t be my first choice around first-impression strangers at work or a conference. Good business writing should be concise and barely noticeable, free of distracting mistakes and quirky style. Peaking my peeve-meter lately, although not specifically limited to grammar, are these:

  • Using the trendily pompous word “curate.”
  • The possessive “its” being misused as “it’s” about 90% of the time, which I fear is a lost cause since social media has emboldened poor writers to just defiantly throw their mistakes and half-baked thoughts out there, often dictated into speech recognition apps without review.
  • Starting sentences with “know” in an awkward attempt to convey phony corporate emotion, as in, “Know that we care about your health” instead of the identical “we care about your health.”
  • Starting sentences with “so,” a Millennial-common writing crutch that turns everything into a bar story, as in, “So my grandmother died last week …”
  • The informal usage of “Dr. John Smith” instead of the correct listing of John’s specific doctorate.
  • Not using the serial (Oxford) comma, thus saving yourself one keystroke while forcing your reader to re-read your messy sentence. 
  • Non-experts using “pop health” to make themselves sound like insiders, which is even sillier when what they really mean is “population health management,” or in most cases, “population health management technology.”
  • The word “utilizes,” which is just a puffed-up way of saying “uses.” Ditto “leverages.” You’re trying too hard to sound smart.
  • FHIR puns that weren’t even clever the first thousand times.

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From HIMSS20 Keynote Speakers – Again?!: “Re: Alex Rodriguez. I just received an email that he will be the Friday afternoon HIMSS20 keynote speaker. What’s your take on the announcement?” High school graduate, stick-and-ball gazillionaire, and admitted steroid user (in between lying through his teeth about it) A-Rod commands a speaking fee of “$100,000 to $1 million” in yet another example of someone being paid exorbitantly for providing minimal societal benefit. Financially struggling patients must be thrilled to be underwriting the chance for the highly-paid executives of their local non-profit hospital – at least that handful that stick around until Friday afternoon — to jock it up in A-Rod’s celebrity glow as he opines on analytics (I’m pretty sure he’s no Billy Beane given that he never managed anyone other than himself in baseball, and even did that questionably except for mastering the art of saying “I’m sorry” while continuing to do what he was sorry for). This anemic HIMSS20 keynote lineup isn’t what the conference needs to stanch its attendance bleeding.


HIStalk Announcements and Requests

I need to replace my old Timex Expedition watch, but so many Amazon watch reviewers have complained that they were stiffed with a damaged or cheaper model or one that isn’t authorized for US sale. Amazon does little to police bait-and-switch sellers or those who create phony reviews even when it’s obvious and sometimes its reviews for several product variants are dumped into a single set of shared reviews, to the point that I’m beginning to look elsewhere for many items, the same problem that drove me from Ebay.


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

Clinical trials platform vendor SignalPath raises $18 million in a Series B funding round.


People

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Blain Newton (HIMSS Analytics) joins electronic aircraft systems vendor Beta Technologies as CFO/COO.

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Nuance promotes Jonathon Dreyer to VP of solutions marketing.

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Hill-Rom promotes Trey Lauderdale to VP/GM of care communications.


Announcements and Implementations

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USPTO awards Medicomp Systems a patent – its fourth since 2016 – for its Quippe platform technology that identifies and filters relevant clinical data for presentation to clinicians at the point of care.

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Strata Decision Technology announces StrataSphere, a cost benchmarking platform that aggregates information from 1,000 hospitals that use the company’s StrataJazz product (financial planning, analytics, and performance) for gaining insights into best practices. Strata customers can opt in at no cost.


Privacy and Security

The Washington Post investigates a reader’s complaint that the privacy policy of the Allscripts Follow My Health portal of George Washington University’s faculty practice allows it to use patient information for marketing, including by “marketing partners.” She found no opt-out agreement. The paper contacted Allscripts, which says the company doesn’t disclose identifiable patient data to third-party marketing companies even though its privacy policy reserves the right to do so. The paper seemed surprised to learn that HIPAA doesn’t cover technology vendors, apparently as confused as laypeople in general in thinking that the badly aging HIPAA is a broad-coverage patient privacy law instead of a requirement only of covered entities and their business associates, all of which enjoy broad leeway under the guise of “treatment, payment, and operations.”


Other

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The Dallas paper observes that not only is Children’s Health in Dallas paying $2.5 million for a high school football stadium’s naming rights, it will contribute nearly $3 million in other benefits to the school over the next 10 years. Reason: the high school is in a high-income, high-growth area that a competing health system is eying. It’s hard to believe, but there was a time when non-profit hospitals acted like charities instead of aggressive businesses that strong-arm patient collections for excessive bills while not paying taxes. No wonder private equity firms are buying all the healthcare businesses they can find – the system is now too big and politically well connected to fail.

Kaiser Health News finds that hospital and doctors are pushing 3D mammograms that haven’t been proven any better than traditional ones despite costing $50 more. Manufacturers (Hologic, GE Healthcare, Siemens, and Fujifilm) have paid doctors $9 million for promotional activities and most of the journal articles were written by doctors who have financial ties to the industry. The manufacturers are also spending big money for consumer marketing, paid celebrity tweets, and lawmaker lobbying that has successfully forced insurers in many states – both private and Medicaid — to cover the screening. The National Cancer Institute will spend $100 million of taxpayer money to determine whether the tests help or hurt the women who receive them, the burden of proof of which should have been on those companies that are raking in cash from their sale. 

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The Lansing State Journal notes that a company has created dozens of 40 Facebook-promoted, politically one-sided websites whose names and appearance attempt to fool readers into thinking they are published by local newspapers or business publications. The same firm also publishes “FDA Reporter,” “FDA Health News,” and “Patient Daily.” The latter’s top story opines that it is time to modernize HIPAA, written by fresh college graduate who obediently quoted Joel White of the health IT vendor lobbying group Health Innovation Alliance (in which the kid wrote “HIPPA” five times vs. “HIPAA” once).

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You might expect a journal’s PR company to spell the name of its editor-in-chief correctly (that being John Halamka, MD, MS), but I see quite a few other mistakes in the self-congratulatory press release (I count at least seven errors in the 16-word sub-headline alone). Publisher Partners in Digital Health has also come up with the most unwieldy and contrived conference name I’ve seen — ConVerge2Xcelerate.


Sponsor Updates

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  • The Collective Medical team assembles 1,800 pantry packs and 1,500 trauma kits for a local school district in under an hour.
  • AdvancedMD will exhibit at the American Medical Billing Association conference October 24-25 in Las Vegas.
  • Apixio, Datica, Clinical Architecture, and Diameter Health will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Artifact Health will exhibit at the CA ACDIS Conference October 25 in Davis, CA.
  • Gartner includes Atlantic.Net in its “2019 Market Guide for Cloud Service Providers to Healthcare Delivery Organizations.”
  • CompuGroup Medical will exhibit at the Louisiana Primary Care Association Annual Conference October 23-24 in Baton Rouge.
  • Dimensional Insight will exhibit at the DV/NJ HIMSS 2019 Fall Conference October 23-25 in Atlantic City.
  • EClinicalWorks congratulates customer The Family Clinic on winning the 2019 CPC+ Practice of the Year award.
  • Optimum Healthcare IT publishes a Q3 healthcare data breaches infographic.

Blog Posts


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Morning Headlines 10/22/19

October 21, 2019 Headlines No Comments

UPMC moving forward to make former South Side hospital into an IT hub

The University of Pittsburgh Medical Center will turn a shuttered outpatient center into an IT center.

Cleveland Clinic, American Well Partner to Launch Digital Health Company

Cleveland Clinic will expand its relationship with American Well to include a new digital health company, The Clinic, that will offer patients access to Cleveland Clinic providers through American Well’s technology.

Humana and Microsoft announce multiyear strategic partnership to reimagine health for aging populations and their care teams

Humana will use Microsoft tools including Azure Cloud, Azure AI, and Azure API for FHIR to develop predictive analytics, natural-language understanding capabilities, and on-demand and virtual medical services for its members and their providers.

Partners HealthCare Creates New Investment Funds to Accelerate Innovation in Medicine

Partners HealthCare funnels $80 million into two new investment funds that will support young companies that develop new technologies and medications based on inventions originating from Partners researchers.

Curbside Consult with Dr. Jayne 10/21/19

October 21, 2019 Dr. Jayne 3 Comments

The past week has been entirely too crazy, working on projects for a couple of vendor clients whose offerings are starting to overlap with each other. Everyone is chasing after certain industry buzzwords, and if you can add a feature or two that gets you into a different space where people might be more willing to spend money than your current prospective clients, apparently you go for it.

It’s been challenging for me as it’s hard to keep track of what’s a real feature that is able to be delivered vs. something that is in the works, but only parts of it are actually in the code, especially in an agile development organization. It’s particularly challenging when company leaders talk about features under development as if they are actually part of a general release.

In a startup organization, words are thrown around much more freely than they typically are in publicly traded companies, who sometimes mind their language a bit to stay on the right side of the shareholders. With that in mind, I was excited when a reader clued me in to a recent analysis looking at corporations’ earnings call transcripts in an attempt to determine whether the words used in the calls are harbingers of credit risk. Researchers at Washington University in St. Louis looked at over 132,000 earnings call transcripts and used machine learning methods to create a measure of credit risk. The resulting information informs an algorithm that assesses elements from changes in credit ratings to risk of bankruptcy.

What if you could extrapolate those findings to examine the earnings call transcripts of EHR vendors to create a model that would let you know how much of what they were saying was possibly accurate vs. what might be considered creative accounting? What if you could use proxy words to identify impending layoffs or bad decisions that were about to make your stock drop? Mr. H follows some of the earnings calls much more closely than I do, but I have definitely heard some interesting comments on calls in the past that could be interpreted in a variety of ways:

“Our cash generation capabilities continue to expand our storehouse of dry powder.” I’m not sure using gunpowder as a comparative term is a great idea in this day and age. Does the company want to seem like it’s war-like and on the offense? Or perhaps it’s a commentary on the executive team’s ability to blow up the company by continued poor decision-making?

“Scary.” I recently read an earnings call transcript that used the word three times in a variety of contexts. Could there be something predictive about the state of mind of the people on the call?

“Our team is always impatient to go faster.” That’s the kind of reassuring language end users love hearing from vendors with a track record of under-delivering or overpromising on features. Not to mention that when you’re caring for people’s loved ones, you typically don’t want your primary tools to be fueled by a spirit of impatience.

Those are immediately attention-getting, but I’d be more interested in the subtle comments that show that something is slightly off or that there might be some level of obfuscation going on. One recent call characterized what clearly looked like a cost-cutting layoff as an effort to speed compliance with new regulatory requirements. With a training database of thousands of vendor earnings call transcripts, I bet you could come up with some very interesting themes and potentially useful indicators.

In the next year or so, I have to start thinking seriously about a performance improvement project so that I can complete it and check the box for renewal of my clinical informatics board certification. Maybe I could build a tool that would better enable the HIStalk team to detect language that would be most predictive of a company that might have juicy things for us to write about, or what their odds might be of winding up on the HISsies ballot. I doubt those applications would be approved by the folks at the American Medical Informatics Association, but they would be entertaining.

If I don’t come up with a project soon, I’m going to have to seriously think about letting my certification lapse. The required projects are actually referred to as “Improvement in Medical Practice” projects, and since I don’t actually practice clinical informatics where I practice clinically, that gets a little dicey. My primary clinical employer doesn’t want the physicians to have anything to do with the EHR – there isn’t even an informatics committee. The COO (who is a practicing physician) calls all the shots on whether we’ll implement new features and how they will be shared with the masses. The likelihood of my being granted any ability to query the data or perform any kind of project is exactly zero.

They do allow a diplomate to substitute a 360-degree evaluation project instead, where they survey a half dozen of their colleagues to find an area that needs improvement, then work on it and survey again. That doesn’t exactly work in the consulting model, where I think my clients might be generally appalled if I asked them to spend resources essentially providing job coaching to someone they’re paying as their expert advisor.

Doing these projects as a way to maintain certification is frustrating regardless of your specialty. During a time when I wasn’t practicing clinically, I had to do a mock “hand hygiene” project where I had to manually enter a downloaded data set and then analyze it. The goal was to simulate the paper surveys that my peers were getting from live patients, but I learned exactly zero sitting there and keying in the data. It’s just another hoop that physicians have to jump through to try to stay certified.

That takes me back to the earnings call transcript project. Maybe if I write it as an abstract with enough sexy buzzwords I can sneak it past the evaluators. Sprinkle in some artificial intelligence, machine learning, and blockchain to get the job done.

If any of you other clinical informaticists out there have creative ideas for what a consulting clinical informaticist can do as a project, I owe you a drink at HIMSS.

For the rest of you: what’s the wackiest thing you’ve ever heard in an earnings call transcript? Leave a comment or email me.

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Morning Headlines 10/21/19

October 20, 2019 Headlines No Comments

Cerner to Acquire AbleVets Further Expanding Strategic and Technical Expertise in U.S. Federal Health Market

Cerner acquires healthcare security-focused government IT contractor AbleVets for undisclosed terms.

Mission Health data breach: e-commerce site contained ‘malicious code’ for 3 years

HCA-owned Mission Health (NC) notifies an unspecified number of consumers that its online store contained malicious code that was sending their payment information to an unauthorized person from March 2016 through June 2019.

Norton Healthcare, UofL Physicians & School of Medicine partner together for the kids

Norton Healthcare, UofL Physicians – Pediatrics and the University of Louisville School of Medicine will integrate their EHRs as part of a new partnership that will take effect in February.

Tower Health cutting 32 Pottstown Hospital jobs

Tower Health (PA) will eliminate jobs at two of its hospitals in a move that representatives say supports its recent Epic installation and the enhanced technology now available on its nursing units.

EverCommerce To Integrate AllMeds and iSalus Healthcare

EverCommerce will integrate subsidiaries ISalus Healthcare and AllMeds, both of which provide healthcare technology to physician practices, and open a new facility in Tennessee later this year.

Monday Morning Update 10/21/19

October 20, 2019 News No Comments

Top News

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Cerner acquires healthcare security-focused government IT contractor AbleVets. Terms were not disclosed.

The company — formed by former Navy oncologist Wyatt Smith, DO in 2012 — reported $96 million in annual income and 345 employees for 2018. It counts among its clients DoD, VA. and HHS.

Cerner will operate the company as a wholly-owned subsidiary. AbleVets is a subcontractor for Cerner’s VA project.

Smith has an extensive health IT background, having served as VP of healthcare for Agilex, a consultant to ONC, deputy CIO for the Military Health System, and manager of the DoD’s AHLTA EHR. He is board-certified in internal medicine, hematology, oncology, and pathology.

The US Digital Service recommended in March 2019 that private-care eligibility software developed by AbleVets for the VA be scrapped because of flaws that were introduced by a rushed timeline.

Cerner previously hired David Waltman — who had led the VA’s VistA modernization program for two years before moving to AbleVets for a few months — six weeks after the VA chose Cerner in a $10 billion, no-bid contract.

CERN shares dropped 0.5% Friday following the announcement.


HIStalk Announcements and Requests

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Most poll respondents would be wary about seeking treatment from a hospital that is known for suing patients over unpaid bills.

New poll to your right or here: Which industry awards do you find meaningful? I ran this same poll a couple of years ago, so it will be fun to compare results. I also added an “enter your own answer” option in case your favorite award wasn’t listed.

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I saw someone on the new season of “Goliath” who looked a bit like Dennis Quaid, but quite different than the lithe, beaming HIMSS09 keynoter. It actually was Dennis, now 65 and no longer married to third wife Kimberly, who was the mother of the heparin-overdosed twins (born by surrogate in 2007 – Meg Ryan was wife #2) who were the subject of their medication error lawsuit against Cedars-Sinai that questionably earned him the HIMSS speaking spot. Cedars and its employees made all the mistakes, but Quaid went after the deep pockets instead in suing the manufacturer of the drugs and eventually settling with them (Cedars also paid $750,000 after the Quaids hinted that they were considering litigation). He formed a patient safety foundation, merged it almost immediately afterward with the Texas Medical Institute of Technology (it, too seems to have faded), made a couple of related documentaries, and hasn’t shown much patient safety interest in years. HIMSS gave his foundation a $10,000 check on stage back in 2009 in addition to whatever speaking fee he required. These days, Dennis is ripped like crazy, frolicking on the beach with his 26-year-old girlfriend (now fiancé, just announced), and always pictured by me as the swaggering Gordo Cooper in “The Right Stuff” in an acting tour de force that Tom Cruise can only wish he had delivered in “Top Gun.”


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Sales

  • England’s Kettering General Hospital NHS Trust signs a 10-year contract with System C for an integrated clinical record and administration system. McKesson acquired System C in early 2011 for $140 million, then sold it and its other UK health and social care businesses to a private equity firm in mid-2014 for undisclosed terms.

People

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Oracle CEO Mark Hurd died Friday of unspecified causes at 62 following a month-long, health-related leave of absence. He was also CEO of HP from 2005 to 2010.

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Google hires former National Coordinator Karen DeSalvo, MD, MPH (Dell Medical School) to the newly created position of chief health officer. She will report to former Geisinger CEO and David Feinberg, MD, MBA (VP, Google Health) and will join another recent Google / Alphabet hire, formed FDA Commissioner and Duke University vice-chancellor Robert Califf, MD, who will head up Google’s medical strategy and policy. DeSalvo and Califf will start their new jobs later this year.


Announcements and Implementations

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Medical expert opinion software vendor Purview provides financial support to allow cancer patients to obtain a remote second opinion from Memorial Sloan Kettering Cancer Center, with medical records sharing facilitated by medical support services vendor PinnacleCare. Purview’s grant supports the Mike Shane Memorial Fund and will initially focus on bile duct cancer diagnosis. Purview investor Mike Shane died of the disease earlier this year.

EClinicalWorks announces that it supports interoperability with both Carequality and CommonWell.


Government and Politics

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A CBS News poll finds that Americans are more worried about healthcare costs than whether everyone has health insurance. Less than half worry about the quality of care and 79% say they are satisfied with the care they receive. Nearly half say big changes are needed to the US healthcare system, while another 30% think it should be rebuilt from scratch.


Privacy and Security

NHS gives Google access to five years’ of patient data from several hospitals. Five of six trusts that had signed data-sharing deals with Google-acquired DeepMind have signed new agreements now that the company’s projects have been placed under Google Health. Critics say such agreements were previously ruled illegal, the hospitals won’t say how much Google is paying them, and patients aren’t aware that their data is being shared with a for-profit company.

HCA-owned Mission Health (NC) notifies an unspecified number of consumers that its online store contained malicious code that was sending their information elsewhere from March 2016 through June 2019. 


Other

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Indiana University will use a $60 million donation from alumnus Fred Luddy —  founder of help desk software vendor ServiceNow – to establish an artificial intelligence institute whose initial focus will be digital health.

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Yale clinicians describe their work to embed clinical decision support for ED prescribing of buprenorphine for opioid use disorder with its Epic system, after reviewing Epic’s capabilities and finding them insufficient. They created an EHR-integrated web app using Epic Active Guidelines (since Epic did not support SMART on FHIR at that time). The eventual integration was seamless, launched from the patient chart navigation bar in an iframe with direct, secure communication. The authors note that such a project involves challenges and recommends that customers focus on updating interoperability standards to support services such as Enterprise Clinical Rules Service.

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EClinicalWorks held its national conference in Orlando this past weekend, October 18-20, as it celebrated its 20th anniversary. 

A ResMed-commissioned survey of 3,000 Americans finds that 56% monitor their health with at least one digital tool; 60% attempt to diagnose themselves via the Internet; and half want technology to improve communication with their PCP, specifically to be able to share information with them. The survey didn’t mention which tools that more than half of consumers are supposedly using, so I’ll remain skeptical in the absence of detailed methodology.

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The Arkansas Department of Human Services shuts down parts of its claims portal following the arrest of an optometry practice’s office manager who discovered that she could “input any number she chose” without the system flagging questionable values. The woman, who is the wife of one of the practice’s optometrists, is charged with filing $600,000 in fraudulent manual Medicaid claims in cases where a patient was insured by both Medicare and Medicaid. Fun fact – the attorney general’s investigator who signed the charging affidavit is named Rhonda Swindle.


Sponsor Updates

  • Lightbeam Health Solutions, Health Catalyst, Waystar, Recondo Technology, Prepared Health, Redox will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Mobile Heartbeat will exhibit at The Future of Nursing New York State Action Coalition event October 21.
  • Netsmart will bring training opportunities to its home health customers to help them prepare for new regulatory requirements related to the Patient-Driven Groupings Model.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the 10th Annual Nebraska Fall Conference October 22 in Omaha.
  • OmniSys will exhibit at the McKesson Prescription Technology Solutions Customer Conference October 22-23 in Pittsburgh.
  • SailPoint acquires Orkus and OverWatchID to deepen governance of cloud applications and infrastructure.
  • TriNetX and Trialbee partner to accelerate patient-centric clinical trials.
  • Vocera will exhibit at the New England Society of Clinical Engineering Symposium Vendor Expo October 22-23 in Framingham, MA.
  • The Dallas Business Journal profiles ZeOmega.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.


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Weekender 10/18/19

October 18, 2019 Weekender 4 Comments

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Weekly News Recap

  • Microsoft and Nuance announce plans to work together to use ambient sensing and conversational AI to help doctors document encounters.
  • Google hires former National Coordinator Karen DeSalvo, MD, MPH to the newly created position of chief health officer.
  • Change Healthcare is reportedly looking for a private equity buyer for its Connected Analytics unit, which includes the Ansos staff scheduling system, at a potential price in the $300 million range.
  • The VA pilots making telemedicine services available at local VFW posts.
  • Northwell Health extends its Allscripts Sunrise agreement through 2027.
  • A KLAS report finds that customers of acquired health IT vendors are equally split among being less satisfied and more satisfied, with just 20% saying nothing changed.
  • Centra (VA) resumes billing and collections following a three-month hiatus that it says was caused by Cerner software problems.

Best Reader Comments

This is inspiring and has so much more potential for healthcare. So many new reimbursements focus on patient engagement (CCM, RPM, PCM, BHI, CoCM). Like Dr. Bhavan and her team at Parkland demonstrated, patient involvement / engagement creates better outcomes. We focus so aggressively on the delivery of healthcare, but who has studied the receipt? Think of this for a second: we’re at a place in healthcare where actively and persistently involving the patient is viewed as disruptive and innovative. Dr. Bhavan’s model included education and team work – to make it easy for the patient – and they certainly did their part yielding massive reduction in re-admission and higher satisfaction. (Matt Ethington)

For those of us who participate in this [Epic] market as HUMAN resources (FTE or contractor), it is a strange situation to learn that after working hard to be offered a role /,contract, your customer / employer will have to submit you to Epic for ‘approval’ before they agree to grant you access to both (a) the resources at Epic’s UserWeb and (b) potentially access to Epic at the client site (even if you’ve been hired). It’s a sobering moment to jump from one employer to another or in and out of the contractor-FTE world to learn that you are not actually in charge of the outcomes of your own decisions and that you never agreed to the terms that are being imposed on your life and livelihood. (Code Jockey)

The restrictions that Epic places on his customers, employees, and third parties on hiring is so frustrating. While I understand they want to protect their IP and reduce poaching, it creates such a toxic attitude among their employees and frustrations to employees who have life changes that require them to move away from Epic. Rather than being able to utilize your skills in the free market, they use a big stick to hold people hostage. They extend those restrictions on their own customers, keeping them from hiring really qualified people that could help make them successful and avoid really expensive consulting costs. It also make hiring Ex-Epic people in the Madison job market incredibly risky because many are just trying to burn their one-year non-compete rather than looking for a longer term role. (Epically Annoyed)

I’ve worked on two Cerner implementations and two Epic implementations. The Cerner implementations had, in my opinion, sleazy salesmen who showed up to take the director out to lunch, drinks, strip clubs, or whatever it took to get the sale and expand the services. The Epic implementations, I never saw any of that going on, not that some client sites didn’t want to be wined and dined and tried to get the Epic AC/AMs to do that. I think you are correct in stating that because Epic is not a public company, Judy does not have the Wall Street pressure, but I also think there is just a generally more clean approach from Epic overall. (X-Tream Geek)

While that [in-hospital employee] telemedicine booth is kind of odd, I think a lot of people still underestimate how much employees don’t want their employer to have permanent access to their full health record, regardless of what kind of end user confidentiality might sit between other colleagues and their data. I know a lot of people who would gladly talk to a booth over anyone that’s also employed by their employer. Though I would bet there’s some type of interoperability that exists between their existing records and this vendor. (Sam Lawrence)

Insurance exists because people overall are risk averse, but from your comments, that’s not you. You sound pretty confident of the outcome, so you prefer to gamble. It’s interesting that if you take the gamble and lose, it’s not actually you paying for it. If you’re uninsured or under insured today (because you don’t feel like you need it), and then a catastrophic event happens, your fellow taxpayers will be conducting a wealth transfer to you. Would you plan on refusing it because it’s unfair to them? You’re also gambling that by the time you need the healthcare system, all the Boomers will be gone and the rational Gen X, Gen Y, and Gen Z folks will vote in an affordable and responsible system. This is a huge gamble, and by George I’d love if it ended up going your way. However, the idea that once the Boomers are gone the way will be clear for sweeping reform is a massive oversimplification of US healthcare politics. (TH)

The youngest Baby Boomers are 54, so they have another 25+ years of living to do before they hit the median life expectancy, by which time us Gen Xers will be in our 60s and the Millennials will be experiencing back spasms, trick knees, and menopause, so we’ll all be oldheads together. GenZ is going to come along and wipe us all out, which is fine – they are the ones really inheriting the mess, so if they want to transform society “Logan’s Run” style, I can’t say I blame them. (HIT Girl)


Watercooler Talk Tidbits

A hospital doctor in England fails to convince a review board that the reason he squeezed a nurse’s bottom was euphoria that was caused by a drug interaction between his allergy pill and Pet Remedy, a calming spray he was using on his dog during a thunderstorm.

The Ohio Board of Pharmacy cites three former pharmacists at the now-closed Mount Carmel West Medical Center (OH) for failing to intervene when high doses of opioids were ordered by ICU doctor William Husel, DO, who faces 25 counts of murder involving inpatient overdose deaths. The board noted that the pharmacists sometimes did not verify drug withdrawals from automated dispensing cabinets until after the drugs had already been administered.

Experts say hospitals are creating an “epidemic of immobility” in which hospital patients are forced to stay in bed, contributing to muscle weakness that can cause life-threatening falls afterward. One study found that one-third of patients aged 70 and older left the hospital more disabled than when they were admitted. Patients are often forced to remain in bed, but may do so voluntarily due to pain or weakness, IV lines that make it hard to walk, a lack of employees to help them, and the reluctance to walk down hospital hallways in flimsy gowns.

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Identical twins who work as nurses at Piedmont Athens Regional Medical Center (GA) work together for the first time in helping deliver another set of twins. That’s Epic photobombing behind them.

Peyton Manning stars in a fun video spot for the children’s hospital bearing his name at Ascension St. Vincent in Indianapolis, to which Manning has donated a reported $50 million since 2007. He played quarterback for the Indianapolis Colts for 14 seasons through 2011.  


In Case You Missed It


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Morning Headlines 10/18/19

October 17, 2019 Headlines No Comments

Microsoft and Nuance join forces in quest to help doctors turn their focus back to patients

Nuance and Microsoft will co-develop ambient sensing and conversational AI software to enable physicians to pay more attention to their patients instead of on administrative tasks.

Google appoints former Obama health official Karen DeSalvo to new chief health officer role

Google hires Dell Medical School professor and former National Coordinator Karen DeSalvo, MD as its first chief health officer.

More than 190,000 without power as nor’easter lashes Maine

A Nor’easter takes down the EHR and other systems Thursday morning at hospitals that are part of Northern Light Health in Maine.

Change Healthcare kicks off process for Connected Analytics unit

Change Healthcare is reportedly looking to sell its Connected Analytics unit, which markets Ansos staff scheduling software, in a deal that could value the unit at between $250 million and $330 million.

News 10/18/19

October 17, 2019 News 1 Comment

Top News

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Nuance and Microsoft will co-develop ambient sensing and conversational AI software to enable physicians to pay more attention to their patients instead of on administrative tasks.

Building upon Nuance’s ambient clinical intelligence software (on display at HIMSS earlier this year) and Microsoft’s intelligent scribe service, the new technologies will be rolled out to select end users early next year.

Initial capabilities will include ambient listening, wake-up word, voice biometrics, signal enhancement, document summarization, natural language understanding, clinical intelligence, and text-to-speech. 


Reader Comments

From Henry W. Jones, III: “Re: Epic’s redacted contract that appeared in the SEC filings of Ardent Health Services. Any assessment that the redaction is moderate and the contents are not worrisome (such as the absence of a gag clause) are overconfident. The redaction leaves holes and many provisions that could be contained but not shown (such as IP claims, liability shifting, unique terms and conditions). We know that Epic demands more redactions and secrecy than other EHR vendors and than vendors in non-medical industries. For example, the contract omits in its litigations listing the Epic vs. Tata saga, which involves over 1,000 court pleadings and an initial Epic jury verdict of $900 million (later reduced to $400 million per state statutes). Latency also yields uncertainty and this was a contract signed eight months ago and posted on the SEC seven months ago, so we don’t know what might have changed. The long-term, non-obvious industry impacts of locking customers into EHR contracts merits serious, granular analysis; the devil is likely to be in the many details that are missing here.” Hank is an IT lawyer and consultant. I interviewed him in 2016.

From Skimmer: “Re: HIStalk. How does anyone find the time to read it all?” Many readers think reading everything here provides positive ROI, and I certainly hope that’s the case. I’ve already surfaced the most important or interesting items among the junk, so it’s up to them to pick the parts of what I run that will be most impactful to their careers as professionals who should be taking the time for continuing (and continuous) education. But if they don’t have the time, the news posts run just three times per week (which is a minimal time investment since it’s broken out into easily skippable sections), the Weekender summarizes the week’s biggest news each Friday morning, and the absolutely most important stories appear in my daily headlines. I hope the 90% of readers who say reading HIStalk helps them do their jobs better are finding it worth their time and thus mine.


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Sales

  • Novant Health (NC) will implement telemedicine services from TytoCare.
  • SwipeSense selects health data integration capabilities from Redox to ensure that its RTLS applications are interoperable with any EHR.

People

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Goliath Technologies names Stacy Leidwinger (Nuance) as chief marketing officer.

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Heather Trafton (Steward Health Care Network) joins Arcadia as COO.


Announcements and Implementations

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Champlain Valley Physician Hospital transitions to Epic as part of a $152 million system-wide deployment within the University of Vermont Health Network.

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Mid-Valley Hospital and Clinic (WA) goes live on Cerner Millennium.

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Lightbeam Health Solutions reports that ACOs that attained a positive savings rate using its population health management technology achieved $602 million in shared savings over the five-year Medicare Shared Savings Program.

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A new KLAS report finds that the HIE technology market is moving to broader use of aggregated data, with advanced users of Allscripts and InterSystems most likely to be using those systems for advanced use cases. KLAS notes, however, that less-advanced users of the Allscripts DBMotion product report dissatisfaction with getting the system up and running, Health Catalyst is consistent in its support but behind in keeping technology promises, Orion Health users say the platform is too rigid to support innovative use cases, and InterSystems customers are strongly satisfied across the board, giving it the highest purchasing energy among the four companies.

WVU Medicine (WV) begins enrolling patients in the National Cancer Institute’s Cancer Moonshot program, one of six organizations funded to use technology to enable patients to report and manage their cancer treatment symptoms.  WVU will use its Epic MyChart to answer patient questions (which can include images or files) and to send out routine surveys, with the patient-entered information flowing back into Epic. 

Philips adds the new Sentry Score predictive algorithm to its ECareManager telehealth software, giving clinicians the ability to prepare for patient ICU interventions in under an hour.


Government and Politics

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The VA launches a multi-site pilot program that will give veterans access to telemedicine services at local VFW or American Legion posts using Internet-connected healthcare pods developed and donated by Philips.

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Former VA Secretary David Shulkin, MD authors “It Shouldn’t be This Hard to Serve Your Country,” a book about his 13 months working in the Trump Administration.


Other

The NFL is rolling out a prescription drug monitoring program as part of its more focused efforts on monitoring pain management and opioids. First announced in May, the league’s PDMP will also be used by unaffiliated physicians.

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A Nor’easter takes down the EHR and other systems Thursday morning at hospitals that are part of Northern Light Health in Maine.

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The Colorado Sun profiles the ways state-based hospitals are using AI and machine learning, with innovations ranging from “digital sitter” remote patient-monitoring efforts, to algorithms that predict and cut treatment time for patients at risk for sepsis, to algorithms that can help radiologists identify areas for concern more quickly and accurately. HealthOne CIO Andy Draper says, “We’re right in the very beginning of it. There are a lot of tools that will pop up and we should embrace and love them all and then over time we’ll see what their real potential is.”


Sponsor Updates

  • EClinicalWorks will exhibit at the TACHC Annual Conference October 21-22 in The Woodlands, TX.
  • Healthfinch will exhibit at the Group Practice Improvement Network Semi-Annual Conference October 23-25 in Portland, OR.
  • The Chartis Group names Aaron Bujnowski (Texas Health Resources) director and leader of the company’s integrated delivery network segment.
  • Healthwise will exhibit at Allscripts ACE HHS October 21-23 in Dallas.
  • Glytec forms a Quality Team to help health systems adopt best practices in glycemic management.
  • InterSystems will exhibit at the Gartner Symposium/ITxpo October 20-24 in Orlando.
  • Yukon Health and Social Services in Canada will upgrade its Meditech system next year.
  • Black Book names Nuance the top vendor for end-to-end healthcare coding, clinical documentation improvement, transcription, and speech-recognition technology.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Book Review: HIT or Miss

October 17, 2019 Book Review 1 Comment

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Reading the third edition of “HIT or Miss” is like trying to reconcile memories of someone’s previously vibrant life with their coldly objective obituary. It contains dozens of examples in which the exuberance, high-fiving (especially by the vendor’s salesperson), and lofty goals of improving patient care via IT somehow ended up as flaming wreckage whose major contribution is to serve as a cautionary tale for the rest of us.

You may well chuckle at the naiveté and hubris of each (unnamed) hospital’s executive and IT teams for making some really bad decisions, but deep down you know your own organization isn’t any better even though its gaffes aren’t included. Hindsight is 20-20.

You also might question why this sort of HIT autopsy holds value and I see your point. The organizations that have yet to make such plus-sized IT mistakes aren’t likely to read the book like the Bible and declare themselves reborn. Every IT project is different and maybe the lessons belatedly learned by other hospitals either aren’t relevant or must be relearned by others.

Still, it’s made clear that the enthusiasm to “do this project right” – implicitly outperforming lesser-skilled peers whose cloak of invincible destiny turned out to be full of holes – can be crushed by a single, cancerous-like cell that metastasizes. Its genesis isn’t notable – a low-level decision made in an overcrowded conference room that smells of stale bagels, Type A executives who insist pushing on to recoup their eye-popping software investment by bringing it live at all costs so they can be photographed at the ribbon cutting, and leaders who allow the scope to creep to appease an influential department head or foot-stomping doctor. Any one of thousands of ever-moving parts can cause the whole machine to blow up once the big switch is pulled.

The biggest takeaway here – not surprising that AMIA was involved – is that hospitals should  listen to their CMIO, clinical IT folks, and patient care front-liners. I had “your vendor” on the list, but I’ll asterisk that – some vendors are determined to make their clients successful and possess the competence to do so, while others peak at getting the contract signed and may do more harm than good.

These examples, provided by and recounted by a stunning roster of industry luminaries and edited by Jonathan Leviss, MD, are representative:

  • A hospital whose voluntary CPOE usage dropped from 60% during the pilot to 15% immediately afterward (and zero shortly after that) as the project team called it mission accomplished, took vacations, and shifted their attention to other priorities.
  • Another (Hospital B) whose patient satisfaction dropped from the 70th percentile to the 5th as its health system parent tried to copy the successful ED implementation in its larger, newer, and more sophisticated Hospital B without involving Hospital B’s clinicians in the build and testing.
  • A hospital that rolled out a legacy data viewer as it implemented a new EHR, but continued to send the viewer new data until its forced retirement three years later, at which time it was discovered that 40% of clinical users were still using it (instead of the new EHR) to look up lab results and clinical notes, after which staff complaints (mostly from surgeons) forced the hospital to reconfigure the new EHR’s screens to look like those of the legacy system.
  • A decision to issue all drug interaction alerts to clinicians, with the intrusive pop-ups being overridden 95% of the time for drug-drug interactions and 87% of allergy warnings, wasting an estimated 12-18% of clinician time.
  • A hospital that decided to implement a new medication reconciliation system and process across four hospitals without performing a pilot project, which had to be shut down two weeks later when the executive-estimated few seconds of pharmacist time required for each patient turned out to be 20-30 minutes.
  • A barcode medication program that failed because IT and facilities engineering weren’t involved in choosing laptops, batteries, and carts and nobody had time to work the trouble tickets.
  • A community hospital that slowly migrated from one ICU vital signs capture system to another as rooms were renovated, but each system interpreted and displayed information differently to the clinicians making decisions.
  • The discovery that a newly implemented fetal monitoring system displayed information for the wrong patient because of a cable plug-in mix-up.

Each of the 48 case studies is interesting, even those that may now be mostly a historical curiosity now that integrated, single-vendor EHRs have eliminated some of the risk points of integration, upgrade timing, and multiple device use.

“HIT or Miss” was a lot more interesting and detailed than I expected. It recounts millions of dollars worth of bad decisions, unfortunate events, and vendor shortcomings that we wouldn’t have heard about otherwise. I’d like to think that no patients were harmed in the making of this book, but I’m certain that isn’t the case. And while IT sophistication grows linearly as health systems get bigger, complexity and thus the potential damage grow exponentially.

This is not my usual book review since it would be missing the point to focus on writing style or entertainment value (although both are excellent). Its value is to show what can go wrong when a project transitions from executive self-congratulation for choosing a bold IT path forward to their underlings trying to make it all work in an ever-changing environment full of self-interest landmines, competing pressures from all sides, and products whose shortcomings aren’t discovered until  analyst sleeves are rolled up.

Perhaps the takeaway is that it’s really tough to implement process change and ever-changing technology in meeting timeline and budget expectations while preserving the originally envisioned benefit to patients without harming them in the process. For that reason, IT leaders might want to stock up on copies to hand out to overconfident C-suiters and board members who feel that their executive insight justifies overriding the advice of those pessimistic, business-naive clinicians who won’t quite yapping about their “concerns” or the potential harm to patients that they can’t say with certainty will actually happen in standing in the way of lighting the candle. Worst is that they are right – you won’t know what you don’t know until you bring the system live and there’s never a perfect time to do that, so at some point you might was well just turn it on and be ready to fix what’s broken.

Thanks to attorney Henry W. “Hank” Jones, III, JD for sending me a copy of the book (he wrote Chapter 48 – “Explore HIT Contract Cadavers to Avoid HIT Managerial Malpractice.”) It’s $60 on Amazon.

EPtalk by Dr. Jayne 10/17/19

October 17, 2019 Dr. Jayne 1 Comment

I had occasion recently to talk with a personal liability attorney, fortunately just socially and not professionally. He had some questions for me about the role of artificial intelligence in healthcare. Fortunately, I was able to point him towards a recent editorial in the Journal of the American Medical Association.

The article has a nice summary of the concerns that many in practice have about AI: communicating recommendations without the underlying rationale; poor training data sets used in the development process; and failure to reach an accurate result or recommendation. The JAMA article notes that case law on AI-related liability is lacking, but existing law can be extrapolated to cover these situations.

The authors’ examples support the use of AI as an adjunct to the existing decision-making process in order to prevent additional liability. However, as AI becomes engrained as part of the standard of care, this approach may necessitate more trust in AI systems at the point of care, in order to prevent the physician from making the error of underutilizing technology that could be of benefit. It’s a complicated equation, for sure.

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The VA recently announced planned steps to increase data sharing with non-VA providers using the Veterans Health Information Exchange. They’re going to shift the current opt-in protocol to one where opt-out is the norm, so patients no longer have to provide a written release for the VA to share their data electronically. A quote from the VA in one of the articles I read about it states that community providers and organizations must have partnership agreements and be part of the VA’s trusted network to receive VA health information. I hope they meant to say that you have to be part of the network to receive information electronically, unless the VA isn’t covered by HIPAA, which allows providers to share information for Treatment, Payment, and Operations without a specific release.

The HIE plans to share information including: problem list, allergies, medications, vital signs, immunizations, laboratory reports, discharge summaries, medical history, records of physicals, procedure results such as radiology reports, and progress notes. Veterans who don’t want their data shared can still opt out, but they will have to be either all in or all out – previous mechanisms which allowed some data to be shared but not others will no longer be permitted.

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Speaking of veterans, telehealth middleware provider Medici has launched “Operation 11/11” to provide no-cost virtual consults to all US veterans on Veterans Day, November 11. Proof of military service is required and participants can pre-register for services from 8 a.m. to 8 p.m. in their time zone on November 11.

Medici is welcoming four military advisors for the initiative and has also partnered with 2nd.MD to provide virtual second opinions for veterans with complex patients. Medici has an interesting model where providers pay to be on the platform and set their own rates for virtual visits. I can imagine it might be compelling for independent physicians, but struggle to see how it plays for the majority of physicians who are in employed situations.

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I was intrigued to hear about Black + Decker’s new automated medication management and home health care assistant device, Pria (first covered on HIStalk nearly a year ago). It’s the first foray into healthcare from the people who brought us the Dustbuster. The voice-activated device tracks and schedules up to 28 medication doses along with reminders and timely dispensing. It also allows patients to have access to family members or caregivers using a built-in camera for video calls. It can also enable reminders for drinking water or other key health-related activities. The product is pricey at $600 plus a $10 monthly subscription.

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I recently became aware of a club I have no desire to be a member of: telehealth providers who have licenses in all 50 states. Becoming licensed in a handful of states is enough work, so I can’t imagine wanting to have dozens of applications in process. The CNBC piece profiles a couple of telehealth providers who advocate for the approach as a way to treat patients more effectively particularly patients in underserved areas.

Data from the Federation of State Medical Boards indicates the club is pretty small, with only 14 physicians licensed everywhere as of 2018 data, up from six in 2016. The number will likely be higher for 2020 given the overall growth in telehealth. One interviewee notes the cost of procuring 50 licenses is around $90,000. In addition, there are annual fees to maintain them. If providers ever surrender a license, there’s also a process to explain that in future license renewals in other states, so if you’re going to do it, you had better be ready to maintain it. I’ve found telehealth compensation for physicians to be lower than pay rates in brick-and mortar situations. Unless you have the temperament to conduct, complete, and document visits every couple of minutes, I don’t see a lot of physicians opting for this type of practice.

An interesting potential use of artificial intelligence was detailed this week in The Wall Street Journal: prediction of marital arguments. Engineers and psychologists are using speech patterns, physiological data, and acoustic / linguistic information to detect potential conflict. One described use case is sending a text message to a highly stressed individual, warning them of an imminent conflict so they can take action.

The original 2017 study followed 19 Los Angeles couples and tracked data such as heart rate, perspiration, and activity levels. A phone app prompted them to document hourly reports on their feelings and also recorded speech content, pitch, and frequency in taking a three-minute recording every 12 minutes. Researchers were able to detect conflict with nearly 80% accuracy. The original data was gathered during a one-day period, which is a significant limitation along with the size of the sample.

A more recent investigation by the same researchers looked at 87 couples, using speed of speech and intonation to detect conflict. The research sounds promising. I hope they consider the next logical investigation, which would be parent-teenager interactions. I’m sure that would be a target-rich environment for conflict identification. Or, we could install such systems in healthcare IT conference rooms across the country – certainly there’s some conflict there!

What do you think about AI identification of conflict? Leave a comment or email me.

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Morning Headlines 10/17/19

October 16, 2019 Headlines No Comments

NFL, players taking strides to address pain management

The NFL is rolling out a prescription drug monitoring program as part of its more focused efforts on monitoring pain management and medications.

I Ran the VA Under President Trump Until He Fired Me. Our First Trump Tower Meeting Was a Job Interview Unlike Any Other

Former VA Secretary David Shulkin, MD releases “It Shouldn’t be This Hard to Serve Your Country,” a book about his 13 months working in the Trump Administration.

VFW Post 6786 First Site in Innovative Initiative Giving Veterans Access to VA Health Services Close to Home

The VA launches a multi-site pilot program that will give veterans access to telemedicine services using Philips technology at local VFW Posts.

Readers Write: It’s More than the EHR That Is Causing Physician Burnout

October 16, 2019 Readers Write 4 Comments

It’s More than the EHR That Is Causing Physician Burnout
By Julie Mann

Julie Mann is chief commercial officer of Holon Solutions of Alpharetta, GA.

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The cause of physician burnout is a frequent topic on this site and many healthcare sites. The culprit in these posts and articles – as well as those written in major publications such as the New Yorker and Fortune – is inevitably the EHR.

The story is familiar by now. Doctors hate EHRs, doctors spend too much time on them, they interfere with patient care, they take away from the coveted doctor-patient relationship, etc.

What many of these articles don’t discuss, however, is that it’s not just the EHR – or even EHRs from many different providers – that are causing inefficiency, frustration, and burnout.

The broader problem is the non-EHR-stored data in payer portals, analytics platforms, HIEs, and elsewhere. Physicians have to log-in and log-out of all these different places for almost every patient, 30 or more times a day, and then search and scan through irrelevant screens of data to find the specific information they want to know. If the important, contextual data were available in their workflow immediately at the point of care, then it would drastically speed up their workflows.

The current federal proposal (now closed for public comment) to solve the interoperability problem may make data easier to share across EHR platforms, but it doesn’t solve the context or workflow problem. What the proposal amounts to is not much different than the early days of HIE and sharing CCDs, which no physician has the time or interest to read because they’re too long and filled with information a physician at the point of care already knows, doesn’t care about at that moment, or doesn’t care about at all.

While the quantity of information shared between different parties may improve if the current interoperability proposal moves forward, it’s unlikely the quality or relevance of the data will change at all. That is because this proposal doesn’t seem to consider workflow or context, which means physicians will spend more time searching and scanning through pages of digital data, resulting in greater frustration levels and experience even more administrative burden.

New or augmented automated workflows can be triggered at the point of care, in concert with patient-relevant context, to make the overall healthcare delivery more meaningful, efficient, and robust to reduce physician frustration.

Patented sensor-based software technology in use at health systems and practices delivers actionable patient data to providers within any EHR system, and from any third-party source, without the need for interfaces. These aren’t APIs that just pass blobs of data back and forth without regard for context or what the physician actually wants to know. Rather the sensors recognize when a provider is in a patient’s chart and automatically surface relevant care gaps and other information within the provider’s workflow immediately when they open the chart.

The information is visually integrated into the workflow (think of it as right next to the chart on the screen), allowing the physician to quickly review information he or she actually cares about instead of logging in , searching, and scanning only to find nothing.

Instead of searching, providers have all the care and coding gap information curated from analytics platforms and other physicians’ charts, but also from population health management companies, a laboratory or radiology testing company, or a SMART on FHIR-enabled application hosted by a third-party system.

The sensors, however, aren’t mind readers. The health system would define which data from which EHRs, applications, portals, and elsewhere their physicians would want to know. Because the sensor technology and supporting application are independent of any EHR or other HIT companies, third-party vendors do not need to get involved. That saves months of waiting and untold dollars for the health system because no vendor needs to create or implement an expensive point-to-point interface.

The final interoperability rule may look exactly like the proposal, but it may not. Instead of waiting to see whatever solution comes from the legislation, if any, health systems can reduce their physicians’ burnout through simple, effective, plug-and-play solutions now.

Healthcare data is expected to grow by more than 36% from last year to 2025, which is the largest trajectory of any of the industries studied. Physicians are already buried in data. More data will only add to health systems’ physician burnout problem if they don’t get a handle on this tsunami of information.

Putting contextual insights in front of physicians immediately in their workflow won’t solve all burnout issues, but it is an important step forward in a crucial patient care quality and financial issue for health systems. Liberating the data will liberate the care.

HIStalk Interviews Kavita Bhavan, MD, Chief Innovation Officer, Parkland Health & Hospital System

October 16, 2019 Interviews 2 Comments

Kavita Bhavan, MD, MHS is associate professor of infectious diseases at the University of Texas Southwestern Medical Center and chief innovation officer at Parkland Health & Hospital System in Dallas, TX.

This interview was conducted by Vikas Chowdhry, MS, MBA, chief analytics and information officer of Parkland Center for Clinical Innovations in Dallas, TX.

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Describe how your career led you to become a chief innovation officer.

I started out as a graduate student in public health at Johns Hopkins and then pursued my MD at Penn State. After completing my residency training in Internal Medicine at Ochsner, I chose infectious diseases, at Washington University, as a subspecialty because it is an area where public health and medicine naturally interface. I joined the faculty at UTSW in 2009, working in an HIV clinic at Parkland.

Shortly after joining the faculty here, I was asked to work in a smaller capacity with a great team of pharmacists on ways in which we could improve delivery of care for uninsured patients that require long courses of IV antibiotics in the outpatient setting. The existing disparity between this group of patients and those with adequate insurance was that they could not access standard forms of outpatient therapy, such as infusion centers, home health services, or skilled nursing facilities.

Prolonged inpatient care is difficult for an individual patient since it limits their ability to return to work or care for family at home. It also impacts the safety net system, where many patients may be waiting to be admitted in the ER. We innovate in this kind of an environment out of necessity and can only succeed when we are given space to rethink care delivery with support from leadership and key input from frontline providers.

What does innovation in healthcare space mean to you?

Innovation in healthcare can present itself in a various forms. While many people associate technology with innovation, I’ve been increasingly interested in thinking about another aspect — low-tech, low-cost approaches to patient-centered innovation to address disparities and improve health equity. The most natural place to start seems to be effectively engaging patients in care processes to reconfigure existing resources to improve high-value care.

What does that mean? In healthcare, we often talk about empowering nurses, social workers, and physicians to practice at the top of their license. What does top of the license for patients look like? Innovation in healthcare includes co-designing care with patients to improve access and address other existing problems. Better clinical outcomes can be achieved with such co-production of care.

There is a shift that occurs when a patient is providing care for themselves at home, as in our home IV antibiotic program. They move from being a passive recipient of care in the hospital to being an active participant in their care at home. We have observed better clinical outcomes over the years while also seeing enhanced engagement and management of one’s health, including other chronic diseases such as diabetes.

Innovation is usually thought of as synonymous with technology. While technology is important, we need to make room for another model of innovation that is even cheaper and easier – recognizing human potential.

How does engagement that goes deeper than “use this app to check your lab results” or “use this device to report your steps” work in practice?

Our self-administered outpatient antimicrobial program at Parkland has become a new standard of care for our patient population and is an example of effective patient engagement. Typically, patients with infections that require long-term antibiotics receive intensive diagnostic and therapeutic services in the first several hospital days. Afterward, they remain in the hospital only to receive antimicrobial infusions.

Insured patients may be discharged early to complete their antimicrobial courses at home with contracted nursing assistance or in lower-cost nursing facilities, but uninsured patients usually remain in the hospital because they cannot afford a healthcare-administered outpatient parenteral antimicrobial therapy (H-OPAT, overseen by the healthcare system).

Those uninsured patients have limited options and may be confined to the hospital, which prevents them from resuming work or other activities of daily living or caring for family members at home. In the safety net hospital setting, this can be a challenge in terms of capacity and the ability to care for other patients, in the ER for example, as a sub-optimal use of resources such as beds.

We approached this problem by piloting our program with a few patients in 2009 with the goal to teach and train the method of self-administrated IV antibiotic therapy by gravity at home. We started the program with minimal resources as patients did not have a home visit or access to home health nurse, infusion center, or devices such as pumps / elastomeric balls (S-OPAT, overseen by the patient themselves).

We began with four patients as a proof of concept and have now cared for more than 4,000 patients through this program. Along the way, our multidisciplinary team listened and learned from our patients what works and what doesn’t work to further refine the process.

We translated education material to appropriate levels of health literacy for our population, achieving a fourth-grade literacy level in English and Spanish and including pictures. After a few years, we moved to an audiovisual process where patients can scan a QR code on the back of an IV bag and be sent to a teaching video on their smart phone where they can watch the process and review all of the steps for infusion at their own pace. This has been effective not only for patients who speak other languages, but also for those who prefer visual learning.

We developed a competency checklist, and using the teach-back method, had patients demonstrate all of the steps of infusion and PICC line care needed to ensure safe discharge from hospital to home.

After the first four years of operation, we tracked clinical outcomes for our S-OPAT patients compared to patients with insurance who left our hospital for healthcare-associated OPAT such as home health or skilled nursing facilities. We were surprised to find that our S-OPAT patients had a 47% lower 30-day readmission rate along with higher patient satisfaction.

How is that possible? When we talked to our patients on return visits, we found they mastered all of the steps and took ownership of the process. It was clear they were more invested with effective engagement. One patient actually said she thought she did better because “it is my own body” versus a nurse coming out to the home to perform a job. We began to appreciate the positive impact of patient engagement with meaningful results.

How do you scale the program?

One of the interesting aspects of this program was that after learning about the success of self-administration, other patients who were insured with access to healthcare-administered therapy wanted to participate in our self-administration process. I have since learned from others that this may fit a model of disruptive innovation. You create something that is useful for a small section, usually a bottom tier of your consumers, that eventually becomes attractive to the broader market. However, unlike a consumer market, adoption by the broader market is determined by a lot of other factors, including existing health policy, reimbursements, etc.

There has been other interest in promoting patient engagement as seen by the recent CMS position on encouraging at-home dialysis. The proposed ESRD Treatment Choices model will give patients an ability to choose at-home dialysis, which may potentially improve satisfaction, lower costs, and improve outcomes.

Could your work have been done at other institutions?

UTSW and Parkland’s partnership is unique because we are committed to caring for a large population of uninsured or underinsured patients with health disparities. Innovation centers attached to larger health systems may have greater investment in technology-based innovation. Our approach has been more patient centered. Our CEO, Fred Cerise, MD, MPH, described another way of looking at innovation that does not need to be driven by profit in his Harvard Business Review article a few years ago

We are likely in the minority coming from a safety net hospital in the larger healthcare innovation space, but there is a need to grow across the country since safety net settings innovate out of necessity.

What’s the most impactful book you have read in the last 12 months?

“The Moment of Lift” by Melinda Gates. She articulates the value of inclusiveness and educating and empowering women to fully recognize our collective potential as a society. There are examples of how impactful this can be around the world and here in the United States.

How do you remain optimistic as a physician when working with a population whose inequities and social disparities are root causes that you can’t address?

The problems are far reaching and there is no simple solution. We are increasingly aware that social determinants affect health and outcomes. Just because we cannot do everything to solve these problems does not mean we cannot do something, to do some small part to help address a given problem to improve the status quo.

I’m lucky to work in an environment where I and many others have the opportunity to make some small difference as we strive to improve patient care.

Morning Headlines 10/16/19

October 15, 2019 Headlines No Comments

Northwell Health extends partnership with comprehensive Allscripts Sunrise™ platform through 2027

Northwell Health extends its Allscripts Sunrise contract through December 2027.

Cerner workers to become Adventist Health employees

Cerner will lay off 350 California employees following Adventist Health’s decision to bring its revenue cycle operation back in house from Cerner RevWorks.

Introducing AncestryHealth®: Actionable Health Insights for You and Your Family

Family history vendor Ancestry launches AncestryHealth, which will sell a $149 profile of genetic screening results that are matched to specific medical health conditions, plus a costlier membership-based service that provides deeper screening and quarterly screening updates.

Queensland Health’s IT problems can be overcome, new eHealth head says

In Australia, the new head of EHealth Queensland says its struggling Cerner implementation can be turned into a showcase project, but urges all of the state’s health bodies to help in getting new sites live while optimizing existing ones.

News 10/16/19

October 15, 2019 News 7 Comments

Top News

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Northwell Health extends its Allscripts Sunrise contract through December 2027.

Northwell’s 19 hospitals have been live on Sunrise since 2005, making it the largest customer of Allscripts.

Northwell extended its Allscripts TouchWorks agreement in 2018. 

MDRX shares rose 1.4% Tuesday after the announcement, performing slightly better than the Nasdaq Composite index for the day.  


Reader Comments

From Grim Sleeper: “Re: Allscripts and Northwell. What are the odds that their collaboration will result in a commercially viable inpatient product that can compete with Epic or Cerner” Zero, my reasoning being thusly even though all of us should be wishing for new inpatient EHR competitors:

  • Allscripts says the new product will be based on Avenel, which is targeted to ambulatory practices but hasn’t sold well in its 18-month history. The company has admitted to stock analysts that it misjudged market interest in a cloud-based EHR that doesn’t offer a paired practice management product, which is a significant oversight for an EHR/PM company.
  • Northwell said in the Allscripts press release that Avenel is immature and its usability needs help from Northwell’s experts, a comment that I’m surprised Allscripts approved.
  • Allscripts has a low-and-dropping inpatient market share in which Sunrise has been replaced with broader, integrated offerings from Cerner and Epic. Northwell will continue using Sunrise for inpatient.
  • Custom developing a product around a key customer’s specifications is a strategy that usually fails miserably except for that one customer, who gets their quirks and petulant demands baked into code that someone has to try to sell to the next hospital. Coding to spec as a follower than a leader is not the best way to create an innovative product that the broad market wants.
  • My conclusion is that Northwell took advantage of knowing it had Allscripts over a barrel as its largest client. I obviously haven’t seen the contract, but I would bet that Northwell is the big financial winner, Allscripts saves face and slings a Hail Mary about a new product (created by improving a not-new product), and we will see in future Allscripts earnings reports whether the new R&D costs and possibly lower revenue contributions from Northwell can be offset by increased additional revenue.
  • The key metrics to watch are overall EHR market share and Allscripts stock price. MDRX shares are up 10% since Paul Black took over as CEO in late 2012, vs. the Nasdaq’s 167% gain and Cerner’s 75% rise, and have shed 23% in the past year.

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From Market Watcher: “Re: Epic contracts. They’re usually a source of mystery, but a moderately redacted copy of one popped up on SEC’s Edgar. I don’t see anything that looks like a gag clause, although there’s a lot of concern about protecting Epic’s IP.” The contract between Epic and Ardent Health Services doesn’t contain anything shocking:

  • Clients pay higher Epic fees as their usage increases.
  • Clients must be current on all Epic payments before bringing a new module live.
  • Disclosure of Epic confidential information is prohibited, and if required by law (such as Freedom of Information Act requests for contract details), the client must notify Epic beforehand and cooperate with Epic to get the legally required disclosure stopped.
  • No non-disparagement clause is present in the redacted version, but the customer is required to make each user sign an agreement to keep Epic’s confidential information confidential. That information includes functionality descriptions, source code, data structures, and implementation methods. Screen shots, which are the most contentious items in that arise in sharing information about system problems among users, aren’t mentioned specifically but probably fall within functionality descriptions (as does documentation, which Epic protects vigorously). 
  • Use of third parties for implementation, staff augmentation, training, support, and hosting is limited to those companies that have signed an agreement with Epic and that have agreed not to hire employees of clients or of Epic.
  • Use of source code, data structures, and APIs can’t be used to develop a product that competes with anything Epic offers or that is “reasonably anticipated Epic software.”
  • The customer is not allowed to solicit or hire (as either an employee or contractor) anyone who has worked on an Epic implementation within the past 12 months without the previous employer’s permission and Epic won’t “work with or provide training” for those exceptions.

From NH: “Re: Novant Health. Creating an innovative electronic patient and family advisory council.” Novant will survey volunteer council members about patient room decor, food quality, and nicer waiting rooms. I’m all for those things, but what I really want from a hospital is for them to put my interests ahead of their profits, develop and follow sound clinical protocols, give me access to caring and highly skilled providers, and send me home vertically and better than when I entered. I might enjoy having better coffee or softer chairs at the oil change place, but that’s not much consolation if the tech uses the wrong filter, doubles my cost by acquiring competitors, or claims to be concerned about my car’s overall health when what they really want is to sell me more services. Consumers can see only the most superficial aspects of healthcare and they assume that they don’t need to worry about the rest, which is not true at all.

From Billing Boy: “Re: patient estimates. They are often wrong, this study finds.” It’s easy to get worked up about patients being charged more than they were told to expect (which would be shocking in any business except healthcare), but portraying those hospitals as dastardly rather than incompetent misses the point. Healthcare billing is so arbitrary and complex that even the hospital itself has no idea what will be billed until after the fact, when all the revenue-obsessed hospital departments have picked the insurance bones clean. Here’s an easy test – give a hospital an anonymized copy of the clinical records from someone’s inpatient stay at their own facility and ask them what they think the itemized bill would look like (no dollar amounts, just which line items the patient would be billed for). It would have little correlation to the bill they actually sent to the patient. Hospitals are right that they don’t know what a given patient needs until they have already provided it, but it’s a mistake to ensure that the variability between estimates and actual bills is strictly due to clinical uncertainty or insurance surprises.


HIStalk Announcements and Requests

Thanks to Jenn for covering my absence of a few days for vacation. I kept up with what she was writing and sent her items that looked interesting, but otherwise spent close to zero time using any computing form factor. Other than the many “circling back” and “pinging you again” re-sent emails from PR people who can’t grasp that not everyone stays online 24×7 or finds their self-serving announcements to be of top importance, I saw no evidence that anyone even noticed my absence, which is how it should be.

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I rarely think of Forbes as an objective, insightful news publication and this doesn’t change my mind – the company has launched a vanity publishing press and is paid-spamming LinkedIn with boilerplate invitations to “business leaders” who are willing to rent the Forbes nameplate to repackage themselves as quote-worthy experts a la “The Art of the Deal.” Its partner company touts that lazy executives can create an industry-captivating book in under 24 hours. Healthcare clients include former CMS Deputy CIO Henry Chao and about a zillion attention-seeking dentists. 


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

Cerner will lay off 350 California employees following Adventist Health’s decision to bring its revenue cycle operation back in house from Cerner RevWorks. Cerner says Adventist Health has offered to hire all of the laid-off employees, while another 1,000 Cerner employees will swap their badges for those of Adventist Health.


Sales

  • Bozeman Health (MT) chooses Kyruus ProviderMatch to integrate patient access in its website and access center.

People

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Per-diem clinician hiring app vendor ConnectedRN hires Matthew Levesque (Athenahealth) as CEO.

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Industry long-timer Kim LaFontana, MBA (Medically Home) joins Livongo as VP.

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BHM Healthcare Solutions promotes Jean Neiner to president and CEO.

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Ajay Kapare (Ellkay) is appointed to the CHIME Foundation Board and its board of trustees.


Announcements and Implementations

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A new KLAS report looks at strategic mergers and acquisitions in healthcare IT, observing that about 40% of customers are happier afterward, 40% are less happy, and 20% see no impact. The percentage of customers anxious to bolt to a new vendor doubles after M&A when long-term customers resent the imposition of intentional nickel-and-diming, crappy support, and R&D slowdowns. Customers are better off if the acquirer is privately held and thus not desperate to pander to shareholders in chasing short-term profits at the expense of long-term strategy. KLAS concludes that M&A fails when the acquirer saddles the former company with layers of bureaucracy and sales-focused goals; fails to get its executives interested in the acquired company; makes grand promises that aren’t kept; and cuts back on support so that the resulting financial numbers make the acquirer’s executives look smart.

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Family history vendor Ancestry launches AncestryHealth, which will sell a $149 profile of genetic screening results that are matched to specific medical health conditions, as well as a more expensive, membership-based service that provides deeper screening and quarterly screening updates. The company has contracted with an independent physician group to order the tests. Stat notes that the tests of competitor 23andMe are regulated by the FDA since consumers order them themselves, while AncestryHealth won’t get FDA oversight because the tests are ordered by doctors but instead will be under CMS’s physician-ordered diagnostic testing rules. Experts note that only 2% of patients who don’t have a family history of a disease will learn something new from such tests, while others say that genetics accounts for less than 10% of longevity, but lack of rigorous science doesn’t usually stand in the way of companies making big money from irrational health concerns (see: Goop). 

A Black Book provider survey of vendors of software and services for coding, clinical documentation improvement, and HIM finds Nuance topping most categories, but Optum360, MModal, Dolbey, Adadyne, Qventus, and Fujitsu also finished first in some areas.

Nvidia and King’s College London create a platform that allows organizations to contribute their imaging data for machine learning-powered brain tumor research without copying it offsite or sharing it directly, with the federated learning system keeping patient data confidential.

Canada-based EHR vendor Premier Health Group will add AI from IBM Watson to its telemedicine app to use a chatbot to reduce clinician time on each call.


Other

In Australia, the new head of EHealth Queensland says its struggling Cerner implementation can be turned into a showcase project, but urges all of the state’s health bodies to help in getting new sites live while optimizing existing ones.

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A reader sent this article about Shots Heard Round the World, a “rapid-response digital cavalry” that helps providers whose vaccine-related social media messages – such as “flu vaccine has arrived – get your shot today” — trigger an electronically mobilized torrent of negative comments, scathing Yelp and Google reviews, and threats from anti-vaxxers from around the world. The group was founded by two employees of Kids Plus Pediatrics, a Pittsburgh area practice that was attacked relentlessly after it published a video explaining the value of HPV vaccine in preventing cancer. They offer the highly detailed and excellent Kids Plus Anti-Anti-Vaxx Toolkit to help practices defend themselves online harassment. Fascinating to me is their analysis of who created the 10,000 negative anti-vaxx comments on their site:

  • 95% were female, most of them either of age 18-24 or over 50.
  • The vast majority were uneducated and either unemployed or underemployed.
  • Attackers were mostly extremist in their politics, both to the left and the right.
  • Every single person who visited the practice’s Facebook page during the eight-day siege whose profile photo featured one of those dopey filters was an anti-vaxx attacker.

In England, a hospital won’t be fined the prescribed $190,000 for 600 incidents in which it placed male and female patients in the same room. The hospital says it has a zero-tolerance approach for mixed-sex rooms, but then stretches the definition of “zero tolerance” by adding that it sometimes does it anyway when all beds are full. NHS England says mixed-sex rooms are detrimental to safety, privacy, and dignity, which it fails to note are already endlessly compromised throughout all aspects of hospital care, but especially when any patient is forced to room with another. Imagine if a hotel did this, even without all employees running in and out, awkward moments involving specimen collection and bedpan usage, receiving visitors, and being separated by just a thin curtain from a dying, moaning, or loudly delusional roommate.

Odd: the elected part-time coroner of an opioid-ravaged Ohio county is charged with illegally prescribing 1.5 million opioid doses over two years and fraudulently billing Medicaid and Medicare in his day job as a pain management doctor. On the other hand, he donated to the county’s Staying Clean Club and its drug task force, so there you go.

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Even odder: Tampa General Hospital opens an OnMed telemedicine consult and drug dispensing booth in its food court so that its employees — who are inside its walls — can seek medical care from clinicians who aren’t. Maybe this is a Halloween-appropriate “the call is coming from inside the house” type situation. It’s not really an admission that employees don’t have time to deal with their own hospital employer’s bureaucracy as patients – the hospital is in business with the vendor and this first booth is a pilot for a broader rollout. The hospital CEO says millennials won’t wait to see a doctor in person, which if you’re a doctor who actually wants to care for patients, is depressingly accurate. The oldest millennials are now in their late 30s, so it would be interesting to see how those who are doctors run their practices and patient encounters.

Georgia lawmakers will require the state’s rural hospital CEOs, CFOs, and board members to complete eight hours of classes in financial management and strategic planning (in an apparent lack of irony).


Sponsor Updates

  • Netsmart processes a record 300 million secure transactions through its CareFabric solution suite in a single month, triple the number of a year ago.
  • AdvancedMD will exhibit at ASDS October 24-27 in Chicago.
  • Apixio will exhibit at the RISE HEDIS & Quality Improvement Summit October 23-25 in Miami.
  • Culbert Healthcare Solutions will exhibit at the Association of Administrators in Academic Pediatrics meeting October 17-18 in Miami.
  • Cumberland partners with Chronicled’s MediLedger Project to advance blockchain supply chain networks for pharma manufacturers.
  • Dimensional Insight will exhibit at the Massachusetts Health & Hospital Association event October 18 in Burlington.
  • ONC names Surescripts as an ONC Program Partner for Electronic Prescribing, proving EHR vendors an alternative test method to ONC-ATL.
  • Netsmart will present and exhibit at the American Health Care Association/National Center for Assisted Living 2019 Convention and Expo through October 16 in Orlando.
  • Prepared Health will exhibit at HLTH, October 27-30 in Las Vegas, as part of the Matter Showcase Pavilion.

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Morning Headlines 10/15/19

October 14, 2019 Headlines No Comments

Parsley Health Launches New Digital Services on Tail of $26M in Series B Raise

Membership-based primary care company Parsley Health raises $26 million and launches an online version of its brick-and-mortar practice.

Claus Torp Jensen Has Been Appointed First Chief Digital Officer and Head of Technology for Memorial Sloan Kettering Cancer Center

Former CVS Health CTO Claus Jensen joins Memorial Sloan Kettering Cancer Center (NY) as its first chief digital officer and head of technology.

Prairieville pediatrics clinic working with FBI, notifying patients after computer attack

Magnolia Pediatrics (LA) alerts patients to an August ransomware attack that infiltrated the practice through its unnamed IT vendor, which wound up paying the ransom.

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Reader Comments

  • Mr. HIStalk: Now you’ve sent me to rewatch episodes of “Arrested Development.”...
  • Bob: Re: 3D mammograms. I've also heard that more "stuff" shows up on 3D imaging, requiring more follow ups and 6 month ins...
  • AnotherDave: Grammar Peeves: "Non-experts using “pop health” to make themselves sound like insiders, which is even sillier whe...
  • S Silverstein: "I would be curious to see proof of your contention that Epic has caused serious patient harm incidents (“caused” co...
  • Doug Dame: Jayne, Dr, 2020. Journal of ToBeDecided. Predicting EHR vendor system enhancements, performance, and corporate survival;...
  • Bill Spooner: I like your idea of the BS barometer. Perhaps one of the investment firms would sponsor it....
  • El Jefe: Discerning the financial health of an IT vendor in healthcare doesn’t require AI nor Machine Learning algorithms. Basi...
  • TH: I'm curious what you mean by "adult supervision phase". Do you mean "going public"? Which is something that a) Epic ...
  • Mr. HIStalk: I think Epic's customers are the best judge of how the company behaves (the same ones who bought the product after their...
  • ellemennopee: Ancestryhealth. Interesting. People won't willingly share a social security number with anyone yet will gladly send of...

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